Rebates and Claims

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Chronic Disease Management Plan

A Chronic Disease Management Plan (formerly called an Enhanced Primary Care or EPC) is a referral only program from your GP which can provide up to 5 Medicare Funded Allied Health sessions per calendar year. Residents of an Aged care facility are also eligible for a multidisciplinary care plan and subsequent visits.

A chronic medical condition is one that has been (or is likely to be) present for six months or longer, for example, asthma, cancer, cardiovascular disease, diabetes, musculoskeletal conditions and stroke. GPs determine whether the patient’s chronic medical condition would benefit from allied health services. Physiotherapy has high levels of evidence of effectiveness for a range of chronic conditions such as arthritis, respiratory conditions or continence. 

At Hindmarsh Physiotherapy we provide a quality service and will invest our time solely to you. Therefore, we do not bulk bill Medicare for physiotherapy at our practice, so there will be a gap payment. These Physiotherapy visits are still billed at a markedly reduced rate to our community with a small $10 out of pocket expense. 

Exercise Physiology visits are BULK BILLED EPCs can be used towards home or aged care facility visits but these will have a
higher out of pocket expense.

Steps

  1. See your GP for a Management Plan
  2. Call our team for an appointment.
    • We will require a Copy of your GP Plan and Referral with your GPs Name, Provider Number and Date of Referral in advance of your first EPC visit. 
    • This needs to be faxed, emailed or dropped in by yourself or sent by your GP Clinic. 
    • If not received, payment will be required on the day for ALL patients.
  3. Our Physiotherapist or Exercise Physiologist will assess, treat and plan for your remaining visits.
  4. Full payments is required on the day
  5. Medicare will reimburse the rebate into your nominated bank account ( you don’t need to do anything).
  6. The GP referral is valid for a year after which you can renew the CDM Plan referral after every 12 months. The eligibility of a renewal of a CDM Plan will be determined by your GP.

EPC Physiotherapy benefits

  • Team-based approach with GP
  • Financial assistance 
  • Quicker recovery – seeing a physio for a chronic ongoing issue can strengthen muscles and tissues and improve your range of motion and flexibility, aiding in quicker recovery.
  • Education 
  • Early intervention – an EPC plan encourages early intervention and preventative care, leading to better health outcomes.
  • Personalised exercises – through an EPC plan, a physio can provide personalised exercises and treatment plans tailored to you.
  • Pain – seeing a physio through an EPC plan can improve pain management of chronic conditions through regular sessions.
  • It is important to consult with your GP to determine eligibility for an EPC plan and, if eligible, contact us on 8346 2000 to start the rehabilitation process.