EPC Programs

I’ve got an Enhanced Primary Care Plan (EPC). What Next?

So, you’ve just been to see your doctor about a chronic condition that you have. Your doctor has told you that they are going to put you on an Enhanced Primary Care Plan (EPC) and that you have up to 5 ‘free’ visits with an Exercise Physiologist.

Let’s break this down and go through any information you may need to know.

What Is An Enhanced Primary Care Plan?

An EPC is a plan on the Medicare Benefits Schedule where GPs are able to plan treatment for patients who suffer from a chronic or terminal medical condition with other medical providers.

Can I get a Medicare Rebate for Exercise Physiology?

The short answer is YES! The long answer is yes, but there are a few conditions.

Firstly, you must meet the criteria, and that is generally centred around ‘chronic’ conditions, meaning something you have had for more than 3 months.

Secondly, you need to have the appropriate referral from your GP, who needs to send you to our clinic – the referral MUST be for Exercise Physiology (make sure that box is ticked – sometimes they get it wrong and that causes frustrating hold-ups to treatment).

Once the EPC form is filled out by your doctor, they will send a copy to the chosen Exercise Physiologist so that they can get you on their system.

At Clinic 88, one of our Admin staff will give you a call once we have the EPC referral and book in your initial appointment. It’s as simple as that and you don’t need to do any extra work!

How many visits will it cover?

EPC allows for a total of up to 5 rebated consults to any referred allied health practitioner, per year. That could include Exercise Physiology, podiatry, dietetics, speech pathology etc.

So for instance, your GP may refer you for 3 Exercise Physiology consults and 2 Podiatry consults.

This number is renewed each calendar year, but you will need a new referral each year to access them.

Is It Really Free?

While we would love to help you out with free treatment, unfortunately, we cannot bulk bill Medicare for Exercise Physiology at our practice, so there will always be a small gap payment.

How does the Medicare EPC rebate process work?

It’s a tricky process- the joys of working with a government body!

At our practice, the first step is to actually pay the full fee upfront but don’t worry, we use your card that has either a savings or cheque account to refund $58.30 back onto your account from Medicare which will arrive within the day or at the very latest, early the next day.