ENHANCED PRIMARY CARE PLANS

What Is An Enhanced Primary Care Plan?

An EPC is a plan on the Medicare Benefits Schedule. The Commonwealth Government, through the Chronic Disease Management initiative, aims to improve coordination of care and provide a more systematic approach to the care of patients with chronic conditions and complex care needs.

An EPC allows for a total of up to 5 rebated consults, to any referred allied health practitioner, per calendar year. That can include a physiotherapist, podiatrist, psychologist, dietitian, etc. The 5 consults can be split amongst the different allied health practitioners, as needed.

An EPC can be renewed each calendar year, but you will need a new referral from your GP each year to access the rebated consults.

East Vic Park Physiotherapy is not a bulk-billing clinic, so there will be a small gap payment on each consult, to be covered by the patient.

At our clinic, you will be required to pay the invoiced fee on the day of consult. Medicare will then process the rebate directly into your bank account, generally the following day. 

EPC Fees as at 1.7.24:

Consultation      $97.00/$107.00 (to be paid on the day)

Medicare rebate $60.35 (refunded to your bank by Medicare)

Gap Fee     $36.65/$46.65 (gap fee)

Summary

1   To access a Medicare rebate, you must meet certain criteria, and that is generally centred around ‘chronic’ conditions, meaning something you have had for more than 3 months.

2  You need to have the appropriate EPC referral from your GP.

3  Advise the reception staff that you have an EPC when making a booking. If booking online, please advise of the EPC in the notes section.

4  On the day of your appointment, pay for your consult in full. Medicare will refund your rebate directly into your bank account. There will be a small gap fee.

If you have any specific questions regarding the EPC process, please call us on 9361 3777.

Please note:

Medicare rebates and Private Health Insurance benefits cannot both be claimed for these consults. Patients must choose whether to access one or the other.

Not all physiotherapists at our clinic accept EPC patients. Please ensure you check with reception before booking.