14/02/2024
Medicare Enhanced Primary Care Plan
What?
An Enhanced Primary Care Plan (EPC) is a referral that is written by your GP which provides eligible patients with Medicare-subsidised allied health appointments, like physiotherapy. An EPC may also be referred to as a GP Management Plan (GPMP).
Who?
To be eligible for a Medicare EPC referral, your GP will need to assess your needs and determine that you would benefit from seeing a specialist, such as physiotherapist. If they believe you would indeed benefit from this, they'll write out a referral and give it to you.
To qualify, chronic medical conditions need to have been present or likely to be present for at least six months, for example: Asthma, arthritis, cancer, cardiovascular disease, diabetes, kidney disease, chronic pain, musculoskeletal conditions, and stroke.
How Much?
From November 1, 2023 the Medicare rebate for the plan is $58.30 rebate for a maximum of 5 appointments per patient each calendar year.
When?
A referral is valid for the stated number of services, up to 5. If all services are not used during the calendar year in which the patient was referred, the unused services can be used in the next calendar year.
