WHAT IS AN ENHANCED PRIMARY CARE PLAN?

An EPC (or CDM) referral is a plan on the Medicare Benefits Schedule where GPs are able to plan treatment with other medical providers, including Physiotherapy.

Certain physiotherapy sessions are claimable through Medicare for treatment of a chronic musculoskeletal condition requiring specific treatment under the EPC/CDM Plan.

WHO PROVIDES ME WITH THE EPC PLAN?

Book an appointment with your GP to see if you are eligible. To access a Medicare rebate, you must meet certain criteria, and that is generally centred around ‘chronic’ conditions, meaning something you have had for 6 months, or is likely to present for 6 months. An EPC Plan can be renewed each calendar year, but you will need a new referral from your GP each year to access the rebated consults.

HOW MANY PHYSIO SESSIONS CAN I GET ON A EPC PLAN? 

An EPC allows for a total of up to 5 rebated physiotherapy consultations per calendar year (this is dependent upon your referral).

HOW MUCH DO THE APPOINTMENTS COST ON AN EPC PLAN?

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

EPC Fees (2023)

Consultation: $78.00 (to be paid on the day)

Medicare rebate:  $58.00 (rebated on the day with a Medicare card & bank card, with a savings or Cheque account)

Gap Fee: $20.00 (out of pocket cost)

Next Step:

  • If you think you may be eligible, book an appointment with your GP to arrange a referral.
  • Once you have your EPC Plan, contact us to book a consultation.
  • If we get the EPC from your doctor, we will call you to make an appointment
  • If you have any specific questions regarding EPC, please don’t hesitate to call us on (07) 3823 2400 or email reception@resultsphysio.com.au
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