Medicare EPC

(EPC) Plans are Medicare incentive based programs that are designed to provide exercise and rehabilitation advice for clients with Chronic Conditions.
These include diabetes, obesity, musculo-skeletal injuries (including lumbar and cervical spine injuries as well as chronic conditions of the knees and shoulders), heart disease, high blood pressure and arthritis. These services can also assist clients with dementia, depression and stroke victims.

Online Exercise

All clients referred as part of an EPC are initially assessed by one of our expert Exercise Physiologists (EP). Following the assessment, the EP will develop a personalised management plan and send a report to the referring GP outlining the management plan goals and the base.

Whether it’s a short burst of care or care for a longer time to achieve your goals, our team can put a plan together to help you now, and into the future.

Some health conditions need a number of health experts to work together and we have been privileged to work alongside other amazing health professionals. Together we can help you manage more complex needs.

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

A Medicare rebate for exercise physiology can be accessed under the CDM Program (formerly the EPC Program), which is the Chronic Disease Management Program (CDMP).

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

Secondly, you need to have the appropriate referral form from your GP, who needs to send you to a specific exercise physiology clinic (hopefully us, we’d love to help!)

The Medicare CDMP 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, physiotherapy, speech pathology, etc. So, for instance, your GP might refer you for 3 exercise physiology consults, and 2 physiotherapy consults.

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

The current Medicare rebate (as at July 2022) is $56.00 per exercise physiology consult, regardless of the specific service that you choose.
That means that the rebate is $53.80 for an initial consult, and any subsequent review consults that you might be recommended for as well.

Unfortunately, we cannot bulk bill Medicare for exercise physiology at our practice, so there will always be a small gap payment. Generally, this is around $9 for your initial consult (which is 30 mins of comprehensive assessment, diagnosis, planning and treatment) and around $9 for any subsequent consults.

What you need to do is pay the full fee upfront yourself first, and then we can process the Medicare rebate and get it back to you.

Specifically, here are the steps:
1. You need to pay the full fee on a CREDIT or DEBIT card or by CASH
2. We use our Practice management software to submit your paid account to Medicare on your behalf to access the $56.00 rebate for you
3. Medicare will credit the $56.00 to your nominated bank account later that day or early the next day.

To wrap it all together:

  • Yes, you can get a Medicare rebate for Exercise Physiology, using the EPC Program
  • You need a specific doctor’s referral and the right type of physical condition
  • You can get $56.00 rebate for up to 5 visits per year
  • There will always be a small gap fee
  • We can process the rebate on-the-spot, straight back onto your debit/ savings account

Exercise Physiology is very safe. It uses evidence and research, and Exercise Physiologists must also meet the same strict legal requirements to work, like your GP and nurses.

If you would like more information about how we can help or if you have any questions at all regarding the CDMP process – please call or email us via hello@exerciseforlife.com.au, and we are more than happy to answer them.

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