Medicare Bulk Billing

Can I claim for Podiatry on Medicare?

Medicare have introduced a system whereby it provides Medicare benefits to be paid for certain allied health services including Podiatry. It covers people with chronic conditions, such as diabetes, and people with complex care needs. 

 

 

What is meant by Chronic Conditions?

Medicare defines a chronic condition as one that has been or is likely to be present for at least 6 months. This includes conditions, but not limited to, cardiovascular illness, diabetes mellitus, mental health conditions, arthritis and musculoskeletal conditions. 

 

 

What are Complex Care Needs?

Complex Care Needs means that, in your doctor’s opinion, you would benefit from care provided by a range of health care professionals who provide different services from your doctor.

 

In the past GP’s have decided that patients have complex care needs if:

  • They  have multiple health problems;
  • They are increasingly frail or dependent;
  • Their health is unstable or deteriorating;
  • They have been in hospital twice or more in the past 6 months.

If any of these examples relates to your circumstances, then you may be eligible for the Medicare rebate for Podiatry  under the Medicare Enhanced Primary Care (EPC) plan.

 

 

What is an Enhanced Primary Care (EPC) Plan?

Under this system, people with a chronic condition or complex care needs who are being managed by their GP will be entitled to receive a Medicare benefit for up to 5 eligible allied health services per year. This means that your GP can designate 1-5 visits to an eligible podiatrist for ongoing podiatry treatment for a 12 month period. This is called an Enhanced Primary Care (EPC) Plan.

 

 

How do I get placed on an EPC Plan?

To receive Medicare benefits for podiatry, a patient must be referred to a podiatrist by their GP using an EPC program referral form for Allied Health Services under Medicare. An appropriate care plan must also be completed by the GP and sent to the podiatrist along with the EPC referral form.

 

Under this scheme your GP will receive feedback from the treating podiatrist after your first visit, then as required or requested.

 

 

How do I claim this benefit?

At the Melton and Bacchus Marsh Foot Clinics we BULK BILL our patients between the hours of 8am - 5pm, Monday - Friday.

 

We then claim the treatment cost from Medicare directly. YOU ARE REQUIRED TO PAY NOTHING ON THE DAY.

 

If you are consulted outside of these hours on an EPC you will be required to pay the scheduled consultation fee and our reception staff will process your Medicare claim.  The scheduled Medicare rebate will be deposited into your nominated bank account within 24 hours.

 

 

Questions?

Please ask you podiatrist or your GP regarding any further questions that you may have about the Medicare EPC Scheme.