What is the Medicare EPC Program?

The Enhanced Primary Care (EPC) program was introduced in 1999 to encourage multidisciplinary care and improve the management of chronic disease. In July 2004 the Federal Government introduced Allied Health Medical Benefits Schedule items to the program. These items were designed to improve care of patients with chronic conditions and complex care needs by funding a limited number of allied health services for patients in the EPC program.

Am I eligible to claim?

Patients who have a chronic condition and complex care needs that are being managed by their G.P. under an Enhanced Primary Care plan may be eligible. A chronic medical condition is one that has been (or is likely to be) present for six months or longer. Patients have complex care needs if they need ongoing care from a multidisciplinary team consisting of their G.P. and at least two other health care providers.

In order to find out whether you are eligible to claim physiotherapy (or other allied health services, such as podiatry) through the Medicare EPC scheme, you will need to see your G.P.

How does it work?

You will need to bring in a special Medicare EPC referral which has been issued by your GP.

We can then bulk-bill your physiotherapy or podiatry consultations directly to Medicare. Please note however that for foot and ankle physiotherapy consultations with Stuart Imer, you will have to pay for your consultation upfront and then take your receipt to Medicare to claim a rebate, as this is a specialised service.

You will then be able to claim a maximum of five services per year. Your G.P. will determine how these five services should be used, for example - it may be five physiotherapy services, or a combination of different services. This will be specified on your referral.

Referring EPC patients

G.P.s will need to complete the following EPC referral form;

 EPC Referral Form for Individual Health Services under Medicare (PDF 88 KB)

 EPC Referral Form for Individual Health Services under Medicare - Fill & Print Version (PDF 116 KB)

Please note that this completed referral must be presented prior to, or at the time of your first consultation. Without this referral we are unable to process the EPC claim.