Enhanced Primary Care Plans (EPC)

The Commonwealth Government has included the services of university trained Exercise Physiologists under Medicare’s allied health measure. Exercise Physiologists are now among the Allied Health Professionals able to provide Medicare services to people with chronic and complex illnesses.

As Physical Inactivity is the second largest cause of chronic disease and ill-health in Australia, the community will now have access to expert advice and management on their lifestyle through the provision of expert advice from experienced Exercise Physiologists.

What is the Enhanced Primary Care Plan (EPC)?

The EPC is a government initiative that allows people with chronic injuries or ailments to access professional services to assist with the management of their condition with the benefits of a Medicare Rebate. The EPC was designed to improve the health and quality of life of the older population and those with chronic injuries or ailments. The EPC allows you to utilise the services of an Exercise Physiologist or Allied Health Professional up to five times within a calendar year and receive a rebate of $52.95 per session through Medicare.

How to access the Enhanced Primary Care Plans?

To be eligible to receive the rebate through Medicare you need a referral, to an Exercise Physiologist from your GP (under item number: 10953). The plan is made to assist patients who have a chronic injury, or health condition that is not being managed effectively. To qualify for the EPC you must have a chronic medical condition that has been present for 6 months or longer that is not being managed well in it’s current state.

Chronic Conditions include:

  • Musculoskeletal Conditions: such as chronic injuries involving the lower back, neck, shoulders, knees, etc
  • Diabetes (Type 1 and 2)
  • Asthma
  • Cancer
  • Cardiovascular Disease
  • Obesity
  • Stroke
  • Arthritis
  • High Blood Pressure
  • Depression and Anxiety

Steps to being on the Enhanced Primary Care Plan

To organise an Enhanced Primary Care Plan a patient must be referred by their general practitioner (GP) and the GP will organise a GP Management Plan (Item 721) and a Team Care Arrangement (Item 723).

After being referred to an Exercise Physiologist, appointments can be made for either a 30 minutes, 45 minutes or a 1 hour consult. A 30 minute consult is $70, a 45 minute consult is $85, and a 1 hour consult is $100.

Under the Enhanced Primary Care Plan you receive a rebate from Medicare of $52.95. The patients can access up to 5 visits per calendar year with an Exercise Physiologist under the Enhanced Primary Care Plan.

GP’s refer to Exercise Physiologists under Item number 10953.

For further information please contact the office on (02) 4957 2757 or Mark Goswell directly on 0411 447674; or talk to your GP at your next appointment.