Medicare Rebates Explained

In Medicare by Kate HLeave a Comment

Podiatrists are fully qualified to assess and assist with all foot concerns using a wide range of quality foot and ankle treatments.

Common conditions include plantar heel pain, ingrown toenails, Diabetes, bunions, issues relating to children’s feet, orthotic requirements etc.

For some of these conditions, a Medicare rebate may be available to you. Understanding your eligibility and likelihood of receiving a Medicare rebate may sound complicated but once understood, we can assure you that it is a fairly easy and sustainable process.

Can I get a Medicare rebate for my podiatry appointment?

The short answer is YES!

The long answer is yes but you need to be eligible for an EPC or CDM plan.

Are you eligible for a Medicare rebate?

A Medicare rebate is made available through the Chronic Disease Management (CDM) plan or more widely known as an Enhanced Primary Care (EPC) program.

To be eligible for this, you need to meet specific criteria. If you have a chronic medical condition, one that has been present for three months or longer, for example Diabetes, you are  eligible for an EPC

From here, your GP can refer you to a specific Podiatry clinic and create a plan of action in which you agree on how to manage your goals.

How many visits will the Medicare EPC rebate cover?

If you are eligible for an EPC, a rebate from Medicare is available for up to 5 visits per calendar year to any referred allied health practitioner.

Your GP can choose how many visits to allocate for a particular practitioner; for example, you may be allocated 1 visit to a Diabetes Educator and 4 visits to a Podiatrist.

How much does the Medicare Rebate cover?

Currently, the Medicare rebate for podiatry is $53.80 for all of your allocated visits to the Podiatrist.

Unfortunately at our clinic, we cannot bulk bill Medicare patients. Due to the high quality service we provide, we believe that our patients take more accountability for their health when there is a small gap fee.

To provide you with an example of cost, our initial consultation and subsequent consultation for an EPC patient is $70. Medicare will rebate you $53.80 of your consultation, leaving you with a gap of $16.20.

How does the Medicare EPC Rebate Process Work?

In our clinic, our EPC patients are required to pay the full consultation amount of $70.

We then logon to the Medicare Online Portal and claim your rebate of $53.80 for you which will be deposited into your bank account (which Medicare should already have) within 24-48 hours.

This means there’s no need for you to cue up at your local Medicare to claim your rebate, we take care of that for you!

Points to remember:

  1. Yes! You can get a Medicare rebate for podiatry, using the EPC/CDM program
  2. To be eligible for an EPC, you to have had a chronic health condition that has been present for more than 3 months
  3. You will need a referral from your GP allocating you up to 5 visits to see a specific allied health professional or in our case, a Podiatrist
  4. You will need to pay the full consultation fee upfront at your appointment
  5. We claim your rebate online for you and $53.80 will be deposited into your account within 24-48 hours of your consultation with your Podiatrist

Easy as that! If you have any further questions, please do not hesitate to call us on 8468 2411.

Yours in keeping people healthy, happy and comfortable

The team at the Whittlesea Foot & Ankle Clinic


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