Medicare Rebates: Can I get a Medicare rebate for Podiatry?
Podiatry is such a vital treatment option for so many conditions, including:
-chronic pain related cases such as foot pain, ankle pain, leg pain, knee pain or hip pain.
– arthritic conditions
– chronic diseases such as diabetes
– and nail and skin conditions
Accessing the Medicare rebate for podiatry should be a simple and easy process, but unfortunately obtaining a Medicare rebate referral is not always easy. There is often conflicting advice depending on which provider or doctor you might have spoken to.
If you don’t know where to start or if you have never been through the process before, we’ve created this simple guide to help you navigate the system and understand what you may be eligible for.
The following information will help you understand the Medicare rebate process in a little more depth.
It can be a really simple process once you understand it, so let us help you wrap your head around the Medicare rebate and how it can work for your podiatry needs.
Can I get a Medicare rebate for Podiatry?
The simple answer is, YES!
The slightly less simple answer is yes, but there are a few conditions.
A Medicare rebate for podiatry can be accessed under the EPC Program, which is the Enhanced Primary Care Program. Sometimes, doctors or practitioners may refer to this as a Team Care Arrangement (TCA), or a general practitioner management plan (GPMP).
So, who then is eligible for a Medicare rebate for Podiatry?
Firstly, you must meet the criteria, and that is focussed around ‘chronic’ conditions, meaning something that you have been experiencing for more than 3 months.
Secondly, you need to have the appropriate referral form from your GP, who needs to allocate a number of visits on this referral to a podiatry clinic.
How many visits will the medicare EPC rebate for Podiatry cover?
The Medicare EPC Program allows for a total of up to 5 rebated consultations to any referred allied health practitioner, per year.
That could include podiatry, dietetics, physiotherapy, speech pathology, etc.
So, for instance, your GP might refer you for 3 physiotherapy consultations, and 2 podiatry consultations.
This number is renewed each calendar year, but you will need a new referral each year.
Once through the system over a calendar year, most organised clients will visit their GP in the New Year and set up a referral and available rebates for the coming year and appointments ahead.
How much does the Medicare rebate for Podiatry cover?
The current Medicare rebate (as at January 2020) is $53.80 per podiatry consultation, regardless of the specific appointment type you choose.
That means that the rebate is $53.80 for an initial consultation, and any subsequent review consultations that you might be recommended for also. The rebate is the same, no matter what reason you may be needing the appointment, eg. Nail and skin care, foot pain or orthotic therapy.
We believe in providing a high quality service at Proactive Health + Movement. We offer service where the client and the treating practitioner have the time to achieve health care goals to a high standard. It is for this reason, we cannot bulk bill Medicare for podiatry at our practice, so there will always be a small gap payment and a huge reason for choosing your best health outcome.
Depending on your reason for attending your first appointment and generally speaking, your gap payment is often around around $35 for your initial consultation (which will be 40 – 60 minutes of getting to know you, a comprehensive assessment, diagnosis, planning and treatment). The gap payment for subsequent consultations is usually around $10 depending on your reason for subsequent consultation.
How does the Medicare rebate process work?
The medicare rebate process can sometimes be a confusing process – however, we understand the difficulties of the system and make this process as easy as we can for you.
At our practice, the Medicare rebate will be requested to part-pay for your consultation. This happens on the spot and at the time of your consultation, so what you need to do is only pay for the gap fee at the conclusion of your consultation.
Specifically, here are the steps:
- We swipe your medicare card and access the $53.80 rebate for you
- (this saves you a trip to a medicare office)
- You pay the gap fee on a Credit card, DEBIT card, or with cash.
Summary:
To wrap it all together:
- Yes, you can get a Medicare rebate for podiatry, using the EPC Program
- You need a specific doctor’s referral, and the right type of physical condition
- You can get $53.80 rebate for up to 5 visits per year
- There will always be a small gap payment
- We can process the rebate on-the-spot, and save you a trip to a medicare office.
If you have any questions at all regarding the EPC process – please call or email us, we are more than happy to answer your enquiries.
Alternatively, get to your GP ASAP and ask for a referral to see a podiatrist who can help you get pain free, feeling great and moving well.
Written by:
Daniel Monteleone
Podiatrist, Strength & Conditioning Coach
