Chronic Disease Management Care Plan (EPC)

The road to recovery can be longer than we expect. Sometimes, we don’t realise the extent of our injuries and what is needed to manage them. For those with a chronic injury or illness, ongoing treatments may be needed, which can be expensive. For select people, the Chronic Disease Management Care Plan (previously known as Enhanced Primary Care plan) can help with the expenses.

What is the Enhanced Primary Care Plan?

The Enhanced Primary Care Plan (EPC) is now the Chronic Disease Management (CDM). CDM allows General Practitioners (GP) to organise the health care of patients with chronic conditions. A GP can allocate a total of 5 sessions per person, per calendar year which Medicare will help fund. Health providers who can provide sessions include:

• Physiotherapist
• Podiatrist
• Exercise physiologist
• Dietician
• Occupational therapist
• Psychologist
• Chiropractor
• Aboriginal health worker
• Audiologist
• Diabetes educator
• Mental health worker
• Osteopath
• Speech pathologist

You are not able to claim 5 appointments for each provider, only a total of 5 appointments. For example, in one calendar year you can claim 2 physiotherapy appointments, 2 podiatry appointments, and 1 audiology appointment.

Who can qualify for CDM?

Patients who have both a valid Medicare card and a chronic medical condition are eligible. A chronic medical condition is one that has been present for at least six months. Examples of chronic conditions can include, asthma, cancer, cardiovascular disease, diabetes, musculoskeletal conditions, and stroke. You must see a GP who must complete a GP management plan and team care arrangements for you.

CDM in Summary

• Available for patients with a chronic medical condition.
• Referrals must be from a GP.
• Maximum of 5 services per patient each calendar year.

How Much do the CDM Physiotherapy Appointments Cost?

If you have received a CDM from your GP, you can receive medical rebates when you visit health providers. Pilates Power & Physiotherapy Cronulla can assist you with injury recovery, but our physiotherapy services are NOT covered by bulk billing schemes. This means you will have to pay the difference between the fee charged and the Medicare rebate.

If you have any questions about the CDM program or would like to book an appointment, speak to our friendly physio reception staff on 8544-1224.