Physiotherapy is, in the majority of cases, the optimal treatment option for many chronic conditions such as Diabetes or heart disease or injuries, including chronic back or neck pain and osteoarthritis of the hips or knees, and there are ways to access Medicare rebates and funding.

To be able to access things like the Medicare rebate for physiotherapy in Colac it is important to understand if you meet the eligibility criteria.

At the Corio Bay Sports Treatment Clinic we want to be able to help you access the help that you need, as quickly as you can, and as experts who see the above types of conditions all the time, we would love to help explain the Medicare rebate process a little more.

CAN I GET A MEDICARE REBATE FOR PHYSIOTHERAPY?

The short answer, is YES!

The long answer is yes, but there are a few conditions.

A Medicare rebate for physiotherapy can be accessed under the CDM Program, which is the Chronic Disease Management Program.  This was formerly known as the Enhanced Primary Care (EPC) Program.

Firstly, you must meet the criteria that you have a ‘chronic’ condition. This means that you have suffered with this condition, injury or problem  for more than 3 months.

Secondly  you need to see your GP who will assess your suitability for a referral and  you need to receive the appropriate referral form from your GP.

The Third requirement  is that you require the support and treatment from 2 different allied health practitioners.

Here is what is stated on the Department of Health Website

“people with chronic conditions and complex care needs”

“A chronic medical condition is one that has been (or is likely to be) present for six months or longer, for example, asthma, cancer, cardiovascular disease, diabetes, musculoskeletal conditions and stroke.

There is no list of eligible conditions. However, the CDM items are designed for patients who require a structured approach and to enable GPs to plan and coordinate the care of patients with complex conditions requiring ongoing care from a multidisciplinary team.”

Patients have complex care needs if they need ongoing care from a multidisciplinary team consisting of their GP and at least two other health or care providers.

HOW MANY VISITS WILL THE MEDICARE CDM REBATE COVER?

The Medicare CDM Program allows for a total of up to 5 rebated consults to any referred allied health practitioner, per year.

That could include physiotherapy, podiatry, occupational therapy, exercise physiology, dietetics , etc.

So, for instance, your GP might refer you for 3 physiotherapy consults, and 2 podiatry consults.  You might also already be seeing a dietitian through Colac Area Health and therefore be able to receive 5 physiotherapy consultations through medicare at The Corio Bay Sports Treatment Clinic.

This number is renewed each calendar year, but you will need a new referral from your GP each year.

HOW MUCH DOES THE MEDICARE REBATE COVER?

The current Medicare rebate (as at June 2018) is $52.95 per physiotherapy consult, regardless of the specific service that you choose.

That means that the rebate is $52.95 for an initial consult, and any subsequent review consults that you might be recommended for as well.

Unfortunately, we cannot bulk bill Medicare for physiotherapy at our practice, so there will always be a small gap payment.  At present this gap fee is $10 which is still well below our private fees.

HOW DOES THE MEDICARE CDM REBATE PROCESS WORK?

At our practice, what you need to do is actually pay the full fee upfront yourself first, and then we can process the Medicare rebate and get it back to you on the spot.

Specifically, here are the steps:

1. You need to pay the full fee on a DEBIT card
2. We swipe your Medicare card and access the $52.95 rebate for you
3. We swipe your DEBIT card again, and put the $52.95 back onto that card on-the-spot.
4. (You cannot use a CREDIT card for this process)

SUMMARY

• Yes, you can get a Medicare rebate for physiotherapy, using the CDM Program
• You need a specific doctor’s referral, and meet the criteria of a chronic condition.
• You can get $52.95 rebate for up to 5 visits per year
• There will always be a small gap fee
• We can process the rebate on-the-spot, straight back onto your debit card

If you have any questions at all regarding the CDM process – please call one of our friendly reception team members who will help you.

Alternatively, consult your GP and ask them if seeing a physiotherapist  would be of benefit for your condition.

Then its time to call the clinic on 52322400 to book an appointment or follow the link here to our page for online booking

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