Clients can access Medicare Rebates for Exercise Physiologists, who are classed as Allied Health Professionals, for the development of exercise and movement-based strategies for the management of chronic diseases.
As Physical Inactivity is the second largest cause of chronic disease and ill-health in Australia, the community has 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 allows you to utilise the services of an Exercise Physiologist up to five times within a calendar year and receive a Medicare rebate 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 3 months or longer that is not being managed well in its current state.
Chronic Conditions include:
- Musculoskeletal conditions: such as poorly managed injuries to the lower back, neck, shoulders, knees, fibromyalgia, arthritis, etc.
- Diabetes (Type 1 and 2)
- Asthma
- Cardiovascular disease
- Obesity
- Stroke
- High Blood Pressure
- Depression, Anxiety and Post Traumatic Stress Disorder
Steps to being referred 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, and initial assessment will be made for a 45-minute consultation. A gap will be charged as the EPC rebate only provides for a 20 minute consultation that is not suitable for the client to receive the attention required to achieve a positive outcome.
The initial assessment will involve:
- History taking of the chronic condition
- An understanding of the goals and needs of the client
- Developing an understanding of the condition and how it is impacting on the client’s quality of life
- A full functional assessment to determine the movement causes that may be impacting on the recovery process for the clients condition
- The functional assessment will determine a client’s range of motion, mobility, stability and functional strength and will NOT cause an increase in symptoms or dysfunction and can be completed by all clients comfortably
- Finally, the Exercise Physiologist will explain to the client the plan for recovery, the expected outcomes and the realistic timeframe that these goals and outcomes can be achieved with the correct commitment to training and movement
- A follow up appointment will be made where the client will be taken through their exercise program. The client will complete all the exercises in the session under the supervision of the Exercise Physiologist. The client will be educated on the importance of the exercises, the muscles that are being targeted and why this is important and at the completion of their session they will be provided access to the exercises on a free app that can be accessed on any devise including phone, tablet, computer or smart tv
Under the Enhanced Primary Care Plan you receive a rebate from Medicare which improves the affordability of the sessions. The patients can access up to 5 visits per 12 months from referral with an Exercise Physiologist under the Enhanced Primary Care Plan.
If you have any enquiries in relation to this program, please contact our administrative staff on 0249572757 or email us directly with your questions to admin@proactiverehab.com.au.
