Info for GPs, Patients & Staff

FREQUENTLY ASKED QUESTIONS:

  1. Is everyone entitled to attend their GP and request an additional 5 visits at the start of each calendar year? YES  (as long as 3 months have passed since their previous review)
  2. Does a patient have to wait for 12 months from their previous referral date? NO
  3. Does the patient need a new Care Plan? NO  (only a review is required unless there has been a significant change in their condition)
  4. Does a patient have to wait to use their 5 visits before requesting another 5? NO  (as long as 3 months have passed since their last review AND it is a new calendar year)

Additional information and examples:

An EPC Management Plan is valid for 2 years. A new plan is only required if there has been a significant change in the patient’s condition.

Only 5 visits can be claimed per calendar year

A review/new referral can only be completed if 3 months have passed since the previous review/referral.

Each January a GP can do a review, and refer the patient for a further 5 visits.

2 different scenarios may come into effect at this point:

  1. A patient is referred for 5 EPC visits by their GP in 2013 and uses all 5 visits in 2013.  In January 2014, the patient may visit their GP for another 5 visits for 2014 (as long as 3 months have passed since the previous referral).
  2. A patient is referred for 5 EPC visits in 2013 BUT ONLY uses 2 visits.  In January 2014, the GP may refer the patient for a further 5 EPC visits, HOWEVER, the patient must first use the REMAINING 3 visits from the 2013 referral and then is ONLY eligible for 2 (of the 5) 2014 visits during the 2014 calendar year (once again, 3 visits will roll over to 2015).

Further info – call Medicare Provider line on 132 150

Or visit www.health.gov.au/MBSonline (search for Chronic Disease Management Plan)

Or call us on 9622 5335 (Regional Physiotherapy & In Balance Fitness)