Info for GPs, Patients & Staff
FREQUENTLY ASKED QUESTIONS:
- 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)
- Does a patient have to wait for 12 months from their previous referral date? NO
- Does the patient need a new Care Plan? NO (only a review is required unless there has been a significant change in their condition)
- 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:
- 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).
- 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)