How do Medicare referrals for Podiatry work?
- If you have a chronic condition (such as diabetes, chronic pain, heart disease etc) your GP may initiate a Chronic Disease Management (CDM) Care Plan (previously called an “EPC”).
- The GP will provide you with a referral that has between 1 and 5 treatments available for your Podiatrist. They may also refer you for some of the 5 treatments to another professional, such as a Chiropractor or Physiotherapist.
- You cannot use more than 5 treatments per calendar year, across the various professionals.
- You are entitled to use the treatments within the life of the care plan (usually a year) to receive a rebate of $58.00 (correct as of 01/07/23) out of the cost of the consultation.
- You may have up to 5 treatments (spread across the various providers) per calendar year.
- The 5 treatments limit resets on the 1st of January, each year, so if you finish the year with 3 treatments available, they disappear and are not accumulated into the next calendar year.
- If you are Aboriginal/Torres Strait Islander you may be entitled to an additional 5 consultations per calendar year, under a slightly different referral that your GP will know about.
Frequently Asked Questions
My GP wrote 6 treatments on my care plan. Does that mean I get 6 treatments?
No. You can only have 5 treatments per calendar year (January-December). It doesn’t matter what the GP writes— Medicare will only rebate 5 treatments per calendar year.
My GP wrote 5 treatments for Chiropractic & 5 treatments for Podiatry. Do I get 5 treatments for each practitioner?
No. You can only have 5 treatments per calendar year, spread across all the providers on the list. It doesn’t matter what the GP writes— Medicare will only rebate 5 treatments per calendar year.
I told my GP that I wanted a Medicare referral for Podiatry and they refused. Are they allowed to do that?
Medicare has strict definitions of who can be referred for a Chronic Disease Management Plan. If your GP doesn’t think you fit the criteria then they will say no. This should probably be taken as a good sign as it means your GP doesn’t think you have a chronic condition (like diabetes or heart disease)!
Are the Podiatry consultations bulk billed?
One of our Podiatrists, Elise Steventon, currently bulk bills follow up consultations. Our more experienced podiatrists, Ellie and Renee, do not bulk bill. Bulk billing has become increasingly unsustainable as successive Governments have not indexed Medicare Rebates in a way that keeps up with inflation and cost of living increases. For all of our podiatrists initial consultations and extended consultations incur a gap fee. In 2023 the Medicare rebate for Podiatry was $58 as of 01/07/2023.
What do I do with my referral, if I receive one?
Let us know that you have a CDM referral when you book in to see the Podiatrist as a new or returning patient. If you are booking online there is a dialogue box in which you can advise us of the referral.
