Can I Get a Medicare Rebate for Exercise Physiology?

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Exercise Physiology is such a vital treatment option for so many conditions, including chronic pain, osteoarthritis, diabetes, cancer, heart disease and back pain. There are ways to access Medicare rebates and funding for conditions such as these.

To be able to access things like a Medicare rebate for exercise physiology should be really easy, but unfortunately Medicare rebates are not always that simple!

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.

It can be a really simple process once you understand it, so let us help you wrap your head around Medicare and how it can work for your physiotherapy needs.

CAN I GET A MEDICARE REBATE FOR EXERCISE PHYSIOLOGY?

YES!

But, you must qualify for them under certain conditions.

A Medicare rebate for exercise physiology can be accessed under the EPC Program, which is the Enhanced Primary Care Program.

Firstly, you must meet the criteria, and that is generally centred around ‘chronic’ conditions, meaning something that you have suffered with for more than 3 months.

Secondly, you need to have the appropriate referral form from your GP, who needs to send you to a specific Exercise Physiology clinic (Hopefully us, we would love to help you!)

HOW MANY VISITS WILL THE MEDICARE EPC REBATE COVER?

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

That could include Exercise Physiology, dietetics, podiatry, physiotherapy, etc.

So, for instance, your GP might refer you for 3 exercise physiology consults, and 2 podiatry consults.

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

HOW MUCH DOES THE MEDICARE REBATE COVER?

The current Medicare rebate (as of Oct 2019) is $53.80 per consult, regardless of the specific service that you choose.

That means that the rebate is $53.80 for an initial consult, and any subsequent review consults that you might be recommended for as well.

Unfortunately, we cannot bulk bill Medicare for exercise physiology at our practice, so there will always be a small gap payment.

HOW DOES THE MEDICARE EPC REBATE PROCESS WORK?

Simple!

At our practice, you may 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 $53.80 rebate for you
  3. We swipe your DEBIT card again, and put the $53.80 back onto that card on-the-spot.
  4. NOTE: You cannot use a CREDIT card for this process

SUMMARY

To wrap it all together:

  • Yes, you can get a Medicare rebate for exercise physiology
  • You need a specific doctor’s referral for the management of a chronic and/or ongoing condition
  • You can get 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 EPC process – please call or email us via the Contact page, and we are more than happy to answer them.

Alternatively, get to your GP ASAP and ask for a referral to see an exercise physiologist who can help you get moving well, feeling great, pain free and back to doing what you love!

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