Medicare Cover Podiatry Appointments?

In our podiatry clinic, we often have new patients who come for initial consultations and ask whether they can use their Medicare cards or whether we bulk bill consultations. The reality is, Podiatry as a speciality within the health sector is still developing and undergoing legislative changes. As such, the Medicare rebates are limited for Podiatry as they are for many other Allied Health professions.
Some patients are able to have a portion of their consultation fees subsidised through Medicare, if they have an Enhanced Primary Care (EPC) plan referral from their doctor.

What is the EPC?

The Enhanced Primary Care plan (EPC) is an initiative by the government whereby patients that are being treated by their doctor for chronic or complex illnesses may be eligible to have a rebate provided by Medicare that can help subsidise some of the costs of seeing a range of allied health practitioners. Some of the chronic and complex conditions that are considered include:
– Diabetes (type 1 and 2)
– Asthma.
– Cancer.
– Cardiovascular diseases.
– Certain musculoskeletal conditions (either acquired or genetic)
– Stroke.
– Mental Illnesses.
– Certain genetic illnesses.

The government’s guidelines state that while there is no concrete list of eligible conditions, Medicare rebates apply to patients who require a structured care program (coordinated by their doctor) which utilises multidisciplinary approach to patient care.

How many visits are subsidised?

For eligible patients, they may be able to receive up to 5 subsidised visits per calendar year. Podiatrists will work with the patient to try and spread out the visits to last the whole year where appropriate however for subsequent visits (outside of the 5) standard fees will apply.

Who would this be suitable for?

From a podiatry perspective, no one patient is the same. Patients who have come in on an EPC referral are often concerned about ensuring that their feet do not suffer any complications from diabetes. At the same time, patients who find it hard to reach their feet to cut their toenails due to arthritis would find the EPC helpful in getting that help. There is no ‘ideal’ patient for whom the EPC is designed, but rather, the focus is on ensuring that patients who do have chronic or complex conditions can have the attention and care their feet deserve thereby reducing any further issues from arising. People who have concerns about their elderly relatives and the level of care their feet receive may be able to take them to see their doctor about obtaining visits for professional consultation and care.

How can I get the Medicare (EPC) referral?
In order to obtain an EPC referral, patients should visit their doctor for a discussion about their medical condition and gauge their suitability. If eligible for the referral, patients will be asked by their doctor who they wish to see (or what it is the patient requires help with), and for patients wishing to come in for Podiatry care, they should inform their doctor to supply 5 visits to podiatry. Patients then bring in the referral on the day of their appointment and the podiatrist can take it from there.

If you have any questions regarding how Medicare relates to your podiatry care or need any more advice about obtaining a referral, please do not hesitate to contact us here at the clinic.

Dr Anel Kapur (Podiatrist)