Medicare Rebates for Podiatry Explained
Podiatrists are your foot and ankle experts. A Podiatrist studies at University for 4 years to be able to be your foot and ankle expert.
Common conditions include plantar heel pain, ingrown toenails, Diabetes, bunions, issues relating to children’s feet, orthotic requirements etc.
For some of these conditions, a Medicare rebate may be available to you. Understanding your eligibility and likelihood of receiving a Medicare rebate may sound complicated but once understood; we can assure you that it is a fairly easy and our team is here to help get your head around it.
If you would prefer to watch our video outlining this blog simply click HERE.
Can I get a Medicare rebate for my podiatry appointment?
The short answer is YES!
The long answer is yes BUT you need to have a specific referral called either an EPC or CDM plan written to our clinic by your Doctor. Not everyone is able to access this referral type and only your Doctor will be able to advise you if you are eligible for such.
Are you eligible for a Medicare rebate?
A Medicare rebate is made available through the Chronic Disease Management (CDM)plan or more widely known as an Enhanced Primary Care (EPC)program.
To be eligible for this, you need to meet specific criteria. If you have a chronic medical condition, one that has been present for three months or longer, for example Diabetes or plantar heel pain that has been present for longer than 3 months with a proper diagnosis.
From here, your GP will refer you to a specific Podiatry clinic and create a care plan which you sign and agree on your goals and work with an allied health professional (in this case a podiatrist) to achieve them.
How many visits will the Medicare EPC rebate cover?
If you are eligible for an EPC, a rebate from Medicare is available for up to 5 visits per calendar year to any referred allied health practitioner.
Your Doctor will choose how many visits to allocate for a particular practitioner/s; for example, you may be allocated 1 visit to a Dietician and 4 visits to a Podiatrist.
How much does the Medicare Rebate cover?
Currently as of July 1st2019, the Medicare rebate for podiatry is $53.80 for all of your allocated visits to the Podiatrist. This is nearly an extra $270 per year towards your health care and achieving your goals.
At the Diamond Valley Foot & Ankle Clinic it is not viable for our team to bulk bill Medicare patients. Due to the high quality service we provide, the time we spend during each appointment, our on going professional development and investment in up to date equipment we cannot provide our patients with the level of care they deserve and require if we bulk billed these appointment. There is also a lot of research indicating that patients take more accountability for their health when there is a small gap fee.
To provide you with an example of cost: With majority of our team Your initial consultation (which is 60 mins of comprehensive assessment, diagnosis, planning and treatment) is around $31.20 and around $16.20 for subsequent consults with majority of our team. This is a small fee for great quality service and access to high end equipment.
How does the Medicare EPC Rebate Process Work?
Medicare stipulates that Medicare patients are required to pay the full consultation amount. We know this can be frustrating but its the requirements of Medicare and the money is back in your account within 24 hours.
We then complete the claim via Medicare’s Online Portal and claim your rebate of $53.80 for you, which will be deposited into your bank account (which Medicare should already have registered) within 24 hours. You don’t need to go to Medicare or go online we do all of this for you!
Points to remember:
- Yes! You can get a Medicare rebate for podiatry BUT need to qualify for a EPC/CDM program
- Only your Doctor can tell you if you are eligible for these Programs.
- You will need a referral from your GP allocating you up to 5 visits to see a specific allied health professional or in our case, a Podiatrist (with our clinics details on the referral)
- You will need to pay the full consultation fee upfront at your appointment
- We claim your rebate online for you and $56.00 will be deposited into your account within 24 hours of your consultation with your Podiatrist
It is that easy! If you have any further questions, please do not hesitate to call us on 9434 4422 alternatively you can book an appointment online HERE.
(To see the video we produced to answer these questions head over to our Facebook page HERE >>>)
Please note this information is correct at the time of publication: September 2022
