Can I Claim on Medicare?

11 November 2021

I have an Enhanced Primary Care (EPC) referral from my Doctor.

What does this mean?

Your doctor has just given you a referral for Podiatry and told you that they are going to put you on an Enhanced Primary Care Plan (EPC) and that you have up to 5 visits with a Podiatrist.

Let’s break this down and go through any information you may need to know.

What is an Enhanced Primary Care Plan (EPC)?

An EPC is a plan on the Medicare Benefits Schedule where GPs can plan treatment for patients who suffer from a chronic or terminal medical condition with other medical providers.

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

Secondly, you need to have the appropriate referral from your GP.

Once the EPC form is filled out by your doctor, they will either hand a copy to you or alternatively fax or email a copy to the chosen provider (eg. Stepping Out Podiatry).

If the doctor has chosen to send a copy to us at Stepping Out Podiatry, and you are a new patient, one of our Admin staff will give you a call once they have the EPC referral and book in your initial appointment.

How many visits can I get?

EPC allows for a total of up to 5 rebated consults per calendar year to any referred allied health practitioner. That could include Podiatry, Dietitian, Speech Pathology, Physiotherapy etc.

So for instance, your GP may refer you for 3 Podiatry consults and 2 Dietitian consults.

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Is it free?

No, it is not free, however Medicare will cover a rebate of $55.10 for all appointments where there is a valid EPC referral.

How does the Medicare EPC process work?

At Stepping Out Podiatry, the first step is to pay the full fee upfront – but don’t worry, we electronically claim your rebate. Medicare will refund $55.10 back into your bank account that you have registered with them. Your rebate should arrive that day or at the very latest, early the next day!

This works out to be (as of Nov 2021) :

Podiatry general foot care assessment – $85.00 (with Pension or Heath Care Card $75)

Gap Payment – $29.90  (with Pension/Health Care Card – Gap payment $19.90)

Initial Podiatry walking/ foot pain assessment – $125.00

Gap Payment – $69.90

Standard Podiatry walking/ foot pain assessment – $105.00

Gap Payment – $49.90


To sum up what you need to know:

  • Yes you can get a Medicare Rebate for Podiatry using the EPC program.
  • You need a current EPC Doctor’s referral.
  • You can get $55.10 rebate or up to 5 visits per year.
  • There will always be a small gap fee.
  • Please note we cannot use Private Health in combination with Medicare.

If you have any questions regarding the EPC process, please call us, our friendly admin staff are more than happy to answer them!