Chronic Disease Management (CDM) Plan

Medicare Rebate — Terms & Conditions  (formerly known as Enhanced Primary Care / EPC)

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What Is a Chronic Disease Management Plan?

A Chronic Disease Management (CDM) Plan is arranged by your GP under the Medicare Benefits Schedule for patients managing a chronic or complex condition that has lasted, or is expected to last, six months or longer. It allows your GP to refer you to other health providers — including your chiropractor — with a Medicare rebate applied to eligible visits.

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How Many Visits Will It Cover?

• A CDM referral covers up to 5 rebated allied health visits per calendar year.

• This limit is shared across every allied health provider you see under the referral — not just our practice. If you're also seeing a physiotherapist or podiatrist under the same plan, those visits count towards the same 5.

• The plan resets each calendar year, but you will need a new referral from your GP each year to access it again.

• Unused visits do not roll over and expire on 31 December.

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Getting Started

• We need your GP referral before we can process a visit under your CDM plan. A faxed or emailed copy is fine to get started, though we recommend bringing in a hard copy as well.

• If we have your referral before your appointment, we can apply your CDM visit at that appointment.

• If we haven't received your referral in time, we're required to see you at your standard applicable rate for that visit, and can begin using your CDM plan from your next appointment once the referral is on file.

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What Will I Pay?

Unlike the previous EPC arrangement, CDM visits are no longer fully rebated — there is a gap fee. You'll pay your normal applicable visit fee at the time of your appointment (PAYG, standard membership, or concession membership rate), and Medicare will rebate $63.40 of that directly to your nominated account.

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How Does the Payment & Rebate Process Work?

• You pay your visit fee at the time of your appointment through our usual Tyro payment terminal, the same as any other visit.

• We submit your Medicare claim on the day of your visit.

• Medicare deposits your $63.40 rebate into your nominated Medicare-linked bank account, generally within 1 business day. This is a separate deposit from Medicare — it is not refunded back onto the card you paid with.

• Please make sure your bank account details are up to date with Medicare so your rebate isn't delayed. You can update your nominated account anytime through your Medicare online account (via myGov) or the Medicare app, under bank account details.

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If Medicare's System Is Unavailable

On the rare occasion Medicare's claiming system is down, we'll charge your visit fee as normal and provide you with a receipt so you can claim your $63.40 rebate yourself via the Medicare app, myGov, or in person at a Medicare branch. We'll always try to submit the claim on your behalf first.

A Few Other Things to Know

• Your 5 visits are a Medicare-set limit, not a clinic policy — we're not able to extend this regardless of your ongoing care needs.

• Once your 5 CDM visits are used, further visits are simply billed at your normal applicable rate — your care continues as usual.

• A new referral is required every calendar year; your CDM plan does not automatically continue.