Does Medicare Cover Podiatry? Podiatry Covered By Medicare?

Blog 19 – Does Medicare Cover Podiatry?

Is there a Medicare podiatry covered rebate available for podiatrists?

There are so many disorders for which podiatry is an essential therapeutic choice, including:

  • cases involving persistent pain, such as knee, hip, ankle, leg, or foot pain
  • Arthritic issues
  • chronic disorders like diabetes
  • and issues with the nails and skin

Accessing Medicare reimbursement for podiatry ought to be a straightforward process, but sadly, getting a referral for the Medicare rebate is not always simple.

Depending on the service or doctor you may have spoken to, there is frequently contradicting information about Medicare.  We’ve put up this straightforward guide to help you get through the Medicare system and understand what you might be eligible for if you have no idea where to begin or have never been through the process for podiatry before.

You can gain a better understanding of the podiatry Medicare rebate procedure by reading the following blog.  Let us assist you in understanding the Medicare rebate and how it can apply to your podiatry condition since, once you do, it can be a pretty straightforward process.

Is there a Medicare entitlement available for podiatry services?

Yes, although under some restrictions, is the slightly more complicated response.

The Enhanced Primary Care Programme, or EPC Programme, offers a Medicare rebate for our services. This is sometimes referred to as a general practitioner management plan (GPMP) or a team care arrangement (TCA).

Therefore, who qualifies for an EPC refund from a podiatrist?

First, you must satisfy the requirements and condition, which centre on “chronic” diseases or ailments that you have had for longer than three months.

Second, you must get the proper recommendation document from your doctor, who must schedule a number of appointments for you at our clinic.

How many visits will be covered by the Medicare rebate for podiatrists?

Any referred allied health patient may get up to five rebated consultations per year under the Medicare EPC Programme – often referred to as a care plan. That might cover speech pathology, dietetics, physiotherapy, podiatry, mental health and more.

Thus, your GP or medical practitioner might recommend that you have two podiatry clinic consultations and three physiotherapy consultations covered by Medicare.  You will require a fresh Medicare recommendation each year, even if this number is reissued annually.

Most organised podiatry patients will contact their doctor in the New Year to set up a Medicare referral, and possible Medicare rebates for the next year, and upcoming appointments after going through the system once over the course of a calendar year.  

What is covered by the Medicare refund for visits to podiatrists?

Regardless of the precise podiatry appointment type you select at the podiatry clinic for your condition, the current Medicare rebate for a consultation is $56.00.

Therefore, the Medicare rebate is $56.00 for the initial podiatry appointment as well as any additional follow-up visits that may be suggested for you known as an EPC care plan.  No matter why you require a podiatry appointment—for nail and skin care, foot pain, or orthotic therapy, for example—the rebate remains the same.

For patients at Bellevue Podiatry who are unable to pay the gap fee, we do provide a bulk billing Medicare podiatry service. If you’d like more details, call us at (03) 9457 2336 and ask about our Medicare podiatry bulk billing option.

What is the procedure for the Medicare refund for my visits?

The Medicare rebate procedure can occasionally be challenging, but we are aware of its challenges and want to make it as simple as possible for you.  At our clinic, you may be asked to partially cover the cost of your consultation using the Medicare refund depending on the appointment type you booked – as mentioned, please speak to our friendly Reception first on (03) 9457 2336 if you would like to explore the details of the bulk billing podiatry service we offer.

Here are the stages in detail if you are paying the Medicare gap (i.e. not bulk billing):

  1. We obtain the $56.00 Medicare rebate for you by using your Medicare card and swiping it (You avoid having to visit a Medicare office this way).
  2. You can pay the podiatry gap fee using cash, a credit card, or a debit card for your services.

What we have covered in this blog:

  • Yes, you can use the health care EPC Programme to get a Medicare rebate for podiatry services.
  • You will need a specific GP, human services, health practitioners or health professionals referral and the eligible physical issue.
  • You’ll be eligible for a $56 rebate for up to five visits per year.
  • There may be a small gap payment not included in your Medicare rebate.
  • We’ll process the podiatry rebate right away to save you the trouble of visiting a Medicare office.
  • We will be pleased to answer any questions you may have about the Medicare EPC procedure if you give us a call or send us an email.
  • Alternately, visit your doctor as soon as possible and get a Medicare referral to a podiatrist who can assist you in being pain-free, feeling fantastic, and moving properly.
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