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Medicare Allied Health Initiative

While most private health funds provide rebates for visits to APDs, some patients may be eligible for a Medicare rebate instead.

The Medicare Allied Health Initiative allows chronically ill people being managed by their GP under the Enhanced Primary Care (EPC) Program access to Medicare rebates for ADP services. Eligible patients are those with a chronic condition, defined as one that is likely to be present for at least 6 months. This includes, but is not limited to, asthma, cancer, cardiovascular disease and diabetes. General practitioners must be managing the patient through the GP Management Plan (GPMP) and the need must be identified as part of a Team Care Arrangement (TCA). (Please note these are not the only criteria for Medicare eligibility for a GPMP, TCA and referral.) The dietitian must provide a service that is directly related to the management of the patient’s chronic condition. General practitioners must then fill out the EPC Program Referral Form for Allied Health Services under Medicare for the rebate to be possible. The Medicare rebate is currently $48.95 per service with out-of-pocket expenses counting toward the extended Medicare safety net. Patients are given a maximum of five allied health visits per calendar year.

Medicare rebates are now also payable for group services for patients with type 2 diabetes, on referral from a GP. Contact Medicare for further information about eligibility, requirements, rebates and referral forms.

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