FAQs2019-02-13T00:18:44+00:00

Frequently Asked Questions

GENERAL INFORMATION2019-02-12T19:56:12+00:00

What is covered by Medicare?

Medicare will cover treatment for those with chronic medical conditions under the Chronic Disease Management Scheme (CDM). Read below to find out if this applies to you.

What is Chronic Disease Management (formerly EPC)?

Chronic Disease Management (formerly Enhanced Primary Care or EPC) is a government incentive which allows individuals with a chronic medical illness or condition to receive Medicare rebates for a maximum of 5 allied health services, such as physiotherapy, each calendar year. A chronic medical condition is one that has been (or is likely to be) present for six months or longer, e.g. musculoskeletal conditions. There is no list of eligible conditions; however, the CDM items are designed for patients who require a structured approach, including those requiring ongoing care from a multidisciplinary team.

Your GP will prepare a CDM plan and refer you to an allied health practitioner (such as Cremorne Physio) if you qualify for treatment. Whether a patient is eligible for CDM services is a clinical judgement for the GP, taking into account the patient’s medical condition and care needs, as well as the general guidance set out by Medicare.

How much is the Medicare rebate?

Currently, the Medicare rebate for CDM is $52.95 per service, with out-of-pocket costs counting towards the extended Medicare safety net.

Is there an out of pocket cost to me?

We are able to process Medicare rebates on the spot. However, there will be a gap to pay between the full Cremorne Physio consultation fee you pay and the Medicare rebate you recieve back on the spot. For more information on fees and rebates, contact our friendly reception team.

Can I use my private health card as well?

It is not possible to use both a CDM claim and your private health insurance for the same physio treatment. If you prefer, you may opt to use private health insurance, but you cannot claim the CDM rebate as well.

What happens if I need more than five physio sessions?

Once you have used your five CDM sessions in a calendar year, you have the option to continue on with treatment. However, there will be no Medicare rebate for these treatments.

MEDICARE2019-02-12T19:55:48+00:00

Is it covered by Medicare?

Medicare will cover treatment for those with chronic medical conditions under the Chronic Disease Management Scheme (CDM). Read below to find out if this applies to you.

What is Chronic Disease Management (formerly EPC)?

Chronic Disease Management was formerly known as Enhanced Primary Care (EPC). The Chronic Disease Programme is a government incentive which allows individuals with a chronic medical illness or condition to receive Medicare rebates for a maximum of five (5) allied health services, such as physiotherapy, each calendar year. A chronic medical condition is one that has been (or is likely to be) present for six months or longer, for example, musculoskeletal conditions. There is no list of eligible conditions; however, the CDM items are designed for patients who require a structured approach, including those requiring ongoing care from a multidisciplinary team.

Your GP will prepare a CDM plan and refer you to an allied health practitioner (such as Cremorne Physio) if you qualify for treatment.Whether a patient is eligible for CDM services is a clinical judgement for the GP, taking into account the patient’s medical condition and care needs, as well as the general guidance set out by Medicare

How much is the Medicare rebate?

Currently the Medicare rebate for CDM is $52.95 per service, with out-of-pocket costs counting towards the extended Medicare safety net.

Is there an out of pocket cost to me?

We welcome all participating private health funds and Medicare. We are able to process health fund rebate and Medicare rebate on the spot. After swiping the private health card there is a gap between the Cremorne Physio fee and the private health fund rebate. Medicare is only able to be used for CDM (Chronic Disease Management) Scheme. There will then be a gap between the full Cremorne Physio consultation fee you will pay and the Medicare rebate you will receive back on the spot.

Can I use my Private Health card too?

It is not possible to use both a CDM claim and your private health insurance for the same physio treatment. If you prefer, you may opt to use Private Health Insurance, but then you cannot claim the CDM rebate as well.

What happens if I need more than five physio sessions?

Once you have used your five CDM sessions in a calendar year, you have the option to continue on with treatment (if required), however there will be no Medicare rebate for these treatments.

PRIVATE HEALTH INSURANCE2019-02-12T19:55:18+00:00

Are Cremorne Physio services covered by private health insurance?

Provided you have the appropriate level of health cover, you can claim back from your health fund for your consultation.

Do you have HICAPS at Cremorne Physio?

Yes, we do have HICAPS on-the-spot claiming.

Will I get a rebate for my physiotherapy consultation?

If you have private health insurance which covers physiotherapy, you will receive a rebate from your health fund. We can claim your rebates on the spot for you through HICAPS. To do so, we will need to swipe your health insurance card, so be sure to bring this with you to every consultation.

Can you tell me how much my health fund will give back?

Different funds provide different rebates. If you need to know what the rebate will be before your consultation, contact your health fund directly to find out from them.

Can I claim with Medicare?

Medicare does not offer rebates on physiotherapy and massage.

Can I get a rebate from my health fund on products such as clinically recommended braces or supports?

Although you may qualify for rebates on certain products with your health fund, our HICAPS facility can only process the treatment component of your claim. In this case, you would pay for the product(s) on the day and submit the receipt to your Health Fund to obtain any applicable rebate.

Can I get a rebate for my massage?

If your health fund extras cover remedial massage and you have not yet reached your limit, you will get a rebate for massage.

I have reached my limit; when can I use my card again for rebates?

Most health funds work on a calendar system with your new annual limit restarting on January 1st every year. Be sure to check with your health fund first, as some run on a financial year calendar.

WORKERS COMPENSATION2019-02-12T19:54:37+00:00

I am a Workers’ Compensation patient. What do I need to bring with me to my first appointment?

If you are a WorkCover patient, you will need a referral from your GP before you are able to commence treatment. You will also need to provide us with your claim and insurance details including:

  •    Name of insurer
  •    Claim number
  •    Name and contact details of case manager
  •    Injury date
  •    Referring doctor’s name and contact details
  •    Letter accepting liability from insurer

What if I have not received a letter from my insurer accepting liability?

If you have not yet received confirmation from your insurer that they accept liability for you claim, it is your responsibility to pay all outstanding accounts until this letter is received. You must then seek reimbursement from your insurer for any accounts settled directly by you.

VETERANS AFFAIRS2019-02-12T19:56:53+00:00

I am a Veterans’ Affairs patient. What do I need to bring with me to my first appointment?

If you are a Veterans’ Affairs patient, a doctor’s referral and your DVA card are required at your first appointment.