If you have a chronic medical condition, you may be eligible for up to 5 partially rebated allied health sessions in a calendar year under a GP Chronic Condition Management Plan (formerly known as Chronic Disease Management Plans/CDMs or Enhanced Primary Care Plans/EPCs).
The Medicare rebate for these sessions is usually $63.40 per session, unless you have reached the Medicare safety net, at which point the rebate is increased to a higher percentage of the total cost of the service (often 80% – 100% of the total cost, depending on the individual circumstances). Most clinics usually charge a gap for these sessions.
To be eligible, you must have a chronic or terminal medical condition that has been, or is likely to be, present for at least six months. There is no specific list of conditions that are eligible, as your GP will determine that with you. However, some examples of conditions which are likely to be covered with a GP Chronic Condition Management Plan (GPCCMP) referral include:
- Chronic musculoskeletal conditions (eg chronic back pain)
- Asthma
- Cancer
- Cardiovascular disease
- Diabetes (Type 1 & 2)
- Kidney disease
- Strokes
The GPCCMP Referral entitles you to access up to 5 Medicare rebates for 1:1 allied health services in a calendar year. These referrals are valid for 18 months.
You can choose to direct all of these 5 sessions towards one specific type of allied health discipline, or split them up between any number of different disciplines. For example, you could direct all 5 sessions towards your Physiotherapist, alternatively, you could decide to have 2 sessions towards your Exercise Physiologist and the remaining 3 sessions towards your Podiatrist.
It’s important to consider how you would like to allocate these sessions, and ensure that either your GP includes that information in their referral letter or that you communicate that to the allied health practitioners you’re seeing under the GPCCMP. This helps to make sure everyone uses the correct number of sessions, and is aligned with your preferences for treatment.
The types of allied health practitioners that you can see through a GPCCMP referral include:
- Aboriginal Health Worker
- Audiologist
- Chiropractor
- Diabetes Educator
- Dietitian
- Exercise Physiologist
- Mental Health Worker
- Occupational Therapist
- Osteopath
- Physiotherapist
- Podiatrist
- Psychologist
- Speech Pathologist
How to obtain a GP Chronic Condition Management Plan (GPCCMP) Referral
To obtain a GPCCMP Referral, you first need to see your GP who will confirm if you are eligible. If you are eligible, the GP or Practice Nurse will prepare the required documentation with you.
GPs can now refer patients directly to allied health services using standard referral letters, simplifying the referral process so it’s now similar to how your GP would refer you to a medical specialist.
This referral letter can be addressed to any practitioner or generally to an allied health discipline, but must reference the type of allied health service you’re needing, and include your relevant medical history.
What happens if I still have the previous version of a GPCCMP, a CDM or EPC Referral
Chronic Disease Management Plan Referrals (otherwise known as CDMs, Enhanced Primary Care Plans or EPCs) is what a GP Chronic Condition Management Plan used to be called. This changed over to the new name and simplified process on the 1st July 2025.
CDM or EPC referrals made before 1 July 2025 will remain valid until all referred services have been provided, or until 2 years from the date of referral (whichever occurs first). If you have sessions remaining on an old CDM or EPC referral, these must be used within 2 years of the date of referral.
How can I use my GPCCMP Referral at Move for Better Health?
Move for Better Health & it’s entire allied health team (which consists of Physiotherapists, Exercise Physiologists, Podiatrists & Psychologists) accepts GPCCMP Referrals, as well as many other types of Medicare and third party referrals.
To use your referral at the time of your appointment, our practice must have your referral on file. Ideally your referral should be sent to us prior to your appointment by the GP, however you can bring a signed hard copy of the referral on the day if needed. Your allied health practitioner must provide a written report to the referring medical practitioner after the first and last session when using this referral.
The GPCCMP referral does not explicitly need to specify how many sessions are allocated to each allied health discipline in the referral letter, this is up to you as the patient to decide. Our reception team will ask you how many sessions you would like to allocate to our clinic or the specific discipline you are seeing.
At the time of billing, we will request payment in full for the service you received. We will then submit your claim to Medicare through our online claiming system, so your Medicare rebate can be refunded into your nominated bank account within a short time frame (usually within 24-48 hours).
The rebate you will receive for each visit under a GPCCMP is $63.40, unless you have reached the Medicare safety net, at which point the rebate is increased to a higher percentage of the total cost of the service. Move for Better Health does not bulk bill for GPCCMP referrals.
Unfortunately you are not able to claim with both Medicare and Private Health Insurance for the same service. However when you have exhausted your allocated Medicare sessions, we can switch to using private health insurance (if you have cover for that allied health discipline) so that you still only need to pay the remaining gap after the private health insurance rebate has been paid.
The costs of each service depends on which type of allied health practitioner you need to see, the type of service you require, and whether you have any government concessions. To find the exact costs and gaps involved with our services, please contact us to find out more.