Medicare CDM

Medicare Rebates & GP Care Plans

We are one of Melbourne's Leading Accredited Exercise Physiologists Gyms & Physiotherapy Clinical Pilates Clinics.

Our patients and members often asks about our exercise physiology gym in Melbourne and if they can claim rebates on their appointments. 

We aim to provide all the information you need to know about Medicare CDM Referrals and how we help support our patients with chronic disease (or terminal) medical condition and complex care needs.

We also have Type 2 Diabetes Classes and can be referred to the program by your doctor to receive a Medicare subsidy for group exercise - Learn more here about Medicare Diabetes Group Exercise Classes

medicare exercise and cdm

Medicare Rebate for Exercise Physiology

Medicare rebates are available for people with a chronic disease (such as arthritis, cancer, osteoporosis) if they are referred by a GP. You can receive a maximum of 5 sessions under Medicare in a calendar year. You will still be out of pocket for these sessions.

You must obtain a referral from your GP. The GP will use the form below.


Exercise Physiology at MVFit is supported and covered under a number of Medicare-funded programs. For sessions to be covered under the Medicare system, you will need a referral to from your GP.

Your GP will determine your eligibility for the program based on your clinical background and will complete the relevant referral form.

To assist you in understanding which Medicare programs cover Exercise Physiology we have listed below – along with a summary of the eligibility criteria.

What is a Medicare CDM Plan Rebate?

It provides you with a Medicare rebate for a maximum of five allied health services per patient each calendar year from eligible providers. Additional services are not possible in any circumstances.


This is a Medicare program where eligible participants (see below for details) are able to get a rebate for up to 5 sessions in a calendar year.

From November 1, 2023 the Medicare rebate for CDM plans is a $58.30 rebate for a maximum of 5 appointments per patient each calendar year.

Who Qualifies for CDM / EPC (Enhanced Primary Care) Plans?

If you have a chronic (or terminal) medical condition that is being managed by your GP under both of these Medicare Chronic Disease Management (CDM) items: a GPMP and TCAs. 


Chronic medical conditions are those that have been, or are likely to be, present for at least 6 months. This includes:

  • Asthma
  • Cancer
  • Cardiovascular disease
  • Diabetes
  • Kidney disease
  • Musculoskeletal conditions
  • Stroke.

GP Management plan (GPMP)

This is prepared by your 'usual medical practitioner' or someone at the same GP practice will provide the GPMP and Team Care Arrangements (TCAs).

Medicare classify your 'usual medical practitoner' as the GP who has provided the majority of services to you in the past 12 months and / or will provide the majority of services in the following 12 months.

When accessing a GPMP you should:

First talk to your GP and if they think you are suitable they will develop the care plan for you. The plan will describe the following:

  • Your healthcare needs, health problems and the relevant conditions
  • management goals and actions they would like you the patient to take
  • the treatments and services that you will need
  • the arrangements for providing the treatment and services and when the plan will be reviewed

GPMP’s are available for patients with a chronic or terminal medical condition who’ll benefit from a structured approach to the management of their care needs.


// Exercise Physiology and GPMPs at MVFit

If your GP believes that structured exercise and having 1 on 1 appointments with an exercise physiologist is suitable for you and your conditions at our gym they will complete the plan and include the details for our exercise physiology clinic.


Moonee Valley Health and Fitness - Exercise Physiology Gym and Clinic

Address: 378 Mt. Alexander Rd, Travancore VIC 3032

Email: info@mvfit.com.au

Phone: (03)9996-0790

Fax: (03)8692-6715

How do I get a Medicare Referral?

Speak to your GP or call our team and discuss whether a GP Care Plan is suitable for you.

How Much is the Medicare Rebate for a EPC / CDM Care Plan in 2023?

From November 1, 2023 the Medicare rebate for CDM plans is a $58.30 rebate for a maximum of 5 appointments per patient each calendar year.

Can I get Medicare Rebates for Exercise Physiology?

Yes.


To qualify for a Medicare rebate, you must have a chronic condition or injury.


A chronic medical condition is one that has been (or is likely to be) present for six months or longer, for example, asthma, cancer, cardiovascular disease, diabetes, musculoskeletal conditions, depression, stroke and many others. As exercise specialists we help people with these types of conditions every day.


We would love to help explain the Medicare rebate process so you can see how it can work for your Exercise Physiology needs.

Can I get Medicare Rebates for Exercise Physiology?

Yes.


To qualify for a Medicare rebate, you must have a chronic condition or injury.


A chronic medical condition is one that has been (or is likely to be) present for six months or longer, for example, asthma, cancer, cardiovascular disease, diabetes, musculoskeletal conditions, depression, stroke and many others. As exercise specialists we help people with these types of conditions every day.


We would love to help explain the Medicare rebate process so you can see how it can work for your Exercise Physiology needs.

Chronic Disease and Exercise - 'Exercise Is Medicine'

Chronic Disease and Exercise

A ‘chronic’ disease is defined as one that has been or is likely to be present for 6 months or longer. Seventy percent of general practice visits are related to chronic disease. These include a range of commonly preventable health conditions.

Our team of exercise physiologists can help with:
  • Diabetes and Pre-Diabetes
  • Obesity/Overweight
  • Arthritis
  • Heart Disease
  • Hypertension
  • Osteoporosis
  • Depression
  • Anxiety
  • Hypercholesterolaemia / Dyslipidaemia
  • Asthma
  • Chronic Obstructive Pulmonary Disease (COPD)
  • Low Back Pain
  • Poly-Cystic Ovarian Syndrome (PCOS)
  • Chronic Fatigue Syndrome
  • Cancer
  • Cardiovascular Disease
  • Musculoskeletal Injury
  • Chronic Fatigue
  • Back, Neck, Shoulder, Knee Pain
  • Occupational Injuries
  • Respiratory Disease and more…

Learn more about chronic conditions and the benefits exercise can have here

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Chronic Disease Management Program (CDM) formerly known as Enhanced Primary Care (EPC)

If you have a chronic medical condition you may get Medicare benefits for allied health services to help manage your condition.

Our Accredited Exercise Physiologists specialise in the delivery of exercise & lifestyle modification programs for people with chronic conditions. The Chronic Disease Management (CDM) program which was formerly known as (Enhanced Primary Care – EPC) is designed to provide specialised individual treatment services to patients who have a chronic medical condition and complex care needs.

The Enhanced Primary Care (EPC) program was originally introduced to provide more preventative care for Australians and improve the coordination of care for people with chronic conditions and complex care needs. The program provides a framework for a multidisciplinary approach to health care.

Speak to the MVFit Trainer Team Today