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GP Chronic Condition Management Plan (GPCCMP) Information

The GP Chronic Condition Management (GPCCM) Plan, previously referred to as the Enhanced Primary Care (EPC) Program, is a government initiative in Australia designed to support patients with chronic medical conditions by providing subsidised access to allied health services, such as chiropractic care.

Below is a concise summary and guidance on how to effectively use this referral system:

What is the Medicare CCM/EPC Plan?

  • Purpose: Assists patients with chronic conditions (lasting 6 months or more) by facilitating referrals from General Practitioners (GPs) to allied health professionals, such as chiropractors, physiotherapists, or dietitians.
  • Subsidies: Medicare covers part of or all of the cost for up to 5 allied health visits per calendar year, reducing out-of-pocket expenses.
  • Eligibility: Patients with chronic conditions (e.g., arthritis, diabetes, or musculoskeletal issues) qualify if their GP determines allied health services are necessary for their care.

How It Works

  1. GP Referral: Your GP assesses your condition and, if appropriate, creates a GPCCM/EPC plan, including a referral to an allied health professional.
  2. Accessing Services: Take the referral to your chosen provider (e.g., Park Holme Chiropractic) after confirming they accept these referrals.
  3. Limit: Up to 5 subsidised or bulk billed visits per calendar year, tailored to your condition and needs. These referrals are valid for 18 months

Benefits

  • Affordable Care: Medicare subsidies reduce financial barriers, making ongoing treatment more accessible.
  • Structured Management: The plan ensures coordinated care between your GP and allied health professionals to effectively manage chronic conditions.
  • Improved Outcomes: Regular access to allied health services can help alleviate symptoms, improve mobility, and enhance quality of life.

Tips for Effective Use

You can choose to direct all 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 Chiropractor, alternatively, you could decide to have 2 sessions towards your Chiropractor and the remaining 3 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 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.

Please note: Medicare claim approvals and payments typically take 24-48 hours. Patients are responsible for payment of account if a claim is rejected, eg. number of sessions exceeded.

  • Discuss with Your GP: Ask your GP if you qualify for a GPCCM/EPC plan and which allied health services would benefit your condition.
  • Choose a Participating Provider: Confirm that your allied health professional (e.g., Park Holme Chiropractic) accepts EPC referrals and offers bulk billing to minimise costs.
  • Track Visits: Monitor your 5-visit limit per year to plan treatments effectively.
  • Stay Engaged: Follow the treatment plan outlined by your GP and allied health professional for optimal results.

If you have further questions about the GPCCMP/EPC program talk to our reception staff or your regular practitioner