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Close-up of Australian Medicare card for podiatry rebate claims

Medicare Rebates for Podiatry – Brunswick

Accessing Medicare rebates for podiatry care with an EPC referral

Did you know that eligible patients may be able to claim a Medicare rebate for podiatry services under the Chronic Disease Management (CDM) plan? This plan was formerly known as the Enhanced Primary Care (EPC) program.

If you have a chronic or ongoing condition that requires podiatry support, your GP can prepare a CDM plan, which may include referrals for up to five allied health visits per calendar year, including podiatry. These visits can be shared between different services (e.g., podiatry, physiotherapy, or dietetics), so it’s important to discuss your priorities with your GP.

Medicare FAQs for Podiatry

Yes — but only under specific conditions.

Medicare does not routinely cover podiatry unless you have a chronic medical condition and your GP has placed you on a Chronic Disease Management (CDM) plan (previously called an EPC or Enhanced Primary Care plan).

This program is designed for people who require coordinated care from multiple allied health professionals. If you’re eligible, you may access up to five allied health visits per calendar year, and podiatry can be included.

As of 2025, each eligible visit attracts a Medicare rebate of approximately $58.30.

How do I know if I’m eligible?

To qualify for Medicare-subsidised podiatry, you must:

  • Have a chronic condition that has lasted (or is expected to last) more than six months

  • Be referred by your GP under a CDM care plan

  • Ensure your GP completes and submits the correct paperwork (item numbers 721 and 723)

  • Be referred specifically to a podiatrist for treatment

What should I expect at the appointment?

  • You’ll pay the full fee at the time of your visit

  • The clinic will submit your Medicare claim electronically

  • Your rebate is generally processed and paid into your bank account within 1–2 working days

Key points to remember:

  • You must have a valid care plan in place before your first visit — rebates cannot be claimed retrospectively

  • You cannot use both Medicare and private health insurance for the same consultation

  • It’s a good idea to confirm with your GP that all referral documentation has been completed and sent through before booking your appointment

Yes — you have the freedom to choose.

If you’ve been referred under a Chronic Disease Management (CDM) plan, you can choose which qualified and registered podiatrist you wish to see, as long as your GP includes “podiatry” as the referred service.

While your GP might recommend a particular practitioner — perhaps someone they regularly refer to — you are under no obligation to attend that clinic. You are entitled to take your referral to any podiatrist of your choosing.

If you’d prefer to see a specific podiatrist, you can ask your GP to either:

  • List your chosen practitioner directly on the referral form
    OR

  • Keep the referral provider-neutral, by stating only the service (e.g. “podiatry”), which allows you to decide later

Medicare rebates for podiatry are only available under specific criteria through the Chronic Disease Management (CDM) plan, previously known as the Enhanced Primary Care (EPC) program.

You may be eligible if:

  • You have a chronic medical condition that has persisted, or is likely to persist, for six months or longer

  • Your condition requires ongoing care from multiple health professionals — for example, both a GP and a podiatrist

  • Your GP considers podiatry an important part of your overall treatment plan

Eligibility is assessed by your GP during a regular consultation. If you qualify, they will prepare a care plan and submit the required paperwork to Medicare (commonly item numbers 721 and 723) before referring you to a podiatrist.

Examples of chronic conditions that may be eligible:

  • Diabetes-related foot complications

  • Arthritis affecting the feet or lower limbs

  • Ongoing heel, ankle, or arch pain

  • Long-term plantar fasciitis

  • Circulatory problems affecting foot health

  • Structural or biomechanical issues requiring allied health support

To access Medicare rebates for podiatry, you’ll need to be placed on a Chronic Disease Management (CDM) plan (previously known as an EPC plan). This process is coordinated through your GP, who will determine whether you meet the eligibility criteria.

Steps to Get Started

1. Book an appointment with your GP
Let your GP know you’d like to discuss whether you’re eligible for a CDM care plan that includes podiatry.

2. Your GP will assess your condition
To qualify, your condition must be chronic — meaning it has lasted, or is expected to last, for six months or more. Additionally, it should require the involvement of at least two health professionals, such as your GP and a podiatrist.

3. Your GP will complete the necessary forms
If you’re eligible, your GP will prepare and lodge the correct Medicare paperwork:

  • Item 721 – GP Management Plan
  • Item 723 – Team Care Arrangement

Make sure your GP specifically includes podiatry as one of the referred services.

4. Ask for a copy of your referral
Although some GPs send the referral directly to the podiatrist, it’s a good idea to keep a copy for yourself, as you may need to present it when booking your appointment.

How long does it take?

Once submitted, the referral may take up to 1-2 weeks to be fully processed through Medicare. You cannot claim any rebates for appointments that occur before your plan is active, so it’s best to wait until confirmation is received.

Tip: If podiatry is your main area of concern, ask your GP whether the full five Medicare-funded visits can be allocated to podiatry care within the calendar year — provided it fits your treatment needs.

The referral is valid for the calendar year in which it was issued, and until all referred visits have been used. If you don’t use all five visits, they do not roll over into the next year.

If you’re eligible under the Chronic Disease Management (CDM) plan (formerly known as EPC), Medicare offers a rebate of approximately $61.80 per approved visit to a podiatrist. This amount is based on the 2025 Medicare Benefits Schedule and may vary in future.

You can receive up to five subsidised allied health visits each calendar year — this total is shared across all referred services, such as podiatry, physiotherapy, or chiropractic, depending on what’s listed in your care plan by your GP.

Do I have to pay anything out of pocket?
Yes. Most podiatrists charge above the Medicare rebate amount, which means you’ll be required to pay the full consultation fee on the day. The clinic will usually process your Medicare claim electronically, and your rebate will be transferred to your bank account within 1–2 business days.

The gap amount — your out-of-pocket expense — will depend on the difference between the clinic’s fee and the rebate.

Example:

  • Standard consultation fee: $98

  • Medicare rebate: $61.80

  • Gap you pay: $36.20

Please note: Rebate amounts are determined by Medicare and are subject to change.

No, Medicare does not allow you to claim both an EPC Medicare rebate and private health insurance for the same consultation. You’ll need to choose one or the other for each appointment.

If you’re using your EPC plan (Medicare’s Chronic Disease Management Program), you’ll receive a Medicare rebate for each eligible visit, and you cannot use your private health cover for those same sessions.

What Happens When I’ve Used All Five EPC Visits?

Once you’ve used your five Medicare-subsidised visits for the calendar year, you can return to using your private health insurance if your policy includes coverage for podiatry. Any additional sessions beyond your EPC allowance will be privately billed, and you may be able to claim a rebate through your health fund depending on your level of cover.

What’s the Difference Between EPC and CDM?

EPC and CDM are often used interchangeably, but they refer to the same Medicare program.

CDM stands for Chronic Disease Management, which is the current name for the Medicare system that provides rebates for certain allied health services, including podiatry. EPC, or Enhanced Primary Care, is simply the older term that many patients and practitioners still use out of habit.

Under this program, your GP can refer you for up to five Medicare-subsidised podiatry visits per calendar year as part of a care plan for a chronic condition.

In short:

  • CDM is the correct, current term

  • EPC is the older name still commonly used

  • Both refer to the same Medicare referral process for accessing subsidised podiatry care

A chronic condition is any health issue that has lasted—or is expected to last—six months or more. This includes physical, mental, or functional problems that impact your day-to-day life.

Examples include:

  • Diabetes

  • Arthritis

  • Ongoing foot pain

  • Peripheral neuropathy

  • Circulatory problems

  • Heel spurs or plantar fasciitis

Complex care needs mean you require support from more than one healthcare provider. For instance, if your GP is managing your diabetes and you also need foot care from a podiatrist, this would be considered complex care.

Why this matters:
If your condition is both chronic and involves multiple healthcare providers, your GP may create a care plan that gives you access to Medicare rebates for up to five podiatry or other allied health visits per calendar year.

If your condition changes significantly, or if you need to see a different type of allied health professional, your GP may need to update your care plan or provide a new referral. Always check in with your GP if you’re unsure, especially before booking an appointment under the Medicare program.

Yes, you can split your EPC visits between different allied health services. For example, your GP may allocate three sessions for podiatry and two for physiotherapy, depending on your care needs. To do this, your GP must include each provider on your referral. Be sure to discuss your treatment goals during your care plan appointment to ensure the right services are included.

Yes. You can be referred to more than one type of practitioner, but the total number of visits still cannot exceed five in the calendar year.

Once your GP has prepared and submitted your EPC referral, you can book an appointment with one of our podiatrists.

On the day of your appointment, you’ll be asked to pay the full consultation fee. After your visit, we’ll process your Medicare rebate electronically through Medicare Online. The rebate—currently $61.80 per visit—will be paid directly into your bank account, usually within one to two business days.

To make sure your rebate goes smoothly, please bring the following:

  • A valid EPC referral from your GP listing podiatry as the referred service

  • Your Medicare card

If you’re not sure how many visits you have left or whether your referral is active, it’s a good idea to check with your GP or Medicare before your appointment.

Yes, you can book an appointment with a podiatrist at any time without a referral. Podiatrists are primary healthcare providers, so there’s no need to see a GP first unless you intend to claim a Medicare rebate under a Chronic Disease Management (CDM) or EPC plan.

If you’re paying privately or using your private health insurance, you do not need a referral.

A GP referral is only required if you’re seeking to claim part of the consultation cost through Medicare. Your GP will need to assess your eligibility and prepare the appropriate care plan paperwork.

If you’re unsure whether Medicare or private health is the best option for your situation, your treating podiatrist can help guide you at your next visit.

If you need podiatry treatment before seeing your GP and being placed on a CDM (EPC) plan, you are still welcome to book and attend an appointment. However, Medicare will not reimburse any consultations that occur before your EPC referral has been completed and lodged by your GP.

This means you will need to pay privately for any visits that take place prior to the referral date. If you have private health insurance that includes podiatry cover, you may be able to claim a rebate through your health fund for those earlier appointments.

Once your EPC referral is active, Medicare rebates will only apply to consultations dated on or after the referral was issued.

If Medicare does not issue your rebate, it is usually due to one of the following reasons:

  • Your GP did not lodge the EPC paperwork correctly

  • The referral did not include podiatry as a referred service

  • You have already used your five Medicare-subsidised visits for the current calendar year

  • The visit occurred before the referral was submitted

As Medicare processes the rebates, any issues are considered a matter between you, your GP, and Medicare. Due to privacy regulations, the clinic is not able to access or resolve rebate issues on your behalf.

What should you do next?
Contact Medicare on 132 150 to clarify why your claim was declined. Once you have that information, speak with your GP to see if the issue can be rectified or if you’re eligible for further entitlements.

Please note: if Medicare does not cover the visit, the full consultation fee remains payable.

No, Medicare limits you to five allied health visits per calendar year under the EPC program. These five visits are shared across all referred services such as podiatry, physiotherapy, or chiropractic, not allocated per provider.

Once you’ve used all five for the year, you won’t be eligible for additional Medicare rebates until 1 January, when your entitlement resets for the new calendar year.

If you still need ongoing care, you can continue as a private patient and pay the full consultation fee. If your private health insurance includes podiatry, you may be able to claim a rebate to help reduce the cost.

Planning to return to Medicare-subsidised care next year? Be sure your GP provides a new EPC referral listing podiatry and allocating the appropriate number of visits.

If you’re unsure how many of your Medicare-subsidised EPC visits you’ve used this year, the easiest way to check is by calling Medicare on 132 150. Have your Medicare card handy and ask how many CDM or EPC allied health visits you’ve already claimed in the current calendar year.

If you’ve seen other providers like a physiotherapist, dietitian, chiropractor or another podiatrist, those appointments may have used some of your five allocated visits. Your GP can also check your care plan and referral history if you need further clarification.

You’re not automatically entitled to five EPC visits. While Medicare allows up to five subsidised allied health appointments per calendar year, it’s up to your GP to decide how many visits to allocate and which services they cover.

Your GP will consider your condition and care needs, and may split the visits between different services—for example, three podiatry visits and two physiotherapy visits. In some cases, fewer than five visits may be approved.

Tip: If you feel you would benefit from all five visits for podiatry care, discuss this with your GP and ask that they be allocated accordingly on your referral.

No, the EPC (Enhanced Primary Care) program does not cover the cost of X-rays.

If your podiatrist believes imaging is necessary to investigate your condition (such as assessing a stress fracture or joint issue), they may refer you to a radiology clinic that offers bulk billing. In most cases, this means there will be no out-of-pocket cost for eligible Medicare cardholders.

Keep in mind that bulk billing usually applies to standard foot or leg X-rays. More advanced scans like MRIs or CTs may incur a fee depending on the provider and referral source.

Final Thoughts

Navigating Medicare and EPC referrals can seem overwhelming at first, but understanding how it works can make a real difference in accessing affordable podiatry care.

If you have a chronic condition and believe podiatry could support your mobility, comfort, or overall health, speak with your GP about setting up an EPC plan. Once approved, you can use your Medicare-subsidised visits with the podiatrist of your choice. If you’re not sure where to begin, explore our EPC FAQs to guide you through the process.

Most importantly, remember: you are in charge of your healthcare. Don’t hesitate to ask questions, clarify your entitlements, and make informed decisions that keep your feet — and your future — in good shape.