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REPS Movement: Your Medicare-Subsidised Exercise Physiology Care Plan Specialists

Medicare-subsidised exercise physiology services can provide a number of benefits for people with chronic health conditions or who are at risk for chronic health conditions. 

Chronic Disease Management Plans (CDM)

CDM plans are a way to help people with chronic medical conditions manage their health. They are prepared by a General Practitioner (GP) and can include a GP Management Plan (GPMP) or Team Care Arrangements (TCAs).

GPMPs are recommended for people with chronic medical conditions, while TCAs are suitable for those with complex care needs and requiring treatment from multiple providers.

Eligibility for Medicare Rebates

Having both a GPMP and TCAs may qualify you for Medicare rebates on certain allied health services related to your chronic condition. However, eligibility for these services is determined by your GP.

What is a GPMP?

A GPMP is an organized approach to care that identifies your needs, outlines services from your GP, and suggests actions for managing your condition. Some chronic medical conditions that may qualify you for a GPMP include asthma, cancer, heart disease, diabetes, arthritis, and stroke.

What is a TCA?

A TCA is developed to coordinate care effectively between your GP and other healthcare providers. It is suitable for individuals with complex care needs.

How to Get a Medicare Rebate

If you have both a GPMP and TCAs, you may be eligible for Medicare rebates on specific allied health services such as exercise physiology, related to your condition. In the case of type 2 diabetes and a GPMP, you may also receive referrals for additional group-based exercise physiology services.

Your Medicare Gap

REPS Movement has a $15 gap on all Medicare services.

Summary

  • A Medicare rebate is available for a maximum of five services per patient each calendar year.
  • Patients must have a GP Management Plan and Team Care Arrangements prepared by their GP.
  • Referrals to allied health providers must be from GPs.

 

Exercise Physiologist with client

About Chronic Medical Conditions

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 and stroke. 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.

Whether a Patient is Eligible

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 in the MBS.

Referrals for Allied Health Services

If you have both a GPMP and TCAs prepared for you by your GP, you may be eligible for Medicare rebates for specific individual allied health services that your GP has identified as part of your care. These services must be directly related to your chronic medical condition.

Referral Form

You can find the referral form for Team Care Arrangements (TCAs) by clicking the button below.

Referral Form

You can also find the referral form for group allied health services for type 2 diabetes by clicking the button below.

Referral Form
Information Sheet

To find out more about Chronic Disease Management (CDM) plans, you can visit the Department of Health website here. This website provides information on what CDM plans are, who is eligible for them, and how to get one. You can also find links to other resources on the website.

1. How has the doctor's care plan helped your exercise goals and overall health?

For the first half of this year, I was struggling with my health because of long Covid and the long-term effects of old injuries. The doctor’s care plan has allowed me to have expert exercise physiology advice and support for five sessions. This has helped me to gradually rebuild my fitness and resilience. 

2. Have you noticed specific fitness or health improvements with the care plan and exercise program reviews?

Because of long Covid I became quite deconditioned and had significantly reduced fitness, muscle strength and stamina. Old injures were also flaring up. The targeted exercise program has allowed me to gradually rebuild my muscle strength, improve my range of movement and increase my overall fitness. Having Murray explain the physiology principles and provide encouragement also helped my psychological wellbeing.

3. How do frequent reviews with the exercise physiologist keep you motivated and accountable?

Frequent reviews ensure that you are doing the exercises correctly, allow you to review your progress and increase your exercise load in a supervised way so that you continue to improve

4. Can you share any positive health outcomes from the combined care plan and exercise guidance?

Having a combined care plan and personalised exercise program gives you confidence and encourages you to keep working towards your health goals. While I still have a way to go, my strength, stamina and range of movement have all improved significantly and I am confident that I will continue to improve.