What Is An EPC And How Can They Help?

At Cooee Speech Pathology we are able to provide our families with options in regards to their funding with systems available within the clinic to process Medicare, private health and NDIS self, plan and agency managed participants.  

What is an EPC?

An EPC is an Enhanced Primary Care Plan or can also be known as a CDM, Chronic Disease Management Plan.  This plan does not require your child to have a diagnosis and can be set up by your GP to access refunds from Medicare.  Your doctor will determine if your child is eligible and if so, will allocate up to 5 sessions towards speech pathology and/or occupational therapy services per calendar year.  Eligibility for this plan is based upon whether your child has a complex, or chronic condition, requiring ongoing care by a multidisciplinary team.  Typically your GP will go through these refunds with you if they deem your child is eligible.

What sessions can I use an EPC for?

EPC’s can be used for speech pathology and/or occupational therapy assessments or sessions, depending on what sessions your GP has allocated.  EPC’s can also be used for telehealth sessions if required.

Does an EPC cover the full fee for therapy?

An EPC or CDM will entitle you to a refund from Medicare of $54.60 per session from the total fee and does not cover the full amount for a session.  All sessions must be paid for in full prior to processing the plan and we do not bulk bill.  The refund for an EPC or CDM is the same for an assessment or a regular therapy session.  

How is an EPC processed?

After attending a session at Cooee, parents pay the regular treatment fee, and then if a plan is in place, we can claim the refund for you on the spot, based on the paperwork provided.  Once full payment has been made we will process your Medicare card, the GP provider details from the plan and we will then insert or swipe your cheque or savings card to refund the $54.60.

We are happy to accept Medicare referrals for families here at Cooee. For us to be able to use any referral for your child, it needs to have either ‘Cooee Speech Pathology’, or your specific therapist’s name written in the Allied Health Professional field.

Want more information?

Check out our Funding and Rebates page by clicking here!

We are also a registered NDIS provider and for more information you can contact us here.

Please do not hesitate to contact a member of our friendly client care team at reception with any questions, as it can get fairly confusing!  You can contact us via email at [email protected] or call us on (07) 3265 4495.  We would be happy to help!  

Giulia Hayward

Practice Manager