ALLIED HEALTH MEDICARE REFERRALS (AHMR)
There are always conflicting ideas on AHMRs and we hope that we can make at least some of these a little clearer for you.
The current Allied Health Medicare Referral (AHMR), formerly called an EPC, can only be issued to you by your GP.
The AHMR is for patients with a chronic medical condition such as Diabetes (all Diabetics are eligible for this referral) or those who have complex care needs.
A maximum of five rebates of $53.80 from Medicare can be given in a calendar year.
Your GP can issue anywhere from one to five visits on your AHMR. These visits do not expire. We prefer that they are used within a three year period, but essentially they will be valid until all visits showing on the AHMR have been used.
Your GP will need to do a Team Care Arrangement (TCA) and possibly a GP Management Plan (GPMP) which will take some time to complete so please allow extra time for this to occur.
A minimum of three practitioners are required to be listed on the TCA. These would include your GP and any allied health professionals you need to see such as a podiatrist, Diabetes educator, dietitian, physiotherapist, exercise physiologist, osteopath, etc. The five visits can be spread across five different allied health services or given to just one or two services - whatever your GP deems necessary for you to continue maintaining your health.
Specialists can be listed on the TCA as one of the three or more medical practitioners, but specialists do not require an AHMR. The AHMR is for Allied Health professionals only.
Practitioners based in hospitals can be listed on the TCA but do not require to be listed on the AHMR as one of the five visits as they are covered by government funding.
An AHMR can be issued at any time during the duration of the TCA. Your GP will not need to do another TCA or GPMP when you require another AHMR if the TCA is still valid. For example - if your TCA is valid for 12 months and you are given two visits on your AHMR to your podiatrist and you use both of them within six months, you could then see if you are able to obtain another two or three visits on a new AHMR without your GP having to do another TCA.
Your GP needs to sign, date and note the number of visits allocated to an allied health service.
If your GP decides that you require two or more services from the same practice, the name of the practice can go in the section for Name (middle of the sheet) and no address needs to be included.
If you only require podiatry and not a specific practitioner, then only "Podiatry" would be required in the Name section and again, the address section can be blank. This is very beneficial if you travel and want to see practitioners in more than one practice or city but also if your preferred practice has more than one practitioner. That way, any of the podiatrists at that practice could see you - especially beneficial if you have an emergency and your preferred practitioner is away and a locum is in place or if your preferred practitioner is booked out and you are unable to wait. This way you will still receive your rebate and don't have to wait for an appointment.
Most allied health practices are private practices but there are also bulk bill practices. If your preferred provider bulk bills, you will not be out of pocket at all and your provider will either charge you the $53.80 and you will get a rebate of $53.80 or they will charge Medicare direct. If your preferred provided is a private practice, you will be charged the consult fee and then you can claim back the rebate of $53.80. Medicare usually deposits the rebates back into your account within a day or two.