Transcription of Enhanced Primary Care (EPC) Program Referral …
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Enhanced Primary Care (EPC) Program Referral …
EPCAHS 0106 Enhanced Primary care (EPC) ProgramReferral form for Allied health Services under MedicareMedicare rebates and Private health Insurance benefits cannot both be claimed for these should be advised that they must choose whether to access one or the patients may access Medicare rebates for up to 5 allied health services (total) in a calendar year. Please indicate the numberof services required by writing the number in the No. of services column next to the relevant NumberPatient s ref NameSurnameAddressNameAddressDate signedPatient detailsPostcodeAllied health Professional (AHP) patient referred to: (Please specify name or type of AHP)PostcodeReferral details Please use a separate copy of the Referral form for each type of serviceNo ofservicesItemNumberAHP TypeAboriginal health Worker 10950No ofservicesItemNumberAHP TypeDietitian10954No ofservicesItemNumberAHP TypeAudiologist10952 Podiatrist10962 Chiropractor10964 Psychologist10968 Chiropodist1096
EPCAHS 0106 Enhanced Primary Care (EPC) Program Referral form for Allied Health Services under Medicare Medicare rebates and Private Health Insurance benefits cannot both be claimed for these services.
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