Chronic Disease Management Plan is available to eligible patients under the Medicare Benefits Scheme. Patients will be given a referral from their GP to visit a podiatrist.
In other words, Government assistance is available.
Chronic Disease Management (CDM) is a government initiative that enables General Practitioners (GPs), allied health providers and a multidisciplinary team to plan and coordinate health care needs of patients with chronic disease or terminal medical conditions.
While there are no list of eligible conditions, a chronic medical condition is one that has been (or is likely to be) present for six months or longer.
For patients with complex care needs, a multidisciplinary team consists of various different health professionals including:
- medical practitioners
- home and community service providers
- allied health professionals
- care organisers
There are 5 different Chronic Disease Management plans and each will be covered in detail further on.
Your GP and allied health providers conduct relevant plans to the service they provide.
Think of the plans by their item numbers.
- Item 721 – General Practice Management Plan (GPMP)
- Item 723 – Team Care Arrangements (TCA)
- Item 729 – GP Contribution to or Contribution to a Review of a Multidisciplinary Care Plan for a Patient who is not a Resident of a Residential Aged Care Facility
- Item 731 – Contribution to or Contribution to a Review of a Multidisciplinary Care Plan for a Patient who is a Resident of a Residential Aged Care Facility
- Item 732 – Review of a GP Management Plan (GPMP) and/or Review of Team Care Arrangements (TCAs)
Let’s say that you have a chronic or terminal medical condition and have complex care needs that require care from a multidisciplinary team, then your GP will need to provide two plans – Item 721 and 723.
On the other hand, let’s say that you have a chronic or terminal medical condition (without a need of a multidisciplinary team), then your GP will only need to provide one plan – Item 721.
As with any Medicare rebate, the process must begin with an appointment with your GP.
Eligible patients will receive a Referral Form for Individual Allied Health Service under Medicare for patients with a chronic medical condition and complex care needs. Each patient is entitled to a maximum rebate of five individual allied health services. If your GP nominates multiple allied health providers, then the five will be divided. Like most government rebates, they have an expiration date. Rebates must be used within each calendar year. A calendar year is defined as the period of time between January 1 and December 31.
If you are like most people then you are probably wondering at this point if there is an out-of-pocket expense associated with visiting a podiatrist. That’s a good question because it will depend on the podiatrist’s fees. A podiatrist can choose to either bulk bill so that there’s no cost or charge an out-of-pocket amount. Good news is that in 2016-17, almost 8 in 10 Medicare services were bulk billed.
Below is an outline of each plan and its purpose.
You can always refer to The Department of Health for more information. A link provided on the bottom of this blog.
Item 721: General Practice Management Plan (GPMP)
Eligible patients will receive a comprehensive plan written by their GP.
What is included in the plan?
- patient’s condition
- healthcare needs
- management goals (agreed by the patient)
- action to be taken by the patient
- documenting the treatments
- review dates
Item 723: Team Care Arrangements (TCA)
For patients that require ongoing care from a number of a multidisciplinary team.
Your GP will collaborate with other participating providers on the treatment/services required.
What is involved in the plan?
Documenting the arrangements of each health service provider and a review date.
Relevant copies will be provided to the collaborating allied health providers.
Item 729: GP Contribution to or Contribution to a Review of a Multidisciplinary Care Plan for a Patient who is not a Resident of a Residential Aged Care Facility
Patients with a chronic or terminal medical condition and complex care needs can have a health care provider other than their usual GP to review their care plan under this item.
As the title states, this is not available to patients of residential aged care facilities.
What is involved in this plan?
Your GP collaborating with other allied health providers preparing or reviewing the plan and including their contribution in the patient’s records.
Item 731: Contribution to or Contribution to a Review of a Multidisciplinary Care Plan for a Patient who is a Resident of a Residential Aged Care Facility
This is good to know if you have an elderly family member and are considering care at an aged care facility.
This item was introduced to cover the resident’s behavioural or lifestyle needs. This is in addition to a care plan prepared for the resident by the aged care facility.
Item 732: Review of a GP Management Plan (GPMP) and/or Review of Team Care Arrangements (TCA)
GPs use this item to review patients who have a current GP Management Plan and Team Care Arrangement plan and require a review of one or both.
What is involved in the review?
Documenting any changes and setting the next review date.
All in all, looking after your health is one thing. Expenses associated with treatment is another. Visit your GP to assess your eligibility for this rebate.
For a comprehensive look into Chronic Disease Management, refer to The Department of Health Question and Answers on the topic at http://www.health.gov.au/internet/main/publishing.nsf/Content/mbsprimarycare-chronicdiseasemanagement-qanda#or
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Please note: All care into researching and writing of this blog has been checked both verbally and in a written statement provided by the relevant department as of 21 September 2018.
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