Medicare Chronic Disease Management

Chronic Disease Management 

Medicare Chronic Disease Management is the new name given to the Enhanced Primary Care Scheme in which patients who fit the referral criteria can receive up to five treatments from a range of allied health providers in one calendar year.

To be able to access the funding, we require a copy of the GPMP (Item 721) and TCA (Item 723) as well as the “Referral Form for Allied Health Services under Medicare”.

According to Medicare, we cannot accept a referral that is less than 365 days1 since the previous one, regardless of the amount of CDM appointments they may have available for that calendar year. Referrals for treatment work on a tme since last referral basis, not calendar year as the CDM entitlements do.

The information regarding this is not always easy to find, so we have provided some information here for easier access. The fact sheet below gives a quick overview for GP's of the referral criteria the patient must meet to be considered eligible for this funding.

Fact Sheet

References:

1. http://medicareaust.com/Accessible/MBS/CDMForGPs/WCAGModule2/index.html Claiming frequency for TCA's and TCA's review items Accessed 16/08/2016