Chronic Disease Management funding under Medicare

Chronic Disease Management funding under Medicare

The Cerebral Palsy Education Centre (CPEC) has the capacity to support children’s develop through the Medicare Chronic Disease Management (CDM) program.

CDM has previously been referred to as Enhanced Primary Care or EPC and access to CDM can be obtained through your GP.

CDM can gain you Medicare rebates on up to a total of 5 sessions with allied health professionals each calendar year, including physiotherapists, occupational therapists or speech pathologists.

Please contact CPEC prior to having your GP submit a CDM referral.

For CPEC to accept a CDM referral we require copies of the following:

  1. A completed “Referral form for Individual Allied Health Services under Medicare for patients with a chronic medical condition and complex care needs”
  2. The GP management Plan (Item 721 / 732) and Team Care Arrangements (Item 723 / 732)

It is important that CPEC sights all of these documents prior to accepting the CDM referral as the goals outlined in your child’s management plan specially identify the goals CPEC therapists must work towards under the CDM sessions.

By reviewing your child’s management plan CPEC therapists can ensure that the services they can provide match your child’s requirements.

If CPEC has any questions about the goals, they will contact you to discuss revising them with your GP.

If the goals in the management plan do not align with what CPEC is able to provide, CPEC will contact you to discuss this issue.

Due to the complex nature of the children CPEC supports, CPEC requests that the number of sessions assigned to CPEC through CDM is 3 or more.

If you are requesting less than 3 sessions please contact CPEC to discuss your individual circumstances prior to submitting the referral.

Please note that CPEC services delivered under the CDM do attract a gap amount.

Full payment for the session is required on the day and a receipt for the Medicare rebate will be provided.

Please contact CPEC for up to date pricing.

Further information on CDM can be accessed at:  http://www.health.gov.au/internet/main/publishing.nsf/Content/mbsprimarycare-chronicdiseasemanagement