The CDM items include a service for ‘GP only’ care planning (the GP Management Plan) in addition to services for multidisciplinary care planning (Team Care Arrangements). Patients who have a chronic or terminal condition (without multidisciplinary care needs) can have a GP Management Plan service. Patients who also have complex care needs can have a GP Management Plan, and a Team Care Arrangements service. GPs can be assisted by practice nurses, aboriginal health workers and other health professionals in providing the new CDM items.
The Items
| Service |
Item |
Preparation of a GP Management Plan
- Provides a rebate for a GP to prepare a management plan for a patient with a chronic or terminal condition (including patients who have multiple chronic conditions and multidisciplinary care needs).
- Recommended frequency is once every two years, supported by regular review services.
- The Medicare fee is $124.95.
- The GP (who may be assisted by their practice nurse or other) assesses the patient, agrees management goals, identifies actions to be taken by the patient, identifies treatment and ongoing services to be provided, and documents these in the GP Management Plan
|
721 |
Review of a GP Management Plan
- Provides a rebate for a GP to review a GP Management Plan (see above).
- Practice nurse or other can assist.
- Recommended frequency is once every six months; can be earlier if clinically required.
- The Medicare fee is $62.50.
- Involves reviewing the patient’s GP Management Plan, documenting any changes and setting the next review date.
|
725 |
Coordination of Team Care Arrangements
- Provides a rebate for a GP to coordinate the preparation of Team Care Arrangements for a patient with a chronic or terminal medical condition who also requires ongoing care from a multidisciplinary team of at least three health or care providers.
- In most cases the patient will already have a GP Management Plan in place but this is not mandatory.
- Recommended frequency is once every two years, supported by regular review services.
- The Medicare fee is $98.95.
- Involves a GP (who may be assisted by their practice nurse or other) collaborating with the participating providers on required treatment/services and documenting this in the patient’s TCA.
|
723 |
Coordination of a Review of Team Care Arrangements
- For patients who have a current TCA and require a review of their TCA.
- Recommended frequency is once every six months; can be earlier if clinically required.
- The Medicare fee is $62.50.
- Involves the GP (who may be assisted by their practice nurse or other) collaborating with the participating providers on progress against treatment/services and documenting any changes to the patient’s TCA.
|
727 |
Contribution to a multidisciplinary care plan being prepared by another health or care provider
- For patients who are having a multidisciplinary care plan prepared or reviewed by another health or care provider (other than their usual GP).
- Recommended frequency is once every six months; can be earlier if clinically required.
- The Medicare fee is $43.40.
- Involves the GP (who may be assisted by their practice nurse or other) collaborating with the providers preparing or reviewing the plan and including their contribution with the patient’s records
|
729 |
Contribution to a multidisciplinary care plan being prepared by another health or care provider for a resident of an aged care facility
- This is for patients in residential aged care facilities and is otherwise identical to Item 729 (immediately above).
|
731 |
Access to allied health and dental care items
Patients who have both a GP Management Plan and a Team Care Arrangements service (which, together, are broadly equivalent to the former EPC multidisciplinary care plan) have access to the allied health and dental care items on the Medicare Benefits Schedule, as do patients who previously had an EPC care plan (Item 720 or 722).
Similarly, residents of aged care homes whose GP has contributed to a care plan prepared by the aged care home (item 730 or new item 731) will continue to have access to the allied health and dental care items. Eligible patients can claim a maximum of 5 allied health and three dental care services per 12 month period.
Patients need to be referred by their GP for services recommended in their care plan on an EPC Program referral form for allied health services under Medicare. Where the GP is referring a patient to more than one allied health professional, s/he will need to use a separate form for each referral.
