Chronic Disease Management Plans (CDM)
CDM plans are a way to help people with chronic medical conditions manage their health. They are prepared by a General Practitioner (GP) and can include a GP Management Plan (GPMP) or Team Care Arrangements (TCAs).
GPMPs are recommended for people with chronic medical conditions, while TCAs are suitable for those with complex care needs and requiring treatment from multiple providers.
Eligibility for Medicare Rebates
Having both a GPMP and TCAs may qualify you for Medicare rebates on certain allied health services related to your chronic condition. However, eligibility for these services is determined by your GP.
What is a GPMP?
A GPMP is an organized approach to care that identifies your needs, outlines services from your GP, and suggests actions for managing your condition. Some chronic medical conditions that may qualify you for a GPMP include asthma, cancer, heart disease, diabetes, arthritis, and stroke.
What is a TCA?
A TCA is developed to coordinate care effectively between your GP and other healthcare providers. It is suitable for individuals with complex care needs.
How to Get a Medicare Rebate
If you have both a GPMP and TCAs, you may be eligible for Medicare rebates on specific allied health services such as exercise physiology, related to your condition. In the case of type 2 diabetes and a GPMP, you may also receive referrals for additional group-based exercise physiology services.
Your Medicare Gap
REPS Movement has a $15 gap on all Medicare services.
Summary
- A Medicare rebate is available for a maximum of five services per patient each calendar year.
- Patients must have a GP Management Plan and Team Care Arrangements prepared by their GP.
- Referrals to allied health providers must be from GPs.
About Chronic Medical Conditions
A chronic medical condition is one that has been (or is likely to be) present for six months or longer, for example, asthma, cancer, cardiovascular disease, diabetes, musculoskeletal conditions and stroke. There is no list of eligible conditions; however, the CDM items are designed for patients who require a structured approach, including those requiring ongoing care from a multidisciplinary team.
Whether a Patient is Eligible
Whether a patient is eligible for CDM services is a clinical judgement for the GP, taking into account the patient’s medical condition and care needs, as well as the general guidance set out in the MBS.
Referrals for Allied Health Services
If you have both a GPMP and TCAs prepared for you by your GP, you may be eligible for Medicare rebates for specific individual allied health services that your GP has identified as part of your care. These services must be directly related to your chronic medical condition.
Referral Form
You can find the referral form for Team Care Arrangements (TCAs) by clicking the button below.
Referral Form
You can also find the referral form for group allied health services for type 2 diabetes by clicking the button below.
Referral Form
Information Sheet
To find out more about Chronic Disease Management (CDM) plans, you can visit the Department of Health website here. This website provides information on what CDM plans are, who is eligible for them, and how to get one. You can also find links to other resources on the website.
