Program Officer

Tracey Roebuck 5229 1922

Quicklinks

• Allied Health Items
• Group Services for type 2 diabetes
• MBS Help Desk

Program Summary

Patients who have had or will have a chronic condition for at least 6 months are eligible for a GP Management Plan (GPMP). Patients who also have complex care needs are also eligible for a Team Care Arrangement (TCA). The GP may be assisted by the Practice Nurse or other health professional in the preparation of these item numbers.

The GPMP / TCA involves:

• An assessment of the patient
• Identification of management goals
• Identification of actions to be taken by the patient
• Identification of treatments and on-going services
• Documentation of all of the above

To develop a TCA there must be at least 2 other health or care providers who will provide different ongoing treatments or services.

One of the other team members may be a medical specialist.

The Practice Nurse may only be one of the team members if providing a different set of services to those provided by the GP. The nurse must have undertaken additional education and gained expertise in the services being provided.

Team Care Arrangement: Collaboration with the participating providers on required services/ treatments and documentation of this in the TCA. Communication between team members must be two way. A blanket agreement for all patients on TCA's with an allied health professional does not meet the requirements.

Chronic Disease Item Numbers

Updates/Latest Developments

On 1st January 2009, the requirement that a Medicare rebate for the prerequisite Chronic Disease Management (CDM) care planning items must be claimed before associated allied health services can be provided and claimed was removed. The Minister for Health and Ageing, the Hon Nicola Roxon MP, announced these changes on 9th December 2008 as part of an MBS review.

These new arrangements will overcome delays experienced by patients and allied health providers when they claim the Medicare rebate for an allied health service, where they have a valid referral. but where a claim for the CDM
item(s) has/have not been processed.

It is important to note, however, that the eligibility requirements for these allied health services have not changed. Patients must still have a chronic medical condition and complex care needs and be managed by their GP under a GP Management Plan (MBS item 721) and Team Care Arrangements (MBS item 723). Where the patient is a resident of an aged care facility, the GP must have provided MBS item 731 by contributing to a care plan developed by the facility.

Resources/Templates:

GP Mangement Plan/Team Care Arrangement Templates
GP Management Plan/Team Care Arrangement Flow Chart
GP Management Plan/Team Care Arrangement Patient Brochure
EPC Feedback Templates
Letter to AHP re patient ineligible for EPC
Letter to AHP re patient on GPMP/TCA with no EPC available

MBS Link

• MBS Search online

Links to Other Websites

• Enhanced Primary Care
• DHS