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Chronic Disease Management and Medicare

Paul Edwards

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[During today’s phone-in meeting, mention was made about Chronic Disease Management and GP Management Plans. If you’re don’t know about these already, here’s some information.]


Prostate Cancer is a chronic medical condition.


Advanced Prostate Cancer Patients may be able to claim Medicare rebates for a maximum of five allied health services per patient each calendar year from eligible providers.


To be able to claim the Chronic Disease Management items under Medicare, you must have a GP Management Plan and Team Care Arrangements in place.


A GP Management Plan is prepared by your GP to provide a structured approach to your care.  It is a comprehensive written plan which describes:

  • your health care needs, health problems and relevant conditions;
  • management goals with which you agree;
  • actions to be taken by you;
  • treatment and services you are likely to need;
  • arrangements for providing this treatment and these services; and
  • arrangements to review the plan by a date specified in the plan.


Team Care Arrangements are prepared by your GP and are for patients who have a chronic or terminal medical condition and complex needs requiring ongoing care from a multidisciplinary team.


Once you have a GP Management Plan and Team Care Arrangements in place, you can be referred for up to five allied health services each calendar year.


The five services can be provided by a single allied health provider or shared across different providers. You can request that your GP refer you to an allied health provider you already know, or your GP can recommend one.


Allied health providers need to meet specific eligibility criteria and be registered with Medicare Australia.

Eligible Allied Health Providers

  • Aboriginal Health Workers
  • Aboriginal and Torres Strait Islander Health Practitioners
  • Audiologists
  • Chiropractors
  • Diabetes Educators
  • Dietitians
  • Exercise Physiologists
  • Mental Health Workers*
  • Occupational Therapists
  • Osteopaths
  • Physiotherapists
  • Podiatrists
  • Psychologists
  • Speech Pathologists

*includes Aboriginal and Torres Strait Islander Health Practitioners, Aboriginal Health Workers, occupational therapists, mental health nurses, psychologists and some social workers.


As with all health services, if a provider accepts the Medicare benefit as full payment for the service, there will be no out-of-pocket cost.  If not, you will have to pay the difference between the fee charged and the Medicare rebate.


This information is based on the information provided at http://www.health.gov.au/internet/main/publishing.nsf/Content/health-medicare-allied-health-brochure.htm

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