Chronic Disease Management Care Plan

What is it?

The Chronic Disease Management Care Plan is for patients who have a chronic condition and complex care needs.

What are the eligibility requirements?

Only a GP is able to determine whether a patient's chronic condition would benefit from allied health services and the needs for such services must be identified in the patient's care plan.

A patient is considered to have complex care needs if they require care from a multidisciplinary team consisting of their GP and at least 2 other health or care providers each of whom provide a different kind of treatment or service to the patient. A chronic medical condition is one that has been or is likely to be present for at least 6 months.

Medicare benefits are available for up to 5 allied health services per eligible patient per calendar year. Exceptions are not possible.

How can I access these services?

Step 1:

Visit your GP who will assess whether you have a chronic condition and complex care needs.

Step 2:

Once your plan is in place your GP will refer you to an appropriate allied mental health care service whereby you can attend up to 5 individual sessions.

The 5 allied health services can be made up of 1 type of service (Eg: 5 Speech Therapy services or 5 Occupational Therapy services) or a combination of different types of service (eg: 1 Speech Therapy session and 4 Occupational Therapy services).

Each service must be at least 20 minutes in duration and be provided to an individual and not a group.

If all services are not used within the calendar year in which the plan was established the un-used services can be used in the next calendar year, however those services will be counted as part of the 5 rebates for allied health services available to the patient for that calendar year.