All information is current as at 1 November 2016.

Access to MBS Rebateable (Private) Allied Health Services through GP-led Care Plans

Access to MBS Rebateable (Private) Allied Health Services through GP-led Care Plans flowchart.

Chronic Disease Management - Individual Allied Health Services

Service type Clients with Chronic Disease Conditions and complex care needs
Client's who have complex care needs and require ongoing care from a multidisciplinary team consisting of their GP and at least two health or care providers.
Ensure patient / client eligibility Eligibility Criteria
Clients living in the community that have a chronic disease condition and their GP has produced a GPMP (MBS Item 721) and TCA (MBS Item 723).
Residents living in a residential aged care facility maybe eligible if the GP has contributed or reviewed a multidisciplinary care plan (MBS Item 731).
Item 10950 Aboriginal health worker or Aboriginal and Torres Strait Islander health practitioner service; Item 10951 Diabetes Education; Item 10952 Audiology; Item 10953 Exercise Physiology; Item 10954 Dietetics services; Item 10956 Mental Health Service; Item 10958 Occupational therapy; Item 10960 Physiotherapy; Item 10962 Podiatry; Item 10964 Chiropractic; Item 10966 Osteopathy; Item 10968 Psychology; Item 10970 Speech pathology.
Role of the GP To refer clients to allied health providers for services recommended in their care plan using the referral form issued by the Department of health or a form that contains all the components.
Contribution of AHW

Services must be at least 20 minutes duration and be provided to an individual patient, with personal attendance with the client.

A written report is required after the first and last service or more often if clinically required.

Reports should include any investigations; tests or assessments carried out on the patient and treatment provided and the ongoing management of the clients condition.

If a provider accepts the Medicare Benefit there will be no out of pocket expenses, if not the patient will have to pay the difference between fee charged and MBS rebate.

Service frequency

5 services per patient each calendar year.

A referral is valid for the stated number of services. If all services are not be used within a calendar year they may be used within the next calendar year. However they will be counted toward the 5 rebates for allied health services available for that calendar year.

Further information MBS Online - Medicare Benefits Schedule
Australian Department of Health - Primary care (GP, nursing, allied health)
Australian Department of Human Services - Education services for health professionals