Important points:
Medicare rebate for a maximum of five allied health services per patient each calendar year from General Practitioners. Unfortunately, no additional services are possible.
A patient must have a GP Management Plan (GPMP) and Team Care Arrangements (TCAs) (or a multidisciplinary care plan for residents of a residential aged care facility).
Your GP will decide whether you would benefit from these services and if so, will refer you for appropriate allied health services.
Allied health services must be given by eligible providers.
Are all patients eligible?
You may be able to claim Medicare rebates for allied health services if you have a chronic (or terminal) medical condition that is being managed by your GP under both of these Medicare Chronic Disease Management (CDM) items: a GPMP and TCAs. The need for allied health services must be directly related to your chronic condition.
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, osteoporosis, musculoskeletal conditions and stroke. There is no list of eligible chronic illness.
Management of your condition
If you have a chronic condition, with or without complex care needs, a GPMP will enable your GP to provide a structured approach to your care. It is a plan of action in which you agree management goals with your GP.
If you also have complex care needs, requiring multidisciplinary care, TCAs will enable your GP to collaborate with at least two other care providers involved in your treatment. TCAs will identify who needs to be involved in your care and help coordinate the team-based approach.
Once you have a GPMP and TCAs in place, you can be given a referral for up to five allied health services each calendar year. Only GP can decide whether you should be referred for these services, and the number of services required.
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
Osteopaths
Physiotherapists
Podiatrists
Psychologists
Dietitians
Exercise Physiologists
Mental Health Workers*
Occupational Therapists
Speech Pathologists
Tags: Mentone General Practice, Mentone, General Practitioner, GP
