Chronic Disease Management (CDM) Plan explained.
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Last Updated: 23rd Jan 2024
What is a Chronic Disease Management (CDM) Plan?
The Chronic Disease Management (CDM) Plan was introduced by the Australian Government to provide additional financial support through Medicare for people with chronic or terminal medical conditions.
Under the scheme the following criteria may mean you are eligible for a Chronic Disease Management (CDM) Plan referral:
If your chronic or terminal medical condition requires the care from a multidisciplinary, team-based approach from your GP and at least 2 other health care providers.
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, musculoskeletal conditions and stroke. There is no list of eligible conditions; however, the Chronic Disease Management (CDM) Plan items are designed for patients who require a structured approach, including those requiring ongoing care from a multidisciplinary team.
Whether someone is eligible for Chronic Disease Management (CDM) services is a clinical judgement for your GP, taking into account your medical condition and care needs, as well as the general guidance set out in the Medicare Benefits Scheme (MBS).
Patients who have a chronic medical condition and complex care needs and are being managed by their GP under a GP Management Plan (item 721) and Team Care Arrangements (item 723) are eligible for Medicare rebates for certain allied health services such as psychology on referral from their GP.
How long is Chronic Disease Management (CDM) Plan valid for?
A referral is valid for the stated number of services. If all services are not used during the calendar year in which the patient was referred, the unused services can be used in the next calendar year. However, those services will be counted towards the five rebates for allied health services available to the patient during that calendar year.
How much money will I get back from Medicare under the Chronic Disease Management (CDM) Plan?
It is possible to receive up to 5 rebates of $50 under the Chromic Disease Management (CDM) Plan if your GP determines that you are eligible and best managed under this referral.
What’s the best Medicare plan to apply for?
Your doctor may determine that if you meet diagnostic criteria for one of the previously mentioned Mental Health Care Plan (MHCP) or Eating Disorder Treatment Plan (EDP), then they may refer you under those better suited plans to assist with your co-occurring medical condition.
Rebates & Medicare Tips!
How to ensure you don’t get charged a full private fee?
You are responsible for obtaining a referral should you wish to receive a Medicare rebate for your appointments.
Our administration and clinical team can assist you with keeping track of the number of Medicare claims that have been made under your referral at our practice, and will prompt you to obtain a re-referral should you wish to continue to receive further rebates.
Upon payment of your appointment, our administration staff will email you a copy of your receipt and the Medicare claim information. Noted on your receipt will be a running count of appointments that have been claimed on your behalf, and the number of rebated appointments that is remaining in this current allotment of session rebates as per referral. We suggest you monitor this number, so that together we can ensure the continuation of rebates if this is important to you.
If any of the above is confusing, or if you have any further questions about the Chronic Disease Management (CDM) Plan / Claiming with Medicare for your Psychologist fees, please get in contact with our Admin team!
We are more than happy to talk it through with you over the phone.