Medicare – enhanced primary care

Patients who are eligible must have a chronic medical condition.  This is one that has been (or is likely to be) present for six months or longer. It includes, but is not limited to, conditions such as asthma, cancer, cardiovascular disease, diabetes, musculoskeletal conditions and stroke.

Patients have complex care needs if they need ongoing care from a multidisciplinary team consisting of their GP and at least two other health or care providers.

GPs determine whether the patient’s chronic medical condition would benefit from allied health services. A Medicare rebate is available for a maximum of five (5) services per patient each calendar year. (Note, however, that allied health providers may set their own fees)

Patients must have a GP Management Plan and Team Care Arrangements prepared by their GP, or be Commonwealth-funded residents of an aged care facility who are managed under a multidisciplinary care plan.

GP refers to allied health professional.

Allied health professionals must report back to the referring GP.’ 2012, Commonwealth of Australia