Medicare
Medicare
For Medicare Provider Enquiries telephone 13 21 50
Medicare EPC Referrals
Medicare Individual Items
The Medicare Allied Health Initiative allows chronically ill people who are being managed by their GP under an Enhanced Primary Care (EPC) plan access to Medicare rebates for allied health services.
See the Department of Health and Ageing website for information on the Enhanced Primary Care Program. This information includes: eligibilty criteria for allied health professionals, factsheets and referral forms.
The EPC plan referral is valid for five visits to any combination of allied health services in a calendar year. For example, if a patient has an EPC plan completed and a referral written in December 2009, the patient is entitled to five visits on that referral. If they only use two in December 2009, the same referral can be used in the next year (ie in 2010), because there are still three visits remaining on that referral. Once the last three visits are used in 2010, the patient will need a new referral from the GP, bearing in mind that the patient will only be entitled to another two visits in 2010, bringing the total to five in that calendar year.
In summary:
- A patient is only entitled to five visits to any combination of allied health services in a calendar year.
- If 5 visits are used over a two calendar years a new referral is required if more allied health services are necessary in the second year and a total of 5 services have not been claimed for that year.
- A new referral is NOT needed at the start of the year ie January 2010, if the patient still has visits remaining on the original referral issued in 2009.
- If the patient has used all of their five visits in 2009 and their EPC plan is still valid, then they will need to get a new referral for 2010.
Medicare Group Items
Medicare rebates are payable for group services provided by eligible diabetes educators, exercise physiologists and dietitians for people with type 2 diabetes, on referral from a GP.
Allied Health Items for People of Aboriginal and Torres Strait Islander Descent
On 1 November 2008 new allied health items were launched to allow people of Aboriginal and Torres Strait Islander descent who have had a health assessment to receive a Medicare benefit for follow up allied health services. To access these items patients must be referred to an eligible allied health provider by their GP.
The Department of Health & Ageing website has information available on the items: a fact sheet for allied health professionals, a fact sheet for GPs, the MBS item descriptors and the MBS explanatory notes.
Electronic Funds Transfer (EFT) for Medicare and Department of Veterans' Affairs (DVA) Benefits
Simplified claiming arrangements for Medicare funded chronic disease allied health services - 1 Jan 2009
The following resources were developed by a multidisciplinary working group to support allied health.
Medicare Group Services Information Pack
This pack contains the practical information allied health professionals need to know about the new items.
Webpresent of roadshow
This is an audio recording of the roadshow together with the roadshow PowerPoint slides.
GP PowerPoint Resource
This is a complete PowerPoint presentation for allied health professionals to use when promoting group services to GPs
Medicare Group Services
This template can be individualised to create a promotional brochure to use with GPs.
Literature review
Medicare and You
'Medicare and You' is an eLearning program. It comprises seven interactive modules regarding Medicare billing. Although primarily aimed at new health care professionals, it will also benefit experienced providers who may want a refresher and be valuable for practice staff.
'Medicare and You' is free to access and easy to use. Each module is self-paced, interactive and case based. Topics include:
- What is Medicare?
- How to use the MBS
- Patient consultations (attendances)
- Enhanced primary care
- Medicare billing and claiming
- Additional Medicare billing information
- Referrals and requests
Simplifying the Mechanics of Patient Care Under Medicare for Dietitians in Private Practice
In July 2008 researchers at Monash University completed an evaluation of Dietetics Medicare Services for Chronic Disease Management. See the Report for details.
