Understanding the Medicare Chronic Disease Management Plan (CDM)
What is a Chronic Disease Management Plan (CDM)?
The Medicare Chronic Disease Management Plan (CDM) is an initiative that helps individuals with chronic medical conditions access allied health services at a reduced rate.
What services are supported through a CDM referral?
The CDM provides eligible individuals with up to 5 Medicare-subsidised sessions per calendar year with an Allied Health Professional, including:
- Dietitians
- Physiotherapists
- Podiatrists
- Speech Pathologists
- Occupational Therapists
- Audiologists
- Exercise Physiologists
- Diabetes Educators
- Mental Health Services
- Aboriginal and Torres Strait Islander Health Services
What conditions qualify for a CDM referral?
A chronic medical condition is defined as a condition that has been, or is likely to be, present for at least 6 months. Some examples include:
- Diabetes
- Cardiovascular disease
- Asthma or chronic lung conditions (e.g. COPD)
- Arthritis
- Chronic pain
- Mental health conditions
- Neurological disorders (e.g. stroke, Parkinson’s disease)
- Gastrointestinal conditions (e.g. Coeliac Disease, IBS)
- Eating Concerns (Allergies, Intolerances, Sensory Concerns)
Your GP will determine eligibility based on your medical history and needs.
How much rebate (money back) can I expect per session?
Medicare provides a rebate of $60.35 per allied health appointment under a CDM referral.
Extended Medicare Safety Net: Once you reach the Extended Medicare Safety Net threshold, you may receive up to 80% of the total appointment cost back.
How do I get a referral for a CDM?
To access a referral, you need to book an appointment with your GP and request a Chronic Disease Management Plan.
Your GP will assess your eligibility and, if approved, provide a referral to an Allied Health Professional of your choice.
Helpful Tip: Some GPs may refer to this plan as a “Care Plan” or “Enhanced Primary Care (EPC) Plan”, as it was previously known.
How long does a CDM referral last?
- The 5 sessions are valid from the date of referral until the end of the calendar year. If you do not use all 5 sessions before December 31, they do not roll over.
Other FAQ
What is the difference between a CDM and an Eating Disorder Treatment Plan (EDP)?
The CDM supports individuals with any chronic medical condition and provides up to 5 sessions per year with an allied health professional.
The EDP is specifically for individuals with a diagnosed eating disorder and provides:
- Up to 20 sessions with an Eating Disorder Dietitian
- Up to 40 sessions with an Eating Disorder Trained Mental Health Clinician
Some GPs may initially refer individuals with an eating disorder via a CDM, but please note this referral only provides 5 sessions rather than the 20 available through an EDP.
I have already accessed 5 Dietitian sessions through a CDM. Can I still get an Eating Disorder Treatment Plan (EDP)?
Yes, you can still qualify for an EDP referral even if you have used Dietitian sessions under a CDM.
However, Medicare caps Dietitian services at 20 sessions per year. If you have already used 5 sessions through a CDM, you will have 15 remaining under an EDP referral.
Does my referral need to be addressed to a specific clinic or clinician?
No. Medicare allows individuals to choose their healthcare providers, even if your GP has addressed the referral to a specific clinic or clinician.
Need more information? Contact us at hello@glowgroup.co or visit www.glowgroup.co.
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