Chiropractic and Chronic Disease Management Plan (CDMP)

 

Can I obtain chiropractic Health services with Medicare’s Chronic Disease Management Plan?

The short answer is Yes.

In Australia the Medicare programme does not fund chiropractic services (as at 2 September 2011) EXCEPT under the Medicare Chronic Disease Management Plan.

In summary this plan allows:

  • 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.

Patient eligability:

The plan requires a GP referral to the chiropractor as below:

  • A GP Management Plan (GPMP) – item 721 (or review item 732); AND
  • Team Care Arrangements (TCAs) – item 723 (or review item 732)

Permanent residents of an aged care facility who are Commonwealth funded, must obtain their referral from a GP who is actively involved in the multidisciplinary care plan prepared for them by the aged care facility or has been involved in a review of the multidisciplinary care plan (item 731).

To be eligible, a patient with a chronic medical condition is one that has been (or is likely to be) present for six months or longer.

People who have private health insurance will need to decide whether to use Medicare, or their private health insurance to pay for these services. Private health insurance ancillary cover cannot be used to ‘top up’ the rebate.

In addition to providing care for the patient, the practitioners involved are required to spend a significant amount of time with record and report keeping over and above normal clinical needs and it is for this reason many practitioners are reluctant to participate in Medicare’s Chronic Disease Management Plan.
The following link to Medicare’s Chronic Disease Management Plan web site gives access to further detail:
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