All Posts tagged rebate

Medicare Allied Health Initiative

While most private health funds provide rebates for visits to APDs, some patients may be eligible for a Medicare rebate instead.

The Medicare Allied Health Initiative allows chronically ill people being managed by their GP under the Enhanced Primary Care (EPC) Program access to Medicare rebates for ADP services. Eligible patients are those with a chronic condition, defined as one that is likely to be present for at least 6 months. This includes, but is not limited to, asthma, cancer, cardiovascular disease and diabetes. General practitioners must be managing the patient through the GP Management Plan (GPMP) and the need must be identified as part of a Team Care Arrangement (TCA). (Please note these are not the only criteria for Medicare eligibility for a GPMP, TCA and referral.) The dietitian must provide a service that is directly related to the management of the patient’s chronic condition. General practitioners must then fill out the EPC Program Referral Form for Allied Health Services under Medicare for the rebate to be possible. The Medicare rebate is currently $48.95 per service with out-of-pocket expenses counting toward the extended Medicare safety net. Patients are given a maximum of five allied health visits per calendar year.

Medicare rebates are now also payable for group services for patients with type 2 diabetes, on referral from a GP. Contact Medicare for further information about eligibility, requirements, rebates and referral forms.

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When and how to make a referral

A referral to Nastaran Habibi should be made when your patient needs more intensive dietary, nutritional and lifestyle behavior education than you can provide in your office environment. Nastaran can help particularly when the patient is in the preparation, action or relapse stages of change.

A consultation generally includes a diet and lifestyle assessment, and nutrition education and counselling. Nastaran will review your patient’s medical and social status, including biochemistry and othe relevant test results, dietary and family history and home environment. In addition she will take anthropometric measurements and collect information on the patient’s individual food preferences and cultural, socio-economic and lifestyle needs. Taking into account the patient’s own goals, knowledge, skills and access to resources, Nastaran will custom design a program for your patient based on the principles of Medical Nutrition Therapy. She integrates self-management training regarding information on nutrient content, food choices, and meal preparation based on each patient’s particular and unique circumstances. Initial appointments are more than 1 hour.

What happens next:

  • You will receive a formal report assessing your patient’s nutritional, physical activity and lifestyle status including Nastaran’s recommendations for improvement, possible barriers to success and guidelines for evaluating progress.
  • During the 45-90 minute follow-up visits, Nastaran will review your patient’s progress, provide further education, encourage continued adherence to the plan and identify any obstacles to success.

In order for your patient to qualify for a Medicare rebate, referral must be through an Enhanced Care Plan. Referrals outside Medicare will still qualify for a Health Fund rebate.

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