Doctor’s Referral System
You can access two types of services through Medicare with a referral from your GP.
- Chronic Disease Management
- Mental Health
We are a Bulk Billing service. There are no out-of-pocket expenses for clients with a GP referral to our services.
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Chronic Disease Management
Chronic Disease Management (formerly Enhanced Primary Care or EPC) — GP services on the Medicare Benefits Schedule (MBS) enable GPs to plan and coordinate the health care of patients with chronic or terminal medical conditions, including patients with these conditions who require multidisciplinary, team-based care from a GP and at least two other health or care providers.
A chronic medical condition is one that has been (or is likely to be) present for six months or longer, for example, asthma, cancer, cardiovascular disease, diabetes, musculoskeletal conditions and stroke. There is no list of eligible conditions; however, the CDM items are designed for patients who require a structured approach, including those requiring ongoing care from a multidisciplinary team.
Whether a patient is eligible for CDM services is a clinical judgement for the GP, taking into account the patient’s medical condition and care needs, as well as the general guidance set out in the MBS.
- A person who has a chronic or terminal medical condition (with or without multidisciplinary care needs) can have a GP Management Plan (GPMP) service.
- A person with a chronic or terminal medical condition and complex care needs, requiring care from a multidisciplinary team, can have a GPMP and Team Care Arrangements (TCAs).
- A chronic medical condition is one that has been (or is likely to be) present for six months or longer, for example, asthma, cancer, cardiovascular disease, diabetes, musculoskeletal conditions and stroke. There is no list of eligible conditions. However, these items are designed for patients who require a structured approach to their care and to enable GPs to plan and coordinate the care of patients with complex conditions requiring ongoing care from a multidisciplinary team.
Chronic Disease Management Referral
A Chronic Disease Management Referral can be used for up to 5 sessions in total per calendar year which is billed by using your Medicare Card for the following services:
- Aboriginal Health Worker/Aboriginal and Torres Strait Islander Health Practitioner
- Dietitian (link to Dietitian)
- Exercise Physiologist
- Mental Health Worker
- Occupational Therapist (link to Occupational Therapist)
- Physiotherapist (link to Physiologist)
- Speech Pathologist
Mental Health is more common than you think. If you have a mental health disorder, you and your doctor can create a plan to treat it and help you get back on track. A Mental Health professional can help you with all kinds of everyday issues. See a list here.
Your mental health treatment plan will have goals agreed by you and your doctor. It will also have:
- treatment options
- support services available.
Keep in mind your health information and treatment plan will be private. Doctors cannot share your information unless you agree to it.
Types of Mental Health Professional Support
If needed, your doctor can refer you to mental health professionals including:
- Social Workers
How much does it cost?
A treatment plan lets you claim for up to 10 sessions each calendar year with a mental health professional. We can accept claims if the health professional is registered with us.
If your health professional decides your eligible, you can have an extra 10 group sessions.
We Bulk Bill so you won’t have to pay anything.
Private Health Insurance (link to Private Health Insurance page)
If you have private health insurance, you may be able to get some money back. You can check with your insurer.
Rural and remote support
If you live in a remote area, it might be hard to see a mental health professional. You may be able to have a telehealth video consultation instead. You can claim for video consultation sessions with a mental health professional.