Hi, Dr. Andrew Arnold here, Chiropractor and owner, Cranbourne Family Chiropractic and Wellness Ctr.

Today Dr. Andrew Arnold talks about Medicare and Chiropractic.

As you are most likely aware, Chiropractic is generally not covered by Medicare. Most of our patients use their private health insurance.

There is, however, an exception.

This is called the ‘Chronic Disease Management plan’ formerly known as the ‘Enhanced Primary Care’ plan.

Let me explain.

“The Chronic Disease Management plan on the Medicare Benefits Schedule (MBS) enables 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 judgment for the GP, taking into account the patient’s medical condition and care needs, as well as the general guidelines set out in the MBS.

Patients who have a chronic medical condition and complex care needs and are being managed by their GP under a GP Management Plan (item 721) and Team Care Arrangements (item 723) are eligible for Medicare rebates for certain allied health services on referral from their GP.”

If you are deemed eligible, you may be entitled to up to 5 visits per person per year fully refundable under Medicare.

Chiropractors who use HICAPs will also be able to bulk bill your payment.

Your Chiropractor is obligated to send the referring GP 2 reports detailing your treatment, tests, progress and prognosis, one after the initial visit, and one at the end.

Once you have consulted your GP, a ‘Team Care Arrangement for provider consent’ is sent to your Chiropractor of choice. Once this is signed and returned, your GP will prepare the CHD plan and provide this to you to present to your Chiropractor.

This process can be logistically challenging for some medical centers due to the time involved so as a patient you may want to give them the heads up this is what you are wanting. Oftentimes, their clinical nurses help with the preparations to take the burden off the GP’s.

Make sure you check this link for more info, or talk with your Chiropractor and/or GP.

About the Author:

Dr. Andrew Arnold is a Chiropractor, married to Dr. Linda Wilson, the Stress Specialist and has two children, Isaac and Bella. He lives in Melbourne, Australia.

Category: Chiropractor

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