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Acknowledgement. This project has been funded by the Australian Better Health Initiative: A joint Australian, State & Territory Initiative. Medicare Group Items. Available 1 May 2007 Multidisciplinary group services for people with type 2 diabetes

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acknowledgement
Acknowledgement

This project has been funded by the Australian Better Health Initiative:

A joint Australian, State & Territory Initiative

medicare group items
Medicare Group Items
  • Available 1 May 2007
  • Multidisciplinary group services for people with type 2 diabetes
  • Service provision by Medicare-registered providers: CDEs &/or AEPs and/or APDs upon referral from General Practitioner
credentialled diabetes educators cdes
Credentialled Diabetes Educators (CDEs)
  • expertise in diabetes management and patient centred diabetes self management education
  • undertake ongoing professional development and comply with ADEA credentialling program
accredited exercise physiologists aeps
Accredited Exercise Physiologists (AEPs)
  • expertise in either health & fitness / exercise rehabilitation
  • undertake ongoing professional development to comply with AAESS accreditation program
accredited practising dietitians apds
Accredited Practising Dietitians (APDs)
  • expertise in medical nutrition therapy and nutrition education
  • undertake ongoing professional development and to comply with the requirements of the APD program
evidence supporting type 2 diabetes group services
↓ glycosylated haemoglobin

↓ fasting blood glucose

↓ systolic blood pressure

↓ need for diabetes medications

↓ anxiety/ stress

↑ knowledge

↑ quality of life

Improving locus of control

Improving blood lipids

↓ body weight

Evidence supporting type 2 diabetes group services

Refer to Deakin, T, McShane, CE, Cade, JE et al. Group based training for self management strategies in people with type 2 diabetes mellitus. Cochrane Database Sys Rev. 2005: CD003417.

which patients are eligible
Which patients are eligible?

To be eligible for allied health group services, a patient must;

  • Have type 2 diabetes
  • Have a relevant care plan in place
  • Be referred by their GP to the eligible allied health professional for assessment for group services
new group items
New Group Items
  • New allied health items - 6 numbers, two for each profession
  • Allow people with type 2 diabetes to receive Medicare rebates for group services provided by;

~CDEs and/or AEPs and/or APDs

  • These services are in addition to the 5 individual allied health services each calendar year
slide11
The group programs available do not have to be limited to type 2 diabetes groups only.
  • Other relevant group programs, such as blood glucose monitoring, fitness or weight management group services, may be available and appropriate for a suitably assessed person with type 2 diabetes to attend.
slide12

GP refers eligible patient to CDE or AEP or APD or practice known be involved in group services under the Medicare Group Item, to be assessed for suitability for a preferred group service.

CDE or AEP or APD individually assesses the patient for suitability and prepares for group services. Patients unsuitable for groups may be screened out at this time.

Report: to GP on assessment undertaken, suitability for group services, nature of proposed group services

Medicare Group Items for People with Type 2 Diabetes

STEP 1:

Referral

STEP 2:

Individual

Assessment

CDE and/or AEP and/or APD conduct group sessions.

A maximum 8 sessions per calendar year.

Sessions must include 2-12 Medicare patients.

Non-Medicare, full-paying patients can also attend.

Report: after last service to referring GP for each Medicare patient.

STEP 3:

Group Services

Insert Logos of all 3 Practitioner types in order of CDE, AEP & APD

step 1 referral

GP refers eligible patient to CDE or AEP or APD or practice known be involved in group services under the Medicare Group Item to be assessed for suitability for a preferred group service

Step 1:Referral
slide15

CDE or AEP or APD individually assesses the patient for suitability and prepares for group services. Patients unsuitable for groups may be screened out at this time.

MBS Items: 81100, 81110, 81120

Rebate: $60

Consultation: minimum 45mins

Report: to GP on assessment undertaken, suitability for group services, nature of proposed group services

Note: 1 assessment claimable per calendar year

Step 2:

Individual Assessment

reporting to gp assessment
Reporting to GP: Assessment
  • Outline of the assessment undertaken
  • Suitability of referred patient for group services
  • Nature of proposed group services
step 3 group services
Step 3: Group Services
  • CDE and/or AEP and/or APD conduct group programs.(81105,81115,81225)
  • A maximum 8 sessions per calendar year.
  • Sessions must be minimum 1 hour duration.
  • Rebate is $15 per patient per sessions.
  • Sessions must include 2-12 Medicare patients.
  • Non-Medicare, full-paying patients can also attend.
  • Report: after last service to referring GP for each Medicare patient.
reporting to gp group services
Reporting to GP: Group Services
  • Attendance record
  • Description of group services conducted
  • Outcomes achieved
how to find your local cde aep apd
How to find your local CDE/AEP/APD
  • Check the relevant association website…
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