Indigenous Chronic Disease Package
Chronic disease management
Table of contents
- Improve your Aboriginal and Torres Strait Islander patients’ health
- GP and Patient Journey flowchart
How to participate in this program- Registering your practice/service for the PIP Indigenous Health Incentive
- Registering your eligible patients for the PBS Co-payment measure
- Cultural awareness training: who needs it?
- Defining ‘chronic disease’ and ‘at risk’
- Identifying and signing up eligible patients
- Specialist Outreach Programs and Care Coordination
- Indigenous Health Project Officers: A resource for General Practices and Indigenous Health Services
- Aboriginal and Torres Strait Islander Outreach Workers
- Chronic disease self-management accredited training for staff
- National Tackling Smoking Workforce
- Healthy Lifestyle Workers
MBS Item numbers for Aboriginal and Torres Strait Islander health services- General restrictions
Items 721 – 732: Chronic disease management
These items are NOT specifically for Aboriginal and/or Torres Strait Islander people but have been included here because they can be accessed as part of chronic disease management.| Item | Description | Fee* | Benefit** | Frequency# |
|---|---|---|---|---|
| 721 | Preparation of a GP Management Plan (GPMP) | $136.05 | 100% = $136.05 | 12 months |
| 723 | Coordination of Team Care Arrangements (TCAs) | $107.80 | 100% = $107.80 | 12 months |
| 729 | Contribution to, or review of a Multidisciplinary Care Plan for patients not in a residential aged care facility | $66.35 | 100% = $66.35 | 3 months |
| 731 | Contribution to, or review of a Multidisciplinary Care Plan for residents of an aged care facility | $66.35 | 100% = $66.35 | 3 months |
| 732 | Review of a GP Management Plan or coordination of a review of Team Care Arrangements | $68.00 | 100% = $68.00 | 3 months |
Items 10950 and 10997: Services provided by a Practice Nurse or Aboriginal Health Worker
These items are NOT specifically for Aboriginal and/or Torres Strait Islander people but any person with a chronic condition.| Item | Description | Fee* | Benefit | Frequency |
|---|---|---|---|---|
| 10950 | Aboriginal or Torres Strait Islander health service by an eligible Aboriginal Health Worker† (For persons with a chronic condition and complex care needs) | $59.90 | 85% = $50.95 | Maximum of 5 services per year (includes 10950) |
| 10997 | Service provided by a Practice Nurse or registered Aboriginal Health Worker | $11.55 | 100% = $11.55 |
Patient eligibility
Items 10950 and 10997 are NOT specific to Aboriginal and/or Torres Strait Islander people. They can be accessed by any eligible patients.For updates on MBS item information visit: www.health.gov.au/mbsonline
10950: Aboriginal Health Worker Service
This item may only be accessed by a patient with a GP Management Plan and Team Care Arrangements OR by a resident of an aged care facility whose medical practitioner has contributed to a Multidisciplinary Care Plan (items 721, 723, 729, 731 and 732).Item 10950 is for an Aboriginal or Torres Strait Islander health service provided to a person by an eligible† Aboriginal Health Worker.
To claim this item, the following criteria must be met:
- the service must be recommended as part of team care arrangement or Multidisciplinary Care Plan;
- the service is of at least 20 minutes duration; and
- the person is referred to the eligible Aboriginal Health Worker by the medical practitioner using a referral form that has been issued by the Department of Health and Ageing or a referral form that contains all the components of the form issued by the Department.
Item 10997: Service provided by a practice nurse or registered Aboriginal Health Worker
Item 10997 may only be accessed by a patient with a GP Management Plan, Team Care Arrangements or Multidisciplinary Care Plan (items 721, 723, 729, 731 and 732).This item will assist patients who require access to ongoing care, routine treatment and ongoing monitoring and support between the more structured reviews of the care plan by the patient’s usual GP.
Item 10997 may be used to provide:
- checks on clinical progress;
- monitoring medication compliance;
- self management advice, and;
- collection of information to support GP reviews of care plans.
For updates on MBS item information visit: www.health.gov.au/mbsonline
Additional MBS items provided by a nurse or registered Aboriginal Health Worker
These items are NOT specifically for Aboriginal and/or Torres Strait Islander people but have been included here because they can be provided by a registered Aboriginal Health Worker.| Item | Description | Fee* | Benefit | Frequency |
|---|---|---|---|---|
| 16400 | Antenatal service by a midwife, nurse or registered Aboriginal Health Worker†† Provided at or from a practice in RRMA 3-7 | $26.25 | 85% = $22.35 | 10 services per pregnancy |
† Aboriginal Health Workers who have been awarded a Certificate Level III in Aboriginal and Torres Strait Islander Health (or an equivalent or higher qualification) from a Registered Training Organisation that meets training standards set by the Australian National Training Authority’s Australian Quality Training Framework can register with Medicare Australia to provide this item.
†† A registered Aboriginal Health Worker means a person in the Northern Territory who is registered as an Aboriginal Health Worker under the Health Practitioners Act 2004 (NT), who is employed or retained by a general practice, or by a health service that has an exemption to claim Medicare benefits under sub-section 19(2) of the Health Insurance Act 1973.
* Current as at 1 Nov 2010.
#CDM services may be provided more frequently in exceptional circumstances.
** Services provided in hospital are rebated at 75% of the schedule fee.