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
• Service provision by Medicare-registered providers: CDEs &/or AEPs and/or APDs upon referral from General Practitioner
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)
• expertise in either health & fitness / exercise rehabilitation
• undertake ongoing professional development to comply with AAESS accreditation program
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
Professional Collaboration
CDE
AEP APD
GP GP
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
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?
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 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
• 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.
STEP 1:
Referral
STEP 2:
Individual
Assessment
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
STEP 3:
Group Services
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.
Medicare Group Items for People with Type 2 Diabetes
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
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, 81120Rebate: $60Consultation: minimum 45minsReport: 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
• Outline of the assessment undertaken• Suitability of referred patient for group services• Nature of proposed 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
• Attendance record• Description of group services conducted• Outcomes achieved
How to find your local CDE/AEP/APD
• Check the relevant association website…
Questions