Billing Chronic Disease Management services under Medicare
There are things to keep in mind if you’re a GP billing Chronic Disease Management (CDM) services.
Under Medicare you can’t bill your patient for a Chronic Disease Management service and an attendance service on the same day.
Medicare benefits aren’t payable for the attendance service, even if the conditions are unrelated or the services were done at different times, so it’s important you bill your patients and Medicare correctly.
You’re responsible for making sure that any items billed to Medicare under your provider number meet the Medicare Benefits Schedule item descriptor and any other legislative requirements in full. This includes items billed to Medicare on your behalf by your practice staff.
If your patient needs to see a different GP on the same day, Medicare benefits are still payable to that GP.
For more information about the billing process for CDM patients see:
- Education Guide: Chronic Disease GP Management Plans and Team Care Arrangements
- Education Guide: Chronic Disease Management services to support Indigenous health
- Section 2.17.10A of the Health Insurance (General Medical Services Table) Regulation 2017
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