New Chronic Disease Management items for patients in residential aged care facilities

Patients in residential aged care facilities can now access Medicare benefits for chronic disease management services. From 22 December 2020, you can start claiming for services provided from 10 December. The frequency and number of these services for residents in aged care facilities is similar to the general population.

Patients need to be on a chronic disease management plan and be reviewed after each referral has expired. Each year they can access:

• 5 individual and 8 group allied health services
• 5 additional services for individual physiotherapy, exercise physiology and occupational therapy
• 2 additional services for group exercise physiology.

The new MBS items are:

GPs and medical practitioners

• Contribute to multidisciplinary care plan 93469, 93475

Allied health

• Initial services 93501-93513
• Subsequent services 93524-93538
• Additional physical therapy services 93518-93520
• Group assessment services 93606-93608
• Group treatment services 93613-93615
• Additional exercise physiology services 93620

Indigenous Australians in residential aged care facilities who’ve had a health assessment can access follow up allied health services.

The new MBS items are:

GPs and medical practitioners

• Health assessments 93470, 93479

Allied Health

• Initial services 93546-93558
• Subsequent services 93579-93593
• Additional physical therapy follow up services 93571-93573

If you travel to a residential aged care facility to provide a chronic disease management service, you can also claim a flag fall service item. You can only claim the flag fall service item for your first appointment at each facility. You can provide services at multiple aged care facilities and claim additional flag fall items in the same day.

You can access MBS Online for help if you have any questions about interpreting MBS items.