Did you know that your aged care facility residents may be eligible to receive their allied health rebated through Medicare?
- This is known as an Enhanced Primary Care Plan (EPC) or Medicare item 731
- Most GP’s do not understand the process, so here is all the information they require for you to reduce your allied health costs!
Requirements for Medicare item 731:
- This item requires the GP to contribute to the care plan which is prepared by the nursing staff for each resident in a residential aged care facility, or it requires the GP to contribute to a review of such a plan
- There should be consent from the resident or their representative
- The residential aged care facility should request that the GP contribute or collaborates in the care plan
- There must be some written record of the GP’s contribution to the care plan
- The item cannot be claimed more than every three months
- Medicare item 731 does not require an attendance with the patient – a GP can contribute on the basis of knowledge of the patient and the health and care needs. This can take place by telephone or in person at the invitation of the provider developing the care plan
- It is expected that the GP’s contribution to a residents care plan be through direct collaboration with the aged care facility at the request of the facility.
- In order for a GP to contribute to a residents care plan the plan must be multidisciplinary. Meaning that the resident has a chronic medical condition and complex needs requiring care from a multidisciplinary team.
- For full details GP’s should refer to the Medicare Benefits Schedule and the Department of Health and Ageing website
When the GP has contributed to the care plan the patient then becomes eligible for five allied health sessions per calendar year under the Medicare Enhanced Primary Care Program
Please contact Wellness & Lifestyles on 8331 3000 for more information on how we can assist in getting your residents on EPCs and start saving you money now!
