Medicare Chronic Disease Management Plans: A Dietitian's Guide

Medicare's Chronic Disease Management (CDM) program is a significant revenue source for Australian dietitians in private practice. Understanding how it works, who's eligible, and how to set up your practice for Medicare claiming can make a real difference to your business.

This guide covers everything APDs need to know about CDMPs and how to optimise your workflow for Medicare clients.

What are Chronic Disease Management Plans?

Chronic Disease Management Plans (also called GP Management Plans, Team Care Arrangements, or Enhanced Primary Care plans) allow GPs to refer patients with chronic conditions to allied health professionals, including dietitians, with Medicare rebates.

The program recognises that chronic conditions like diabetes, heart disease, and obesity benefit from multidisciplinary care involving GPs, dietitians, exercise physiologists, and other allied health professionals.

 

How the Rebates Work

Standard Allied Health Sessions

Under a standard CDMP, patients can access:

5 subsidised sessions per calendar year across all allied health services (shared between dietitians, exercise physiologists, podiatrists, etc.)

Current rebate: Approximately $61 per session (check current MBS schedule for exact amounts)

Your fee: You can charge above the rebate—the difference is the patient's gap payment

Eating Disorder Plans

Patients with eligible eating disorders can access:

Up to 20 sessions per year with a dietitian

Additional 20 sessions with a mental health professional

Higher rebates than standard allied health items

This is a significant opportunity for dietitians working in eating disorder treatment.

 

Patient Eligibility

To access Medicare-subsidised dietitian services, patients must:

Have a chronic medical condition: Lasting or expected to last 6 months or more

Have a GP Management Plan (GPMP): Created by their GP (MBS item 721)

Have Team Care Arrangements (TCA): Coordinating care between providers (MBS item 723)

Receive a referral: From the GP to the dietitian specifically

Common eligible conditions include: Type 2 diabetes, cardiovascular disease, obesity, kidney disease, malnutrition, gastrointestinal conditions, and eating disorders.

 

The Referral Process

For a patient to claim Medicare rebates for your services:

1. 1. GP creates GPMP and TCA: The GP documents the patient's chronic condition and care needs.
2. 2. GP writes referral: Specifies dietitian services and number of sessions.
3. 3. Patient attends your appointment: You provide dietetic care.
4. 4. You claim or patient claims: Either bulk bill or patient claims rebate.
5. 5. You report back to GP: Send consultation report within required timeframe.

 

Setting Up for Medicare Claiming

Provider Registration

To claim Medicare rebates, you need to:

Hold current APD credential with Dietitians Australia

Register as a Medicare provider through HPOS (Health Professional Online Services)

Obtain your Medicare provider number

Claiming Methods

Bulk Billing: You accept the Medicare rebate as full payment. The patient pays nothing. You claim directly from Medicare.

Patient Claiming: You charge your full fee. The patient pays upfront and claims the rebate back from Medicare. Most private practice dietitians use this method.

Hybrid: Some practices bulk bill certain patient groups (pensioners, healthcare card holders) while charging private fees to others.

Claiming Technology

Options for processing Medicare claims:

Tyro: EFTPOS terminal with integrated Medicare claiming

Medipass: Mobile app for Medicare claiming

Cliniko: Practice management software with Medicare integration

Manual claiming: Patient claims through MyGov/Medicare app

 

Documentation Requirements

Medicare compliance requires proper documentation:

What You Must Have

Valid referral from GP (check it includes allied health services)

Copy of the patient's GPMP/TCA (or confirmation one exists)

Clinical notes for each session

What You Must Provide

Report to GP: Send a written report after consultations

Reports should include: services provided, outcomes, recommendations, and any concerns

Timeliness matters—send reports promptly while care is ongoing

 

Pricing Strategies for CDMP Clients

Typical approaches used by Australian dietitians:

Standard Gap Fee

Charge your normal consultation fee. Patient pays full fee and claims rebate back. Example: $150 fee - $61 rebate = $89 gap for patient.

Reduced Gap for CDMP

Offer slightly lower fees for Medicare clients to reduce their out-of-pocket costs and attract more referrals. Example: $120 fee - $61 rebate = $59 gap.

Bulk Billing

Accept the Medicare rebate as full payment. Best for practices wanting to build volume or serve low-income communities. Be aware this significantly reduces your per-session income.

 

Maximising Value from Limited Sessions

With only 5 sessions per year, you need to deliver maximum value. Tips:

Use Technology to Extend Your Reach

Software like Foodzilla helps you:

Create comprehensive meal plans quickly: Spend consultation time on education, not manual planning.

Provide ongoing resources: Clients access meal plans, recipes, and grocery lists through the app between sessions.

Monitor progress remotely: Clients can log food and track progress without using a Medicare session.

Communicate between sessions: Secure messaging for quick questions without booking appointments.

Structure Sessions Strategically

Initial assessment: Comprehensive evaluation and goal setting

Follow-ups: Spaced to allow time for implementation and habit formation

Final session: Review progress and create long-term maintenance plan

Supplement with Private Services

Once Medicare sessions are exhausted, offer private packages for clients wanting continued support. Many clients are willing to pay privately once they've experienced results.

 

Building GP Referral Relationships

Your Medicare client flow depends on GP referrals. Build these relationships:

Introduce yourself: Visit local practices with your information

Make referrals easy: Provide clear information about how to refer

Communicate well: Send professional, timely reports back to GPs

Demonstrate value: Share outcomes that matter to GPs (improved HbA1c, weight loss, etc.)

Be reliable: See referred patients promptly, reducing GP complaints from patients

 

Software for CDMP Practices

The right tools make Medicare claiming and client management seamless:

Practice Management: Cliniko for scheduling, records, and Medicare claiming

Meal Planning: Foodzilla for meal plans using Australian food data

Claims Processing: Tyro or Medipass for point-of-sale Medicare claiming

Foodzilla integrates with Cliniko, so you can import clients and manage nutrition services alongside your practice management.

 

Start Seeing Medicare Clients

Medicare CDMPs provide a steady stream of clients for Australian dietitians who set up their practices properly. Register as a provider, build GP relationships, and use software that helps you deliver maximum value within limited sessions.

Foodzilla helps Australian APDs serve Medicare clients efficiently with AUSNUT/FSANZ databases, automated meal planning, and a client app that extends your care between sessions.