CHRONIC DISEASE MANAGEMENT PLAN

A Chronic Disease Management plan (formally Enhanced Primary Care Plan) is completed by your GP prior to your appointment. The care plan can be made out to either Dietetics, Speech Pathology or Occupational Therapy (depending on which therapist you are working with) and entitles the child to 5 rebates per calendar year to the value of $52.95/session. The family is required to cover the gap payment.  Families are unable to use both Medicare and Private Health rebates in the one consult.

MENTAL HEALTH CARE PLANS

Mental Health Care plan for access to our Infant Mental Health worker. This plan must be completed by your GP/Paediatrician/Psychiatrist prior to your first appointment and entitles the recipient to 6 rebates per year initially (with the option to extend) to the value of $74.80/session. The family is required to cover the gap payment.

MEDICARE

Depending on the criteria your child meets, there are three (3) different Initiatives that can be accessed from Medicare.

1. Chronic Disease Management Plan (CDM) – can sometimes still be referred to as an EPC (Enhanced Primary Care Plan)

The CDM is available for those clients with chronic or terminal medical conditions. Your eligibility is determined by your GP including those requiring multidisciplinary, team based care from a GP and at least two other health care providers (such as an Occupational Therapist).

Those that are eligible can claim a maximum of five (5) allied health services in the period from 1st January to 31^st December (MBS items 10950-10970), however your referral can remain current for two years. If any of your 5 sessions are carried over to the following calendar year as long as your date of the initial referral remains current (within 2 years) you can use the remainder of the sessions available under that referral.

The MBS item code for Speech Pathology is 10970; Occupational Therapy is 10958; Dietetics 10954 with a rebate of $52.95. The 5 sessions can be a combination of therapists and once they have been completed, the therapist will write a completion summary back to the GP.

For more information, please click on the link:

CDM Fact Sheet – Department of Health & Ageing

2. Better Access to Mental Health Care Initiative

This can either be called:

• GP Mental Health Care Plan –– if you have a referral from a GP or
• Focused Psychological Strategies – if you have a referral from a Paediatrician

This initiative was introduced to improve the treatment and management of mental illness within the community by increasing community access to mental health professionals and team-based mental health care. This allows the client to access ten (10) therapy sessions per calendar year. Those that are eligible can claim a maximum of Six (6) Occupational Therapy sessions under one referral. A referral can be current for two (2) years. If the OT believes more therapeutic intervention would be of benefit they can write back to the referring practitioner requesting another 4 sessions (it is the responsibility of the client to go back to the referring practitioner to gain another referral for these extra sessions otherwise they will not be able to claim these under this initiative)

If any of your sessions are carried over to the following calendar year as long as your date of the initial referral remains current (within 2 years) you can use the remainder of the sessions available under that referral.  At the completion of the 10^th session, the OT will write a completion summary back to the referring practitioner.

The MBS code used for this Initiative is 80135 with a rebate of $74.80 available.

For more information please click on this link:

Better Access to Mental Health Care Fact Sheet – Department of Health & Ageing

3. Helping Children with Autism

In 2008, the Helping Children with Autism (HCWA) program created new items in the MBS to provide early intervention services from eligible allied health professionals (occupational therapists, psychologists, and speech pathologists) for children diagnosed with autism/pervasive development disorder (PDD). Medicare items are available for eligible children to access services from eligible audiologists, occupational therapists, optometrists, orthoptists, physiotherapists, psychologists and speech pathologists.  A child is eligible to access the autism program if he/she has a treatment and management plan provided by a paediatrician or psychiatrist (after referral from a general practitioner) before the child’s 13th birthday with treatment services to be completed before the child’s 15th birthday.

A referral from a paediatrician (using MBS item 135) or psychiatrist (using MBS item 289) is required to receive allied health treatment services (MBS items 82020 (Speech Pathology), 82025 (Occupational Therapy)).

The MBS code used for this is Speech Pathology 82020 and Occupational Therapy 82025 both with a rebate of $74.80 available.

NDIS PLANS

Lively Eaters Feeding Services is a recognised provider under the National Disability Insurance Scheme.  We are a registered provided under the National Quality and Safeguards Commission. You are able to use your Early Intervention or Therapeutic Supports funding to access support from the Lively Eaters Dietitians, Occupational Therapists, Speech Pathologists and Mental Health Specialists.

Read more about our NDIS service here

INTENSIVE FEEDING PROGRAM FOR TUBE WEANING – HOSPITAL or HOME BASED

The intensive hospital based program is partly covered by Private Health Insurance Hospital cover with an additional Program Fee payable (please contact our clinic for further details regarding this). Dependent children must be covered under the family cover for this to be applicable. The parent/carer is covered to stay with the child for the duration.

Families who do not have private health insurance (hospital cover) are encouraged to contact the clinic directly to enquire about a quote for the intensive programs.  The cost of our program is considerably less than international programs and we are flexible in how and where this may be carried out in order to assist families financially.

Therapy hours are claimable under an eligible NDIS plan.

INTENSIVE ‘VENTURE OUT’ FAMILY MEALTIME PROGRAM – HOME/APARTMENT BASED

Lively Eaters therapists successfully work with families within the home or apartments (for interstate families) to modify, adapt and improve feeding behaviours, mealtime enjoyment and acceptance of different foods.

An individual quote will be prepared for your specific circumstances following an initial assessment, should this be the most appropriate way of assisting your family. Therapy hours are claimable via an eligible NDIS plan.