The MBS outlines the fee associated with each service item. Table 2 outlines the Schedule Fee listed for each CDM item. For non-admitted patients, CDM services typically attract 100% rebate of the Schedule fee[1]. Around 99% of CDM services in 2019 were bulk billed. This is higher than the overall bulk-billing rate for non-referred GP attendances, which was 90% in 2020–21 (Department of Health 2022).
Table 2: Fee summary for Medicare CDM services, 2019
| Description |
Fee ($) |
|
Preparation of a GP Management Plan (GPMP)
– item 721
|
146.55
|
|
Preparation of a GP Management Plan (GPMP)
– item 229
|
117.25
|
|
Coordination of Team Care Arrangements (TCAs)
– item 723
|
116.15
|
|
Coordination of Team Care Arrangements (TCAs)
– item 230
|
92.90
|
|
Review of a GP Management Plan or Coordination of a Review of Team Care Arrangements
– item 732
|
73.20
|
|
Review of a GP Management Plan or Coordination of a Review of Team Care Arrangements
– item 233
|
58.55
|
|
Contribution to a Multidisciplinary Care Plan, or to a Review of a Multidisciplinary Care Plan, for a patient who is not a care recipient in a residential aged care facility
– item 729
|
71.55
|
|
Contribution to a Multidisciplinary Care Plan, or to a Review of a Multidisciplinary Care Plan, for a patient who is not a care recipient in a residential aged care facility
– item 231
|
57.25
|
|
Contribution to a Multidisciplinary Care Plan, or to a review of a multidisciplinary care plan, for a resident in an aged care facility
– item 731
|
71.55
|
|
Contribution to a Multidisciplinary Care Plan, or to a review of a multidisciplinary care plan, for a resident in an aged care facility
– item 232
|
57.25
|
Note: Fees as at July 2019.
Source: AIHW analysis of MBS data maintained by the Department of Health and Aged Care and sourced from Services Australia.
[1]100% of the Schedule fee for non-referred attendances by general practitioners to non-admitted patients and services provided by a practice nurse or Aboriginal and Torres Strait Islander health practitioner on behalf of a general practitioner (MBS Online 2021).
Benefits paid
Close to $1 billion was paid by Medicare for CDM services (Table 3). This represents a rate of $39,414 per 1,000 population. Of this, GPMPs had the highest overall costs ($420 million), followed by a Review of GPMP or TCAs ($286 million) and Coordination of TCAs ($283 million).
Table 3: Medicare benefits paid for CDM services, 2019
| CDM services |
Item number |
Total Medicare benefits paid ($) |
% of total benefits paid for CDM items |
Medicare benefits per 1,000 population ($) |
|
Preparation of a GP Management Plan (GPMP)
|
721, 229
|
419,554,093
|
42.0
|
16,541.1
|
|
Coordination of Team Care Arrangements (TCAs)
|
723, 230
|
282,761,853
|
28.3
|
11,148.0
|
|
Review of a GP Management Plan or Coordination of a Review of Team Care Arrangements
|
732, 233
|
285,988,854
|
28.6
|
11,275.2
|
|
Contribution to a Multidisciplinary Care Plan, or to a Review of a Multidisciplinary Care Plan, for a patient who is not a care recipient in a residential aged care facility
|
729, 231
|
162,997
|
0.0
|
6.4
|
|
Contribution to a Multidisciplinary Care Plan, or to a review of a multidisciplinary care plan, for a resident in an aged care facility
|
731, 232
|
11,249,190
|
1.1
|
443.5
|
|
Total CDM services
|
|
999,716,987
|
100.0
|
39,414.3
|
Note: Expenditure results are not adjusted for inflation.
Source: AIHW analysis of MBS data maintained by the Department of Health and Aged Care and sourced from Services Australia.
References
Department of Health (2022) Statistics under Medicare, Department of Health website, viewed 5 May 2022.
