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Programs - Chronic Disease Management

Diabetes Incentive

The Diabetes Incentive consists of the following components;

  • Sign-On Payment: One-off payment for notifying the Australian Government that the PIP practice uses a diabetes register and recall/reminder system.
  • Outcomes Payment: Payment to PIP practices that complete an annual cycle of care for a target proportion of their patients with diabetes.
  • Service Incentive Payment: Payment to providers working within a PIP practice for each annual cycle of care for a patient with diabetes, payable once per year per patient.

Diabetes Annual Cycle of Care for patients with Diabetes Mellitus:-

2517           Level B         

2521           Level C         

2525           Level D         

SIP $40  - the PIP component is paid once 20% of diabetic patients have had an annual HbA1c performed

Note: the incentive number is entered instead of the routine consultation item number

 

 

Annual Cycle of Care includes:

The minimum requirements of care to complete an annual Diabetes Cycle of Care for patients with established diabetes mellitus must be completed over a period of at least 11 months and up to 13 months, and must include:

Assess diabetes control by measuring HbA1c 

At least once every  year

Ensure that a comprehensive eye examination is carried out* 

At least once every two years

Measure weight and height and calculate BMI**            

At least twice every cycle of care

Measure blood pressure              

At least twice every cycle of care

Examine feet***                         

At least twice every cycle of care

Measure total cholesterol, triglycerides and HDL cholesterol    

At least once every year

Test for micro albuminuria                    

At least once every year

Provide self-care education         

Patient education regarding diabetes management

Review diet               

Reinforce information about appropriate dietary choices

Review levels of physical activity

Reinforce information about appropriate levels of physical activity

Check smoking status                    

Encourage cessation of smoking (if relevant)

Review of medication                    

Medication review

 *    Not required if the patient is blind or does not have both eyes.

**    Initial visit: measure height and weight and calculate BMI as part of the initial patient assessment.     Subsequent visits: measure weight.

***    Not required if the patient does not have both feet.

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