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Becoming a Medicare providerMedicare Australia recognises Credentialled Diabetes Educators (CDEs) as the providers of diabetes education.
To learn more about becoming a Medicare provider or to download the application form for initial and/or additional provider numbers, please visit the website of Medicare Australia.
Medicare Australia considers the ADEA as the regulatory body for CDEs.
The ADEA expects all CDEs to participate in the Re-Credentialling Program and lodge applications for re-credentialling according to instructions on the recredentialling page.
All CDEs who have been granted CDE status as a membership benefit must maintain a financial full ADEA membership.
Please be aware that ADEA reports all practitioners with lapsed CDE status to Medicare, including those due to non-financial membership, within one month which results in loss of provider status.
People with diabetes can claim rebates for five consultations with allied health care professional per year as part of Medicare’s Chronic Disease Management (CDM) framework.
Diabetes education by a CDE is in included in the total number of these five visits.
The specific MBS item number for diabetes education is 10951 (face to face), 93000 (video), and 93013 (phone).
People with type 2 diabetes are eligible to claim rebates for attending group programs conducted by a CDE, a dietitian, or an exercise physiologist.
The rebates include one individual consultation to assess if attendance in group education is suitable as well as eight hours of group consultations.
The MBS item number for diabetes education is 81100 for the individual assessment and 81105 for group services.
Group consultations are in addition to any individual consultations.
To learn more, please read our Introduction of Group Items or our Guide to allied health group MBS items in type 2 diabetes.
First Nations people with diabetes can claim rebates from five follow-up allied health consultations.
The MBS item number for diabetes education is 81305 (face to face), 93048 (video), and 93061 (phone).
Consultations are in addition to any individual consultations under the CDM framework or group program attendance.
The person with diabetes must be referred by their GP. The GP must undertake consultation identified by MBS item numbers specific to the type of referral (e.g. general practice management plan and team care arrangements for individual consultations) before the person with diabetes consulting a CDE.
The referral must be completed on the referral form designated by Medicare to the specific type of consultation (e.g. individual, group).
Medicare periodically audits and recovers payment from CDEs that cannot substantiate claims for services.
The documentation required to substantiate a claim depends on the type of Medicare service provided:
1. Individual Chronic disease management consultations
To substantiate each MBS item number 10951 claimed, CDEs must keep the following documentation (which can be tracked with the Chronic Disease Management (CDM) referral log).
2. Follow-up individual consultations for indigenous people
To substantiate each First Nations–specific MBS item number claimed, CDEs must keep the following documentation (which can be tracked with the Indigenous follow up referral log):
3. Group services for type 2 diabetes
To substantiate each MBS item number 81105 claimed, CDEs must keep the following documentation (which can be tracked with the type 2 group referral log):
ADEA encourages CDEs to review these logs periodically and ensure no documentation is missing. Good record keeping practices help CDEs show Medicare compliance.
Details about all referral and eligibility criteria for all diabetes education services are available from the website of the Australian Department of Health and Ageing and the Medicare Benefits Schedule for diabetes education services as of 17 April 2023.
The ADEA recommends that CDEs considering employment in the primary care sector, general practice, or private practice visit the government’s programs and initiatives for allied health professionals.
Visiting the MBS education for health professionals webpage program may also be beneficial.
The ADEA also suggests that CDEs join the Private Practice Special Interest Group to network and exchange information with peers who provide diabetes education consultations through Medicare. You can access this group through two platforms:
Becoming a Medicare providerMedicare Australia recognises Credentialled Diabetes Educators (CDEs) as the providers of diabetes education.
To learn more about becoming a Medicare provider or to download the application form for initial and/or additional provider numbers, please visit the website of Medicare Australia.
Medicare Australia considers the ADEA as the regulatory body for CDEs.
The ADEA expects all CDEs to participate in the Re-Credentialling Program and lodge applications for re-credentialling according to instructions on the recredentialling page.
All CDEs who have been granted CDE status as a membership benefit must maintain a financial full ADEA membership.
Please be aware that ADEA reports all practitioners with lapsed CDE status to Medicare, including those due to non-financial membership, within one month which results in loss of provider status.
People with diabetes can claim rebates for five consultations with allied health care professional per year as part of Medicare’s Chronic Disease Management (CDM) framework.
Diabetes education by a CDE is in included in the total number of these five visits.
The specific MBS item number for diabetes education is 10951 (face to face), 93000 (video), and 93013 (phone).
People with type 2 diabetes are eligible to claim rebates for attending group programs conducted by a CDE, a dietitian, or an exercise physiologist.
The rebates include one individual consultation to assess if attendance in group education is suitable as well as eight hours of group consultations.
The MBS item number for diabetes education is 81100 for the individual assessment and 81105 for group services.
Group consultations are in addition to any individual consultations.
To learn more, please read our Introduction of Group Items or our Guide to allied health group MBS items in type 2 diabetes.
First Nations people with diabetes can claim rebates from five follow-up allied health consultations.
The MBS item number for diabetes education is 81305 (face to face), 93048 (video), and 93061 (phone).
Consultations are in addition to any individual consultations under the CDM framework or group program attendance.
The person with diabetes must be referred by their GP. The GP must undertake consultation identified by MBS item numbers specific to the type of referral (e.g. general practice management plan and team care arrangements for individual consultations) before the person with diabetes consulting a CDE.
The referral must be completed on the referral form designated by Medicare to the specific type of consultation (e.g. individual, group).
Medicare periodically audits and recovers payment from CDEs that cannot substantiate claims for services.
The documentation required to substantiate a claim depends on the type of Medicare service provided:
1. Individual Chronic disease management consultations
To substantiate each MBS item number 10951 claimed, CDEs must keep the following documentation (which can be tracked with the Chronic Disease Management (CDM) referral log).
2. Follow-up individual consultations for indigenous people
To substantiate each First Nations–specific MBS item number claimed, CDEs must keep the following documentation (which can be tracked with the Indigenous follow up referral log):
3. Group services for type 2 diabetes
To substantiate each MBS item number 81105 claimed, CDEs must keep the following documentation (which can be tracked with the type 2 group referral log):
ADEA encourages CDEs to review these logs periodically and ensure no documentation is missing. Good record keeping practices help CDEs show Medicare compliance.
Details about all referral and eligibility criteria for all diabetes education services are available from the website of the Australian Department of Health and Ageing and the Medicare Benefits Schedule for diabetes education services as of 17 April 2023.
The ADEA recommends that CDEs considering employment in the primary care sector, general practice, or private practice visit the government’s programs and initiatives for allied health professionals.
Visiting the MBS education for health professionals webpage program may also be beneficial.
The ADEA also suggests that CDEs join the Private Practice Special Interest Group to network and exchange information with peers who provide diabetes education consultations through Medicare. You can access this group through two platforms:
