Becoming a Medicare provider
Medicare 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.
Maintaining your credentialling status
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 CDE pathway page.
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All CDES who have been granted CDE status as a membership benefit must maintain a 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.
Consultations
Individual
People living 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.
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Diabetes education by a CDE is included in the total number of these five visits.
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The specific MBS item numbers for diabetes education are 10951 (face-to-face), 93000 (video), and 93013 (phone).
Group services in type 2 diabetes
People living with type 2 diabetes are eligible to claim rebates for attending group programs conducted by a CDE, a dietitian, or an exercise physiologist.
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The rebates include one individual consultation to assess if attendance in group education is suitable as well as eight hours of group consultations.
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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.
Aboriginal and Torres Strait Islander
Aboriginal and Torres Strait Islander people living with diabetes can claim rebates from five follow-up allied health consultations.
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The MBS item numbers for diabetes education are 81305 (face-to-face), 93048 (video), and 93061 (phone).
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Consultations are in addition to any individual consultations under the CDM framework or group program attendance.
Eligibility
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 living with diabetes consulting a CDE.
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The referral must be completed on the referral form designated by Medicare to the specific type of consultation (e.g. individual, group).
Need more information?
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.
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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.
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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:
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Diabetes in Private Practice SIG on Facebook: ADEA PPSIG | Facebook
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Private Practice member group on Connekt: Private Practice – Diabetes Connekt