Medicare – Items 721 & 723

Item 721

A comprehensive written plan must be prepared describing: (NGATSAR)

  1. the patient’s health care needs, health problems and relevant conditions;
  2. management goals with which the patient agrees;
  3. actions to be taken by the patient;
  4. treatment and services the patient is likely to need;
  5. arrangements for providing this treatment and these services; and
  6. arrangements to review the plan by a date specified in the plan.

In preparing the plan, the provider must: (ERACA)

  1. explain to the patient and the patient’s carer (if any, and if the practitioner considers it appropriate and the patient agrees) the steps involved in preparing the plan; and
  2. record the plan; and
  3. record the patient’s agreement to the preparation of the plan; and
  4. offer a copy of the plan to the patient and the patient’s carer (if any, and if the practitioner considers it appropriate and the patient agrees); and
  5. add a copy of the plan to the patient’s medical records.

A copy of the written plan must be retained for 2 years.

Item 723

When coordinating the development of Team Care Arrangements (TCAs), the general practitioner must:

  1. consult with at least two collaborating providers, each of whom will provide a different kind of treatment or service to the patient, and one of whom may be another medical practitioner, when making arrangements for the multidisciplinary care of the patient; and
  2. prepare a document that describes GATSAR:
    1. treatment and service goals for the patient;
    2. actions to be taken by the patient;
    3. treatment and services that collaborating providers will provide to the patient; and
    4. arrangements to review (i), (ii) and (iii) by a date specified in the document; and
  3. explain the steps involved in the development of the arrangements to the patient and the patient’s carer (if any, and if the practitioner considers it appropriate and the patient agrees);
  4. discuss with the patient the collaborating providers who will contribute to the development of the TCAs and provide treatment and services to the patient under those arrangements; and
  5. record the patient’s agreement to the development of TCAs;
  6. give copies of the relevant parts of the document to the collaborating providers;
  7. offer a copy of the document to the patient and the patient’s carer (if any, and if the practitioner considers it appropriate and the patient agrees); and
  8. add a copy of the document to the patient’s medical records.

The document described above must be retained for 2 years.

One of the minimum two service providers collaborating with the GP can be another medical practitioner.  The patient’s informal or family carer can be included in the collaborative process but does not count towards the minimum of three collaborating providers.