The treatment cycle aims to improve the quality of care for our clients by supporting better coordination and communication between general practitioners (GPs), allied health providers and clients.
Known as the treatment cycle, this is a way to refer our clients to allied health providers. A referral to an allied health provider will last either 12 sessions or 1 year, whichever ends first. Clients can have as many treatment cycles as their GP decides are clinically necessary. These arrangements ensure the health care is the most appropriate for our client’s needs.
Our client's GP will be their care coordinator. You will work with our client and their GP to help our client:
- meet their treatment goals
- receive the best treatment available
Our client will talk with their GP, who will prepare a referral.
The referral should specify the condition or conditions for you to treat.
Our client can have as many treatment cycles as the GP recommends. This may include more than one allied health service at the same time.
When treatment starts, ask our client about their health goals and make a Patient Care Plan.
You can use your clinical notes as a Patient Care Plan as long as it contains:
- provider name and number of the referring health care provider
- date of the referral and date of initial consultation
- condition(s) being treated or reason for referral
- patient goals
- the planned treatment regimen, including treatment modality, the anticipated type, number and frequency of services
- where relevant, list details of any aids and appliances the patient requires
- the expected outcomes or results of the treatment regimen for the entitled person plus proposed timelines
- objective assessment results based on the use of validated outcome measurement and diagnosis of the condition(s)
- a record of the entitled person’s agreement to the Personal Care Plan
You may notice other health conditions that weren’t included in the referral. If this happens, tell the GP and include details in the plan.
If our client has had a long break between treatments, you may require another referral. Our client will need to go back to their GP and request a new referral.
Once the treatment has finished, prepare an end of cycle report and send it to the GP.
The end of cycle report needs to include all the conditions you have been treating.
It needs to cover at least 2 sessions, the initial consultation plus one other.
You can send the end of cycle report to the GP after 8 sessions instead of 12 if our client either:
- has treatment appointments close together
- lives in a remote area
If another health professional sent you the referral, send the end of cycle report to them plus a copy to the GP.
You can recommend that our client continues to see you for their treatment.
The treatment cycle does not apply to clients with a Totally and Permanently Incapacitated (TPI) Gold Card when you refer them to either:
- exercise physiology services
The treatment cycle will apply if you refer a TPI client to other allied health services, such as:
- occupational therapy
Some clients may benefit from a more tailored referral arrangement specific to their needs. This is done through the At Risk Client Framework.
A client may benefit from the At Risk Client Framework if they have all or some of the following factors:
- complex psychosocial factors
- severe health needs
- severe functional impairment
Under the framework, clients can have tailored arrangements for 3, 6 or 12 months. These must be requested by the GP.
More information is available in the following documents:
We will pay you $30 (excl GST) to prepare an end of cycle report. You can find the item number on our fee schedules. You can claim through Medicare.
Visit Allied Health Professionals for up to date Notes for Allied Health Providers. Fee schedules are available at the Dental and Allied Health fee schedules page.
Why was the treatment cycle introduced?
The treatment cycle commenced on 1 October 2019 and aims to provider better care coordination and health outcomes for DVA clients accessing allied health treatment.
How has the role of the allied health provider changed under the treatment cycle arrangements?
At the beginning of each treatment cycle allied health providers will conduct an initial consultation. During the initial consultation a Patient Care Plan (PCP) will be created (or reviewed if this is a subsequent treatment cycle) for the client. Note the requirement for a patient care plan is not new to the treatment cycle arrangements.. The PCP should include an assessment using validated outcome measures and SMART goals: Specific, Measurable, Achievable, Relevant and Timed.
At the end of the treatment cycle allied health providers will need to prepare a report on the client’s progress using the mandatory end of cycle report template. The report must include assessment of the client’s progress using validated outcome measures and will include recommendations for further treatment if required. The allied health provider will send the report to the client’s usual GP.
In circumstances where continuity of care is required, the allied health provider should collaborate with the referring GP to support timely access to GP consultations and allied health treatment for the DVA client. A collaborative approach ensures that care for DVA clients is well coordinated and remains relevant to their clinical needs.
Are any treatments excluded from the new referral arrangements?
The treatment cycle does not apply to:
* dental and optical services, as GP referrals are not currently required
* hearing services
* Open Arms – Veterans & Families Counselling, which provides free and confidential counselling to anyone who has served at least one day in the Australian Defence Force and the veteran community
* therapies that have other treatment limits. The relevant provider notes and fee schedule will advise which therapies are excluded from the treatment cycle.
Are any clients excluded from the new referral arrangements?
DVA clients who have a Totally and Permanently Incapacitated (TPI) Gold Card are exempt from the treatment cycle arrangements for exercise physiology and physiotherapy services.
Do treatment cycle referral arrangements apply for DVA clients with a DVA Rehabilitation Plan?
Yes. Allied health services for DVA clients with a DVA medical management rehabilitation plan to assist them to manage their accepted conditions, are funded through their Gold card or White cards. The treatment cycle applies to these allied health services.
How do I provide feedback or raise concerns if I encounter problems with the treatment cycle?
If you have any questions or feedback about the treatment cycle you can email DVA GeneralEnquiries [at] dva.gov.au
Totally and Permanently Incapacitated (TPI) client exemption
What exemption applies for TPI clients?
The treatment cycle does not apply to exercise physiology or physiotherapy services for TPI Gold Card holders.
TPI clients receiving physiotherapy or exercise physiology:
* need an annual or indefinite referral for physiotherapy or exercise physiology;
* can have as many sessions as are clinically necessary in the period covered by the referral; and
* do not need the physiotherapist or exercise physiologist to report to the GP after 12 sessions.
Exercise physiology and physiotherapy services for TPI clients must be clinically necessary, evidence based and goals focused.
For allied health services other than physiotherapy or exercise physiology, TPI clients must use the treatment cycle.
How can providers identify a TPI client?
TPI clients hold a DVA Gold Card embossed with the letters ‘TPI’.
Can exercise physiologists and physiotherapists claim end of treatment cycle reports for TPI veterans?
No. Exercise physiologists and physiotherapists cannot claim the end of treatment cycle report for TPI clients as they are exempt from the treatment cycle arrangements.
How long does a referral last?
A referral is valid for one year from the date of issue, or for 12 sessions of allied health treatment, whichever ends first.
Are DVA clients required to attend a face-to-face appointment with their GP to obtain a referral?
Yes. Clients should obtain a new referral from their GP at either an appointment made for this specific purpose or as part of any of their regular appointments.
COVID-19 temporary health care arrangements
During the COVID-19 pandemic, DVA clients can access health care through temporary measures including telehealth consultations. Note, GPs are required to have an existing and continuous relationship with a patient in order to provide telehealth services under temporary COVID-19 arrangements. A relationship is defined as the GP, or another provider in the same practice, has provided at least one face-to-face service to the patient in the last 12 months. See COVID-19 information page for more information: https://www.dva.gov.au/providers/provider-news/covid-19-information-heal...
Can medical specialists and hospital discharge planners refer clients to allied health services?
Yes, medical specialists and hospital discharge planners are able to refer to allied health services for an initial treatment cycle, but subsequent referrals must be made by the client’s usual GP. An initial referral may also be made by a health care professional (other than a hospital discharge planner) as part of a hospital discharge.
Can the referral be made to an allied health practice or does it have to be to an individual allied health professional?
The referral can be made to either an individual allied health provider or an allied health practice. If the referral is made to a practice the client should aim to see one practitioner from the practice for the full treatment cycle, where possible.
Is a separate referral required for each condition to be treated?
No. The referral from the GP must specify the condition or conditions to be treated, not the service to be provided. At any one time, an allied health provider should only have one treatment cycle per client, not one treatment cycle per condition per client. If a client has multiple conditions being treated by the same allied health provider, these should all be covered under a single treatment cycle.
Who is responsible for monitoring the number of sessions against each referral?
The treating allied health provider or administrative staff are required to monitor session numbers to ensure the client is receiving treatment under a valid referral.
What if the client does not require 12 treatments?
If a client achieves all the outcome measures in their patient care plan in less than 12 treatments or if treatment is no longer effective for the condition identified in the GP referral, their allied health provider can complete an end of cycle report after a minimum of two sessions (initial plus one other consultation).
Is a new referral required if there is a significant gap in treatment?
If there is an unplanned gap in treatment (e.g. if the client attends for three sessions, then stops for six months before returning), the allied health provider should use their clinical judgment to decide whether the client needs a new referral or whether they can continue their current treatment cycle.
Can a DVA client continue to receive treatment while waiting for access to a GP to review the report and provide a new referral?
It is preferred that all allied health treatment is provided against a valid referral. To support continuity of care when treatment frequency is high, the allied health provider can provide the report to the client’s usual GP after 8 sessions, but before the 12th session. This should be done with agreement of the client and their usual GP. For example, this might be necessary where the DVA client lives in a rural area where their GP only visits once a month.
Patient Care Plans
Can the treating provider’s clinical notes act as a Patient Care Plan?
Yes, if it contains all the required information.
Is a separate Patient Care Plan required for each condition being treated?
No, only one Patient Care Plan per client is required. However, the Patient Care Plan should be shared with the client’s usual GP at the start of the treatment cycle. This will assist the GP to coordinate the health care for the client. In some circumstances the allied health provider may identify conditions or concerns that were not included in the referral. Sharing a copy of the patient care plan with the client’s usual GP is particularly important in these circumstances.
Will providers be remunerated for completing a Patient Care Plan?
No, Patient Care Plans are best clinical practice and should form part of an initial consultation. These are not a new DVA requirement.
Is a new Patient Care Plan required for a patient who presents with a new condition or a change in an existing condition?
No, an update of the existing Patient Care Plan is sufficient. However, new conditions must be reported to the client’s usual GP.
End of Cycle Report
Is there a minimum number of treatments in a treatment cycle before a report fee can be claimed?
Yes, a minimum of two sessions (initial plus one other consultation) is required.
Will a short length of treatment (e.g. three or four sessions) require a report?
Yes, providers should complete a report at the end of a treatment cycle even if it isn’t 12 sessions. However, to claim a report at least two sessions should have occurred, an initial and another consultation. Completion of the report attracts a payment which can be claimed through usual claiming practices.
Is an end of cycle report required for each condition?
No, the treatment cycle report should include all conditions being treated by the allied health provider.
If the client is referred by a specialist or hospital discharge planner, who is the report sent to?
The allied health provider preparing the report must send a copy to the referring provider and the DVA client’s usual GP.
Is a fee payable for the end of cycle report?
Yes. Allied health providers can claim the End of Cycle report item on completion of the report at the end of each treatment cycle. Please check the fee schedule for your profession for the relevant item number to claim. Note the report item is not payable if an initial consultation item has not previously been claimed.