Coordinated Veterans’ Care (CVC) Program
The CVC Program provides proactive care coordination for eligible Veteran Card holders with chronic conditions and complex care needs. General Practitioners (GPs) and participants work as a team to improve the participant’s health, wellbeing and reduce hospitalisations.
Back to topInformation for providers
The CVC Program supports eligible Veteran Card holders with chronic health conditions and complex care needs through care coordination. The program requires a proactive approach to improve participant health, wellbeing and reduce hospitalisations.
Within a general practice setting, the GP works collaboratively with the participant to develop a comprehensive care plan that addresses the participants health goals, treatment needs and supports the ongoing management of their care.
The GP oversees the delivery of this care plan, supported by a Care Coordinator (usually a practice nurse), who manages the day-to-day coordination of services included in the plan and maintains regular contact with the participant.
The CVC Program promotes health literacy, self-management and best practice coordination of care through a person-centred approach.
Back to topWho can participate
Veteran Card – All Conditions (known as Gold Card) holders with a chronic health condition may access the CVC Program if they meet the full program eligibility criteria.
Veteran Card – Specific Conditions (known as White Card) holders with a DVA-accepted mental health condition that is chronic may also access the program. A DVA-accepted mental health condition is one that DVA has formally accepted as being related to the veteran’s military service.
To be eligible, all Veteran Card holders must:
- be Australian residents
- be living in the community (not in residential aged care)
- have complex care needs, and
- be at risk of hospitalisation.
The full program eligibility criteria can be found in the Notes for CVC Program Providers.
Who is not eligible
Veteran Card – Specific Conditions holders who do not have a DVA-accepted mental health condition are not eligible for the CVC Program. They may still be able to access mental health treatment through Non-Liability Health Care.
Veteran Card holders who are permanent residents of an aged care facility are not eligible for the CVC Program. This does not apply to those receiving short term respite care.
Veteran Card holders recovering from a hospital stay and enrolled in the Department of Health, Disability and Ageing’s Transition Care Program are not eligible to access the CVC Program until their period of transition care has concluded.
Veteran Card holders who have been diagnosed with a terminal condition and are not expected to live beyond 12 months are not eligible to access the CVC Program.
Back to topNotes for the CVC Program
Before delivering the CVC Program, GPs and Care Coordinators must review the Notes for CVC Program Providers (Notes) to ensure compliance with program requirements.
The Notes set out the legal requirements for those delivering the CVC Program, including:
- GPs
- Care Coordinators, who can be either the GP themselves or a:
- Practice Nurse
- DVA-contracted Community Nursing Provider
- Aboriginal and/or Torres Strait Islander Primary Health Worker
View the Notes:
Back to topClaiming
The CVC Program must be delivered by the participant's usual GP who provides the majority of their care and understands their health goals and treatment needs.
To claim for the CVC Program, the GP must have formally enrolled the participant into the program. Payments that usual GPs can claim are shown in the table below.
Claims for the CVC Program are submitted through Medicare and are checked against eligibility criteria prior to payment.
Claims for the following items can be made at specific times based on the date of service:
- In person initial assessment and program enrolment item
These items can only be claimed once in the lifetime of a Veteran Card holder, following the assessment process and development of the care plan.- UP01 – GP with practice nurse
- UP02 – GP without practice nurse
- In person completion of 90-day period of care – review of care plan and eligibility item
Claims can be made after the completion of the 90-day period of care, using day 1 of the 90-day period as the date of service when submitting the claim.- UP03 – GP with practice nurse
- UP04 – GP without practice nurse
Payments usual GPs can claim
| Usual GP Type | In-person initial assessment and program enrolment | Item number | Completion of 90 day period of care — in-person review of care plan and eligibility | Item number | Total amount year 1 (includes initial assessment) | Total amount for subsequent years |
|---|---|---|---|---|---|---|
| GP with practice nurse | $515.55 | UP01 | $538.00 | UP03 | $2667.55 | $2152.00 |
| GP without practice nurse | $322.30 | UP02 | $241.80 | UP04 | $1289.50 | $967.20 |
Note: There is no provision for Telehealth services under the CVC Program. All claims for CVC items are required to be for in-person consultations with the participant’s usual GP.
CVC items can be claimed in addition to other Repatriation Medical Fee Schedule (RMFS) and Medicare Benefits Schedule (MBS) items available to eligible Veteran Card holders. This includes the GP Chronic Condition Management Plan.
Enrolment in the CVC Program does not provide access to any type of medication or direct treatment in any form. Veteran Card holders are encouraged to discuss their medication and treatment needs with their usual GP.
The CVC claiming cycle
A period of care under the CVC Program is 90 days.
Claims for payment cannot be submitted to Medicare until the period of care is complete.
The date of service is day 1 of the 90-day period of care.
To help calculate when to submit your claim based on the correct date of service, please use the:
All CVC claims are processed directly by Services Australia through Medicare. If there is an error in a claim, it will be rejected by Medicare and will need to be resubmitted. Further information on rejected claims and their reason codes is available on the Services Australia website at Look up a Medicare reason code—Health professionals.
Providers can look up the relevant reason code to understand why a claim was rejected and what action may be required.
If you have questions about claims, please contact Medicare on 1300 550 017.
Back to topThe role of a Community Nurse in the CVC Program
GP's who do not have access to a practice nurse may choose to work with a DVA-contracted Community Nursing provider to support them to deliver of the CVC Program. In this partnership, the Community Nurse plays a central role in coordinating care for the CVC Program participant.
The Community Nurse will work closely with the participant and GP, maintaining regular communication with the GP to ensure the care plan is effectively implemented.
For more information, including details on the payments DVA-contracted Community Nurses can claim, please refer to Information for DVA contracted Community Nursing Providers.
Back to topCVC Training and Education
As a GP, nurse or other health provider, you can access training to help you deliver the CVC Program and support veterans and their families.
Health providers can also access the training resources developed by the Australian Government to assist you to deliver medical services to all Australians.
Further information on DVA and other Australian Government resources is provided below.
Health providers may also reach out to their local Primary Health Network for information on available training.
Information guides
Two versions of the CVC Program information brochure are available to provide GPs, Care Coordinators and Veteran Card holders with information about the CVC Program. These versions contain a minor correction on the eligibility of Veteran White Card holders.
- CVC Program information brochure (read version) (PDF 1.3 MB) is an online read format, suitable for screen readers.
- CVC Program information brochure (print version) (PDF 1.9 MB) is a ‘print and fold’ format to produce a DL brochure for patients. To print this version of the brochure, ensure you use the embedded print settings and fold the two outer edges into a brochure format.
A Guide for General Practice is available to support practices to deliver the CVC Program and assist those considering delivering the CVC Program. The latest version contains a minor correction on the eligibility of Veteran White Card holders.
Additional Resources
There are a range of training options and courses to assist health professionals in understanding and caring for our veterans.
Back to topCVC provider resources
The resources previously available on the CVC Toolbox website have moved to this page and have been refreshed. These simplified, more user-friendly resources bring together key components specifically designed to help providers navigate CVC service delivery, including the patient eligibility assessment tool, CVC care plan template, Ready Reckoner (claiming calculator) and ‘Find a Health Service’ link.
CVC eligibility tool
The Veteran Card eligibility checker tool helps GPs assess whether Veteran Card holders may be eligible for the CVC Program. The current version of the tool contains an All Conditions Pathway (formerly Gold Card Eligibility Tool) and Specific Conditions Pathway (formerly White Card Eligibility Tool)
CVC care plan template
The CVC care plan template helps providers document a Veteran Card holder’s care team, health conditions, goals, planned actions and review points to support coordinated care under the CVC Program. The refreshed template now covers both Veteran Card types where these were previously provided as separate documents.
The template is intended as a guide, however you may choose to use another template that is more compatible with your procedures and/or practice software.
Providers must refer to the CVC Provider Notes to ensure their care plan captures the full scope of information required under the CVC Program.
CVC Program Ready Reckoner
The CVC Program Ready Reckoner helps providers calculate when to submit claims for each 90-day period of care, noting that UP03 and UP04 items are claimed retrospectively after the end of each period. The first tab of the attached has instructions and illustrated claiming examples – ‘CVC Claiming Tips’ and the live tool where you can enter your patient’s dates is at the second tab ‘CVC Ready Reckoner Claiming Tool’.
Find a Health Service
The Find a Health Service directs providers to healthdirect’s Service Finder, where they can search by service type and postcode to find providers who may participate in care plans for enrolled veterans.
Contact the CVC Program team
If you have questions about the CVC Program, you can contact us by calling 1800 VETERAN (1800 550 457) or send an email to CVCProgram@dva.gov.au.
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