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Coordinated Veterans' Care (for providers)

Important notice

Recent notification of changes are regarding ACU training modules only. The CVC Program will continue to be delivered as usual.

Logo: Coordinated Veterans' Care (CVC) Program


The Coordinated Veterans' Care (CVC) Program is a team-based program designed to increase support for Gold Card holders with one or more targeted chronic conditions or complex care needs; and those who are at risk of unplanned hospitalisation. The CVC Program focuses on improving the management of chronic conditions and quality of life for eligible Gold Card holders who are most at risk of unplanned hospitalisation. Gold Card holders can include veterans, war widow/widowers and dependants. The CVC Program is aimed at Gold Card holders with the following chronic conditions:

  • congestive heart failure
  • coronary artery disease
  • pneumonia
  • chronic obstructive pulmonary disease
  • diabetes.

GPs are paid to enrol Gold Card holders onto the CVC Program and to provide ongoing, comprehensive and coordinated care with the assistance of their practice nurse or a community nurse (from a DVA-contracted provider).

Guide for General Practice

The Coordinated Veterans' Care Program—Guide for General Practice gives you detailed information about the CVC Program, including patient eligibility and step-by-step instructions to prepare your practice, enrol participants and provide ongoing care.


The training provided by ACU will no longer be available after 31 October 2018. Training for the CVC Program is currently being reviewed and updates will be provided. The CVC Program will continue to be delivered as usual. This website contains information on setting up your practice for the CVC Program, claiming and eligibility. If you require any assistance please contact the CVC Team.

How to claim

By participating in CVC, GPs can claim the following payments through DHS, Medicare. Full details about how to claim CVC payments are in the Coordinated Veterans' Care Program—Guide for General Practice booklet.

Payments GPs can claim—Amounts effective 1 July 2018
  Initial Incentive Payment Quarterly Care Payments Total year 1 Total year 2 onward
  $ Item # $ Item #
GP with practice nurse $430.55 UP01 $449.30 UP03 $2227.75 $1797.60
GP without practice nurse $269.05 UP02 $201.80 UP04 $1076.25 $807.20

Date of service

CVC payments can be claimed on a three-monthly basis for a period of ongoing clinical care. The quarterly period of care is equal to 90 calendar days.

The Date of Service for each quarterly period is the first day of the quarterly period. The claim for payment is made after the last day of the quarterly period.

For example, if the period of care runs from 3 March to 1 June; the Date of Service is 3 March but the claim for the UP03 or UP04 payment cannot be made until after 1 June (i.e. the end of the quarterly period).

Please use the self-populating ready reckoner, in the following section, to calculate Dates of Service.

Claiming date ready reckoners

The reckoner automatically calculates the Date of Service and the claiming date for each CVC enrolled patient.

Fee schedule

The full fee schedule for CVC Program items is available at Coordinated Veterans' Care program. Payment amounts are reviewed annually. Payments are in addition to all existing GP Fee Schedule items for consultations and chronic disease management items.

CVC Social Assistance

CVC Social Assistance is a short-term service (up to 12 weeks) available to CVC Program participants to help them re-engage in community life through social contact or accompaniment to a social activity.

How do I refer someone for CVC Social Assistance?

If you feel a CVC Program participant fits the criteria for CVC Social Assistance, you need to fax or send a written referral for a CVC Social Assistance assessment to a Veterans' Home Care (VHC) Assessment Agency. For information on the nearest VHC Assessment Agency, phone 1300 550 450.

CVC Pilot

The CVC Pilot is a short, early intervention, self-help program (six-to-eight weeks) for veterans with mild to moderate anxiety or depression and a chronic physical condition, accompanied by pain. The pilot will run until December 2019.

See CVC Pilot for more information including eligibility criteria and available locations.

Notes for CVC Providers

These Notes set out additional legal requirements for GPs, practice nurses and Aboriginal Health Providers under the CVC Program.

Service partners

The Department of Veterans' Affairs contracted two external organisations to assist in the ongoing delivery of the Coordinated Veterans' Care Program. These are:

Bupa Health Dialog

Bupa Health Dialog logo

Bupa Health Dialog offers evidence-based wellness, prevention and chronic disease management services to help meet the health needs of Australians.

Bupa Health Dialog assists DVA by analysing its extensive client data to identify and contact the veterans and war widows who are DVA Gold Card holders and most likely to benefit from taking part in the CVC Program.

CVC Program Evaluation Reports

DVA developed a framework to enable a rigorous process for monitoring and evaluating the CVC Program over a four-year period, from May 2011–May 2015.

The key elements of the framework included:

  • Cost effectiveness and benefit to veterans
  • Service utilisation, and
  • Implementation and service delivery.

The findings from the three evaluation reports continue to inform DVA's ongoing program improvements.

The following three evaluations were commissioned.

Grosvenor Management Consulting

Grosvenor undertook the independent evaluation of the CVC Program objectives, mainly performance and cost effectiveness.


Bupa undertook an analysis on CVC service utilisation and the changes between Gold Card holders enrolled in the CVC Program, compared to those who are eligible, but were not enrolled.

Flinders University

Flinders undertook a qualitative study on the implementation of the CVC Program and service delivery in general practice. This study included a comprehensive literature review of primary care interventions that sought to reduce health care costs as well as conducting qualitative interviews.


For queries about the CVC Program and details of DVA Community Nursing Providers email or phone 1800 550 457 and ask to speak to Coordinated Veterans' Care.

Resources and brochures

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