Claiming a rebate for an Accredited Practising Dietitian (APD) in Australia can be done through two main avenues: private health insurance and Medicare. Here's a comprehensive guide on how to claim rebates and the differences between these options:

If you have private health insurance with extras cover that includes dietetics, you may be eligible for a rebate on your dietitian visits.

Claiming Process:

1. Check your policy: Confirm that your extras cover includes dietetics services.
2. Book an appointment: Ensure you're seeing an Accredited Practising Dietitian (APD).
3. Pay for the service: You'll need to pay the full fee upfront.
4. Claim your rebate: Submit a claim to your health fund, either on the spot using HICAPS or later via your fund's claiming process.

Key Points:

- Rebate amounts vary between health funds and policy levels.

- There may be annual limits on the number of visits or total rebate amount.

- You can typically claim immediately after each appointment.

- No referral is required from a GP to claim through private health insurance.

Medicare rebates for dietitian services are available through the Chronic Disease Management (CDM) program, formerly known as Enhanced Primary Care (EPC) plans.

Eligibility:

- You must have a chronic or complex condition requiring multidisciplinary care. Usually the condition needs to have been present for longer than 3 months to be considered.
- Your GP needs to determine that you would benefit from allied health services as part of your care.

Claiming Process:

1. GP Assessment: Your GP will assess your eligibility for a CDM plan.
2. Care Plan Creation: If eligible, your GP will create a GP Management Plan (GPMP) and Team Care Arrangement (TCA)
3. Referral: Your GP will provide a referral to the APD as part of your care plan.
4. Book an Appointment: Schedule a visit with an APD, informing them of your Medicare referral.
5. Attend the Session: The dietitian will provide the service and process your Medicare claim.
6. Rebate: Medicare will cover a portion of the fee, with you paying any gap.

Key Points:

- You're eligible for up to 5 allied health services per calendar year under this plan.
- The Medicare rebate is approximately $60.35 per visit. If you have met your Medicare Safety Net threshold, then the rebate will be up to 85% of the cost, please check with Medicare about your Safety Net.
- You'll need to pay the gap between the dietitian's fee and the Medicare rebate.
- Your GP must review your care plan periodically.

To view the differences between Private Health and Medicare Rebates please click here

- You cannot claim both private health and Medicare rebates for the same service.
- Check with your dietitian about their fees and rebate processes before your appointment if you are still uncertain.
- Keep track of your visits to ensure you don't exceed your annual limits.