Coordinated Veterans’ Care (CVC) Frequently Asked Questions
What is the CVC Program?
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.
The GP works collaboratively with the participant to develop a comprehensive care plan (care plan) that includes their health goals and treatment needs. 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.
As each participant’s needs are different, their care plan and the nature of the care coordination will vary accordingly. The CVC Program is about genuine, ongoing engagement with the participant and collaboration with other treating health providers where appropriate.
Eligible Veteran Card holders may remain in the CVC Program for as long as they continue to benefit from participation. Before delivering the CVC Program, GPs and Care Coordinators must review the Notes for CVC Program Providers to ensure compliance with program requirements.
Who can participate?
Veteran Gold Card holders with a chronic health condition can access the CVC Program if they meet the program eligibility criteria.
Veteran White Card holders who have a DVA accepted mental health condition that is chronic (a condition accepted by DVA as being related to military service) can also access the CVC Program if they meet the program eligibility criteria.
All Veteran Card holders must be Australia residents living in the community, 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.
Are War Widows eligible to participate?
All Veteran Card holders, including War Widow(er)s, that meet the program eligibility criteria can access the CVC Program.
Who is not eligible to participate?
Veteran White Card holders who do not have a DVA-accepted mental health condition are not eligible to access the CVC Program. However, they may have access to mental health treatment through Non-Liability Health Care.
Veteran Card holders who are permanent residents of an aged care facility are not eligible to access the CVC Program. This does not apply to those receiving short term respite care.
Veteran Card holders recovering from a hospital stay who are enrolled in the Department of Health and Aged Care’s Transition Care Programme are not eligible to access the CVC Program until their period of transition care has concluded.
How is the CVC Program delivered?
To enrol a Veteran Card holder into the CVC Program, the GP must conduct an in person medical and health assessment to determine if they meet the full program eligibility criteria and would benefit from participation. The CVC Toolbox has an eligibility tool to support GPs in completing this assessment.
If the Veteran Card holder is eligible, the GP must obtain their consent to participate in the CVC Program. Once consent has been provided, the GP works with the participant to develop a comprehensive care plan. This care plan is tailored to the participants individual health goals, treatment needs and outlines how care will be coordinated, monitored and reviewed.
The GP and Care Coordinator work collaboratively with the participant to deliver and/or coordinate the services outlined in the are plan. The Care Coordinator is responsible for maintaining effective and regular communication (at least monthly) with the participant, as well as engaging with other treating health providers as required.
The GP is required to provide leadership, oversight, feedback and guidance to the Care Coordinator throughout.
GPs and Care Coordinators must review the Notes for CVC Program Providers to ensure compliance with program requirements when delivering the CVC Program.
What is a period of care?
A period of care refers to a 90-day timeframe during which care coordination services outlined in the participant’s care plan are delivered.
Before the end of each period of care, the participant must attend an in person visit with their usual GP to review the care plan and assess eligibility for continued participation in the CVC Program.
This review must occur prior to the commencement of the next period of care and before a claim for the current period is submitted.
When and how can I make a claim?
The CVC Program is funded under DVA’s Repatriation Medical Fee Schedule (RMFS). 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
DVA provides a claim calculator that helps providers determine the correct dates for submitting claims based on the first date of each 90-day period of care for a participant.
All 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 - Services Australia. 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.
Can the CVC Program be delivered via Telehealth services?
No. 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.
For any exception to this, prior approval is required in writing from DVA for each claim and can only be considered under exceptional circumstances.
Can CVC Program services be claimed in addition to services under the Medicare Benefits Schedule (MBS) and Repatriation Medical Fee Schedule (RMFS)?
Yes. 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.
Is medicinal cannabis available through the CVC Program?
The CVC Program supports participants through care coordination. Enrolment in the CVC Program does not provide access to any type of medication or direct treatment in any form, including medicinal cannabis. Veteran Card holders are encouraged to discuss their medication and treatment needs with their usual GP.
Further information for providers about dispensing medicines under the Repatriation Pharmaceutical Benefits Scheme (RPBS) is available at DVA Concessional medicines under the RPBS webpage.
Information about access to medicinal cannabis through the RPBS is available on the DVA medicinal cannabis webpage. The Veterans’ Affairs Pharmaceutical Advisory Centre (VAPAC) is available to discuss the medicinal cannabis approval process with both Veteran Card holders and GPs.
You can contact them by emailing ppo@dva.gov.au or calling 1800 552 580.
Who can I contact if I have questions or need more information?
If you have questions or need more information about the CVC Program, you can call 1800 550 457 or email cvcprogram@dva.gov.au.
Additional information on the CVC Program is available on the DVA Website at Coordinated Veterans’ Care (CVC) Program.
FAQs
You can download these FAQs below: