CDM Treatment Programme
The CDM Treatment Programme was introduced in 2020 and is now available for adult GMS/DVC patients aged 18 years and over who have a diagnosis of one or more the following diseases:
Asthma
Type 2 Diabetes
Chronic Obstructive Pulmonary Disease (COPD)
Cardiovascular Disease including:
Stable Heart Failure
Ischaemic Heart Disease
Cerebrovascular Disease (Stroke/TIA)
Atrial Fibrillation
The above disease definitions are available in the appendices of the 2019 GP Agreement.
Eligible patients aged 18 years and over who are registered under the Diabetes Cycle of Care and the Heartwatch Programme need to be transitioned on to the new CDM Treatment Programme. Payments under the Diabetes Cycle of Care and the Heartwatch Programme will cease for such patients were a data return under the CDM Treatment Programme is received by the PCRS.
The following service enhancements as part of the roll out of Phase 3 of the CDM Programme have been agreed. The commencement of Phase 3 roll out is dependent on the development of the necessary IT developments with a target implementation timeline of Autumn 2023.
Hypertension for patients with GMS/DVC over 18 years and including stage 1 hypertension will be included in the CDM Prevention Programme.
All women (GMS and non GMS) who suffered gestational diabetes or pre-eclampsia since January 2023 will be included in the Prevention Programme and where such women develop diabetes, they will be included in the CDM Treatment Programme.
Health Amendment Act Cardholders (HAA) will be eligible for registration on the CDM programme.
A number of measures to update and streamline the Care Plan have been agreed, which will be incorporated as Phase 3 comes on-stream.
Further details associated with the above will be communicated to GPs in advance of implementation date. In the meantime, GPs may continue to avail of OCF for Hypertension.
Combinations of Chronic Diseases
To reflect the more complex consultations which take place when co-morbidities exist the fee rate is higher for patients who have multiple conditions. There are seven separate conditions four of which are listed under Cardiovascular Disease. These are all individual conditions. For example, if a patient has 2 of these cardiovascular diseases then the GP is paid at the fee rate for a patient with two chronic conditions, the same way that if a patient has type 2 diabetes and one of the named cardiovascular diseases.
CDM Treatment Programme Review Structure
To support patients in managing their chronic condition(s) there are two scheduled reviews in a 12 month period (Annual Review & Interim Review) as set out in the GP Agreement with an interval of at least four months between each scheduled review.
Each 12 month period is a 12 month window which commences on the anniversary of the initial Chronic Disease Treatment Registration visit.
Following the first Treatment Programme review, the next review (Interim Review) should take place no earlier than 4 months after.
If an Interim Review does not take place within the 12 month window the next review will be an Annual Review.
No more than two reviews can be submitted within the 12 month window. The rules as set out above apply to the MCDM reviews also.
It is envisaged that each of the scheduled reviews will require a visit to the GP and to the Practice Nurse. The scheduled reviews should be planned so they are of optimal value to the patients and the practice team; for example, if the patient is due to have a consultation with their GP, any planned investigations should be carried out by the Practice Nurse prior to the GP consultation thereby ensuring that results of such investigations are available to the eligible patient’s GP for each scheduled review.
Where blood tests are less than three months old at the date of the in surgery CDM Treatment Programme Review the blood results can be populated from the existing patient chart or record, otherwise the bloods will need to be repeated and results available prior to the GP consultation.
A written Care Plan must be agreed and issued to the patient following the completion of the review.
Claiming Process & Fees
You will be required to submit a data return to the HSE, in the required format, following each of the scheduled reviews through your GP Practice Management System. Reimbursement of 50% of the relevant annual fee, as set out in the table below, will issue to you from the PCRS following receipt of each data return. 10% superannuation is also payable in relation to each visit.
Payment for the bloods required under this programme are included in the fee payable per eligible patient, however you may claim an ECG STC when they are undertaken as part of a review.
Patient Type | Fee Per In Surgery Visit |
Patient with 1 chronic condition | €105 |
Patient with 2 chronic conditions | €125 |
Patient with 3 chronic conditions | €150 |
The below table represents the total annual fee available per patient on the CDM Treatment Programme.
Patient Type | Total Annual Fee* |
Patient with 1 chronic condition | €210 |
Patient with 2 chronic conditions | €250 |
Patient with 3 chronic conditions | €300 |
*Subject to two dataset returns.
MODIFIED CDM PRG????