Coordinated Veterans’ Care Program - clinical fact sheet and MCQ

Overview

The Coordinated Veterans’ Care Program (CVCP), administered by the Department of Veterans’ Affairs (DVA), is an Australian Government initiative designed to reduce the risk of hospitalisations for eligible veterans and war widows, by providing structured, proactive care coordination in the community. 

This program allows the patient’s regular GP to formalise and expand upon the support they may already offer, with the potential to receive structured payments of up to $2,097.40 per year. 

This FastTrack provides a guide to billing the CVCP, and outlines a strategy for its practice-wide integration.

An introduction to the CVC program, including its components, benefits, and eligibility can be found here. 

Billing process 

Table 1 Coordinated Veterans' Care Program item numbers (effective from 1 July 2025)

Periods of care and billing cycles  

A ‘period of care’ is a 90-day interval in which the services specified in the participant’s care plan are provided.

Before the end of each period of care, the participant must attend an in-person review with their regular GP to:

 (1) review the care plan

 (2) determine eligibility for continued participation in the CVCP

Note:  there are no telehealth item numbers for the CVCP so all visits must be face-to-face. 

This face-to-face review must take place before the next period of care begins. It is recommended that the review take place in the two weeks before the end of the current care period. 

This review needs to take place before any claim (UP03 or UP04) for the current period can be submitted. 

The DVA’s self populating “Ready Reckoner” can be used to plan care cycles, ensure correct dates of service and claim appropriately.

Submitting an initial claim for the CVCP

CVC item numbers for the initial claim

The initial claim item numbers are:

• UP01 – when both a GP and additional care coordinator are involved
• UP02 – when the GP manages care independently

A UP01 or UP02 item can only be claimed once per Veteran Card holder, even if the veteran changes GP, or exits the program and re-enrols at a later date. The UP01 or UP02 can be claimed on the day of enrolment into the program. 

The additional care coordinator can be a practice nurse or Aboriginal and Torres Strait islander healthcare worker.

All CVC item numbers are billed directly to DVA and must be bulk-billed.

The requirements before the initial claim

Before submitting the claim, ensure the veteran meets the eligibility requirements, their consent has been obtained and documented in the medical record, a comprehensive plan has been developed, and a copy given to the veteran. For more detail on the process, see our overview of the CVC program.

What is the date of service?

The date at which the initial assessment and enrolment is completed is the start of the care period and the initial date of service.

The initial claim (UP01 or UP02) can be submitted on the same day as the assessment and enrolment – this is the first period of care. The GP  should keep a record of the first date of service, to ensure patient review and claim for subsequent periods of care every 90 days.

Transfer of care to a new practice 

The CVCP is designed for the veteran's usual GP to provide coordinated care and can only be formally delivered and claimed by that one GP and their practice team.

If the patient has had the UP01 or UP02 claimed by a GP and has then changed GPs or locations, the new doctor can claim the subsequent care payments UP03 or UP04 at the end of the period of care. It is best practice that the GP asks the patient to advise the previous GP of the changed CVC arrangements. 

The practice may also contact DVA to confirm when they may begin claiming for a new period of care, as only one GP can claim for a veteran at a time (within the same 90 days). 

Submitting ongoing claims for the CVCP 

Ongoing payments for UP03 or UP04 can be submitted through Medicare Online 90 days after the initial service. 

For example:

• a review is done by a GP and care coordinator on the 7th of May
• the period of care therefore runs from 7th of May to the 5th of August
• UP03 for the service on the 7th of May can only be claimed after the 5th of August, for example on the 6th of August

Rejected claims 

Some reasons for claims being rejected are: 

• the veteran is a White Card holder and does not have an accepted mental health condition
• UP03 or UP04 being claimed before the end of the care period
• UP01 or UP02 has previously been claimed by more than one doctor
• incorrect date of service

DVA staff are available to assist with rejected claims and can be contacted via the provider line on 1800 550 457 or by emailing health.approval@dva.gov.au.

References

• Department of Veterans’ Affairs. Coordinated Veterans’ Care (CVC) Program. 2025. Available at: https://www.dva.gov.au/get-support/providers/programs-services/coordinated-veterans-care/coordinated-veterans-care-cvc-program. (last accessed August 2025).
• Coordinated Veterans’ Care Program. Claiming and payments. 2021. Available at:  https://cvctoolbox.dva.gov.au/Claim-Calculator. (last accessed August 2025).
• Department of Veterans’ Affairs. Notes for coordinated veterans’ care program providers. 2021. Available at: https://www.dva.gov.au/sites/default/files/2021-07/notes-cvc-providers-1jul2021.pdf. (last accessed August 2025). 
• Coordinated Veterans’ Care Program. A guide for general practice. 2024. Available at: https://www.dva.gov.au/sites/default/files/2024-12/cvc-a-guide-for-general-practice.pdf. (last accessed August 2025). 
• Coordinated Veterans’ Care Program mailbox; CVCProgram@dva.gov.au 
• Department of Veterans’ Affairs. Coordinated Veterans’ Care (CVC) Program White Card Holder information. 2025. Available at: https://www.dva.gov.au/providers/programs-services-information-for-providers/coordinated-veterans-care-cvc-program-white-card-holder-information. (last accessed Dec 2025).

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