Frequently Asked Questions

For DVA to accept liability for a service related condition a compensation claim must be submitted and the claim accepted by DVA (except for conditions eligible for non-liability health care and provisional access to medical treatment).

Veterans who have a White Card are entitled to receive clinically necessary health care funded by DVA for their accepted condition. (Prior approval will be required for some items that are not on the MBS, PBS or RPBS). Veterans who have a Gold Card are entitled to receive health care funded by DVA for all clinically necessary health care services. (Prior approval will be required for some items that are not on the MBS, PBS or RPBS).

Veteran Card holders may present digital versions of their plastic DVA White or Gold Cards, which clients can access through the online DVA portal MyService. You can view your patient’s health conditions that are covered by DVA, below their digital card on their MyService account, on their device, once they log in. You can also check what’s covered by calling 1800 550 457.

Not all veterans will have a DVA card. However all Australian veterans are eligible for one.

Historically  those leaving the ADF did not automatically interact with DVA and the veteran had to personally apply to get a White Card or Gold card.

In more recent times all those leaving the ADF receive a White Card even if they have no current health concerns. This White Card allows them to receive DVA funded Non Liability Health Care for all mental health conditions and for cancers and tuberculosis (eligibility criteria apply).

The 2021 Census recorded that 581,139 Australians reported that they have served or are currently serving in the ADF. As at March 2024 there were 289,915 Veteran Card Holders (103,688 Gold Card and 186,227 White card holders).

Therefore not all veterans will have a DVA card. Some are well and have no health concerns as a result of their service whilst some veterans do not want to engage with DVA. Others may be unaware of the services and support DVA has to offer. Asking “have you ever served in the ADF” at patient enrolment can capture those who are eligible for DVA services, but who may not yet be engaged. They can be encouraged to obtain a veteran card  by calling 1800 VETERAN (1800838372).

DVA will pay for a veteran’s treatment for some conditions without accepting these conditions as service related (no claim required). DVA may cover:

• A client's treatment costs by a mental health provider for any mental health condition, such as posttraumatic stress disorder – this is NLHC (mental health) and can be accessed by any veteran after one day full-time service
• A client's treatment costs when diagnosed with cancer (malignant neoplasm) or pulmonary tuberculosis – there are service-related eligibility criteria.

Under the Provisional Access to Medical Treatment program, or PAMT, DVA will pay for the treatment for certain conditions before liability has been accepted. The list of conditions eligible for PAMT is found at Get treatment while you wait on a claim (PAMT) | Department of Veterans' Affairs (dva.gov.au). This means that your patient has submitted a claim they do not have to wait for DVA to approve their claim before they can access DVA funded treatment.

As long as the consultation includes the accepted condition the whole consultation can be billed to DVA.

You cannot charge gap fees if you accept veteran card payments.

• Item 23: Consultation less than 20 mins
• Item 36: Consultation of at least 20 minutes
• Item 44: Consultation of at least 40 minutes

Department of Veterans' Affairs Quick guide for GPs

War widows with a Gold Card are eligible to participate in the Co-ordinated Veteran’s Care (CVC) Program if they have one or more chronic health condition.

The CVC Program is a team-based program where the participant, a General Practitioner (GP) and a care coordinator (usually a practice nurse) work together to develop a plan to meet the health needs of the participant and manage their ongoing care. The CVC Program is for veterans with complex care needs who are at risk of unplanned hospitalisation, and who hold either:

• a Veteran Gold Card and have one or more chronic health condition/s, or

• a Veteran White Card and have a DVA-accepted mental health condition

All former full time members of the ADF (Navy, Army and Air Force)  are entitled to have a Veteran’s Health Check.   They are still entitled if they continue to serve as a reservist  but have finished full time service.

Those who have done Reserve service only and  who have completed at least one day of continuous full time service (CFTS) and have finished serving in the Reserve are also entitled to a Veteran’s Health Check.  CFTS means the Reservist has made a voluntary undertaking to serve on a full time basis for an agreed period (e.g. to deploy on operations for 2 weeks or to fill a workforce vacancy on a full time basis for 12 months). The veteran will know if they have done CFTS and the date their service ended.

A useful form to guide the assessment is found at  D9388 - Veteran Health Check. This is used for both the One -Off Health Check and the Annual Veterans Health Check as described below.

One-off Veteran Health Check

This can occur at any time after the veteran has finished full time or reserve service (only) with the ADF .  No white or gold veteran card is required  and it can be billed through the following  MBS item numbers.

• 701 brief health assessment, lasting no more than 30 minutes
• 703 standard health assessment, lasting no more than 45 minutes
• 705 long health assessment , lasting no more than 60 minutes
• 707 prolonged health assessment, lasting more than 60 minutes

This health check can only  be claimed once for an eligible patient. Gap payments may be charged if your client uses their Medicare card.

Annual Veterans Health Check every year for 5 years post leaving the ADF

This can be provided to  those who have left the ADF from 1 July 2019 onwards  and is available every year for the first  five years after finishing service. These  Annual Veterans’ Health Check are fully-funded by DVA . (GPs must accept DVA Veteran Cards  as full payment and no gap fee can be charged). This is billed through the Repatriation Medical Fee Schedule (RMFS) using the following item numbers

• MT701 brief health assessment, lasting no more than 30 minutes

• MT703 standard health assessment, lasting no more than 45 minutes

• MT705 long health assessment, lasting no more than 60 minutes

• MT707 prolonged health assessment, lasting more than 60 minutes

For veterans who left after 01 July 2019 and more than 5 years have passed and they have not had this annual health check they are still entitled to the One- Off Veteran Health Check if they have not had one done previously.

You should refer to the closest specialist who is willing to accept DVA’s treatment arrangements and fee schedules.

DVA will fund the medical and surgical treatment of entitled persons as a private hospital patient in public hospitals, contracted private hospitals, contracted private mental health hospitals, and contracted day procedure centres. Contracted facilities are found at: Hospitals | Department of Veterans' Affairs (dva.gov.au). Prior approval is required before referring a patient to treatment in a non-contracted private hospital, non-contracted private mental health hospital, and non-contracted day procedure centres. Contracted facilities are around at:

Hospitals | Department of Veterans' Affairs (dva.gov.au)

GPs can refer DVA clients to an allied health provider if they have a clinical need. You will need to follow the treatment cycle. A referral for the specified condition or conditions lasts either 12 sessions or 1 year. Clients can have as many treatment cycles as you decide is clinically necessary. When the treatment ends the allied health provider will send you an end of cycle report. You can use your own stationery or the DVA referral form. You do need to include the veteran's DVA number.

Open Arms Veterans and Families Counselling provides a range of free services to assist the ex-serving community and their families. This includes face to face or telehealth counselling, group programs and peer support.

If a GP suspects that a veteran patient has a new diagnosis of ADHD, they should first undertake an assessment using a validated screening tool such as the Australian Evidence-Based Clinical Practice Guidelines for ADHD. There is no established screening tool for diagnosing autism in adults, and a diagnosis is usually made in combination with in-person observations and interactions. If the GP feels that a diagnosis of ADHD or Autism Spectrum Disorder is likely, they can then refer the veteran to a neuropsychologist or psychiatrist for further assessment under Non-Liability Health Care (Mental Health) arrangements. Psychiatrists must accept DVA RMFS fees and not charge a gap fee. Neuropsychologists must register with DVA directly before providing services to entitled persons and cannot charge a gap fee. There are three item numbers (CL20, CL25, CL30) for the provision of neuropsychological assessments that apply. To be eligible to provide neuropsychology services to entitled persons of the veteran community, a provider must:

• be registered with the Psychology Board of Australia; and
• hold an endorsement in clinical neuropsychology from the Psychology Board of Australia; or
• show evidence of their qualifications in neuropsychology, including:
  • an accredited doctorate in neuropsychology and at least one year of approved, supervised, full-time equivalent practice; or
  • an accredited master's in neuropsychology and a minimum of two years of approved, supervised, full-time equivalent practice.

Neuropsychology assessments up to four hours can be claimed directly from Medicare (CL20). Assessments over four hours (CL25 and CL30) require Prior Financial Authorisation (D1328) from DVA. If as a result a mental health condition is identified, then clinically appropriate treatment can be funded under NLHC (MH) arrangements. Medications may be funded through the Repatriation PBS following Chief Health Officer approval in the relevant state or territory. Open Arms Veterans and Families Counselling Service does not provide an assessment service for ADHD or autism but will provide psychological treatment as appropriate.