Enteral Feeding Supplement
You need all of the following documentation to claim the enteral feeding supplement on behalf of a care recipient:
- written certification by a medical practitioner that the care recipient has a medical need for enteral feeding
- written certification by a medical practitioner or dietician that the dietary formula prescribed is nutritionally complete
- details of the care recipient’s particular enteral feeding requirements. These can be detailed in the medical certificate, the care recipient’s care plan, and hospital discharge papers or in the dietician’s enteral feeding instructions.
Either a dietician or a medical practitioner can certify in writing that the dietary formula is nutritionally complete. However, only a medical practitioner can certify the care recipient’s medical need for enteral feeding.
Only nutritionally complete liquid dietary formulas administered by a nasogastric, gastrostomy or jejunostomy feeding method can be approved for funding. Funding cannot be claimed for dietary formulas which are taken orally, used as food supplements, or administered in addition to food by mouth.
The enteral feeding supplement is not payable for intermittent or supplementary enteral feeding that is given in addition to oral feeding.
Applying for the enteral feeding supplement
The approved provider is responsible for completing the application form available on the Department of Human Services (DHS) website. Once completed, the form and supporting evidence can be emailed to DHS at firstname.lastname@example.org or posted to:
Department of Human Services
GPO Box 9923
SYDNEY NSW 2001
The form and evidence must be fully completed before DHS can process an application. If a form is not fully completed or the evidence is not provided then DHS will be unable to process the application.
For enquiries about the progress of an application, approved providers can contact DHS on 1800 195 206 or email email@example.com
When payment begins
The enteral feeding supplement is payable from the date of delegate approval (on behalf of the Secretary of the Department of Health). In most circumstances, the delegate will backdate payment to the date of medical certification or the date the care recipient entered care, whichever is later.
Notification of approval will appear on a service’s Medicare payment statement, listed against the respective care recipient under the Payment Type column.
Supplement payment rates
The standard enteral feeding supplement is paid on behalf of an eligible care recipient to cover the cost of formula, equipment and other costs associated with administration of enteral feeding. There are different rates of standard supplement for bolus and non-bolus feeding. Current daily rates are listed on the Schedule of subsidies and supplements.
A higher enteral feeding supplement may be payable.
If the actual cost of providing enteral feeding to the care recipient is equal to or more than 125 per cent of the standard supplement rate. The amount of the higher enteral feeding supplement is equivalent to the actual cost of providing enteral feeding.
Higher costs may occur when a care recipient requires:
- a greater volume of formula each day, for example if the care recipient is of a larger than average build or needs to put on weight
- a more expensive formula to meet his or her special medical needs, for example a person with an illness such as diabetes may need a formula with additional nutrients or calories, and this type of formula may be more expensive
- a higher number of bolus feeds per day
- a formula to be delivered over time or a thicker formula. In this case a mechanical pump is needed to assist with the formula delivery. If a mechanical pump is required then an additional flexitainer may also be required.
The higher supplement is not payable where higher costs are due to a more expensive source of supply. The rate of higher supplement is payable on a case by case basis, subject to delegate approval.
The enteral feeding supplement does not automatically follow the care recipient if they change providers.
If you are the new provider for a care recipient who previously received the enteral feeding supplement, you will need to reapply for the supplement on behalf of the care recipient. This applies to both home care and residential care.
What is enteral feeding?
Enteral feeding is an alternative method of providing nutrients, including water, through a tube placed in the nose, the stomach, or the small intestine. Enteral feeding is given to people who have conditions which affect their ability to absorb nutrients via the gastrointestinal tract, or who cannot swallow food.
The nutrients are provided in a liquid form via nasogastric, gastrostomy or jejunostomy tubes. Enteral feeding can be dispensed as bolus (single) feeds, or as non-bolus (continuous) feeds.
Enteral feeding must be provided in the most economical way available, taking into account the medical needs of the care recipient.
Other government payments
A home care recipient who needs electrical equipment to facilitate enteral feeding may also be eligible for the Essential Medical Equipment Payment. This payment is not specific to aged care. The care recipient is responsible for applying for this payment directly through Centrelink.
Care recipients eligible for the enteral feeding supplement may no longer be eligible for state and territory government aids and equipment schemes. Please contact your jurisdiction for more information.
Enquiries regarding the enteral feeding supplement can be directed to firstname.lastname@example.org.