FAQ

The Chronic Disease Co-Care Pilot Scheme (CDCC Pilot Scheme) provides subsidy for the public to conduct screening for and manage target chronic diseases, including diabetes mellitus and hypertension, in the private healthcare sector via a "Family Doctor for All" and multidisciplinary public-private partnership model coordinated by District Health Centre (DHC)/ District Health Centre Express (DHCE). The CDCC Pilot Scheme aims to facilitate early detection and timely intervention of such chronic diseases and encourage self-health management by Scheme Participants, so as to help them better manage their chronic diseases and prevent complications, as well as reduce the demand for public specialised and hospital services.
The CDCC Pilot Scheme comprises a Screening Phase followed by, where applicable, a Treatment Phase based on the diagnosis of each Scheme Participant. In the Screening Phase, Scheme Participants will be provided with screening services including medical consultation and assessment by Family Doctors, investigation services, diagnosis and selection of an appropriate management plan. In the Treatment Phase, Family Doctors will provide medical consultation and medication, as clinically indicated, for eligible Scheme Participants. Based on the diagnosis and clinical condition of Scheme Participants, nurse consultation, allied health services and investigation services may also be provided as appropriate.
The Government has expanded the CDCC Pilot Scheme to cover blood lipid testing for eligible individuals, allowing for a more comprehensive approach to the assessment and proper management of cardiovascular disease risk factors, including the "three highs" (high blood pressure, high blood sugar and high cholesterol).

Following the expansion of CDCC Pilot Scheme, all eligible individuals can receive blood lipid testing during the Screening Phase. Through blood lipid testing and management, Scheme Participants can better effectively prevent or lower the risk of cardiovascular disease with lifestyle modification and drug treatment.
Private doctors are required to meet the following criteria for enrolment in the CDCC Pilot Scheme:
  1. Practising in a private healthcare facility;
  2. Being included in the general register in accordance to Section 14 or Section 14A of the Medical Registration Ordinance (Cap. 161 of the laws of Hong Kong) and holding a valid practising certificate;
  3. Being a healthcare provider enrolled in the Electronic Health Record Sharing System (eHRSS); and
  4. Being listed in the Primary Care Directory (PCD)
Interested private doctors may enrol in the CDCC Pilot Scheme either by invitation from the Government or through their own volition online through the eHRSS.
To streamline the enrolment process for Medical Group Clinics, eligible private doctors under their group practice can enrol as Family Doctors through their authorised Clinic Administrator(s) for provider-based enrolment via eHRSS.

The Medical Group is required to submit the completed and signed Authorisation Form for facilitating private doctor enrolment by Clinic Administrator and the summary private doctor list to the Programme Office via fax or email (the blank Authorisation Form and summary template could be provided by the Programme Office on request).

Programme Office will proceed for the relevant settings on the CDCC IT Platform according to the received documents. Upon completion of the settings, Programme Office will send an email to inform the Medical Group that the relevant function has been enabled. The authorised Clinic Administrator could login to eHRSS for completing the enrolment procedures of the relevant private doctors by means of provider-based enrolment in the CDCC IT Platform and submit the required supporting documents to Programme Office accordingly.
The Family Doctors will receive a confirmation email from Programme Office with the Information kit for Family Doctors and relevant links, such as the website of the CDCC Pilot Scheme, for reference.
After submission of enrolment, the Family Doctors can click "Print Appendices" at the last page of "Enrolment Submission" to download related forms. For more details and video guide, please browse the website of the CDCC Pilot Scheme (www.primaryhealthcare.gov.hk/cdcc) or call the CDCC Pilot Scheme hotline at 2157 0500 for assistance.
Family Doctors under the CDCC Pilot Scheme are required to enrol in the PCD. If private doctors are not enlisted on the PCD, they may submit an application online at www.pcdirectory.gov.hk, or through the eHealth System (Subsidies) if they have already enrolled in the Health Care Voucher Scheme and/ or the Vaccination Subsidy Scheme and/ or Residential Care Home Vaccination Programme. For details, please contact the PCD Hotline at 3576 3658 or email to phcc@healthbureau.gov.hk for further assistance.
Regardless of the other public-private partnership programmes participated by Family Doctors (e.g. GOPC PPP), the Family Doctors have to enrol to the CDCC Pilot Scheme by either online enrolment or through their authorised Clinic Administrator(s) for provider-based enrolment in the CDCC IT Platform.

If Family Doctors enrolling to the CDCC Pilot Scheme are also participating in GOPC PPP and intend to use the same Bank Account for reimbursement, they only need to submit a copy of their MCHK Annual Practising Certificate as supporting document to the Programme Office and are not required to submit the "Authority for Payment to a Bank" Form or any copy of Bank Statement and Business Registration Certificate.
Family Doctors can join the CDCC Pilot Scheme even if they have not joined the GOPC PPP.
If a private doctor wants to join the CDCC Pilot Scheme, he/ she needs to enrol to the Pilot Scheme, irrespective of whether he/ she is a network service provider of DHC/ DHCE.
To enrol in the CDCC Pilot Scheme as a Scheme Participant, an individual is required to meet the following criteria:
  1. is a holder of a valid Hong Kong Identity Card within the meaning of the Registration of Persons Ordinance (Cap. 177), unless he/ she is a holder of the Hong Kong Identity Card by virtue of a previous permission to land or remain in Hong Kong granted to him/ her and such permission has expired or ceased to be valid; or is a holder of a valid Certificate of Exemption within the meaning of the Immigration Ordinance (Cap.115);
  2. is aged 45 years or above;
  3. has no known medical history of diabetes mellitus/ hypertension, nor related symptom(s); and
  4. has registered as a DHC/ DHCE member and agrees to share his/ her data in the eHRSS with related service providers.
The eligibility criteria of Scheme Participants remains unchanged following the expansion of CDCC Pilot Scheme. For details of the eligibility criteria for Scheme Participants, please refer to Q4.
The eligibility criteria of Scheme Participants remains unchanged following the expansion of CDCC Pilot Scheme. For details of the eligibility criteria for Scheme Participants, please refer to Q4.
Based on his/ her understanding of the individual's condition through consultation and review of the relevant information obtained, the Family Doctor can determine according to the best of his/ her knowledge whether an individual has been diagnosed with diabetes mellitus/ hypertension before, and his/ her eligibility to enrol in the CDCC Pilot Scheme.
With clear documentation of the event, the diagnosis of hypertension made by emergency service doctor does not inhibit the individual from enrolling in the CDCC Pilot Scheme if the referral to emergency service is made by Family Doctor or DHC/ DHCE healthcare staff during enrolment.
The individual can participate in the CDCC Pilot Scheme if her blood sugar level returns to non-diabetic range after baby delivery and fulfils other eligibility criteria for the CDCC Pilot Scheme.
Eligible individuals can enrol in the CDCC Pilot Scheme at DHC/ DHCE or at the clinics of Family Doctors who have joined the CDCC Pilot Scheme and support participant enrolment.
Family Doctors may enrol eligible individuals at their clinics via the CDCC IT Platform. A detailed guide and video on conducting the enrolment is posted on the website of the CDCC Pilot Scheme.
Family Doctors may advise such eligible individuals to visit DHC/ DHCE to facilitate their enrolment to the CDCC Pilot Scheme.
Family Doctors can advise the individual to go to the corresponding DHC/ DHCE for clarification and follow-up.
Online training video and user guides are provided. Family Doctors can download the guides from the website of the CDCC Pilot Scheme.
Scheme Participants can select a suitable Family Doctor by searching the website of CDCC Pilot Scheme, which provides the list of Family Doctors with their essential information including practice district, service charge under the CDCC Pilot Scheme and participation in other Government subsidised primary healthcare programmes (e.g. Elderly Healthcare Voucher Scheme).
Family Doctors are selected solely according to the Scheme Participants' own personal choice. DHC/ DHCE staff will first ask Scheme Participants if they have an existing frequently/ regularly attending doctor (i.e. named doctor). If their named doctor has already enrolled as a Family Doctor in the CDCC Pilot Scheme, Scheme Participants may choose the named doctor as their Family Doctor if they want. If Scheme Participants want to choose their named doctor who is not an enrolled Family Doctor of the CDCC Pilot Scheme, the DHC/ DHCE will send invitation letter to that named doctor to join the CDCC Pilot Scheme before Scheme Participants can be paired with their named doctor.
Pairing may take place at Family Doctor clinics or DHC/ DHCE. Eligible individuals may enrol in the CDCC Pilot Scheme at the Family Doctor clinics which support participant enrolment and directly pair with the Family Doctor visited, provided that the individual Scheme Participants have not been previously paired with any Family Doctor. Scheme Participants may also visit their registered DHC/ DHCE to carry out the pairing process or apply for a change of their paired Family Doctor. DHC/ DHCE staff will provide a list of eligible doctors for Scheme Participants to select as their Family Doctor, according to their own choice. Scheme Participants may choose their existing frequently/ regularly attending doctor (i.e. named doctor) as their Family Doctor if the named doctor has also joined the CDCC Pilot Scheme. DHC/ DHCE staff will not recommend or assign any Family Doctors to the Scheme Participants. After successful pairing, Scheme Participants will be arranged to receive screening and, if applicable, treatment by their selected Family Doctors.
For the Screening Phase, Family Doctors are required to accept any Scheme Participants who have been referred to them by DHC/ DHCE to participate in the CDCC Pilot Scheme. Acceptance of Scheme Participants in the Treatment Phase is subject to mutual agreement between the Family Doctors and the Scheme Participants.
In general, Family Doctors are not required to indicate any quota for accepting Scheme Participants. In the event that the Family Doctor's clinic is temporarily unavailable for accepting new Scheme Participants due to interruption or suspension of services, the Family Doctors should inform the Programme Office immediately via email at cdccdoctor@healthbureau.gov.hk or fax to 3427 9359 and provide the details of the clinic, the reason(s) for service interruption or suspension and the expected date, if possible, for resumption of services.
When a doctor has completed enrolment application and submitted relevant information and supporting document, or a Family Doctor on the list needs to update information, Programme Office will review the submitted document and issue an email for acknowledgement. The list of Family Doctor on the website will usually be updated once a week.
Family Doctors may terminate their participation in the CDCC Pilot Scheme by giving not less than 90 days' written notice, to the Programme Office via email to cdccdoctor@healthbureau.gov.hk or fax to 3427 9359, and to the Scheme Participants under his / her care. A Family Doctor may, without terminating his/ her participation in the CDCC Pilot Scheme, terminate the doctor-patient relationship with any specific Scheme Participant by giving not less than 30 days' written notice, to the Programme Office and that specific Scheme Participant to allow adequate time for re-pairing of Family Doctor to ensure continuity of care to the Scheme Participant.
Scheme Participants are encouraged to maintain a long term relationship with their paired Family Doctor. However, if they do want to change their paired Family Doctor, they may submit the request to DHC/ DHCE for arrangement. The request will be handled on a case-by-case basis.
Family Doctors may contact the CDCC Pilot Scheme's hotline at 2157 0500 for assistance. The hotline operates from 9:00am to 9:00pm Monday to Saturday. If the line is busy or if the call is made outside of operating hours, Family Doctors may leave a voicemail and we will respond to the inquiry as soon as possible during our office hours.
The service fee for the Screening Phase is the aggregate amount of a fixed one-off Government subsidy of $196 payable upon the completion of screening, and the one-off co-payment of $120 or less charged by the Family Doctors and payable by the Scheme Participants at their first subsidised medical consultation visit of the Screening Phase.
The Screening Phase covers medical consultation and assessment in relation to screening for diabetes mellitus and hypertension, reviewing investigation result(s), and making diagnosis by the Family Doctors. Before the completion of the Screening Phase, Family Doctors are required to input the following information in the CDCC IT Platform:
  • Attendance record for at least one face-to-face subsidised medical consultation visit
  • Completed mandatory fields for medical consultation record
  • Investigation result(s)
  • Diagnosis
  • Selected management plan
The Screening Phase can be started with subsidised medical consultation provided by the paired Family Doctor immediately following successful enrolment of eligible individuals in the CDCC Pilot Scheme.
The service fee is a one-off fee, irrespective of the number of medical consultations provided to the Scheme Participant.
The criteria for receiving Government subsidy in the Screening Phase is to have at least one face-to-face medical consultation for attendance record. However, any other medical consultations can be done by phone or online.
For Scheme Participants with HbA1c ≤ 5.9% or FPG ≤ 6 mmol/L but without hypertension
Scheme Participants will re-enter the Screening Phase in three years' time. Family Doctors can arrange for medical consultation visit and investigation services for Scheme Participants once every 3 years (or more frequently if clinically indicated).

For Scheme Participants diagnosed with prediabetes with HbA1c 6.0% - 6.4% or FPG 6.1 mmol/L - 6.9 mmol/L but without hypertension
Family Doctors can arrange for investigation services annually (or more frequently if clinically indicated) and any additional investigation services as necessary during medical consultation visit(s) included in the Treatment Phase.

After the investigation result(s) become available, Family Doctors need to explain the result(s) to the Scheme Participants and manage the Scheme Participants following the Operation Manual of the CDCC Pilot Scheme as posted on the website of the CDCC Pilot Scheme. DHC/ DHCE will also provide nursing support and care coordination for Scheme Participants according to the Operation Manual.
If Scheme Participants were not diagnosed with diabetes mellitus and/ or hypertension in previous screening(s) conducted prior to the expansion of the CDCC Pilot Scheme to include blood lipid testing, and is currently being followed up by DHC/ DHCE, the Scheme Participants shall be arranged to undergo blood lipid testing for dyslipidemia together with rescreening of diabetes mellitus and hypertension. The paired Family Doctors of Scheme Participants may also arrange for them to undergo blood lipid testing as clinically indicated.

If Scheme Participants have been diagnosed with prediabetes/ diabetes mellitus and/ or hypertension, and is under the Treatment Phase, the paired Family Doctors of Scheme Participants would refer them for blood lipid testing and any other applicable investigation as part of the laboratory investigations conducted annually or more frequently as clinically indicated.
The number of subsidised medical consultation visits Scheme Participants are entitled to is subject to their diagnosis. Scheme Participants diagnosed with diabetes mellitus and/ or hypertension are entitled to a maximum of 6 subsidised medical consultation visits per year, while those diagnosed to have prediabetes with HbA1c 6.0% - 6.4% or FPG 6.1 mmol/L - 6.9 mmol/L having no hypertension are entitled to a maximum of 4 subsidised medical consultation visits per year.

Scheme Participants diagnosed with specified condition of dyslipidaemia without prediabetes, diabetes mellitus or hypertension are entitled to a maximum of 4 subsidised medical consultation visits in the first year and 2 subsidised medical consultation visits for each subsequent year while those who are diagnosed with specified condition of dyslipidaemia as well as with prediabetes or diabetes mellitus/ hypertension are entitled to a maximum of 4 or 6 subsidised medical consultation visits per year respectively.
The service fee for the Treatment Phase is the aggregate amount of a fixed Government subsidy for one subsidised medical consultation visit in the Treatment Phase, and the co-payment determined by the Family Doctors and payable by the Scheme Participants for that subsidised medical consultation visit. The service fee for each subsidised visit covers the medical consultation and assessment, medication (if any) and related referral.
On enrolment to the CDCC Pilot Scheme, Family Doctors are required to inform the Government of the amount of co-payment they will charge each Scheme Participant for each subsidised medical consultation visit during the Treatment Phase. This co-payment determined by the Family Doctors may differ from the Government recommended co-payment fee.
Scheme Participants are required to go through Screening Phase before proceeding to the Treatment Phase. The Screening Phase is an essential step to ensure a correct diagnosis is made and an appropriate management plan can be arranged for Scheme Participants.
A "Participant Programme Year" is each 12-month period in which a Scheme Participant is enrolled in the CDCC Pilot Scheme, and is counted from the date on which the Scheme Participant is admitted into a management programme of the Treatment Phase based on his/ her diagnosis, and recounted on the same date each year (e.g. if a Scheme Participant enters the Treatment Phase on 1 November 2023, the next "Participant Programme Year" will be counted from 1 November 2024).
Where a Scheme Participant's clinical condition changes during the Treatment Phase, the Family Doctor will make a new diagnosis and change to the respective management programme. If a Scheme Participant's diagnosis is changed during a "Participant Programme Year", the start date for his/ her current "Participant Programme Year" will be reset from the date on which the new diagnosis is made, the subsidised medical consultation visit quotas the Scheme Participant is entitled to each "Participant Programme Year" and all subsequent incentive targets will also be reset and re-calculated according to the updated diagnosis.
To ensure the adequate utilisation of the Government subsidised the CDCC Pilot Scheme, Family Doctors are required to provide face-to-face consultation services in order to validate the actual attendance of subsidised visits.
In case of any change in the Scheme Participant's clinical condition during the Treatment Phase which warrants a change in his/ her diagnosis, the Family Doctor may change the management programme accordingly. For details, please refer to the Operation Manual for Family Doctors of the CDCC Pilot Scheme as posted on the website of the CDCC Pilot Scheme.
To support and empower Family Doctors in long-term management of Scheme Participants, the Government has developed a bi-directional referral mechanism with the Hospital Authority (HA) involving seven HA Clusters under the CDCC Pilot Scheme. Based on the pre-defined criteria, if a Scheme Participant is assessed by a Family Doctor as having clinical needs (such as undesirable disease control or complications), the Family Doctor can arrange for the Scheme Participant to receive a one-off specialist consultation at a designated Medicine Specialist Out-patient Clinic of the HA according to the guidelines. For details of the criteria required to arrange for a specialist consultation under this mechanism, please refer to the Operation Manual for Family Doctors of the CDCC Pilot Scheme as posted on the website of the CDCC Pilot Scheme.

Upon the Scheme Participant's attendance of the specialist consultation, the HA specialist will provide the Family Doctor with a care plan based on the Scheme Participant's clinical condition. The Family Doctor will then monitor the clinical condition of the Scheme Participant as appropriate and take follow-up actions in accordance with the care plan. This special arrangement is not regarded as a specialist out-patient referral nor follow-up consultation, and each attendance is charged at a standardised fee of $135. The HA in general would not arrange follow-up appointments for Scheme Participants. In the event that drug prescription is required for Scheme Participants, a charge of $15 will be applied per prescribed drug item. Medical fee waiver is not applicable to this arrangement, and same fees apply to Scheme Participants who are HA staff or civil service eligible persons.

If none of the conditions required for referral under this mechanism is met, but the Family Doctor nonetheless determines that specialist consultation / treatment is necessary, he/ she may refer the Scheme Participant to receive healthcare services at specialist out-patient clinics under HA following prevailing mechanism.
Scheme Participants are only entitled to use one subsidised medical consultation visit quota per day. Additional medical consultation(s) on any single day is/ are not covered under the scope of the CDCC Pilot Scheme and are considered the private arrangement between the Family Doctors and Scheme Participants. Scheme Participants will have to pay the full costs specified by Family Doctors, out-of-pocket for such additional service(s) or treatments.
Scheme Participants can seek care for both chronic and episodic illnesses at any given subsidised medical consultation visit. Family Doctors will provide holistic care to Scheme Participants, and so may assess the overall health status of the Scheme Participant at any subsidised medical consultation visit. Scheme Participants are also encouraged to inform their Family Doctor of their overall health conditions.

If Family Doctors are required to provide treatment for other health problems or illnesses of Scheme Participants outside the scope of the CDCC Pilot Scheme, this will be subject to the mutual agreement and Scheme Participants should pay any relevant fees to the Family Doctors.
During each subsidised medical consultation visit of the Treatment Phase, Scheme Participants will receive management of their chronic illnesses. When receiving treatment for their chronic illnesses, Scheme Participants may also receive diagnosis and treatment for episodic illnesses during the same subsidised medical consultation visit when required. If Scheme Participants receive treatment for episodic illnesses only, such is considered outside the scope of the CDCC Pilot Scheme and Scheme Participants have to pay the full costs specified by the Family Doctors.
The CDCC Pilot Scheme comprises a Screening Phase followed by, where applicable, a Treatment Phase based on the diagnosis of each Scheme Participant. For services rendered within the scope of the CDCC Pilot Scheme, Scheme Participants are only required to pay the co-payment fee.

Having regard to clinical need and subject to mutual agreement between the Family Doctor and Scheme Participant, services outside the scope of the CDCC Pilot Scheme may be provided. Family Doctors should explain to Scheme Participants that such medical services and medications fall outside the scope of the CDCC Pilot Scheme, inform Scheme Participants of any fees arising from such items and obtain agreement and consent from Scheme Participants to receive and pay for those services and/ or medications.
It is desirable for Family Doctors to have relieving service arrangement in place during their absence. The assigned relieving doctor(s) is required to enrol in the CDCC Pilot Scheme as a Family Doctor and provide service for subsidised medical consultation to Scheme Participants.
The laboratory investigation results can be accepted by Family Doctors as long as the tests are performed by investigation services providers in Hong Kong within 6 months from the first subsidised medical consultation visit in the Screening Phase.
The turnaround time for investigation services may vary depending on the investigation item(s) and the designated investigation services provider conducting the test(s). Generally, the test(s) may be completed within a few days. The Family Doctors will receive the investigation results electronically through CDCC IT Platform once available.
Upon referral by their Family Doctor, Scheme Participants can receive relevant investigation services (lab tests, ECGs) at investigation services providers, which are designated by Government. The addresses of the designated investigation services providers and the Scheme Participants' co-payment fee will be displayed on the website of the CDCC Pilot Scheme for public information. Scheme Participants need to ask their Family Doctor about the assigned designated investigation services provider.
There are two designated investigation services providers for the CDCC Pilot Scheme. Each Family Doctor's clinic will be assigned to one of these providers according to the tender specifications with due consideration to the clinics' district location.
Scheme Participants will choose from any of the service points of the investigation services providers assigned to their chosen Family Doctors for receiving investigation services. The service points and service hours can be found on the referral slip issued by the Family Doctors.
Subject to the mutual agreement between Scheme Participants and Family Doctors, Scheme Participants may pay out-of-pocket to choose to receive investigation services from service providers other than the Government designated investigation services providers. Scheme Participants will have to pay the full costs of investigation services incurred without Government subsidy.
The Family Doctors can reject an investigation result issued by Government designated investigation services providers during either the Screening or Treatment Phases. If the Family Doctors consider that the result does not fulfill the requirements specified in the investigation request, they can request investigation services providers to repeat the test or conduct additional investigation as indicated. If the investigation cannot be completed according to the explanation provided by the investigation services providers, the Family Doctors can assess the importance of the incomplete item. If it is deemed essential for the investigation, the Family Doctors can issue a new investigation service request and instruct the Scheme Participants to repeat the investigation. On the other hand, if the incomplete item is not considered crucial to the investigation, the Family Doctors can proceed with clinical management.
Subject to Scheme Participants' clinical needs and the mutual agreement between Scheme Participants and Family Doctors, Scheme Participants may receive investigation services for items outside the investigation list of the CDCC Pilot Scheme. The fees incurred for Scheme Participants who choose to receive investigation services outside the scope of the CDCC Pilot Scheme will be at their own expense.
Family Doctors can provide a copy of the investigation report upon Scheme Participants' request. Scheme Participants shall pay at their own expense any costs charged by individual Family Doctors.
Designated DHC/ DHCE staff can review the management plans of Scheme Participants through the CDCC IT Platform. For special issues related to Family Doctor pairing or the management plans of Scheme Participants, Family Doctors may call or email the designated DHC/ DHCE staff.
Family Doctors need to print a referral letter for Scheme Participants and/ or fax the referral letter to the responsible DHC/ DHCE. DHC/ DHCE will make appointments with nurse clinic/ allied health professionals for the Scheme Participants in accordance with their assigned management plans and recommendation from Family Doctors.
Scheme Participants may choose to use nurse clinic/ allied health services other than the Government designated service providers, however Scheme Participants have to pay out-of-pocket for the full costs incurred without Government subsidy.
The CDCC Pilot Scheme covers more than 50 items of basic medications, providing a relatively lower cost supply for Family Doctors. The list of medications covered under the "Specified Drugs" list is available for reference on the website of the CDCC Pilot Scheme.

Family Doctors shall prescribe medications based on clinical indication of Scheme Participants. The following medications are covered under the CDCC Pilot Scheme and no extra charge shall be incurred to Scheme Participants:

  1. For chronic diseases
    • All chronic diseases medications listed under the basic tier of the "Specified Drugs" list (including anti-diabetic drugs, anti-hypertensive drugs, supplementary drugs to anti-hypertensive and lipid-regulating drugs).
  2. For episodic illnesses
    • All episodic illnesses medications listed under the basic tier of the "Specified Drugs" list;
    • Up to 3 days of episodic illnesses medications outside the "Specified Drugs" list.
When clinically indicated, Family Doctors may also prescribe and charge for:
  • Any medications outside the aforementioned (1) & (2) situations;
  • Any treatment involving the use of medications at the clinic (e.g. injection for acute pain relief).
The charging for these circumstances shall be made under mutual agreement with Scheme Participants.
Family Doctors may use their own clinic's drugs or purchase "Specified Drugs" from designated drug suppliers at discounted prices offered under the CDCC Pilot Scheme. Family Doctors can make orders, view order status, check remaining order balance and review past orders using the CDCC IT Platform.
Family Doctors can start ordering "Specified Drugs" via the CDCC IT Platform after being paired with the first Scheme Participant. A "Starter Pack" comprising all drugs listed on the "Specified Drugs" list will then be available for purchase by the Family Doctors.
Family Doctors and the drug suppliers can contact each other directly in case of any issues, including delivery error or drug recall, late delivery, shelf-life or dispute regarding the "Specified Drugs" delivered by the drug suppliers. All payments for the "Specified Drugs" should be paid by Family Doctors to the drug suppliers directly.
The Government will specify the maximum quantity of "Specified Drugs" which Family Doctors may purchase in a specified period at discounted prices offered under the CDCC Pilot Scheme. It is important for Family Doctors to input the prescription record for each subsidised medical consultation visit onto the CDCC IT Platform so that the system can deduce the quantity of drugs available for purchase and whether the Family Doctors can receive the quarterly Government subsidy for medication.
The specified price of individual drug item will be displayed in the electronic drug ordering platform of eHealth when an enrolled Family Doctor order the drug.

For a full price list of all drugs, Family Doctors could raise a request to the Programme Office by submitting "Request Form for Reference Pricing Information of Specified Drugs" via fax or email. The form can be downloaded from the CDCC Pilot Scheme Website (https://www.primaryhealthcare.gov.hk/cdcc/en/hp/resources.html).
Subject to Scheme Participants' clinical needs and the mutual agreement between the Scheme Participants and the Family Doctors, the Family Doctors may, at a subsidised medical consultation visit, prescribe chronic disease medications for a duration that they determine to be the most appropriate for the Scheme Participants based on their clinical judgment.

When Family Doctors prescribe any chronic diseases medications listed under the basic tier of the "Specified Drugs" list, no extra charge shall be incurred to Scheme Participants.

When clinically indicated, Family Doctors may also prescribe and charge for any chronic disease medication outside the aforementioned situation, or any treatment involving the use of medications at the clinic (e.g. injection for acute pain relief). The charging for these circumstances shall be made under mutual agreement with Scheme Participants.
Subject to Scheme Participants' clinical needs and the mutual agreement between the Scheme Participants and the Family Doctors, the Family Doctors may, at a subsidised medical consultation visit, prescribe episodic illness medications for a duration that they determine to be the most appropriate for the Scheme Participants based on their clinical judgment.

When Family Doctors prescribe any episodic illnesses medications listed under the basic tier of the "Specified Drugs" list, or up to 3 days of episodic illnesses medications outside the "Specified Drugs" list, no extra charge shall be incurred to Scheme Participants.

When clinically indicated, Family Doctors may also prescribe and charge for any episodic illness medications outside the aforementioned situations, or any treatment involving the use of medications at the clinic (e.g. injection for acute pain relief). The charging for these circumstances shall be made under mutual agreement with Scheme Participants.
If medication(s) under the basic tier of "Specified Drugs" is / are prescribed for chronic diseases, Family Doctors will receive a quarterly Government subsidy for medication. A fixed amount of $105 per Scheme Participant will be reimbursed to Family Doctors, at a maximum frequency of once per quarter and four times per calendar year. If no medication(s) under the basic tier of "Specified Drugs" for chronic diseases were prescribed by Family Doctors for Scheme Participants in a quarter, no Government subsidy would be made for that quarter.
As an incentive for Family Doctors to perform administrative work of enrolling participants directly to the CDCC Screening Phase at their clinics, a one-off administration fee of $76 is to be paid to Family Doctors for each successful enrolment of eligible participant to the Screening Phase of the CDCC Pilot Scheme. This arrangement was effective on 22 March 2024, till the completion of the pilot scheme and to be reviewed at appropriate time. Family Doctors can submit claims of administration fee from 1 August 2024 onwards, including the retrospective records of administration fee dated from 22 March 2024, through the CDCC IT Platform.
For the Screening Phase, Family Doctors can charge the one-off co-payment of $120 or less at the first subsidised medical consultation visit. For the Treatment Phase, the Family Doctors can charge the co-payment determined by them, as specified during their enrolment and/ or annual co-payment adjustment in the CDCC Pilot Scheme, or less at each subsidised medication consultation visit.
If DHC/ DHCE has contacted Scheme Participant for blood lipid testing at his/ her paired Family Doctor, the Scheme Participant would need to pay a one-off co-payment fee of $120 or less to the Family Doctor, which would include medical consultation visit(s) and related laboratory investigation services. The Government will provide a one-off fixed subsidy of $196 to the Family Doctor to cover the relevant expenses. The co-payment amount to be paid by Scheme Participants for the Screening Phase remains the same following the expansion of the CDCC Pilot Scheme to include blood lipid testing.

If a Scheme Participant is under the Treatment Phase, the Scheme Participant only has to pay the co-payment fee to the investigation services provider for each investigation item requested, and the Government will provide a partial subsidy to the investigation services provider. This has no effect on the co-payment or subsidy paid to the Family Doctor for each subsidised medical consultation visit.
Family Doctors may adjust the amount of co-payment they had determined under the Treatment Phase on an annual basis (details of which will be announced by the Government) and such adjustments shall not take effect before the effective date announced by the Government.
Family Doctors providing service in multiple registered service locations can determine different co-payment amount for each registered service location.
For the Screening Phase, the Government subsidy is a fixed one-off amount of $196. For the Treatment Phase, the Government subsidy amount is $166 for each subsidised medication consultation visit.
Scheme Participants are entitled to use the electronic vouchers under the Government's Elderly Healthcare Voucher Scheme towards the settlement of the co-payment charged by Family Doctors, provided that the Family Doctor accepts Elderly Healthcare Vouchers.
Family Doctors can submit claims of subsidy for subsidised medical consultation visit, quarterly medication fee and incentive payment (if any) under the CDCC IT Platform on any day of next month. Submitted claims shall be verified by the Government. Subject to verification and acceptance of the claim, payment shall be made by the Government within 30 clear working days from the date of which the submitted claims are to the satisfaction of and not disputed by the Government.
Incentive targets are applicable to the Treatment Phase only and the specific target parameters depend on whether the Scheme Participants are diagnosed with (i) diabetes mellitus; (ii) hypertension; (iii) diabetes mellitus + hypertension; or (iv) hypertension + prediabetes.
The prerequisite for Family Doctors to be eligible to receive an incentive payment is based on three pooled service outcomes respective to the control of blood glucose and blood pressure for diabetes mellitus and/ or hypertension for respective Scheme Participants under their care. If among the Scheme Participants with diabetes mellitus and/ or hypertension under the Family Doctor's care, at least 70% of Scheme Participants with relevant conditions who achieved the target in each of the pooled service outcomes, the Family Doctor fulfills the prerequisite for incentive. The incentive will be calculated based on the service outcomes at the end of each calendar year (The first calendar year for which such achievement will be considered is 2025).

 
Category Target Parameters Applicable Disease Groups Achievement Requirements for Target Parameters
("Number of Scheme Participants" refers to those Scheme Participants who have completed his "Participant Programme Year" ending in the calendar year.)
 HT + Pre-DM   HT   DM + HT   DM 
Pooled Service Outcome DM management:
HbA1c < 7% 		    ✓ ✓ Number of Scheme Participants who have achieved the HbA1c target over the number of Scheme Participants from DM+HT and DM disease groups must be ≥ 70%
DM management:
BP < 130/80 		    ✓ ✓ Number of Scheme Participants who have achieved the BP target over the number of Scheme Participants from DM+HT and DM disease groups must be ≥ 70%
HT management:
BP < 140/90 		✓ ✓     Number of Scheme Participants who have achieved the BP target over the number of Scheme Participants from HT+Pre-DM and HT disease groups must be ≥ 70%
Data sources of HbA1c are from both records (i) manually input by Family Doctors in the CDCC IT Platform's treatment consultation documentation (including subsidised medical consultation visits and self-financed visits); and (ii) automatically uploaded from laboratory investigation report (whenever applicable), within the 12-month Participant Programme Year.

The latest reading of HbA1c record from the CDCC IT Platform for each Scheme Participant with diabetes mellitus with/ without hypertension under the Family Doctors' care will be used in the calculation of the corresponding pooled service outcome.
The BP records of a Scheme Participant documented in the CDCC IT Platform under medical consultation(s) (including subsidised medical consultation visits and self-financed visits) and nurse clinic consultation(s) within the 12-month Participant Programme Year in the Treatment Phase will be used for working out the mean BP.

The mean office BP of each Scheme Participant with diabetes mellitus and/ or hypertension under the Family Doctors' care will be adopted in the calculation of the corresponding pooled service outcome.
The incentive payment mechanism will only consider Scheme Participants that have completed their second "Participant Programme Year" (PPY) or beyond, and have met their individual achievement requirements. The incentive payment for Family Doctor is calculated as below:

The number of actual subsidised medical consultation visits in the Treatment Phase attended by the Scheme Participants within their respective completed PPY^ and who have achieved their respective applicable individual achievement requirements within their respective completed PPY ending in the calendar year
X
(the Government Subsidy per subsidised medical consultation visit for the Treatment Phase*
+
the Government recommended co-payment amount per subsidised medical consultation visit for the Treatment Phase#)
X
15%

^Second PPY or beyond
*Currently at $166
#Currently at $150

Example of a Family Doctor who fulfilled prerequisite for incentive calculation:
  1. Scheme Participants who completed and achieved incentive criteria in their Participant Programme Years before cut-off by the end of that calendar year (Scheme Participant 1-3) are included in the incentive calculation of the Family Doctor.
  2. The amount of incentive payment to be paid to the Family Doctor will be calculated based on Scheme Participant 1-3's actual no. of subsidised consultation sessions attended (excluding any self-financed consultations), and reference price per subsidised consultation (currently at $166+$150=$316).
 
Scheme Participant paired with the Family Doctor Actual no. of subsidised consultations attended by Scheme Participant (Max. 6) Fulfilled/ did not fulfill incentive criteria Incentive amount to the Family Doctor
Scheme Participant 1 4 Fulfilled 4 x $316 x 15% = $189.6
Scheme Participant 2 2 Fulfilled 2 x $316 x 15% = $ 94.8
Scheme Participant 3 3 Fulfilled 3 x $316 x 15% = $142.2
Scheme Participant 4 6 Not fulfill /
Total $426.6

(For details of the Scheme Participant's individual achievement requirements, please refer to the Scheme Participant's FAQ 60-64: https://www.primaryhealthcare.gov.hk/cdcc/en/gp/faq.html)
Family Doctors can submit claim of the incentive payment in respect of a calendar year through the "Submit Reimbursement" function in the Administration Page under the CDCC IT Platform when he/ she had already met the requirements for incentive payment. The incentive payment receivable by Family Doctors are calculated automatically by the CDCC IT Platform in respect of a calendar year. The first calendar year for which such achievement will be considered is 2025.
Family Doctor's incentive payment is calculated at the end of each calendar year (The first calendar year for which such achievement will be considered is 2025), based on the total number of qualified Scheme Participants under his/ her care that have completed their second "Participant Programme Year" or beyond, and have met their individual achievement requirements.

If a Scheme Participant who has completed his/ her second "Participant Programme Year" or beyond and has met his/ her individual achievement requirements had changed his/ her paired Family Doctor in the Treatment Phase before the end of the calendar year, this Scheme Participant's outcome(s) in the Treatment Phase will be counted towards the newly paired Family Doctor.

(For details of the calculation of Family Doctor's incentive payment amount, please refer to Q87.)
(For details of the Scheme Participant's individual achievement requirements, please refer to the Scheme Participant's FAQ 60-64 https://www.primaryhealthcare.gov.hk/cdcc/en/gp/faq.html)
Where a Scheme Participant's clinical condition changes during the Treatment Phase, the Family Doctor may make a new diagnosis and change to the respective management programme. If a Scheme Participant's diagnosis is changed, the start date for his/ her current "Participant Programme Year" will be reset, and the respective applicable individual achievement requirements will also be recalculated from the date on which the new diagnosis and management plan are adopted. Subsequently, the incentive calculation of the Family Doctor will be affected if the Scheme Participant's "Participant Programme Year" is not completed by the end of that calendar year.

(For details of the Scheme Participant's individual achievement requirements, please refer to the Scheme Participant's FAQ 60-64: https://www.primaryhealthcare.gov.hk/cdcc/en/gp/faq.html)
Family Doctor's incentive payment is calculated at the end of each calendar year (The first calendar year for which such achievement will be considered is 2025), based on the total number of qualified Scheme Participants under his/ her care that have completed their second "Participant Programme Year" or beyond, and have met their individual achievement requirements.

If the Scheme Participant had already completed his/ her applicable individual achievement requirements within the respective "Participant Programme Year" before he/ she withdraws from the CDCC Pilot Scheme, then the Scheme Participant's outcome in the Treatment Phase will still be counted for the Family Doctor's incentive payment at the end of that calendar year.

(For details of the calculation of Family Doctor's incentive payment amount, please refer to Q87.)
(For details of the Scheme Participant's individual achievement requirements, please refer to the Scheme Participant's FAQ 60-64: https://www.primaryhealthcare.gov.hk/cdcc/en/gp/faq.html.)
If a Family Doctor had already met the requirements for incentive payment and had submitted claims for his/ her eligible incentive payment before he/ she withdraws from the CDCC Pilot Scheme, then his/ her incentive payment will be processed as normal.
All Scheme Participants and Family Doctors are required to participate in the eHRSS so as to enable sharing of clinical information between the private and the public sectors. For details, please visit the eHRSS website at https://www.ehealth.gov.hk or contact the Healthcare Provider eHRSS hotline at 3467 6230 for assistance.
Family Doctors can contact either service provider of eHRSS and/ or Primary Healthcare Commission to update the information before starting their application. Family Doctors can contact the Healthcare Provider eHRSS hotline at 3467 6230, and/ or PCD Hotline at 3576 3658 for assistance.
For the Screening Phase, the Scheme Participant's attendance record, medical assessment result(s), investigation result(s), diagnosis, selected management plan and payment record are required to be documented on the CDCC IT Platform. For the Treatment Phase, the Scheme Participant's attendance record, medical assessment and management, payment record and, where applicable, medication record and investigation result(s) are required to be documented on the CDCC IT Platform.
In case of any difficulty accessing the eHRSS platform, Family Doctors can call the Healthcare Provider eHRSS hotline at 3467 6230 for assistance. For information on how to use the CDCC IT Platform, Family Doctors can either read user documents from the eHRSS, or call the CDCC Pilot Scheme hotline at 2157 0500 for assistance.
Family Doctors can request a new SMS OTP by pressing 'Resend'. If the problem persists, Family Doctors can contact the Healthcare Provider eHRSS hotline at 3467 6230 for assistance.
Family Doctors can update their contact details, such as telephone number and communication means, via the eHealth App or the eHealth hotline for general public at 3467 6300 after identity verification.
If Family Doctors have any updates/ changes to make to the information they previously provided for enrolment, they are required to inform the Programme Office immediately via email (at cdccdoctor@healthbureau.gov.hk) or by fax (to 3427 9359). Upon receiving such request, the Programme Office will proceed with updating the information on the CDCC IT Platform.

Family Doctors should also inform the Primary Healthcare Commission of corresponding update of such information, by using the PCD online service provider platform. For enquiries about PCD, please contact the PCD Hotline at 3576 3658 or by email to phcc@healthbureau.gov.hk for further assistance.