Changes to Chronic Disease Management MBS items

From 1 July 2025, Medicare Benefits Schedule (MBS) items will be changing to:

• replace the current GP Management Plan and Team Care Arrangements with a single GP Chronic Condition Management Plan
• support continuity of care by requiring patients registered for MyMedicare to access management plans through the practice where they are registered. Patients who aren’t registered will be able to access management plans through their usual GP
• encourage management plan reviews by:
  • equalising the fees for developing and reviewing plans
  • requiring patients to have their plan established or reviewed in the last 18 months so they can retain access to allied health and other services
• formalise referral processes for allied health services so they are more consistent with other referral arrangements
• ensure patients do not lose access to their current services through transition arrangements for existing patients with GP Management Plans and Team Care Arrangements.

Upcoming changes to MBS Chronic Disease Management Arrangements | Australian Government Department of Health and Aged Care

New item numbers are also anticipated to outline the important role of practice nurses, Aboriginal health workers and Aboriginal and Torres Strait Islander health practitioners in assisting GPs in the preparation of chronic conditions management plans and reviews.

To encourage more regular reviews and ongoing care, the MBS fees for planning and review items will be equalised.

Patients will also need to have their GP chronic condition management plan prepared or reviewed in the previous 18 months to access related allied health services.

New Chronic Conditions Management items also leverage MyMedicare and are likely to drive a wave of MyMedicare registrations by patients.

To support continuity of care, patients registered through MyMedicare are only able to access their GP chronic condition management plan and review items through the practice where they are registered for MyMedicare (patients not registered for MyMedicare will be able to access the items through their usual GP).

Currently 1.5 million Australians are registered for MyMedicare.

Chronic conditions management activities make up a substantial proportion of general practice activity with 2022-2023 data from the Australian Institute of Health and Welfare identifying that:

• Almost one in six (16 per cent; 4.1 million) Australians claimed a Chronic Disease Management service
• 60 per cent of people (10.2 million) who visited a GP in the last 12 months had a long-term health condition

To prevent any disruptions to care, patients with an existing GP management plan and/or team care arrangement in place prior to 1 November 2024 will be able to continue to access services consistent with those plans for two years.

From 1 November 2026, a new GP chronic condition management plan will be required for ongoing access to allied health services. In addition, from 1 November 2026, a GP chronic condition management plan will be required to access domiciliary medication management reviews (items 245 and 900).

Steps to prepare your practice

Consider preparing your practice team for Chronic Conditions Management and MyMedicare patient registration:

• Discuss what these changes mean with your practice team and identify activities or processes to review or update (e.g. incorporate MyMedicare registration in workflows for chronic disease/conditions management)
• Register your practice for MyMedicare if you have not done so already
• Encourage your patients to register with MyMedicare, particularly those with a chronic condition or existing care plan:
  1. Prepare your practice team to speak about MyMedicare with patients. Discuss MyMedicare at practice meetings, print copies of the MyMedicare brochures and MyMedicare patient registration frequently asked questions for your practice team to have on hand while discussing with patients
  2. MyMedicare Registration form: Include the MyMedicare Registration form and brochure with your patient consent and data collection form
  3. Update your practice website: Include links to MyMedicare brochures, MyMedicare patient registration information, and MyMedicare patient registration frequently asked questions
  4. Display: MyMedicare posters and brochures in your practice waiting room/reception and display MyMedicare patient videos in your waiting room screens
  5. Post on socials: post about MyMedicare on your practice social media pages using these official social media tiles.

The MyMedicare communication resources for General Practice includes social media tiles, videos, brochures and posters.

South Western Sydney PHN will keep you updated with more information about these changes as they are released.

Please contact us at enquiries@swsphn.com.au for information and support.