Changes to chronic disease management MBS items begin 1 July

The Department of Health, Disability and Ageing’s changes to the Medicare Benefits Schedule (MBS) framework for chronic disease management in primary care will come into effect on 1 July.

The new Chronic Condition Management model aims to simplify, streamline and modernise chronic condition care, improving access and continuity for patients managing long-term conditions. 

These changes primarily affect medical practitioners, however, allied health professionals providing MBS services should be aware of the changes to plan and referral requirements.

CDM Plus will present two free webinars on the changes. Details below

At a glance

The changes will:

• Replace the current GP Management Plan (GPMP) and Team Care Arrangements (TCA) with a single GP Chronic Condition Management Plan (GPCCMP)
• Support continuity of care by requiring patients registered for MyMedicare to access management plans and reviews 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 (see new MBS item numbers below)
• Requiring patients to have their plan established or reviewed in the previous 18 months to continue to access allied health 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 GPMPs and TCAs
• Practice nurses, Aboriginal and Torres Strait Islander health practitioners, and Aboriginal health workers can assist in preparing or reviewing plans

Other key points for GPs:

• There will be a transition period of two years to enable people currently on GPMP’s to be transferred to GPCCMPs. Any new plan or review completed after 1 July needs to be a GPCCMP and meet the appropriate referral requirements
• Patients who had a GPMP or TCA in place prior to 1 July 2025 will be able to continue to access services consistent with those plans for two years. From 1 July 2027, a GPCCMP will be required for ongoing access to allied health services
• Consistent with current arrangements, unless exceptional circumstances apply, a GPCCMP can be prepared once every 12 months (if necessary) and reviews conducted once every three months. New plans do not need to be prepared each year, existing plans can continue to be reviewed
• There will be no change to eligibility criteria, ie a condition present or likely to be present for more than six months. There is no specific list of eligible conditions. It is up to GP discretion to determine if someone would benefit from GPCCMP
• A patient may still be on a GPCCMP even if no multi-disciplinary care is required
• Where multidisciplinary care is required, patients will be able to access the same range of services currently available through GPMP and TCAs

Other key points for allied health providers:

• Current Enhanced Primary Care (EPC) plans will remain valid until plans are complete. Patients will then need to transition to the new referral pathway. Any new allied health referrals after 1 July need to be completed using the new referral pathway
• GPs and prescribed medical practitioners will refer patients with a GPCCMP to allied health services directly. The previous EPC referral form will no longer be needed
• The requirement to consult with at least two collaborating providers, as described under the current TCA, will be removed
• There is no longer a need to have confirmed acceptance from the allied health provider, however the provider still needs to meet their reporting requirements
• Referrals are valid for 18 months unless otherwise specified by the referring GP
• The number of allied health visits remain at a maximum of five per year
• Referrals can be signed and transmitted electronically. There are minimum requirements which must be included in the referral letter

MBS items

From 1 July 2025:

• Items for GPMPs (229, 721, 92024, 92055), TCAs (230, 723, 92025, 92056) and reviews (233, 732, 92028, 92059) will cease and be replaced with a new streamlined GPCCMP (see table below for item numbers)
• To encourage reviews and ongoing care, the MBS fees for planning and review items will be equalised. The fee for the preparation or review of a plan will be $156.55 for GPs and $125.30 for prescribed medical practitioners
• These changes do not affect multidisciplinary care plan items (231, 232, 729, 731, 92026, 92027, 92057, 92058)

Table 1: Chronic Condition Management Items commencing 1 July 2025*  

Factsheets on upcoming changes to Chronic Disease Management Framework

For more information, the following factsheets are available from MBS Online:

Allied Health Providers (updated: 6 June 2025)

Practice Nurse, Aboriginal Health Workers and Aboriginal and Torres Strait Islander Health Practitioners (updated: 6 June 2025)

Transition Arrangements for Existing Patients (updated: 22 May 2025)

Referral Arrangements for Allied Health Services (updated: 22 May 2025)

MBS Items for GP Chronic Condition Management Plans (updated: 22 May 2025)

Support is available

For support on MyMedicare and upcoming GPCCMP changes, please contact your Practice Advancement/Practice Support Officer.