MBS Archives | South Western Sydney PHN

09 June 2026

From 1 July, GPs must retain evidence of patients assigning their Medicare benefit to the provider and keep it for two years.

A valid Assignment of Benefit (AoB) must be in place before bulk-billed claims are submitted to Medicare.

If Medicare rejects a claim and an MBS item number needs to be changed GPs will be required to seek a new AoB to ensure the patient’s agreement matches the revised service details.

If you use Tyro for Medicare Bulk Bill Easyclaim, you are already capturing evidence of the assignment through your terminal. While in this workflow, services are paid immediately, therefore, this option may not cater for clinics which complete an end-of-day reconciliation process before batching services to Medicare.

What can I do to prepare now?

decide now how you’re going to implement this in your practice
review your policies and processes, for example end of day billing “sign off” before batching
start using a paper process now so your patients get used to assigning their benefit for bulk billing
check your SMS ID is registered with the Australian Communications and Media Authority
make sure your third-party products are ready and use and your communications channels and online booking notices
educate your clinicians and make sure your patients are ready

Find out more

This article appeared in Practice Pulse on Wednesday, 10 June 2026. If you are a GP, practice nurse or practice manager in South Western Sydney and do not get the weekly Practice Pulse email, speak to your Practice Support Officer.

28 October 2025

Changes will be made to the Better Access initiative for psychiatrists, psychologists and GPs through the Medicare Benefits Schedule, from 1 November.

Changes will include:

improving the Better Access initiative to meet the needs of individuals and improve equity of access to mental health supports and services
supporting the holistic relationship between a patient and their healthcare provider, leading to improved patient outcomes
reducing the administrative burden and complexity for GPs and Prescribed Medical Practitioners (PMP) by providing greater flexibility by using time-tiered professional (general) attendance MBS items to review a Mental Health Treatment Plan (MHTP), refer a patient for mental health treatment and undertake general mental health consultations

From 1 November 2025:

A Medicare benefit will only be payable for MHTP preparation, referrals for treatment services and reviews of a MHTP when a patient has seen either a GP/PMP at the patient’s MyMedicare registered practice or their usual medical practitioner if not registered with MyMedicare. These requirements do not affect patients who have been referred via a Psychiatrist Assessment and Management Plan or by a direct referral from an eligible psychiatrist or eligible paediatrician.
GP and PMP MHTP review items (2712, 92114, 92126, 277, 92120, and 92132) and GP and PMP ongoing mental health consultation items (2713, 92115, 92127, 279, 92121 and 92133) will be removed from the MBS.

Key points:

Removal of the 12 review and mental health consultation items provides GPs and PMPs greater flexibility to use the most appropriate time-tiered professional (general) attendance item, reflecting the time spent with patients. This includes items for longer consultations and, where applicable, the triple bulk billing incentive to review MHTPs and deliver mental health care and support to patients.
Any MHTP referral dated prior to 1 November 2025 will remain valid until all treatment services specified in the referral (within the maximum session limit for the course of treatment) have been delivered to the patient.
The MyMedicare and usual medical practitioner requirements will also apply to GP/PMP telehealth items for MHTPs, with these services no longer exempt from the established clinical relationship rule. Further information on the GP MBS telehealth (video and phone) established clinical relationship criteria and exemptions will be available from 1 November 2025 in explanatory note AN.1.1 on MBS Online.
These changes to do not affect focussed psychological strategies which can continue to be available to any patient from any eligible GP and eligible PMP who has the appropriate training recognised by the General Practice Mental Health Standards Collaboration.
Treatment services referred to under the Better Access Initiative are for patients who require at least a moderate level of mental health support.
Information on other free or low-cost Commonwealth funded mental health treatment services can be found at Medicare Mental Health

More resources:

MyMedicare

MBS Online

This article appeared in Practice Pulse on Wednesday, 29 October 2025. If you are a GP, practice nurse or practice manager in South Western Sydney and do not get the weekly Practice Pulse email, speak to your Practice Support Officer.

29 September 2025

Changes to bulk billing incentives from 1 November 2025 will expand the eligibility of bulk billing incentives (BBI) to all Australians with a Medicare card.

Currently, GPs only receive Medicare bulk billing incentives if they bulk bill children under 16 years old and Commonwealth concession card holders.

Additionally, from 1 November 2025, practices can choose to register and participate in the Bulk Billing Practice Incentive Program (BBPIP) and will equally share in the additional incentive payment of 12.5 per cent of MBS billings for eligible services.

A new calculator has been released for general practice owners, managers and individual GPs to estimate annual earnings from Medicare BBIs and the new BBPIP. Access the Bulk Billing Incentives Calculator.

A Bulk Billing Incentives Calculator User Guide is also available explaining how to use the calculator.

The calculator uses MBS information about BBPIP MBS eligible services only. It uses data to build an average annual provider and practice payment estimate for BBPIP MBS eligible services for your practice type and location. The payment model can be used as a baseline to estimate if you will benefit from joining BBPIP.

To get the most accurate estimate, have these details handy before you commence using the calculator:

select your role as a GP or a practice manager (or equivalent)
practice location by Modified Monash Model (MMM) classification
percentage of billings paid to the practice
billing type – bulk billing only, mixed billing or private billing
number of BBPIP MBS eligible services provided per year
percentage of BBPIP MBS eligible services provided to concession card holders or children under 16 years old
your bulk billing rates, average privately billed fees and annual proportion of BBPIP MBS eligible service types, including:
- short (level A)
- standard (level B)
- long (level C)
- extended/Prolonged (level D/E)
management plans and reviews
other BBPIP MBS eligible services

These details can be found in your practice management system. Please refer to the User Guide for step-by-step instructions to support use of the calculator.

Additional resources including fact sheets and videos are available at Strengthening Medicare with more bulk billing resources.

An Expression of Interest (EOI) form is also available here for providers who intend to join the BBPIP. Practices that complete the EOI form will be mailed communications material for their practice to display from 1 November when they register for BBPIP.

Further details and instructions on how to register in BBPIP will be provided later this year, and registration for BBPIP will be available from 1 November 2025.

To participate in BBBPIP, practices will need to be registered for MyMedicare. Instructions on how to register for MyMedicare are available on the Services Australia Health Professional Education Resources website.

Participation in BBPIP is voluntary for practices. If a practice chooses to participate, all GP at your practice must bulk bill all eligible services. For practices continuing to operate a mixed billing model, the RACGP has materials for practices to help them plan and communicate their billing arrangements to patients.

For practice support please contact your Practice Support Officer or Practice Advancement Officer.

This article appeared in Practice Pulse on Wednesday, 1 October 2025. If you are a GP, practice nurse or practice manager in South Western Sydney and do not get the weekly Practice Pulse email, speak to your Practice Support Officer.

08 July 2025

New chronic condition management MBS items came into effect on 1 July, bringing changes to how general practices bill and manage care for patients with chronic conditions.

What does this mean for your general practice?

Existing Chronic Disease Management (CDM) plans and referrals will remain valid until July 2027. There is no need to take immediate action to transition CDM patients to new GPCCMPs.
Use the new GPCCM MBS item numbers (see table below) in place of the ceased CDM item numbers.
When billing any new GPCCM plans or undertaking reviews of a CDM plan, use the MBS item numbers for an initial GPCCMP (965, 392, 29029, 29060). This is necessary as GPCCMP review item numbers cannot be claimed unless a new GPCCMP has been billed.
If you are a MyMedicare practice, encourage any patients with a CDM plan or GPCCMP to register with your practice for MyMedicare.
Explain to them MyMedicare establishes a unique link to the general practice they wish to see most of the time for ongoing care and management of their chronic health condition/s.
If a patient does not wish to register for MyMedicare, they should be reassured MyMedicare is voluntary, and they can continue to access GPCCM care through their usual practice.
Be sure to schedule regular CCM reviews at the conclusion of each first or review appointment, and clearly explain the care planned for the next review to each patient.
Practice nurses, Aboriginal and Torres Strait Islander health practitioners, and Aboriginal health workers can assist the GP or prescribed medical practitioner to prepare or review a GPCCMP.
Team Care Arrangements are no longer required and referral arrangements to allied health providers have been simplified.
Check MyMedicare registration of your patients prior to scheduling CCM plans.
Patients registered for MyMedicare at another general practice are not eligible for CCM MBS items at your practice.

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

<th” scope=”col”>Prescribed medical practitioner MBS items

Name of Item	GP MBS items
Prepare a GP chronic condition management plan – face to face	965	392
Prepare a GP chronic condition management plan – video	92029	92060
Review a GP chronic condition management plan – face to face	967	393
Review a GP chronic condition management plan – video	92030	92061

For more information on GPCCM changes, MBS Online has released a series of factsheets here:

MBS Online – Upcoming changes to the MBS Chronic Disease Management Framework

For support on MyMedicare, GPCCM change queries, and quality improvement support, contact your Practice Advancement or Practice Support Officer.

This article appeared in Practice Pulse on Wednesday, 9 July 2025. If you are a GP, practice nurse or practice manager in South Western Sydney and do not get the weekly Practice Pulse email, speak to your Practice Support Officer.

02 June 2025

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*

Name of item	GP item number	Prescribed medical practitioner item number
Prepare a GP chronic condition management plan – face to face	965	392
Prepare a GP chronic condition management plan – video	92029	92060
Review a GP chronic condition management plan – face to face	967	393
Review a GP chronic condition management plan – video	92030	92061

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.

27 May 2025

Bulk billing changes for general practice start on 1 November, expanding MBS incentives to cover all Australians with a Medicare card.

The expanded eligibility means current bulk billing incentives payable to practices which bulk bill children under 16 years of age and patients with a Commonwealth concession card, will expand to include all Australians with a Medicare card.

Practices will also be able to choose if they wish to participate in the new Bulk Billing Practice Incentive Program (BBPIP).

New information on both of these bulk billing measures is now available on the Department of Health, Disability and Ageing website, including frequently asked questions and details on eligible MBS services.

Additionally, all general practices registered for Practice Incentives Programs have been sent an individual letter outlining the financial benefits of bulk billing changes, via their Services Australia digital mailbox in the HPOS system.

The letter is unique to each practice, based on the practice’s billing information from 2024 available to Services Australia to estimate the financial impact for individual practices. Refer to this embedded link to ensure you receive important messages in HPOS.

Practices participating in the new BBPIP will receive an additional 12.5 per cent incentive payment on every $1 of MBS benefit earned from eligible services, split between the GP and the practice.

General practices can register to participate in the program from 1 November.

Accredited practices can prepare in advance by registering for MyMedicare now.

Instructions on how to register for MyMedicare are available on the Services Australia Health Professional Education Resources website.

To BBPIP or not to BBPIP?

In the leadup to 1 November, general practices in Australia will need to decide if they are going to participate in BBPIP and consider their own unique practice circumstances.

In considering their decision, practices may wish to reflect on a range of factors which may inform their decision or planning for these changes including:

business models
care models
workforce
patient characteristics and expectations
appointment availability/demand
practice infrastructure

For assistance, please reach out to your Practice Advancement Officer (PAO) or Practice Support Officer (PSO).

30 August 2024

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.

15 May 2024

South Western Sydney residents will benefit from a boost in funding for additional Medicare Urgent Care Clinics and a network of new Medicare Mental Health Centres – two of the standout commitments from last night’s Federal Budget.

In handing down the government’s third budget, Treasurer Jim Chalmers said overall spending on health and aged care in 2024-25 would be $146.1 billion, including investments to strengthen Medicare ($2.8 billion), deliver cheaper medicines ($4.3 billion) and invest in a fit and healthy Australia ($1.3 billion).

The government committed $227 million in last night’s budget to increase the number of Medicare Urgent Care Clinics by 29 to 87, enabling more patients to receive fully-bulk billed urgent care from GPs or nurses in more locations.

A $361 million boost over four years to the range of free mental health services was also announced, including funding for 61 walk-in Medicare Mental Health Centres, building on the established Head to Health network. The centres will provide free, walk-in access to a psychologist or psychiatrist for adults with complex and high mental health needs.

This investment includes funding Primary Health Networks to work in partnership with general practice to provide mental health nurses and other allied health workers, for free wraparound care and support to patients with complex needs, in between GP and specialist appointments.

South Western Sydney PHN Chief Executive Officer, Dr Keith McDonald PhD, said the bolstering of access to bulk-billed services both through Urgent Care Clinics and new mental health measures was welcome at a time when the cost of living was impacting access to healthcare.

Dr McDonald said the Australia Bureau of Statistics found the proportion of people who reported delaying or not going to a GP due to the cost grew from 7 per cent 2022-23 compared to 3.5 per cent in 2021-22.

“South Western Sydney was lucky enough to benefit from the opening of a Medicare Urgent Care Clinic (UCC) at Campbelltown Medical and Dental last December,” he said.

“The UCC has made it easier for local residents to access free, high quality care from highly trained GPs and nurses, while freeing up emergency departments to focus on life threatening emergencies,’’ he said.

“We’re looking forward to future announcements about the expansion of the network to additional sites across our region.”

Other announcements of note in last night’s budget include:

$91.1 million to boost the supply of healthcare in areas of shortage, including Primary Health Networks supporting health services at risk of closing.
$882.2 million to ensure older people get the medical support they need. This includes funding to upskill the residential aged care workforce and provide virtual care services, and deliver complex care for older people outside of the hospital.
From 1 August 2024, people in residential aged care will be more likely to receive quality and continuous care from a GP, with GPs and practices eligible to receive quarterly incentive payments, on top of Medicare rebates, to manage the health of their MyMedicare registered residents.
$1.4 billion to upgrade technology systems and digital infrastructure across the aged care sector in preparation for the new Aged Care Act.
$38.8 million for people aged 45 to 49 to join already eligible 50 to 74-year-olds in screening for bowel cancer by requesting a free test kit.
$598.9 million for the continuation of the National COVID-19 Vaccine Program to enable vaccinations to prevent severe COVID-19 disease.
$588.5 million over eight years for a national low intensity digital mental health service, which is free of charge and free of need for referral.
$35.9 million over four years to extend terminating mental health measures, to enhance the delivery of mental health and suicide prevention services and to provide greater funding certainty for service providers. $21 million of this will fund the PHN Targeted Regional Initiatives for Suicide Prevention (TRISP) for 2024-25.
Indexation on Medicare Benefits Schedule rebates is expected to deliver almost $900 million in additional benefits in 2024-25. This is on top of around $940 million in additional Medicare benefits already delivered in 2023-24.
Students in nursing, midwifery and social work will benefit from the establishment of a Commonwealth Prac Payment. This will support them while they undertake mandatory placements required for higher education and vocational education and training qualifications. Eligible students will be able to access $319.50 per week during their clinical and professional placement periods.

11 January 2024

The Department of Health and Aged Care is inviting feedback from general practices about its Strengthening Medicare reforms.

The survey comprises multiple choice questions, mainly focused on bulk billing behaviours since the tripling of the bulk billing incentive on 1 November 2023.

The survey will be sent to general practices on a quarterly basis to allow the department to measure the impact of Strengthening Medicare reforms over time, building in new policy measures as they come online.

Take the survey

Download Strengthening Medicare factsheet

30 May 2023

Effective communication between GP and patient is an important part of a clinical service and vital to achieving clinical outcomes.

There are many factors affecting communication, including a language barrier where an interpreter is necessary, hearing issues, speech difficulty, intellectual disability and/or dementia.

For GPs claiming for time-tiered MBS items, total consultation time includes the time required to communicate effectively with the patient.

Should more time than usual be required for effective communication between GP and patient, it is reasonable to claim a longer attendance item than might otherwise be expected for the service.

This applies to both face-to-face and telehealth services.

GPs and other providers should make a record in the patient’s notes about why extra time was required. For example, adding ‘consultation extended due to use of interpreter’, and, if relevant, citing the Translating and Interpreting Service (TIS) job number.

When calculating the timed attendance item for a consultation, only the time spent with the patient face-to-face, or on the line in a telehealth call, can be counted.

Find out more