MyMedicare and Chronic Conditions

A single GP Chronic Condition Management Plan has been introduced from 1 July 2025 as part of the rollout of the MyMedicare program. This replaces GP management plans and team care arrangements. Transition arrangements will be in place for 2 years to ensure current patients do not lose access to services.

The update is reflected in major changes to the Medicare Benefits Schedule (MBS) items for chronic disease management and:

• requires patients be enrolled in MyMedicare to access management plans through the practice where they are enrolled (patients who aren’t enrolled will be able to access management plans through their usual GP).
• encourages 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.
• formalises referral processes for allied health services so they are more consistent with other referral arrangements.

More information on the program is available from Upcoming changes to MBS Chronic Disease Management Arrangements | Australian Government Department of Health, Disability and Ageing

See below for further resources and information.

For General Practice For Allied Health professionals For patients

For General Practice

From 1 July, MBS items for GP management plans (229, 721, 92024, 92055), team care arrangements (230, 723, 92025, 92056) and reviews (233, 732, 92028, 92059) are no longer available.

As part of the new chronic condition management arrangements, patients registered through MyMedicare need to access the GP chronic condition management plan and review items through the practice where they are registered. Other patients are able to access the items through their usual GP.

To encourage reviews and ongoing care, the MBS fees for planning and review items are equalised. The fee for the preparation or review of a plan is $156.55 for GPs and $125.30 for prescribed medical practitioners. Patients need to have their GP chronic condition management plan prepared or reviewed in the previous 18 months to continue to access allied health services.

Patients that had a GP management plan and/or team care arrangement in place prior to 1 July 2025 are able to continue accessing services consistent with those plans for two years. From 1 July 2027, a GP chronic condition management plan will be required for ongoing access to allied health services.

For information or support, GPs and general practice staff can contact their Practice Facilitator or email [email protected]

Chronic Condition Management Items commencing 1 July 2025

Item Name	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

 

Key Points There is no change to patient access to the range of services required for multidisciplinary care. GPs and prescribed medical practitioners can refer patients with a GP chronic condition management plan to allied health services directly. The requirement to consult with at least two collaborating providers has been removed. Practice nurses, Aboriginal and Torres Strait Islander health practitioners and Aboriginal health workers are able to assist a GP or prescribed medical practitioner to prepare or review a GP chronic condition management plan. Unless exceptional circumstances apply, a GP chronic condition management plan can be prepared once every 12 months (if necessary) and reviews can be conducted once every 3 months. It is not required that a new plan be prepared each year. Existing plans can continue to be reviewed. The changes do not affect multidisciplinary care plan items (231, 232, 729, 731, 92026, 92027, 92057, 92058).

Resources Upcoming Changes to Chronic Disease Management Framework – Overview | MBS Online Upcoming Changes to Chronic Disease Management MBS Items – Transition Arrangements for Existing Patients |MBS Online Upcoming Changes to Chronic Disease Management Framework – MBS Items for GP Chronic Condition Management Plans |MBS Online Chronic Conditions Management General Practice Activation Series Activity 1 – New Year CDM Resolutions | Practice Connect Chronic Conditions Management General Practice Activation Series Activity 2 – Planning with your practice team | Practice Connect Chronic Conditions Management General Practice Activation Series Activity 3 – MyMedicare patient engagement and registration communications | Practice Connect Chronic Conditions Management team roles template for general practices | Practice Connect Chronic Conditions Management Quality Improvement Workbook | Practice Connect GP Chronic Conditions Management MBS User Guide | Practice Connect MyMedicare How To: Meet Chronic Conditions Management claims requirements | Practice Connect Conversation Starters for GPs – Introducing GP Chronic Condition Management Plans to patients | Practice Connect Conversation Starters for Practice Managers and Reception Staff – Introducing GP Chronic Condition Management Plans to patients | Practice Connect

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For Allied Health professionals

Allied Health professionals providing MBS services should be also aware of the changes to plan and referral requirements.

From 1 July 2025, the requirements for referrals to the following allied health services (and their video and phone equivalent items) are:

• Group M3 (subgroup 1) – individual allied health services for patients with a chronic condition (referred under the chronic conditions management arrangements)
• Group M8 – pregnancy support counselling allied health services
• Group M9 – allied health group services for patients with type 2 diabetes (referred under the chronic conditions management arrangements)
• Group M10 (subgroup 1) – complex neurodevelopmental disorders and eligible disabilities allied health services.

For information or support, Allied Health professionals and practice staff can email [email protected]

Key Points The current forms for referring to allied health services are no longer be required. Referrals can be in the form of referral letters, consistent with the arrangements for referrals to medical specialists. Referrals for allied health services written prior to 1 July 2025 remain valid until all services under the referral have been provided. New referrals for allied health services should meet the new referral requirements that come into effect on 1 July 2025, regardless of whether the referral is made under a GPMP, TCA or GPCCMP. Patients can continue to access allied health and other services under their existing plans until 30 June 2027.

Resources Upcoming Changes to Chronic Disease Management Framework – Overview | MBS Online Upcoming Changes to Chronic Disease Management MBS Items – Transition Arrangements for Existing Patients |MBS Online Upcoming Changes to Chronic Disease Management Framework – Referral Arrangements for Allied Health Services | MBS Online

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For patients

The revised framework has been designed to support patients through improved continuity of care and improved arrangements for the transfer of information between members of their care team. Health professionals are encouraged to speak with patients about the changes.

Resources Information for patients Register for MyMedicare | Services Australia MyMedicare patient registration – Frequently asked questions | Australian Government Department of Health, Disability and Ageing