Chronic conditions management

The number of visits available under chronic condition management plan is unchanged. The available allocations remain:

• Up to five individual allied health services per calendar year, or 10 for patients of Aboriginal or Torres Strait Islander descent.
• Up to five services provided on behalf of a medical practitioner by a practice nurse or Aboriginal and Torres Strait Islander health practitioner.
• For patients with type 2 diabetes, an assessment of their suitability for group dietetics, diabetes education or exercise physiology services and, if they are suitable, up to eight group services for the management of diabetes per calendar year.

The requirement to have at least two collaborating providers has been removed. Referrals are now in the form of letters, consistent with those to medical specialists.

Referral letters do not need to specify the name of an allied health provider. A generic referral to ‘physiotherapist’, for example, allows the patient to attend an allied health professional of their choosing.

There is no need to specify the number of sessions for each referral. However, it may be useful to include this information if visits will be divided between different providers.

An allied health provider is not required to acknowledge a referral, but must report to the referring practitioner after the first and last service.

For patients with a GPMP or TCA in place before 1 July 2025 no immediate action is required. Access to services provided through MBS item 10997 and its telehealth equivalents 93201 and 93203 continues until 30 June 2027.

Referrals for allied health services written prior to 1 July 2025 will remain valid until all services under the referral have been provided, as long as these are completed by 30 June 2027.

Any patient requiring a review of an existing GPMP or TCA should be transitioned to a GPCCMP.

Referral for allied health services should meet the updated referral requirements, regardless of whether it is made under a GPMP, TCA or GPCCMP.

From 1 July 2027

• All CCM patients will need to be transitioned to a GPCCMP to have ongoing access to allied health and other services.
• Patients will require a GPCCMP to be eligible for a Department of Health, Disability and Ageing Home Medicines Review.

• Chronic Condition Management Items | HealthPathways
• Chronic Conditions Management – MBS User Guide (.pptx) | National MyMedicare PHN Implementation Program
• Changes to Chronic Disease Management MBS Items – Implications for MyMedicare Registration (.pdf) | Australian Government Department of Health, Disability and Ageing
• Factsheets | MBS Online
• National member webinar: CDM update (5 June 2025) | RACGP

Your relationship manager can support your practice through this transition – contact our Primary Care Team on 9347 1188, or at primarycare@nwmphn.org.au to arrange one-on-one support.