The Chronic Condition Management (CCM) framework under the Medicare Benefits Schedule (MBS) was updated on 1 July 2025. Allied health professionals should be aware of the following key changes.
Eligibility
CCM plans now apply to any patient with at least one medical condition that has been (or is likely to be) present for at least six months, or is terminal where their GP determines a structured care approach is beneficial.
Referral process
Referral letters replace formal referral forms. Letters:
- do not need to name a specific provider (for example, ‘physiotherapist’ is sufficient)
- do not need to specify the number of visits, though this can be included if helpful
- are valid for 18 months, unless otherwise stated.
Acknowledgement of referrals is no longer required, but providers must still report back to the referring GP after the first and last service.
Collaboration requirements
Allied health providers are no longer required to collaborate in the creation of care plans.
Service allocations
The number of visits available under a CCM plan is unchanged. The available allocations remain:
- up to five individual allied health services per calendar year (10 for Aboriginal or Torres Strait Islander patients)
- up to five group services for eligible patients with type 2 diabetes.
Transition period
Existing care plan referrals remain valid until 30 June 2027, or until all allocated services are used.
Impacted MBS groups
These changes apply to referrals under the following groups:
- M3 (subgroup 1) – individual allied health services for patients with a chronic condition (referred under the CCM arrangements)
- M8 – pregnancy support counselling allied health services
- M9 – allied health group services for patients with type 2 diabetes (referred under the CCM arrangements)
- M10 (subgroup 1) – complex neurodevelopmental disorders and eligible disabilities allied health services
- M11 – allied health services for Aboriginal and Torres Strait Islander people (referred under the CCM arrangements or following a health assessment).
For further details, visit MBS Online and our CCM web page.
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For assistance, contact our Primary Care team at alliedhealth@nwmphn.org.au
