From 1 July 2025, there will be a new framework for chronic disease management. The changes will simplify, streamline, and modernise the arrangements for health care professionals and patients.
These changes primarily affect medical practitioners, however, allied health professionals providing MBS services should be aware of the changes to plan and referral requirements.
Transition arrangements will be in place for 2 years to ensure current patients do not lose access to services.
What are the changes?
Items for GP management plans (229, 721, 92024, 92055), team care arrangements (230, 723, 92025, 92056) and reviews (233, 732, 92028, 92059) will cease and be replaced with a new streamlined GP chronic condition management plan (see table below for item numbers).
The updated framework will be known as chronic condition management.
To support continuity of care, patients registered through MyMedicare will be required to access the GP chronic condition management plan and review items through the practice where they are registered. Other patients will be able to access the items through their usual GP.
Where multidisciplinary care is required, patients will be able to access the same range of services currently available through GP management plans and team care arrangements.
GPs and prescribed medical practitioners will refer patients with a GP chronic condition management plan to allied health services directly. The requirement to consult with at least two collaborating providers, as described under the current team care arrangements will be removed.
Practice nurses, Aboriginal and Torres Strait Islander health practitioners and Aboriginal health workers will be able to assist the GP or prescribed medical practitioner to prepare or review a GP chronic condition management plan.
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. Patients will also need to have their GP chronic condition management plan prepared or reviewed in the previous 18 months to continue to access allied health services.
Consistent with current arrangements, 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.
Patients that had a GP management plan and/or team care arrangement 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 GP chronic condition management plan will be required for ongoing access to allied health services.
These changes do not affect multidisciplinary care plan items (231, 232, 729, 731, 92026, 92027, 92057, 92058).
For more information, MBS Online has released a selection of factsheets.
How can Healthy North Coast help?
To support you and your teams with the upcoming changes:
- We recently hosted a CCM webinar, with presenters Kim Poyner and Riwka Hagen. While the webinar took place before the finer details of the changes were announced, it still provides valuable support to help you and your teams prepare for the upcoming changes, including workflows, roles and responsibilities. The slide deck from this webinar is also helpful.
- There will be a follow-up webinar in mid-June which will cover the newest information.
- There will be a third webinar further down the track, to hear how practices are going with the integration of the changes and to help ensure long-term sustainability.
- We have developed some Quality Improvement activities on our Primary Care Impact page to help you prepare for the changes:
If you have any questions about these changes, please contact your Regional Manager.
