Medical practitioners can refer eligible patients with chronic conditions to allied health and primary care professionals. Allied health and primary care professionals can claim Medicare benefits for some services.
You can learn about billing chronic condition individual allied health and Aboriginal and Torres Strait Islander health and wellbeing services.
These allied health professionals can provide services:
- audiologists
- chiropractors
- diabetes educators
- dietitians
- exercise physiologists
- mental health workers
- occupational therapists
- osteopaths
- physiotherapists
- podiatrists
- psychologists
- speech pathologists.
These primary care professionals can provide services:
- Aboriginal health workers
- Aboriginal and Torres Strait Islander health practitioners.
To claim items for services the health professional must:
- attend the appointment in-person for at least 20 minutes
- treat the patient individually and not through group treatment.
If you’re an allied health or primary care professional, you can check your eligibility for Medicare benefits through the Medicare Benefits Schedule (MBS) items online checker in HPOS. You can also call Medicare.
Eligible patients can use 5 services per calendar year. The 5 services may be either:
- one type of service, for example 5 physiotherapy services
- a combination of different types of services, for example one dietetic and 4 podiatry services.
Patients are eligible for these services if their medical practitioner has completed a GPCCMP.
Patients with a GP management plan or team care arrangement in place before 1 July 2025 can continue to access services consistent with those plans until 30 June 2027.
Learn about the relevant MBS item descriptions, fact sheets and explanatory notes on the MBS Online website.
From 1 July 2027, a GPCCMP will be required for ongoing access to allied health and Aboriginal and Torres Strait Islander health and wellbeing services.
Patients in the community and permanent residents of a residential aged care facility (RACF) are eligible. Their medical practitioner must have previously contributed to at least one of the following:
- a multidisciplinary care plan prepared for them by the RACF if they are in an RACF
- a multidisciplinary care plan prepared for them by another medical practitioner if they are in the community
- a review of the care plan.
This includes when these patients are being discharged from hospital under the plan.
Hospital in-patients are not eligible for these services.
You can check patient eligibility in the MBS items online checker in HPOS.
You can also call Medicare.
The referring medical practitioner decides whether the patient’s chronic condition would benefit from allied health or Aboriginal and Torres Strait Islander health and wellbeing services.
It isn’t appropriate for allied health or primary care professionals to:
- provide a partly completed referral to a referring medical practitioner for signing
- pre-empt the decision about the services that the patient requires.
Referrals under a GPCCMP are valid for the timeframe stated in the referral. If there’s no timeframe stated, they are valid for 18 months from the first service date provided under the referral.
The allied health or primary care professional must provide a written report to the referring medical practitioner after the first and last service. They can provide the reports more often if clinically necessary.
Reports should include all the following:
- investigations, tests and assessments carried out
- treatment provided
- recommendations on how to manage the patient’s condition in the future.