GP chronic condition management plans

Learn the relevant item descriptions, fact sheets and explanatory notes on the MBS Online website.

If your patient has a chronic medical or terminal condition, they may be eligible for services under:

• General practitioner chronic condition management plans (GPCCMP)
• Mental health case conferences (MHCC).

The patient’s usual medical practitioner or someone at the same practice should bill GPCCMP items. You’re a patient’s usual medical practitioner if you, or are located at a medical practice that either:

• has provided the majority of services to the patient in the past 12 months
• will provide the majority of services in the following 12 months.

Patients registered through MyMedicare must access GPCCMP items through the practice where they are registered.

General practitioner chronic condition management plans (GPCCMP)

Once your patient agrees with their GPCCMP, offer them a copy and add a copy to their medical record. To prepare a GPCCMP, you can bill item 392 if you’re a prescribed medical practitioner or item 965 if you’re a GP.

A range of MBS-supported multidisciplinary services may be available to patients with a GPCCMP if those services are eligible with their plan.

Billing chronic condition management (CCM) items

To be eligible for a GPCCMP, your patient must have at least one medical condition that has been, or is likely to be, present for at least 6 months or is terminal.

You can bill these MBS item numbers for CCM.

You can provide these services more frequently in exceptional circumstances. For example, when there is a significant change in a patient’s condition.

Note on the patient’s invoice or receipt, or include service text for electronic claims if there’s either:

• exceptional circumstances
• significant change in clinical condition.

This helps us to assess the claim.

We suggest that practices call and encourage patients to attend an appointment to review their care plan.

Learn the explanatory notes on MBS Online for more information on Chronic condition management items.

Co-claiming restrictions

You can’t bill and claim these CCM and general attendance items for the same patient on the same day.

If your patient needs to visit a different practitioner on the same day, we’ll pay benefits for both consults.

Mental Health Case Conferences

Your patient is eligible for MHCC if they’re being managed under either:

• a mental health treatment plan
• an eating disorder treatment and management plan.

This table shows the MBS items that can be billed for MHCCs.

Learn more about Mental Health Case Conferencing items on the MBS Online website.