Requirements of care plans and case conferences

Eligibility for General Practitioner chronic condition management plan (GPCCMP)

To be eligible for a GPCCMP your patient must have a chronic or terminal medical condition. If your patient would benefit from multidisciplinary care to manage their chronic condition, you can refer them for treatments and services.

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

have provided the majority of services to your patient in the past 12 months
will provide the majority of services in the following 12 months.

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

A multidisciplinary team includes:

your patient’s usual medical practitioner
other collaborating health or care providers.

Each person in the team must provide a different type of ongoing treatment or service. Not all members need to be Medicare eligible health professionals. Your patient’s informal or family carer isn’t counted as part of this team.

Changes from 1 July 2025

Patients with a GP management plan or team care arrangement in place before 1 July 2025 can continue to access services for those plans until 30 June 2027.

From 1 July 2027, a GP chronic condition management plan will be required for ongoing access to allied health services. A GP chronic condition management plan will also be required to access domiciliary medication management reviews (items 245 and 900).

Eligibility for a mental health case conference (MHCC)

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

a GP Mental Health Treatment Plan (GPMHTP)
an eating disorder treatment and management plan (EDP).

You must consult with a multidisciplinary team for a MHCC.

Allied health professionals are eligible if they meet qualification requirements and offer any of the following:

psychological therapy health service
focused psychological health service
dietetics health service.

Each person in the team must provide a different type of ongoing treatment or service.

Your patient’s informal or family carer isn’t counted as part of this team.

Claiming frequency

You can claim the following once every 12 months:

preparation of a GPCCMP
development of a GPMHTP or EDP.

You can claim for each of the following once every 3 months:

review of a GPCCMP
review of a GPMHTP or EDP
contribution to a Multidisciplinary Care Plan or to a review for a patient who isn’t in a residential aged care facility
contribution to a Multidisciplinary Care Plan or to a review for a resident in an aged care facility.

You can provide these services more frequently in exceptional circumstances. For example, when there’s 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.

Reviews

We suggest practices call and encourage their patients to attend an appointment to review their care plan. You can review a care plan once every 3 months.