GPCCMP FAQ - Allied Health Referrals Under GPCCMP
Categories:
Understanding GPCCMP & Key Changes – Overview of the GP Chronic Care Management Program and what’s new under GPCCMP.
Transitioning Existing Patients & Plans – How to move existing care plan patients smoothly into GPCCMP.
Staff Roles & Responsibilities – Clarifies who does what in GPCCMP workflows, from GPs to nurses and admin staff.
Specific Patient Groups & Edge Cases – Advice for managing complex patients and uncommon GPCCMP scenarios.
Practice Management & Clinical Software – Guides for using clinical software and Cubiko tools to support GPCCMP workflows.
Patient Communication & Operational Planning – Templates and tips for engaging patients and planning care delivery efficiently.
MyMedicare Requirements – What practices and patients need to know about MyMedicare registration and eligibility.
MBS Item Numbers & Billing – Understand which MBS items apply, how to claim correctly and avoid common billing errors.
GPCCMP Plan Creation & Reviews – Step-by-step guidance for creating, reviewing and updating GP Chronic Care Management Plans.
Financial Strategy & Practice Efficiency – Practical tips to improve billing accuracy, profitability and workflow efficiency.
Compliance & Quality Assurance – Stay compliant with RACGP, Medicare and MyMedicare requirements when delivering care plans.
How have allied health referral requirements changed under GPCCMP?
The Bottom Line:
The good news is that allied health referrals are now much simpler and more flexible, removing significant administrative burden from your practice. You no longer need to coordinate with allied health providers before making referrals, and you can refer patients directly using standard referral letters instead of special forms - just like referring to other medical specialists. What's particularly helpful is that referrals are valid for 18 months from the first service (not from the referral date), and you don't need to specify provider names or session numbers, giving patients much more choice and flexibility.
The Facts:
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From 1 July 2025, referral forms will no longer be used for allied health services; instead, referral letters will be used, consistent with the referral process for medical specialists
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The requirement for a GP or prescribed medical practitioner to consult with at least two collaborating providers in the development of a patient's plan has been removed
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GPs and prescribed medical practitioners will refer patients with a GPCCMP directly to relevant services
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Allied health providers do not need to confirm acceptance of the referral or provide input into the preparation of the GPCCMP
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However, the requirements for allied health providers to provide a written report back to the GP after the provision of certain services (e.g., the first service under a referral) are unchanged
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Unless otherwise specified by the referring medical practitioner, referrals to allied health services for patients with a chronic condition will be valid for 18 months from the date of the first service provided under the referral
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These new referral requirements apply to all allied health referrals under the chronic conditions management framework, as well as some other MBS-supported allied health services including Group M3 (subgroup 1), Group M8, Group M9, Group M10 (subgroup 1), and Group M11
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Referrals for allied health services written prior to 1 July 2025 will remain valid until all services under that referral have been provided
Sources: Upcoming Changes to Chronic Disease Management Framework – Overview – Factsheet, page 2; Upcoming Changes to Chronic Disease Management Framework – MBS Items for GP Chronic Condition Management Plans – Factsheet, pages 2, 4; Upcoming Changes to Chronic Disease Management Framework – Referral Arrangements for Allied Health Services – Factsheet, pages 1, 2, 3; MBS Online explanatory note AN.15.6; MBS Online explanatory note AN.15.6
Links and Resources:
Official Information:
Role-Based Implementation Guides:
Do I still need to consult with two allied health providers before making a referral?
The Bottom Line:
No, this requirement has been completely removed to make your life easier and streamline the chronic disease management process. You can now refer patients directly to allied health services without any prior consultation or collaboration requirements - one less administrative step to worry about. This change recognises that GPs are best placed to determine what services their patients need without mandatory collaboration requirements.
The Facts:
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The requirement for a GP or prescribed medical practitioner to consult with at least two collaborating providers in the development of a patient's plan has been removed
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GPs and prescribed medical practitioners will refer patients with a GPCCMP directly to relevant services
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Allied health providers do not need to confirm acceptance of the referral or provide input into the preparation of the GPCCMP
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Collaboration with members of the patient's multidisciplinary team will no longer be required in the development of the plan
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The changes aim to simplify, streamline, and modernise the arrangements for health professionals
Sources: Upcoming Changes to Chronic Disease Management Framework – Overview – Factsheet, page 2; Upcoming Changes to Chronic Disease Management Framework – MBS Items for GP Chronic Condition Management Plans – Factsheet, pages 2, 4; Upcoming Changes to Chronic Disease Management Framework – Referral Arrangements for Allied Health Services – Factsheet, page 1; MBS Online explanatory note AN.15.6; MBS Online explanatory note AN.15.6
Links and Resources:
Official Information:
Role-Based Implementation Guides:
What are the new format and content requirements for allied health referrals under GPCCMP?
The Bottom Line:
Referrals are now standard referral letters (like you'd write to a specialist) instead of the old EPC forms, making them much more straightforward. The practical reality is that you need to include basic information: your details, the date, reason for referral, and patient information - but you don't need to specify the provider name or number of sessions, giving patients more choice. The requirements are set out in the Health Insurance (Section 3C – Allied Health Services) Determination 2024 and mirror those for referrals to medical specialists.
The Facts:
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From 1 July 2025, referral forms will no longer be used for allied health services; referral letters will be used, consistent with the referral process for medical specialists
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The requirements for referrals to allied health professionals are set out in the Health Insurance (Section 3C – Allied Health Services) Determination 2024 (Allied Health Determination) and mirror those for referrals to medical specialists
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To be valid, a referral letter must include: the name of the referring practitioner; the address of the practice, or the practitioner's provider number at that practice; the date on which the referring practitioner made the referral; the validity of the referral (if relevant); be in writing; be signed by the referring practitioner (which may be by electronic signature); be dated; explain the reasons for referring the patient, including any information about the patient's condition that the referring practitioner considered necessary to give the allied health professional
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For referrals to individual or group allied health services (Group M3 Subgroup 1, Group M9 and Group M11) referrals will be valid for 18 months from the date of the first service provided under the referral, unless otherwise specified by the referring practitioner
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Referrals do not need to specify the name of the allied health provider to provide the services
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Referrals do not need to specify the number of services to be provided; however, referring medical practitioners can still specify the number of services if they choose to do so
Sources: Upcoming Changes to Chronic Disease Management Framework – Overview – Factsheet, page 2; Upcoming Changes to Chronic Disease Management Framework – Referral Arrangements for Allied Health Services – Factsheet, page 2; MBS Online explanatory note AN.15.6; MBS Online explanatory note AN.15.6
Links and Resources:
Official Information:
Role-Based Implementation Guides:
Do I need to include how many sessions or the provider's name in a referral?
The Bottom Line:
No, you don't need to include either, which gives patients significantly more choice and flexibility in where and how they access services. You'll find this simplifies your referral process while empowering patients to choose their preferred providers. You can still specify the number of sessions if you want to for clinical reasons, but it's completely optional. What's important to note is that acceptance of a referral is at the discretion of the individual allied health practitioner, subject to anti-discrimination legislation.
The Facts:
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Referrals do not need to specify the name of the allied health provider to provide the services
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Referrals do not need to specify the number of services to be provided
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However, nothing prevents the referring medical practitioner from specifying the number of services to be provided under the referral, if they choose to do so
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One of the objectives of the changes is to provide patients with greater choice and flexibility
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The patient can take the referral to any eligible allied health professional of the same profession/type specified in the referral of their choosing
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Acceptance of a referral is at the discretion of the individual practitioner, subject to anti-discrimination legislation
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This recognises that some patients accessing allied health services may wish to access a higher number of services than are supported by the MBS
Sources: Upcoming Changes to Chronic Disease Management Framework – Referral Arrangements for Allied Health Services – Factsheet, page 2; MBS Online explanatory note AN.15.6; MBS Online explanatory note AN.15.6
Links and Resources:
Official Information:
Role-Based Implementation Guides:
Can I send allied health referrals electronically under GPCCMP?
The Bottom Line:
Yes, you can absolutely send allied health referrals electronically, which is actively encouraged to minimise the risk of lost referrals. This is a helpful step towards more modern and efficient practice workflows, reducing paperwork and making the process smoother for everyone. The Electronic Transactions Act 1999 allows for documents required under Commonwealth Law, such as referrals under the Allied Health Determination, to be signed and transmitted electronically.
The Facts:
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Referrals can be signed and transmitted electronically
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The Electronic Transactions Act 1999 allows for documents required under Commonwealth Law, such as referrals under the Allied Health Determination, to be signed and transmitted electronically
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Where the intended allied health provider is known, referring practitioners are encouraged to send referrals electronically where possible to minimise the risk of lost referrals
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Electronic signatures are acceptable for referral signing requirements
Sources: Upcoming Changes to Chronic Disease Management Framework – Referral Arrangements for Allied Health Services – Factsheet, page 2; MBS Online explanatory note AN.15.6; MBS Online explanatory note AN.15.6
Links and Resources:
Official Information:
Role-Based Implementation Guides:
How long do allied health referrals remain valid under GPCCMP?
The Bottom Line:
Allied health referrals for chronic condition patients are valid for 18 months from the date of the first service provided under the referral (not from the referral date), unless you specify a different validity period. This gives patients plenty of time to access their services without rushing and aligns with the requirement for patients to have had their GPCCMP prepared or reviewed within the last 18 months to continue accessing services. You'll find this is much more practical than the previous system.
The Facts:
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Unless otherwise specified by the referring medical practitioner, referrals to allied health services for patients with a chronic condition will be valid for 18 months from the date of the first service provided under the referral
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For referrals to individual or group allied health services (Group M3 Subgroup 1, Group M9 and Group M11) referrals will be valid for 18 months from the date of the first service provided under the referral, unless otherwise specified by the referring practitioner
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These timeframes are measured from the date the first service is provided under the referral, not the date of the referral
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This aligns with the requirement for patients with a GP chronic condition management plan to have had their plan put in place or reviewed within the last 18 months to continue to access services
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For specialist services the default referral length is 12 months from the date of the first service provided under the referral (for comparison)
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Referrals to allied health professionals cannot be indefinite referrals
Sources: Upcoming Changes to Chronic Disease Management Framework – Referral Arrangements for Allied Health Services – Factsheet, page 2; MBS Online explanatory note AN.15.6; MBS Online explanatory note AN.15.6
Links and Resources:
Official Information:
Role-Based Implementation Guides:
What confirmation or acknowledgment is required from allied health providers for GPCCMP referrals?
The Bottom Line:
No confirmation or acknowledgment is required from allied health providers when you make a referral - one less thing to chase up and manage administratively. However, they still need to provide written reports back to you after certain services (like the first service under a referral) to keep you in the loop about your patient's progress. This maintains clinical communication while removing unnecessary administrative steps.
The Facts:
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There is no requirement for allied health providers to confirm acceptance of the referral or provide input into the preparation of the GPCCMP
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However, the requirements for allied health providers to provide a written report back to the GP after the provision of certain services (e.g., the first service under a referral) are unchanged
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Requirements for allied health providers to report back to the referring practitioner at certain points (e.g. after the first and last service under a referral) have not changed
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Acceptance of a referral is at the discretion of the individual practitioner, subject to anti-discrimination legislation
Sources: Upcoming Changes to Chronic Disease Management Framework – MBS Items for GP Chronic Condition Management Plans – Factsheet, pages 2, 4; Upcoming Changes to Chronic Disease Management Framework – Referral Arrangements for Allied Health Services – Factsheet, pages 1, 2; MBS Online explanatory note AN.15.6; MBS Online explanatory note AN.15.6
Links and Resources:
Official Information:
Role-Based Implementation Guides:
Are mental health plans (e.g., Better Access) and DVA services affected by the GPCCMP changes to referrals?
The Bottom Line:
No, these services remain completely separate and unchanged. The GPCCMP referral changes only apply to allied health services under the chronic conditions management framework. Your existing processes for Better Access, DVA services, focused psychological strategies, eating disorder services, and diagnostic audiology continue as normal - no changes needed to your current workflows for these services.
The Facts:
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The new referral requirements apply to all allied health referrals under the chronic conditions management framework, as well as some other MBS-supported allied health services
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As of 1 July 2025, these requirements do not apply to other MBS-supported allied health services, including Better Access psychological therapy services, focussed psychological strategies (allied mental health) services, eating disorder allied health services, or diagnostic audiology services
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These changes do not affect multidisciplinary care plan items
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The new referral requirements apply to: Group M3 (subgroup 1) – individual allied health services for patients with a chronic condition; Group M8 – pregnancy support counselling allied health services; Group M9 – allied health group services for patients with type 2 diabetes; Group M10 (subgroup 1) – complex neurodevelopmental disorders and eligible disabilities allied health services; Group M11 – allied health services for Aboriginal and Torres Strait Islander people
Sources: Upcoming Changes to Chronic Disease Management Framework – Overview – Factsheet, page 2; Upcoming Changes to Chronic Disease Management Framework – Referral Arrangements for Allied Health Services – Factsheet, page 3; MBS Online explanatory note AN.15.6; MBS Online explanatory note AN.15.6
Links and Resources:
Official Information:
Role-Based Implementation Guides:
How will allied health visits be tracked without EPC forms?
The Bottom Line:
The MBS factsheets don't provide specific information about how allied health visits will be tracked without the EPC forms. The practical reality is that tracking visits will be up to the patient and allied health provider to manage, as the nature of the services themselves isn't changing - only the referral process and item descriptors are being updated.
The Facts:
The MBS factsheets don't provide specific information about visit tracking mechanisms.
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The nature of the individual and group allied health services that can be provided under the chronic condition management arrangements are not changing as part of these reforms, only the item descriptors are changing due to the removal of GPMPs/TCAs and commencement of GPCCMPs
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Providers are responsible for ensuring services claimed from Medicare using their provider number meet all legislative requirements and they may be required to submit evidence for compliance checks related to Medicare claims
Sources: Upcoming Changes to Chronic Disease Management MBS Items – What Do the Changes Mean for Allied Health Providers? – Factsheet, page 2; MBS Online explanatory note AN.15.6; MBS Online explanatory note AN.15.6
Links and Resources:
Official Information:
Role-Based Implementation Guides:
Can allied health providers check remaining visits through PRODA?
The Bottom Line:
The MBS factsheets don't provide specific information about whether allied health providers can check remaining patient visits through PRODA or other systems. This operational detail would typically be available through Services Australia or allied health provider resources. What we know is that providers remain responsible for ensuring services meet all legislative requirements and may be required to submit evidence for compliance checks.
The Facts:
The MBS factsheets don't provide specific information on checking remaining visits through PRODA or other systems.
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Providers are responsible for ensuring services claimed from Medicare using their provider number meet all legislative requirements and they may be required to submit evidence for compliance checks related to Medicare claims
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Practitioners should ensure they keep adequate and contemporaneous records
Sources: MBS factsheets reviewed; information gap identified; MBS Online explanatory note AN.15.6; MBS Online explanatory note AN.15.6
Links and Resources:
Official Information:
Professional Resources:
Allied Health Professionals Australia: Various allied health professional associations
Disclaimer: This FAQ is for general information only and reflects our understanding of upcoming changes to chronic disease management frameworks at the time of publication. For the most accurate and up-to-date guidance, please refer to official sources such as the Department of Health and Aged Care or Medicare. Cubiko is not responsible for any actions taken based on this information.