GPCCMP FAQ - Financial Strategy & Practice Efficiency
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.
Compliance & Quality Assurance – Stay compliant with RACGP, Medicare and MyMedicare requirements when delivering care plans.
Allied Health Referrals Under GPCCMP – How to manage allied health referrals linked to GP Chronic Care Management Plans.
What's the best way to set fees for GPCCMP – should we bulk bill or charge privately?
The Bottom Line:
It is up to your practice and your practitioners. GPCCMP items are eligible for bulk billing incentives when you bulk bill eligible patients, and they'll be included in the Bulk Billing Practice Incentive Program from 1 November 2025. Here's what this means for your practice finances: the impact will depend on your billing approach for each patient - the new fees represent a change from previous arrangements where GPMP preparation was $164.35, TCA preparation was $130.25, and reviews were $82.10.
The Facts:
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GPCCMP items may be claimed with single bulk billing incentives when eligible patients are bulk billed and will be included in the Bulk Billing Practice Incentive Program from 1 November 2025
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The MBS fees for planning and review items are equalised, with both the 965 and 967 items providing a fee of $156.55 for GPs and $125.30 for PMPs
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Previously, the rebate for preparation of a GPMP was $164.35, preparation of TCAs was $130.25 and a review was $82.10
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The impact of the changes on annual funding for chronic disease management will depend on the billing approach for each patient
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To encourage reviews and ongoing care, the MBS fees for planning and review items will be equalised at $156.55 for GPs and $125.30 for prescribed medical practitioners
Sources: Upcoming Changes to Chronic Disease Management Framework – MBS Items for GP Chronic Condition Management Plans – Factsheet, pages 1, 2; Upcoming Changes to Chronic Disease Management Framework – Overview – Factsheet, page 2; RACGP Summary of changes to Chronic Disease Management (CDM) Framework, page 1
Links and Resources:
Financial Planning:
Billing Support:
Visual Item Transition Guide: Shows exact transitions from old items (721/723→965, 732→967, etc.)
Official Information:
Services Australia Provider Enquiry Line: 13 21 50
Should I change consultation appointment lengths for GPCCMP creation and reviews for optimal efficiency?
The Bottom Line:
The MBS factsheets don't provide specific guidance on optimal appointment lengths for GPCCMP services. The practical reality is you have complete flexibility to adjust appointment lengths to match your practice's workflows and clinical preferences but also sustainable business reality.
The Facts:
The MBS factsheets don't provide specific guidance on optimal appointment lengths for GPCCMP services.
Note: Workflow documents suggest considering the comprehensive time requirements for GPCCMP services when scheduling appointments.
Links and Resources:
Workflow Planning:
Efficiency Analysis:
How can I optimise the financial benefits of the new GPCCMP system?
The Bottom Line:
The key to the new program is the equalised fees for both plan preparation and reviews, plus the range of services that can be accessed under each GPCCMP. With reviews available every 3 months if clinically relevant and consistent fees of $156.55 for GPs, you'll find this creates much more predictable revenue streams and opportunity for patient engagement.
The Facts:
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The MBS fee to prepare a GPCCMP is $156.55 for GPs and $125.30 for PMPs
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Unless exceptional circumstances apply, items for preparing a GPCCMP can be claimed every 12 months if clinically relevant; GPCCMP reviews are available every 3 months if clinically relevant
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GPCCMP items may be claimed with single bulk billing incentives when eligible patients are bulk billed and will be included in the Bulk Billing Practice Incentive Program from 1 November 2025
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To encourage reviews and ongoing care, the MBS fees for planning and review items are equalised at $156.55 for GPs and $125.30 for prescribed medical practitioners
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An existing GPCCMP can be reviewed and amended on an ongoing basis, and it is not required that a new plan be prepared each year
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Patients can access up to 5 individual allied health services per calendar year (10 services for patients of Aboriginal or Torres Strait Islander descent) and up to 5 services provided by a practice nurse or Aboriginal and Torres Strait Islander Health Practitioner (item 10997 at $14.00 fee)
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For patients with type 2 diabetes, an assessment of their suitability for group services and, if suitable, up to 8 group services for diabetes management per calendar year
Sources: Upcoming Changes to Chronic Disease Management Framework – MBS Items for GP Chronic Condition Management Plans – Factsheet, pages 1, 2, 3, 4; Upcoming Changes to Chronic Disease Management Framework – Overview – Factsheet, page 2; MBS Online explanatory note MN.12.4
Links and Resources:
Financial Modelling:
Strategic Planning:
Billing Support:
How often should I schedule GPCCMP reviews to get the best balance of care and financial sustainability?
The Bottom Line:
We are currently producing some resources to assist you with this.
The Facts:
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Unless exceptional circumstances apply, GPCCMP reviews are available every 3 months if clinically relevant
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Plans may be prepared or reviewed earlier if exceptional circumstances apply
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While GPCCMPs do not expire, patients must have had a GPCCMP prepared or reviewed in the previous 18 months to continue to access allied health and other services under the plan
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To encourage reviews and ongoing care, the MBS fees for planning and review items are equalised at $156.55 for GPs and $125.30 for prescribed medical practitioners
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An existing GPCCMP can be reviewed and amended on an ongoing basis, and it is not required that a new plan be prepared each year
Sources: Upcoming Changes to Chronic Disease Management Framework – MBS Items for GP Chronic Condition Management Plans – Factsheet, pages 1, 4; Upcoming Changes to Chronic Disease Management Framework – Overview – Factsheet, page 2
Links and Resources:
Financial Planning:
Clinical Planning:
Billing Reference:
How can I keep workflows smooth, reduce admin, and manage the ongoing workload with GPCCMP in place?
The Bottom Line:
Here's what's helpful to know: the new GPCCMP framework is designed to simplify chronic condition management by removing collaboration requirements and multiple plan complexity. The practical reality is that this streamlined approach should reduce administrative burden compared to the previous GPMP/TCA system.
The Facts:
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The changes aim to simplify, streamline, and modernise the arrangements for health professionals
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The requirements for a GPCCMP have been streamlined compared to GPMPs and TCAs. Consultation with at least two collaborating providers is no longer required
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There is no requirement for allied health providers to confirm acceptance of the referral or otherwise provide input into the preparation of the GPCCMP
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GPs and PMPs can refer patients with a GPCCMP directly to relevant services
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Patients registered with MyMedicare must access GPCCMP items through the practice where they are enrolled; patients that are not registered may access the services through their usual GP
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You'll find that Cubiko's suite of metrics makes it easy to support workflow management: Recalls, Overdue Reminders, Appointments with no rebookings, and Cancelled Appointments help identify workflow gaps and support continuous improvement
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From 1 July 2027, a GPCCMP will be required to access domiciliary medication management reviews (items 245 and 900), creating additional future opportunities for integrated care planning
Sources: Upcoming Changes to Chronic Disease Management Framework – MBS Items for GP Chronic Condition Management Plans – Factsheet, pages 1, 5; Upcoming Changes to Chronic Disease Management Framework – Overview – Factsheet, pages 2, 3; Practice Owner and Practice Manager CCMP Workflow.
Links and Resources:
Workflow Streamlining:
Efficiency Tools:
Administrative Support:
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.