GPCCMP FAQ - MBS Item Numbers & Billing
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.
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.
Allied Health Referrals Under GPCCMP – How to manage allied health referrals linked to GP Chronic Care Management Plans.
What are the new MBS item numbers for GPCCMP preparation and reviews?
The Bottom Line:
From 1 July 2025, new, streamlined MBS item numbers replace the old GPMP and TCA system. You now have four clear items for each provider type: prepare face-to-face, prepare video, review face-to-face, and review video. Practice nurses, Aboriginal and Torres Strait Islander Health Practitioners and Aboriginal Health Workers are now formally recognised to assist with preparation and reviews. Much simpler than before!
The Facts:
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New GP items: 965 (prepare face-to-face), 92029 (prepare video), 967 (review face-to-face), 92030 (review video)
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New PMP items: 392 (prepare face-to-face), 92060 (prepare video), 393 (review face-to-face), 92061 (review video)
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The ceased items are replaced with new items for GPs and PMPs to prepare and review GPCCMPs
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Practice nurses, Aboriginal and Torres Strait Islander Health Practitioners and Aboriginal Health Workers can assist the GP or prescribed medical practitioner to prepare or review a GPCCMP, with this assistance formally specified in the regulatory arrangements for the new items
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These new items apply to both face-to-face and telehealth (video) services with fees of $156.55 for GPs and $125.30 for PMPs
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Patients registered with MyMedicare must access GPCCMP items through the practice where they are enrolled, while patients not registered with MyMedicare can access these services at any practice but should use their usual GP
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Items for the preparation or review of a GPCCMP cannot be co-claimed on the same day as general attendance MBS items
Sources: Upcoming Changes to Chronic Disease Management Framework – MBS Items for GP Chronic Condition Management Plans – Factsheet; Upcoming Changes to Chronic Disease Management Framework – Overview – Factsheet; MBS Online explanatory note AN.0.47, AN.15.3, AN.15.4, AN.15.5, AN.15.6
Links and Resources:
Official Information:
Billing Support:
Role-Based Implementation Guides:
Can I do GPCCMPs or reviews via telehealth and what are the specific requirements?
The Bottom Line:
Yes, you can do GPCCMPs via video telehealth using items 92029/92030 (GPs) or 92060/92061 (PMPs). Importantly, GPCCMP telehealth items are NOT subject to the usual "established clinical relationship" rule that applies to most GP telehealth items. Instead, they follow the same MyMedicare and "usual medical practitioner" requirements as face-to-face GPCCMP items.
The Facts:
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GPCCMP telehealth items available: 92029 (GP prepare), 92030 (GP review), 92060 (PMP prepare), 92061 (PMP review)
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GPCCMP telehealth items are NOT subject to the established clinical relationship rule that applies to most general practice telehealth items
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Instead, GPCCMP telehealth items are subject to the same MyMedicare and usual medical practitioner requirements as the face-to-face GPCCMP items
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Patients registered with MyMedicare must access GPCCMP telehealth items through the practice where they are enrolled, while patients not registered with MyMedicare can access these services at any practice but should use their usual GP
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The regulations define "usual medical practitioner" as a GP or PMP who: (1) has provided the majority of services to the person in the past 12 months; OR (2) is likely to provide the majority of services to the person in the following 12 months; OR (3) is located at a medical practice that has provided (or is likely to provide) the majority of services to the person in the past/next 12 months
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Consistent with general telehealth rules, GPCCMP telehealth items cannot be used when the patient is an admitted patient of a hospital
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The fees are the same as face-to-face items: $156.55 for GPs, $125.30 for PMPs
Sources: Upcoming Changes to Chronic Disease Management Framework – MBS Items for GP Chronic Condition Management Plans – Factsheet; MBS Online explanatory note AN.0.47, AN.15.3, AN.15.4, AN.15.5, AN.15.6
Links and Resources:
Official Information:
Billing Support:
Role-Based Implementation Guides:
Related Questions:
What are the new MBS item numbers for GPCCMP preparation and reviews?
How does billing work with the new GPCCMP items, including co-claiming rules and frequency?
When can I bill GPCCMP items earlier than the usual 12-month/3-month timing?
The Bottom Line:
You can prepare or review a GPCCMP earlier than the usual timing rules when "exceptional circumstances" apply. This means there has been a significant change in the patient's clinical condition or care circumstances that necessitates the service. You must document the exceptional circumstances and indicate this when claiming to ensure proper payment.
The Facts:
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Standard timing rules: GPCCMP can be prepared once every 12 months (and any new plan must be at least 3 months after the last review), and reviewed once every 3 months
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Exceptional circumstances allow earlier services when there has been a significant change in the patient's clinical condition or care circumstances that necessitates the performance of the service
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The particulars of the exceptional circumstances should be documented in the patient's record to substantiate the claim
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Services Australia needs to be advised that exceptional circumstances apply to pay a benefit sooner than generally allowable
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To facilitate payment, the patient's invoice, Medicare voucher or digital claim should indicate that exceptional circumstances apply - no further explanation is required to support payment
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Example scenario: A patient has a GPCCMP for asthma that was reviewed 1 month ago, then gets diagnosed with type 1 diabetes. You can review their plan (or develop a new plan) as a priority due to exceptional circumstances
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There is no minimum amount of time required to spend with the patient, but all MBS requirements must be met including that the GP or PMP must attend the patient, discuss the plan, and ensure the patient understands and agrees with it
Sources: Upcoming Changes to Chronic Disease Management Framework – MBS Items for GP Chronic Condition Management Plans – Factsheet; MBS Online explanatory note AN.0.47, AN.15.3, AN.15.4, AN.15.5, AN.15.6
Links and Resources:
Official Information:
Billing Support:
Role-Based Implementation Guides:
Related Questions:
How does billing work with the new GPCCMP items, including co-claiming rules and frequency?
How close to the 3-month mark can I do a review? Is it 3 months and 1 day?
Which old MBS item numbers for GPMPs and TCAs are being replaced by the new GPCCMP items?
The Bottom Line:
All the old GPMP and TCA items ceased on 1 July 2025 and are replaced by the streamlined GPCCMP items. The specific ceased items are: GPMPs (229, 721, 92024, 92055), TCAs (230, 723, 92025, 92056), and all review items (233, 732, 92028, 92059). You now have one unified set of items instead of multiple different ones.
The Facts:
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From 1 July 2025 the following MBS items ceased:
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GP management plans: 229, 721, 92024, 92055
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Team care arrangements: 230, 723, 92025, 92056
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Reviews: 233, 732, 92028, 92059
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The ceased items are replaced with new items for GPs and PMPs to prepare and review GPCCMPs
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New GP items: 965 (prepare face-to-face), 92029 (prepare video), 967 (review face-to-face), 92030 (review video)
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New PMP items: 392 (prepare face-to-face), 92060 (prepare video), 393 (review face-to-face), 92061 (review video)
Sources: Upcoming Changes to Chronic Disease Management Framework – MBS Items for GP Chronic Condition Management Plans – Factsheet; Upcoming Changes to Chronic Disease Management Framework – Overview – Factsheet; MBS Online explanatory note AN.0.47, AN.15.3, AN.15.4, AN.15.5, AN.15.6
Links and Resources:
Official Information:
Billing Support:
Role-Based Implementation Guides:
Related Questions:
When do the old GPMP/TCA item numbers cease to be billable and can I still bill review items for existing plans?
What happens to patients with existing GPMPs and TCAs after 1 July 2025?
When do the old GPMP/TCA item numbers cease to be billable and can I still bill review items for existing plans?
The Bottom Line:
All old GPMP/TCA items ceased on 1 July 2025 - you cannot bill them anymore, including review items for existing plans. If a patient with an old plan needs a review, you must transition them to a new GPCCMP instead.
The Facts:
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From 1 July 2025, GP management plans (229, 721, 92024, 92055) and team care arrangements (230, 723, 92025, 92056) ceased
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Reviews (233, 732, 92028, 92059) also ceased on 1 July 2025
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MBS items for reviewing GPMPs and TCAs ceased on 1 July 2025 - if a patient requires a review of their GPMP and/or TCA after 1 July 2025 they should be transitioned to a new GP chronic condition management plan (GPCCMP)
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From 1 July 2025, any new plans put in place will need to meet the requirements of a GPCCMP
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Patients with GPMPs and/or TCAs in place prior to July 1, 2025, can continue to access services consistent with those plans during a transition period until June 30, 2027
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Individual and group allied health services can be accessed under existing GPMPs and TCAs until June 30, 2027
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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
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From 1 July 2027, a GPCCMP will be required for ongoing access to MBS-funded allied health services and domiciliary medication management reviews (items 245 and 900)
Sources: Summary of changes to Chronic Disease Management (CDM) Framework; Upcoming Changes to Chronic Disease Management MBS Items – Transition Arrangements for Existing Patients – Factsheet
Links and Resources:
Official Information:
Role-Based Implementation Guides:
Related Questions:
What happens to patients with existing GPMPs and TCAs after 1 July 2025?
When should I transition patients to GPCCMP and what are the billing timing rules?
What are the Medicare rebate fees for GPCCMP items and how do they compare to previous GPMP/TCA fees?
The Bottom Line:
The new GPCCMP fees are $156.55 for GPs and $125.30 for PMPs for both preparation and review. This simplifies your billing because both preparation and review have the same fee, compared to the old system where you had different fees for GPMPs, TCAs, and reviews. These items will be included in the Bulk Billing Practice Incentive Program from 1 November 2025.
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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The fee for reviewing a GPCCMP is the same: $156.55 for GPs and $125.30 for PMPs
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Previously, the rebate for preparation of a GPMP (MBS Items 721, 92024) was $164.35, preparation of TCAs (MBS Items 723, 92025) was $130.25 and a review (MBS Item 732, 92028) was $82.10
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The new Medicare fee is the same for the preparation and the review of a plan
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To encourage reviews and ongoing care, the MBS fees for planning and review items have been equalised
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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
Sources: Summary of changes to Chronic Disease Management (CDM) Framework; Upcoming Changes to Chronic Disease Management Framework – MBS Items for GP Chronic Condition Management Plans – Factsheet; MBS Online explanatory note AN.0.47, AN.15.3, AN.15.4, AN.15.5, AN.15.6
Links and Resources:
Official Information:
Financial Analysis Tools:
Billing Support:
Role-Based Implementation Guides:
Related Questions:
What do the GPCCMP changes mean financially for my practice?
How can I optimise the financial benefits of the new GPCCMP system?
How does billing work with the new GPCCMP items, including co-claiming rules and frequency?
The Bottom Line:
You can prepare a GPCCMP once every 12 months and review it every 3 months if clinically relevant. The key rule is that you cannot co-claim GPCCMP items with general attendance items on the same day. However, you CAN co-claim GPCCMP items with practice nurse services (item 10997) when they provide separate, clinically relevant services consistent with the patient's plan. Patients must have had a GPCCMP prepared or reviewed in the previous 18 months to continue accessing allied health services.
The Facts:
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Items for preparing a GPCCMP can be claimed every 12 months if clinically relevant
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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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Items for the preparation or review of a GPCCMP cannot be co-claimed on the same day as general attendance items (items 3, 4, 23, 24, 36, 37, 44, 47, 52, 53, 54, 57, 58, 59, 60, 65, 123, 124, 151 and 165)
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Practice nurses, Aboriginal and Torres Strait Islander Health Practitioners and Aboriginal Health Workers can assist the GP or prescribed medical practitioner to prepare or review a GPCCMP, but cannot claim item 10997 for their assistance time as GPCCMP items are complete medical services
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Co-claiming GPCCMP items with practice nurse services (10997, 93201, 93203) IS appropriate when the practice nurse provides a separate, clinically relevant service consistent with the patient's plan. Examples include:
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Review and wound treatment: GP reviews GPCCMP (item 967) and practice nurse dresses diabetic wound (item 10997) on same day
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Plan/review and immunisation: GP prepares GPCCMP (item 965) and practice nurse administers vaccine (item 10997) on same day
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Review and parenteral medication: GP reviews GPCCMP (item 967) and practice nurse administers B12 injection or denosumab (item 10997) on same day
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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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It is not required that a new plan be prepared each year; existing plans can continue to be reviewed
Sources: Upcoming Changes to Chronic Disease Management Framework – MBS Items for GP Chronic Condition Management Plans – Factsheet; Summary of changes to Chronic Disease Management (CDM) Framework; MBS Online explanatory note AN.0.47, AN.15.3, AN.15.4, AN.15.5, AN.15.6, MN.12.4
Links and Resources:
Official Information:
Billing Support:
Role-Based Implementation Guides:
What are the record keeping and compliance requirements for GPCCMP items?
The Bottom Line:
You must keep adequate and contemporaneous records for all GPCCMP services and retain any documents created as part of the GPCCMP for 2 years. You're also responsible for ensuring all services meet legislative requirements and may need to provide evidence for Medicare compliance checks.
The Facts:
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Providers are responsible for ensuring services claimed from Medicare using their provider number meet all legislative requirements and 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 (see GN.15.39 for guidance on what constitutes adequate and contemporaneous records)
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Where a GPCCMP item specifies the creation of a document, that document must be retained for 2 years as specified in Clause 4.3 of the Health Insurance Act 1973
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The GP or prescribed medical practitioner must attend the patient, have a discussion with them about the plan, and be satisfied that the patient understands and agrees with the plan (including actions they are to take), even if staff have assisted in preparing or reviewing the plan
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Hospital-employed practitioners have restrictions: GPCCMP items can only be used by medical practitioners who are either (1) not employed by the proprietor of a hospital that is not a private hospital, OR (2) employed by such a hospital but providing the service outside the course of that employment
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Nurse practitioners can provide item 10997 services as they meet the definition of a practice nurse, provided they're working in general practice or a health service with a relevant section 19(2) exemption
Sources: Upcoming Changes to Chronic Disease Management Framework – MBS Items for GP Chronic Condition Management Plans – Factsheet; MBS Online explanatory note AN.0.47, AN.15.3, AN.15.4, AN.15.5, AN.15.6, MN.12.4
Links and Resources:
Official Information:
Compliance Information:
Role-Based Implementation Guides:
Related Questions:
How does billing work with the new GPCCMP items, including co-claiming rules and frequency?
When can I bill GPCCMP items earlier than the usual 12-month/3-month timing?
Are there bulk billing incentives under GPCCMP and how do they compare to the old system?
The Bottom Line:
Yes, you can claim bulk billing incentives when you bulk bill eligible patients for GPCCMP services, and from November 2025, GPCCMPs will also be included in the expanded Bulk Billing Practice Incentive Program - giving you additional financial support for providing these essential chronic disease management services.
The Facts:
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GPCCMP items may be claimed with single bulk billing incentives when eligible patients are bulk billed
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GPCCMPs will be included in the Bulk Billing Practice Incentive Program from 1 November 2025
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When you bulk bill eligible patients for GPCCMP services, you can claim bulk billing incentives as part of the government's broader commitment to supporting bulk billing
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The Bulk Billing Practice Incentive Program inclusion represents additional financial support beyond the current single bulk billing incentives
Sources: Upcoming Changes to Chronic Disease Management Framework – MBS Items for GP Chronic Condition Management Plans – Factsheet; MBS Online explanatory note AN.0.47, AN.15.3, AN.15.4, AN.15.5, AN.15.6
Links and Resources:
Official Information:
Financial Analysis Tools:
Role-Based Implementation Guides:
Related Questions:
What's the best way to set fees for GPCCMP – should we bulk bill or charge privately?
What do the GPCCMP changes mean financially for my practice?
Do GPCCMP item fees increase each year with Medicare indexation?
The Bottom Line:
The MBS factsheets don't provide specific information about indexation of GPCCMP item fees, but as standard MBS items, they would typically follow normal Medicare indexation processes that apply to other MBS items.
The Facts:
The MBS factsheets don't provide specific information on this topic regarding GPCCMP item indexation.
Links and Resources:
Official Information:
Financial Analysis Tools:
Related Questions:
What are the Medicare rebate fees for GPCCMP items and how do they compare to previous GPMP/TCA fees?
How can I optimise the financial benefits of the new GPCCMP system?
How many GPCCMP plans can be done in one day/session?
The Bottom Line:
While there isn't a stated limit on the number of different patients for whom you can prepare or review GPCCMPs in a single day, it's crucial to adhere to the frequency rules for individual patients and your clinical decision making.
The Facts:
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A GPCCMP can be prepared once every 12 months, if clinically relevant
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Reviews can be conducted once every 3 months, if clinically relevant
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Items for the preparation or review of a GPCCMP cannot be co-claimed on the same day as general attendance items
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Practice nurses, Aboriginal and Torres Strait Islander Health Practitioners and Aboriginal Health Workers can assist the GP or prescribed medical practitioner to prepare or review a GPCCMP
Sources: Upcoming Changes to Chronic Disease Management Framework – MBS Items for GP Chronic Condition Management Plans – Factsheet; Upcoming Changes to Chronic Disease Management Framework – Overview – Factsheet; MBS Online explanatory note AN.0.47, AN.15.3, AN.15.4, AN.15.5, AN.15.6
Links and Resources:
Official Information:
Role-Based Implementation Guides:
Related Questions:
Should I change consultation appointment lengths for GPCCMP creation and reviews for optimal efficiency?
How does billing work with the new GPCCMP items, including co-claiming rules and frequency?
How close to the 3-month mark can I do a review? Is it 3 months and 1 day?
The Bottom Line:
The official guidance states that GPCCMP reviews can be conducted "every 3 months." The provided MBS factsheets do not explicitly state a "plus one day" rule. We are currently suggesting 3 months and 1 day to be on the safe side.
The Facts:
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GPCCMP reviews can be conducted every 3 months, if clinically relevant
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Unless exceptional circumstances apply, reviews can be conducted once every 3 months
Sources: Upcoming Changes to Chronic Disease Management Framework – MBS Items for GP Chronic Condition Management Plans – Factsheet; Upcoming Changes to Chronic Disease Management Framework – Overview – Factsheet; MBS Online explanatory note AN.0.47, AN.15.3, AN.15.4, AN.15.5, AN.15.6
Links and Resources:
Official Information:
Role-Based Implementation Guides:
Related Questions:
What are the timing rules and billing frequencies for GPCCMP creation and reviews?
How does billing work with the new GPCCMP items, including co-claiming rules and frequency?
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.