GPCCMP FAQ - MyMedicare Requirements
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.
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.
Allied Health Referrals Under GPCCMP – How to manage allied health referrals linked to GP Chronic Care Management Plans.
How does MyMedicare affect patient access to GPCCMP services?
The Bottom Line:
MyMedicare registration determines where patients can access GPCCMP services, creating clear pathways for chronic disease management.
Patients registered with MyMedicare must access GPCCMP services at their enrolled practice, while non-registered patients can continue accessing services through their usual GP at any practice. This system strengthens continuity of care while providing flexibility for non-registered patients, with the added benefit that telehealth GPCCMP services are not subject to the established clinical relationship rules that apply to most general practice telehealth items;
The Facts:
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Patients registered with MyMedicare must access GPCCMP items through the practice where they are enrolled
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Patients that are not registered may access the services through their usual GP
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The Regulations define "usual medical practitioner" as: "a general practitioner or prescribed medical practitioner: 1. who has provided the majority of services to the person in the past 12 months; or 2. who is likely to provide the majority of services to the person in the following 12 months; or 3. located at a medical practice that: a. has provided the majority of services to the person in the past 12 months; or b. is likely to provide the majority of services to the person in the next 12 months"
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These requirements are the same for face to face and telehealth items
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Telehealth items (92029, 92030, 92060, 92061) are not subject to the established clinical relationship rule that applies to most general practice telehealth items
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Instead, telehealth GPCCMP items are subject to the same MyMedicare and usual medical practitioner requirements as the face-to-face items
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To support continuity of care, patients registered through MyMedicare will be required to access the GP chronic condition management plan and review items through the practice where they are registered
Sources: Upcoming Changes to Chronic Disease Management Framework – MBS Items for GP Chronic Condition Management Plans – Factsheet, page 3; MBS Online explanatory note AN.0.47; MBS Online explanatory note AN.0.47
Links and Resources:
Official Information:
Role-Based Implementation Guides:
Billing Support:
Is MyMedicare registration mandatory for GPCCMP services and what are the exceptions?
The Bottom Line:
MyMedicare registration isn't mandatory for all patients to access GPCCMP services. What this means for your practice is that non-registered patients can still access GPCCMP services through their usual GP, giving them flexibility while registered patients get the benefit of structured continuity at their enrolled practice.
The practical reality is that this creates two clear pathways: registered patients must use their enrolled practice, while non-registered patients can continue with their usual GP anywhere, provided they meet the "usual medical practitioner" definition.
The Facts:
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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 at any practice
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The Regulations define "usual medical practitioner" as: "a general practitioner or prescribed medical practitioner: 1. who has provided the majority of services to the person in the past 12 months; or 2. who is likely to provide the majority of services to the person in the following 12 months; or 3. located at a medical practice that: a. has provided the majority of services to the person in the past 12 months; or b. is likely to provide the majority of services to the person in the next 12 months"
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These requirements are the same for face to face and telehealth items
Sources: Upcoming Changes to Chronic Disease Management Framework – MBS Items for GP Chronic Condition Management Plans – Factsheet, page 3; MBS Online explanatory note AN.0.47; MBS Online explanatory note AN.0.47
Links and Resources:
Official Information:
Role-Based Implementation Guides:
What happens if a patient is registered with MyMedicare at another practice but seeks GPCCMP services from us?
The Bottom Line:
If a patient is registered with MyMedicare at another practice, they must access GPCCMP services at their registered practice, not yours. This ensures continuity of care and supports the structured approach to chronic disease management. The good news is that patients have the ability to change their registration if they want to continue their chronic condition management with your practice, giving them control over where they receive their ongoing care.
The Facts:
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Patients registered with MyMedicare must access GPCCMP items through the practice where they are enrolled
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Patients who are not registered may access the services through their usual GP
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Patients can change their MyMedicare registration to a different practice if they choose
Sources: Upcoming Changes to Chronic Disease Management Framework – MBS Items for GP Chronic Condition Management Plans – Factsheet, page 3; MBS Online explanatory note AN.0.47; MBS Online explanatory note AN.0.47
Links and Resources:
MyMedicare Information:
Role-Based Implementation Guides:
How do I check a patient's MyMedicare registration status and view their registration details?
The Bottom Line:
The MBS factsheets don't provide specific information about how to check a patient's MyMedicare registration status or view their registration details.
PRODA, your Practice Management System updates and Cubiko tools provide MyMedicare status information.
The Facts:
The MBS factsheets don't provide specific information on checking MyMedicare registration status or viewing registration details.
Sources: MBS factsheets reviewed; information gap identified
Links and Resources:
MyMedicare Support:
Role-Based Implementation Guides:
How can I encourage patients to register for MyMedicare if they don't see the point?
The Bottom Line:
The key is highlighting how MyMedicare strengthens their relationship with your practice and ensures seamless, continuous care for their chronic conditions. You'll find that emphasising the practical benefits - like guaranteed access to their regular GP for chronic disease management and the structured support this provides - helps patients understand the value. The framework is designed to enhance continuity of care, which benefits both patients and practices through more coordinated chronic disease management.
The Facts:
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To support continuity of care, patients registered through MyMedicare will be required to access the GP chronic condition management plan and review items through the practice where they are registered
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Patients who are not registered may access the services through their usual GP at any practice
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The framework supports continuity of care and plays a role in long-term care planning
The MBS factsheets don't provide specific information about patient communication strategies for MyMedicare registration.
Sources: Upcoming Changes to Chronic Disease Management Framework – Overview – Factsheet, page 2; MBS Online explanatory note AN.0.47; MBS Online explanatory note AN.0.47
Links and Resources:
MyMedicare Information:
Role-Based Implementation Guides:
Can a non-registered patient have multiple GPCCMPs across different practices?
The Bottom Line:
The MBS factsheets don't specifically address whether non-registered patients can have multiple GPCCMPs across different practices. What we know is that non-registered patients can access services through their usual GP, but the factsheets focus on access points rather than multiple plan scenarios. The practical reality is that this situation may be complex given the "usual medical practitioner" definition, and we're waiting for further clarification from official sources.
The Facts:
The MBS factsheets don't provide specific information about multiple GPCCMP scenarios for non-registered patients.
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Patients that are not registered may access the services through their usual GP
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The Regulations define "usual medical practitioner" as: "a general practitioner or prescribed medical practitioner: 1. who has provided the majority of services to the person in the past 12 months; or 2. who is likely to provide the majority of services to the person in the following 12 months; or 3. located at a medical practice that: a. has provided the majority of services to the person in the past 12 months; or b. is likely to provide the majority of services to the person in the next 12 months"
Sources: Upcoming Changes to Chronic Disease Management Framework – MBS Items for GP Chronic Condition Management Plans – Factsheet, page 3; MBS Online explanatory note AN.0.47; MBS Online explanatory note AN.0.47
Links and Resources:
Official Information:
Role-Based Implementation Guides:
Billing Support:
What happens when a GP changes practices - can patients follow them for GPCCMP care?
The Bottom Line:
For MyMedicare registered patients, it depends on whether they update their registration to follow their GP to the new practice. Non-registered patients have more flexibility to follow their usual GP to any practice for GPCCMP care, as long as the GP meets the "usual medical practitioner" definition. Registered patients can update their MyMedicare registration if they want to continue with their GP at the new practice, giving them control over their care continuity.
We are waiting for information on billing arrangements around this.
The Facts:
-
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
-
The Regulations define "usual medical practitioner" as: "a general practitioner or prescribed medical practitioner: 1. who has provided the majority of services to the person in the past 12 months; or 2. who is likely to provide the majority of services to the person in the following 12 months; or 3. located at a medical practice that: a. has provided the majority of services to the person in the past 12 months; or b. is likely to provide the majority of services to the person in the next 12 months"
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Patients can change their MyMedicare registration to a different practice
Sources: Upcoming Changes to Chronic Disease Management Framework – MBS Items for GP Chronic Condition Management Plans – Factsheet, page 3; MBS Online explanatory note AN.0.47; MBS Online explanatory note AN.0.47
Links and Resources:
MyMedicare Information:
Role-Based Implementation Guides:
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.