Chronic disease management plan (now GPCCMP): what Medicare covers

Short answer: since 1 July 2025, the plan your GP writes for a long-term health condition is called a GP chronic condition management plan (GPCCMP). It replaced the GP management plan and team care arrangement, often called a chronic disease management plan. With a current plan and a referral, Medicare pays $63.40 towards each of up to 5 allied health visits a year. That’s 85% of the $74.55 schedule fee from 1 July 2026. Physiotherapy, podiatry, chiropractic, exercise physiology, occupational therapy and eight other services count. The practice sets its own fee, so you pay the difference unless it bulk bills.

The old names and the new one

Before July 2025, GPs used two documents: a GP management plan (GPMP) and a team care arrangement (TCA). Together they were often called a chronic disease management (CDM) plan. Some people still call it an EPC plan or enhanced primary care plan.

On 1 July 2025 both were replaced by one GP chronic condition management plan. For patients, that means one plan instead of two, a referral letter instead of the old form, and no need for your GP to consult two other providers before referring you.

If your plan is older. If you had both a GPMP and a TCA before 1 July 2025, you can keep using them for allied health visits until 30 June 2027. After that you’ll need the new plan. Referrals written before 1 July 2025 stay valid until you’ve used every visit on them.

One MBS explanatory note gives other dates, but the item wording and Services Australia say 30 June 2027. Ask your GP when to switch.

Which allied health visits Medicare helps pay for

Medicare calls the rebate the “benefit”. Every service below has the same schedule fee and benefit.

Rules for all of them:

• Each visit must last at least 20 minutes and be one-on-one.

• Video and phone visits use items 93000 and 93013, at the same fee, and count towards the same yearly limit.

• Massage therapy isn’t on the list.

• People with type 2 diabetes can also get one assessment and up to 8 group sessions a year for diabetes education, exercise physiology or dietetics.

Mental health care plans are a different scheme (Better Access) with their own rules.

Who is eligible

• You have at least one medical condition that has lasted, or is likely to last, at least 6 months, or is terminal.

• There’s no list of conditions. Your GP decides whether a plan suits you.

• You live in the community. Aged care residents use a different plan with the same access. Hospital in-patients can’t claim these allied health visits.

• If you’ve registered with a practice through MyMedicare, get the plan there. If not, see your usual GP: the GP or practice that has given you most of your care in the past 12 months, or is likely to in the next 12.

How many visits a year

• Up to 5 individual visits per calendar year, in total. That’s across all professions, not 5 each: say, 5 physiotherapy visits, or 1 dietetics and 4 podiatry.

• Aboriginal and Torres Strait Islander patients can have up to 10.

• The count resets on 1 January. Unused visits don’t carry over.

• Your Medicare online account shows how many you’ve used (care plan service history).

• Beyond 5, you pay the full fee, or may be able to use private health extras or a state or primary health network program. You can’t claim Medicare and extras for the same visit.

What you pay: the gap

For allied health visits, Medicare pays 85% of the schedule fee. On a $74.55 schedule fee, that’s $63.40.

The practice sets its own fee, and your gap is that fee minus $63.40. At exactly the schedule fee, you’d pay $11.15. A practice that bulk bills accepts the $63.40 as full payment, so you pay nothing. If you pay up front, you can claim the benefit back from Medicare.

Fees vary, so we don’t quote typical prices. Ask each practice.

If your Medicare out-of-pocket costs add up over a year, the Medicare Safety Nets may increase what you get back.

How to get the plan from your GP

1. Book with your usual GP (or your MyMedicare practice). Say it’s for a GP chronic condition management plan, and ask if you need a longer booking.

2. Write the plan together. It sets out your condition, goals, actions, likely services and when it will be reviewed. A practice nurse may help. You agree to it and are offered a copy.

3. Get a referral letter for each service in your plan. The letter names a profession, not a person. A physiotherapy referral works with any eligible physiotherapist, but not a chiropractor. It lasts for the period written on it, or 18 months from your first visit if none is written. It needn’t say how many visits.

4. Keep the plan current. A GP can prepare a new plan once every 12 months and review it every 3 months, or sooner if your condition changes significantly. The plan doesn’t expire, but it must have been prepared or reviewed in the last 18 months for your visits to stay covered.

What the GP visit costs. Preparing or reviewing the plan is MBS item 965 or 967, with a schedule fee of $160.60. Medicare pays 100% of the schedule fee for GP visits outside hospital, so a bulk-billed plan costs you nothing. If the GP charges more, you pay the difference.

After your first and last allied health visit, the practitioner sends your GP a written report.

What to ask the practice before booking

• Do you accept GP chronic condition management plan referrals?

• Does the practitioner I’ll see have a Medicare provider number?

• What’s your fee for a care plan visit, and what will I pay after the $63.40 benefit? Do you bulk bill any care plan visits?

• Can you claim the Medicare benefit for me on the day, or do I claim it myself?

• How long is the appointment, and do you offer video or phone visits under the plan?

• For an exercise physiologist, dietitian, speech pathologist, audiologist or diabetes educator: are you accredited for Medicare services?

How to check a practitioner is registered

On the Ahpra register. The Australian Health Practitioner Regulation Agency (Ahpra) public register covers chiropractors, occupational therapists, osteopaths, physiotherapists, podiatrists, psychologists, and Aboriginal and Torres Strait Islander health practitioners. You can search it by profession, state, suburb or postcode, and name or registration number.

Through a professional body. Exercise physiologists, dietitians, speech pathologists, audiologists and diabetes educators aren’t on the Ahpra register. For Medicare, MBS Online relies on the bodies named in the table above, and each has an online search. MBS Online notes that some practitioners choose not to appear on these lists, so if you can’t find someone, ask.

To claim Medicare, a registered practitioner also needs a Medicare provider number.

Finding an allied health professional through Localdex

Localdex lists physiotherapy, chiropractic, podiatry, exercise physiology, occupational therapy, psychology and massage. You can describe the service you need and your suburb, and send a request to up to three practices. Nothing is sent until you approve it. The request form asks only for the service, not your symptoms or medical history. It’s free for customers and covers South East Queensland and Northern Rivers NSW.

No practice in these categories has a profile on Localdex yet. If your search finds none, you can leave your request with us for up to 90 days while we look. Keep health details out of the optional notes.

Describe the service you need

Localdex doesn’t give health advice. For questions about your health, talk to your GP or call healthdirect on 1800 022 222.

FAQ

What replaced the chronic disease management plan? On 1 July 2025, the GP chronic condition management plan (GPCCMP) replaced the GP management plan and team care arrangement.

Does Medicare cover physio? Under this scheme, yes, with a current plan and a referral: $63.40 per visit (from 1 July 2026), for up to 5 allied health visits a year.

How many physio sessions do I get on a care plan? Up to 5 a year, shared with any other allied health visits under the plan.

Is it the same as a mental health care plan? No. Mental health treatment plans are a separate Medicare scheme with their own rules.

I had a GP management plan before July 2025. Do I need a new one? If you also had a team care arrangement, both stay usable for allied health visits until 30 June 2027. After that, you’ll need a GP chronic condition management plan.

Sources

• MBS Online, item 10960 and notes AN.15.3, AN.15.5, AN.15.6, MN.3.1 (fee updated 1 July 2026; notes 1 November 2025): https://www9.health.gov.au/mbs/fullDisplay.cfm?type=item&q=10960&qt=item

• MBS Online, items 10950 to 10970, 93000, 93013 (fees updated 1 July 2026; swap the item number in the URL), e.g. 10953: https://www9.health.gov.au/mbs/fullDisplay.cfm?type=item&q=10953&qt=item

• MBS Online, item 965 and note AN.0.47 (fee updated 1 July 2026; note 1 November 2025): https://www9.health.gov.au/mbs/fullDisplay.cfm?type=item&q=965&qt=item

• MBS Online, note AN.15.4 (1 November 2025): https://www9.health.gov.au/mbs/fullDisplay.cfm?type=note&q=AN.15.4&qt=noteID

• Department of Health, Disability and Ageing, framework changes overview factsheet (22 May 2025): https://mbsonline.gov.au/internet/mbsonline/publishing.nsf/650f3eec0dfb990fca25692100069854/35bc9280594efa33ca258c9200126149/$FILE/PDF%20Version%20-%20Upcoming%20Changes%20to%20Chronic%20Disease%20Management%20Framework%20-%20Overview.PDF

• Services Australia, services under a GPCCMP (30 June 2026): https://www.servicesaustralia.gov.au/services-available-under-gp-chronic-condition-management-plan

• Services Australia, allied health billing rules (9 April 2026): https://www.servicesaustralia.gov.au/mbs-billing-rules-for-chronic-condition-allied-health-and-other-primary-health-care-items

• Services Australia, requirements for a chronic condition management plan (21 August 2025): https://www.servicesaustralia.gov.au/requirements-for-chronic-condition-management-plan

• Services Australia, Medicare benefit percentages (accessed 13 October 2026): https://operational.servicesaustralia.gov.au/public/Pages/your-health/011-43000000-01.html

• Services Australia, bulk billing (1 July 2026): https://www.servicesaustralia.gov.au/bulk-billing

• Services Australia, Medicare Safety Nets thresholds (1 January 2026): https://www.servicesaustralia.gov.au/what-are-medicare-safety-nets-thresholds

• Services Australia, mental health care and Medicare (2 October 2026): https://www.servicesaustralia.gov.au/mental-health-care-and-medicare

• Ahpra, register of practitioners (accessed 13 October 2026): https://www.ahpra.gov.au/Registration/Registers-of-Practitioners.aspx

• healthdirect, management of chronic conditions (reviewed September 2024; uses the older name): https://www.healthdirect.gov.au/management-of-chronic-conditions

Medicare details are current as of 13 October 2026. Check MBS Online or Services Australia before you book.