The GP chronic condition management plan: items 965 and 967 explained for practice teams.

The key point

Since 1 July 2025, one GP chronic condition management plan (GPCCMP) has replaced the GP management plan and team care arrangements. GPs bill item 965 to prepare it and item 967 to review it, both $160.60 (AUD) from 1 July 2026. A plan can be prepared once every 12 months and reviewed every 3 months, and the patient needs a plan prepared or reviewed in the last 18 months to keep using allied health, Aboriginal and Torres Strait Islander health and wellbeing, and practice nurse services. MyMedicare-registered patients must get the plan from their registered practice.

Item numbers in this guide

These are the MBS items this guide refers to.⁠^{[1][2][7][15]}

What is a GP chronic condition management plan?

A GP chronic condition management plan is a single written plan that a GP or prescribed medical practitioner prepares with a patient who has a chronic condition.⁠^[1]⁠^[2] It replaced GP management plans and team care arrangements on 1 July 2025.⁠^[1]⁠^[2] The plan describes the condition and care needs, goals agreed through shared decision making, the actions the patient will take, the treatment and services they are likely to need, any referrals, and when the plan will be reviewed.⁠^[1]

A patient is eligible if they have at least one medical condition that has been, or is likely to be, present for at least 6 months, or is terminal.⁠^[1]⁠^[4] There is no list of eligible conditions and no specific diagnosis is needed: the MBS note gives the example of chronic pain present for more than 6 months whose cause has not been diagnosed.⁠^[1] Whether a patient would benefit from a structured plan is the GP’s clinical judgement, and the service must be clinically relevant.⁠^[1]

A plan does not have to include allied health referrals.⁠^[1]⁠^[3] The plan lists the services the patient will be referred to only if they would benefit from multidisciplinary care, and providers do not have to accept a referral before the plan is finalised.⁠^[1]

The plan is not available to people in residential aged care (called a residential care home in the MBS from 1 November 2026), who may be eligible for a multidisciplinary care plan instead.⁠^[1]⁠^[2]⁠^[16] Private hospital in-patients can have a face-to-face plan; public hospital in-patients are not eligible.⁠^[1]

GPCCMP item numbers and fees

All fees in this guide are in Australian dollars (AUD). GPs bill item 965 to prepare a plan and item 967 to review it; both have a schedule fee of $160.60 from 1 July 2026, up from $156.55 when the items started on 1 July 2025.⁠^[1]⁠^[2]⁠^[10] Prescribed medical practitioners bill 392 and 393, at $128.55 from 1 July 2026 (previously $125.30).⁠^[2]⁠^[14] The Medicare benefit is 100% of the fee out of hospital.⁠^[10]

The video items (92029 and 92030 for GPs, 92060 and 92061 for prescribed medical practitioners) pay the same as the face-to-face items.⁠^[11]⁠^[15] They are not subject to the established clinical relationship rule that applies to most GP telehealth; the same MyMedicare and usual GP requirements apply instead.⁠^[1] They cannot be used when the patient is admitted to hospital.⁠^[1] From 1 November 2026, the phone items (92033 and 92034 for GPs, 92063 and 92064 for prescribed medical practitioners) can also be used to prepare or review a plan, at the same fees as the face-to-face items.⁠^[15]⁠^[16] Before you bill the phone items, check their item descriptors on MBS Online, starting from the MBS Online summary of changes from 1 November 2026.

For billing, the main change is the review fee. The old review item 732 paid $82.10 in the March 2025 schedule; item 967 now pays the same as preparing a plan.⁠^[3]⁠^[13] The MBS note says that for most patients periodic reviews are likely to be appropriate and a new plan every 12 months is not required, although that remains a clinical decision.⁠^[1]

Reviews now pay the same as a new plan, so a review that is clinically appropriate but never booked is a $160.60 item not billed. A billing review flags potential gaps in care plan claims for the practice to check. Request a free billing optimisation report ↗

How often can you prepare or review a GPCCMP, and does it expire?

Unless exceptional circumstances apply, a plan can be prepared no more than once every 12 months, a new plan must be at least 3 months after the last review, and a plan can be reviewed no more than once every 3 months.⁠^[1]⁠^[2] Each service must also be clinically relevant.⁠^[1]⁠^[2]

Exceptional circumstances mean a significant change in the patient’s clinical condition or care circumstances that makes the service necessary sooner.⁠^[1] For an early service, record the particulars in the patient’s notes and mark the invoice, voucher or digital claim to show that exceptional circumstances apply; no further explanation is needed for payment.⁠^[1]

Plans do not expire.⁠^[1]⁠^[2] For allied health, Aboriginal and Torres Strait Islander health and wellbeing services and practice nurse services, the patient must have had the plan prepared or reviewed in the previous 18 months.⁠^[1]⁠^[7] A patient whose last review was 19 months ago still has a plan, but cannot use those services until the plan is reviewed or a new one is prepared.⁠^[1]

Who can bill items 965 and 967?

For a patient registered in MyMedicare, only the practice they are registered with can prepare and review their plan.⁠^[1]⁠^[4]⁠^[9] For a patient who is not registered, the patient’s usual GP, or another GP at the same practice, should bill it.⁠^[4] The usual GP is the GP or practice that has provided most of the patient’s services in the past 12 months, or is likely to in the next 12 months.⁠^[1]⁠^[4]

GP items can be claimed by GPs only, and prescribed medical practitioner items by prescribed medical practitioners only.⁠^[1] The GP must see the patient, discuss the plan and be satisfied that the patient understands and agrees with it.⁠^[1] There is no minimum time.⁠^[1]

In practice, this means registration status has to be checked before the appointment, not after the claim. A patient registered in MyMedicare with another practice cannot have their plan with you unless their registration changes.⁠^[1]⁠^[9]

What can be claimed on the same day as a GPCCMP?

A GP cannot bill a standard consultation for the same patient on the same day as preparing or reviewing their plan.⁠^[1]⁠^[4] If the patient also sees a different health professional that day, Services Australia pays both.⁠^[4] The standard consultations excluded by the MBS note include items 3, 4, 23, 24, 36, 37, 44 and 47, their telehealth equivalents, and other general practice attendance groups.⁠^[1] Record the date of service as the day the attendance happened.⁠^[1]

For the practice nurse item (10997), it depends on what the nurse did. Time spent helping prepare or review the plan is part of the plan item.⁠^[1]⁠^[7] A separate service that follows the plan, such as a wound dressing or vaccine, can be claimed on the same day if each item’s requirements are met.⁠^[7]⁠^[8]

A mental health treatment plan is not on the excluded list, and the MBS note’s own worked example has a GP completing a mental health treatment plan in the same consultation as a GPCCMP to support a mental health referral.⁠^[1] Each service still has to be clinically relevant.

On bulk billing incentives, the May 2025 MBS factsheet says plan items may be claimed with single bulk billing incentives when eligible patients are bulk billed.⁠^[2]

How allied health referrals work under a GPCCMP

A patient can use MBS-supported allied health services when they have a plan prepared or reviewed in the previous 18 months and a written referral letter from the GP.⁠^[1]⁠^[6] Referral forms are no longer used; since 1 July 2025 every new referral is a letter, whichever plan type it is made under.⁠^[3]⁠^[5]

The letter must name the referring practitioner, give the practice address or provider number, state the date, and explain the reasons for the referral, including information about the patient’s condition.⁠^[6] It must be signed, and an electronic signature is acceptable.⁠^[6] It does not need to state the number of services, and the patient can take it to any eligible provider of the profession named.⁠^[6]

A chronic condition referral is valid for the period stated in it or, if none is stated, 18 months, counted from the first service under the referral.⁠^[6] Allied health providers do not have to accept the referral or contribute before the plan is finalised.⁠^[1]⁠^[2]⁠^[6] If the patient consents, the GP shares the relevant parts of the plan with them.⁠^[1]⁠^[2]

Each calendar year a patient with a plan can have up to 5 individual allied health services (10 for Aboriginal or Torres Strait Islander patients), up to 5 practice nurse services, and, for type 2 diabetes, an assessment for group services and up to 8 group sessions.⁠^[1]⁠^[2] The count resets on 1 January without a review, and unused services do not carry over.⁠^[1]

Is a GPCCMP the same as a multidisciplinary care plan?

No. A GPCCMP is the GP’s own plan with the patient. Multidisciplinary care plan items are for contributing to, or reviewing, a plan developed by other health professionals.⁠^[4] That plan needs at least 3 collaborating providers supplying different types of services.⁠^[4] The multidisciplinary care plan items were not changed on 1 July 2025.⁠^[3]

For allied health access, the difference matters. For a patient living in the community, a multidisciplinary care plan on its own does not give access to MBS-supported allied health or Aboriginal and Torres Strait Islander health and wellbeing services, so they need a GPCCMP.⁠^[4] For a resident of a residential aged care facility, a multidisciplinary care plan may give that access.⁠^[4]

Old GPMP and TCA plans until 30 June 2027

Patients with a GP management plan or team care arrangement made before 1 July 2025 can keep using allied health, Aboriginal and Torres Strait Islander health and wellbeing, and practice nurse services consistent with that plan until the end of 30 June 2027.⁠^[3]⁠^[5]⁠^[12] From 1 July 2027 those services need a GPCCMP.⁠^[3]⁠^[5]

Item 967 cannot be used to review an old plan: the review items are for GPCCMPs only, so the GP prepares a new plan with 965 instead.⁠^[2]⁠^[5] Referrals issued before 1 July 2025 remain valid until their services are used.⁠^[5]

The practical task is a list: every patient still relying on a legacy plan, sorted by when they will next need a service, with one named person who reruns it. Without an owner the list is right once and then goes stale, and patients find out at the allied health front desk. The detailed questions about old items 721, 723 and 732 are answered in our questions-and-answers guide to GP management plans and team care arrangements.

Where the practice nurse and item 10997 fit

A practice nurse, Aboriginal and Torres Strait Islander health practitioner or health worker can help prepare or review a plan, but the plan is between the GP and the patient: the GP must see the patient and is responsible for the service, and no separate item is claimed for the nurse’s part.⁠^[1]

Between reviews, item 10997 covers services a practice nurse or Aboriginal and Torres Strait Islander health practitioner provides on behalf of, and under the supervision of, the GP.⁠^[7]⁠^[12] Examples in the MBS note are immunisations in line with the plan, monitoring progress and recording results, and self-management advice.⁠^[7] The fee is $14.35 from 1 July 2026, and the GP claims it.⁠^[7]⁠^[12]

A patient can have up to 5 of these services per calendar year in total across 10997 and its video and phone equivalents 93201 and 93203.⁠^[7]⁠^[12] To be eligible, the patient needs a GPCCMP prepared or reviewed in the last 18 months, a multidisciplinary care plan, or, until the end of 30 June 2027, a GP management plan or team care arrangements prepared before 1 July 2025 (for the video and phone items, both).⁠^[7]⁠^[12]

A GPCCMP workflow for the practice

The plan works best as a cycle the practice runs on purpose: find eligible patients, check they can be billed at your practice, prepare the plan, book the reviews and watch the 18-month window. Which patients need a plan, and when to review or re-plan, stays a clinical decision for the GP; the workflow only makes sure nothing is missed.

Many practices run this from spreadsheets, diary notes and recall reminders set by hand. That works, but it is repeated manual work every week, reminders are missed when staff change or go on leave, and a patient whose 18 months lapse usually finds out at the allied health front desk rather than at your practice.⁠^[1][7]

• Recall list: patients with a chronic condition and no plan, plans due for review, legacy GPMP or TCA patients before 30 June 2027, and plans approaching 18 months since the last preparation or review.
• Before booking: check MyMedicare registration or usual GP status, the date of the last 965 or 967, and whether the patient is a legacy-plan patient who needs a new 965 rather than a review.
• Booking: make the plan or review its own appointment, so the same GP is not also billing a standard consultation that day.⁠^[1] Book a separate nurse appointment if a 10997 service is planned.
• Nurse preparation: the nurse can gather history, measurements and goals beforehand; that time is part of the plan item, not 10997.⁠^[1]⁠^[7]
• The consultation: the GP sees the patient, agrees the plan, records consent and agreement, writes referral letters and sets the review timeframe.⁠^[1]
• After the visit: offer the patient a copy, add the plan to the record, and upload it to My Health Record where possible (encouraged, not required for the claim).⁠^[1] Keep the plan for at least 2 years, the retention period the MBS note sets for documents an item requires.⁠^[1] Book the first review before the patient leaves.
• Between reviews: schedule 10997 services consistent with the plan and track the 5-per-year count.⁠^[7]
• Software: check that practice software templates, recall rules and fee lists use 965 and 967 and the 1 July 2026 fees. Vendor templates can lag schedule changes, and old 721 and 723 templates left in place invite errors.
• Ownership: give recalls and unpaid claims a named owner. When everyone assumes reception or the nurse is following up, nobody is.

Common GPCCMP billing errors

The errors below come from timing, eligibility or same-day claiming rather than from the content of the plan. These are the ones to check first.⁠^{[1][2][4][5][6][7][9][10]}

• Claiming a general attendance item (such as 23 or 36) by the same GP on the same day as 965 or 967.⁠^[1]⁠^[4]
• Claiming 10997 for nurse time spent helping prepare or review the plan.⁠^[1]⁠^[7]
• Using 967 to review a GPMP or TCA made before 1 July 2025, instead of preparing a new plan with 965.⁠^[2]⁠^[5]
• Preparing a plan for a MyMedicare patient who is registered with another practice.⁠^[1]⁠^[9]
• Preparing a new plan within 12 months, or within 3 months of the last review, or reviewing within 3 months, without documented exceptional circumstances and the claim flag.⁠^[1]
• Billing a plan for a resident of residential aged care, or a video item for an admitted hospital patient.⁠^[1]
• Letting the 18-month window lapse, so allied health, Aboriginal and Torres Strait Islander health and wellbeing, and practice nurse services are no longer covered.⁠^[1]⁠^[7]
• Using an out-of-date referral form instead of a signed referral letter.⁠^[5]⁠^[6]
• A fee list in practice software that was not updated on 1 July 2026.⁠^[10]

Each of these errors is a claim that may be rejected, reduced or questioned later. A billing review of your care plan claims since July 2025 shows potential gaps worth a closer look. Request a free billing optimisation report ↗