Members should be aware that from 1 July 2025, there will be a new framework for chronic disease management in primary care. These changes implement the recommendations of the MBS Review Taskforce and are designed to streamline, simplify and modernise the MBS items for patients and practitioners.
These changes primarily affect medical practitioners; however, allied health professionals delivering MBS services should also be aware of changes to plan and referral requirements.
What does this mean for chiropractors?
We recommend that all chiropractors read the factsheets from the Department of Health about What the changes mean for Allied Health and Referral Arrangements for Allied Health.
In summary:
- From 1 July 2025, GP Management Plans (GPMPs) and Team Care Arrangements (TCAs) will be replaced with a single GP Chronic Condition Management Plan (GPCCMP).
- The nature of the individual and group allied health services that can be provided under the chronic condition management arrangements is not changing as part of these reforms. However, there are changes to the item descriptors for these items because of the removal of GPMPs and TCAs, and commencement of GPCCMPs.
- Referrals for allied health services written on or after 1 July 2025 will be in the form of a letter, not the form used previously. Referrals written before 1 July 2025 remain valid until all services under the referral have been provided (see separate factsheet on referral requirements).The changes remove multiple plans and existing collaboration requirements.
- All other MBS requirements of the existing allied health services are unchanged, including requirements to provide written reports to the referring medical practitioner.[1]
Further fact sheets about these changes, including referral transition arrangements, are accessible via MBS online.
UPDATE: 26 June 2025
The ACA has fielded questions from members about these upcoming changes and understands the change may have created some confusion and concern. We have identified some information and clarity gaps and sought further information on behalf of members, both via Medicare and via other stakeholders, including Allied Health Professions Australia (AHPA).
The following clarifications and additional information has been provided:
Referrals do not need to specify the number of services provided
This has been confirmed. While the number of services to be provided is not required to be included in the referral nothing prevents the referring medical practitioner from specifying the number of services to be provided under the referral, if they choose to do so. The new GPCCMP framework has been revised from its original format to better reflect and respect the patient/practitioner relationship that exists between patients and their allied health providers and allied health providers and general practitioners. The new arrangements promote patient choice. Under the new arrangements, referrals will no longer need to specify the name of the allied health provider to provide the services.
As a result, patients and providers will need to monitor the availability of their MBS supported allied health services, noting that there has been an existing need to do this where, for example, a referral is used beyond a single calendar year. For the majority of patients, it will be possible to establish the number of services they intend to seek from a particular provider at the point of intake. Where the number of available services is less clear, providers can check a patient’s eligibility for services using the MBS items online checker in HPOS Check MBS Item numbers – Health professionals – Services Australia or the care plan history in HPOS Patient details in HPOS – Health professionals – Services Australia. Patients can check their history using the care plan service history functions in their Medicare Online Account.
We suggest members ensure they have processes in place to support monitoring the availability of a patient’s MBS supported Allied Health services.
18-month validity of referrals
This doesn’t change annual item limits. The total number of Medicare supported allied health services in a calendar year has not changed. Patients can receive up to five services in a calendar year (ten for Aboriginal and Torres Strait Islander patients), regardless of the date the plan was prepared. Providers can check a patient’s eligibility for services using the MBS items online checker in HPOS Check MBS Item numbers – Health professionals – Services Australia or the care plan history in HPOS Patient details in HPOS – Health professionals – Services Australia. Patients can check their history using the care plan service history functions in their Medicare Online Account.
Unless a different period is stated on the referral, referrals for allied health services under the revised framework are valid for 18 months from the first service provided under the referral. The 18-month period aligns with the new requirement for patients to have their GP chronic condition management plan prepared or reviewed in the previous 18 months to retain access to MBS-supported allied health services.
Valid referral to an allied health provider
GPs can include the address of the practice, or the practitioner’s provider number at that practice, of the referring practitioner. The new requirements have brought the arrangements for referrals to allied health in line with the existing requirements for referrals to medical specialists. These arrangements are long standing and supported by the relevant systems.
Tracking Medicare visits with freedom to choose any providers
The new referral arrangements are designed to improve the transfer of relevant clinical information to whichever allied health provider the patient chooses to access. As is currently the case, a referral does not always correctly indicate the total number of services remaining in a calendar year, especially where a referral has been carried over more than one calendar year or where a patient has changed providers. Providers can check a patient’s eligibility for services using the MBS items online checker in HPOS Check MBS Item numbers – Health professionals – Services Australia or the care plan history in HPOS Patient details in HPOS – Health professionals – Services Australia. Patients can check their history using the care plan service history functions in their Medicare Online Account.
Reporting requirements for allied health providers
There are no changes to the reporting requirements. The reporting requirements set out in the Health Insurance (Section 3C General Medical Services – Allied Health Services) Determination 2024 state: “after the service, the eligible provider [the allied health provider] gives a written report to the referring medical practitioner mentioned in paragraph (a):
(i) if the service is the only service under the referral—in relation to that service; or
(ii) if the service is the first or last service under the referral—in relation to that service; or
(iii) if neither subparagraph (i) nor (ii) applies but the service involves matters that the referring medical practitioner would reasonably expect to be informed of —in relation to those matters.”
Reports must be provided following the first and last services. For most patients, it will be possible to establish the number of services the patient intends to access under the referral at the point of intake. This will be based on their need to distribute services amongst different provider types, as reflected in their GPCCMP. The reporting frequency will therefore be clear, noting that allied health providers must also provide a report to the referring practitioner when there is a clinical need to do so. Associated changes to the GP items also promote more frequent reviews, allowing the GP to issue new referrals in response to the patient’s clinical needs. The 18-month validity for referrals mean that patients must return to their referring practitioner to obtain new referrals.
As has been the case under the existing items, there are occasions when the patient does not return for the planned number of services. The advice for these circumstances remains the same. If the provider suspects that the patient will not return, they should provide the final report to the referring provider. There is no consequence for over-reporting. If it is subsequently discovered that it was not the final visit there would be no consequence if another final report is written for the same patient. Referrals are required for MBS-supported allied health services regardless of how frequently the GP reviews the plan. Where there is a valid referral in place for a particular allied health service at the time the review is undertaken it is not necessary for the GP to issue a new referral at that time.
Indexation
Indexation will be applied. It has been confirmed that indexation will be applied to MBS allied health items from 1 July 2025. The indexation rate to be applied on 1 July 2025 is 2.4 per cent. The allied health items are included in the “most of the General Medical Services items” mentioned on the 1 July 2025 news page. This can be confirmed by downloading the XML file on the downloads page of MBS online and searching for the item numbers. Alternatively, it can be confirmed via the Health Insurance Legislation Amendment (Indexation) Determination 2025 – Federal Register of Legislation.
GP planning item limitations
No restrictions. AHPA have been advised in relation to a question about the 12-month limit on GPs claiming planning items that there are no restrictions or dependencies between these GP planning items. Providing a patient is eligible for more than one of these plans, they can have more than one without timing or other restrictions between them. Essentially, they do not interact, rather they are individual treatment pathways.
As more information and updates are provided to the ACA, we will ensure members have access to this information. If you require support during this transition, or have further questions, please contact the ACA team for support.
[1] Department of Health (2025) Upcoming Changes to Chronic Disease Management Framework – What do the Changes Mean for Allied Health Providers. Available at: https://www.mbsonline.gov.au/internet/mbsonline/publishing.nsf/Content/Factsheet-Upcoming%20changes%20to%20the%20MBS%20Chronic%20Disease%20Management%20Framework