Chronic condition management plans: what Medicare covers

A GP Chronic Condition Management Plan is a structured plan for someone with a chronic or terminal condition whose GP considers they would benefit from coordinated care. Where allied health is clinically appropriate, it can support Medicare benefits for services such as physiotherapy, podiatry and dietetics. The whole framework changed on 1 July 2025, and the plans it replaced are still being phased out.

What is a GP Chronic Condition Management Plan?

The full name is a GP Chronic Condition Management Plan, usually shortened to GPCCMP. It is a written plan developed with your GP for a chronic or terminal condition, where a structured approach to your care would be useful.

Chronic, for Medicare's purposes, means a condition that has been present or is likely to be present for at least six months. There is no list of diagnoses that automatically qualify. Whether a plan is appropriate is your GP's clinical judgement.

The plan records your health needs, your treatment and management goals, the actions you can take yourself, the services you may need, and when it should be reviewed. Where allied health is part of your care, it also records which services are being recommended and why.

What replaced the GP Management Plan and Team Care Arrangement?

Before 1 July 2025, chronic condition care under Medicare usually meant two separate arrangements: a GP Management Plan, or GPMP, and a Team Care Arrangement, or TCA.

Both were replaced by the single GP Chronic Condition Management Plan. The change also removed the old requirement for your GP to consult at least two other providers before the plan could be finalised, which was one of the main reasons the old process took so long to complete.

You will still hear these called a care plan, a chronic disease management plan, a GPMP or an EPC. Those names are all still in circulation. GP Chronic Condition Management Plan is the current one.

What if you still have an old GPMP or TCA?

You do not lose access because the system changed. Transitional arrangements were put in place for plans and referrals that already existed.

• A GP Management Plan or Team Care Arrangement made before 1 July 2025 can keep supporting services consistent with it until 30 June 2027.
• An allied health referral written before 1 July 2025 stays valid until the services it covers have been provided.
• If an older plan now needs reviewing, it is not reviewed under the new items. Your GP moves you across to a GP Chronic Condition Management Plan instead.
• From 1 July 2027, a current GPCCMP is required to keep accessing the allied health services.

So there is nothing to do simply because the name changed. The point at which your plan next needs a clinical review is the natural moment to move across.

Who is eligible?

The starting point is a chronic or terminal condition, meaning one present or likely to be present for at least six months. Conditions like diabetes, arthritis, asthma, cardiovascular disease and persistent pain are commonly managed this way.

Having a diagnosis for six months does not automatically entitle someone to five allied health appointments. Your GP still has to decide that a structured plan is appropriate for you, and that the specific services being considered are clinically relevant to it.

These plans are for people living in the community. If you are a permanent resident of an aged care home, the equivalent route is a multidisciplinary care plan prepared by the facility with your GP contributing to it, which carries the same access to allied health services.

How many allied health sessions does Medicare cover?

For an eligible patient with a current plan, Medicare benefits are available for up to five individual allied health services in a calendar year, from 1 January to 31 December. Aboriginal and Torres Strait Islander patients can access up to ten.

Five is the total across every eligible service you use, not five with each profession. Three physiotherapy visits and two with a dietitian uses the lot.

The eligible professions are audiology, chiropractic, diabetes education, dietetics, exercise physiology, mental health work, occupational therapy, osteopathy, physiotherapy, podiatry, psychology and speech pathology. The individual practitioner also has to meet Medicare's requirements for the service they are providing.

Can a chronic condition plan cover podiatry?

Yes. Podiatry is one of the professions covered by the chronic condition arrangements. Whether Medicare-supported podiatry is appropriate in your case depends on your condition, your care needs and the referral your GP makes.

A podiatry referral does not come with five appointments attached. The annual limit is shared across all the allied health services you use, so podiatry draws on the same five.

The practice has a podiatrist on site. Where podiatry is included in a chronic condition management plan, there is no out-of-pocket cost for those appointments, and reception can book them for you.

Does a chronic condition management plan expire?

The plan itself does not expire. There is a rule attached to it that behaves like an expiry date, though, and it is the one worth understanding: for Medicare-supported allied health services to remain accessible, the plan must have been prepared or reviewed within the previous eighteen months.

The distinction matters in practice. Your plan can still exist, and still describe your care accurately, while the allied health services under it have quietly stopped being claimable because too long has passed since it was last looked at.

This applies to the current arrangements. Older GP Management Plans and Team Care Arrangements sit under the separate transition rules running to 30 June 2027.

How long does an allied health referral last?

The referral runs on its own clock, separate from the plan.

For referrals written from 1 July 2025, it lasts for whatever period your GP states on it. If no period is stated, it stays valid for eighteen months from the date of the first service provided under it.

Both periods are eighteen months, which is deliberate: they were set to the same length so they tend to move together rather than catching people out. They still start on different dates, though. The plan's clock runs from when it was prepared or reviewed, and the referral's runs from your first appointment under it.

How do allied health referrals work now?

Since 1 July 2025 there is no prescribed referral form. Referrals are ordinary letters, the same as referrals to a specialist, and they can be signed electronically.

The referral has to name the type of service and explain why you are being referred, along with your details and the referring practitioner's. It does not have to name a particular practitioner, and it does not have to state a number of services.

That is a real change in your favour. A physiotherapy referral can be taken to any eligible physiotherapist you choose. What it cannot do is cross professions: a physiotherapy referral will not work for podiatry or chiropractic.

The practitioner you see has to write back to your GP after the first and the last service under the referral, and more often if there is something clinically worth reporting. Those reports are what keep your GP's picture of your care current.

Which GP or practice has to prepare the plan?

If you are registered with MyMedicare, the plan preparation and review services have to come through the practice you are registered with. It is a firmer rule than it is for some other Medicare plans, so it is worth knowing which practice you are registered with before you book.

If you are not registered with MyMedicare, the service should come from your usual medical practitioner. That means the GP, or a GP at the practice, that has provided most of your care over the past twelve months or is expected to over the next twelve.

Chapel Street Medical Centre is a registered MyMedicare practice.

What does it cost?

Two separate costs, set by different people: the GP appointment used to prepare or review the plan, and the allied health services you use afterwards.

Medicare has dedicated items for preparing and reviewing a plan, so it is not billed as an ordinary consultation. Whether the appointment is bulk billed or leaves a gap depends on the practice's fees and your circumstances.

Allied health providers set their own fees. Medicare pays a set benefit for an eligible service, and where the fee is higher you pay the difference. Some bulk bill these services and some do not.

How do reviews work?

A review is where your GP looks at how the plan is working, considers your progress and any reports from the practitioners treating you, and updates the plan where it needs updating.

Medicare's review items generally cannot be claimed more than once every three months unless there are exceptional circumstances. That is a ceiling, not a schedule. Reviews should happen when there is a clinical reason for one.

A review also resets the eighteen-month clock described above, because the rule reads on when the plan was prepared or reviewed, whichever is more recent.

How can you check when your plan was last reviewed?

Your Medicare online account shows both your claims history and your care plan history. You can reach it through myGov on the web or in the myGov app.

That is the quickest way to answer the eighteen-month question for yourself, and it is worth checking before booking allied health rather than after. An allied health practice cannot see services you have claimed elsewhere, so they may not be able to tell you where you stand.

Before you book

Say when you book that you want to discuss a chronic condition management plan. These appointments use their own Medicare items and usually need longer than a standard consultation, so reception needs to know in advance.

Bring an up-to-date medication list and the details of any allied health practitioners already involved in your care. If you have an older GP Management Plan or Team Care Arrangement, say so, so your GP can weigh up whether to leave it running through the transition or move you across now.

At Chapel Street Medical Centre in St Kilda, every GP appointment is with Dr Michael Battat. If you have an ongoing condition and want to talk through whether a plan would help, you can book online or call the practice on (03) 9534 5151.

One thing to check first, because it is the rule that catches people out: if you are registered with MyMedicare at another practice, the plan items have to be claimed there rather than here. That is worth sorting out before an appointment rather than at the end of one.

For questions about your Medicare record, your claims or your eligibility, Medicare general enquiries is 132 011.