GP clinics will need to be prepared come July 1 when changes to Medicare chronic disease management items are enacted.
As of the new financial year, items for preparation of GP management plans, team care arrangements and reviews will be replaced with a GP chronic condition management plan (GPCCMP).
According to the Department of Health and Aged Care the changes aim to not only simplify arrangements but promote continuity of care, encourage the regular review of chronic condition management plans and support communications between a patient’s multidisciplinary care team.
Currently the rebate for preparation of a GP management plan is $164.35, preparation of team care arrangements is $130.25, and a review is $82.10.
Under the new framework, those items will be simplified so there is an item that covers plan preparation and another for plan review.
The Medicare fee will be $156.55 for GPs when preparing and also when reviewing a plan, and $125.30 for prescribed medical practitioners.
Changes to the way Medicare handles chronic disease management were flagged in 2024 with the expectation they would come into place late that year, but they were ultimately delayed with specific details not being released until late May 2025.
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RACGP President Dr Michael Wright took to social media following the announcement where he expressed frustration at what he said was a lack of notice about what will be “major changes to the workflow of general practice”.
“I know that many patients will have been booked for these plans and reviews after the start date of the new process,” he said.
“And software providers are going to have to move quickly to get ready for the start date.
“We will help patients, GPs, and practices through this transition with information as quickly as possible. This is obviously going to be a big change for many practices.
“CDM is core business in general practice and with nearly eight million Australians accessing these items last year, they are a crucial health service and crucial to the financial viability of many practices.
“The RACGP have written on multiple occasions seeking clarity about these changes on behalf of the profession.
“I am very annoyed that the detailed information has been kept so long from the people who need to implement these changes.”
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Under the changes, patients with at least one chronic medical condition that has been, or is likely to be, present for at least six months, or is terminal, are eligible for a chronic disease management plan.
Patients that had a GP management plan and/or team care arrangement in place before July 1, 2025 will be able to continue to access services consistent with those plans for two years, while all new plans and referrals must follow the new rules.
Patients will be eligible for the plan if their condition is managed by their GP or prescribed medical practitioner, whether or not multidisciplinary care is required.
The requirement to consult with at least two collaborating providers, as described under the current team care arrangements, will be removed.
The current referral form for allied health services will no longer be required as referrals will be able to be done in the form of referral letters.
The changes are a result of a review by the MBS Review Taskforce, which was informed by the General Practice and Primary Care Clinical Committee.
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