Medicare Benefits Schedule - Item 93061

Phone attendance provided to a person who is of Aboriginal or Torres Strait Islander descent by an eligible allied health or Aboriginal and Torres Strait Islander primary health care professional if:

(a) a medical practitioner has undertaken a health assessment and identified a need for follow‑up health services; or

(b) the patient has a chronic condition and complex care needs being managed by a medical practitioner (other than a specialist or consultant physician) under:

(i) a GP chronic condition management plan that has been prepared or reviewed in the last 18 months; or

(ii) until the end of 30 June 2027—a GP Management Plan and Team Care Arrangements prepared prior to 1 July 2025; or

(iii) a multidisciplinary care plan; and

the service is recommended in the patient’s plan or arrangements as part of the management of the patient’s chronic condition and complex care needs;

(c) the person is referred to the eligible health practitioner by a medical practitioner; and

(d) the service is provided to the person individually; and

(e) the service is of at least 20 minutes duration; and

(f) after the service, the eligible health practitioner gives a written report to the referring medical practitioner mentioned in paragraph (b):

(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 the 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;

to a maximum of 10 services (including any services to which this item or item 93000, 93013, 93048 or any item in Subgroup 1 of Group M3 or any item in Group M11 of the Allied Health and other Primary Health Care Services Determination applies) in a calendar year

Fee: $72.65 Benefit: 85% = $61.80

(See para MN.11.1 of explanatory notes to this Category)

Extended Medicare Safety Net Cap: $217.95

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Publication date: 1 November 2025

SUMMARY

This note sets out the requirements for the individual health services specifically for Aboriginal and Torres Strait Islander patients with a chronic condition, or whose need for those services was identified through a health assessment.

Aboriginal and Torres Strait Islander patients are also eligible for the individual health services available to all other patients through chronic condition management plan arrangements, (see MN.3.1).

This note also explains the rules around the 10 individual health services available to Aboriginal and Torres Strait Islander patients per calendar year.

The need for health services must be:

• identified as a necessary follow up services by a GP or prescribed medical practitioner when undertaking the patient’s health assessment, or
• for patients with a chronic condition, recommended in a patient’s GP chronic condition management plan (see AN.15.3), or for residents of a residential aged care facility recommended in a patient’s multidisciplinary care plan (see AN.15.8). Until 1 July 2027, these services are also available to patients that have both a GP management plan and team care arrangement (see AN.15.5) and any individual health services would then need to be recommended in their team care arrangement.

On 1 July 2025 GP management plans and team care arrangements were replaced with new GP chronic condition management plan (see AN.15.3) items. These new items provide a streamlined and simplified approach to multidisciplinary care for patients with a chronic condition. Transition arrangements are in place for existing patients with a GP management plan and team care arrangement (see AN.15.5). New requirements for referrals to health services written on or after 1 July 2025 also came into effect on this date (see AN.15.6).

References in this note to the term “Management Plan” refer to any of a GP chronic condition management plan, GP management plan and team care arrangement, or a multidisciplinary care plan for a resident of a residential aged care facility.

USE OF THE ITEMS

The requirements of the items for individual health services are set out in the Health Insurance (Section 3C General Medical Services - Allied Health and other Primary Health Care Services) Determination 2024 (the Determination) and the Health Insurance (Section 3C General Medical Services – Telehealth and Telephone Attendances) Determination 2021 (Telehealth Determination).

Is there a minimum length for the service?

Yes, the Determination and Telehealth Determination specifies that the service must last at least 20 minutes.

How many individual health services can be claimed for a patient?

Aboriginal and Torres Strait Islander patients can access up to 10 MBS-supported individual health services per calendar year (January to December).

The annual total limit of 10 individual health services per patient can include a combination of the following items, up to a maximum of 10 services:

• up to 5 services under a GP chronic condition management plan or, for residents of a residential aged care facility, a multidisciplinary care plan (10950, 10951, 10952, 10953, 10954, 10956, 10958, 10960, 10962, 10964, 10966, 10968, 10970, 93000 and 93013 - MBS Group M3 and equivalent telehealth services) (see MN.3.1).
• up to 10 services under MBS Group M11 and equivalent telehealth services (81300 to 81360, 93048 and 93061).

The 10 services can be made up of one type of service (e.g. 10 physiotherapy services) or a combination of different types of services (e.g. 2 dietetic and 8 podiatry services).

The patient must have an identified need through a health assessment, or the service provided must be recommended in the patient’s Management Plan. How does the health provider know what is in the health assessment or Management Plan?

Subject to the patient’s consent, the patient’s health provider should be given the relevant parts of the Management Plan. In addition, the treating health provider must also receive a referral from the treating medical practitioner (see AN.15.6).

How long does a referral last?

For referrals written on or after 1 July 2025, referrals will be valid for the length of time specified in the referral, or if no timeframe is specified, 18 months from the date of the first service provided under the referral. The referral may also specify the number of services to be provided, however, this is not required.

For referrals written prior to 1 July 2025, the referral must specify the number of services. The referral remains valid until all services are provided.

For further information on referrals see AN.15.6.

Should the referral be for a specific health professional?

No. The patient can take the referral to any eligible health professional of the same profession/type specified in the referral of their choosing. For example, a referral to physiotherapy services can be taken to any physiotherapist, but it cannot be used to access chiropractic services.

For further information on referrals see AN.15.6.

My patient has more than 10 individual health services identified/recommended. Which ones should be billed to the MBS?

The MBS benefit is the patient’s benefit. It is up to the patient to decide how they use their MBS benefits. Some patients can access additional services using private health insurance extras cover, non-MBS services (e.g. through state or Primary Health Network programs), or self-funding.

Providers should obtain informed financial consent from patients before a service. Therefore, it is important that you clarify with the patient whether they would like to use their MBS benefit for the service.

Can the patient claim for a service under Medicare and private health insurance?

No. Patients cannot claim MBS benefits and payments under their private health insurance fund for the same service.

How do I know how many individual health services a patient has already used this year?

You can check a patient’s eligibility for a service through the MBS Items Online Checker Check MBS Item numbers - Health professionals - Services Australia and view their care plan history through HPOS Patient details in HPOS - Health professionals - Services Australia. Patients can also check their care plan service history through their Medicare Online Account.

My patient has elected not to claim MBS benefits for the service. Do I still need to meet all of the requirements of the MBS item?

No. However, it is still good practice to provide regular updates to the patient’s medical practitioner about their progress.

Am I required to provide information back to the referring medical practitioner?

Yes. The Determination requires that the health professional provide a written report to the referring medical practitioner:

"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.”

What should I include in a report back to the referring medical practitioner?

Generally, written reports should include:

• any investigations, tests, and/or assessments carried out on the patient
• any treatment provided, and
• future management of the patient's condition or problem

ELIGIBLE PATIENTS

Aboriginal and Torres Strait Islander patients are eligible for these individual health services if they have been referred (see AN.15.6) by a GP or prescribed medical practitioner and:

• they have had a health assessment undertaken by a GP or prescribed medical practitioner which identified the need for follow-up health services, or
• they have a chronic condition and:
  • GP chronic condition management plan that has been put in place or reviewed in the last 18 months, or
  • until 1 July 2027, a GP management plan and team care arrangement that were in place before 1 July 2025, or
  • are a resident of a residential aged care facility and have a multidisciplinary care plan, and
  • the service provided is consistent with the Management Plan.

ELIGIBLE PRACTITIONERS

Health professionals are eligible to provide these services if they meet the qualification and credentialling requirements set out in the Determination (see AN.15.4). To provide MBS services, eligible health professionals must have a Medicare Provider Number.

There are MBS item numbers for each type of health service for face-to-face services. However, all service types are provided using the same items for video (93048), or telephone (93061) services. The treating health professional must satisfy themselves that a service is appropriate to be delivered by video or telephone. The service cap applies across all modalities.

Service	Eligible health professionals (must meet all relevant credentialling requirements)	MBS item number (face to face service)
Aboriginal and Torres Strait Islander health and wellbeing service	Aboriginal and Torres Strait Islander health worker  Aboriginal and Torres Strait Islander health practitioner	81300
Audiology health service	Audiologist	81310
Chiropractic health service	Chiropractor	81345
Diabetes education health service	Credentialled diabetes educator	81305
Dietetics health service	Accredited practising dietitian	81320
Exercise physiology health service	Accredited exercise physiologist	81315
Mental health service	Aboriginal and Torres Strait Islander health worker Aboriginal and Torres Strait Islander health practitioner Credentialled mental health nurse Occupational therapist Psychologist (general registration) Social worker	81325
Occupational therapy health service	Occupational therapist	81330
Osteopathy health service	Osteopath	81350
Physiotherapy health service	Physiotherapist	81335
Podiatry health service	Podiatrist	81340
Psychology health service	Psychologist (general registration)	81355
Speech pathology health service	Certified practising speech pathologist	81360

 RECORD KEEPING AND REPORTING REQUIREMENTS

The Determination requires that the health professional provide a written report to the referring medical practitioner:

"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.”

It is a requirement that, where an item specifies the creation of a document (however described) and a document it created, the document must be retained for the period of 2 years. This includes records made by the health provider for reporting back to the referring medical practitioner.

Providers are responsible for ensuring services claimed from Medicare using their provider number meet all legislative requirements and they may be required to submit evidence for compliance checks related to Medicare claims. Practitioners should ensure they keep adequate and contemporaneous records. For information on what constitutes adequate and contemporaneous records see GN.15.39.

RELEVANT LEGISLATION

Details about the legislative requirements of the MBS item(s) can be found on the Federal Register of Legislation at www.legislation.gov.au. Individual health items are set out in two regulatory instruments:

Health Insurance (Section 3C General Medical Services – Allied Health and other Primary Health Care Services) Determination 2024 – items 81300, 81305, 81310, 81315, 81320, 81325, 81330, 81335, 81340, 81345, 81350, 81355 and 81360.
Health Insurance (Section 3C General Medical Services – Telehealth and Telephone Attendances) Determination 2021 - items 93048 and 93061

Related Items: 81300 81305 81310 81315 81320 81325 81330 81335 81340 81345 81350 81355 81360 93048 93061