Medicare Benefits Schedule - Item 93286

Phone attendance by an eligible dietitian to provide a dietetics health service to a person for assessing the person’s suitability for group services for the management of type 2 diabetes, including taking a comprehensive patient history, identifying an appropriate group services program based on the patient’s needs and preparing the person for the group services if:

(a) the person has type 2 diabetes; and

(b) the patient is 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 prepared prior to 1 July 2025; or

(iii) a multidisciplinary care plan; and

(c) the patient is referred to an eligible diabetes educator by the medical practitioner; and

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

(e) the service is of at least 45 minutes duration; and

(f) after the service, the eligible dietitian gives a written report to the referring medical practitioner mentioned in paragraph (c);

payable once in a calendar year for this or any other assessment for group services item (including services to which this item, item 92384, or in items 81100, 81110 and 81120 apply)

Fee: $93.25 Benefit: 85% = $79.30

(See para MN.9.1, MN.9.2 of explanatory notes to this Category)

Extended Medicare Safety Net Cap: $279.75

• Previous - Item 93285
• Next - Item 93718

Publication date: 1 November 2025

SUMMARY

This note sets out the requirements for assessing a patient with type 2 diabetes suitability for group diabetes education, dietetics or exercise physiology allied health services to support their diabetes management. These services are part of the MBS framework for patients with a chronic condition (see AN.15.3).

Assessments of suitability for group allied health services are available to patients with type 2 diabetes with a GP chronic condition management plan (see AN.15.3) or residents of a residential aged care facility that have a multidisciplinary care plan (see AN.15.8). Until 1 July 2027 these services are also available to patients that have a GP management plan (see AN.15.3).

The service must be consistent with the patient’s plan and a medical practitioner must refer the patient for the service (see AN.15.6).

Patients can access 1 group allied health assessment service each calendar year.

On 1 July 2025 GP management plans were replaced with new GP chronic condition management plan (see AN.15.3) items. Transition arrangements are in place for existing patients with a GP management plan (see AN.15.5). New requirements for referrals to allied health services written on or after 1 July 2025 also came into effect (see AN.15.6).

USE OF THE ITEMS

These services are to assess a patient’s suitability for group diabetes education, dietetics and/or exercise physiology services to support the management of their type 2 diabetes. The assessment includes:

• Taking a comprehensive patient history
• Identifying an appropriate group services program based on the patient's needs, and
  
  
• Preparing the person for group services. 

The requirements of the items for assessments of a patient’s suitability for group allied health services are set out in the Health Insurance (Section 3C General Medical Services - Allied Health and other Primary Health Care Services) Determination 2024 (Health 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 assessment?

Yes, the Health and Telehealth Determination specifies that the assessment must last at least 45 minutes.

This is an assessment for group services. Is it provided to a group or the individual?

The assessment must be provided to an individual. While it is an assessment of the patient’s suitability for group services the assessment must not be provided in a group setting.

I am a diabetes educator. If I find the patient suitable, can they only access group diabetes education services?

No. You are assessing their suitability for group services relating to the management of type 2 diabetes. If they are assessed as suitable, they will be able to access any combination of diabetes education, dietetics and exercise physiology group services.

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

Yes. You must provide a written report back to the referring GP or prescribed medical practitioner.

How many group allied health assessment services can be claimed for a patient?

Patients can access one suitability assessment for group allied health services per calendar year.

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.

For referrals written where the assessment was undertaken prior to 1 July 2025 the referral with the completed assessment 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 allied health professional?

No. The patient can take the referral to any eligible allied health professional of the same profession/type specified in the referral of their choosing. For example, a referral to credentialled diabetes educator for an assessment can be taken to any credentialled diabetes educator but it cannot be taken to an accredited exercise physiologist.

For further information on referrals see AN.15.6.

ELIGIBLE PATIENTS

To be eligible for this MBS service a patient must:

• Have type 2 diabetes
• Be being managed by a GP or prescribed medical practitioner under:
  
  • a GP chronic condition management plan that has been put in place of reviewed in the last 18 months, or
    
    
  • Until 1 July 2027, a GP management plan that was in place before 1 July 2025, or
    
    
  • Are a resident of a residential aged care facility and have a multidisciplinary care plan, and
    
    
• Be referred for the service by their GP or prescribed medical practitioner (see AN.15.6).

ELIGIBLE PRACTITIONERS

These services can be provided by credentialled diabetes educators, accredited practising Dieticians and accredited exercise physiologists. These allied health practitioners must have a Medicare Provider Number to provide these services. For further information on the qualification requirements for allied health professionals to provide MBS services see AN.15.4.

RECORD KEEPING AND REPORTING REQUIREMENTS

The Health Determination requires that the allied health provider that performs the assessment provides a written report back to the referring medical practitioner.

It is a requirement that, where an item specifies the creation of a document (however described) and a document is created, the document must be retained for a period of 2 years. This includes records made by the allied 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. These items are set out in the following regulatory instruments:

• Health Insurance (Section 3C General Medical Services – Allied Health and other Primary Health Care Services) Determination 2014 – items 8110, 81110, 81190
• Health Insurance (Section 3C General Medical Services – Telehealth and Telephone Attendances) Determination 2021 – items 93284, 93286

Related Items: 81100 81110 81120 93284 93286

Publication date: 1 November 2025

SUMMARY

This note sets out the requirements for group diabetes education, dietetics and exercise physiology allied health services for patients with type 2 diabetes to support the management of their condition. These services are part of the MBS framework for patients with a chronic condition (see AN.15.3).

Patients are eligible for group allied health services if they have type 2 diabetes and have been assessed as suitable for group health services by a credentialled diabetes educator, accredited practising dietitian or an accredited exercise physiologist (see MN.9.1). Assessments are available to patients with a GP chronic condition management plan (see AN.15.3) and residents of a residential aged care facility with a multidisciplinary care plan (see AN.15.8). Until 1 July 2027 they are also available to patients with a GP management plan that was put in place prior to 1 July 2025 (see AN.15.5).

Patients can access up to 8 group allied health services per calendar year.

On 1 July 2025 GP management plans and team care arrangements were replaced with new GP chronic condition management plan items (see AN.15.3). New requirements for referrals to eligible health services written on or after 1 July 2025 also came into effect (see AN.15.6).

USE OF THE ITEMS

Group allied health services are available for diabetes education, dietetics and exercise physiology for the management of type 2 diabetes.

The requirements of the items for group allied 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 Health 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 assessment?

Yes, the Health and Telehealth Determinations specifies that the group session must last at least 60 minutes.

How many group allied health therapy services can be claimed for a patient?

Patients can access 8 group allied health therapy services per calendar year. This is in addition to any individual allied health services the patient may be eligible for.

It is February. Does my patient need another assessment to continue group therapy services this year?

No. Once a patient has been assessed as suitable for group services, they do not require another assessment to continue. However, in some circumstances their medical practitioner may request another assessment, for example, if there has been a significant change in their condition.

How many patients need to be in the group?

To use the MBS items there must be a minimum of two and maximum of 12 patients in attendance. The diabetes educator, dietician or exercise physiologist providing the service must keep an attendance record for the group.

My patient was assessed as suitable for a group health service by a diabetes educator. Can they only access group diabetes education services?

No. They have been assessed as suitable for group health services relating to the management of type 2 diabetes. They can access any combination of diabetes education, dietetics and exercise physiology group services.

Can one session cover more than one of diabetes education, dietetics and exercise physiology?

A collaborative approach, where diabetes educators, exercise physiologists and dietitians work together to develop group service programs in their local area, is encouraged. However, for more than one MBS group service to be delivered on a day the requirements of both items must be met. 

For example, a credentialled diabetes educator delivers a 60-minute group diabetes education service to the patient and the patient then attends a 60-minute dietitians group health session for an accredited practising dietician later in the day. These two services cannot be delivered in the same 60-minute period.

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

Yes, if the service is the last group service in the program the diabetes educator, dietitian or exercise physiologist who delivered the service must prepare or contribute to a written report back to the referring medical practitioner to meet the requirements of the item.

ELIGIBLE PATIENTS

Patients are eligible for group health services if they have type 2 diabetes and have been assessed as suitable for group health services under items 81100, 81110, 81120 or 93284 (see MN.9.1).

Patients being managed by the GP or prescribed medical practitioner through a GP chronic condition management plan (see AN.15.3) need to have had their plan put in place or reviewed within the last 18 months to be eligible for services.

Patients with a multidisciplinary care plan must be a resident of an aged care facility to be eligible for these services.

Until 1 July 2027, patients who have a GP management plan that was put in place before 1 July 2025 can continue to access these services under that plan.

ELIGIBLE PRACTITIONERS

These services can be provided by credentialled diabetes educators, accredited practising dieticians and accredited exercise physiologists. These allied health practitioners must have a Medicare provider number to provide these services. For further information on the qualification requirements for allied health professionals to provide MBS services (see AN.15.4).

RECORD KEEPING AND REPORTING REQUIREMENTS

If the service is the last group service in the program the diabetes educator, dietitian or exercise physiologist who delivered the service must prepare or contribute to a written report back to the referring medical practitioner to meet the requirements of the item. 

It is a requirement that, where an item specifies the creation of a document (however described) and a document is created, the document must be retained for a period of 2 years. This includes the report/s back to the referring GP or prescribed medical practitioner that the allied health professional is required to write or contribute to under these items.

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 can be found on the Federal Register of Legislation at www.legislation.gov.au. These items are set out in:

• Health Insurance (Section 3C General Medical Services – Allied Health and other Primary Health Care Services) Determination 2024 – items 81105, 81115, 81125
• Health Insurance (Section 3C General Medical Services – Telehealth and Telephone Attendances) Determination 2021 – item 93285

Related Items: 81100 81110 81120 93284 93285 93286