Medicare Benefits Schedule - Note AN.15.4

Publication date: 1 November 2025

SUMMARY

This note sets out the range of allied health and Aboriginal and Torres Strait Islander health and wellbeing services (health services), and the professionals who can provide those services, for patients with a GP chronic condition management plan (see AN.0.47) and residents of an aged care facility (home) who have a multidisciplinary care plan (see AN.15.7 and AN.15.8). 

Patients who had a GP management plan and a team care arrangement in place prior to 1 July 2025 can also access these services under those plans until 1 July 2027 (see AN.15.5 for further information on transition arrangements).

HEALTH SERVICES AVAILABLE

Individual allied health and Aboriginal and Torres Strait Islander health and wellbeing services

Patients with a GP chronic condition management plan or residents of an aged care facility with a multidisciplinary care plan can access up to 5 MBS-supported individual health services in a calendar year (10 for patients of Aboriginal or Torres Strait Islander descent). The requirements for MBS 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).

The Determination sets out the following services that can be provided to individual patients under the MBS chronic condition management framework:

Group allied health services – patients with Type 2 diabetes 

Patients with type 2 diabetes that have a GP chronic condition management plan or are a resident of an aged care facility with a multidisciplinary care plan can have 1 assessment of their suitability for group allied health services per calendar year, and if suitable up to 8 allied health group sessions. The allied health services available are: 

Are all members of an allied health or Aboriginal and Torres Strait Islander primary health care profession eligible to provide services through the MBS?

This depends on the profession. Some professional groups require specific qualifications, accreditation or credentialing to provide services under the MBS.

How do I check an allied health or Aboriginal and Torres Strait Islander primary health care professional is eligible to provide MBS-supported services to my patient?

To provide services under the MBS individual health professionals must have a Medicare Provider Number. Allied health and Aboriginal and Torres Strait Islander primary health care providers listed on the registers identified below are eligible to provide MBS-supported services and may have Medicare Provider Numbers.

The following health professions can be found through the Ahpra register at Australian Health Practitioner Regulation Agency - Home (ahpra.gov.au). The register can be searched by health practitioner type, state/territory, suburb and postcode. All practitioners in the following professions that appear on the Ahpra register are eligible to provide MBS-supported services if they have a Medicare Provider Number:

• Aboriginal and Torres Strait Islander health practitioners
  
  
• Chiropractors 
  
  
• Occupational therapists 
  
  
• Osteopaths 
  
  
• Physiotherapists 
  
  
• Podiatrists
   
• Psychologists 

Other professions are registered through their member organisations, which have registers on their websites. It is important to note that some health professionals may choose not to appear on the public register. 

• Aboriginal and Torres Strait Islander health workers providing these services must have a Certificate III or above in Aboriginal and/or Torres Strait Islander Primary Health Care from the Health (HLT) training package
  
  
• Accredited Exercise physiologists are accredited by Exercise & Sports Science Australia. See Find an Accredited Exercise Professional
  
  
• Accredited Practising Dietitians are accredited by Dietitians Australia. See Find a Dietitian (dietitiansaustralia.org.au)
  
  
• Audiologists are either:
  
  
  • Full members of Audiology Australia and certified as an Audiology Australia Accredited Audiologist. See Find an Audiologist - Audiology Australia, or
     
  • Full/Ordinary members or a Fellow of the Australian College of Audiology, with Hearing Rehabilitation Specialist and Diagnostic Rehabilitation Specialist Competencies. See Member Directory – The Australian College of Audiology (acaud.com.au)
    
    
• Certified Practising Speech pathologists are certified by Speech Pathology Australia. See Find a Speech Pathologist (speechpathologyaustralia.org.au)
  
  
• Credentialled diabetes educators are registered with the Australian Diabetes Educators Association. See ADEA | Find a CDE - ADEA
   
• Credentialled mental health nurses are certified by the Australian College of Mental Health Nurses. See Find a Credentialed Mental Health Nurse (acmhn.org)
  
  
• Social workers are Members of the Australian Association of Social Workers (AASW) and accredited by AASW as meeting the criteria set out in the “AASW Accredited Mental Health Social Worker Application Criteria” (July 2022) or as an accredited social worker. See Find a Social Worker (aasw.asn.au). 

ELIGIBLE PATIENTS 

Patients with a GP chronic condition management plan and residents of an aged care facility with a multidisciplinary care plan can access up to 5 MBS-supported (10 for patients of Aboriginal and Torres Strait Islander descent) individual allied health services and Aboriginal and Torres Strait Islander health and wellbeing services per calendar year (see MN.3.1) for further details). 

Patients with type 2 diabetes and either a GP chronic condition management plan or a multidisciplinary care plan (for residents of an aged care facility) may also be eligible for group services (see MN.9.1 and MN.9.2 for further details).

Patients who had a GP management plan and/or team care arrangement in place prior to 1 July 2025 can continue to access individual and group services (as applicable) under those plans until 1 July 2027 under transition arrangements (see AN.15.5).

In all cases, the patient’s general practitioner or prescribed medical practitioner must refer the patient to the service and the service must be consistent with the patient’s GP chronic condition management plan or multidisciplinary care plan (or team care arrangement) (see AN.15.6).

RECORD KEEPING AND REPORTING REQUIREMENTS

The Determination requires the allied health professional or Aboriginal and Torres Strait Islander primary health care professional to provide a written report to the referring medical practitioner in relation to a service if that service is:

• the only service under the referral
  
  
• the first or last service under the referral, or
  
  
• any other service if the service involves matters that the referring medical practitioner would reasonably expect to be informed of.

RELEVANT LEGISLATION

Details about the legislative requirements of the MBS item(s) can be found on the Federal Register of Legislation. Allied health and Aboriginal and Torres Strait Islander health and wellbeing items are set out in the Health Insurance (Section 3C General Medical Services – Allied Health and other Primary Health Care Services) Determination 2024.

Related Items: 232 392 393 731 965 967 92027 92029 92030 92058 92060 92061

• Previous - Note AN.15.3
• Next - Note AN.15.5

Contribution by a general practitioner by video to:
(a) a multidisciplinary care plan for a patient in a residential aged care facility, prepared by that facility, or to a review of such a plan prepared by such a facility; or
(b) a multidisciplinary care plan prepared for a patient by another provider before the patient is discharged from a hospital, or to a review of such a plan prepared by another provider.
(other than a service associated with a service to which items 235 to 240 or 735 to 758 of the general medical services table apply)

NOTE: It is a legislative requirement that this service must be performed by the patient’s eligible telehealth practitioner (please see Note AN.1.1 for the definitions as some exemptions do apply)

Fee: $82.10 Benefit: 100% = $82.10

(See para AN.15.3, AN.15.4, AN.15.6, AN.15.8, AN.36.2 of explanatory notes to this Category)

Video attendance by a general practitioner to prepare a GP chronic condition management plan for a patient

Fee: $156.55 Benefit: 100% = $156.55

(See para AN.0.47, AN.15.3, AN.15.4, AN.15.5, AN.15.6, AN.36.2 of explanatory notes to this Category)

Video attendance by a general practitioner to review a GP chronic condition management plan prepared by the general practitioner or an associated medical practitioner

Fee: $156.55 Benefit: 100% = $156.55

(See para AN.0.47, AN.15.3, AN.15.4, AN.15.5, AN.15.6, AN.36.2 of explanatory notes to this Category)

Contribution by a medical practitioner (not including a general practitioner, specialist or consultant physician) by video to:
(a) a multidisciplinary care plan for a patient in a residential aged care facility, prepared by that facility, or to a review of such a plan prepared by such a facility; or
(b) a multidisciplinary care plan prepared for a patient by another provider before the patient is discharged from a hospital, or to a review of such a plan prepared by another provider
(other than a service associated with a service to which items 235 to 240 or 735 to 758 of the general medical services table apply)

NOTE: It is a legislative requirement that this service must be performed by the patient’s eligible telehealth practitioner (please see Note AN.1.1 for the definitions as some exemptions do apply)

Fee: $65.70 Benefit: 100% = $65.70

(See para AN.15.3, AN.15.4, AN.15.6, AN.15.8, AN.36.2 of explanatory notes to this Category)

Video attendance by a prescribed medical practitioner to prepare a GP chronic condition management plan for a patient

Fee: $125.30 Benefit: 100% = $125.30

(See para AN.0.47, AN.15.3, AN.15.4, AN.15.5, AN.15.6, AN.36.2 of explanatory notes to this Category)

Video attendance by a prescribed medical practitioner to review a GP chronic condition management plan prepared by the prescribed medical practitioner or an associated medical practitioner

Fee: $125.30 Benefit: 100% = $125.30

(See para AN.0.47, AN.15.3, AN.15.4, AN.15.5, AN.15.6, AN.36.2 of explanatory notes to this Category)

Contribution by a general practitioner (not including a specialist or consultant physician) to:

(a) a multidisciplinary care plan for a patient in a residential aged care facility, prepared by that facility, or to a review of such a plan prepared by such a facility; or

(b) a multidisciplinary care plan prepared for a patient by another provider before the patient is discharged from a hospital, or to a review of such a plan prepared by another provider

(other than a service associated with a service to which item 735, 739, 743, 747, 750 or 758 applies)

Fee: $82.10 Benefit: 100% = $82.10

(See para AN.15.3, AN.15.4, AN.15.6, AN.15.8, AN.36.2 of explanatory notes to this Category)

Professional attendance by a general practitioner to prepare a GP chronic condition management plan for a patient

Fee: $156.55 Benefit: 75% = $117.45 100% = $156.55

(See para AN.0.47, AN.15.3, AN.15.4, AN.15.5, AN.15.6, AN.36.2 of explanatory notes to this Category)

Professional attendance by a general practitioner to review a GP chronic condition management plan prepared by the general practitioner or an associated medical practitioner

Fee: $156.55 Benefit: 75% = $117.45 100% = $156.55

(See para AN.0.47, AN.15.3, AN.15.4, AN.15.5, AN.15.6, AN.36.2 of explanatory notes to this Category)

Either:
(a) contribution to a multidisciplinary care plan, for a patient in a residential aged care facility, prepared by that facility, or contribution to a review of a multidisciplinary care plan, for a patient, prepared by such a facility; or
(b) contribution to a multidisciplinary care plan, for a patient, prepared by another provider before the patient is discharged from a hospital or contribution to a review of a multidisciplinary care plan, for a patient, prepared by another provider;
by a prescribed medical practitioner, other than a service associated with a service to which any of items 235 to 240, 735, 739, 743, 747, 750 or 758 apply

Fee: $65.70 Benefit: 75% = $49.30 100% = $65.70

(See para AN.7.1, AN.15.3, AN.15.4, AN.15.6, AN.15.8, AN.36.2 of explanatory notes to this Category)

Professional attendance by a prescribed medical practitioner to prepare a GP chronic condition management plan for a patient

Fee: $125.30 Benefit: 75% = $94.00 100% = $125.30

(See para AN.0.47, AN.15.3, AN.15.4, AN.15.5, AN.15.6, AN.36.2 of explanatory notes to this Category)

Professional attendance by a prescribed medical practitioner to review a GP chronic condition management plan prepared by the prescribed medical practitioner or an associated medical practitioner

Fee: $125.30 Benefit: 75% = $94.00 100% = $125.30

(See para AN.0.47, AN.15.3, AN.15.4, AN.15.5, AN.15.6, AN.36.2 of explanatory notes to this Category)