Care Plans & Health Assessments

Practical billing tips, clinical gotchas, and nurse vs GP rules — for the desk, not the manual.

📋 Sources: MBS Online — Department of Health and Aged Care. Explanatory notes AN.0.36 (time-tiered health assessments), AN.0.43 (715), AN.0.47 (GPCCMP), MN.12.3 (10987), MN.12.4 (10997). MBS Book July 2026. Item cessations (721/723/732 July 2025; 2712/2713 November 2025) verified from MBS Online.
This page is a practical reference guide — always verify clinical and billing requirements at mbsonline.gov.au and consult your practice’s billing software and indemnity insurer for advice specific to your situation.

🇦🇺 MBS July 2026 For GPs & Practice Nurses

⚠️ Items 721 (GPMP), 723 (TCA), and 732 (CDM review) ceased July 2025. Items 2712 and 2713 (MHTP review/prepare) ceased November 2025. Use 965/967 and 2715/2717 instead. Details below.

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Health Assessments — 715, 701–707

Once per 9–12 months • Time-tiered from Jul 2025

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Billing summary

Item

Duration (personal attendance time)

Fee

701

Brief — less than 30 minutes

$71.00

703

Standard — 30–45 minutes

$165.05

705

Long — 45–60 minutes

$227.75

707

Prolonged — more than 60 minutes

$321.75

715

Aboriginal & TSI Health Assessment — every 9 months (not 12)

$254.10

Who is eligible

👤

75 and older — once per 12 months. No specific risk factors required. Aim is preventive health and functional assessment.

👤

45–49 years, at risk of chronic disease — once per 12 months. Must have an identified risk factor (e.g. family history of diabetes, obesity, hypertension, current smoker). Not available if already diagnosed with the condition.

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Intellectual disability — once per 12 months. Any age. Does not need to be living in a residential facility.

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Refugees and other humanitarian entrants — once per 12 months. Must have arrived in Australia within the last 12 months and hold an eligible visa.

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Aboriginal and Torres Strait Islander people (715) — every 9 months (not 12). All ages. Separate item, separate requirements. Practice nurses and ATSIHP can assist.

👤

Veterans (one-off) — a single one-off health assessment for eligible ex-ADF members. Check AN.0.69 for specific eligibility.

Tips & rules

✅

Time-tiered from 1 July 2025. Choose 701–707 based on how long you personally spend with the patient, not on the setting. The nurse prep time does not count toward the GP’s attendance time.

✅

Nurses can assist — with information collection (history, vitals, questionnaires) and providing patients with information about recommended interventions, at the GP’s direction. This is explicitly permitted under the Regulations.

✅

Must offer a written report — the patient (or their carer) must be offered a written summary of the assessment with recommendations. Keep a copy in the clinical record.

❌

10997 cannot be co-claimed with 701–707 or 715 on the same day. Health assessments are “complete medical services.” If the nurse does work that day, it is considered part of the assessment — not a separate billable service.

❌

Health assessments are not health screening services. You cannot include screening tests that are not clinically required for the patient’s management. A 715 is an assessment, not a tick-box screen.

⚠️

Records must be retained for at least 2 years from the date the written report was created. Audits do happen — document duration of personal attendance time clearly.

✅

715 + 10987: After a 715, the practice nurse can claim 10987 for follow-up services (up to 10 times per calendar year). See the Practice Nurse section below.

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Chronic Condition Management — GPCCMP (965 / 967)

Replaced GPMP 721 • TCA 723 • CDM 732 from Jul 2025

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Billing summary

Item

Service

Fee

965

Prepare a GP chronic condition management plan (GPCCMP) — face to face

$160.60

967

Review a GPCCMP — face to face

$160.60

392

Prepare GPCCMP — prescribed medical practitioner (non-VR GP)

$125.30

393

Review GPCCMP — prescribed medical practitioner

$125.30

721

GPMP — CEASED July 2025. Use 965.

Ceased

723

TCA — CEASED July 2025. Use 965.

Ceased

732

CDM review — CEASED July 2025. Use 967.

Ceased

Who is eligible

👤

Patients with at least one chronic condition — no age restriction. Condition must require ongoing management (e.g. type 2 diabetes, COPD, heart disease, CKD, depression, arthritis, cancer). The plan must be clinically appropriate and relevant to the chronic condition.

Tips & rules

✅

GP must personally attend and see the patient — even if a nurse assists. The GP must discuss the plan with the patient and be satisfied that the patient understands and agrees with it. There is no minimum time requirement, but all requirements of the item must be met.

✅

Plan does not expire — but the patient must have had their plan prepared or reviewed within the last 18 months to continue accessing CDM allied health services (10997). Keep your recall system tight.

✅

5 CDM services per calendar year (10997 face to face + 93203 phone + 93201 video — in any combination). Resets automatically on 1 January. Unused services do not roll over.

❌

Cannot co-claim 965/967 with a standard consult on the same day by the same practitioner. Items 23, 36, 44, and all standard attendance items are excluded. If an unrelated acute issue needs to be addressed, it should be done at a different appointment.

⚠️

10997 cannot be co-claimed on the day the nurse assists with the plan itself — the plan/review is a complete service. However, 10997 can be claimed on the same day if the nurse provides a separate, distinct clinically relevant service (e.g. wound dressing, vaccine administration) that is also documented in the plan. Document both services clearly.

✅

New plan every 12 months if clinically required — but a review (967) is sufficient if the plan remains appropriate. A new plan is not mandatory annually.

ℹ️

Telehealth variants: 92029 (prepare, video) and 92030 (review, video) require MyMedicare registration and usual medical practitioner relationship. Check telehealth eligibility before billing.

🧠

Mental Health Treatment Plan — MHTP (2715 / 2717)

Requires GPMHSC training • NOT a referral • 2712/2713 ceased Nov 2025

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Billing summary

Item

Service

Fee

2715

MHTP prepare — 20–40 min (requires GPMHSC training)

$108.95

2717

MHTP prepare — ≥40 min (requires GPMHSC training)

$160.50

2700

MH consultation — ≥20 min (no GPMHSC required)

$85.80

2701

MH consultation — ≥40 min (no GPMHSC required)

$126.35

2712

MHTP review — CEASED November 2025. Use 23/36/44 for reviews.

Ceased

2713

MHTP prepare (old) — CEASED November 2025. Use 2715/2717.

Ceased

Critical tips

🚨

The MHTP is NOT a referral. You must send a separate referral letter to the psychologist or other provider. The MHTP unlocks the sessions — it does not substitute for the referral. Include diagnosis, relevant history, medications, and treatment goals in the referral letter.

❌

2715/2717 require GP Mental Health Skills Training (GPMHSC). If you do not have GPMHSC, use 2700/2701 instead for mental health consultations. Do not bill 2715/2717 without the training — this is an audit risk.

✅

MHTP reviews since November 2025: Bill a standard consultation item (23, 36, or 44) for MHTP reviews. Items 2712 and 2713 ceased from November 2025 as part of the Better Access redesign.

ℹ️

Better Access sessions unlocked: 10 individual + 10 group psychological therapy sessions per calendar year. Sessions are calendar-year based, not 12 months from the plan date. Patients can use different providers for individual and group.

⚠️

From November 2025, MHTP is linked to MyMedicare. Confirm your patient’s registration status in HPOS before billing. Telehealth MHTP items have specific MyMedicare and usual medical practitioner requirements.

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MHTP and GPCCMP can coexist for the same patient if the mental health condition and the chronic condition are genuinely separate management issues. Do not create duplicate plans for the same condition.

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Practice Nurse — Items 10997 & 10987

CDM services • 715 follow-up • What nurses can and can’t do

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Nurse items at a glance

Item

Use

Limit

10997

CDM service for patient with GPCCMP (face to face). Consistent with the patient’s plan.

5/year

93201

CDM service — video (same as 10997 but telehealth). Requires established relationship.

5/year

93203

CDM service — telephone (same as 10997 but phone).

5/year

10987

Follow-up service for ATSI patient after a 715 health assessment.

10/year

The 5 CDM services per year (10997/93201/93203) are a combined cap — not 5 of each.

What nurses CAN do

✅

Assist with health assessments (701–707, 715) — take history, vitals, administer questionnaires (e.g. GPCOG, PHQ-9), provide patient education at GP’s direction. This is permitted under the Regulations.

✅

Assist with GPCCMP preparation/review — collecting information, patient education. But the GP must see the patient, discuss the plan, and take responsibility.

✅

Claim 10997 for CDM services — immunisations, wound dressing, progress monitoring, medication administration, patient education — all consistent with the patient’s GPCCMP. Supervision from GP in Australia required (remote supervision OK).

✅

Claim 10987 after a 715 — education, health check follow-up, medication monitoring, chronic disease prevention, progress checks for ATSI patients. Up to 10 per calendar year. GP must be in Australia and able to be contacted.

✅

Nurse practitioners count as practice nurses for 10997 and 10987 purposes. They may also separately use nurse practitioner attendance items — but the two cannot be claimed for the same service/time.

What nurses CANNOT do

❌

Cannot claim 10997 when assisting with the GPCCMP preparation or review itself — those are complete services. 10997 must be a separate, distinct clinical service that is documented in the plan.

❌

Cannot claim 10987 for GPCCMP patients — 10987 is strictly for ATSI patients who have received a 715. It does not flow from a GPCCMP.

❌

Cannot provide supervision from overseas — the supervising GP must be in Australia and able to be contacted for timely clinical advice. If the GP is overseas, another GP in Australia must take supervisory responsibility.

❌

Cannot claim 10997 when co-claiming 701–707 or 715 — health assessment items are complete services. No nurse billing alongside them on the same day.

⚠️

Enrolled nurses count as practice nurses for these items. Aboriginal and Torres Strait Islander Health Practitioners are also eligible to provide services under 10987 and 10997.

⚡

Common Mistakes & Audit Risks

Things to double-check before submitting

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🚨

Claiming 721/723/732 after July 2025 or 2712/2713 after November 2025. These items are ceased. Medicare will reject claims. Use 965/967 and 2715/2717/23/36/44 respectively.

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Billing 2715/2717 without GPMHSC Mental Health Skills Training. This is a compliance risk. Use 2700/2701 if you don’t have the training.

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Co-claiming 965/967 with a standard consult (23/36/44) on the same day. This is not permitted. Document the plan appointment separately.

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Not sending a separate referral letter for Better Access. The MHTP does not substitute for a referral. The psychologist cannot see the patient on Better Access without a referral letter.

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Claiming a health assessment more frequently than permitted. 715 is every 9 months; 701–707 cohorts are generally once per 12 months. Check the date of the last assessment before billing.

⚠️

Not documenting personal attendance time for 701–707. Since July 2025 these are time-tiered. Record the start and end time of the GP’s personal attendance in the clinical notes.

⚠️

GPCCMP patient hasn’t been reviewed in 18+ months. The patient loses eligibility for CDM allied health services until the plan is reviewed. Set a recall at 12 months.