✓ Item numbers and fees verified against the MBS Book July 2026, 22 Oct 2026Amounts other than Medicare schedule fees (for example out-of-pocket costs, price ranges and worked examples) are indicative and vary by provider and circumstances. Confirm current figures with the provider or the official source.
Sources
MBS Book July 2026 — items 965, 967, 701–705, 23/36/44, 66551, 66560, 66542, 66545, 66536, 81100–81125. AN.15.3 (GPCCMP), MN.9.1–9.2 (group education). mbsonline.gov.au
Services Australia. MBS billing rules for GP chronic condition management plans. Updated 1 July 2025. Disclaimer: Fees indexed periodically — verify at mbsonline.gov.au. Educational reference only, not affiliated with Services Australia.
Preparing a new GP chronic condition management plan (GPCCMP). Item 965 in the MBS Book July 2026. Items 721 (GPMP) and 723 (TCA) are not listed in that edition.
965
GPCCMP preparation
$160.60 MBS Bk Jul 2026
Benefit as listed in the MBS Book: 75% = $120.45; 100% = $160.60. See explanatory notes AN.15.3 to AN.15.6 for requirements and co-claiming rules.
Reviewing an existing GPCCMP. Item 967 in the MBS Book July 2026, for a plan prepared by the GP or an associated medical practitioner.
967
GPCCMP review
$160.60 MBS Bk Jul 2026
Benefit as listed in the MBS Book: 75% = $120.45; 100% = $160.60. See explanatory notes AN.15.3 to AN.15.6.
MyMedicare-registered patients must access GPCCMP items at their registered practice. Allied health plan must be within last 18 months for group program access.
No dedicated MBS item for insulin initiation. Bill the consultation using the standard attendance or GPCCMP item appropriate to what was done.
36
Standard consultation — 20 to 39 minutes
$87.10 MBS Bk Jul 2026
For insulin titration review or brief initiation discussion when no care plan prepared.
44
Standard consultation — 40 minutes or more
$128.35 MBS Bk Jul 2026
For insulin initiation with patient education when no GPCCMP prepared same visit.
965 / 967
GPCCMP preparation / review — if a care plan is prepared or reviewed in the same consultation
$160.60 / $160.60 MBS Bk Jul 2026
Use the GPCCMP item instead of a standard consultation if the care plan is prepared or reviewed in the same appointment.
Diabetes review consultation. Bill standard attendance or GPCCMP review depending on what was done.
23 / 36 / 44
Standard consultation — bill based on duration (6–19 / 20–39 / 40+ min)
$45.05 / $87.10 / $128.35 MBS Bk Jul 2026
For routine review not requiring care plan update.
66551
HbA1c — management of established diabetes
$16.80 MBS Bk Jul 2026
⚠️ Maximum 4 per 12 months. Document clinical reason if more frequent testing is genuinely needed.
66560
Microalbumin — quantitation in urine
$20.10 MBS Bk Jul 2026
Benefit 75% = $15.10; 85% = $17.10. Items 73840 and 73844 are the point-of-care items limited to QAAMS-participating services.
Type 2 Diabetes Risk Evaluation — for 40–49 year olds with high AUSDRISK score. AUSDRISK must be completed within last 3 months. Claimable once every 3 years per patient.
701 / 703 / 705
Time-tiered health assessment — use appropriate item based on consultation duration
$71.00 / $165.05 / $227.75 MBS Bk Jul 2026
Do not co-claim standard consultation on same day unless clinically necessary and distinct. Eligible once every 3 years per patient.
Group diabetes education — T2DM only. Patient must have current GPCCMP. Step 1: assessment of suitability. Step 2: group sessions.
81100 / 81110 / 81120
Assessment of suitability for group services — a separate item per discipline: 81100 (diabetes educator), 81110 (exercise physiologist), 81120 (dietitian). Individual, face-to-face, at least 45 minutes.
$95.65 each MBS Bk Jul 2026
Once per calendar year (shared limit across all three assessment items, plus telehealth equivalents 93284/93286). GP refers — the allied health provider assesses and claims; written report back to the GP required.
81105 / 81115 / 81125
Group sessions — diabetes education / exercise physiology / dietetics. Min 60 min, 2–12 patients per group.
$23.80 each MBS Bk Jul 2026
Up to 8 group sessions/year combined across all three, plus telehealth equivalent 93285 — separate from the 5 individual sessions. GP written report required after the final session in the program.
5 individual allied health sessions per calendar year — resets 1 January. Current GPCCMP required. Track sessions below. Source: MBS Book July 2026, AN.15.3Source: MBS Book July 2026, AN.15.3
Individual sessions — 2026
Sessions used this year
0
Group sessions — 2026 (separate, up to 8) MBS Book July 2026, MN.9.2
Group sessions used
0
Allied health providers under GPCCMP
Patient distributes 5 sessions across any combination:
🧠 Psychologist
🥗 Dietitian
🦶 Podiatrist
🏃 Exercise physiologist
🦴 Physiotherapist
👁️ Optometrist
💬 Speech pathologist
🔊 Audiologist
🧑⚕️ Social worker
🔧 Occupational therapist
Medicare rebate $63.40 per session for most individual allied health items (schedule fee $74.55, 85% benefit; MBS Book July 2026). Most providers charge above the rebate — advise patients to ask about the gap fee. Sessions reset 1 January each year.
Common errors with allied health referrals
Referring without a current GPCCMP — patients cannot access the 5 subsidised sessions without an active plan. Check plan currency before referring.
Using the same referral after 12 months — the GPCCMP expires. Renew the plan and provide a new referral letter; the patient then gets a fresh 5 sessions for the new calendar year.
HbA1c tracker — item 66551 · max 4 per 12 months
Tap to mark each HbA1c requested this 12-month period.
OGTT — diagnosis of diabetes mellitus (≥2 glucose measurements)
Diagnostic
$18.95 MBS Bk Jul 2026
66545
GCT in pregnancy — GDM screening (1–2 glucose measurements)
Pregnancy
$15.80
66536
HDL cholesterol — CVD risk in diabetes
No stated limit
$11.05 MBS Bk Jul 2026
All fees: MBS Book July 2026. Indexed periodically — verify at mbsonline.gov.au before billing.
Common billing errors
HbA1c beyond 4 per year (66551) — hard limit. A 5th request within 12 months may result in Medicare audit and benefit recovery. Document clinical justification carefully.
GPCCMP and standard consultation co-claimed same day — generally not permitted. Only bill both if services are clinically necessary, distinct, and documented as such.
Using GPMP (721) or TCA (723) — not listed in the MBS Book July 2026. Use GPCCMP items 965 (prepare) and 967 (review).