HMR, DMMR & RMMR — Medication Review Guide for GPs
MBS items 900, 903 — eligibility, 5-step process, billing rules, and the 2027 GPCCMP change
Sources — all Tier 1, verified from MBS Book July 2026
1. Australian Government. Medicare Benefits Schedule Book — July 2026. Group A17 (Domiciliary and Residential Management Reviews). Items 900, 903, 245, 249. Explanatory notes AN.0.52 (DMMR), AN.7.18 (RMMR), AN.15.3 (co-claiming), GN.15.39 (record keeping). Available at mbsonline.gov.au
2. Health Insurance Act 1973, s4.3 — document retention requirements.
3. Health Insurance (General Medical Services Table) Regulations 2021 — DMMR and RMMR service definitions.
Disclaimer: Fees from MBS Book July 2026 — indexed periodically, verify at mbsonline.gov.au before billing. This page is educational reference only and is not affiliated with Services Australia. The 2027 GPCCMP requirement is drawn from MBS Book July 2026 AN.0.52 — verify current requirements at mbsonline.gov.au.
MBS Book July 2026Tier 1 — verifiedJuly 2027 change — act now
⏰ From 1 July 2027 — GPCCMP required for DMMR access
From 1 July 2027, patients will only be eligible for a DMMR (HMR) if they have a GP Chronic Condition Management Plan (GPCCMP). The MBS Book confirms the GPCCMP requirement but does not yet specify a currency rule for DMMR access. As GPCCMPs already need to be reviewed within 18 months to support allied health access, keeping plans current is the practical safeguard. If your polypharmacy patients don't have a care plan, start getting them one now. Source: MBS Book July 2026, AN.0.52.
⚡
Which item — DMMR or RMMR?
3 questions. Get the item, fee, and the rules that apply.
1. Where does the patient live?
2. Has the patient had a medication review in the last 12 months?
3. From 1 Jul 2027 Does the patient have a current GP Chronic Condition Management Plan (GPCCMP)?
Item
—
Fee (100% benefit)
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Terminology — HMR, DMMR, RMMR
Three names, two services. HMR is the everyday name; DMMR and RMMR are the MBS terms.
Common name
HMR
Home Medicines Review. Used by GPs and pharmacists in everyday practice. This is what patients and most clinicians call it.
MBS name (community patients)
DMMR
Domiciliary Medication Management Review. The official MBS term for HMR. Item 900 (GP). Same service — different name.
MBS name (aged care residents)
RMMR
Residential Medication Management Review. For patients in residential aged care facilities. Item 903 (GP). Different from HMR/DMMR — patient setting is the distinction.
Source: MBS Book July 2026, Group A17, AN.0.52, AN.7.18
Who is eligible for DMMR (HMR) — community patients
✓
Has a chronic medical condition OR a complex medication regimen
✓
Not having their therapeutic goals metAssess this at the time of referral — document your clinical reasoning
✓
Living in the communityNot an inpatient of a hospital or care recipient in a residential aged care facility
✗
Not eligible if: admitted to hospital or in residential aged careAged care residents → use RMMR (item 903) instead
✗
Not within 12 months of previous DMMRUnless significant change in condition or medication regimen — document exceptional circumstances
Source: MBS Book July 2026, item 900 descriptor, AN.0.52
Who is eligible for RMMR — residential aged care
✓
Care recipient in a residential aged care facilityIncludes facilities formerly known as nursing homes and hostels
✓
Not within 12 months of previous RMMR (items 249 or 903)Unless significant change in medical condition or medication management plan
✓
New residents can have RMMR on admissionNo time restriction between previous DMMR and first RMMR after aged care admission
Source: MBS Book July 2026, item 903 descriptor, AN.7.18
Who conducts the review?
The GP initiates and completes the review process — but the medication review itself is conducted by an accredited pharmacist.
The pharmacist is not paid through the MBS. The GP's MBS items (900/903) cover the GP's work only — assessment, referral, discussion with pharmacist, and writing the medication management plan. The pharmacist is funded through a separate government program (NPS MedicineWise/PSA program). The GP does not need to arrange or pay the pharmacist — the patient takes the GP referral to a community pharmacy.
All 5 steps must be completed before the MBS claim can be submitted. This is a complex service — billing opens only at completion. Source: MBS Book July 2026, AN.0.52.
DMMR / HMR — GP's 5 required steps (item 900)
1
Assess the patient — confirm eligibility
Assess that the patient (a) has a chronic medical condition or complex medication regimen AND (b) is not having their therapeutic goals met. Document your clinical reasoning. With patient's consent.
MBS item 900(a) · AN.0.52
2
Refer to community pharmacist + provide clinical information
Refer the patient to a community pharmacy or accredited pharmacist. Provide the pharmacist with relevant clinical information — current medication list, relevant diagnoses, concerns, and goals. The patient takes this referral to a pharmacy of their choice.
MBS item 900(b)(i)(ii) · AN.0.52
3
Pharmacist conducts the review
The accredited pharmacist visits the patient at home (community patients) or the facility (aged care) and reviews their medications. The pharmacist's work is funded through a separate program — this step is not the GP's responsibility to arrange beyond the referral.
Pharmacist role — not MBS-funded for pharmacist
4
Discuss results with reviewing pharmacist
Discuss the DMMR results with the pharmacist — including suggested medication management strategies. This can be done in writing, by phone, or by video. You do not need to meet in person.
MBS item 900(c) · AN.0.52
5
Develop and provide written medication management plan
Develop a written medication management plan following the discussion with the patient. Provide the written plan to a community pharmacy chosen by the patient. Keep a copy in the patient's medical record. Retain for 2 years (Health Insurance Act 1973).
Source: MBS Book July 2026, items 900 and 903, AN.0.52, AN.7.18
Record keeping requirements
Keep documentation for 2 years. The Health Insurance Act 1973 requires documents created as part of these services to be retained for a minimum of 2 years. The department conducts regular post-payment auditing. Source: Health Insurance Act 1973 s4.3; MBS AN.0.52.
Your records should include: clinical reasoning for eligibility, clinical information provided to pharmacist, pharmacist discussion notes, written medication management plan, and confirmation plan was provided to pharmacy.
Claim only after all steps are complete. An MBS claim cannot be submitted until all required elements of the DMMR or RMMR have been provided. Source: MBS Book July 2026, AN.0.52, AN.7.18.
MBS items — fees from July 2026
900
GP — DMMR (HMR) for community patient. All 5 steps completed.
$185.35 MBS Book Jul 2026
100% benefit = $185.35. EMSN cap: $500.00. Only if item 245 does not apply in same 12 months.
245
Prescribed medical practitioner — DMMR for community patient.
$148.25 MBS Book Jul 2026
100% benefit = $148.25. EMSN cap: $433.50. For prescribed medical practitioners (not GPs).
903
GP — RMMR for patient in residential aged care facility.
$126.90 MBS Book Jul 2026
100% benefit = $126.90. EMSN cap: $371.10. Only if item 249 does not apply in same 12 months.
249
Prescribed medical practitioner — RMMR for aged care facility resident.
$101.45 MBS Book Jul 2026
100% benefit = $101.45. EMSN cap: $296.70. For prescribed medical practitioners only.
Same-day claiming rules
In general, you can claim another consultation item on the same day as a DMMR or RMMR — but both conditions must apply:
✓
Both services must be clinically relevant and distinct
✓
The other item must not have restrictions on same-day claiming with DMMR/RMMR
✗
If the patient attendance relates solely to the DMMR/RMMR, only the DMMR/RMMR item can be claimed
Source: MBS Book July 2026, AN.15.3, AN.0.52
Exceptional circumstances — early repeat
A DMMR or RMMR can be provided sooner than 12 months if there has been a significant change in the patient's medical condition or medication management plan requiring a new review.
How to claim early: Indicate "exceptional circumstances apply" on the patient invoice, Medicare voucher, or digital claim. No further explanation is required to support payment. However, document the reason for exceptional circumstances in your records.
Common billing errors
Claiming before all 5 steps are complete — an MBS claim for DMMR/RMMR can only be submitted once the entire service is finished, including the written medication management plan being provided to the pharmacy.
Claiming 900 and 245 in the same 12-month period for the same patient — items 900 and 245 are mutually exclusive per 12 months for the same patient (unless exceptional circumstances apply).
Not documenting the patient attendance — these items require personal attendance by the GP on the patient. The GP must physically see the patient as part of the service. Third parties (nurses, carers) may assist communication but do not replace the GP attendance.
Not tracking the 2027 GPCCMP requirement — from 1 July 2027, community patients must have a GPCCMP to be eligible for DMMR. The MBS does not yet specify a currency rule, but plans need to be reviewed within 18 months for allied health access regardless. Identify your polypharmacy patients without care plans now.
Use this before billing item 900. All elements must be documented before submitting the MBS claim.
DMMR / HMR completion checklist
0 of 7 completedRequired before billing item 900
Patient assessed — chronic condition or complex regimen confirmedAnd therapeutic goals not currently being met. Documented in patient record with clinical reasoning.
Patient consent obtainedInformed consent for DMMR process including sharing clinical information with pharmacist.
Patient living in community confirmedNot an inpatient or aged care resident. If in aged care → use RMMR (item 903) instead.
Referral to pharmacist provided + clinical information sentCurrent medication list, relevant diagnoses, concerns, therapeutic goals sent to accredited pharmacist or community pharmacy.
Pharmacist has conducted the reviewPharmacist has visited patient and completed their review. Results received by GP.
DMMR results discussed with pharmacistIncluding suggested medication management strategies. Can be by phone, video, or writing. Documented in notes.
Written medication management plan developed and provided to pharmacyPlan developed following discussion with patient. Copy provided to a community pharmacy chosen by the patient. Copy kept in patient record for 2+ years.
✅ All steps completed — item 900 can now be billed. Ensure documentation is in the patient's record before submitting the Medicare claim.
2027 readiness — identify patients now
From 1 July 2027, DMMR/HMR will require a current GPCCMP. Run a search in your PMS now for:
→
Patients who have had a DMMR in the last 2 yearsThese are your existing HMR patients — ensure they have a GPCCMP before July 2027
→
Patients on 5+ regular medications without a care planClassic DMMR candidates who may not yet have a GPCCMP — ideal time to prepare one
→
Patients in RACFRMMR has no GPCCMP requirement — these patients are not affected by the 2027 change