MBS item 10997: Nurse or ATSIHP service under a chronic condition plan

What to check before you bill item 10997

Each line links to the MBS passage it comes from.

• In person (the video and phone versions are separate items) MN.12.4
• Given by a practice nurse (including a nurse practitioner working as one) or an Aboriginal and Torres Strait Islander health practitioner Item 10997
• The patient has at least one chronic condition MN.12.4
• Not an admitted hospital patient Item 10997
• Has one of: a GP chronic condition management plan prepared or reviewed in the last 18 months; until 30 June 2027, a GP management plan or team care arrangement made before 1 July 2025; or a multidisciplinary care plan Item 10997
• The service follows the patient’s plan (the kind of care the plan sets out) Item 10997
• The nurse gave a service of their own, not help with preparing or reviewing the plan MN.12.4
• Given on your behalf and under your supervision Item 10997
• The nurse or health practitioner is qualified and trained for the service MN.12.4
• You were in Australia and readily contactable for clinical advice MN.12.6

How often item 10997 can be claimed

• Up to 5 a calendar year across the in-person, video, and phone versions; the count resets each 1 January and unused services don’t roll over MN.12.4

Billing item 10997 with other items

With a consultation on the same day: only if it’s distinct. A consult on the same day if it is a distinct, clinically relevant service with no duplication MN.12.6

Can’t be billed with item 10997

• Health assessment (75+, aged care, and other target groups) (all 8 items, including 701, 703, 705, 707, 224, and 225)
  • Not in conjunction with a time-tiered health assessment (the assessment is a complete service, including any nurse help) AN.0.36

Only in some cases with item 10997

• Aboriginal and Torres Strait Islander health check (items 715, 228, 92004, and 92011)
  • Not for a nurse’s or health practitioner’s help with an Aboriginal and Torres Strait Islander health assessment (it is a complete service) AN.0.43
• Acupuncture (items 193, 195, 197, and 199)
  • A consult on the same day if it is a distinct, clinically relevant service with no duplication MN.12.6
• General consultation (all 153 items, including 23, 36, 3, 4, 24, and 37)
  • A consult on the same day if it is a distinct, clinically relevant service with no duplication MN.12.6
• Prolonged attendance on a patient in imminent danger of death (all 10 items, including 160, 161, 162, 163, 164, and 214)
  • A consult on the same day if it is a distinct, clinically relevant service with no duplication MN.12.6
• Patient-end support for a specialist video consultation (all 32 items, including 373, 374, 375, 376, 377, and 378)
  • A consult on the same day if it is a distinct, clinically relevant service with no duplication MN.12.6
• Urgent after-hours attendance (all 8 items, including 585, 588, 591, 594, 599, and 600)
  • A consult on the same day if it is a distinct, clinically relevant service with no duplication MN.12.6
• Vaccine given by an Aboriginal and Torres Strait Islander health practitioner (item 10988)
  • Another nurse or health practitioner service on the doctor’s behalf at the same visit, when the services are distinct, clinically relevant, and not duplicated MN.12.6
  • For an Aboriginal or Torres Strait Islander patient with both a care plan and a health assessment, one nurse or health practitioner service (e.g. a vaccine or wound care) can fit this, the health check follow-up, and, for a health practitioner’s vaccine or wound care, those items too; the MBS names no winner, so the doctor picks MN.12.4
  • A health practitioner’s vaccine for a patient with a care plan, or an Aboriginal or Torres Strait Islander patient who has had a health check, can also fit the care plan nurse service or the health check follow-up; the MBS names no winner, so the doctor picks (those two have yearly caps, this one doesn’t) MN.12.6
• Wound care by an Aboriginal and Torres Strait Islander health practitioner (item 10989)
  • The same day as a different nurse or health practitioner service on the doctor’s behalf (a vaccine, a health check follow-up, a care plan nurse service, or specialist video support), when both are distinct and not duplicated MN.12.2
  • For an Aboriginal or Torres Strait Islander patient with both a care plan and a health assessment, one nurse or health practitioner service (e.g. a vaccine or wound care) can fit this, the health check follow-up, and, for a health practitioner’s vaccine or wound care, those items too; the MBS names no winner, so the doctor picks MN.12.4
  • A health practitioner’s wound care for a patient with a care plan, or an Aboriginal or Torres Strait Islander patient who has had a health check, can also fit the care plan nurse service or the health check follow-up; the MBS names no winner, so the doctor picks (those two have yearly caps, this one doesn’t) MN.12.6
• Accessing a port or long-term line (flush, bloods, or drugs) (item 14221)
  • A practice nurse flushing or using a port or line on your behalf, for a patient whose chronic condition plan includes it, can fit both this and the practice nurse care plan service. The one act is billed once, and the MBS names no winner: pick one TN.1.27
• Menopause health assessment (menopause and perimenopause) (items 695 and 19000)
  • Not for a nurse’s help with a menopause health assessment (it is a complete service) AN.14.3
• Practice nurse follow-up after a health check (Aboriginal and Torres Strait Islander patient) (items 10987, 93200, and 93202)
  • For an Aboriginal or Torres Strait Islander patient with both a care plan and a health assessment, one nurse or health practitioner service (e.g. a vaccine or wound care) can fit this, the health check follow-up, and, for a health practitioner’s vaccine or wound care, those items too; the MBS names no winner, so the doctor picks MN.12.4
  • For a patient with both a health assessment and a care plan, one nurse or health practitioner service (e.g. a vaccine or wound care) can fit this, the care plan nurse service, and, for a health practitioner’s vaccine or wound care, those items too; the MBS names no winner, so the doctor picks MN.12.3
• Therapeutic venesection (item 13757)
  • A venesection done by a practice nurse on your behalf, for a patient whose chronic condition plan includes it, can fit both this and the practice nurse care plan service. The one act is billed once, and the MBS names no winner: pick one Item 13757

Can be billed with item 10997

• GP chronic condition management plan (care plan) (items 965, 92029, 392, and 92060)
  • The same day as preparing the care plan, when the nurse’s service is separate from, but part of, the plan (e.g. a vaccine the plan calls for) MN.12.4
  • A practice nurse or health practitioner service the same day that is separate from, but consistent with, the plan (e.g. a vaccine, wound dressing, or injection the plan calls for); not the nurse’s help with the plan itself MN.12.4
• Care plan review (GP chronic condition management plan) (items 967, 393, 92030, and 92061)
  • The same day as reviewing the care plan, when the nurse’s service is separate from, but part of, the plan (e.g. a wound dressing or an injection) MN.12.4
  • A practice nurse or health practitioner service the same day that is separate from, but consistent with, the plan (e.g. a vaccine, wound dressing, or injection the plan calls for); not the nurse’s help with the plan itself MN.12.4
• Nurse or Aboriginal health worker support during a specialist video consult (item 10983)
  • Another nurse or health practitioner service on the doctor’s behalf at the same visit, when the services are distinct, clinically relevant, and not duplicated MN.12.6

Bulk-billing incentive

An extra payment when a doctor bulk bills an unreferred service. With item 10997, one of these:

Other versions

Practice nurse service for a patient with a care plan has 3 items. The others:

Often done at the same visit

• Nurse monitoring visits for diabetes often include an HbA1c, which a practice accredited for point-of-care testing can do in the rooms on the doctor’s behalf. (items 66551, 66554, and 73812)

Where the MBS is unclear

• The descriptor counts "item 92301", which isn’t a current item; MN.12.4 counts 10997, 93201, and 93203, so 92301 looks like a typo for 93201. The limit here follows MN.12.4. Item 10997

Common questions

What is the fee for MBS item 10997?

The schedule fee is $14.35, and the Medicare benefit is 100% of it ($14.35). That’s under the MBS in force from 1 August 2026.

Can item 10997 be done by video or phone?

No. In person (the video and phone versions are separate items).

How often can item 10997 be claimed?

Up to 5 a calendar year across the in-person, video, and phone versions; the count resets each 1 January and unused services don’t roll over.

Can item 10997 be claimed on the same day as a consultation?

Yes, if it’s distinct. A consult on the same day if it is a distinct, clinically relevant service with no duplication.

Can you bill 10997 and 701 together?

No. Not in conjunction with a time-tiered health assessment (the assessment is a complete service, including any nurse help). (Source: MBS AN.0.36.)

Can you bill 10997 and 965 together?

Yes. The same day as preparing the care plan, when the nurse’s service is separate from, but part of, the plan (e.g. a vaccine the plan calls for). (Source: MBS MN.12.4.)

Can you bill 10997 and 967 together?

Yes. The same day as reviewing the care plan, when the nurse’s service is separate from, but part of, the plan (e.g. a wound dressing or an injection). (Source: MBS MN.12.4.)

Can you bill 10997 and 715 together?

Only in some cases. Not for a nurse’s or health practitioner’s help with an Aboriginal and Torres Strait Islander health assessment (it is a complete service). (Source: MBS AN.0.43.)

Can you bill 10997 and 23 together?

Only in some cases. A consult on the same day if it is a distinct, clinically relevant service with no duplication. (Source: MBS MN.12.6.)

Can you bill 10997 and 695 together?

Only in some cases. Not for a nurse’s help with a menopause health assessment (it is a complete service). (Source: MBS AN.14.3.)

What can’t item 10997 be billed with?

The MBS has a rule against billing item 10997 with these: health assessment (75+, aged care, and other target groups). Each rule and its source is on this page.

Can item 10997 be billed with a bulk-billing incentive?

Yes. An extra payment when a doctor bulk bills an unreferred service. The items are 10990, 10991, 75855, 75856, 75857, and 75858.

Sources

• Item 10997: Group M12 Services Provided by a Practice Nurse, an Aboriginal and Torres Strait Islander Health Worker or an Aboriginal and Torres Strait Islander health practitioner on behalf of a Medical Practitioner › Subgroup 3 Services Provided By A Practice Nurse Or Aboriginal And Torres Strait Islander Health Practitioner On Behalf Of A Medical Practitioner
• Note MN.12.4: Services for a person with a chronic medical condition by a practice nurse or Aboriginal and Torres Strait Islander health practitioner on behalf of a medical practitioner (MBS Items 10997, 93201, 93203)
• Note MN.12.6: Services provided on behalf of a medical practitioner by a practice nurse and/or Aboriginal and Torres Strait Islander primary health care professionals (MBS Items 10983, 10987, 10988, 10989, 10997, 93200, 93201, 93202, 93203)
• Note AN.0.43: Health assessments for persons of Aboriginal and Torres Strait Islander descent (MBS Items 715, 228, 92004, 92011)
• Note MN.12.2: Wound management services provided by an Aboriginal and Torres Strait Islander health practitioner on behalf of a medical practitioner (MBS Item 10989)
• Note AN.0.36: Time-Tiered Health Assessments (Items 701, 703, 705, 707, 224, 225, 226, 227)
• Note TN.1.27: Appropriate billing of item 13950 – parenteral administration of antineoplastic agents
• Note AN.14.3: Menopause and Perimenopause Health Assessments (MBS items 695 and 19000)
• Note MN.12.3: Follow up service provided on behalf of a medical practitioner for an Aboriginal and Torres Strait Islander person who has received a health assessment (MBS Item 10987, 93200, 93202))
• Item 13757: Group T1 Miscellaneous Therapeutic Procedures › Subgroup 8 Haematology
• Item 93201: Group M18 Allied Health and other primary health care telehealth services › Subgroup 23 Follow up service provided by a practice nurse or Aboriginal and Torres Strait Islander health practitioner – Video Services