MBS item 965: Prepare a GP chronic condition management plan

What to check before you bill item 965

Each line links to the MBS passage it comes from.

• By a GP (a non-VR doctor uses the prescribed medical practitioner version) Item 965
• In person (the video versions are separate) AN.0.47
• Has a condition present (or likely to be) for at least 6 months, or a terminal condition AN.0.47
• Lives in the community, not in residential aged care (a resident may get a multidisciplinary care plan instead) AN.0.47
• Not a public hospital in-patient (a private in-patient is fine in person) AN.0.47
• At the practice where the patient is registered in MyMedicare; if they aren’t registered, you are their usual doctor or practice AN.0.47
• Not given in the course of employment by a public hospital AN.0.47
• A written plan describing the patient’s chronic condition and health care needs AN.0.47
• Health and lifestyle goals developed with the patient (shared decision making) AN.0.47
• Actions the patient will take AN.0.47
• Treatments and services the patient is likely to need, with any referrals and their purpose AN.0.47
• Arrangements to review the plan, with a proposed timeframe AN.0.47
• If referring to other providers: the patient’s consent to share relevant parts of the plan with them, and those parts sent AN.0.47
• Recorded the patient’s consent and agreement to the plan AN.0.47
• Offered a copy of the plan to the patient (and their carer, if appropriate and the patient agrees), and added a copy to the records AN.0.47
• You saw the patient, discussed the plan, and are satisfied they understand and agree with it (even if a nurse helped prepare it) AN.0.47
• A practice nurse’s or health practitioner’s help preparing the plan is part of this service, not a separate nurse chronic condition service (a separate service the plan calls for can be) AN.0.47

How often item 965 can be claimed

• One new plan in 12 months, unless exceptional circumstances (a significant change in the patient’s condition or care circumstances, documented in the record and flagged on the claim) AN.0.47
• At least 3 months after the patient’s last plan review: no other plan or review in the 3 months up to this one, unless exceptional circumstances AN.0.47

Billing item 965 with other items

With a consultation on the same day: no. No general attendance (consult) for the same patient on the same day AN.0.9

Can’t be billed with item 965

• Acupuncture (items 193, 195, 197, and 199)
  • No general attendance (consult) for the same patient on the same day AN.0.9
• Prolonged attendance on a patient in imminent danger of death (all 10 items, including 160, 161, 162, 163, 164, and 214)
  • No general attendance (consult) for the same patient on the same day AN.0.9
• Patient-end support for a specialist video consultation (all 32 items, including 2485, 2488, 2491, 2494, 2484, and 2487)
  • No general attendance (consult) for the same patient on the same day AN.0.9
• 24-hour ambulatory blood pressure monitoring (ABPM) (item 11607)
  • Not in association with a heart health check, a health assessment (including an Aboriginal and Torres Strait Islander health check), a GP chronic condition management plan or its review, a contribution to a multidisciplinary care plan, or a case conference (including a cancer case conference) Item 11607
• General consultation (all 153 items, including 23, 36, 3, 4, 24, and 37)
  • Not on the same day as a general attendance (consult) for the same patient; AN.0.47 lists these items AN.0.47
  • Not on the same day as preparing or reviewing a GP chronic condition management plan for the same patient AN.0.9
• Urgent after-hours attendance (all 8 items, including 585, 599, 594, 588, 591, and 600)
  • Not on the same day as a general attendance (consult) for the same patient; AN.0.47 lists these items AN.0.47
  • No general attendance (consult) for the same patient on the same day AN.0.9
• Contribution to a multidisciplinary care plan (aged care facility or hospital plan) (items 729, 92026, 231, and 92057)
  • Not within 12 months after you were paid for preparing this patient’s GP chronic condition management plan AN.15.7
• Multidisciplinary case conference (all 12 items, including 735, 739, 743, 747, 750, and 758)
  • The prescribed medical practitioner versions aren’t for a conference associated with preparing or reviewing a GP chronic condition management plan, or with contributing in person to a multidisciplinary care plan Item 235
  • Not for a conference associated with preparing or reviewing a GP chronic condition management plan, or with contributing to a multidisciplinary care plan (in person or by video) Item 758
  • Not for a conference associated with preparing or reviewing a GP chronic condition management plan, or with contributing in person to a multidisciplinary care plan Item 240

Only in some cases with item 965

• Care plan review (GP chronic condition management plan) (items 967, 393, 92030, and 92061)
  • A patient whose GP management plan or team care arrangement dates from before 1 July 2025 gets a new plan (this service), not a review: those plans can’t be reviewed with the new review items AN.15.5
  • For a patient who already has a GP chronic condition management plan, whether to review it or prepare a new one is the doctor’s call within the limits (a new plan once in 12 months and 3 months after a review); the MBS expects periodic reviews for most patients unless a major change warrants a new plan AN.0.47

Can be billed with item 965

• Eating disorder treatment and management plan (EDTMP) (all 16 items, including 90250, 90251, 90252, 90253, 90254, and 90255)
  • Alongside an eating disorder treatment and management plan when this plan is for a separate chronic medical condition AN.36.2
• Mental health treatment plan (MHTP) (all 16 items, including 2715, 2700, 2701, 2717, 272, and 276)
  • A GP mental health treatment plan can also be completed when the patient also needs mental health support (AN.0.47’s example) AN.0.47
• Practice nurse service for a patient with a care plan (items 10997, 93201, and 93203)
  • 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
  • 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

Bulk-billing incentive

An extra payment when a doctor bulk bills an unreferred service. With item 965, one of these:

Other versions

GP chronic condition management plan (care plan) has 4 items. The others:

What comes next

• Review the plan with the patient (no more often than every 3 months); a plan prepared or reviewed in the last 18 months keeps nurse and allied health services available. (items 967, 393, 92030, and 92061)
• Up to 5 practice nurse or Aboriginal and Torres Strait Islander health practitioner services a calendar year that follow the plan (monitoring, wound care, vaccines, self-management advice). (items 10997, 93201, and 93203)

Often done at the same visit

• A practice nurse service that is separate from, but part of, the new plan (such as an overdue vaccine the plan calls for) can be given and claimed the same day (MN.12.4). (items 10997, 93201, and 93203)
• For a patient with diabetes, HbA1c is checked when the plan is set up; a practice accredited for point-of-care testing can measure it in the rooms. (items 66551, 66554, and 73812)

Old item numbers

Items 229, 230, 721, 723, 92024, 92025, 92055, and 92056 no longer exist. The MBS says: “GP Management Plans (MBS items 229, 721, 92024 and 92055) and Team Care Arrangements (MBS items 230, 723, 92025 and 92056) were replaced with the new GP chronic condition management plan framework” AN.15.5

Where the MBS is unclear

• AN.0.47 calls 92029 and 92060 "telehealth" items, but their descriptors are video only: a plan prepared by phone fits no item. AN.0.47
• AN.0.47 limits the same-day ban to the same practitioner, while AN.0.9 says general attendance and chronic condition management items "cannot be claimed on the same day for the same patient" (any practitioner). Whether another doctor at the practice can bill a consult for the patient that day is unclear. AN.0.47

Common questions

What is the fee for MBS item 965?

The schedule fee is $160.60, and the Medicare benefit is 100% of it ($160.60). That’s under the MBS in force from 1 August 2026.

Can item 965 be done by video or phone?

No. In person (the video versions are separate).

Who can bill item 965?

By a GP (a non-VR doctor uses the prescribed medical practitioner version).

How often can item 965 be claimed?

One new plan in 12 months, unless exceptional circumstances (a significant change in the patient’s condition or care circumstances, documented in the record and flagged on the claim). At least 3 months after the patient’s last plan review: no other plan or review in the 3 months up to this one, unless exceptional circumstances.

Can item 965 be claimed on the same day as a consultation?

No. No general attendance (consult) for the same patient on the same day.

Can you bill 965 and 23 together?

No. Not on the same day as a general attendance (consult) for the same patient; AN.0.47 lists these items. (Source: MBS AN.0.47.)

Can you bill 965 and 2715 together?

Yes. A GP mental health treatment plan can also be completed when the patient also needs mental health support (AN.0.47’s example). (Source: MBS AN.0.47.)

Can you bill 965 and 10997 together?

Yes. 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. (Source: MBS MN.12.4.)

Can you bill 965 and 11607 together?

No. Not in association with a heart health check, a health assessment (including an Aboriginal and Torres Strait Islander health check), a GP chronic condition management plan or its review, a contribution to a multidisciplinary care plan, or a case conference (including a cancer case conference). (Source: MBS Item 11607.)

Can you bill 965 and 729 together?

No. Not within 12 months after you were paid for preparing this patient’s GP chronic condition management plan. (Source: MBS AN.15.7.)

What can’t item 965 be billed with?

The MBS has a rule against billing item 965 with these: acupuncture, prolonged attendance on a patient in imminent danger of death, patient-end support for a specialist video consultation, 24-hour ambulatory blood pressure monitoring (ABPM), general consultation, urgent after-hours attendance, contribution to a multidisciplinary care plan (aged care facility or hospital plan), and multidisciplinary case conference. Each rule and its source is on this page.

Can item 965 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.

Do items 229, 230, 721, 723, 92024, 92025, 92055, and 92056 still exist?

No. The MBS says: “GP Management Plans (MBS items 229, 721, 92024 and 92055) and Team Care Arrangements (MBS items 230, 723, 92025 and 92056) were replaced with the new GP chronic condition management plan framework”. Today it’s the GP chronic condition management plan (care plan), item 965.

Sources

• Item 965: Group A15 GP chronic condition management plans, multidisciplinary care plans and case conferences › Subgroup 1 GP chronic condition management plans and multidisciplinary care plans
• Note AN.0.47: GP chronic condition management plans (MBS items 392, 393, 965, 967, 92029, 92030, 92060, 92061)
• Note AN.0.9: Using time-tiered professional (general) attendance items
• Item 11607: Group D1 Miscellaneous Diagnostic Procedures And Investigations › Subgroup 5 Vascular
• Note AN.36.2: Eating Disorders Treatment and Management Plans Explanatory Notes
• Note AN.15.5: GP chronic condition management plans – transition arrangements for existing patients with a GP Management Plan and/or Team Care Arrangement
• Note AN.15.7: Multidisciplinary care plans for patients who are not a care recipient in a residential aged care facility (MBS items 231, 729, 92026, 92057)
• Item 235: Group A7 Acupuncture and Non-Specialist Practitioner Items › Subgroup 6 Prescribed medical practitioner chronic condition management plans, multidisciplinary care plans and case conferences
• Item 758: Group A15 GP chronic condition management plans, multidisciplinary care plans and case conferences › Subgroup 2 Case Conferences
• Item 240: Group A7 Acupuncture and Non-Specialist Practitioner Items › Subgroup 6 Prescribed medical practitioner chronic condition management plans, multidisciplinary care plans and case conferences
• Item 735: Group A15 GP chronic condition management plans, multidisciplinary care plans and case conferences › Subgroup 2 Case Conferences
• Item 236: Group A7 Acupuncture and Non-Specialist Practitioner Items › Subgroup 6 Prescribed medical practitioner chronic condition management plans, multidisciplinary care plans and case conferences
• Item 237: Group A7 Acupuncture and Non-Specialist Practitioner Items › Subgroup 6 Prescribed medical practitioner chronic condition management plans, multidisciplinary care plans and case conferences
• Item 238: Group A7 Acupuncture and Non-Specialist Practitioner Items › Subgroup 6 Prescribed medical practitioner chronic condition management plans, multidisciplinary care plans and case conferences
• Item 239: Group A7 Acupuncture and Non-Specialist Practitioner Items › Subgroup 6 Prescribed medical practitioner chronic condition management plans, multidisciplinary care plans and case conferences
• Item 739: Group A15 GP chronic condition management plans, multidisciplinary care plans and case conferences › Subgroup 2 Case Conferences
• Item 743: Group A15 GP chronic condition management plans, multidisciplinary care plans and case conferences › Subgroup 2 Case Conferences
• Item 747: Group A15 GP chronic condition management plans, multidisciplinary care plans and case conferences › Subgroup 2 Case Conferences
• Item 750: Group A15 GP chronic condition management plans, multidisciplinary care plans and case conferences › Subgroup 2 Case Conferences
• 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)