MBS item 967: Review a GP chronic condition management plan

What to check before you bill item 967

Each line links to the MBS passage it comes from.

• By a GP (a non-VR doctor uses the prescribed medical practitioner version) Item 967
• In person (the video versions are separate) AN.0.47
• Has a GP chronic condition management plan (made from 1 July 2025, not an old GP management plan or team care arrangement), prepared by you or an associated doctor Item 967
• 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
• Discussed and documented the patient’s progress against the plan’s goals AN.0.47
• Discussed and documented whether the plan needs updating (goals still right, input from the care team) AN.0.47
• Updated the arrangements and timeframe for the next review AN.0.47
• If referring to other providers: the patient’s consent to share relevant parts of the updated plan with them, and those parts sent AN.0.47
• Recorded the patient’s consent and agreement to the updates AN.0.47
• Offered a copy of the updated plan to the patient (and their carer, if appropriate), and added it 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) AN.0.47
• A practice nurse’s or health practitioner’s help with the review 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 967 can be claimed

• One review in 3 months, unless exceptional circumstances (a significant change in the patient’s condition or care circumstances, documented and flagged on the claim) AN.0.47

What item 967 needs first

• A GP chronic condition management plan already prepared (by you or an associated doctor) AN.0.47 (items 965, 392, 92029, and 92060)

Billing item 967 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 967

• 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
• 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 967

• GP chronic condition management plan (care plan) (items 965, 392, 92029, and 92060)
  • 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 review once in 3 months; a new plan once in 12 months and 3 months after a review) AN.0.47
  • 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

Can be billed with item 967

• 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
• 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 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

Bulk-billing incentive

An extra payment when a doctor bulk bills an unreferred service. With item 967, one of these:

Other versions

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

What comes next

• A reviewed plan keeps the patient’s access to up to 5 practice nurse or Aboriginal and Torres Strait Islander health practitioner services a calendar year for another 18 months. (items 10997, 93201, and 93203)

Often done at the same visit

• A practice nurse service that is separate from, but part of, the plan (such as a wound dressing or an injection the plan calls for) can be given and claimed the same day as the review (MN.12.4). (items 10997, 93201, and 93203)
• For a patient with diabetes, HbA1c is usually rechecked at plan reviews; a practice accredited for point-of-care testing can measure it in the rooms. (items 66551, 66554, and 73812)

Old item numbers

Items 233, 732, 92028, and 92059 no longer exist. The MBS says: “MBS items for reviewing a GP Management Plan or Team Care Arrangement (MBS items 233, 732, 92028 and 92059) also ceased” AN.15.5

Where the MBS is unclear

• A plan prepared at another (unassociated) practice can’t be reviewed with these items, and the MBS doesn’t say what to do instead; preparing a new plan is the only planning option left. Item 967
• AN.15.5, which isn’t linked to the review items, says a GP Management Plan or Team Care Arrangement made before 1 July 2025 must not be reviewed with these items: a new plan is prepared instead. AN.0.47
• AN.0.47 calls 92030 and 92061 "telehealth" items, but their descriptors are video only: a review done 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 967?

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 967 be done by video or phone?

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

Who can bill item 967?

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

How often can item 967 be claimed?

One review in 3 months, unless exceptional circumstances (a significant change in the patient’s condition or care circumstances, documented and flagged on the claim).

Can item 967 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 967 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 967 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 967 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 967 and 735 together?

No. 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). (Source: MBS Item 735.)

What can’t item 967 be billed with?

The MBS has a rule against billing item 967 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, and multidisciplinary case conference. Each rule and its source is on this page.

Can item 967 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 233, 732, 92028, and 92059 still exist?

No. The MBS says: “MBS items for reviewing a GP Management Plan or Team Care Arrangement (MBS items 233, 732, 92028 and 92059) also ceased”. Today it’s the care plan review (GP chronic condition management plan), item 967.

Sources

• Item 967: 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
• 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)