Medicare Care Plans for Allied Health: What You Need to Know in 2026
By The Kitt Team
What a Medicare care plan actually is (for allied health)
A Medicare care plan is the formal mechanism a GP uses to coordinate ongoing care for a patient with a chronic or complex condition, and it’s what gives your patient access to Medicare-rebated allied health services. The document authorises those services. Without it, your patient pays in full.
Simple enough in principle. But the naming has caused genuine confusion over the years, and the 2025 reform added one more layer: the plan got a new name.
The current formal name is the GP Chronic Condition Management Plan, abbreviated to GPCCMP. You’ll still hear “care plan”, “CDM plan”, and “chronic disease management plan” used interchangeably in practice, and all of those terms are reasonable shorthand in conversation. The term “Enhanced Primary Care” or EPC, which many clinicians absorbed during training or early practice, was retired on 1 July 2025. For why clinicians still say “EPC” and how the term maps to today’s pathway, see enhanced primary care plans: history and what matters now. For day-to-day conversation, “care plan” works fine. But for correspondence with GPs and any written documentation, GPCCMP is the term you want.
The GP prepares the plan. Your role is to receive the referral, deliver the service, and report back. The plan sets the framework; your clinical work and your documentation fill it.
What changed on 1 July 2025
The most significant change was structural. Before 1 July 2025, the Medicare pathway for chronic condition management had two components: the GP Management Plan (GPMP), which the GP prepared, and the Team Care Arrangements (TCA), which required the GP to consult with at least two other health providers before the patient could access rebated allied health services. That second step, the TCA, added administrative weight without reliably adding clinical value, so it was removed.
From 1 July 2025, the GPCCMP replaced both the GPMP and the TCA. One plan, one process. The requirement to coordinate with two providers before referring is gone, and the older Enhanced Primary Care framing was retired at the same time. The stated aim of the reform was to simplify chronic condition management and reduce administrative burden on GPs and practices.
If a patient came to you before 1 July 2025 with a referral written under the old GPMP/TCA system, that referral remains valid through the transition period. You don’t need to send them back to their GP for a new plan. Check with Medicare or the Department of Health and Aged Care if you have a specific case you’re unsure about.
For a detailed breakdown of how the GPCCMP itself works, what the GP records in the plan, and the clinical eligibility criteria, see our post on the chronic disease management plan. This article gives you the allied health overview; that one goes into the plan mechanics.
Referrals are now a letter, not a form
Under the old TCA model, allied health providers were formally part of the coordination process. The new system works differently. The GP writes a letter of referral to the allied health provider, much the same way they’d refer a patient to a specialist. You receive it, note the referral, and begin the service.
You don’t need to formally accept or confirm acceptance back to the GP. There is no requirement for you to have had input into preparing the plan. The referral letter doesn’t need to name you specifically, “physiotherapist” is sufficient as a descriptor, and it doesn’t need to specify a number of visits. Whether you take on a new patient remains at your professional discretion, subject to your usual anti-discrimination obligations, but there is no formal acceptance step required under the current system.
For more on what a referral letter under the GPCCMP should contain, and what to check when you receive one, see our guide on allied health referral letters.
How many services a patient gets, and the calendar year
Up to five Medicare-rebated allied health services per calendar year. Ten for Aboriginal and Torres Strait Islander patients. Those numbers are per patient under the plan, not per provider, and that distinction matters more than most clinicians realise when they first encounter care plan patients.
The cap is shared across all allied health providers seeing that patient under the plan. If your patient attends three sessions with you and two with a dietitian, they have used all five services for the year. They don’t get five for physiotherapy and a separate five for dietetics. Five total, split however they choose across whichever allied health types they access. This catches people out regularly; the Medicare 5-visit rule walks through the shared-cap mistake and a front-desk intake checklist. It’s worth asking a new patient early in the piece whether they’re currently seeing anyone else under their care plan.
The count is per calendar year and resets on 1 January. Unused services don’t roll over to the following year. If a patient has two services remaining in late November and doesn’t use them, those services lapse on 31 December.
The patient generally needs a plan that was prepared or reviewed within the previous 18 months to keep accessing rebated services. If their plan is more than 18 months old and hasn’t been reviewed, they need to go back to their GP before rebated services can continue. Referrals are valid for the timeframe stated in the letter, or 18 months from the first service if no timeframe is given.
What the rebate covers
The Medicare benefit for each eligible allied health service under a care plan is around $61.80 at the time of writing. That figure is indexed and will change over time, so treat it as a guide rather than a fixed number, and check the current Medicare Benefits Schedule before you quote patients anything specific.
It’s a rebate towards your fee, not a cap on it and not necessarily the full fee. Gap fees are common, and your practice sets its own schedule. Your patient claims the rebate through Medicare; the gap is what they pay out of pocket. This article isn’t the place for a billing walkthrough, but understanding the approximate rebate amount helps you have an honest conversation with patients before their first session under the plan.
Your documentation obligations as the allied health provider
This is the part of the system that most directly affects your day-to-day. And it hasn’t changed with the 2025 reform, which means there is no ambiguity about what’s expected of you.
When you see a patient under a GPCCMP referral, you have a reporting obligation to the referring GP. You must provide a written report after the first service, after the last service under the referral, and whenever there are clinical matters the referring GP would reasonably expect to be told about. If you only see the patient once under the referral, a report on that single service is required.
First service. Last service. Any clinically significant developments in between. Not just at the end. The first report matters because it tells the GP you’ve seen the patient, what you found on initial assessment, and what your plan is. That’s clinical communication, not a bureaucratic formality. The GP made the referral based on what they knew at the time; your initial findings complete the picture and allow them to coordinate care from a fully informed position.
Good SOAP notes are the foundation of good reporting. If your session notes are clear, specific, and tied to functional outcomes, the GP report follows naturally. If they’re vague, the report will be too, and that undermines the point of the whole arrangement. Think of it this way: a Medicare care plan is, at its core, a documentation relationship between you and the referring GP. The quality of your notes and reports is what makes it a genuine coordination tool rather than a Medicare billing formality.
Some clinicians use tools like Kitt to draft GP reports and clinical notes directly from the session, so they can review and send them without building each report from scratch. If the reporting burden is what makes care plan patients feel like more work than they’re worth, that’s a documentation workflow worth examining.
A quick worked example
This is a hypothetical scenario. It’s illustrative, not a real patient or real outcome.
Amara is 54 and has type 2 diabetes with associated peripheral neuropathy. Her GP prepares a GPCCMP and writes a referral letter to your physiotherapy practice. The letter notes she’s been referred for physiotherapy, doesn’t specify a number of sessions, and is valid for 12 months.
Amara attends her first physiotherapy session. You complete your initial assessment, identify two contributing musculoskeletal issues, and outline a treatment plan. That first session triggers your first reporting obligation: a written report to the referring GP summarising your findings and proposed approach, sent promptly after the session.
Amara also sees a dietitian under the same care plan. After three physiotherapy sessions and two dietitian consultations, she has used all five of her shared rebated services for the calendar year (see the Medicare 5-visit rule for why the cap is shared, not per provider). It’s now August. She can’t access any further rebated allied health services under the plan until 1 January.
At her third and final physiotherapy session for the year, you write your last report. You summarise her progress, note outstanding concerns, and flag that she’d benefit from a GP review before the next calendar year to ensure her plan is current and her referral renewed. That report closes the loop. It gives her GP everything they need to act.
Key Takeaways
- The current Medicare care plan for chronic conditions is the GP Chronic Condition Management Plan (GPCCMP); “GPMP”, “TCA”, and “EPC” refer to the previous system, retired from 1 July 2025.
- From 1 July 2025, the GPCCMP replaced the GPMP and TCA; the requirement to coordinate with two providers before referring allied health was removed.
- Eligible patients can access up to five rebated allied health services per calendar year (ten for Aboriginal and Torres Strait Islander patients), shared across all allied health providers on the plan.
- The five-service count resets on 1 January each year and unused services don’t roll over.
- The patient’s plan must have been prepared or reviewed within the previous 18 months for rebated services to remain accessible.
- Allied health referrals under the GPCCMP are now a letter; you don’t need to formally accept the referral or have had input into the plan.
- Your reporting obligations are: written report after the first service, after the last service, and whenever there is a clinical matter the GP would reasonably expect to know about.
- The Medicare rebate is around $61.80 per eligible service at the time of writing, indexed, and a contribution towards your fee rather than the full amount.
Frequently Asked Questions
What is a Medicare care plan called now?
The current formal name is the GP Chronic Condition Management Plan, abbreviated to GPCCMP. It replaced the GP Management Plan (GPMP) and Team Care Arrangements (TCA) from 1 July 2025. “Care plan” remains widely used as shorthand in conversation, but GPCCMP is the correct current term for documentation and any correspondence with Medicare or referring GPs.
How many allied health sessions does a patient get per year?
Up to five Medicare-rebated allied health services per calendar year, or ten for Aboriginal and Torres Strait Islander patients. That cap is shared across all allied health providers the patient sees under the plan. If a patient attends three physiotherapy sessions and two occupational therapy sessions, they’ve used all five services for the year, regardless of how many providers were involved.
Do the 5 services reset each year?
Yes. The count resets on 1 January each year. Unused services from the previous year don’t carry over, so a patient with two services remaining on 31 December loses those when the year turns. For rebated services to continue, the patient’s plan also needs to have been prepared or reviewed within the previous 18 months.
Do I still need to accept the referral?
Under the current system, there is no formal acceptance step required. The GP sends a letter of referral, and you receive it and proceed. You don’t need to confirm acceptance back to the referring GP, and you weren’t required to have had any input into preparing the plan. Whether you take on a new patient remains your professional choice, subject to anti-discrimination obligations, but that’s separate from any Medicare requirement.
How much is the Medicare rebate for allied health?
The Medicare benefit for each eligible allied health service under a care plan is around $61.80 at the time of writing. That figure is indexed and changes over time, so check the current Medicare Benefits Schedule before quoting patients a specific gap amount. The rebate is a contribution towards your fee; gap fees are standard practice and your clinic sets its own rates.
When do I have to write to the GP?
You must provide a written report to the referring GP after your first service with the patient, after the last service under the referral, and whenever there are clinical matters the GP would reasonably expect to be told about. If you only see the patient once under that referral, a report on that single service is required. These reporting obligations are unchanged by the 2025 reform.