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GP Chronic Condition Management Plan 

What this is

A GP Chronic Condition Management Plan (GPCCMP) is a structured plan developed by a general practitioner for a person with a long-term medical condition.  A chronic, long term medical condition generally refers to a condition that has been present, or is expected to be present, for six months or more.

 

The GPCCMP forms a comprehensive management plan and may include:

  • Current health conditions

  • Goals of care 

  • Current treatments

  • Planned review dates

  • Referral to other health professionals

 

Why it exists

Complex chronic conditions often require coordinated care; GPCCMPs exist to:

  • Support structured management

  • Encourage regular reviews

  • Improve communication between healthcare providers, especially in multidisciplinary care of  a complex chronic medical condition

  • Facilitate coordinated care across different members of the health system

 

How it works in practice

In general a patient and their general practitioner will develop goals, treatments and monitor outcomes in the management of a complex chronic health condition.  

 

Clinical decisions about whether a plan is suitable are made by the treating practitioner and the existence of a chronic condition does not automatically mean a plan will be created.

 

Funding and system structure

GP Chronic Condition Management Plans sit within the Medicare-funded primary care system.

In general:

  • The Australian Government funds Medicare

  • General practitioners claim Medicare benefits for eligible services

  • Allied health referred to within the plan may claim Medicare benefits for eligible services

  • Patients may incur out-of-pocket costs depending on the practice’s billing arrangements.

 

Billing arrangements vary between practices. Access to services may vary by location, workforce availability, and individual circumstances.  The plan itself does not guarantee access to other services, funding, or allied health care. Referrals and service availability are subject to clinical judgement, eligibility rules, and local service capacity.

 

 

Relationship to allied health services

In some cases, a Chronic Condition Management Plan may be associated with referral to certain allied health services under Medicare.

 

However:

  • Referral decisions are made by the treating practitioner in consultation with the patient

  • Medicare rules and limits apply

  • Access depends on provider availability and eligibility criteria

 

Private health insurance, where held, operates separately and does not replace Medicare.

 

 

What this does not mean

A GP Chronic Condition Management Plan:

  • Does not guarantee access to specific services

  • Does not create automatic entitlement to funding

  • Does not replace specialist care where clinically required

  • Does not override clinical judgement

  • Does not ensure bulk billing

 

Eligibility and funding arrangements may change over time. Official government sources provide the most current information.

 

Who decides

  • Clinical suitability is determined by the treating general practitioner

  • Funding rules are set by the Australian Government

  • Service access depends on workforce, location, and provider participation.

 

This website does not determine access or entitlement.

 

Access considerations across Australia

Access to general practice and allied health services may vary:

  • Between metropolitan, regional, and remote areas

  • Depending on workforce availability

  • Based on individual health needs and circumstances

 

People in rural and remote communities, including Aboriginal and Torres Strait Islander communities, may experience different access pathways and service availability.

 

 

Official information sources

For current and authoritative information, refer to:

Official government sources prevail where there is any difference between this page and published policy.

 

 

Important Information

This page provides general educational information about how GP Chronic Condition Management Plans operate within the Australian health system.   It is not medical advice, eligibility advice, financial advice, or insurance advice. It does not determine individual access to services or entitlements.  Health systems, funding arrangements, and eligibility rules can change over time. For the most accurate and up-to-date information, check official government sources and discuss your individual situation with your GP or healthcare team.  Official government sources prevail. Clinical decisions are made by healthcare professionals. This website does not determine access, eligibility, or entitlement, and no professional relationship is created by using this site.

 

 

Last reviewed: February 2026

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