Medicare Care Plans:
GP Management Plans and Team Care Arrangements
This is a summary of the Medicare-funded Team Care Arrangements (TCA) and GP Management Plan (GPMP). It includes general information about the plan, as well as useful resources and links for further information.
What is the difference between TCA and GPMP?
A GPMP is designed to help people with chronic medical conditions (present for more than 6 months) or a terminal illness by providing an organised approach to care. This is overseen and managed by the GP.
A TCA plan is aimed to support people with complex care needs that requires a multidisciplinary support. The goal is to manage this condition using a multidisciplinary team approach, including at least two other health or care providers (this may be a mix of allied health professionals, a specialist, support worker, or education providers such as schools). A list of multidisciplinary care team members can be find here (click through to slide 4).
Ultimately, your GP will decide which care plan will be suitable to meet your child’s needs.
Eligibility
Patients are eligible if they meet the following criteria:
Chronic or terminal conditions: Patients with conditions expected to last for at least six months or terminal conditions.
Complex care needs: Ongoing care from a GP and at least two other healthcare providers.
Referral requirements: Patients must have:
a GP Management Plan (item 721/92024)
Team Care Arrangements (item 723/92025) in place or a multidisciplinary care plan from a residential aged care facility.
What services are covered?
Patients are eligible for 5 allied health services per calendar year in total for either care plan:
These may be provided by a single service (eg. 5 physiotherapy sessions), or a combination (eg. 4 physiotherapy and 1 podiatry session)
Services provided by a variety of allied health professionals, including:
Audiologists, chiropractors, dietitians, physiotherapists, podiatrists, speech pathologists, psychologists, osteopaths, diabetes educators, exercise physiologists
Each therapist will need to write a letter to your GP after their initial session, and also after the final session under the care plan
What is the Medicare rebate?
The Medicare rebates below are accurate as of January 2025. This is the amount that Medicare will cover, however if a service does not bulkbill, you will need to cover the cost of the gap. You will need to check with potential therapy clinics if their therapists have a Medicare provider number. If so, they should be able to process the relevant Medicare item numbers for the GP Management Plan.
Allied health professional = $60.35
How often can GPs refer for these care plans?
There is a minimum 3-month interval between the initial referral and a follow up referral (otherwise known as a care plan review).
If there is a new chronic condition and a new TCA plan or GPMP is required, this requires a minimum of 12 months between initial referrals.
Useful Links:
Disclaimer: While we strive to provide accurate and up-to-date information and resources, the information on this website is intended as a general reference only. We encourage all readers to conduct their own research to ensure that any information or links provided are accurate and relevant to their specific circumstances and needs.