Chronic disease individual allied health practitioner items

Rules about billing Medicare Benefits Schedule (MBS) items for chronic disease services and how to apply them.

Read the relevant item descriptions, fact sheets and explanatory notes on the MBS Online website.

Medical practitioners can refer eligible patients with chronic diseases to allied health practitioners. Allied health practitioners can bill and claim Medicare benefits for some services.

For an allied health professional to bill and claim Medicare benefits for these services, they must do all of the following:

  • be eligible to deliver the service
  • bill for an eligible patient
  • bill the services using the correct Medicare Benefits Schedule (MBS) item number
  • give reports to the referring medical practitioner.

A medical practitioner must refer the patient.

Eligible patients can use 5 services per calendar year. The services can be either:

  • one type of service, for example 5 physiotherapy services
  • a combination of different types of services, for example one dietetic and 4 podiatry services.

Eligible allied health professionals and relevant MBS item numbers

These allied health professionals can provide services for the following item numbers:

  • Aboriginal Health Workers or Aboriginal and Torres Strait Islander Health Practitioners - item 10950
  • Audiologists - item 10952
  • Chiropractors - item 10964
  • Diabetes educators - item 10951
  • Dietitians - item 10954
  • Exercise physiologists - item 10953
  • Mental health workers - item 10956
  • Occupational therapists - item 10958
  • Osteopaths - item 10966
  • Physiotherapists - item 10960
  • Podiatrists - item 10962
  • Psychologists - item 10968
  • Speech pathologists - item 10970.

To claim these items the allied health professional must both:

  • attend the appointment in-person for at least 20 minutes
  • treat the patient face-to-face and not through group treatment.

Billing requirements

Patients are eligible for these allied health services if their medical practitioner has billed and claimed both:

  • a general practitioner management plan (GPMP) - item 229 or 721
  • team care arrangements (TCAs) - item 230 or 723.

If the patient is a permanent resident of a residential aged care facility (RACF), their medical practitioner must have previously contributed to either:

  • a multidisciplinary care plan prepared for them by the RACF
  • a review of the care plan - item 232 or 731.

Hospital in-patients are not eligible for these services.

Page last updated: 28 June 2024.
QC 74146