MBS Chronic Disease Management Items: The Practice Nurse's Guide to GPMP, TCA and Item 10990

If you're a practice nurse in an Australian GP clinic, chronic disease management (CDM) is probably the backbone of your week — recalls, care plan paperwork, health assessments and follow-up appointments. Knowing exactly which MBS items sit underneath that work (and what the rules are) makes you faster at preparing appointments, and helps your practice claim correctly the first time.

This guide walks through the items you'll touch most often: GPMP (item 721), Team Care Arrangements (item 723), health assessments (including item 715), GP reviews, and the practice nurse items — most importantly item 10990. It's written for nurses, not billing managers: the focus is on what you do at each step.

First, the ground rules: what a practice nurse can and can't bill

Medicare claims in general practice are made by medical practitioners (or by the practice on their behalf). Practice nurses don't hold their own Medicare provider numbers for these services. What nurses do have is a set of items the GP can claim for services you deliver on their behalf — item 10990 is the everyday example — and a huge amount of preparation work that makes GP items billable and audit-proof.

Three principles run through every CDM item:

• The GP stays clinically responsible. You work under their supervision and delegation, and they authorise the plan or service.
• Documentation carries the claim. If it isn't written in the record — patient consent, the plan content, reviews — the practice can't defend the claim.
• Items change. Descriptions, fees and rules are updated regularly (fees are typically indexed each 1 November). The MBS Online description for each item is the only authoritative source.

The CDM items you'll see on the day sheet

Item	What it is	Your role as the nurse
721 — GPMP	GP Management Plan for a patient with a chronic condition expected to last 6+ months. Prepared by the GP.	Pre-appointment: collect observations, pathology, history and current medications so the GP can finalise the plan efficiently. Book the dedicated, adequately long appointment.
723 — TCA	Team Care Arrangements, where the GP brings in at least two other care providers (e.g. physio, dietitian, podiatrist).	Confirm the collaborating providers' details, prepare the referral paperwork, and book the review cycle afterwards.
2755 / 2757 — GP reviews	GP review of a GPMP (and TCA where it exists) — claimed by the GP, not the nurse.	Run the recall system so reviews aren't missed (commonly 3–6 monthly in many practices, per the GP's clinical judgement), and pre-populate the review data.
715 — Health assessment	Annual health assessment for Aboriginal and Torres Strait Islander patients.	Often nurse-led: complete the assessment components, flag follow-up actions for the GP, and organise the follow-up items (see 10987 note below).
10990 — Practice nurse item	Lets the GP claim for an attendance you provide on their behalf for chronic disease management — the workhorse nurse item in general practice.	Deliver the service (wound care, chronic disease follow-up, education) under the GP's supervision, and document it as if the GP were in the room.

Item 10990 in practice

Item 10990 is the reason a nurse-led chronic disease clinic can be sustainable for a practice. The core conditions to keep in mind:

• The service is provided by a practice nurse, on behalf of the GP, in the course of chronic disease management.
• The patient must have had a GP Management Plan (item 721) or a health assessment within the previous 12 months — this is the condition that trips up most rejected claims, so check the record before you book the appointment as a 10990.
• You work under the supervision of the GP, and there are limits on how often it can be claimed per patient per year — confirm the current count in the MBS Online note rather than relying on memory or a colleague's rule of thumb.

A practical habit: build a pre-appointment checklist in your practice software — "GPMP or HA in last 12 months? Y/N" — so the front desk doesn't have to guess at billing time.

The paperwork traps that cause claim rejections

• Missing or unsigned consent. CDM plans require the patient's agreement to be documented.
• Plans "finalised" without the GP. You can draft and gather, but the GP prepares and authorises the plan — keep your drafting separate from their sign-off in the record.
• Review dates never booked. The plan is only as good as its recall cycle. Book the review before the patient leaves.
• Same-day double-ups. Some services can't be claimed together on the same day — when in doubt, check the item's "restrictions" flags (the P/R/E codes) on MBS Online.

Where nurses add the most value in the CDM cycle

Practices that run CDM well treat it as a pipeline, not a set of one-off appointments: a recall list that never goes stale, pre-appointment data collection that shortens the GP's consult, team referrals actually followed up, and a review booked at every touchpoint. That pipeline work is nurse work — and it's where the paperwork side pays off fastest. Docsert AI turns scattered notes, summaries and extracts into tidy, structured care-plan documents in minutes, using smart templates that work with Best Practice — you review, edit and finalise every output. The ClinicIQ calculators and CDM checklists cover the rest of the workflow.

This article is general information for Australian practice nurses, not medical or billing advice. MBS item descriptions, fees and claim rules change — always confirm against the current MBS Online item descriptors and your practice software's billing guidance before claiming. Patient care decisions remain the responsibility of the treating practitioner.

Frequently asked questions

Can practice nurses claim Medicare items themselves?

No. Medicare claims in general practice are made by medical practitioners or by the practice on their behalf. Practice nurse services are billed under specific items — most commonly MBS item 10990 — which the GP claims for an attendance the nurse provides on their behalf, under the GP's supervision.

What is MBS item 10990?

Item 10990 lets a GP claim for an attendance provided by a practice nurse on the GP's behalf as part of chronic disease management. Key conditions include that the patient has had a GP Management Plan (item 721) or a health assessment within the previous 12 months, that the nurse works under the GP's supervision, and that claim frequency limits are respected. Check the current MBS Online note for the full descriptor.

Do practice nurses prepare GPMPs and TCAs?

Nurses commonly collect the information and draft the content — observations, pathology, medications, patient goals and provider details — but the GPMP (721) and TCA (723) are prepared and authorised by the GP. Keep the drafting work and the GP's authorisation clearly documented as separate steps.

How often can item 10990 be claimed for a patient?

There are limits on the number of 10990 services per patient in a 12-month period, and the exact count has changed over time. Confirm the current limit in the MBS Online item note rather than relying on memory or practice folklore.

What's changed in chronic disease management items for 2026?

Item descriptors, fees and rules are updated regularly — fees are typically indexed each 1 November, and CDM arrangements have been the subject of ongoing MBS reform. Treat MBS Online (mbsonline.gov.au) as the source of truth and subscribe to its updates.