From 1 July 2025, the way general practices deliver and claim for chronic disease care will change significantly. The two existing Medicare items for care planning (GPMP and TCA) will be replaced by a single, simpler structure: the GPCCMP, with new item numbers 965 (initial) and 967 (review).

These changes aim to streamline chronic care delivery, but for many GPs, the shift brings questions:

• How will this affect the way we work with patients?
  
• Will billing remain sustainable?
  
• How can we ensure reviews are completed on time without increasing workload?
  

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At Lyrebird Health, we have partnered with Bp Premier to answer these questions clearly and directly. We have built CDM support into Lyrebird and it’s available out of the box for practices using Best Practice, so the transition is simple, effective and sustainable.

What is changing on 1 July?

The current GPMP (721) and TCA (723) items, which together paid nearly $300, will be replaced by:

• 965 for initial chronic care planning
  
• 967 for quarterly reviews
  

Each item pays a flat $156. While the individual payment is lower, eligibility has expanded. Up to 60 percent of patients may now qualify for a chronic care plan, compared to 16 percent previously. This shift is an opportunity to reach more patients with consistent care but only if the workflow makes it possible.

The solution is already in your workflow

To support this transition, Lyrebird has worked with Bp Premier to deliver a new CDM experience that operates entirely within the Bp Premier environment. There are no extra logins, no new systems and no retraining required.

Workflow: What Happens When a GP Opens a Patient Record

Step 1: Patient Context
For Lyrebird-subscribed clinics, launching from within Bp Premier brings in rich patient context including allergies, medications, active medical history, family history, and social history so clinicians have everything they need at a glance.

Step 2: Eligibility Check
Lyrebird checks whether the patient is eligible for CCM billing (MBS 965 or 967), based on clinical history and current Medicare rules for practices that use Cubiko.

Step 3: Workflow Launch & Care Plan Generation
If eligible:

• Lyrebird launches a pre-filled, review-ready care plan workflow
  
• The GP sees a streamlined CCM interface with correct fields and billing guidance and no manual templates required
  

Review reminders are not yet written back to Bp Premier. This feature is coming soon.

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Step 4: Action and Billing
Once the care plan is created or reviewed:

• Lyrebird updates the clinical record with the necessary notes for Medicare compliance
  
• It ensures the correct billing logic (MBS 965/967) is followed
  

Billing codes are not yet written back to Bp Premier. This feature is coming soon.

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Why this matters for patients

These changes are not just about item numbers. Chronic care planning supports real outcomes, especially for those managing ongoing health issues.

Lyrebird’s integration ensures that:

• Patients receive their care plans and reviews on time
  
• GPs can focus on care, not paperwork
  
• Reviews become a regular part of patient support
  

All of this happens during a standard appointment, without needing separate admin visits.

Want to see it in action?

Join our free 30-minute education session:
🎓 Mastering the CDM to CCM Transition with Lyrebird
🗓 Tuesday 9 July, 7:00pm AEST
🎙 With Dr Sean Stevens and Lyrebird’s Head of Product, Virginia Murdoch

Register here

Can’t attend live? Register anyway and we will send you the replay.

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