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Additional MBS items are now available for:
- telehealth and telephone attendances
- pathology testing
- chronic disease management
- coronavirus (COVID-19) vaccine attendances.
MBS telehealth and telephone items
You can use these MBS items if you provide phone and video services to patients for:
- general attendances
- specialist attendances
- allied health
- health assessments
- chronic disease management and team care arrangements
- Medicare items for Complex neurodevelopmental disorder and eligible disability
- mental health treatment and planning
- eating disorder treatment and management
- focused psychological strategies
- oral and maxillofacial surgical attendances
- pregnancy support counselling
- antenatal and postnatal attendances
- nurse practitioner attendances
- participating midwives attendances.
If you’re a GP or a medical practitioner, you can only use these items for patients:
- you have an existing relationship with
- who have visited your practice for a face-to-face service in the last 12 months.
There’s some exemptions to this rule if patients are:
- in isolation or quarantine due to COVID-19
- confirmed as COVID-19 positive, either through laboratory testing or an approved COVID-19 rapid antigen test in the last 7 days
- experiencing homelessness
- under 12 months of age
- treated at an Aboriginal Medical Service or an Aboriginal Community Controlled Health Service
- in a natural disaster area
- needing mental health support
- requiring urgent after hours service in unsociable hours
- undergoing eating disorder support or pregnancy counselling.
Health professionals can:
- bulk bill patients at their discretion
- use these items with existing bulk bill incentive items.
Blood borne viruses, sexual and reproductive health services
GPs and medical practitioners can use temporary items 92715-92742 for telehealth services for:
- blood borne viruses
- sexual and reproductive health.
You can’t use these items for the following consultations:
- Assisted Reproductive Technology (ART)
- antenatal care.
These services are:
- exempt from the existing relationship rule
- intended to help patients use medical services where there’s barriers due to privacy or limited service availability.
Find out more about these MBS items on the MBS online website.
Nicotine and smoking cessation counselling services
GPs and medical practitioners can use temporary items 93680-93705 for face-to-face and telehealth attendances services.
This includes nicotine and smoking cessation counselling, care and advice.
These items are:
- exempt from the existing relationship rule
- intended to help patients use medical services where there’s barriers due to privacy or limited service availability.
Coronavirus (COVID-19) vaccines support services
GPs and qualified health professionals can use items 93644-93661 to assess a patient’s suitability to get a COVID-19 vaccine.
This service is free to patients and the MBS items must be bulk billed. You must provide patients a face-to-face assessment before they’re given the vaccine.
You can bulk bill this service to Medicare when your patient:
- is assessed and gets the vaccine
- has been assessed but doesn’t get the vaccine for clinical reasons
- has been assessed but doesn’t consent to the vaccine.
Except for items 93660 and 93661, if you provide a COVID-19 vaccine suitability assessment:
- you must provide the vaccine immediately after
- the supervising GP must be present at the same location.
If you’re a qualified health professional, you can use vaccine suitability assessment items 93660 and 93661 if:
- it’s not at the general practice or hospital
- you provide it on behalf of a medical practitioner who’s not at the same service location.
Flag fall arrangements
Use the flag fall service item number 90005 if you assess your patient’s suitability for a vaccine at a:
- residential aged care facility
- residential disability setting facility
- person’s place of residence
- place other than at the practice location, not including a hospital.
You can only claim the flag fall service item for your first appointment at each location.
COVID 19 vaccine booster incentive ended
From 1 February 2023, Medicare benefits are no longer available for a COVID-19 vaccine booster incentive service.
Find out more about simplified COVID-19 Vaccinations on the MBS online website.
In-depth patient assessment
Use items 10660 and 10661 when providing additional assessment and advice on your patient’s risk and benefits for the COVID-19 vaccine.
Billing requirements:
- the GP or medical practitioner must attend in person for more than 10 minutes
- it must be bulk-billed
- it must be provided with a COVID-19 vaccine suitability assessment service (93644-93656)
- you can only claim items once per patient per lifetime.
Co-claiming
The vaccine support items can’t be co-claimed with:
- bulk-billing incentive items 10990, 10991, 10992, 75855, 75856, 75857, 75858
- Aboriginal and Torres Strait Islander health practitioner immunisation item 10988.
You can co-claim COVID-19 vaccine suitability assessment items with normal attendance items.
For example, item number 23 where the patient both:
- attends for an unrelated condition
- is eligible for the vaccine.
The relevant incentive item is still payable for the other attendance.
Make a note on the account or include service text for electronic claims. Suitable text may include:
- times of each attendance
- ‘Unrelated to COVID-19 assessment’ on the attendance item.
This helps us assess the claim.
Patients shouldn’t need more than one vaccine suitability assessment on the same day.
You can provide another service on the same day if:
- there’s exceptional circumstances
- you record the exceptional circumstance in the patient’s notes.
Find out more about these MBS items on the MBS online website.
Attendance items for COVID-19 antiviral treatment
Temporary items 93716-93717 are for long phone attendances when you assess if patients need COVID-19 antiviral treatment.
Find out more about the COVID-19 oral anti-viral medication on the MBS Online website.
MRI mRNA COVID-19 vaccine related myocarditis
You can use item 63399:
- for cardiac magnetic resonance imaging (MRI) to diagnose myocarditis associated with mRNA COVID-19 vaccination
- when myocarditis cannot be definitively diagnosed using conventional imaging and other diagnostic tests.
Find out more about this MBS item on the MBS Online website.
MBS pathology items for coronavirus (COVID-19) and other respiratory pathogens
There’s certain temporary MBS pathology items you can use if you perform pathology tests for COVID-19.
You must bulk bill them if you perform these tests out-of-hospital.
You can privately bill for private patients admitted to hospital.
If you perform COVID-19 pathology testing, use items:
If you perform combined testing of COVID-19 and other respiratory pathogens, use items:
Pathology items 69506-69515 are exempt from patient episode coning and limited to one per day.
Find out more about MBS pathology items for coronavirus (COVID-19) and other respiratory pathogens on the MBS online website.
Assignment of benefit requirements
You need your patient’s agreement to bulk bill the items before we can pay you the Medicare benefit.
You can get their agreement either:
- in writing
- by email
- verbally during the consultation.
If you get verbal agreement from your patient, you must write:
- ‘unable to sign’ in the Patient signature field
- why the patient is unable to sign in the Provider field, for example COVID-19.
You must keep a record of the agreement.
Getting verbal consent is a temporary policy measure.