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Read the relevant item descriptions, fact sheets and explanatory notes on the MBS Online website.
About aftercare
Aftercare is the post-operative care and treatment provided to a patient after an operation or procedure.
It includes all attendances until the patient’s recovery and the final check or examination. Aftercare services can be provided in a hospital, private rooms or the patient’s home.
Aftercare is not always limited to the practitioner who performed the procedure.
The MBS fee includes an aftercare component for most:
- operations
- procedures
- fractures
- dislocations.
If an item doesn’t include aftercare, it’s noted in its description.
Medicare doesn’t cover aftercare related entirely to cosmetic procedures or non-MBS services.
Read more about aftercare on the MBS Online website.
Aftercare periods
The practitioner performing the procedure determines the aftercare period based on the patient’s needs. The type and duration of aftercare may vary between patients, even if they’ve had the same procedure.
Some surgical items include a minimum aftercare period in their description or explanatory note.
We set aftercare periods for surgical items to help assess attendance items claimed after a patient’s procedure. These periods don’t determine if a service is aftercare.
Attendances in the aftercare period
For most surgical items, the Schedule fee includes normal post-operative care. This means an attendance item cannot be billed for normal aftercare. However, if the description of the surgical item specifically excludes aftercare, an attendance item can be billed for the aftercare provided.
Medical treatment directly related to a patient’s recovery should be provided by the practitioner that performed the procedure.
General practitioner attendances and aftercare
If you work in general practice and did not perform the initial procedure, you can bill an attendance item for aftercare services provided to a patient.
If you performed the procedure, you cannot bill an attendance item for routine aftercare.
Read more about general practitioner attendances and aftercare on the MBS Online website.
Not normal aftercare
You can bill an attendance item during an aftercare period if the service is not normal aftercare.
A service is not normal aftercare if you see a patient for either:
- an unrelated condition
- complications from the procedure.
Before billing an attendance item, you should ask the patient about any recent procedures or operations they may have had with another practitioner.
If you bill for an attendance that is not normal aftercare, you need to tell us by either:
- setting the aftercare override indicator in your software
- noting not normal aftercare in the service text, using ‘not normal aftercare’, ‘not aftercare’, ‘NNAC’ or ‘NNA’.
Examples
A patient had a hip replacement, a week later they see their general practitioner for a possible infection in the wound. The general practitioner needs to advise the attendance is “not normal aftercare”.
A dermatologist performs a skin excision; in the following days the patient sees an ophthalmologist. The ophthalmologist needs to advise the attendance is “not aftercare”.
“Not normal aftercare” and “not aftercare” are different scenarios but have the same billing requirements.
Public patient in a public hospital
Public patients can access in-patient aftercare free of charge as part of the public hospital services.
If a public patient independently chooses to see a different practitioner privately for aftercare, you can bill for any post-operative care provided under an attendance item.