Practice nurse items

Rules about billing Medicare Benefits Schedule (MBS) items for services provided by a practice nurse on behalf of a medical practitioner and how to apply them.

Read the relevant Medicare Benefits Schedule (MBS) item descriptors and explanatory notes on the MBS Online website.

Billing requirements

Practice nurses can deliver some services on behalf of and under the supervision of medical practitioners.

A practice nurse is either a registered nurse or enrolled as a nurse. They must also be employed by, or have their services retained by, a medical practitioner.

Services billed by a practice nurse must meet certain item requirements.

These items don’t apply to patients admitted to hospital.

Item 10987 - health assessment follow up

This service is available to Aboriginal and Torres Strait Islander People who’ve had a health assessment, including MBS items 228 or 715.

It’s also available to children who’ve had a health check as part of the Northern Territory Emergency Response.

You can claim this item 10 times per patient per calendar year.

You can claim this item if a practice nurse provides the service consistent with the patient’s health check.

The service can be provided between further consultation with the patient’s medical practitioner.

As part of the service, the nurse can:

  • check on clinical progress and access to services
  • educate patients on medication compliance and monitoring
  • complete examinations or interventions as identified by the health check
  • take a medical history
  • educate, monitor, counsel and provide lifestyle advice
  • provide prevention advice for chronic conditions and associated follow up.

Item 10997 - chronic disease monitoring and support

The service is available to patients with a GP Management Plan, Team Care Arrangements or Multidisciplinary Care Plan.

The MBS items for these services are 229, 230, 231, 232, 233, 721, 723, 729, 731 or 732.

You can claim this item up to 5 times per patient per calendar year.

You can claim this item if either:

  • a practice nurse provides monitoring and support to an eligible patient consistent with their care plan
  • it’s provided between structured reviews of the care plan by the patient’s usual medical practitioner.

As part of the service, the nurse can:

  • check on clinical progress
  • monitor medication compliance
  • provide self-management advice
  • collect information to support the review of a care plan.

You can’t claim this item with another antenatal attendance item provided to the same patient on the same day by the same practitioner. You also can’t claim it with items 10990, 10991 10992, 75855, 75856, 75857 or 75858.

You can claim this item up to 10 times per patient per pregnancy.

You can claim this item if the nurse provides an antenatal service at or from an eligible practice location in a regional, rural or remote area.

Billing an attendance item and practice nurse item

In some instances, both the medical practitioner and the nurse may need to see the patient. If this is the case, you can claim both a practice nurse item and an attendance item. The duration of an attendance item doesn’t include the time a patient spends with the nurse.

Exception for antenatal attendances

The medical practitioner can claim if the consultation was before or following an antenatal service provided by a nurse. However, in these circumstances, you can’t claim the practice nurse item.

Page last updated: 15 June 2024.
QC 74138