Changes to MBS items during the coronavirus (COVID-19) response

As part of the coronavirus (COVID-19) response, there are changes to the MBS items.

There's additional MBS items available for:

  • telehealth and telephone attendances
  • pathology testing
  • mental health support
  • chronic disease management
  • coronavirus (COVID-19) vaccine attendances.

Temporary MBS telehealth and telephone items

You can use these MBS items if you provide phone and video services to patients.

They're available until 31 December 2021 for the following services:

  • general attendances
  • specialist attendances
  • allied health
  • health assessments
  • chronic disease management and team care arrangements
  • early interventions for children with autism, pervasive developmental disorder or 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.

If you’re a GP, you can only use the temporary items for patients who visited your practice in the last 12 months (existing relationship).

There are some exemptions to this rule for patients:

  • living in an area under stage 3 coronavirus restrictions
  • experiencing homelessness
  • under 12 months of age
  • treated at an Aboriginal Medical Service or an Aboriginal Community Controlled Health Service
  • needing mental health support
  • requiring urgent after hours service in unsociable hours or pregnancy counselling.

Health professionals can bulk bill patients at their discretion.

You can use these temporary items with existing bulk bill incentive items.

Blood borne viruses, sexual and reproductive health services

GPs can use items 92715-92742 for telehealth services associated with blood borne viruses, sexual and reproductive health.

Assisted Reproductive Technology (ART) and antenatal care are excluded.

These services are:

  • available until 31 December 2021
  • exempt from the existing relationship rule
  • intended to help patient's access medical services where there are barriers due to privacy or limited service availability.

You can find out more about these MBS items in the Department of Health fact sheet.

Nicotine and smoking cessation counselling services

GPs can use items 93680-93705 for face-to-face and telehealth attendances. This includes nicotine and smoking cessation counselling, care and advice.

These items are:

  • available until 30 June 2022
  • exempt from the existing relationship rule
  • intended to help patients access medical services where there are barriers due to privacy or limited service availability.

You can find out more about these MBS items in the Department of Health fact sheet.

Private patients receiving specialist care in-hospital

Temporary specialist MBS items are available if you can’t meet with your patient in-hospital because of COVID-19.

Use these items when you admit your patient into a private or public hospital and you’re either:

  • in a COVID-19 hotspot declared area
  • directed to isolate
  • directed to quarantine.

The items are available until 31 December 2021. These changes help patients to continue to access essential Medicare rebates for consultations.

Telehealth specialist and consultant physician services are eligible for a rebate of 85% of the MBS schedule fee.

Patients are also eligible for Medicare safety net benefits, however private health insurance benefits aren’t payable for these attendances.

Service Telehealth items Telephone items
Specialist 91846 - 91847 91848 - 91849
Consultant physician 92471 - 92473 92425 - 92427
Consultant psychiatrist 92461 - 92466 92501 - 92506
Public health physician 92517 - 92520 92525 - 92528
Neurosurgery 92615 – 92616 92625 – 92626
Anaesthesia 92702 92713
Oral and maxillofacial surgical 54006 - 54007 54011 - 54012

You can find out more about specialist telehealth MBS items on the Department of Health website.

Coronavirus (COVID-19) vaccines support services

GPs and suitably qualified health professionals can use items 93624-93656 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. Patients are expected to have a face-to-face assessment before they get the first, second and subsequent doses of the vaccine.

You can bill this service to Medicare when your patient:

  • is assessed and receives the vaccine
  • has been assessed but doesn’t receive the vaccine for clinical reasons
  • has been assessed but doesn’t consent to the vaccine.

From 11 October 2021 patients who are severely immunocompromised can access a subsequent (third) vaccination. The same second dose suitability assessment items apply.

To provide a COVID-19 vaccine suitability assessment, the vaccine must be available immediately after the assessment in the same location. The supervising GP must be present at the location where the service is being undertaken.

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.

You can only claim the flag fall service item for your first appointment at each location.

In-depth patient assessment

Use items numbers 10660 and 10661 when providing additional assessment and advice related to your patient’s risk and benefits for the COVID-19 vaccine.

Billing requirements:

  • personal attendance by the GP or medical practitioner lasting more than 10 minutes
  • must be bulk-billed
  • provided with COVID-19 vaccine suitability assessment service (93624-93656)
  • can be claimed once per patient per lifetime.

Co-claiming

The vaccine support items can’t be co-claimed with:

  • bulk-billing incentive items 10990, 10991, 10992
  • Aboriginal and Torres Strait Islander health practitioner immunisation item 10988.

COVID-19 vaccine suitability assessment items may be co-claimed with normal attendance items. For example, item number 23 where the patient attends for an unrelated condition and 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 will help us assess the claim.

Patients shouldn’t require more than one vaccine suitability assessment on the same day. However, if there are exceptional circumstances another service can be provided on the same day. These exceptional circumstances must be recorded in the patient’s notes.

You can find more information about these MBS items on the Department of Health’s website.

Additional mental health support

Patients can access up to 10 additional mental health treatment sessions. Medicare covers these sessions.

Your patient is eligible for the sessions if all of the following apply:

  • they have a current mental health treatment plan
  • they’ve had a review with their GP
  • they’ve used all of their previous Medicare covered sessions.

Make sure you use the MBS items when providing extra sessions for your patients. You can find out more about the MBS additional mental health items on the Department of Health website.

These items are available until 30 June 2022.

Support for patients in residential aged care

Patients in residential aged cared facilities can access MBS mental health and multidisciplinary care items during the coronavirus (COVID-19) response.

These items finish on 30 June 2022.

They apply to residents who benefit from referral to allied health services under the following treatment, management or care plans:

  • Multidisciplinary Care Plans
  • GP Management Plans
  • Shared Care Plans
  • Team Care Plans
  • Aboriginal and Torres Strait Islander Health Assessments
  • Mental Health Treatment Plans.

If you travel to residential aged care facilities to provide these services, you can also use flag fall service items:

You can only use them for your first appointment at each facility.

You can find out more about MBS items for aged care residents in these Department of Health fact sheets:

MBS pathology items for coronavirus (COVID-19)

There are certain MBS pathology items to use if you perform pathology tests for COVID-19.

These items will be available until 31 December 2021 and must be bulk billed.

Use items 69479 or 69480 if you perform COVID-19 pathology testing.

Use item 69501 to claim for testing on asymptomatic workers in selected industries.

You can find out more about the MBS pathology items on the Department of Health 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. This will finish on 31 December 2021.

Page last updated: 28 October 2021