Education guide - Aftercare or post-operative treatment
Information about aftercare in the Medicare Benefits Schedule (MBS).
Make sure you read the relevant item descriptions and explanatory notes at MBS Online.
Aftercare is the post-operative care and treatment provided to patients after an operation.
This includes all attendances until recovery and the final check or examination. Aftercare services can take place at a hospital, private rooms or a patient’s home.
MBS fees for most surgical items in MBS Group T8 include an aftercare component.
Some MBS services don’t include aftercare. This is noted in their description. Group T8 items not containing this note include aftercare.
Note: Aftercare for a cosmetic procedure or non-Medicare services don’t attract Medicare benefits. This applies to normal and not normal aftercare services.
You determine an aftercare period based on your patient’s needs. The type and duration of aftercare may vary between patients even if they’ve had the same operation.
Some surgical items include a minimum period of aftercare. This will be noted in the items descriptor or explanatory notes of the MBS.
We set aftercare periods for surgical items to help us accurately assess attendance items claimed after a patient’s operation. These periods don’t determine if a service you’ve provided is aftercare.
Attendances in the aftercare period
Schedule fees for most surgical items include normal post-operative care. This means you can’t bill attendance items for normal aftercare.
However, if the MBS description of the surgical item you performed excludes aftercare in the items description, you can bill attendance items for providing aftercare.
GP attendances and aftercare
If a patient can’t return to the same practitioner who performed the surgical item for aftercare, a different practitioner can bill attendance items for the aftercare they provide.
Specialists and consultant physicians can’t bill an attendance for normal aftercare services in this same situation.
Not normal aftercare
You can bill an attendance item during an aftercare period if the service isn’t normal aftercare.
A service isn’t normal aftercare if you see a patient for:
- an unrelated condition
- complications from the operation.
If an attendance you bill isn’t normal aftercare, you need to tell us by:
- setting the Aftercare Override Indicator in your software
- including ‘not normal aftercare’ in service text. This can either be Not Normal Aftercare, NNAC, NNA.
Delegation of aftercare
You can choose to hand over aftercare services to another specialist or consultant physician.
For example, you may hand over aftercare to another specialist if your patient lives in a rural or remote area and can’t return for aftercare services.
If another specialist or consultant physician provides aftercare, the Medicare benefit can be split between each practitioner. This arrangement is made between the practitioners.
Public patient in a public hospital
Public patients can access in-patient aftercare for free of charge as part of the public hospital service. This includes normal and not normal aftercare.
If a public patient chooses to see a different practitioner privately for aftercare, any post-operative care provided can be billed under an attendance item.
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Page last updated: 1 November 2019
This information was printed 11 August 2020 from https://www.servicesaustralia.gov.au/organisations/health-professionals/topics/education-guide-aftercare-or-post-operative-treatment/33201. It may not include all of the relevant information on this topic. Please consider any relevant site notices at https://www.servicesaustralia.gov.au/individuals/site-notices when using this material.