Practice nurse items

Information about how to claim services provided by a practice nurse on behalf of a medical practitioner.

Make sure you read the relevant Medicare Benefits Schedule (MBS) item descriptors and explanatory notes at MBS Online.

Patient and claiming eligibility

A practice nurse is someone who is both:

  • either a registered nurse or enrolled as a nurse
  • employed (or services are retained) by a medical practitioner.

Practice nurses can deliver some services on behalf of and under the supervision of medical practitioners. Services must meet certain item requirements, as shown in the table below.

Item Service Patient and claiming eligibility Item requirements
10983 Telehealth patient-end clinical support

This service is available where it’s necessary to assist with a video-conferencing service rendered anywhere in Australia.

You can claim this item if:

  • the nurse provides clinical support to a patient during an eligible videoconferencing consultation with a specialist, consultant physician or psychiatrist
  • the specialist, consultant physician or psychiatrist makes the decision to provide clinical support to the patient.
10987 Health assessment follow up

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

It's also available to children who've received 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.
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:

  • 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.
16400 Antenatal service

You can't claim this item:

  • together with another antenatal attendance item provided to the same patient on the same day by the same practitioner
  • in conjunction 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.

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

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.

Exceptions

Telehealth attendances

If both a nurse and a medical practitioner attend a telehealth consultation, you can only claim either the medical practitioner or nurse attendance item.

If you’re claiming a telehealth patient-end attendance item, you can’t include the time a patient spends with a nurse.

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.

More information

Read more about:

Contact us for MBS item interpretation.

Provide your feedback on our education resources.

Page last updated: 13 April 2022.
QC 33236