Consultations

MBS item
Service Claim period
MBS payment (as of November 2016)
3
(Level A) Brief
N/A
$16.95
23 (Level B) Standard: <20 mins
N/A
$37.05
36
(Level C) Long: ≥ 20mins
N/A
$71.70

44

(Level D) Prolonged: ≥ 40 mins
N/A
$105.55
10990
Bulk Billing Item: DVA, under 16s and concession card holders
N/A
Fee: $7.20
Benefit: $6.15
10991
Bulk billing Item: as above for GPs in regional, rural and remote areas and some areas of need as listed in MBS.
N/A
Fee: $10.85
Benefit: $9.25

Health Assessments

MBS item
Service Claim period
MBS payment (as of November 2016)
701
Health Assessment*- Brief (≤30 mins)
*for eligibility, see notes
$59.35
703
Health Assessment* - Standard (30-45 mins)
$137.90
705
Health Assessment*- Long (45-60 mins)
$190.30
707 Health Assessment*- Prolonged (60 mins)
$268.80
715
Aboriginal and/or Torres Strait Islander Health Assessment
May be provided every 9 months
$212.25

Chronic Disease Management for eligible clients

MBS item
Service Claim period
MBS payment (as of November 2016)
721
Preparation of a GP Management Plan
24 months
(min 12 months*)
$144.25
723
Coordinate the development of Team Care Arrangements
24 months
(min 12 months*)
$114.30
729
Contribution by a GP to a Multidisciplinary Care Plan prepared by another provider or
to review a Multidisciplinary Care Plan prepared by another provider
6 months
(min 3 months*)
$70.40
731 Contribution by a GP to a multidisciplinary care plan for a patient in a Residential Aged Care Facility (RACF) prepared by that facility
or
to review of such a plan prepared by a RACF
6 months
(min 3 months*)
$70.40
732 Review of a GP Management Plan
or
Coordinate a review of Team care Arrangements
6 months
(min 3 months*)
$72.05

Practice Nurse

MBS item
Service Claim period
MBS payment (as of November 2016)
10987
Follow up service provided on behalf of medical practitioner for an Indigenous person who has received a health assessment
Maximum 10 per year
$24.00
10997
Provision of monitoring and support for a person with a chronic disease who has a GP Management Plan, Team Care Arrangement or Multidisciplinary Care Plan
Maximum 5 per year $12.00

Individual allied health Services for CDM for eligible patients

MBS item
Service Claim period
MBS payment (as of November 2016)
10950
Aboriginal Health Worker service
Combined maximum of 5 visits per year to eligible patients

Fee: $62.25

Rebate: $52.95

10951
Diabetes Education service
10952
Audiology
10953
Exercise Physiology
10954
Dietetics services
10956
Mental Health service
10958
Occupational Therapy
10960
Physiotherapy
10962
Podiatry
10964
Chiropractic
10966
Osteopathy
10968
Psychology
10970
Speech pathology

Assessment by allied health for groups services

MBS item
Service Claim period
MBS payment (as of November 2016)
81100
Diabetes Education Service - Assessment for Group Services for the management of Type 2 Diabetes
1 per calendar year
$79.85
81110
Exercise Physiology Service - Assessment for Group Services for the management of Type 2 Diabetes
$79.85
81120
Dietetics Service - Assessment for Group Services for the management of Type 2 Diabetes
$79.85

Group services

MBS item
Service Claim period
MBS payment (as of November 2016)
81105
Diabetes Education service - Group Service as provided by a Diabetes Educator
8 services per calendar year
$19.90
81115
Exercise Physiology service - Group Service as provided by an Exercise Physiologist
$19.90
81125
Dietetics Service - Group Service as provided by a Dietetics service
$19.90

GP case conferencing

MBS item
Service Claim period
MBS payment (as of November 2016)
735
GP to organise and coordinate a case conference in a Residential Aged Care facility or a community Case conference or a discharge case conference
(15-20 mins)
Check MBS descriptor as claim period dependant is on other MBS item numbers being clained.
$70.65
739
GP to organise and coordinate a case conference in a Residential Aged Care facility or a community Case conference or a discharge case conference
(20-40 mins)
$120.95
743
GP to organise and coordinate a case conference in a Residential Aged Care facility or a community Case conference or a discharge case conference
(40 mins)
$201.65
871
GP to lead and coordinate a multidisciplinary case conference on a patient with cancer to develop a Multidisciplinary treatment plan
$80.30

GP Participation in case conferencing organised / coordinated by another provider

MBS item
Service  Claim period
MBS payment (as of November 2016)
747
GP to participate in a case conference in a Residential Aged Care Facility or a Community case conference or a discharge case conference
(15-20 mins)
Maximum 5 per 12 month period.
$51.90
750
GP to participate in a case conference in a Residential Aged care Facility or a Community case conference or a discharge case conference
(20-40 mins)
$89.00
758
GP to participate in a case conference in a Residential Aged care Facility or a Community case conference or a discharge case conference
(40 mins)
$148.20
872
GP to participate in a multidisciplinary case conference on a patient with cancer to develop a multidisciplinary treatment plan
$37.40

Medication review

MBS item
Service Claim period
MBS payment (as of November 2016)
900
Domiciliary Medication Management Review (DMMR/HMR) for patients living in the community setting
12 months*
$154.80
903
Residential Medication Management Review (RMMR) - for a permanent resident of a residential aged care facility
12 months*
$106.00

Mental health

MBS item
Time
Service  Claim period
MBS payment (as of November 2016)
2700
≥ 20 mins
GP Mental Health Treatment Plan - GP has not undertaken Mental Health Skills Training
12 months
$70.30
2701 ≥ 40 mins
$103.50
2712
GP Mental Health Care Plan Review
3 months
$70.30
2713
≥ 20 mins
GP Mental Health Consultation - not being associated with a service to which item numbers 2702, 2710 or 2712 apply
Unrestricted
$70.30
2715
≥ 20 mins
GP Mental Health Treatment Plan - GP has completed Mental Health Skills Training
12 months
$90.95
2717 ≥ 40 mins
$131.35
2721

Focused Psychological Strategies - purpose of providing focused psychological strategies for assessed mental disorders by a medical practitioner registered with Medicare Australia. Items are time limited

$90.70
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Consultations

MBS item
Service Claim period
MBS payment (as of November 2016)
3
(Level A) Brief
N/A
$16.95
23 (Level B) Standard: <20 mins
N/A
$37.05
36
(Level C) Long: ≥ 20mins
N/A
$71.70

44

(Level D) Prolonged: ≥ 40 mins
N/A
$105.55
10990
Bulk Billing Item: DVA, under 16s and concession card holders
N/A
Fee: $7.20
Benefit: $6.15
10991
Bulk billing Item: as above for GPs in regional, rural and remote areas and some areas of need as listed in MBS.
N/A
Fee: $10.85
Benefit: $9.25

Health Assessments

MBS item
Service Claim period
MBS payment (as of November 2016)
701
Health Assessment*- Brief (≤30 mins)
*for eligibility, see notes
$59.35
703
Health Assessment* - Standard (30-45 mins)
$137.90
705
Health Assessment*- Long (45-60 mins)
$190.30
707 Health Assessment*- Prolonged (60 mins)
$268.80
715
Aboriginal and/or Torres Strait Islander Health Assessment
May be provided every 9 months
$212.25

Chronic Disease Management for eligible clients

MBS item
Service Claim period
MBS payment (as of November 2016)
721
Preparation of a GP Management Plan
24 months
(min 12 months*)
$144.25
723
Coordinate the development of Team Care Arrangements
24 months
(min 12 months*)
$114.30
729
Contribution by a GP to a Multidisciplinary Care Plan prepared by another provider or
to review a Multidisciplinary Care Plan prepared by another provider
6 months
(min 3 months*)
$70.40
731 Contribution by a GP to a multidisciplinary care plan for a patient in a Residential Aged Care Facility (RACF) prepared by that facility
or
to review of such a plan prepared by a RACF
6 months
(min 3 months*)
$70.40
732 Review of a GP Management Plan
or
Coordinate a review of Team care Arrangements
6 months
(min 3 months*)
$72.05

Practice Nurse

MBS item
Service Claim period
MBS payment (as of November 2016)
10987
Follow up service provided on behalf of medical practitioner for an Indigenous person who has received a health assessment
Maximum 10 per year
$24.00
10997
Provision of monitoring and support for a person with a chronic disease who has a GP Management Plan, Team Care Arrangement or Multidisciplinary Care Plan
Maximum 5 per year $12.00

Individual allied health Services for CDM for eligible patients

MBS item
Service Claim period
MBS payment (as of November 2016)
10950
Aboriginal Health Worker service
Combined maximum of 5 visits per year to eligible patients

Fee: $62.25

Rebate: $52.95

10951
Diabetes Education service
10952
Audiology
10953
Exercise Physiology
10954
Dietetics services
10956
Mental Health service
10958
Occupational Therapy
10960
Physiotherapy
10962
Podiatry
10964
Chiropractic
10966
Osteopathy
10968
Psychology
10970
Speech pathology

Assessment by allied health for groups services

MBS item
Service Claim period
MBS payment (as of November 2016)
81100
Diabetes Education Service - Assessment for Group Services for the management of Type 2 Diabetes
1 per calendar year
$79.85
81110
Exercise Physiology Service - Assessment for Group Services for the management of Type 2 Diabetes
$79.85
81120
Dietetics Service - Assessment for Group Services for the management of Type 2 Diabetes
$79.85

Group services

MBS item
Service Claim period
MBS payment (as of November 2016)
81105
Diabetes Education service - Group Service as provided by a Diabetes Educator
8 services per calendar year
$19.90
81115
Exercise Physiology service - Group Service as provided by an Exercise Physiologist
$19.90
81125
Dietetics Service - Group Service as provided by a Dietetics service
$19.90

GP case conferencing

MBS item
Service Claim period
MBS payment (as of November 2016)
735
GP to organise and coordinate a case conference in a Residential Aged Care facility or a community Case conference or a discharge case conference
(15-20 mins)
Check MBS descriptor as claim period dependant is on other MBS item numbers being clained.
$70.65
739
GP to organise and coordinate a case conference in a Residential Aged Care facility or a community Case conference or a discharge case conference
(20-40 mins)
$120.95
743
GP to organise and coordinate a case conference in a Residential Aged Care facility or a community Case conference or a discharge case conference
(40 mins)
$201.65
871
GP to lead and coordinate a multidisciplinary case conference on a patient with cancer to develop a Multidisciplinary treatment plan
$80.30

GP Participation in case conferencing organised / coordinated by another provider

MBS item
Service  Claim period
MBS payment (as of November 2016)
747
GP to participate in a case conference in a Residential Aged Care Facility or a Community case conference or a discharge case conference
(15-20 mins)
Maximum 5 per 12 month period.
$51.90
750
GP to participate in a case conference in a Residential Aged care Facility or a Community case conference or a discharge case conference
(20-40 mins)
$89.00
758
GP to participate in a case conference in a Residential Aged care Facility or a Community case conference or a discharge case conference
(40 mins)
$148.20
872
GP to participate in a multidisciplinary case conference on a patient with cancer to develop a multidisciplinary treatment plan
$37.40

Medication review

MBS item
Service Claim period
MBS payment (as of November 2016)
900
Domiciliary Medication Management Review (DMMR/HMR) for patients living in the community setting
12 months*
$154.80
903
Residential Medication Management Review (RMMR) - for a permanent resident of a residential aged care facility
12 months*
$106.00

Mental health

MBS item
Time
Service  Claim period
MBS payment (as of November 2016)
2700
≥ 20 mins
GP Mental Health Treatment Plan - GP has not undertaken Mental Health Skills Training
12 months
$70.30
2701 ≥ 40 mins
$103.50
2712
GP Mental Health Care Plan Review
3 months
$70.30
2713
≥ 20 mins
GP Mental Health Consultation - not being associated with a service to which item numbers 2702, 2710 or 2712 apply
Unrestricted
$70.30
2715
≥ 20 mins
GP Mental Health Treatment Plan - GP has completed Mental Health Skills Training
12 months
$90.95
2717 ≥ 40 mins
$131.35
2721

Focused Psychological Strategies - purpose of providing focused psychological strategies for assessed mental disorders by a medical practitioner registered with Medicare Australia. Items are time limited

$90.70

All information is current as at 1 November 2016.

Health Assessments

Service type Health Assessments
MBS 701-Brief (≤30 mins); MBS 703 - Standard (30-45 mins);
MBS 705-Long (45-60 mins); MBS 707 - Prolonged (60 mins or more)
Time related health assessments are determined by the complexity of the client's presentation and the specific requirements that have been established for each eligible client group.
Ensure patient / client eligibility Eligibility Criteria
A) People aged 45-49 years with a high risk of developing type 2 Diabetes as per DRAT*.
B) People aged between the age of 45 and 49 who are at risk of developing a chronic disease.
C) People aged 75 years and older.
D) Permanent residents of a Residential Aged Care Facility.
E) People who have an Intellectual disability.
F) Humanitarian entrants who are resident in Australia with access to Medicare services, including Refugees and Special Humanitarian Program and Protection program entrants.
G) Former serving members of the Australian Defence Force including former members of permanent and reserve forces.
Obtain patient consent Explaining the service any other associated costs with the client, gaining and recording consent to proceed.
Role of the GP Ultimate responsibility for delivery of the service, which must include a personal attendance by a GP with the client which may or may not include the clients' carer or representative as necessary.
Role of the PN or AHW To assist in the collection of information, providing patients with information about recommended interventions at the direction of the GP.
Health assessment elements

Information collection, including taking a patient history and undertaking or arranging examinations  and investigations as required; making an overall assessment of the patient; recommending appropriate interventions; providing advice and information to the patient; keeping a record of the health assessment, and offering the patient a written report about the health assessment, with recommendations about matters covered by the health assessment; offering the patient's carer (if any, and if the medical practitioner considers it appropriate and the patient agrees) a copy of the report or extracts of the report relevant to the carer.

Frequency of service (Once every 3 years)
People aged 45-49 years with a high risk of developing type 2 Diabetes as per DRAT.
(Once only)
People aged between the age of 45 and 49 who are at risk of developing a chronic disease; Humanitarian entrants who are resident in Australia with access to Medicare services, including Refugees and Special Humanitarian Program and Protection program entrants; Former serving members of the Australian Defence Force including former members of permanent and reserve forces.
(Provided annually)
People aged 75 years and older; Comprehensive Medical Assessment for Permanent residents of a Residential Aged Care Facility; People who have an Intellectual disability.
Associated MBS items Item 701; Item 703; Item 705; Item 707 Health Assessments
Further information MBS Online - Medicare Benefits Schedule
Australian Department of Health - Primary care (GP, nursing, allied health)
Australian Department of Human Services - Education services for health professionals

Health Assessments for Aboriginal and Torres Strait Islanders

Service type Aboriginal and Torres Strait Islander Health Assessment
MBS 715

Ensure patient / client eligibility Eligibility Criteria
A person who is of Aboriginal or Torres Strait Islander descent in the following age ranges Children between ages of 0 and 14 years;  Adults between the ages of 15 and 54 years and Older people over the age of 55 years
Obtain patient consent Explaining the service and any other associated costs with the client, gaining and recording consent to proceed
Role of the GP Ultimate responsibility for delivery of the service, which must include a personal attendance by a GP
Role of the PN or AHW To assist in the collection of information, providing patients with information about recommended interventions at the direction of the GP
Develop a plan Elements of a Health Assessment
Information collection, including taking a patient history  and undertaking or arranging examinations  and investigations as required; making an overall assessment of the patient; recommending appropriate interventions;  providing advice and information to the patient; keeping a record of the health assessment, and offering the patient a written report about the health assessment, with recommendations about matters covered by the health assessment and in the instance where required offering a copy or extracts to the carer. At each life stage ie children; adult and older person there specific criteria related to obtaining a patient history; psychosocial examination and investigations.
Frequency of service Many be provided every 9 months.
Associated MBS items If after receiving a health assessment, a patient who is fifteen years and over but under the age of 55 years, is identified as having a high risk of developing type 2 diabetes as determined by the DRATS Australian Type 2 Diabetes Risk Assessment Tool, the medical practitioner may refer that person to a subsidised lifestyle modification program, along with other possible strategies to improve the health status of the patient.
Further information MBS Online - Medicare Benefits Schedule
Australian Department of Health - Primary care (GP, nursing, allied health)
Australian Department of Human Services - Education services for health professionals

More information

GP-led care planning and access to MBS-rebates for allied health services for clients with chronic disease and complex care needs

Clients living in the community with at least one medical condition that has been present for more than six months or is terminal and requires care from at least 3 collaborating health care providers (including the GP) are eligible for up to five Medicare rebates per calendar year for allied health services provided by Medicare-registered providers if during the last two years their usual GP has prepared a care plan for them and:

Note that the GP must refer to allied health providers using the referral form issued by the Department of Health, or another form that is similar and contains all the components of that form.

Chronic Disease management items are designed for patients who require a structured approach, including those requiring ongoing care from a multidisciplinary team.

Client eligibility for MBS-rebates for allied health services

For clients living in the community a chronic medical condition is one that has been (or is likely to be) present for six months or longer.

Patients who have a chronic medical condition and complex care needs and are being managed by their GP under a GP Management Plan (MBS item 721) and Team Care Arrangements (MBS item 723) are eligible for up to five Medicare rebates per calendar year for certain allied health services on referral from their GP.
GPs are required to refer patients for services recommended in their care plan, using the referral form issued by the Department or a form that contains all the components of the Department's form.

Care planning with general practice

The Victorian Government has provided advice to agencies in relation to involving GPs through GPMP.

All information is current as at 1 November 2016.

Care planning - management of Chronic Disease conditions for patients living in the community

Service type Preparation of a GP Management Plan MBS 721
or
Review of a GP Management Plan MBS Item 732
and
Provision of monitoring and support for a person with a chronic disease by a practice nurse or Aboriginal and Torres Strait Islander health practitioner MBS Item 10997
Ensure patient / client eligibility Eligibility Criteria
MBS Item 721/732

Client has at least 1 medical condition that has been or is likely to be present for at least 6 months or is terminal.
or
MBS item 10997
Client has a GP Management Plan, Team Care Arrangements or Multidisciplinary Care Plan in place; and the service is consistent with the GP Management Plan, Team Care Arrangements or Multidisciplinary Care Plan.
Obtain patient consent Explaining the service any other associated costs with the client, gaining and recording consent to proceed.
Role of the GP Ultimate responsibility for delivery of the service, which must include a personal attendance by a medical practitioner with the client which may or may not include the clients carer or representative as necessary.
Role of the PN or AHW To assist in client assessment, identification of client needs and coordinating care and services.
Develop a plan Assess the client to identify and confirm needs, problems and conditions. Agree on management goals with the client for changes to be achieved by the treatment and services identified in the plan. Preparation of a comprehensive written plan describing the client's needs, goals, proposed actions, treatment and services and setting a review date.
Frequency of service MSB item 721
Maximum of 1 per client in a 12 month period.
The recommended frequency is every two year, with 6 monthly reviews.
MBS item 732
Maximum of 1 per client in a three month period.
The recommended frequency is every six months
MBS Item 10997
Maximum of 5 services per patient in a calendar year.
Associated MBS items Item 723 Coordination of Team Care Arrangements; Item 732 Coordinate a review of Team Care Arrangements.
More information MBS Online - Medicare Benefits Schedule
Australian Department of Health - Primary care (GP, nursing, allied health)
Australian Department of Human Services - Education services for health professionals

Care planning - management of Chronic Disease conditions for patients living in the community

Service type MBS Item 723
GP to coordinate the development of Team Care Arrangements

Or
MBS Item 732
Coordinate a review of Team care Arrangements

Ensure patient / client eligibility Eligibility Criteria
The patient has at least one medical condition that has been present for at least six months; or is terminal, and requires ongoing care from at least three collaborating health or care providers, each of whom provides a different kind of treatment or service to the patient, and at least one of whom is a GP.
Obtain patient consent Initial explanation of the service and any other associated costs to the client, gaining and recording consent to proceed by the GP.
Role of the GP Consult with at least two collaborating providers, each of whom will provide a different kind of treatment or service to the patient, preparation of  a document ( see below) Explaining the steps involved in the development of the arrangements to the patient and the patient's carer; discusses with the patient the collaborating providers who will contribute to the development of the TCAs and provide treatment and services to the patient under those arrangements; and  record the patient's agreement to the development of TCAs; give copies of the relevant parts of the document to the collaborating providers; offer a copy of the document to the patient and the patient's carer (if any), and adds a copy of the document to the patient's medical records.
Role of the PN or AHW May assist in patient assessment, identification of patient needs and making arrangements for services.
Prepare documentation
Prepare a document that describes:
A) treatment and service goals for the patient;
B) treatment and services that collaborating providers will provide to the patient;
 C) actions to be taken by the patient; and D)arrangements to review.
Frequency of service MSB item 723
Maximum of 1 per client in a 12 month period.
MBS item 732
Maximum of once per client in a three month period.
May be claimed every 12 months
Associated MBS items MBS Item 721 Preparation of a GP management Plan; MBS item 732 Review of a GP Management plan; MBS Item 10997 Monitoring and Support by PN or AHW; MBS Item 10950- 10970 Individual Allied health Services for Chronic Disease Management
More information MBS Online - Medicare Benefits Schedule
Australian Department of Health - Primary care (GP, nursing, allied health)
Australian Department of Human Services - Education services for health professionals

GP care planning - management of Chronic Disease conditions for patients living in the community

Service type MBS Item 729
Contribution by a GP to a Multidisciplinary Care Plan, or to a Review of a Multidisciplinary Care Plan, prepared by another provider.
or
MBS Item 731
Contribution to a Multidisciplinary Care Plan, or to a review of a multidisciplinary care plan, for a resident in an aged care facility (RACF).
Ensure patient / client eligibility Eligibility Criteria
Patient has at least 1 medical condition that has been or is likely to be present for at least 6 months or is terminal.
MBS Item 729
Available to: patients in the community; both private and public in-patients being discharged from hospital.
It is not available to patients in a residential aged care facility
Or
MBS item 731
Available to residents in a residential aged care facility only.
Obtain patient consent Explaining the service any other associated costs with the patient, gaining and recording consent to proceed.
Role of the GP Prepare part of the plan or amendments to the plan and documenting in the patient's medical records; or to give advice to a person who prepares or reviews the plan and documents advice given in the patient's medical notes.
Develop a plan Developing a written plan for a patient that describes treatment and services to be provided to the patient by the collaborating providers
Item 729

This is  prepared by a either GP in consultation with two other collaborating providers, each of whom provides a different kind of treatment or service to the patient, and one of whom may be another GP; or
a collaborating provider in consultation with at least two other collaborating providers, each of whom provides a different kind of treatment or services to the patient;
Item 731
This is prepared by a collaborating provider, in consultation with at least two other collaborating providers, each of whom provides a different kind of treatment or services to [...?]
Frequency of service MSB item 729
Minimum claiming period every 3 months
MBS 731
Minimum claiming period every 3 months
More information MBS Online - Medicare Benefits Schedule
Australian Department of Health - Primary care (GP, nursing, allied health)
Australian Department of Human Services - Education services for health professionals

GP care planning - Group Allied Health Services for people with Type 2 Diabetes

Service type Assessment for Group Services for the Management of Type 2 Diabetes
Diabetes education  provided to a person by an eligible provider for the purposes of ASSESSING a person's suitability for group services for the management of type 2 diabetes, including taking a comprehensive patient history, identifying an appropriate group services program based on the patient's needs, and preparing the person for the group services.
MBS Item 81100 (Diabetes Education Service) MBS Item 81110 (Exercise Physiology) MBS Item 81120 (Dietetics Service)
Ensure patient / client eligibility Eligibility Criteria
The service is provided to a person who has type 2 diabetes; and is being managed by a GP under a GP Management Plan [ie item 721 or 732], or if the person is a resident of an aged care facility, their GP has contributed to a multidisciplinary care plan item 731.
Obtain patient consent Initially explanation of the service and any other associated costs to the client, gaining and recording consent to proceed by the GP, reiterated and confirmed by the Allied health care provider.
Role of the GP To manage the person using a GP Management Plan (Item 721 or 732), or to contributed to a multidisciplinary care plan for those living in a RACF (Item 731).
To refer the eligible patient to an eligible provider using a referral form that contains all the key components of the form issued by the Department of Health & Human Services.
Role of the AHP Assessing a person's suitability for group services for the management of type 2 diabetes, including taking a comprehensive patient history, identifying an appropriate group services program based on the patient's needs, and preparing the person for the group services.
Feedback and contribution Following the service the eligible provider after the service gives a written report to the referring GP.
Frequency of service MSB item 81100; 81110 and 81120
Maximum of 1 per client in a calendar year.
Associated MBS items Item 721 Preparation of a General Practice management Plan: Item 723 Coordination of Team care Arrangements; Item 732 Review of a GP Management Plan and/or Coordinate a review of Team Care Arrangements; Item 731 Contribution by a GP to a MD care plan for a patient in a RACF.
More information MBS Online - Medicare Benefits Schedule
Australian Department of Health - Primary care (GP, nursing, allied health)
Australian Department of Human Services - Education services for health professionals

Service type Diabetes Education Service- Group Services for the Management of Type 2 Diabetes
MBS Item 81105 (Diabetes Educator) MBS Item 81115 (Exercise Physiology) MBS Item 81125 (Dietetics Service)

Diabetes education health service provided to a person by an eligible provider as a GROUP SERVICE for the management of type 2 diabetes.
Ensure patient / client eligibility Eligibility Criteria
The person has been assessed as suitable for a type 2 diabetes group service under assessment item 81100, 81110 or 81120; and the service is provided to a person who is part of a group of between 2 and 12 people.
Obtain patient consent

Initially explanation of the service and any other associated costs to the client, gaining and recording of consent during the assessments phase, reiterated and confirmed by the Allied health care provider facilitating the group sessions.

Role of the GP To manage the person using a GP Management Plan (Item 721 or 732) or to contributed to a multidisciplinary care plan for those living in a RACF (Item 731). To refer the eligible patient to an eligible provider using a referral form that contains all the key components of the form issued by the Department of Health. There is no additional requirement for a Team Care Arrangement (item 723) in order for the patient to be referred for group allied health services.
Role of the AHP Group allied health service providers are strongly encouraged to deliver multidisciplinary group services programs that allow patients to benefit from a range of interventions designed to assist in the management of their type 2 Diabetes. On completion of the group services program, each allied health professional must provide, or contribute to, a written report back to the referring GP in respect of each patient.  The report should describe the group services provided for the patient and indicate the outcomes achieved.
Feedback and contribution On completion of the group services program, each allied health professional must provide, or contribute to, a written report back to the referring GP in respect of each patient.  The report should describe the group services provided for the patient and indicate the outcomes achieved.
Frequency of service

Patients are eligible for up to eight group allied health services in total (items 81105, 81115 and 81125 inclusive) per calendar year.

Associated MBS items

Item 721 Preparation of a GP Management Plan; Item 732 Review of a GP Management Plan; Item 731 Contribution by a GP to a Multidisciplinary care plan for a patient in a RACF.

More information MBS Online - Medicare Benefits Schedule
Australian Department of Health - Primary care (GP, nursing, allied health)
Australian Department of Human Services - Education services for health professionals

All information is current as at 1 November 2016.

MBS items for Case Conferencing by a GP in a Residential Aged Care Facility or a community case conference or a discharge case conference

Service type GP case conferencing
MBS item 735 (15-20 mins); MBS item 739 (20-40 mins); MBS item 743 (40 mins)

GP to organise or coordinate a case conference in a Residential Aged Care facility or a community case conference or a discharge case conference.  
or
MBS item 871
GP to lead and coordinate a multidisciplinary case conference on a patient with cancer to develop a multidisciplinary treatment plan.
Ensure patient / client eligibility For patients with at least one medical condition that: has been (or is likely to be) present for at least six months; or is terminal; and require ongoing care from a multidisciplinary case conference team which includes: a medical practitioner; and at least two other members, each of whom provides a different kind of care or service to the patient and is not a family carer of the patient, and one of whom may be another medical practitioner.
Obtain patient consent The GP must explain to the patient the nature of a multidisciplinary case conference, and ask the patient for their consent to the conference taking place; which must be documented in the patient's notes.
Role of the GP To explain to the patient the nature of a multidisciplinary case conference, and ask the patient for their agreement to the conference taking place; record the patient's agreement to the conference; record he day on which the conference was held, and the times at which the conference started and ended; record the names of the participants; offer the patient and the patient's carer (if any, and if the practitioner considers it appropriate and the patient agrees) a summary of the conference and provide this summary to other team members; discuss the outcomes of the conference with the patient and the patient's carer (if any, and if the practitioner considers it appropriate and the patient agrees); and record all matters discussed and identified by the case conferencing team and put a copy of that record in the patient's medical records.
Case conference team
Examples of persons who, for the purposes of care planning and case conferencing may be included in a multidisciplinary care team are allied health professionals: Aboriginal health care workers; asthma educators; audiologists; dental therapists; dentists; diabetes educators; dietitians; mental health workers; occupational therapists; optometrists; orthoptists; orthotists or prosthetists; pharmacists; physiotherapists; podiatrists; psychologists; registered nurses; social workers; speech pathologists. A team may also include home and community service providers, or care organisers, such as: education providers; "meals on wheels" providers; personal care workers; probation officers. The patient's informal or family carer may be included as a formal member of the team in addition to the minimum of three health or care providers.  The patient and the informal or family carer do not count towards the minimum of three.
Elements of a case conference
Elements of a case conference (MBS Items 735-758)
Process by which a multidisciplinary team discusses a patients history; identifies the patients multidisciplinary care needs; identifies the outcomes to be achieved by members of the case conference team giving care and service to the patient; identifies tasks that need to be undertaken to achieve these outcomes and allocates those tasks to members of the case conference team and assess whether previously identified outcomes if any have been achieved.
Frequency of service A rebate will not be paid within 12 months of a previous claim for item 721, or within three months of a claim for items 729, 731 or 732 (for a review of a GP management plan), except where there are exceptional circumstances that require the preparation of a new GP management plan.
Further information MBS Online - Medicare Benefits Schedule
Australian Department of Health - Primary care (GP, nursing, allied health)
Australian Department of Human Services - Education services for health professionals

MBS items for GP participation in case conferencing in a Residential Aged Care Facility; Community case conference or a discharge case conference.

Service type GP participation in case conferencing
MBS item 747, MBS item 750, MBS item 758

GP to participate in a case conference organised/ coordinated by another provide in a Residential Aged Care facility or a community case conference or a discharge case conference.  
or
MBS item 872
GP to participate in a multidisciplinary case conference on a patient with cancer to develop a multidisciplinary treatment plan.
Ensure patient / client eligibility For patients with at least one medical condition that: has been (or is likely to be) present for at least six months; or is terminal; and require ongoing care from a multidisciplinary case conference team which includes: a medical practitioner; and at least two other members, each of whom provides a different kind of care or service to the patient and is not a family carer of the patient, and one of whom may be another medical practitioner.
Obtain patient consent The provider must explain to the patient the nature of a multidisciplinary case conference, and ask the patient for their consent and document in the patient's notes.
Role of the GP Attendance by a GP as a member of a case conference team, to participate in a case conference in a residential aged care facility or a community case conference or a discharge case conference (not being a service associated with a service to which items 721 to 732 apply).
Role of the case conferencing provider
The patient does not have to be present at a case conference, though in some cases their presence may be appropriate.
Arrange for the case conference to occur face-to-face, by phone or by video conference, or through a combination of these. The minimum three care providers (including the GP) must be in communication with each other throughout the conference.
Document all meeting and outcomes.  
Provide copies of outcomes to all participants.
Develop a plan Discuss a patient's history; and
Identify the patient's multidisciplinary care needs; and
Identify outcomes to be achieved by each team member; and
Identify tasks that need to be undertaken to achieve these outcomes, and allocate those tasks to members of the case conference team; and
Assess whether previously identified outcomes (if any) have been achieved.
Frequency of service MBS item 747 (15-20 mins); MBS item 750 (20-40 mins); MBS item 758 (40 mins)
Maximum of 5 conferences per resident in 12 month period.
Further information MBS Online - Medicare Benefits Schedule
Australian Department of Health - Primary care (GP, nursing, allied health)
Australian Department of Human Services - Education services for health professionals

All information is current as at 1 November 2016.

Completion of the annual cycle of care for patients with Diabetes Mellitus

Service type Consultation at consulting rooms by a GP in which the annual cycle of care in completed for a patient
 MBS Item 2620 (5-25 mins); MBS Item 2622 (25-45 mins); MBS Items 2624 (> 45 mins)
Level B MBS 2517; Level C MBS 2521; Level D MBS Item 2525
Consultation at a place other than consulting rooms by a GP
MBS Item 2622 (5-25 mins); MBS Item 2633 (25-45 mins); MBS Items 2635 (>45mins)
MBS Item 2518; MBS Item 2522; MBS Item 2526
Ensure patient / client eligibility Eligibility Criteria
A person with diagnosed Diabetes Mellitus
Role of the GP Level of attendance correlates to the time spent, complexity of the consultation, and completing the minimum requirements of a cycle of care.
Level A
GP to take a short patient history; limited examination and management if required
Level B
GP to take patient history; perform a clinical examination; arrange any necessary investigations; implement a management plan; and provide appropriate preventive health care.
Level C
GP to take patient history; perform a clinical examination; arrange any necessary investigations; implement a management plan; and provide appropriate preventive health care.
Role of the PN or AHW To identify eligible clients, establish or manage a patient recall and practitioner reminder system.
Elements of a cycle of care Every visit
Self care education; review diet; physical activity; ascertain and review smoking status; check weight.
Every 6 months
Measure weight; height and calculate BMI; Measure Blood pressure; Foot examination.
Every Year
Measurement of HbA1c; Lipid profile; Micro-albuminuria and eGFR.
Every 2 years
Comprehensive eye assessment.
Period of completion Over a period of 11 and up to 13 months.
Further information MBS Online - Medicare Benefits Schedule
Australian Department of Health - Primary care (GP, nursing, allied health)
Australian Department of Human Services - Education services for health professionals

Completion of the annual cycle of care for patients with Asthma

Service type Consultation at consulting rooms by a GP in which the asthma cycle of care is completed
 Level B MBS Item 2546 (<20 mins); Level C MBS Item 2552 (20 mins); Level D MBS Items 2558 (40 mins)
or
Consultation at a place other than consulting rooms by a GP in which the asthma cycle of care is completed
Level B MBS Item 2547 (<20 mins); Level C MBS Item 2553 (20 mins); Level D MBS Items 2559 (40 mins)
Ensure patient / client eligibility Eligibility Criteria
Patients who meet the following criteria can be assumed to have been assessed as having moderate to severe asthma: Symptoms on most days, OR Use of preventer medication, OR Bronchodilator use at least 3 times per week, OR hospital attendance or admission following an acute exacerbation of asthma.
Role of the GP Level of attendance correlates to the time spent, complexity of the consultation, and obtaining a cervical smear from the identified target group.
Level A
GP to take a short patient history; limited examination and management if required.
Level B
GP to take patient history; perform a clinical examination; arrange any necessary investigations; implement a management plan; and provide appropriate preventive health care.
Level C
GP to take patient history; perform a clinical examination; arrange any necessary investigations; implement a management plan; and provide appropriate preventive health care.
Role of the PN or AHW To identify eligible clients, establish or manage a patient recall and practitioner reminder system.
Elements of a cycle of care At a minimum the Asthma Cycle of Care must include: - at least 2 asthma related consultations within 12 months for a client with moderate to severe asthma (at least 1 ( the review) is a consultation that was planned at a previous consultation) - documented diagnosis and assessment of level of asthma control and severity of asthma - review of the clients use of and access to asthma related medication and devices - provision to the client of a written asthma action plan (if the client is unable to use a written asthma action plan - discussion with the client about an alternative method of providing an asthma action plan, and documentation of the discussion in the client's medical records)- provision of asthma self-management education to the client.
Claiming period

Each 12 month period unless clinically indicated by exceptional circumstances.

Further information MBS Online - Medicare Benefits Schedule
Australian Department of Health - Primary care (GP, nursing, allied health)
Australian Department of Human Services - Education services for health professionals
National Asthma Council Australia

Taking a Cervical Smear from a Person who is unscreened or Significantly Under-screened

Service type

Provision of a cancer screening service for a person who is unscreened or significantly under-screened.

Consultation at consulting rooms by a GP in which a cervical smear is taken:
Level A MBS Item 2497; Level B MBS Item 2501 (<20 mins); Level C MBS Item 2504 (20 mins); Level D MBS Items 2507 (40 mins)

Consultation at a place other than consulting rooms by a GP in which a cervical smear is taken:
Level B MBS Item 2503 (<20 mins); Level C MBS Item 2506 (20 mins); Level D MBS Items 2509 (40 mins)

Ensure patient / client eligibility Eligibility Criteria
Applies only to a person between the ages of 20 and 69 years inclusive who has a cervix, has had intercourse and has not had a cervical smear in the last four years.
Role of the GP Level of attendance correlates to the time spent, complexity of the consultation, and obtaining a cervical smear from the identified target group.
Level A
GP to take a short patient history; limited examination and management if required.
Level B
GP to take patient history; perform a clinical examination; arrange any necessary investigations; implement a management plan; and provide appropriate preventive health care.
Level C
GP to take patient history; perform a clinical examination; arrange any necessary investigations; implement a management plan; and provide appropriate preventive health care.
Role of the PN or AHW To identify eligible clients, establish or manage a patient recall and practitioner reminder system.
Frequency of service

Once every 4 years.

Further information MBS Online - Medicare Benefits Schedule
Australian Department of Health - Primary care (GP, nursing, allied health)
Australian Department of Human Services - Education services for health professionals

All information is current as at 1 November 2016.

Medication Management reviews

Service type Domiciliary Medication Management Review (DMMR) or Home Medicines Review
MBS Item 900
Or
Residential Medication Management Review (RMMR)
MBS Item 903
Ensure patient / client eligibility Eligibility Criteria
For clients  who would benefit from a review of their medication due to risk factors such as their co-morbidities, age or social circumstances, the type and complexity of their medications or a lack of knowledge and understanding to use medicines effectively.
MBS item 900
Available to clients living in the community who meet the criteria.
MBS Item 903
Available to clients who are permanent residents in a Residential Aged Care Facility (RACF).
Obtain patient consent Explaining the service any other associated costs with the client, gaining and recording consent to proceed.
Role of the GP MBS item 900
Assesses the clients medication management needs, obtains the clients consent; refers the patient to a community pharmacy or an accredited pharmacist for a DMMR, provides relevant clinical information required for the review, discusses with the reviewing pharmacist the results of that review including suggested medication management strategies; and develops a written medication management plan following discussion with the client
MBS Item 903
Discusses and obtains consent for an RMMR from the new or existing resident; collaborates with the reviewing pharmacist regarding the pharmacy component of the review; provides input from the resident's Comprehensive Medical Assessment (CMA), or if a CMA has not been undertaken, provides relevant clinical information for the resident's RMMR; discusses findings of the pharmacist review and proposed medication management strategies with the reviewing pharmacist (unless exceptions apply); develops and/or revises a written medication plan for the resident; and consults with the resident to discuss the medication management plan and its implementation.
Risk factors for medication related adverse events conference A client currently taking five or more regular medications; more than 12 doses of medication per day; significant changes made to medication in the last three months; medications with a narrow therapeutic index or medications requiring therapeutic monitoring; symptoms suggestive of an adverse drug reaction; sub-optimal response to treatment with medicines; suspected non-compliance or inability to manage medication related therapeutic devices; difficulty managing their own medicines because of literacy or language difficulties, dexterity problems or impaired sight, confusion/dementia or other cognitive difficulties; patients attending a number of different doctors, both general practitioners and specialists; and recent discharge from a facility / hospital (in the last four weeks).
Frequency of service

MBS Item 900 and MBS Item 903
Every 12 months unless there has been a significant change in the clients condition or medication regime.

Further information MBS Online - Medicare Benefits Schedule
Australian Department of Health - Primary care (GP, nursing, allied health)
Australian Department of Human Services - Education services for health professionals

All information is current as at 1 November 2016.

Service type Management of bulk billed services
Provision of unreferred services
Medical Services
MBS Item 10990; MBS Item 10991(Eligible areas); MBS Item 10992 (After hours)
Diagnostic Imaging
MBS Item 64990; MBS Item 64991 (Eligible area)
Pathology Services
MBS Item 74990; MBS Item 74991 (Eligible area)
Ensure patient / client eligibility Eligibility Criteria
For all clients under the age of 16 or for Commonwealth concession card holders who are not admitted patients of a day hospital or day care facility, and provided from a practice location in either any or an eligible area. Refer to the Medicare Benefits Scheme website for a comprehensive list of eligible areas.
Service requirements
The service must be bulk billed and then the bulk billing incentive item can be claimed in conjunction with it. The bulk billing incentive must also be bulk billed.
Frequency of claims
As long as the business rules for the unreferred medical service are met, and the business rules for the bulk billing bonus items are also met, there are no limits as to the number of bulk billing item numbers that can be claimed for that batch.
Further information MBS Online - Medicare Benefits Schedule
Australian Department of Health - Primary care (GP, nursing, allied health)
Australian Department of Human Services - Education services for health professionals

All information is current as at 1 November 2016.

About practice nurse MBS item numbers

Medicare rebates are available where practice nurses (or Aboriginal health workers) provide specific types of services on behalf of a general practitioner. These items are for:

A summary of the relevant MBS items is provided on this page under 'Practice nurse services'.

Practice Nurse Incentive Program

The Commonwealth government introduced the Practice Nurse Incentive Program (PNIP) on 1 January 2012. The program provides incentive payments to eligible general practices to offset the costs of employing a practice nurse and support an expanded role for nurses working in general practice.

General practices, including those in urban areas as well as Aboriginal Medical Services and Aboriginal Community Controlled Health Services, may be eligible for these incentive payments. One of the eligibility requirements is that the practice is accredited under the Royal Australian College of General Practitioners Standards for general practice.

Payments are made to eligible general practices that apply for the PNIP. Practices not eligible for incentive payments under the PNIP may be eligible for grand parenting payments if they are financially disadvantaged by the removal of the six MBS practice nurse items related to immunisation, wound management and pap smears.

For further information about the range of financial incentives available through the PNIP, visit the Medicare website.

Practice nurses services

Service type MBS item 10983 Patient end Telehealth Service - in the community
MBS item 10984 Patient end Telehealth Service - in a RACF

MBS item 10987 Follow up service for a person who has received an Aboriginal and Torres Strait Islander Health check
MBS Item 10997 Monitoring and support of a client with a chronic disease
MBS Item 10987 Follow up services for an Indigenous person following a Health Assessment
MBS Item 16400 Antenatal Service
These services are provided by Practice Nurses; Aboriginal health workers or Midwives (Item 16400) on behalf of and under the supervision of a GP.
Eligibility criteria
Access Criteria
MBS Item 10983

The patient is located both within a telehealth eligible area; and at the time of the attendance is at least 15 kms by road from the specialist, physician or psychiatrist.
MBS item 10984
The patient is receiving care in a RACF.
MBS Item 10987
For an Indigenous patient who has received an Aboriginal and Torres Strait Islander people's Health Assessment.
MBS Item 10997
 For a patient with a chronic disease condition who has a GP Management plan, Team care Arrangement or Multidisciplinary plan in place.
MBS Item 16400
For a patient requiring an antenatal service.
Role of the GP Supervisory position.
PN; AHW or Midwife role
MBS Item 10983
To provide clinical support to a patient who's participating in a video conferencing consultation with a specialist, consultant physician or psychiatrist, including documentation of the service that was provided.
MBS Item 10984
To provide clinical support to a patient living in a RACF who's participating in a video conferencing consultation with a specialist, consultant physician or psychiatrist, including documentation of the service that was provided.
MBS Item 10987
To assist Indigenous patients who have received a health check, which has identified a need for follow up services.
MBS Item 10997
To assist patients who require access to ongoing care, routine treatment and ongoing monitoring and support between structured reviews of the GP Management Plan.
MBS Item 16400
To provide an antenatal service from a practice location in a regional, rural or remote area.
Frequency of service

MBS Item 10983 / 10984 not defined.
MBS Item 10987 maximum of 10 times per calendar year.
MBS Item 10997 maximum of 5 services per patient in a calendar year.
MBS Item 16400 can only claimed 10 times per pregnancy.

Further information MBS Online - Medicare Benefits Schedule
Australian Department of Health - Primary care (GP, nursing, allied health)
Australian Department of Human Services - Education services for health professionals
MBS Online - Telehealth: Specialist video consultations under Medicare