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

Notes

MBS rebates are increased annually on 1 November. The rebate amounts are current as at 1 November 2016. Check at the MBS Online website.

All remuneration shown is the benefit that the provider can claim from Medicare if the service is bulk-billed, or the rebate that the patient can claim from Medicare if the service is privately billed.

All information is current as at 1 November 2016. Health professionals intending to use these items and seeking more comprehensive information, including the MBS requirements for each item, should refer to the Australian Department of Health website, the Medicare Benefits Schedule (MBS) book and/or the Allied Health MBS book. Health professionals can search for specific items at the MBS Online website, or telephone Medicare Australia on (03) 9605 7964.

Footnotes

  1. All information provided in these documents is current as at 1 June 2015. Health professionals intending to use these items should refer to the Medicare Benefits Schedule book or the Allied Health Schedule book for more comprehensive information, including the MBS requirements for each item. Alternatively, you can search for specific items at the MBS Online website, telephone the Medicare Australia Provider Line on 132 150 or contact your Primary Health Network. Note that the Medicare Benefits Schedule is currently updated three to four times a year.
  2. Clients living in a Commonwealth-funded residential aged care facility are also eligible if they are being managed under a care plan to which their usual GP has contributed (#731).
  3. The term 'usual GP' means the doctor (or practice) that has provided the majority of services to the client over the previous 12 months, or that will provide the majority of services over the next 12 months.
  4. It is acceptable for practices to claim remuneration for both items at the same time, providing the Medicare criteria for both items have been fulfilled.
  5. Available at the Australian Department of Health website.
  6. Mental disorder is a term used to describe a range of clinically diagnosable disorders that significantly interfere with an individual's cognitive, emotional or social abilities (refer to World Health Organization 1996 Diagnostic and management guidelines for mental disorders in primary care: ICD-10, Chapter V, primary care version). Dementia, delirium, tobacco-use disorder and mental retardation are not regarded as mental disorders for the purposes of these item numbers.
  7. From 1 January 2013, the geographic eligibility criteria for telehealth Medicare Benefits Schedule (MBS) items were amended to align with the Australian Standard Geographical Classification Remoteness Area (ASGC-RA) classifications. MBS benefits will now only be available for services provided to patients who are located outside of RA1-Major Cities. You can check if a location is telehealth eligible at the DoctorConnect website. Go to 'search the map', choose the 'ASGC Remoteness Areas Layer' and enter the address of your patient's location during the consultation. The definitions of eligible areas are subject to change by the Department of Health and Ageing - see the MBS Online website for the latest information.