News
1 July MBS changes impacting general practice
From assignment of benefit to indexation and new MBS items – what do incoming changes mean for GPs? newsGP provides a detailed summary.
The 1 July MBS indexation factor of 2.6% has been met with disappointment from the RACGP and members.
The new financial year brings a handful of changes to the MBS, including updates to indexation and assignment of benefit processes – both of which have raised significant concerns with GPs.
Early results of a newsGP poll suggest that of several 1 July MBS changes, GPs are most concerned about the impact of indexation and assignment of benefit changes on their practice.
In addition, Medicare billing items have also been added and amended. newsGP provides a summary below of changes impacting general practice from 1 July.
MBS indexation
An indexation factor of 2.6% will be applied to most medical and diagnostic services and pathology items, including:
- most general medical services items, except certain attendance items by doctors without vocational training
- most diagnostic imaging services (excluding positron emission tomography items and nuclear medicine modifier items), except positron emission tomography items in Group I4 (Subgroup 2) and nuclear medicine modifier items in Group I4 (Subgroup 3)
- pathology items in Group P1, P4, P5, P6, P8 and P12.
The announcement of the annual indexation last month led to the
RACGP reiterating warnings that ‘inadequate’ funding risks the viability of general practices. It said that while the indexation factor is better than a Medicare freeze, the 4.2% CPI increase over the past year means the value of rebates is not keeping pace with inflation and increasing costs of providing care.
The
RACGP’s MBS online tool has further information about accurate rebates after 1 July.
Assignment of benefit
GPs have expressed
ongoing concerns since the assignment of benefit reforms were announced – in particular the administrative burden and their impact on patients, especially those in residential aged care facilities (RACFs).
Following
strong advocacy from the RACGP and collaboration with the Department of Health, Disability and Ageing (DoHDA),
several key changes to assignment of benefit rules were confirmed two weeks before the 1 July changes were due to begin.
Verbal consent will be allowed in all settings until 1 July 2027, and enduring assignment of benefit will be an option for all MyMedicare registered patients, RACFs patients, and those attending Aboriginal community controlled health organisations.
Providers and software vendors who have already prepared or are preparing for the new arrangements, including through digital solutions, should continue that work.
Compliance will not commence until regulatory changes are complete and will begin with prevention and education.
Further information on the assignment of benefit reforms is available on the
RACGP website and the
DoHDA FAQs page.
New paediatric sleep items
Two new paediatric sleep study MBS items (12218 and 12219) will be available for unattended Level 2 polysomnography out-of-laboratory, home-based sleep studies. These studies are for the investigation of sleep disordered breathing in children aged 3–11 years and adolescents aged 12–18 years.
For patients to receive these sleep studies, referral by a medical practitioner to a qualified paediatric sleep medicine practitioner is required. The paediatric sleep medicine practitioner will also need to determine that the investigation is necessary, and an unattended sleep study is appropriate for the investigation.
Further information is available on the
MBS fact sheet.
New item for colonoscopy following a positive FOBT
A new MBS item (32219) for colonoscopy following a positive faecal occult blood test (FOBT) will be listed, as well as MBS item 32222 amended to remove FOBT services from the descriptor.
The new item 32219 will provide for colonoscopy following a positive FOBT when the test has been performed for screening purposes – when a patient is asymptomatic.
The creation of this new item is intended to provide clarity for practitioners and patients on appropriate use of MBS colonoscopy items and assist in the monitoring of asymptomatic patient clinical journeys. It is also intended to improve interaction between the MBS and the National Bowel Cancer Screening Program.
Further information is available on the
MBS fact sheet.
Other 1 July changes
GPs are also
reminded that pathology and diagnostic imaging results will be uploaded by default to My Health Record from 1 July, where they can be viewed instantly by patients.
As the next phase of the Share by Default changes that started last year, the
RACGP sees this change as a further step towards interoperability and an opportunity to modernise data sharing arrangements with patients and other healthcare providers, while improving patient health literacy.
While the college supports initiatives to enable seamless data flow across healthcare systems and recognises that timely access to this data is associated with better outcomes for patients, it notes some potential consequences such as patients declining follow-up care, requesting longer follow-up consults, or experiencing anxiety from self-interpreting the results.
More information is available on the
Australian Digital Health Agency website.
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Will the 2.6% MBS indexation applied from 1 July influence the way you bill?