1 November MBS changes explained

Sweeping changes to Medicare items will come into place on 1 November, including landmark reforms to bulk-billing incentives.
 
The most prominent of these is the new Bulk Billing Practice Incentive Program (BBPIP), as well as changes to telehealth, the Better Access Scheme, and new and amended items for long-acting reversible contraceptives (LARC).
 
Below, newsGP provides a summary of the key updates impacting general practice from 1 November.
 
Changes to bulk-billing incentive items
From 1 November, all Medicare-eligible patients will be eligible for Medicare bulk-billing incentives, achieved by updating the item descriptors for all Group M1 bulk-billing incentive items to remove references to children under 16 and concession card holders.
 
These changes do not affect the bulk-billing incentives for diagnostic imaging or pathology services.
 
For more information on the change in eligibility for bulk-billing incentives, an MBS Online factsheet is available.
 
From Saturday, practices will also be able to participate in the BBPIP, providing additional funding where practices bulk bill all patients. Practices do not need to be participating in the BBPIP to bill the expanded bulk-billing incentive items.
 
Resources for RACGP members, including seven webinar recordings, factsheets, posters, postcards, FAQs, website copy and on-hold and reception scripts for members to use, are available on a dedicated RACGP webpage.
 
Changes to telehealth
From 1 November, patients will be able to satisfy the established clinical relationship requirement for telehealth consultations by being registered for MyMedicare with the consulting practice.
 
Patients who are not registered for MyMedicare will continue to require a face-to-face visit in the previous 12 months with their GP and/or practice to be eligible for telehealth consultations.
 
Mental health consultations conducted via telehealth are no longer exempt from the established clinical relationship requirement.
 
Patients seeking mental health consultations via telehealth will need to be registered with the practice under MyMedicare or have seen the GP, or another health professional at that practice, face-to-face in the last 12 months.
 
This change does not apply to Focussed Psychological Strategies consultations which remain exempt from the established clinical relationship requirement.
 
Nurse practitioner MBS telehealth items will be subject to the established clinical relationship requirement.
 
For more information, an MBS Online factsheet is available.
 
Changes to the Better Access Scheme
From 1 November Mental Health Treatment Plans (MHTPs) must be completed by the patient’s MyMedicare registered practice or the patient’s usual medical practitioner – the GP who has provided most services to the person in the past 12 months or who is likely to provide most services to the person in the following 12 months.
 
MBS items 2713 (attendance related to a mental disorder) and 2712 (review of a GP MHTP) and their telehealth equivalents will be removed from the MBS.
 
GPs will instead be required to conduct mental health consultations and GP MHTP reviews using standard consultation items. Where these services are bulk billed, the tripled bulk-billing incentive can be claimed.
 
Referrals for mental health treatment services dated prior to 1 November 2025 remain valid until all treatment services under that referral, within the maximum session limit for the course of treatment, have been provided to the patient.
 
For more information, an MBS Online factsheet is available.
 
New and amended items for LARC
From 1 November there will be several changes to existing LARC items and a new LARC item will be created.
 
Schedule fees for MBS items 35503, 35506, 14206, and 30062 are increasing.
 
A new MBS item, 35501, will be introduced to provide a loading of 40% of the fee for the relevant LARC insertion and removal items, when a patient’s LARC insertion or removal service and any consultation or other MBS items associated with providing the service are bulk billed.
 
The item descriptor for items 35503 and 35506 will be amended to add a reference to new MBS item 35501.
 
The descriptor for item 30062 will be amended to remove reference to ‘as an independent procedure’.
 
For further information, an MBS Online factsheet is available online.
 
Changes to skin excision MBS items
From 1 November 2025, there will be amendments to several MBS items to include healing by secondary intention – the wound is left open to heal naturally, instead of repairing the wound by suture, skin flap or skin graft.
 
When a wound is left open to heal naturally, only the relevant skin excision item should be claimed by a provider.
 
For more information, an MBS Online factsheet is available online.
 
A summary of the 1 November changes is available on the RACGP website.
 
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Better Access Scheme bulk billing Bulk Billing Practice Incentive Program LARC telehealth