Advertising


News

Changes to the MBS from 1 November


Morgan Liotta


31/10/2023 11:18:35 AM

The penultimate month of 2023 will usher in a suite of changes, including indexation, bulk-billing incentives, and Level E item updates.  

1 November calendar
Updated indexation from 1 November builds on the previous rate of 3.6% applied to most MBS services on 1 July.

Come 1 November, there will be changes to the MBS GPs should be aware of.
 
As announced, in the 2023–24 Federal Budget, indexation of 0.5% will be applied to most general medical and diagnostic imaging services, as well as a range of pathology item numbers.
 
Additionally, Level E items will bring standard consultations lasting 60 minutes or more to the MBS, while triple bulk-billing incentives are finally due to come into effect.
 
The first day of November also marks the beginning of MyMedicare-linked incentives for registered patients. Where a patient is registered for MyMedicare, tripled bulk-billing incentives will be billable for Level C and D telehealth (video and phone) general attendance consultations and Level E video consultations.
 
A more detailed breakdown of the 1 November changes is listed below.
 
Indexation
An additional indexation factor of 0.5% will be applied to:

  • most general medical services items
  • most diagnostic imaging services, excluding nuclear imaging services
  • pathology items in Group P12 (74990, 74991, 75861, 75962, 75863 and 75864).

This builds on the annual fee indexation of 3.6% applied to most MBS services on 1 July 2023. The RACGP’s MBS online tool will be updated on 1 November with relevant new items and rebates.
 
Bulk-billing incentive increases
Seven existing bulk-billing incentive items are set to be amended and 13 new items will be added to the MBS.
 
There are no changes to patient eligibility for bulk-billing incentives. Commonwealth concession card holders and patients aged under 16 years of age will be eligible for tripled bulk-billing incentives when they receive an eligible service.
 
Tripled bulk-billing incentives do not apply to all GP-billable MBS items, and can only be co-claimed with the following items:

  • MBS Levels B, C, D and E face-to-face general attendance consultations (and out-of-rooms, residential aged care facilities and after-hours equivalents)
  • MBS Level B telehealth general attendance consultations (video and phone)
  • Where a patient is registered for MyMedicare, tripled bulk-billing incentives will also be billable for Level C and D telehealth (video and phone) general attendance consultations and Level E video consultations
For all other MBS items, the existing, standard bulk-billing incentives will remain billable. More information is available in the MBS Online Supporting bulk billing in general practice factsheet.
 
The new general support incentive items are listed in the table below:
 
MBS item number Billable area MBS benefit
75870 Metropolitan $20.65
75871 Modified Monash area 2 $31.40
75872 Modified Monash area 2–7 (after-hours) $31.40
75873 Modified Monash area 3–4 $33.35
75874 Modified Monash area 5 $35.45
75875 Modified Monash area 6 $37.40
75876 Modified Monash area 7 $39.70
 
When billing items for patients linked to MyMedicare, the following MBS items should be used:
 
MBS item number Billable area MBS benefit
75880 Metropolitan $20.65
75881 Modified Monash area 2 $31.40
75882 Modified Monash area 3–4 $33.35
75883 Modified Monash area 5 $35.45
75884 Modified Monash area 6 $37.40
75885 Modified Monash area 7 $39.70

 
Level E items
From 1 November new general attendance consultation items for consultations 60 minutes and over by GPs and other medical practitioners (Level E items) will be available.
 
Like current general attendance items, Level E items will be available for face-to-face consultations, out-of-room consultations, consultations in residential aged care facilities and video consultations. Phone items are not available for Level E consultations.
 
Existing restrictions on same-day co-claiming of general attendance and chronic disease management MBS items and the standard caps for the Extended Medicare Safety Net will also apply to the Level E items.
 
As part of this change, existing Level D items will now have a maximum consultation length.
 
Further information is available from the Department of Health and Aged Care’s General Attendance Items table, which includes new Level E items, and the MBS Online Level E long consultations factsheet.
 
New Level E items:

  • Item 123, MBS benefit: $191.20
  • Item 124, MBS benefit: $220 for one patient (refer to Ready Reckoner for fees for multiple patients)
  • Item 90054, MBS benefit: $191.20
  • Item 91920, MBS benefit: $191.20
  • Item 5071, MBS benefit: $220.25
  • Item 5076, MBS benefit: $248.85 for one patient (refer to Ready Reckoner for fees for multiple patients)
  • Item 5077, MBS benefit: $271.70 for one patient (see Ready Reckoner for fees for multiple patients)
 
Other MBS changes
  • Existing Level D items will be amended to include a maximum attendance time
  • A minimum service time of six minutes will be introduced for Level B GP consultation items 23, 24, 5020, 5023, 5028 and 90035 applying to a consultation service lasting at least six minutes and less than 20 minutes
  • New phone items 91900 (Level C) and 91910 (Level D) will be introduced for longer general practice attendances with a GP, where the patient is registered under MyMedicare with the billing practice
  • Amendments to telehealth item 91800, to introduce appropriate minimum and maximum consultation times
  • Existing phone item 91894 will be deleted. This item currently provides patients in rural and remote areas with access to longer general practice phone consultation items. Patients in these areas will continue to have access to longer general practice phone services where they are registered under MyMedicare
 
Administrative changes to ‘other medical practitioner’ MBS items
For administrative reasons, the Department of Health and Aged Care will change references to a medical practitioner who is not a general practitioner, specialist, or consultant physician from ‘other medical practitioner’ to ‘prescribed medical practitioner’.

There are no policy changes resulting from these changes, which are designed to help streamline the MBS regulatory framework.
 
Likewise, no changes to item numbers, eligibility or requirements will arise from the updated language. Providers may notice minor drafting amendments to a number of items and regulatory clauses; however, these changes are administrative in nature only.
 
For further information see the Administrative changes to OMP and GP MBS items factsheet.
 
Full details of MBS changes from 1 November impacting general practice are also available on the RACGP website.
 
Log in below to join the conversation.



bulk-billing incentives indexation MBS changes Medicare items


newsGP weekly poll What is your chief concern with role substitution?
 
7%
 
0%
 
5%
 
0%
 
7%
 
1%
 
0%
 
76%
Related






newsGP weekly poll What is your chief concern with role substitution?

Advertising

Advertising


Login to comment

Dr Campbell Robert Crilly   1/11/2023 9:15:19 AM

The medicare system is increasingly complex and difficult to negotiate. GP's are under more pressure from every angle in providing medical services. The indexation provided is not in line with current inflation levels. GP's should charge each patient what they think their service is worth. The business pressure on medical practice is continuing and relying on the medicare payment system is unsustainable when compared to increases in business costs.


Dr Aletia Vivienne Johnson   1/11/2023 9:43:29 AM

Thank you so much for this information! Otherwise my head would explode into a confused pile of goo.


Dr Muhammad Navaid Ahmed   14/11/2023 8:47:19 PM

Ok! so after training for ten years, and multiple fellowships, 5min of my professional time (actually five minutes and 59 seconds) is worth just $12 quid? (70% of $18)

Bravo! should have become a plumber