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How to access Medicare support for third COVID vaccine doses
GPs can conduct suitability assessments and administer third doses with the same item numbers used for second doses.
A Department of Health (DoH) fact sheet has explained the process for immunocompromised patients to access Medicare rebates for their third dose of a COVID vaccine.
The Australian Technical Advisory Group on Immunisation (ATAGI) recently confirmed severely immunocompromised people should receive a third dose of a COVID-19 vaccine as part of their primary course.
According to the DoH, the same second dose MBS items are used during this process, including when a medical practitioner performs a suitability assessment for a patient and determines they are not suitable for a third vaccination dose.
For GPs, MBS items 93644, 93645, 93653 and 93654, are available to assess patients’ suitability for the second or subsequent dose of a COVID-19 vaccine dose.
Flag-fall and in-depth patient assessments may also be claimed if all other eligibility requirements are met; however, in-depth patient assessments are only eligible once per patient’s lifetime.
The flag-fall is paid in addition to the vaccine suitability assessment items and can be claimed once for each visit to a residential aged care facility, residential disability facility, or a patient’s home,
regardless of how many patients are assessed for COVID-19 vaccination.
The additional PIP payment is not claimable for a third dose, and remains payable only when the first and second vaccine doses are administered under the same general practice.
Services rendered under the COVID-19 vaccine suitability assessment items will only attract a Medicare rebate where the service is billed in the name of the supervising GP, who must be present at the location at which the vaccine suitability assessment service is undertaken and must accept full responsibility for the service.
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