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July MBS changes revealed


Morgan Liotta


28/06/2024 4:16:00 PM

MBS indexation and the removal of COVID telehealth rebates and exemptions headline this year’s updates.

1 July calendar on Medicare background
Come 1 July, MBS changes to telehealth items and indexation updates will come into effect.

With the start of the new financial year signifying changes to the MBS, newsGP provides a summary of the key updates impacting general practice from 1 July.
 
Indexation of MBS items
From 1 July, an indexation factor of 3.5% will be applied to most general medical services items, most diagnostic imaging services and most pathology items in Group P12.
 
The impact on GP standard consultation items is outlined below:

  • MBS item 3, Level A consultation: $18.95 > $19.60
  • MBS item 23, Level B consultation: $41.40 > $42.85
  • MBS item 36, Level C consultation: $80.10 > $82.90
  • MBS item 44, Level D consultation: $118.00 > $122.15
  • MBS item 123, Level E consultation: $191.20 > $197.90
With healthcare inflation for the 12 months up to April reaching 6.1%, the low indexation means patient rebates continue to slide relative to the cost of care.

Telehealth items
The Department of Health and Aged Care (DoHAC) is planning to remove level C phone rebates for antiviral consultations (93716), as well as the COVID 12-month relationship exemption.
 
The RACGP has raised concerns about these changes, and is calling on the Federal Government to reconsider the decision because of the expected impact on GPs and patients.
 
‘These items must remain in place for the foreseeable future, given the ongoing spread of COVID-19 in the community and the clinical guidelines associated with timely treatments,’ President Dr Nicole Higgins told newsGP.

‘It remains inappropriate for patients with COVID-19 to be forced to attend a practice just to be eligible to receive Medicare rebates … and places other patients and practice staff at unacceptable risk.’

MBS item 93716 has been billed more than 300,000 times since it was introduced in July 2022.

The DoHAC has confirmed it will remove exemptions to the established clinical relationship requirement for the following services and categories:
 
  • non-directive pregnancy counselling telehealth consultations (MBS items 92136 and 92138)
  • people with a confirmed COVID-19 diagnosis (via PCR test or RAT) in the last seven days 
  • people seeking a request to a private pathologist for PCR testing in relation to COVID-19. 
Exemptions will remain for people isolating because of a COVID-related state or territory public health order, or in COVID-19 quarantine because of a state or territory public health order.
 
Telehealth pregnancy support items can still be billed, but the patient will need to have had at least one face-to-face attendance at the practice or with the provider delivering the service in the past 12 months. The DoHAC has advised that items for blood-borne viruses and sexual or reproductive health service telehealth consultations can be used instead of non-directive pregnancy counselling items where clinically relevant.
 
GP mental health telehealth items will continue with a permanent exemption to the established clinical relationship criteria.
 
In addition, blood-borne viruses and sexual or reproductive health service telehealth consultation items which are currently temporary will be made permanent. These items will continue to be exempt from the established clinical relationship requirements.
 
More information on the 1 July changes to the MBS is available on the RACGP website and MBS Online. The RACGP’s MBS online tool will also be updated on 1 July to provide a full list of indexed MBS item benefits.
 
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COVID-19 EOFY general practice billing indexation MBS changes Medicare items telehealth items


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Dr Inflation   29/06/2024 6:56:46 AM

The reality is that a 3.5% increase for bulk billing is akin to a 1.75% increase as it will be taxed at the marginal tax rate.

We need to protest the indexation calculation now, be more like nurses, as opposed to our naive save the world before looking after our own practices viewpoint which the RACGP seems to covet.

Be careful who you vote for. The best way to protect your vulnerable patients is to avoid voting for save the world types and vote for people who will challenge the government who see gps as soft touches.


Dr Poodle Hairstyle   29/06/2024 10:06:31 AM

The Telehealth Covid-19 infection level C antiviral assessment M/C item number & established clinical relationship exemption should be retained. The Covid pandemic is still ongoing at present. The waiting room is already full of coughing patients, those with Influenza, Covid or RSV , & patients on chemotherapy, diabetics, organ transplant recipients, infants & the elderly. There is no mask mandate & most people decline to wear a mask. I advised an organ transplant patient to wait in a separate area and he just shrugged his shoulders & told me he wants to sit in the main waiting room with everybody else. He said he has stopped worrrying about it & is just living his life day to day. He attends multiple OPDs at the local public hospital every few weeks and he said "The hospital is full of Covid & no-one is masking. I'm sure to catch it whatever I do."


Dr Christopher St John Kear   29/06/2024 1:15:27 PM

In truth, the rebate increases will amount to less than the 1.75% referred to by our anonymous Dr Inflation. Half of that, or more will be lost on practice expenses which nurses and hospital based medics just don't have to pay.
Our government has no clue about GP life, and it seems that they want to hand our jobs over to the pharmacists. I wonder how they expect this to turn out for the patients, who have to see someone with no clue about medicine or diagnostic processes....?


Dr Peter James Strickland   29/06/2024 2:12:35 PM

The levels of rebates are now laughable --Item 23 rebate should be a minimum of no less than $80 in 2024. Ask the governemnt to get a basic legal opinion for $43 --- it will be 10 times that! Just don't accept it and tell your patients that the Medicare insurance they pay through their taxes has been seriously compromised by the Federal Govt, and does NOT cover the basics of economics of running a high quality medical practice anymore --they are putting the monies into public servants/hospitals whose mid-range salaries are in the region of $300,000/person, and they want GPs to earn half that amount for up to twice the responsibility approximately, and then have State Govts adding payroll tax to GPs in certain States --it is CHAOS and socialistic taxing of a vital component of society actually saving them money and 'face'! Don't put up with it folks, and make decisions now to reject all this nonsense of rebates ---no bulk-billing!


Dr Abdullah Fadil Abdullah Alsharik   1/08/2024 2:02:47 PM

its really funny the way that medicare is treated GP ! its disrespect and undermining the profession ,so expect more rise in mixed /private billing with all that .its the fault of all involved (doctor,RACGP,AMA) that they have no unified voice to ask for fair increase in the MBS rebate .