News

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MBS changes for general practice from 1 November

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newsGP outlines the upcoming changes to the Medicare Benefits Schedule (MBS) applicable to general practice.
 
Diagnosis of hypertension via ambulatory blood pressure monitoring
A new MBS item (11607) will be introduced for diagnosis of hypertension through ambulatory blood pressure monitoring for people with suspected hypertension.
 
The purpose of the service is to monitor a patient’s blood pressure continuously over 24 hours via a wearable device to diagnose whether they are hypertensive.
 
The service includes fitting of the device, analysis of the data, generation of a report and development of a treatment plan, and all consultations associated with the service. Although this service is intended primarily for use by GPs, it is available to all medical practitioners.
 
In March 2019, the RACGP provided a submission to the Medical Services Advisory Committee on a MBS item number for ambulatory blood pressure monitoring. The college supported the item to be utilised by GPs.
 
Mark Morgan, Bond University Professor of General Practice and Chair of RACGP Expert Committee – Quality Care, welcomes the new MBS item number.
 
‘It is good to see that patients will be able to access a rebate for ambulatory blood pressure monitoring,’ he told newsGP.
 
‘Ambulatory blood pressure monitoring gets around the “excusitis” that is common in clinical practice where high blood pressure is blamed on rushing around or the last cup of coffee.
 
‘Evidence suggests that ambulatory monitoring is a good predictor of clinical outcomes associated with high blood pressure. These include heart attacks, heart failure, chronic kidney disease and stroke.’
 
Professor Morgan said current guidelines suggest that absolute cardiovascular risk calculation should use carefully collected clinic blood pressure readings. This aligns with recommendations from the RACGP Red Book that support the use of ambulatory blood pressure monitoring or home-measurements when there are indicators that clinic blood pressure is unreliable.
 
‘For most patients, high blood pressure should be managed with lifestyle risk reductions,’ Professor Morgan said.
 
‘With a few exceptions, medication should be reserved for patients with high absolute cardiovascular risk where it is recommended to use a statin and antihypertensive.’
 
More information on the news item number is available on the MBS Online fact sheet and quick reference guide.
 
Glycated haemoglobin point-of-care testing
A new MBS item number (73812) will be introduced for glycated haemoglobin (HbA1c) point-of-care testing (PoCT).
 
This service can be provided by or on behalf of a medical practitioner who works in a general practice that is accredited against the PoCT accreditation module under the National General Practice Accreditation Scheme, administered by the Australian Commission on Safety and Quality in Health Care.
 
In 2018, the RACGP released the Standards for PoCT to support the implementation of PoCT in a general practice setting, and has since been advocating for PoCT item numbers for general practice.
The MBS item number that has been introduced requires general practices to be accredited against the RACGP Standards for PoCT.
 
The service may be claimed a maximum of three times per patient in a 12-month period, but not claimed by a patient if a total of four other HbA1c testing items − laboratory or PoCT − have already been provided to the patient in the last 12 months.
 
An equivalent item (73826) is also being introduced for nurse practitioners working in an eligible general practice.
 
More information about the new item for medical practitioners is available in the relevant legislation.
 
newsGP will publish more detailed information relating to this item number, and how it aligns with the RACGP Standards, after 1 November.
 
Other changes to the MBS
A number of other changes relevant to general practice will be introduced to the MBS from 1 November 2021, including:

• new MBS items for eligible allied health practitioners participating in multidisciplinary case conferences with medical practitioners
• aligning MBS varicose vein items with contemporary clinical practice.

An overview of all MBS changes from 1 November is available on MBS Online, along with several fact sheets providing further details.
 
The RACGP’s MBS online tool will be updated to reflect the 1 November changes to ensure GPs have access to the most up-to-date item descriptors and rebates.
 
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MBS item Medicare Benefits Schedule point-of-care testing

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