Upcoming MBS changes GPs need to know

Anastasia Tsirtsakis

22/02/2023 4:13:11 PM

A series of MBS changes impacting general practice will go live on 1 March.

A calendar dated 1 March.
The item numbers impacted include audiology, mental health and chronic disease services, among others.

As of next month, a number of changes will be introduced to the Medicare Benefits Schedule (MBS).
These include the amendment of various existing items, which hare designed to give GPs greater flexibility to refer patients to audiology services, along with new item numbers to facilitate family and carer participation in the Better Access scheme.
To assist members, newsGP summarises the key changes below.
Otolaryngology, head and neck surgery changes
To reduce referral restrictions and improve access to audiology services, as of 1 March, several MBS items (82300, 82306, 82309, 82312, 82315, 82318, 82324 and 82332) will be amended.
As a result, GPs will be able to refer patients directly to an audiologist for these services, rather than requiring a request from a non-GP specialist in either otolaryngology, head and neck surgery or neurology.

Meanwhile, to address inappropriate use of item 41647 (ear toilet), the item will be amended to specify that it cannot be used for the removal of uncomplicated wax in the absence of other disorders of the ear.
According to the Department of Health and Aged Care (DoH), the changes will ensure the items reflect contemporary clinical practice, and that the benefits are appropriate for the skill and complexity of the relevant procedure.
Complex neurodevelopmental disorders and disabilities
In response to recommendations from the MBS Review Taskforce, the Federal Government has decided to expand the age of eligibility for item 139 from under 13 to under 25 for patients who have an eligible disability, and to increase the number of assessment services from four to eight.
Additionally, item terminology will be updated from ‘Pervasive Developmental Disorder’ to ‘Complex Neurodevelopmental Disorder’ to reflect contemporary language.
To further increase access, the list of eligible disabilities will also expand to include people living with Fetal Alcohol Spectrum Disorder (FASD), Lesch-Nyhan Syndrome, and 22q deletion syndrome.
The aim of the changes, according to the DoH, is to facilitate equitable access to high quality care for Australians presenting late with neurodevelopmental disorders.
Health assessment changes
The definition of ‘relevant visa’ will be updated for the purposes of providing health assessment services to refugees and other humanitarian entrants.
This update will reflect relevant changes to refugee and humanitarian visa types within the Migration Regulations 1994.
Focussed psychological strategies
To facilitate family and carer participation in treatment under the Better Access to Psychiatrists, Psychologists and General Practitioners initiative, four new items (2739, 2741, 2743 and 2745) will be introduced.
Eating disorder and mental health services
As part of the changes, two pre-COVID-19 GP videoconference items (90279 and 90280) for geographically restricted eating disorder and mental health services will be removed.
This change will consolidate eating disorder and mental health telehealth services to remove duplication of equivalent services.
Patients will continue to have access to telehealth services for eating disorder psychological treatment and mental health services via videoconference (items 92182 and 92184) and telephone (items 92194 and 92196).
Chronic disease management
As of 1 March, same-day co-claiming restrictions will be introduced for GP management plans, team care arrangements and multidisciplinary care plans for items 721, 723 and 732.
These changes will align with restrictions on telehealth and phone items.
Clinically suspected melanoma item fee changes
From 1 March, the rebates for seven items for excisions of clinically suspected melanoma (31377 to 31383) will be increased slightly.
The items were first introduced on 1 November 2022; however, following their implementation it was noted that indexation had not been applied correctly. The changes to the fees will ensure they are in alignment with the fees for existing benign skin excision items.
These changes will not affect existing arrangements for the definitive excision of malignant melanoma, appendageal carcinoma, malignant connective tissue tumour of skin, or merkel cell carcinoma of skin. These services can continue to be claimed under items 31371–31376.
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