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To access MBS item numbers online: http://www.mbsonline.gov.au
Item No Item Name – Short Description MBS Benefit
CONSULTATIONS GROUP A1 - Vocationally Registered GROUP A2 - Non-Vocationally Registered
3 CONSULT BRIEF (^) LEVEL A Straightforward cases e.g. Immunisation (^) GROUP A1 $ 16. 60 LEVEL B,C & D Professional attendance by GP involving, where clinically relevant: a) Taking a history; b) Undertaking clinical examination; c) Arranging any necessary investigation; d) Implementing a management plan; e) Providing appropriate preventive health care; in relation to one or more health related issues, with appropriate documentation _Level B: taking a selective history; Level C: taking a detailed history; Level D: taking an extensive history._ 23 CONSULT STANDARD LEVEL B^ less than^ 20 minutes (see description above)^ VR GROUP A1 $ 3 6.3 0
36 CONSULT LONG LEVEL C^ at least 20 minutes (see description above)^ VR GROUP A1 $ 70.3 0 (^44) CONSULT PROLONGED LEVEL D^ at least 40 minutes (see description above)^ VR GROUP A1 $ 10 3. 52 CONSULT BRIEF <5MINS Non-VR GROUP A2 $ 11. 53 CONSULT STANDARD 5 - 25MINS Non-VR GROUP A2 $ 21. 54 CONSULT LONG 25 - 45MINS Non-VR GROUP A2 $ 38. 57 CONSULT PROLONGED >45MINS Non-VR GROUP A2 $ 61.
EMERGENCY IMMINENT DANGER The patient must be in imminent danger of death. One or more medical practitioners
can claim these items for simultaneous attendance on one patient. The time spent by the practitioner does not have to be continuous.
160 CRITICAL CONDITION, prolonged attendance in treatment of 1 - 2HR $ 21 7. 161 CRITICAL CONDITION, prolonged attendance in treatment of^^2 - 3HR^ $ 3 61. 162 CRITICAL CONDITION, prolonged attendance in treatment of 3 - 4HR $ 506. 163 CRITICAL CONDITION, prolonged attendance in treatment of 4 - 5HR $ 6 51. 164 CRITICAL CONDITION, prolonged attendance in treatment of >5HR $ 7 23.
HOME VISITS These items are for consultations at a place other than consulting rooms, including when RMPs visit remote NT
community aged care facilities. For after-hours home visits, refer to the separate cheat sheet “After-Hours”. ITEM GROUP A1 – Vocationally Registered (^) ITEM GROUP A2 – Non-VR 4 HOME VISIT BRIEF LEVEL A, see above See Table 1 (^) 58 <5MINS See Table 2 24 HOME VISIT STANDARD (^) LEVEL B, see above See Table 1 (^) 59 5 - 25MINS See Table 2 37 HOME VISIT LONG LEVEL C, see above See Table 1 (^) 60 25 - 45MINS See Table 2 47 HOME VISIT PROLONGED LEVEL D, see above See Table 1 (^) 65 >45MINS See Table 2 No of PATIENTS
TABLE 1 – GROUP A1 – HOME VISITS TABLE 2 – GROUP A 2 – HOME VISITS ITEM 4 ITEM 24 ITEM 37 ITEM 47 ITEM 58 ITEM 59 ITEM 60 ITEM 65 ONE $ 4 2.05 $ 6 1.75 $ 9 5.75 $ 12 8.95 $ 24.00 $ 33.50 $ 51.00 $ 73. TWO (^) $ 2 9.30 $ 4 9.00 $ 83.00 $ 1 1 6.20 $ 16.25 $ 24.75 $ 43.25 $ 65. THREE $ 2 5.10 $ 4 4.80 $ 7 8.80 $ 1 1 2.00 $ 13.65 $ 21.85 $ 40.65 $ 62. FOUR (^) $ 22. 95 $ 4 2.65 $ 7 6.65 $ 109.85 $ 12.35 $ 20.35 $ 39.35 $ 61. FIVE $ 21. 70 $ 4 1.40 $ 7 5.40 $ 108.60 $ 11.60 $ 19.50 $ 38.60 $ 60. SIX $ 20. 85 $ 40.55 $ 7 4.55 $ 107.75 $ 11.10 $ 18.90 $ 38.10 $ 60. SEVEN+ $ 18. 55 $ 3 8.25 $ 7 2.25 $ 105.45 $ 9.20 $ 16.70 $ 36.20 $ 58.
ATTENDANCE AFTER-HOURS Medicare generally classifies clinic hours as 8am-6pm Monday to Friday, and 8am-12noon
Saturday. For item numbers and details of after-hours attendances, refer to the separate cheat sheet “After-Hours”.
MEDICARE INCENTIVES An additional rebate can be claimed for bulk billed services in Rural and Remote areas, where the
service is provided to a Commonwealth Concession Card holder or to a child under the age of 16 years.
10991 GENERAL MEDICAL SERVICES TABLE (GMST) – Claimed in conjunction with each service $ 9.1 0 64991 DIAGNOSTIC IMAGING SERVICES TABLE (DIST) – Claimed in conjunction with each service $ 9.1 0 74991 PATHOLOGY SERVICES TABLE (PST) – Claimed in conjunction with items in Group 9 $ 9.1 0
Note: Aged care facilities in remote communities in the Northern Territory are not recognised as such by the Department of Health and Aging. Therefore, if a doctor attends a client in a remote community aged care facility, the item to claim is a home visit at a place other than a consulting room.
FREQUENTLY USED MBS ITEMS
Updated: 01 January 2013
Medicare Australia Indigenous Hotline
Department of Health is a Smoke Free Workplace
Item No Item Name – Short MBS Benefit
Item 732 can be claimed twice on the same day – once as a review for item 721, and once as a review for item 723. It must be noted on the claim that they
A consultation can also be claimed with item numbers marked
A consultation can also be claimed with item numbers marked if it is clinically indicated that a problem must be treated immediately (to be noted on the claim) A consultation can also be claimed with items marked if they are not for related conditions (to be noted on the claim) A consultation can also be claimed with items marked if not at the same time (times to be noted on the claim)
- 16500 ANTENATAL ATTENDANCE $ 40. ANTENATAL - 16591 ANTENATAL ATTENDANCE pregnancy >20 wks – only one per pregnancy $ 1 21.3 - 16518 LABOUR MANAGEMENT INCOMPLETE- THEN TRANSFER $ 3 83. - 16519 LABOUR AND DELIVERY $ 6 19. - 16522 MANAGEMENT OF COMPLICATED LABOUR & DELIVERY $ 1,554. - # 11506 SPIROMETRY-BEFORE & AFTER BRONCHODILATOR $ 17. SIMPLE PROCEDURES For other commonly claimed items, refer to cheat sheets “Lesions” and “Fractures & Dislocations” - # 11700 ECG TRACING & REPORT $ 26. - # 14206 IMPLANON INSERTION (hormone or living tissue implantation by cannula) $ 30. - # 30062 IMPLANON REMOVAL includes suturing $ 5 1. - # 30023 DEEP OR CONTAMINATED WOUND SUTURE REG BLOCK $ 27 7. - # 30026 SUTURE < 7CM SUPERFICIAL NOT FACE $ 4 4.4 - # 30029 SUTURE < 7CM DEEP NOT FACE $ 7 6.5 - # 30032 SUTURE < 7CM SUPERFICIAL FACE $ 70. - # 30035 SUTURE < 7CM DEEP FACE $ 9 9.9 - # 30038 SUTURE > 7CM SUPERFICIAL NOT FACE $ 7 6.5 - # 30041 SUTURE > 7CM DEEP NOT FACE $ 12 2. - # 30045 SUTURE > 7CM DEEP FACE $ 9 9. - # 30052 SUTURE EYELID/NOSE/EAR $ 215. - # 30061 FOREIGN BODY SUPERFICIAL–REMOVAL OF (INC CORNEA/SCLERA) $ 20.0 - # 30064 FOREIGN BODY SUBCUTANEOUS - REMOVAL OF $ 9 3. - # 30067 FOREIGN BODY DEEP – REMOVAL OF $ 1 90. - # 30071 BIOPSY SKIN $ 4 4.4 - # 30219 HAEMATOMA, FURUNCLE,ABSCESS, LESION–INCISION WITH DRAINAGE OF $ 2 3.2 - # 36800 URINARY CATHETER $ 23. - # 41500 FOREIGN BODY EAR – REMOVAL OF by means other than simple syringing $ 70.1 - # 41659 FOREIGN BODY NOSE – REMOVAL OF by means other than simple probing $ 6 5. - # 42644 FOREIGN BODY CORNEA/SCLERA – REMOVAL OF IMBEDDED $ 6 1. - # 73802 HB OR FBC Medicare incentive 74991 if applicable $ 3.9 PATHOLOGY Medicare incentive 74991 if applicable - # 73806 PREGNANCY TEST Medicare incentive 74991 if applicable $ 8. - # 73840 HbA1c (QAAMS project participants only) Medicare incentive 74991 if applicable $ 14. - # 73844 Urinary ACR (QAAMS project participants only) Medicare incentive 74991 if applicable $ 17. - 701 - CHRONIC DISEASE MANAGEMENT - 701 <30mins $58.2 0 703 3 0<45mins $135.2 0 705 45<60mins $186.5 5 707 60+mins $263.5 Health Assessments – time based, including the time taken by the RMP, RAN and AHP - 715 ABORIGINAL & TORRES STRAIT ISLANDER PEOPLES HEALTH ASSESSMENT $ 20 8.1 - 721 CHRONIC DISEASE MANAGEMENT PLAN (CDMP) preparation by GP ONLY $ 1 41. - 723 CHRONIC DISEASE MANAGEMENT PLAN (CDMP) preparation of TEAM CARE ARRANGEMENTS $ 1 12. - 732 REVIEW of a CHRONIC DISEASE MANAGEMENT PLAN (CDMP) $ 70. - 735 ORGANISE CASE CONF 15-20 minutes, not discharge $ 6 9.2 were two different services, and the time each item 732 was commenced also noted (explanatory note A.36 MBS) - 739 ORGANISE CASE CONF 20 - 40 minutes, not discharge $ 11 8.6 - 743 ORGANISE CASE CONF > 40 minutes, not discharge $ 19 7.7 - 2100 Attendance at health centre Level A At least 5 minutes $ 22. TELEHEALTH Refer to Telehealth cheat sheet for telehealth attendances at a place other than consulting rooms - 2126 Attendance at health centre Level B Less than 20 minutes $ 48. - 2143 Attendance at health centre Level C 20 - 39 minutes $ 94. - 2195 Attendance at health centre Level D 40 or more minutes $ 139.7 - 2713 ATTENDANCE in relation to a mental disorder, lasting at least 20 minutes $ 70.3 MENTAL HEALTH
- Note that items 2702 and 2710 were discontinued 01 November
- 2700 GP Mental Health Treatment Plan (for GPs without mental health skills training), at least 20 minutes $ 70.3
- 2701 GP Mental Health Treatment Plan (for GPs without mental health skills training), at least 40 minutes $ 103.
- 2715 GP Mental Health Treatment Plan (for GPs with mental health skills training), at least 20 minutes $ 89.
- 2717 GP Mental Health Treatment Plan (for GPs with mental health skills training), at least 40 minutes $ 131.
- 2712 REVIEW of a GP Mental Health Treatment Plan (applicable to items 2700, 2701, 2715, 2717) $ 70.3
- Darwin Rural Department of Health – Remote Health Medicare Trainers
- Central Australia 8951 7754 /
- East Arnhem
