Quality Improvement Council

MBS Item Numbers

Main Resources

New Medicare Health Assessment Resource kit includes the following fact sheets and proformas for each Health Assessment.

  • Health Assessments
  • Healthy Kids Check,
  • 45-49 years,
  • 40-49 with high risk of developing Type 2 diabetes,
  • Over 75years,
  • CMA for RACF residents,
  • People with an intellectual disability,
  • Refugees and other humanitarian entrants,
  • Aboriginal & Torres Strait Islanders
  • Healthy Kids Check provided by a Nurse or Aboriginal Health Worker
  • Click here to download http://www.health.gov.au/internet/main/publishing.nsf/Content/mha_resource_kit

New MBS Item Numbers as of 1st May 2010

As you would be aware there are changes to the MBS as of the 1st May 2010 To assist you with these changes the Government has issued a number of information sheets to highlight questions you may have.

Resources 

Changes to MBS Items 1st May

Please find these Quick reference resources on the changes to the MBS effective as of 1st May 2010. These resources shows the item numbers up to 30th April and the changes after the 1st May.
This is another resource on the changes to the MBS from Australian Doctor http://www.australiandoctor.com.au/pdf/MBS_270x190.pdf

Question and Answers – The Changes to Medicare Primary Care items from 1 May 2010:

http://www.health.gov.au/internet/main/publishing.nsf/Content/mbsprimarycare-changes-to-medicare-primary-care-items-qanda#7

There will be fee increases to level C and D general attendance items including: items 36 and 44; GP acupuncture items 197 and 198; Practice Incentive Payments items 2504, 2507, 2521, 2525, 2552 and 2558;

There will be no change to the fee for item 23 (Level B). The item descriptor will change to allow GPs to address multiple health issues and provide valuable preventive health care

Health Assessments

From 1 May 2010, there will be four time-based health assessment items, consisting of brief, standard, long and prolonged consultations.

  • (MBS Item 701 < 30min) A Brief Health Assessment will be used to undertake simple and straightforward health assessments.
  • (MBS Item 703 30-45min) A Standard Health Assessment will be used for more complex consultations.
  • (MBS Item 705 45-60min) A Long Health Assessment will be used for extensive consultations.
  • (MBS Item 707 >60min) A Prolonged Health Assessment will be used for complex consultations.

Changes to Medicare Primary Care Items

This fact sheet sets out the changes to Medicare attendance items for vocationally-recognised General Practitioners (GPs) as a result of the Medicare Benefits Schedule (MBS) Review which will be effective from 1 May 2010.CLICK HERE

MBS July 09 Updates CLICK HERE

Diabetes Risk Assessment- Use one of the Health Assessment Items listed above depending on the time taken for each patient.

GP Referral Form - This form is mandatory for use in referring patients who are at high risk of Type 2 Diabetes to a Life Modification Program File and is in Word format

Questions and Answers PDF - Information of who is eligible for the Diabetes Risk Item

AUSDRISK the Australian Type 2 Diabetes Risk Assessment tool - The Mandatory risk assessment tool to use with Item 713 in PDF format so please print off for use.

Fact Sheet - Outlines patient eligibility, the assessment tool,subsidised Lifestyle Miodification Program, Components of the risk evaluation, the role of the GP and other health Professionals

  • Lifestyle Modification Patient Brochure - a brochure for your patients to explain what the Lifestyle Modification Program is and how much it will cost. It will also explain what's involved with the program.For patients aged 40-49years
  • Must complete the AUSDRISK assessment tool and a specific GP referral form
  • Patients must be at "high risk" in order for Doctor to claim item number
  • Doctor must have ruled out a Diabetes diagnosis by either doing a Fasting Blood Glucose test, or an Oral Glucose Tolerance Test in the last 12months
  • Doctors can claim the item number now, BUT must keep a register of eligible patients to go into a Life Modification Program (LMP)
  • The Practice Nurse can assist patients to complete the assessment form prior to seeing the Doctor
  • The Life Modification Program will cost the Patient $50 and the Government will pay the LMP Provider a further $210
  • If the patient is a health care card holder or pensioner the government will pay all the $260 to the LMP Provider
  • Item 701, 703, 705, or 707 cannot be claimed in conjunction with another GP attendance item on the same day
  • A person who has previously accessed item 717 (the 45-49 health check) can only become eligible for a Diabetes risk assessment when three years has elapsed
  • A diabetes risk assessment does not preclude an eligible person from accessing the 45-49 health check in relation to the risk of developing another chronic disease
  • Life Modification Programs will be a group session with a max of 15 people. Each session will be approximately 90 minutes duration

Healthy Kids Check - Item numbers (701, 703, 705, 707 (for GPs) and 10986 (for Nurses)

Questions and Answer Sheet - This sheet tells you who is eligible for the item.What the purpose of the check is.Who can provide the healthy Kids Check and how often.What the check must include and whether it is necessary for the child to receive the 4 year old immusisations to have the check done.Is there a specific time taken to do the Health check? What are the item numbers to use with the Healthy Kids Check.  

Fact Sheet - Gives information on the Information needed to be collected, assessment,interventions,the health advice which must be given to each parent/carer as part of the item number, the need for immunisation and roles of the GP and Practice Nurse

Get Set 4 Life - habilts for healthy kids - Information about the Guide for parents & carers

Booklets can be ordered from DoHA on www.health.gov.au/internet/main/publishing.nsf/Content/Healthy_Kids_Check

For a patient who is receiving or has received their four year old immunisation

  • The child’s carers must be given the governments publication on developing healthy habits for kids –The Guide (Please note that orders can be no larger than 100 at a time)
  • This is not an annual health check – once only per child
  • Consent from the child’s parents must be obtained before conducting the health check and this must be recorded on the patient record
  • Other notes to include in the patient’s record are
  • That a copy of the guide has been given to the parents
  • The GP should be the patients "usual doctor" i.e. the GP who has provided the majority of services to the patient in the last 12mths and/or is likely to provide the majority of services in the following 12 mths.
  • All GP’s whether vocationally registered are eligible Practitioners
  • The health check can also be undertaken by the Practice Nurse on behalf on the GP. The Nurse is required to be a Registered Div1 or Div 2 Nurse who is employed by, or whose services are otherwise retained by the General Practice
  • If the nurse identifies any health concerns that require medical intervention, the patient must be reviewed by the patient’s "usual doctor" to arrange any referrals or follow- up as clinically required
  • GP’s are advised to consult their insurer concerning indemnity coverage for services performed on their behalf
  • Continuing professional development is recommended for all nurses and GP’s providing the Healthy Kids Check.
  • Supervision at a distance is recognised as an acceptable form of supervision, so the claiming GP does not have to be physically present at the time the service is provided, however the GP should be contactable if required.
  • If the nurse & GP are at the same location it is up to the GP to decide if they are going to see the patient. If the GP does see the patient and that visit does not form part of the Health Check then the GP is entitled to claim a Medicare number for the time and complexity of their personal attendance. Where the Practice Nurse provides another service (e.g. Immunisation) on the same day, the GP can claim both items.
  • Item 10990 can be claimed in conjunction with items 709 and 711.

EPC Dental Items 2008 - were going now they're back for the moment!

GP Dental Referral Form - A word document to use for Dental referrals as part of the EPC Dental Items initiative

Fact Sheet on Dental Items - This fact sheet is a summary of the Medicare dental items and what these arrangements mean for GP's.

  • DoHA had advised that the Medicare dental items for people with chronic conditions and complex needs (Items 85011 - 87777), introduced by the previous Government in November 2007 were to be withdrawn from the Medicare Benefits Schedule by June 302008. This affects referrals by GP's and services by dentists, dental specilaists and dental prothetists.
  • The current opposition has blocked changes to the legislation so the "old" system will continue until Parliament sits again
  • Subject to Parliamnet's agreement, the Governement intends to close this scheme to all patients at the earliest opportunity once Parliament resumes on 26th August 2008
  • It is important that patients and providers understand that, in closing the scheme, the Governement does not intend to provide a transition period for treatment to be completed. Once the scheme is closed, patients will not be able to access these Medicare rebates
  • BGPN has a list of participating Dentists