As General Practitioners, navigating the complexities of the Medicare Benefits Schedule (MBS) is an essential yet challenging aspect of your practice. While many of you are well-versed with the common MBS items, there are some lesser-known billing opportunities that might benefit your practice and your patients. This blog will shed light on a few of these, helping you to potentially enhance your service provision and billing efficiency.

**Disclaimer:** It is crucial that you ensure you are familiar with the MBS, including any explanatory notes. The MBS is a complex area, and always consult the latest MBS updates and explanatory notes before billing these item numbers.

1. Mental Health Case Conferencing

Case conference item numbers have been available on the MBS for many years, but many providers may not be aware that there are separate item numbers for Mental Health Case Conferencing. Introduced on 1 July 2023, the new Mental Health Case Conferencing items aim to improve multidisciplinary, collaborative, and coordinated mental health care. Here are some key aspects of these changes:

  • Eligibility and Coordination: GPs, other medical practitioners, consultant psychiatrists, or consultant paediatricians can organise and coordinate the case conference. They must involve at least two other multidisciplinary team members and obtain the patient’s consent.
  • New Item Numbers: There are 21 new MBS items including time-tiered items for organising (930, 933, 935, 969, 971, 972, 946, 948, 959) and participating (937, 943, 945, 973, 975, 986, 961, 962, 964) in these conferences.
  • Allied Health Involvement: Items 80176, 80177, and 80178 allow for the participation of eligible clinical psychologists, social workers, occupational therapists, and dietitians to attend the case conference.

What Does This Mean for Providers?

These new items are designed to:

  • Improve access to collaborative mental health care.
  • Promote good communication and shared care between providers.
  • Ensure equal access to case conferences for patients with mental health conditions and chronic diseases.

Patient Eligibility

These case conferences are applicable for patients referred under Better Access services or those with an active Eating Disorder Treatment and Management Plan (EDTMP).

2. Rib Fracture Management (Item 47471)

Presentations to general practice for suspected or confirmed rib fractures are not uncommon, particularly in the setting of trauma and falls. There is an item number for consultations involving rib fractures, including those managed non-operatively and can be billed on each attendance which manages a rib fracture.

RIBS (one or more), treatment of fracture of – each attendance

This item can be co-billed with other attendance items such as 23, 721, and 2715 (if the associated service has also occurred), and includes:

  • Discussions on pain relief.
  • Providing education on the natural trajectory of rib fractures.
  • Ruling out other pathologies such as pneumothorax.

Fees

  • Fee: $49.00
  • Benefit: 75% = $36.75, 85% = $41.65

3. Aboriginal Health Assessments (Item 715)

It can be easy to get caught up in the day-to-day presentations to general practice, but having a structured approach to preventative healthcare assessments can greatly benefit patients as well as providing GPs with remuneration for their services. The Health Assessment for Aboriginal and Torres Strait Islander Peoples (MBS Item 715) provides a comprehensive framework for assessing the health and wellbeing of Indigenous Australians across various life stages. It is just one of the measures which can be used to reduce the gap in life expectancy for Aboriginal and Torres Strait Islander Peoples:

  • Eligibility: All individuals of Aboriginal and Torres Strait Islander descent.
  • Assessment Elements: Includes patient history, examination, overall assessment, recommending interventions, and offering advice and information.
  • Benefits: Allows eligible individuals to access 10 Medicare-subsidised allied health sessions per year which can improve patient’s access to multi-disciplinary care.

This item provides an opportunity to ensure preventive health care is tailored and accessible, improving overall community health outcomes and is not time-based.

It can be claimed for a professional attendance by a general practitioner at their consulting rooms or in another place other than a hospital or residential aged care facility not more than once in a 9-month period.

Fees

  • Fee: $241.85
  • Benefit: 100% = $241.85

While these MBS items provide additional opportunities for enhancing patient care and practice efficiency, always remember to stay updated with the latest MBS guidelines. This will ensure your billing practices remain compliant and effective.

For further details on these items and other changes, please visit the MBS Online website.

References

Australian Government Department of Health and Aged Care. (Last updated: 2023). Mental Health Case Conferencing Factsheet. https://www.mbsonline.gov.au/internet/mbsonline/publishing.nsf/Content/19A027B7D2C9BCC1CA2589D300115D44/$File/PDF%20-%20Mental%20Health%20Case%20Conferencing.pdf

Australian Government Department of Health and Aged Care. (n.d.). MBS Items. https://www9.health.gov.au/mbs/fullDisplay.cfm?type=item&q=47471&qt=item&criteria=47471

Australian Government Department of Health and Aged Care. (n.d.). MBS Explanatory Notes.https://www9.health.gov.au/mbs/fullDisplay.cfm?type=note&q=AN.0.43&qt=noteID&criteria=715

he Royal Australian College of General Practitioners (RACGP). (2019). MBS Item 715 Health Check Templates. https://www.racgp.org.au/the-racgp/faculties/aboriginal-and-torres-strait-islander-health/guides/2019-mbs-item-715-health-check-templates