13 March 2020 (COVID-19) MBS & DVA Item Update

13 March 2020 (COVID-19) MBS & DVA Item Update

The 13 March 2020 (COVID-19) item update is now available to download.

Please read through all these notes prior to running your item update.

If you are prompted, please update your Medcomms.

Current annual support customers can download the new fees via the item update button in Impulse. If you are unsure of this process, you can find the instructions here: https://support.mednet.com.au/portal/kb/articles/updating-items

Released

  1. Medicare
  2. DVA

Summary of Changes

On 11 March 2020, the Prime Minister, the Hon. Scott Morrison MP, announced a $2.4 Billion health plan to fight COVID-19 to protect all Australians, including vulnerable groups such as the elderly, those with chronic conditions and Indigenous communities, from the coronavirus (COVID-19).

      o Bulk-billed video-conference consultation services, which can be provided by GPs, specialists, consultant physicians, obstetricians, consultant psychiatrists, nurse practitioners, allied mental health workers and midwives, for certain vulnerable people;
      o Bulk-billed telephone consultation services which can be provided by GPs, specialists, consultant physicians, obstetricians, consultant psychiatrists, nurse practitioners, allied mental health workers and midwives for certain vulnerable people (see items 91809 to 91817 below);
      o Bulk-billed pathology services where a medical practitioner has requested a test for SARS-CoV-2 under a new item; and
      o Bulk-billed pathology services for a pathologist to test for SARS-CoV-2 and relevant respiratory viruses, if the treating practitioner did not request them.
NEWS - on 16 March 2020, it has been confirmed that certain services provided by obstetricians and midwives are included in the above (claimable from 13 March 2020)
      Changes include the 'usual GP' has been expanded to include where there has been a face to face attendance in the previous 12 months with the practitioner or at the practice. The 'need for a limited examination' has been removed from the GP and Other Medical Practitioner items.
      These items will be claimable from 13 March 2020 and further items will be added to the MBS XML and MBS Online as soon as possible.
      As details of the new MBS items continue to develop, this page (and associated fact sheets) will be updated.

The XML is available from the March 2020 downloads page.

There are also new bulk-billed video-conference items for GP and other doctors working in general practice to continue to provide certain health services to their patients during the period of their isolation. Allied health providers with appropriate mental health training who are in isolation for possible COVID-19 infection will also be able to continue to provide mental health services to their patients during the period of their isolation.

Vulnerable/isolated patients are those where at least one of the following apply:
(a) the person has been diagnosed with COVID-19 virus but who is not a patient of a hospital; or
(b) the person has been required to isolate themselves in quarantine in accordance with home isolation guidance issued by Australian Health Protection Principal Committee (AHPPC); or
(c) the person is considered more susceptible to the COVID-19 virus being a person who is:
      (i) at least 70 years old; or
      (ii) at least 50 years old and is of Aboriginal or Torres Strait Islander descent; or
      (iii) is pregnant; or
      (iv) is a parent of a child under 12 months; or
      (v) is already under treatment for chronic health conditions or is immune compromised; or
(d) the person meets the current national triage protocol criteria for suspected COVID-19 infection.

A health professional at risk for COVID-19 means a person that:
(a) has been diagnosed with COVID-19 but who is not a patient of a hospital; or
(b) has been required to isolate themselves in quarantine in accordance with home isolation guidance issued by the Australian Health Protection Principal Committee.

SUMMARY OF CHANGES INCLUDED IN THIS EDITION

New Telehealth Items for COVID-19 vulnerable and/or isolated patients (defined below)

GENERAL PRACTITIONER TELEHEALTH ATTENDANCES for COVID-19 for vulnerable and/or isolated patients and for isolated health professionals providing medical services to existing patients (defined above)
Existing Items face to faceCOVID-19 Telehealth items
General Practitioners
23Professional attendance less than 20 minutes91800Telehealth attendance less than 20 minutes
36Professional attendance at least 20 minutes91801Telehealth attendance at least 20 minutes
44Professional attendance at least 40 minutes91802Telehealth attendance at least 40 minutes
Other Medical Practitioners
53Professional attendance more than 5 minutes but not more than 25 minutes (metro)91803Telehealth attendance more than 5 minutes but not more than 25 minutes (metro)
54Professional attendance more than 25 minutes but not more than 45 minutes (metro)91804Telehealth attendance more than 25 minutes but not more than 45 minutes (metro)
57Professional attendance more than 45 minutes (metro)91805Telehealth attendance at least 45 minutes (metro)
185Professional attendance more than 5 minutes but not more than 25 minutes (regional)91806Telehealth attendance more than 5 minutes but not more than 25 minutes (regional)
189Professional attendance more than 25 minutes but not more than 45 minutes (regional)91807Telehealth attendance more than 25 minutes but not more than 45 minutes (regional)
203Professional attendance more than 45 minutes (regional)91808Telehealth attendance at least 45 minutes (regional)
GENERAL PRACTITIONER TELEPHONE ATTENDANCES for COVID-19 for vulnerable and/or isolated patients and for isolated health professionals providing medical services to existing patients (if video-conferencing is not available)
Existing Items face to faceCOVID-19 Telephone attendance items
General Practitioners (for when video-conferencing is not available)
23Professional attendance less than 20 minutes91809Telephone attendance less than 20 minutes
36Professional attendance at least 20 minutes91810Telephone attendance at least 20 minutes
44Professional attendance at least 40 minutes91811Telephone attendance at least 40 minutes
Other Medical Practitioners (for when video-conferencing is not available)
53Professional attendance more than 5 minutes but not more than 25 minutes (metro)91812Telephone attendance more than 5 minutes but not more than 25 minutes (metro)
54Professional attendance more than 25 minutes but not more than 45 minutes (metro)91813Telephone attendance more than 25 minutes but not more than 45 minutes (metro)
57Professional attendance more than 45 minutes (metro)91814Telephone attendance at least 45 minutes (metro)
185Professional attendance more than 5 minutes but not more than 25 minutes (regional)91815Phone attendance more than 5 minutes but not more than 25 minutes (regional)
189Professional attendance more than 25 minutes but not more than 45 minutes (regional)91816Phone attendance more than 25 minutes but not more than 45 minutes (regional)
203Professional attendance more than 45 minutes (regional)91817Phone attendance at least 45 minutes (regional)
SPECIALIST, CONSULTANT PHYSICIAN AND PSYCHIATRIST TELEHEALTH ATTENDANCES for COVID-19 for vulnerable and/or isolated patients and for isolated health professionals providing medical services (defined above)
Existing Items face to faceCOVID-19 Telehealth items
104Initial attendance91822Telehealth initial attendance
105Subsequent attendance91823Telehealth subsequent attendance
110Initial attendance91824Telehealth initial attendance
116Subsequent attendance91825Telehealth subsequent attendance
119Minor attendance91826Telehealth minor attendance
300Consultation, continuing patient, not more than 15 minutes, fewer than 50 attendances91827Telehealth consultation, continuing patient, not more than 15 minutes
302Consultation, continuing patient, 15 to 30 minutes, fewer than 50 attendances91828Telehealth consultation, continuing patient, 15 to 30 minutes
304Consultation, continuing patient, 30 to 45 minutes, fewer than 50 attendances91829Telehealth consultation, continuing patient, 30 to 45 minutes
306Consultation, continuing patient, 45 to 75 minutes, fewer than 50 attendances91830Telehealth consultation, continuing patient, 45 to 75 minutes
308Consultation, continuing patient, more than 75 minutes, fewer than 50 attendances91831Telehealth consultation, continuing patient, more than 75 minutes
SPECIALIST, CONSULTANT PHYSICIAN AND PSYCHIATRIST TELEPHONE ATTENDANCES for COVID-19 for vulnerable and/or isolated patients and for isolated health professionals providing medical services (defined above)
Existing Items face to faceCOVID-19 Telephone items
104Initial attendance91832Telephone initial attendance
105Subsequent attendance91833Telephone subsequent attendance
110Initial attendance91834Telephone initial attendance
116Subsequent attendance91835Telephone subsequent attendance
119Minor attendance91836Telephone minor attendance
300Consultation, continuing patient, not more than 15 minutes, fewer than 50 attendances91837Telephone consultation, continuing patient, not more than 15 minutes
302Consultation, continuing patient, 15 to 30 minutes, fewer than 50 attendances91838Telephone consultation, continuing patient, 15 to 30 minutes
304Consultation, continuing patient, 30 to 45 minutes, fewer than 50 attendances91839Telephone consultation, continuing patient, 30 to 45 minutes
306Consultation, continuing patient, 45 to 75 minutes, fewer than 50 attendances91840Telephone consultation, continuing patient, 45 to 75 minutes
308Consultation, continuing patient, more than 75 minutes, fewer than 50 attendances91841Telephone consultation, continuing patient, more than 75 minutes
OBSTETRICIAN TELEHEALTH ATTENDANCES
Existing ItemsCOVID-19 items
16400Antenatal Service Provided by a Nurse, Midwife or an Aboriginal and Torres Strait Islander health practitioner on behalf of, and under the supervision of, a medical practitioner91850Telehealth Antenatal Service Provided by a Nurse, Midwife or an Aboriginal and Torres Strait Islander health practitioner on behalf of, and under the supervision of, a medical practitioner
16407Mental Health Assessments for Obstetric Patients by an obstetrician or GP91851Telehealth Mental Health Assessments for Obstetric Patients by an obstetrician or GP
16408Postnatal attendance by a midwife (on behalf of and under the supervision of the medical practitioner who attended the birth); or
(ii) an obstetrician; or
(iii) a general practitioner
91852Telehealth Postnatal attendance by a midwife (on behalf of and under the supervision of the medical practitioner who attended the birth); or
(ii) an obstetrician; or
(iii) a general practitioner
16500Antenatal Care by a specialist obstetrician91853Telehealth Antenatal Care by a specialist obstetrician
OBSTETRICIAN TELEPHONE ATTENDANCES
Existing ItemsCOVID-19 items
16400Antenatal Service Provided by a Nurse, Midwife or an Aboriginal and Torres Strait Islander health practitioner on behalf of, and under the supervision of, a medical practitioner91855Telephone Antenatal Service Provided by a Nurse, Midwife or an Aboriginal and Torres Strait Islander health practitioner on behalf of, and under the supervision of, a medical practitioner
16407Mental Health Assessments for Obstetric Patients by an obstetrician or GP91856Telephone Mental Health Assessments for Obstetric Patients by an obstetrician or GP
16408Postnatal attendance by a midwife (on behalf of and under the supervision of the medical practitioner who attended the birth); or
(ii) an obstetrician; or
(iii) a general practitioner
91857Telephone Postnatal attendance by a midwife (on behalf of and under the supervision of the medical practitioner who attended the birth); or
(ii) an obstetrician; or
(iii) a general practitioner
16500Antenatal Care by a specialist obstetrician91858Telephone Antenatal Care by a specialist obstetrician
NURSE PRACTITIONER TELEHEALTH ATTENDANCES
Existing Items face to faceCOVID-19 Telehealth items
82205Professional attendance less than 20 minutes91178Telehealth attendance less than 20 minutes
82210Professional attendance at least 20 minutes91179Telehealth attendance at least 20 minutes
82215Professional attendance at least 40 minutes91180Telehealth attendance at least 40 minutes
NURSE PRACTITIONER TELEPHONE ATTENDANCES
Existing Items face to faceCOVID-19 Telephone items
82205Professional attendance less than 20 minutes91189Telephone attendance less than 20 minutes
82210Professional attendance at least 20 minutes91190Telephone attendance at least 20 minutes
82215Professional attendance at least 40 minutes91191Telephone attendance at least 40 minutes
MENTAL HEALTH TELEHEALTH ATTENDANCES
Existing Items face to faceCOVID-19 Telehealth items
General Practitioners (credentialed)
2729FPS treatment of 30 to 40 minutes (videoconference)91818Telehealth attendance FPS treatment of 30 to 40 minutes
2731FPS treatment of more than 40 to minutes (videoconference)91819Telehealth attendance FPS treatment of more than 40 to minutes
Other Medical Practitioners
371FPS treatment of 30 to 40 minutes (videoconference)91820Telehealth attendance FPS treatment of 30 to 40 minutes
372FPS treatment of more than 40 to minutes (videoconference)91821Telehealth attendance FPS treatment of more than 40 to minutes
Clinical Psychologists
80001Professional attendance lasting more than 30 minutes but less than 50 minutes91166Telehealth attendance lasting more than 30 minutes but less than 50 minutes
80011Professional attendance lasting at least 50 minutes91167Telehealth attendance lasting at least 50 minutes
Psychologists
80101Professional attendance lasting more than 20 minutes but less than 50 minutes91169Telehealth attendance lasting more than 20 minutes but less than 50 minutes
80111Professional attendance lasting at least 50 minutes91170Telehealth attendance lasting at least 50 minutes
Occupational Therapists
80126Professional attendance lasting more than 20 minutes but less than 50 minutes91172Telehealth attendance lasting more than 20 minutes but less than 50 minutes
80136Professional attendance lasting at least 50 minutes91173Telehealth attendance lasting at least 50 minutes
Social Workers
80151Professional attendance lasting more than 20 minutes but less than 50 minutes91175Telehealth attendance lasting more than 20 minutes but less than 50 minutes
80161Professional attendance lasting at least 50 minutes91176Telehealth attendance lasting at least 50 minutes
    MENTAL HEALTH TELEPHONE ATTENDANCES
    Existing Items face to faceCOVID-19 Telephone items
    General Practitioners (credentialed)
    2729FPS treatment of 30 to 40 minutes (videoconference)91842Telephone attendance FPS treatment of 30 to 40 minutes
    2731FPS treatment of more than 40 to minutes (videoconference)91843Telephone attendance FPS treatment of at least 40 minutes
    Other Medical Practitioners
    371FPS treatment of 30 to 40 minutes (videoconference)91844Telephone attendance FPS treatment of 30 to 40 minutes
    372FPS treatment of more than 40 to minutes (videoconference)91845Telephone attendance FPS treatment of at least 40 minutes
    Clinical Psychologists
    80001Professional attendance lasting more than 30 minutes but less than 50 minutes91181Telephone attendance lasting more than 30 minutes but less than 50 minutes
    80011Professional attendance lasting at least 50 minutes91182Telephone attendance lasting at least 50 minutes
    Psychologists
    80101Professional attendance lasting more than 20 minutes but less than 50 minutes91183Telephone attendance lasting more than 20 minutes but less than 50 minutes
    80111Professional attendance lasting at least 50 minutes91184Telephone attendance lasting at least 50 minutes
    Occupational Therapists
    80126Professional attendance lasting more than 20 minutes but less than 50 minutes91185Telephone attendance lasting more than 20 minutes but less than 50 minutes
    80136Professional attendance lasting at least 50 minutes91186Telephone attendance lasting at least 50 minutes
    Social Workers
    80151Professional attendance lasting more than 20 minutes but less than 50 minutes91187Telephone attendance lasting more than 20 minutes but less than 50 minutes
    80161Professional attendance lasting at least 50 minutes91188Telephone attendance lasting at least 50 minutes

MIDWIFE TELEHEALTH ATTENDANCES
Existing Items face to faceCOVID-19 items
82105Short antenatal attendance at least 20 minutes91211Short telehealth antenatal attendance at least 20 minutes
82110Long antenatal attendance at least 40 minutes91212Long telehealth antenatal attendance at least 40 minutes
82130Short postnatal attendance at least 20 minutes91214Short telehealth postnatal attendance at least 20 minutes
82135Long postnatal attendance at least 40 minutes91215Long telehealth postnatal attendance at least 40 minutes
MIDWIFE TELEPHONE ATTENDANCES
Existing Items face to faceCOVID-19 items
82105Short antenatal attendance at least 20 minutes91218Short telephone antenatal attendance at least 20 minutes
82110Long antenatal attendance at least 40 minutes91219Long telephone antenatal attendance at least 40 minutes
82130Short postnatal attendance at least 20 minutes91221Short telephone postnatal attendance at least 20 minutes
82135Long postnatal attendance at least 40 minutes91222Long telephone postnatal attendance at least 40 minutes

NEW AND AMENDED PATHOLOGY ITEMS

Existing Items face to faceCOVID-19 items
Pathology
n/an/a69485Test for SARS-CoV-2 under new item 69485, to be provided in conjunction with other separate viral respiratory tests (provided under items 69494, 69495 or 69496)
69494
69495
69496
Detection of a virus or microbial antigen or microbial nucleic acid (not elsewhere specified) (pathologist determinable)69494
69495
69496
These tests are now also pathologist-determinable if item 69485 has been requested and items 69494, 69495 or 69496 were not requested as part of the same single patient episode

The links to the legislation are below:

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