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Changes to MBS consultation items co-claiming rules, effective 1/11

The Department of Health has informed RANZCO on changes to claiming rules of MBS subsequent consultation items together with surgical operation items. The changes which would affect ophthalmology are:

MBS 105 and other subsequent consultation items co-claiming: No same-day co-claiming of MBS items for subsequent attendance with any item in group T8 that has an MBS fee of $300 or more. This means that subsequent consultation items (105, 116, 119, 386, 2806, 2814, 3010, 3014, 6019, 6052, and 16404) cannot be co-claimed with any surgical operations items (these are item number starting with ‘4’) which carry a rebate of $300 or over.
MBS 111 – subsequent consultation items: The following new subsequent consultation item will be introduced on the same day. MBS item 111 allows co-claiming with surgical items which carry a rebate of $300 or more in specific circumstances. Below is the wording of this item, subject to passage of legislation:

MBS 111 (Fee: $43): Professional attendance at consulting rooms or in hospital by a specialist in the practice of his or her specialty following referral of the patient to him or her by a referring practitioner—an attendance after the first attendance in a single course of treatment, if: 
(a) during the attendance, the specialist determines the need to perform an operation on the patient that had not otherwise been scheduled; and
(b) the specialist subsequently performs an operation on the patient, on the same day; and
(c) the operation is a service to which an item in Group T8 applies; and
(d) the amount specified in the item in Group T8 as the fee for a service to which that item applies is $300 or more. 

For any particular patient, once only on the same day.

For more information, please refer to the MBS Fact Sheet, available here.

Last updated: April 8, 2019

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