MEDICARE AND COVID-19 VACCINATIONS
COVID-19 vaccine suitability assessment service
From March 2021, 16 new MBS items were made available to GPs and other qualified health professionals to assess patients for their suitability to receive a COVID-19 vaccine.
The Government has mandated that the MBS COVID-19 vaccine suitability assessment service is free to Medicare eligible patients and the MBS items must be bulk billed.
In order for a vaccine suitability assessment service to be billed to Medicare, the patient must receive a face-to-face attendance from the GP or suitably qualified health professional.
While it is not necessary for the GP to undertake the assessment themselves, the service must be billed in the name of the supervising GP.
The MBS COVID-19 vaccine suitability assessment service items only apply to a professional attendance where:
a dose of COVID-19 vaccine is immediately available for administration to the patient at the practice location following a suitability assessment service; or
for a suitability assessment service provided outside a practice location, including in the patient’s home or at a Residential Aged Care Facility, a dose of COVID-19 vaccine is immediately available for administration to the patient at the location at which the service is provided.
Multiple Same Day Attendances
Standard MBS multiple same-day attendance rules apply for COVID-19 vaccination-related services.
Co claiming of COVID-19 vaccine suitability assessment services with other items
In relation to the co-claiming of these items with other MBS items, this is permitted where another GP service is provided that is unrelated to the vaccine assessment item.
When seeking to co-claim for an unrelated attendance at the same time as a vaccine suitability assessment service, it is recommended that GPs include a note stating that:
“The additional service [MBS item…] is clinically relevant but not related to the vaccine suitability assessment service [MBS item…].”
Patients do not need to book a separate GP appointment prior to assessment for the vaccine.
The COVID-19 vaccine suitability assessment service items are specifically intended to cover consultations by a GP (or suitably qualified health practitioner working on behalf of a GP) for the purpose of assessing a patient’s suitability for the COVID-19 vaccine.
For more information, see the MBS COVID-19 vaccine suitability assessment service factsheet here.
Proof of eligibility for phase 1b
Where patients attend for a COVID-19 vaccination and they are not usual patients of the practice, the Government has prepared guidance for practices in relation to eligible patient cohorts and what documentation is required to confirm eligibility.
This information can be found at this link.
There is no requirement for patients to have their clinical records transferred over to the vaccinating practice as part of the assessment process.