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MBS Specialist and Consultant Physician subsequent attendance items

The following information is provided by the Department of Health as a reminder to the appropriate use of MBS Specialist and Consultant Physician subsequent attendance items.

02 Dec 2019

INFORMATION FOR MEMBERS   

The following information is provided by the Department of Health as a reminder to the appropriate use of MBS Specialist and Consultant Physician subsequent attendance items.

A co-claiming restriction was introduced on 1 November 2017 to prevent providers billing a subsequent consultation item (105, 116, 119, 386, 2806, 2814, 3010, 3014, 6019, 6052, or 16404) on the same day as any Group T8 item (30001-50952) with an MBS fee greater than $300 (currently $304.80). The restriction supports the ‘complete medical service’ rule where the consultation component is an integral part of the surgical procedure.

To assist patients with unexpected conditions, subsequent attendance items (111, 115, 117, 120) were introduced.

 

Subsequent attendance items

Planned component

Unplanned component

111, 117, 120

Consultation

Clinical need for an operation with MBS fee of $304.80 or more

115

Operation with MBS fee of $304.80 or more

Unrelated consultation where deferral would represent a clinical risk

It is expected practitioners will only bill these items for exceptional circumstances and maintain contemporaneous records to identify why the procedure or consultation is necessary for the patient, including the clinical risk to defer.

Items 111, 115, 117, and 120 must be co-claimed with a Group T8 item (ie not billed on their own) with a MBS fee equal to or greater than $304.80. The Department of Health will continue to monitor the use of these items closely to ensure patients are billed appropriately and identify if further education or compliance action is required.

 


Published: 02 Dec 2019