What are the changes?
From 1 November 2018, changes will be made to ophthalmology items for minimally invasive glaucoma surgery (MIGS). This will provide increased access to MBS items for MIGS by:
a) The permanent listing of MBS item 42705 for MIGS in conjunction with cataract surgery. This will include an increased fee of $911.10; and
b) The listing of a new MBS item for the removal / replacement of MIGS devices due to device related complications.
Why are the changes being made?
The listing of these services was recommended by the Medical Services Advisory Committee (MSAC) in November 2017. Further details about the MSAC Application can be found at the MSAC website.
What does this mean for providers?
Eligible providers can continue to access MBS item 42705 for insertion of MIGS devices in conjunction with cataract surgery at an increased fee. Item 42705 remains otherwise unchanged. A new item for the removal and/or replacement of stents following device related medical complications will also be listed from 1 November 2018.
What does this mean for patients?
Eligible patients may now receive increased Medicare rebates when undergoing MIGS in conjunction with cataract surgery. Patients may also now receive Medicare rebates in the event of requiring removal of MIGS devices due to device related complications.
When will this change be reviewed?
The Department of Health regularly reviews the usage of new and amended MBS items in consultation with the profession.
All MBS items may be subject to compliance processes and activities, including random and targeted audits which may require a provider to submit information about the services claimed.
Significant variation from forecasted expenditure may warrant review and amendment of fees, and incorrect use of MBS items can result in penalties including the health professional being asked to repay monies that have been incorrectly received.
Where can I find more information?
The full item descriptor and information on other changes to the MBS can be found at the MBS Online website or by calling the Department of Human Services on 132 150.
(Draft wording of items to be finalised through regulatory amendments)
|MBS item 42705|
|Lens extraction and insertion of intraocular lens, excluding surgery performed for the correction of refractive error except for anisometropia greater than 3 dioptres following the removal of cataract in the first eye, performed in association with a trans-trabecular drainage device or devices, in a patient diagnosed with open angle glaucoma who is not adequately responsive to topical anti-glaucoma medications or who is intolerant of anti-glaucoma medication.
|Fee: $911.10 Benefit: 75% = $683.35 85% = $774.45|
|MBS item 42505|
|Complete removal from the eye of a trans-trabecular drainage device or devices, with or without replacement, following device related medical complications necessitating complete removal.
|Fee: $300.75 Benefit: 75% = $225.60 85% = $255.65|