From 1 November 2018:
New item for dialysis supervision in very remote areas (Item 13105):
· Registered nurses, Aboriginal Health workers and Aboriginal and Torres Strait Islander health practitioners will be able to bill item 13105 for the supervision of dialysis in very remote areas of Australia defined as Modified Monash Model 7.
· The service must be supervised by a medical practitioner, either in person or remotely.
· The patient’s care must be managed by a nephrologist, who must treat or review the patient in person or remotely every 3 to 6 months.
· The patient cannot be an admitted patient of a hospital.
Amendments to indwelling peritoneal catheter for dialysis (Items 13109 and 13110):
· The descriptor for item 13110 has been amended to align with the descriptor for item 13109.
Removal of insertion of temporary catheter for peritoneal dialysis item (Item 13112):
· Item 13112 for the establishment of peritoneal dialysis by abdominal puncture and insertion of a temporary catheter removed from the MBS.
Why are the changes being made?
These changes are a result of a review by MBS Review Taskforce, which was informed by the Renal Clinical Committee (RCC). More information about the Taskforce and associated committees is available at MBS Review Taskforce website.
A complete copy of the RCC’s final report can be found at the Renal Clinical Committee website.
Implementation of changes to items for weekly dialysis and the insertion and removal of arteriovenous shunts, also recommended as part of this review, have been deferred pending further consultation with providers in the first instance and consultation by the vascular clinical committee of the taskforce for arteriovenous shunts.
Further information on these changes will be provided in due course.
What does this mean for providers?
Registered nurses, Aboriginal Health workers and Aboriginal and Torres Strait Islander health practitioners delivering dialysis services in very remote communities defined by Modified Monash Model 7 will now be able to utilise a new MBS item, provided they meet the other requirements of the item descriptor.
What does this mean for patients?
Having dialysis funding available for services in very remote areas will provide greater access for patients, leading to better attendance for dialysis and improved health outcomes.
This change will also help address the economic, cultural and social impacts on Indigenous Australian renal patients by providing greater access for these services on country.
Patients should not be negatively affected by removed or amended items, and will have continued access to clinically relevant services.
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.
New and amended items
(Draft wording of items to be finalised through regulatory amendments)
|Item Number||Descriptor||Schedule fee|
|Haemodialysis for a patient with end-stage renal disease if:
(a) the service is provided by a registered nurse, an Aboriginal health worker or an Aboriginal and Torres Strait Islander health practitioner on behalf of a medical practitioner; and
(b) the service is supervised by the medical practitioner (either in person or remotely); and
(c) the patient’s care is managed by a nephrologist; and
(d) the patient is treated or reviewed by the nephrologist every 3 to 6 months (either in person or remotely); and
(e) the patient is not an admitted patient of a hospital; and
(f) the service is provided in a Modified Monash 7 area
|Indwelling peritoneal catheter (Tenckhoff or similar) for dialysis, removal of (including catheter cuffs). (Anaes.)||$228.50|
|Haemodialysis in very remote areas (Item 13105)
The purpose of item 13105 is for the management of haemodialysis to a person with end-stage renal disease. The service is provided in very remote areas (defined as Modified Monash 7) by a registered nurse, an Aboriginal health worker or an Aboriginal and Torres Strait Islander health practitioner on behalf of a medical practitioner. The service is supervised by a medical practitioner (either in person or remotely).
As a condition of receiving the Medicare-funded dialysis treatment, the patient’s care must be managed by a nephrologist, with the patient being treated or reviewed by the nephrologist every 3 to 6 months (either in person or remotely).
The patient is not an admitted patient of a hospital and the service is provided in a primary care setting.
Item 13104 should not be claimed if item 13105 is claimed
Item links: 13104