The 1 January 2015 MBS files (DOC, PDF, ZIP, ASCII and XML) can now be downloaded from the 1 January 2015 downloads page.
The following changes will take effect from 1 January 2015 (updated 15 January 2015):
New Items (from 1 January 2015)
10910 10911 60001 60004 60007 60010 60013 60016 60019 60022 60025 60028 60031 60034 60037 60040 60043 60046 60049 60052 60055 60058
60061 60064 60067 60070 60073 60076 60079
Deleted Items (from 1 January 2015)
10900
Amended Description (from 1 January 2015)
10907 10912 10913 10914 10921 10922 10923 10924 10925 10926 10927 10928 10929 11820 13703 13706 13870 13873 13876 13881 13882 13885
13888 30165 30168 30171 30174 30189 32213 32218 32220 32221 35412 45522 45556 45638 45639 52375 55064 55085 60000 60003 60006 60009
60012 60015 60018 60021 60024 60027 60030 60033 60036 60039 60042 60045 60048 60051 60054 60057 60060 60063 60066 60069 60072 60075
60078 60918 60927 73338
There will be no changes commencing on 19 January 2015
Further information can be found on the Department of Health website.
Fee Amended (from 1 January 2015)
10905 10907 10912 10913 10914 10915 10916 10918 10921 10922 10923 10924 10925 10926 10927 10928 10929 10930 10931 10932 10933 10940
10941 10942 10943 73338
Health Assessment for Aboriginal and Torres Strait Islander People amendment:
Item 715 has been amended to remove reference to Aboriginal Health Worker being able to assist General Practitioners in performing this type of health assessment. This long-standing change was made in the Regulations in July 2012.
Autologous Blood and Other Blood Product Injection Services
As part of the 2014-15 Budget, the Australian Government announced amendments to the Medicare Benefits Schedule (MBS) to restrict access to medicare benefits for autologous blood (and blood product) injection services.
The new budget measure will remove access to Medicare benefits for all autologous blood (and blood products) injection services for the treatment of musculoskeletal and other conditions. Specifically, the measure will remove MBS rebates for blood administration, diagnostic imaging and consultation items on the MBS where an autologous blood injection service is performed. Legislative changes to implement this budget measure will take effect 1 January 2015.
As part of the legislative amendment process, MBS items 13703 and 13706 will also be updated to specify 'transfusion of blood' instead of the existing (broader) term 'administration of blood'.
New items for comprehensive eye examinations
Item 10900 has been removed and replaced with two new MBS items.
New item 10910 has been introduced for comprehensive eye examinations within 36 months for asymptomatic patients under 65 years.
New item 10911 has been introduced for comprehensive eye examinations within 12 months for asymptomatic patients at least 65 years of age.
Items 10907, 10912-10914, 10921-10929 have been amended accordingly to recognise these new items.
On 1 January 2015, all optometry fees on the MBS will be reduced so that the rebate is reduced by five per cent.
Changes to KRAS testing to include testing for RAS mutations
Item 73338 previously provided for the testing of tumour tissue from a patient with metastatic colorectal cancer to determine if the patient met the requirements relating to Kirsten ras (KRAS) gene mutation status for access to either cetuximab or panitumumab under the PBS. Recent clinical evidence indicates that merely identifying whether the patient is a KRAS wild-type patient in determining eligibility for cetuximab or panitumumab is too limited.
Expanding genetic testing to include testing for RAS mutations and to limit PBS subsidy of cetuximab and panitumumab to those patients demonstrated to have no RAS mutations, rather than to those with just no KRAS mutations, supports improved health outcomes. Item 73338 has been updated to reflect this change.
For a Medicare benefit to be payable under the updated item 73338, the test must be conducted for all clinically relevant mutations on KRAS exons 2, 3 and 4 and NRAS exons 2, 3 and 4, or until a RAS mutation is found. Enabling the requirements of the item descriptor to be met once any RAS mutation is found means that once the test indicates that the patient is not RAS wild-type and therefore not suitable for access to cetuximab and panitumumab under the PBS, a pathologist is not required to continue testing for other clinically relevant mutations.
Dental Benefits Schedule amendments:
Item 88412 has been added to provide for situations where root canal therapy cannot be completed. Item 88412 has a limitation of one per tooth. A benefit is not payable for any other endodontic service if new item 88412 has been provided on the same tooth. The limitations on item 88455 and 88768 have also been amended. The 'Guide to the Child Dental Benefits Schedule', which contains the Dental Benefits Schedule, is available at the Department of Human Services website and will be updated to include the new item and limitations prior to 1 January 2015.
Changes to Level A and Level B items:
On 15 January 2015, the Minister for Health and Minister for Sport the Hon Sussan Ley MP, announced that the changes to the time requirements for GP consultations, scheduled to commence from 19 January 2015, will not proceed. This means from 19 January 2015:
- Level A GP consultation items 3 (GP general) and 5000 (GP after-hours) will continue to be untimed, as per the existing item requirements.
- Level B GP consultation items 23 (GP general) and 5020 (GP after-hours) will apply to attendances lasting less than 20 minutes, as per the existing item requirements.
There will also be no change to the time requirements for consultation items for non-vocationally recognised GP and nurse practitioners. This means from 19 January 2015 there will be no changes to the existing requirements for:
- Non-VR GP Group A2 consultation items 52 (general) and 5200 (after-hours);
- Non-VR GP A23 consultation items 53 (general) and 5203 (after-hours); and
- Nurse practitioner items 82200 and 82205.
Further information can be found on the Department of Health website