August 2020 News

News summary for August 2020

Page last updated: 23 July 2020

Changes to the MBS commencing on 1 August 2020.

The August 2020 MBS files are available on the August 2020 downloads page.

Summary of Changes – Cardiac Imaging Services – August 2020

30 new items, 9 items had descriptor changes and 18 items ceased.

From 1 August 2020, there will be a revised structure of items for cardiac imaging services.

The changes to cardiac services have been made to encourage best practice and improve patient outcomes. Patients should not be negatively affected by the changes and will have continued access to clinically relevant services.
Changes will be made to MBS items for cardiac imaging services to better clarify the clinical requirements and circumstances where this testing and repeat testing is appropriate, reducing patient’s exposure to unnecessary testing. These changes will promote high-value use of electrocardiogram (ECG), echocardiogram, ambulatory ECG, ECG stress testing and stress echocardiogram. Changes to myocardial perfusion studies will reduce unnecessary exposure to radiation, when an equivalent investigation can be undertaken that does not require the use of radiation.
The Taskforce recommended these changes following an extensive period of stakeholder consultation and consultation with the sector that uses these items. More information about the Taskforce and associated Committees is available at the Department of Health website.

From 1 August 2020 changes will be made to MBS items for cardiac imaging services to better clarify the clinical requirements and circumstances where this testing and repeat testing is appropriate. These changes will promote high-value use of electrocardiogram (ECG), echocardiogram, ambulatory ECG, ECG stress testing, myocardial perfusion studies and stress echocardiogram.

Due to the deletion of a number of items, 9 items which referenced these deleted items have had their descriptors amended to remove any references to deleted items.

The Government agreed to these changes to clarify the clinical requirements and circumstances where this testing and repeat testing is appropriate, and to better align with clinical guidelines. The Government agreed to recommendations in the 2018-19 Mid-Year Economic and Fiscal Outlook (MYEFO) under the Guaranteeing Medicare – strengthening primary care measure.

Further information is available on the safe and best practice cardiac imaging services factsheet page.

Summary of Changes – Ovarian Cancer Services – August 2020

Item 73301 has been created to fund genetic testing for BRCA1 and BRCA2 variants present because of either hereditary (germline) or non-hereditary reasons, in the tumour tissue from a patient with advanced ovarian, fallopian tube or peritoneal cancer. The test may be requested by a specialist or consultant physician to determine eligibility for the PBS listed drug olaparib.

Item 73302 has been created to test patients with advanced ovarian, fallopian tube or peritoneal cancer who have had a tumour identified as having a BRCA variant, to determine whether that variant is present as the result of a germline (hereditary) variant in that patient.

Update of existing MBS item 73295 to align structure, language and specification of patient group with two MBS new items, 73301 and 73302.

Other Changes – August 2020

Amend item 73344 to enable testing for the ROS1 gene rearrangement by FISH to determine eligibility for newly PBS-subsidised entrectinib, in addition to crizotinib.

In line with the PBS listing for Botox, Dysport or Xeomin, and recommendations from MSAC and PBAC, Medicare Benefits Schedule item 18365 (for the injection of botox for the treatment of moderate to severe spasticity of the upper limb following a stroke) will be expanded to provide for treatment following an acute event, including stroke.

Changes to MBS Items for August 2020

New Items (31)11704 11705 11707 11714 11716 11717 11723 11729 11730 11731

55126 55127 55128 55129 55132 55133 55134 55137 55141 55143

55145 55146 61321 61324 61325 61329 61345 61349 61357 73301

73302

Amend Items (12)11718 11721 11729 12203 12204 12205 12207 12208 12250 18365 73295 73344
Ceased Items (18)11700 11701 11702 11708 11709 11710 11711 11712 11722 55113 55114 55115 55116 55117 61302 61303 61306 61307

Relevant legislative changes

Health Insurance Legislation Amendment (2020 Measures No. 1) Regulations 2020

The purpose of the Health Insurance Legislation Amendment (2020 Measures No. 1) Regulations 2020 is to remove nine Medicare Benefits Schedule (MBS) cardiac items from the DIST and to remove nine cardiac MBS items from the GMST from 1 August 2020.

Health Insurance (Section 3C Diagnostic Imaging Services – Cardiac Services) Determination 2020

The purpose of the Health Insurance (Section 3C Diagnostic Imaging Services – Cardiac Services) Determination 2020 is to list 19 new Medicare Benefits Schedule (MBS) items for cardiac diagnostic imaging services from 1 August 2020. The Determination lists eight new ultrasound items for an echocardiographic examination, four new ultrasound items for stress echocardiography testing, and seven new items for myocardial perfusion studies.

Health Insurance (Section 3C General Medical Services – Cardiac Services) Determination 2020

The purpose of the Health Insurance (Section 3C General Medical Services – Cardiac Services) Determination 2020 is to list 10 new Medicare Benefits Schedule (MBS) items for cardiac imaging services from 1 August 2020.

Health Insurance (Section 3C General Medical Services – Botox, Dysport or Xeomin Injection) Amendment Determination 2020

The purpose of Health Insurance (Section 3C General Medical Services – Botox, Dysport or Xeomin Injection) Amendment Determination 2020 is for the PBS listing for Botox, Dysport or Xeomin, and recommendations from MSAC and PBAC, Medicare Benefits Schedule item 18365 (for the injection of botox for the treatment of moderate to severe spasticity of the upper limb following a stroke) to be expanded to provide for treatment following an acute event, including stroke.

Health Insurance (Section 3C Co-Dependent Pathology Services) Amendment Determination (No. 5) 2020

The purpose of Health Insurance (Section 3C Co-Dependent Pathology Services) Amendment Determination (No. 5) 2020 is to update existing MBS item 73295 to align structure, language and specification of patient group with two MBS new items, 73301 and 73302.