The 1 November 2015 MBS files (XML, DOC, PDF, ZIP) can now be downloaded from the 1 November 2015 downloads page.
The following changes will take effect from 1 November 2015:
37831 72858 72859 73899 73900
291 22060 37830 38615 38618 39615 45051 74995
Healthy Kids Check:
From 1 November 2015, Healthy Kids Check provided by general practitioners (GPs) using the MBS health assessment items will no longer be available.
Healthy Kids Checks provided on a GP's behalf by a practice nurse or Aboriginal and Torres Strait Islander Health Practitioner under MBS item 10986 will cease, and item 10986 will be removed from the MBS.
A GP may continue to provide a health assessment service for a patient, including a child, using existing MBS time-tiered general attendance items.
Aboriginal and Torres Strait Islander children will continue to have access to health assessment services under item 715, which can be provided every nine months and is more comprehensive than the Health Kids Check.
Children will still be able to receive health assessments in state and territory - funded Infant Health clinics. The Healthy Kids Check duplicates services provided by state and territory governments.
This change will allow for an endoscopic approach in addition to cranioplasty, for repair of skull fracture with rhinorrhoea or otorrhoea.
Paediatric Services Review - Stage 1
The new item 37831, will be introduced to cover Hypospadias, when conducted on a person under 10 years of age. It will receive a 30 percent fee loading in line with the recommendations from the review. Item 37830 which currently covers Hypospadias for all ages will be amended to cover Hypospadias, when performed on a person 10 years of age and over.
Ventricular Assist Device
Item 38615 and 38618 have been amended to exclude the use of ventricular assist devices (VAD) as destination therapy in the management of heart failure.
The strength of the available evidence in relation to the safety, clinical effectiveness and cost-effectiveness of VAD as destination therapy has not yet been considered by the Medical Services Advisory Committee.
Contour Reconstruction amendment:
Item 45051 has been amended to clarify the item's use, and include it in the list of MBS items subject to scrutiny by the Medicare Claims Review Panel (MCRP) before it can be claimed.
Cardiac Perfusion Services
At their meeting on 2 April 2015, after considering the available evidence presented in relation to the safety, clinical effectiveness and cost-effectiveness of cardiac perfusion services, the Medical Services Advisory Committee (MSAC) recommended that the descriptor for item 22060 and the associated explanatory notes should be amended to incorporate the intent of: continuous attendance during the perfusion service; personal operation of the heart lung machine (HLM); and meeting the training requirements for perfusion set by the Australian and New Zealand College of Anaesthetists (ANZCA).
Addition of External expert opinions for morphological pathology (histology and cytopathology) items:
Items 72858 and 72859 have been included in the Pathology Services Table to provide public funding for external expert opinions for morphological pathology.
Items 72899, 73900 have been included to support items 72858 and 72859 as PEI and item 74995 has been amended as the bulk billing incentives.
Midwifery Services - Intrapartum Care
The Health Insurance (Midwife and Nurse Practitioner) Determination 2015 will be amended to include an 'exceptional circumstances' provision. The provision comes into effect on 1 November 2015 and will enable midwives to transfer intrapartum care from one participating midwife to another participating midwife within a 12 hour period, due to exceptional circumstances, yet still enable the midwife to claim Medicare benefits appropriately.