August 2022 News

News containing information on changes to the MBS for 1 August 2022

Page last updated: 20 July 2022

The 1 August 2022 Medicare Benefits Schedule (MBS) files are available on the August 2022 Downloads page.

The purpose of the Health Insurance Legislation Amendment (2022 Measures No. 2) Regulations 2022 (the Regulations) is to amend the General Medical Services Table and Health Insurance Regulations 2018, from 1 August 2022 to fix typographical errors and omissions made through previous regulation changes. Health Insurance Legislation Amendment (2022 Measures No. 2) Regulations 2022 (the Regulations).

The August 2022 MBS Regulations will amend the GMST and the HIR to clarify the co-claiming arrangements for colorectal surgery item 32006, increase the fee for gynaecological surgery item 35723 and prescribe item 93423 (review of a mental health plan for an aged care resident) in subsection 28(1) of the HIR. The Regulations will also make a minor amendment to a clause relating to the review of a mental health treatment planning item and resolve an incorporated documents issue as identified by the Senate Standing Committee for the Scrutiny of Delegated Legislation.

Minor changes to Gynaecology MBS items

From 1 August 2022, the item descriptors of seven gynaecology MBS items and fee increase for one gynaecology MBS item will be amended.

The changes will improve clarity and better align the items with the original intent of recommendations of the MBS Taskforce Review of Gynaecology items. The changes are:

  • Items 35631, 35632, and 35641 will be amended to remove references to the American Fertility Society (rAFS) scale of endometriosis and replace the references with minimal, mild, moderate and severe.
  • Items 35633 and 35635 will be amended to remove reference to the European Society for Hysteroscopy (ESH) classifications. This will now be included in the explanatory note.
  • Item 35637 will be amended to better reflect the requirements of the service provided by amended the co-claiming restrictions.
  • Item 35723 will be amended to increase the fee as recommended by the MBS Taskforce.
  • Item 35754 will be amended to better align the requirements of the service provided with the intent of the MBS Review Taskforce recommendation.

Minor change to colorectal surgery item 32006

From 1 August 2022, item 32006 will be amended to clarify that the services should not be performed in conjunction with other colorectal surgery item 32024, 32025, 32026 or 32028. The purpose of this change is to better align item 32006 with the original intent of the MBS Taskforce recommendations and clarify the appropriate claiming arrangements for practitioner to reflect best practice.

Diagnostic Imaging PET and Gallium-67

From 1 August 2022, there will be one new alternative positron emission tomography (PET) item (61527) to enable patient access to an alternative (PET) imaging service during supply disruptions of the radiopharmaceutical gallium-67 (Ga-67).

This new item will enable continuity of patient care by ensuring patients continue to have affordable access to an appropriate diagnostic imaging service.

The new item will enable providers to substitute a PET imaging scan when a preferred Ga-67 based scan under item 61429, 61430, 61442, 61450 or 61453 has been requested and is not available due to the supply interruption.


Administrative changes to align GP Telehealth and Phone fees

From 1 August 2022, there will be an administrative amendment to change the benefit calculation from 85% to 100% of the fee for MBS item 93423. This is an administrative change that reduces the fees of this item, so the benefit paid for the service remains unchanged. Item 93423 is claimable for general practitioners phone attendance services delivered for the purpose of reviewing mental health treatment planning, psychiatry assessments and management planning for care recipients of a residential aged care facility.

Other Amendments

From 1 August 2022, there will also be a minor amendment to a clause relating to the review of a mental health treatment planning item. This change will allow a face-to-face review to be undertaken even if the patient had their initial treatment plan provided under telehealth items. The following items will have the amendment made, 92112, 92113, 92116 or 92117.