The 1 July 2022 Medicare Benefits Schedule (MBS) files are available on the July 2022 Downloads page.
From 1 July 2022 there will be a number of changes to the MBS. These changes include implementing annual fee indexation, the Government’s response to recommendations form the MBS Review Taskforce (the Taskforce) regarding colorectal surgery services and the Government’s response to recommendations from the independent Medical Services Advisory Committee (MSAC) on pathology services, prostate-specific membrane antigen (PSMA) positron emission tomography (PET) services, abdominoplasty services and transcatheter aortic valve implantation (TAVI) services.
A number of changes to the General Medical Services Table (GMST), Pathology Services Table (PST) and Diagnostic Imaging Services Table (DIST) will be implemented through the Health Insurance Legislation Amendment (2022 Measures No. 1) Regulations 2022 (the Regulations).
Indexation From 1 July 2022, indexation will be applied to most of the general medical services items, all diagnostic imaging services, except nuclear medicine imaging and six pathology items (74990, 74991, 75861, 75862, 75863 and 75864). The MBS indexation factor for 1 July 2022 is 1.6 per cent.
For the first time, from 1 July 2022 indexation will apply to MRI diagnostic imaging services in Group I5.
Changes to colorectal surgery servicesFrom 1 July 2022, there will be changes to colorectal surgery items to better align these services with contemporary and evidence-based treatment and to simplify and streamline items relating to colorectal surgery services. The changes include deleting outdated items, combining items that are provided together into a single item, and updating the descriptors of items to better describe modern techniques. Patients will benefit from improved patient safety and quality of care and may also benefit through a reduction in unnecessary services and related out-of-pocket expenses.
Changes to pathology servicesChanges to genetic testing and cervical screening services will be implemented from 1 July 2022. These changes include:
- introducing four new items for genomic testing for heritable cardiomyopathies;
- introducing four new items for genetic testing for diagnosis of inheritable cardiac arrhythmia disorders;
- introducing two new items for Non-Invasive Prenatal Testing for fetal Rhesus D genotype;
- introducing six new items for genetic testing for heritable kidney disease other than Alport syndrome;
- introducing four new items for genetic testing for alpha thalassaemia;
- amending item 73325 to allow the service to be delivered to patients with primary myelofibrosis and introducing four new items for testing for myeloproliferative neoplasms;
- amending cervical screening items 73071 and 73073 to expand access to self‑collected cervical screening tests; and
- amending pre-implantation genetic testing items 73385, 73386 and 73387 to clarify the policy intent of the services.
Changes to diagnostic imaging servicesFrom 1 July 2022:
- Two new MBS items will be introduced for prostate-specific membrane antigen (PSMA) positron emission tomography (PET) study for the initial staging of intermediate to high-risk patients with prostate cancer and for the restaging of patients with recurrent prostate cancer.
- Annual indexation of Magnetic Resonance Imaging (MRI) services will recommence and the MBS rebate for bulk billed MRI services will be brought in line with other diagnostic imaging services.
Transcatheter Aortic Valve Implantation (TAVI)From 1 July 2022, changes to TAVI services will be implemented. The changes will introduce two new items (38522 and 38523) and amend TAVI procedural items 38495 and 38514. These changes were recommended by MSAC.
New item 38522 will be for the treatment of symptomatic severe native calcific aortic stenosis in a patient at low risk of complications for open surgical aortic replacement. New item 38523 will be for the insertion of a dual-filter (multi-filter) cerebral embolic protection (CEP) device when a patient is undergoing a TAVI procedure. Existing items 38495 and 38514 will be amended to apply a co-claiming restriction against new item 38522.
Abdominoplasty for postpartum rectus diastasisFrom 1 July 2022, a new item (30175) will be introduced for radical abdominoplasty with repair of rectus diastasis where the patient has an abdominal wall defect because of pregnancy. This change was recommended by MSAC.
Changes to the Professional Services Review (PSR) SchemeFrom 1 July 2022, the 80/20 rule will be reapplied to GP telehealth and phone items. Under the 80/20 rule, a medical practitioner is taken to have engaged in inappropriate practice if they have rendered or initiated 80 or more ‘relevant service’ on each of 20 or more days in a 12 month period.
The 30/20 rule, which applies to phone services performed by GPs, other medical practitioners in general practice, and consultant physicians, will also be reintroduced on 1 July 2022. This means a practitioner will be considered to have practiced inappropriately if they render more than 30 phones services on a day more than 20 times in a 12 month period.