1 November 2023 pathology MBS changes

Effective from 1 November 2023, new and amended pathology items were listed on the Medicare Benefits Schedule, which includes:

• New pathology items 73437, 73438 and 73439, which allow testing for genetic variants in patients with non-squamous non-small cell lung carcinoma to be performed as a pathologist-determinable service;
• A fee increase for item 73418 for genetic testing for cardiac arrhythmias;
• New items 73440, 73441, 73442, 73443 and 73444 will be introduced for genetic testing for childhood hearing loss;
• New items 73445, 73446, 73447 and 73448 will be introduced for gene panel testing for haematological malignancies;
• New items 73451 and 73452 will be introduced for genetic testing to determine carrier status of cystic fibrosis, spinal muscular atrophy, and fragile X syndrome in patients who are planning pregnancy or already pregnant, and their reproductive partner;
• New items 73453, 73454 and 73455 will be introduced for reproductive carrier testing for specific genetic variants that cause nine severe conditions commonly found in the Ashkenazi Jewish population, with testing available to individuals of reproductive age who identify as being of Ashkenazi Jewish decent;
• New items 73456, 73457, 73458, 73459, 73460, 73461 and 73462 will introduced for the diagnosis of mitochondrial disease in patients who are suspected of having either acute or chronic diseases, and the cascade testing of their biological relatives;
• Amendment to the schedule fee for item 73418 from $400.00 to $1,200.00;
• New item 66585 will be introduced for the quantification of N-terminal pro B-type natriuretic peptide (NT-proBNP) or B-type natriuretic peptide (BNP) in patients with systemic sclerosis, to assess the risk of pulmonary arterial hypertensions;
• Amendments to prostate specific antigen testing items 66655, 66656, 66659 and 66660 and introduction of new item 66654 for testing patients with a first degree relative diagnosed with prostate cancer as a ‘high risk’ patient;
• New items 71202 and 73310 will be introduced for the detection of measurable residual disease (MRD) in patients with acute lymphoblastic leukaemia using flow cytometry and next-generation sequencing methods;
• New item 73306 will be introduced for the EndoPredict brand gene expression profiling test, which is a genetic test that looks at expression levels of several genes that can be involved in breast cancer;
• Pathology item 73343 will be incorporated into the PST; and
• Amendments to item 73296 and 73297 to expand the eligible patient population which can access testing of genes associated with breast, ovarian, fallopian tube or primary peritoneal cancer.