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Medicare Schedule update - 1st Nov 2017 [Expired]
Posted by Sinclair Hughes on 01 November 2017 09:19 AM

MBS effective 1 NOVEMBER 2017

Please refer to the complete MBS publication for a full list of changes.  A summary of these changes is included below.

Please note that while the importation of the Rates file (Rates.Aus) will update the Medicare table in the database, this is only used for Bulk Bill Claiming and no new invoice codes will be created or deleted.  Invoice items will not be modified or altered in any way.  New Invoice Codes will need to be made using the 'Make Codes' option on the Setup > Financial > Invoices tab, if any of the new item numbers are required for invoicing and/or online claiming (other than Medicare or DVA).  This can only be done once the new rates file has been imported (this only needs to be done once per database).

 

Please note that Medicare benefits are not payable for items 105 (and others) when claimed in association with an item in group T8 with a schedule fee of $300 or more.  The restriction applies when the procedure is performed by the same practitioner, on the same patient, on the same day. 

Three new attendance items (111, 117 and 120) have been listed for the use in extenuating circumstances.

Item

111

Professional attendance at consulting rooms or in hospital by a specialist in the practice of his or her specialty following referral of the patient to him or her by a referring practitioner an attendance after the first attendance in a single course of treatment, if:

(a) during the attendance, the specialist determines the need to perform an operation on the patient that had not otherwise been scheduled; and

(b) the specialist subsequently performs the operation on the patient, on the same day; and

(c) the operation is a service to which an item in Group T8 applies; and

(d) the amount specified in the item in Group T8 as the fee for a service to which that item applies is $300 or more

For any particular patient, once only on the same day