Increasing MBS Rebate for Selected GP Procedures (PDF 232 KB)
Increasing MBS Rebate for Selected GP Procedures (Word 492 KB)
What do the changes involve?
The MBS items for some procedural services currently have different fees for GPs and specialists. This is depicted by ‘G’ (GP) and ‘S’ (specialist) items, whereby a lower fee is set for a procedural service performed by a GP than for the same service performed by a specialist. The current priced GP items will be removed and the specialist items will be amended to allow both GPs and specialists to claim the same fee for these services, set at the specialist rate. This change will see 43 MBS ‘S’ items amended and 31 current ‘G’ items deleted.
Why is the Government making this change?
This change acknowledges that minor procedures performed by specialists and GPs should be equally renumerated.
This change is based on a recommendation of the Medicare Benefits Schedule Review Taskforce.
What does this mean for MBS claiming?
The GP (lower fee) items will be removed from the MBS. GPs will be able to claim the higher fee items which were only available previously to specialists. There will be no change to the fees for MBS items claimed by specialists.
Change to item description/fees:
Items to be deleted from the MBS:
30009, 30013, 30041, 30048, 30067, 30074, 30102, 30106, 30110, 30265, 30282, 30620, 30634, 30638, 30675, 35512, 35516, 35526, 35617, 35639, 35676, 35683, 35687, 35712, 35716, 37622, 41665, 41788, 41792, 41796, 41800
Draft amendments to items in the MBS (final wording of items subject to finalisation and passage of legislation):
| 30010 | Localised burns, dressing of, under general anaesthesia (not involving grafting) Fee: $73.90 Benefit: 75% = $55.45 |
| 30014 | Extensive burns, dressing of, under general anaesthesia (not involving grafting) Fee: $155.40 Benefit: 75% = $116.55 |
| 30042 | Skin and subcutaneous tissue or mucous membrane, repair of wound of, other than wound closure at time of surgery, other than on face or neck, large (more than 7 cm long), involving deeper tissue, other than a service to which another item in Group T4 applies Fee: $185.60 Benefit: 75% = $139.20 85% = $157.80 |
| 30049 | Skin and subcutaneous tissue or mucous membrane, repair of wound of, other than wound closure at time of surgery, on face or neck, large (more than 7 cm long), involving deeper tissue Fee: $185.60 Benefit: 75% = $139.20 85% = $157.80 |
| 30068 | Foreign body in muscle, tendon or other deep tissue, removal of, as an independent procedure Fee: $276.80 Benefit: 75% = $207.60 85% = $235.30 |
| 30075 | Diagnostic biopsy of lymph gland, muscle or other deep tissue or organ, as an independent procedure, if the biopsy specimen is sent for pathological examination Fee: $149.75 Benefit: 75% = $112.35 85% = $127.30 |
| 30103 | Sinus, excision of, involving muscle and deep tissue Fee: $183.90 Benefit: 75% = $137.95 85% = $156.35 |
| 30107 | Ganglion or small bursa, excision of, other than a service associated with a service to which another item in this Group applies Fee: $219.95 Benefit: 75% = $165.00 85% = $187.00 |
| 30111 | Bursa (large), including olecranon, calcaneum or patella, excision of Fee: $371.50 Benefit: 75% = $278.65 85% = $315.80 |
| 30266 | Salivary gland, removal of calculus from duct or meatotomy or marsupialisation, one or more such procedures Fee: $149.75 Benefit: 75% = $112.35 85% = $127.30 |
| 30283 | Ranula or mucous cyst of mouth, removal of Fee: $204.70 Benefit: 75% = $153.55 85% = $174.00 |
| 30621 | Repair of symptomatic umbilical, epigastric or linea alba hernia requiring mesh or other formal repair of, in a person 10 years of age or over, other than a service to which item 30403 or 30405 applies Fee: $407.50 Benefit: 75% = $305.65 |
| 30635 | Varicocele, surgical correction of, other than a service associated with a service to which items 30638, 30641 and 30644 apply—one procedure Fee: $291.80 Benefit: 75% = $218.85 |
| 30641 | Orchidectomy, simple or subcapsular, unilateral with or without insertion of testicular prosthesis Fee: $407.50 Benefit: 75% = $305.65 |
| 30676 | Pilonidal sinus or cyst, or sacral sinus or cyst, excision of Fee: $379.05 Benefit: 75% = $284.30 85% = $322.20 |
| 35513 | Bartholin’s cyst, excision of Fee: $221.70 Benefit: 75% = $166.30 85% = $188.45 |
| 35517 | Bartholin’s cyst or gland, marsupialisation of Fee: $146.00 Benefit: 75% = $109.50 85% = $124.10 |
| 35527 | Urethral caruncle, excision of Fee: $146.00 Benefit: 75% = $109.50 85% = $124.10 |
| 35618 | Cervix, cone biopsy, amputation or repair of, other than a service to which item 35577 or 35578 applies Fee: $218.00 Benefit: 75% = $163.50 85% = $185.30 |
| 35640 | Uterus, curettage of, with or without dilatation (including curettage for incomplete miscarriage) under general anaesthesia or under epidural or spinal (intrathecal) nerve block, including procedures to which item 35626, 35627 or 35630 applies, if performed Fee: $183.00 Benefit: 75% = $137.25 |
| 35677 | Ectopic pregnancy, removal of Fee: $ 536.00 Benefit: 75% = $402.00 |
| 35684 | Uterus, suspension or fixation of, as an independent procedure Fee: $ 471.15 Benefit: 75% = $353.40 |
| 35688 | Sterilisation by transection or resection of fallopian tubes, via abdominal or vaginal routes or via laparoscopy using diathermy or another method Fee: $397.25 Benefit: 75% = $297.95 |
| 35713 | Laparotomy, involving oophorectomy, salpingectomy, salpingo-oophorectomy, removal of ovarian, parovarian, fimbrial or broad ligament cyst—one such procedure, other than a service associated with hysterectomy Fee: $452.85 Benefit: 75% = $339.65 |
| 35717 | Laparotomy, involving oophorectomy, salpingectomy, salpingo-oophorectomy, removal of ovarian, parovarian, fimbrial or broad ligament cyst—2 or more such procedures, unilateral or bilateral, other than a service associated with hysterectomy Fee: $ 545.30 Benefit: 75% = $409.00 |
| 37623 | Vasotomy or vasectomy, unilateral or bilateral Fee: $229.85 Benefit: 75% = $172.40 85% = $195.40 |
| 41668 | Nasal polyp or polypi, removal of Fee: $219.95 Benefit: 75% = $165.00 |
| 41789 | Tonsils or tonsils and adenoids, removal of, in a person aged less than 12 years Fee: $295.70 Benefit: 75% = $221.80 |
| 41793 | Tonsils or tonsils and adenoids, removal of, in a person 12 years of age or over Fee: $ 371.50 Benefit: 75% = $278.65 |
| 41797 | Tonsils or tonsils and adenoids, arrest of haemorrhage requiring general anaesthesia, following removal of Fee: $144.00 Benefit: 75% = $108.00 |
| 41801 | Adenoids, removal of Fee: $162.95 Benefit: 75% = $122.25 |