The 1 July 2023 Medicare Benefits Schedule (MBS) files are available on the July 2023 Downloads page.
Summary of Change for 1 July 2023
From 1 July 2023, there will be changes to the Medicare Benefits Schedule (MBS). The changes include annual fee indexation and minor administrative changes in addition to implementation of the Government’s response to recommendations from the independent MBS Review Taskforce (the Taskforce) on plastic and reconstructive surgery services, and the independent Medical Services Advisory Committee’s (MSAC) recommendations relating to certain pathology and diagnostic imaging services.
The changes will affect:
From 1 July 2023, annual fee indexation will be applied to:
- most of the general medical services items;
- most diagnostic imaging services (but excluding nuclear imaging services); and
- pathology items in Group P12 (74990, 74991, 75861, 75862, 75863 and 75864).
Changes to plastic and reconstructive surgery services
From 1 July 2023, there will be changes to plastic and reconstructive surgery services to implement the Government’s response to Taskforce recommendations. These changes will:
- Consolidate and restructure some existing items to simplify claiming, to reflect contemporary clinical and surgical practice and for consistency throughout the MBS. Affected areas include burn treatments, breast cancer and reconstruction, cranio-maxillofacial/oral and maxillofacial items, paediatric plastic surgery items.
- Introduce new services for fat grafting for defects arising from breast surgery, breast cancer treatment/prevention and congenital breast deformity.
- Minimise inappropriate cosmetic use of services.
New mental health case conferencing services
From 1 July 2023, 21 items will be introduced for mental health case conferencing services for patients receiving treatment under the Better Access to Psychiatrists, Psychologists and General Practitioners through the MBS (Better Access) initiative or an eating disorder treatment and management plan. The new items are: 930, 933, 935, 937, 943, 945, 946, 948, 959, 961, 962, 964, 969, 971, 972, 973, 975, 986, 80176, 80177 and 80178.
Other changes to general medical services
From 1 July 2023, the following changes will be made to the MBS:
- Cardio-thoracic item 38680 will be amended so that tumour excision services under this item may only be performed in-hospital;
- Orthopaedic item 49706 will be amended to allow patients to access this service where no infection is indicated;
- Therapeutic nuclear medicine item 16015 will be amended to apply to patients with all cancer types;
- Items 13761 and 13762 for extracorporeal photopheresis treatments of graft versus host disease will be amended to apply once per each treatment in a 25-session treatment cycle, rather than once per cycle;
- Increased fees will apply to items 16003, 16006, 16009, 16012 and 16018 to reflect the cost of radiopharmaceuticals used;
- Item 32221 for the removal or revision of an artificial bowel sphincter will be repealed; and
- Other administrative and machinery changes.
From 1 July 2023, a new nuclear medicine item 61466 will be introduced for cerebro-spinal fluid transport studies using indium-111 and item 61409 will be amended to specify use of technetium-99m and increase the fee to better reflect the cost of this radiopharmaceutical. Item 63545 will also be amended to clarify claiming requirements for liver MRIs to ensure appropriate use.
Pathology Services
From 1 July 2023, changes to pathology services include the introduction of four new pathology items and an amendment to one item. New item 73429 will be introduced for initial diagnosis somatic gene panel testing. Items 73434 and 73435 will be introduced for single gene testing for heritable neuromuscular disorders and item 73427 will be amended to include item 73434 as a pathway to item 73427 services.
New item 69505 will also be introduced for antimicrobial drug susceptibility testing.
Relevant legislation
Health Insurance Legislation Amendment (2023 Measures No. 1) Regulations 2023
Health Insurance Legislation Amendment (Indexation) Determination 2023