The 1 March 2023 Medicare Benefits Schedule (MBS) files are available on the March 2023 Downloads page
Summary of Change for 1 March 2023
From 1 March 2023 there will be several changes to the Medicare Benefits Schedule (MBS). These changes include minor administrative and policy changes, as well as the Government’s response to recommendations from the independent MBS Review Taskforce (the Taskforce) and the Medical Services Advisory Committee (MSAC) Executive.
Changes to the Health Insurance (General Medical Services Table) Regulations 2021 (GMST) and the Health Insurance Regulations 2018 (HIR) will be implemented through the Health Insurance Legislation Amendment (2022 Measures No. 4) Regulations 2022 commencing from
1 March 2023.
Other changes will also be implemented through the creation of, or amendments to legislative instruments under subsection 3C(1) of the Health Insurance Act 1973.
Details of the changes are as follows:
Otolaryngology, head and neck surgery changes to implement the Government’s response to recommendations from the Taskforce in relation to services for otolaryngology diagnostic procedures, audiology services and ear, nose and throat surgical operations to ensure the items reflect contemporary clinical practice and the Medicare benefits appropriately reflect the skill and complexity of the relevant procedure.
These changes include:
- · adjusting item descriptors to reflect complete medical services and contemporary clinical practice;
· introducing co-claiming restrictions to minimise potentially inappropriate claims;
· creating new groupings of items to facilitate achieving these priorities; and
· deleting obsolete services.
Thoracic surgery item changes to implement the Government’s response to recommendations from the Taskforce relating to thoracic surgery services to ensure they align with contemporary clinical practice.
These changes aim to:
· improve the structure and sequencing of thoracic surgery MBS items to ensure a logical and simplified approach, organising the items into anatomical areas of increasing procedure complexity;
· restrict inappropriate co-claiming;
· introduce new services that reflect current clinical practice; and
· delete outdated and obsolete items that do not reflect current best practice.
These changes include:
- · updating condition terminology to reflect contemporary usage;
· the addition of eligible disabilities: fetal alcohol spectrum disorder, Lesch Nyhan syndrome and 22q deletion syndrome; and
· extended eligibility for these services from under 13 years of age to under 25 years of age to facilitate high quality of care for Australians presenting late with neurodevelopmental disorders and to provide equitable access for Australians with eligible disabilities.
Health assessment changes to update the definition of relevant visa for the purposes of health assessment services for a refugee or other humanitarian entrant to reflect relevant changes to refugee and humanitarian visa types within the Migration Regulations 1994.
Focussed psychological strategies services changes for the introduction of four new items (2739, 2741, 2743 and 2745) to facilitate family and carer participation in treatment under the Better Access to Psychiatrists, Psychologists and General Practitioners (Better Access) initiative.
Eating disorder and mental health service changes for the removal of four pre-COVID-19 general practitioner and medical practitioner video conference items (90279, 90280, 90281 and 90282) and 17 pre-COVID-19 allied health video conference items for geographically restricted eating disorder and mental health services. This change consolidates eating disorder and mental health telehealth services to remove duplication of equivalent services. Patients will continue to have access to telehealth services for eating disorder psychological treatment and mental health services under items 92182, 92184, 92186 and 92188 in the Health Insurance (Section 3C General Medical Services – Telehealth and Telephone Attendances) Determination 2021.
GP management plans, team care arrangements and multidisciplinary care plans changes to introduce the equivalent same day co-claiming restrictions for items 721, 723 and 732 that apply for telehealth and phone items 91790, 91800, 91801, 91802, 91890, 91891, 91792, 91803, 91804, 91805, 91892, 91893, 91794, 91806, 91807, 91808, 91894, 91895, 92210 and 92211. The equivalent telehealth and phone items, which were first introduced as part of the Government’s response to the COVID-19 pandemic, have been continued on an ongoing basis.
Diagnostic Imaging Services
Whole body Magnetic Resonance Imaging (MRI) made through a legislative instrument under subsection 3C(1) of the Health Insurance Act 1973 for the introduction of new item 63564. This item is for a whole-body MRI scan to enable the detection of cancer in patients with germline pathogenic TP53 variants.
The purpose of the Health Insurance Legislation Amendment (2022 Measures No. 4) Regulations 2022 (the Regulations) is to amend the GMST and the HIR from 1 March 2023.
The purpose of the Health Insurance (Section 3C Diagnostic Imaging Services – Whole Body Magnetic Resonance Imaging Scan) Determination 2022 is to introduce a new Medicare MBS item 63564, which is for whole body magnetic resonance imaging (MRI) scan to enable the detection of cancer in patients with germline pathogenic TP53 variants.
The purpose of the Health Insurance Legislation Amendment (2023 Measures No.1) Determination 2022 is to amend the Health Insurance (Allied Health Services) Determination 2014 and the Health Insurance (Section 3C General Medical Services – Telehealth and Telephone Attendances) Determination 2021.
Please note that this news page is correct at the date of publication listed under “Page last updated”and does not account for any updates to the MBS since this time.