MBS ANSWERS

General

Do you get one item 132 and two item 133’s every 12 months?

31 August 20

Doctor A worked in a public hospital outpatient department where they exercised a right of private practice. They thought that they were not automatically permitted to bill item 132 every 12 m…

Are inpatient and outpatient episodes considered as separate for billing purposes, so that when a patient is discharged a new episode of care automatically commences?

26 August 20

Question: If the same treating rehab physician sees a patient following discharge in their outpatient rooms, can this be billed as an item 132 (obviously with a relevant referral), or is it an…

Can a GP with surgical training bill item 41764?

17 August 20

A general practitioner has asked whether they can claim item 41764 given they have appropriate surgical training to perform the procedure, which is a nasendoscopy/sinoscopy.

…

Can oncologists bill item 14206 and does it come under the supervision rules?

17 August 20

A practice manager for an oncology practice asked whether the oncologists can claim item 14206 even though it is in the assisted reproductive technology (ART) section of the MBS, because it ac…

Is a written handover sheet a valid inpatient referral between specialists covering each other on weekends, or does it have to be a formal letter?

4 August 20

Doctor A was a respiratory and sleep physician who had been trying to obtain clarity around this question. The question specifically related to weekend cover when doctors are rostered to cover…

Are annual enrolment or membership fees legal in a bulk billing setting?

1 August 20

Annual enrolment or membership fees have been a controversial feature of bulk billing GP practices in recent years. One example was the now defunct National Health Co-op in the ACT, which publicly c…

Can I bulk bill a Medicare service and charge for a related non-Medicare service simultaneously?

1 August 20

A gastroenterology practice asked whether a service provider providing two services to a patient on the same day, one for which there is an MBS item number, and the other for which there is no…

Can a group of specialists operating under a single brand, but with their own separate practices, agree to charge the same fees?

1 August 20

A group of haematologists in private practice, who operate across various locations under a single brand with a central point of contact, asked if they could agree to all charge the same fees….

When I am covering another physician’s inpatients and it’s the first time I see the patient, can I bill an initial consultation?

27 July 20

When one physician covers another’s inpatients who have already been admitted, but are new to the doctor covering for the weekend, Dr A wanted to know if it is acceptable to bill item 110? Dr …

If a specialist sees a non-admitted patient in an approved private emergency department, can they bill to Medicare and is the patient entitled to a rebate?

10 July 20

Billing to Medicare for non-admitted patients in public hospital emergency departments is strictly prohibited, even if patients have private health insurance and are happy to use it. This is p…

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MBS ANSWERS

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General

Do you get one item 132 and two item 133’s every 12 months?

Are inpatient and outpatient episodes considered as separate for billing purposes, so that when a patient is discharged a new episode of care automatically commences?

Can a GP with surgical training bill item 41764?

Can oncologists bill item 14206 and does it come under the supervision rules?

Is a written handover sheet a valid inpatient referral between specialists covering each other on weekends, or does it have to be a formal letter?

Are annual enrolment or membership fees legal in a bulk billing setting?

Can I bulk bill a Medicare service and charge for a related non-Medicare service simultaneously?

Can a group of specialists operating under a single brand, but with their own separate practices, agree to charge the same fees?

When I am covering another physician’s inpatients and it’s the first time I see the patient, can I bill an initial consultation?

If a specialist sees a non-admitted patient in an approved private emergency department, can they bill to Medicare and is the patient entitled to a rebate?