MBS ANSWERS

Public Hospital billing

Can you claim MBS items that have an “(H)” at the end of the description and no 85% rebate as outpatient services?

14 April 25

I work in a public hospital and suddenly all of my outpatient procedures that I bulk bill are being rejected. They have been paid without issue for years. What’s going on?

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Is the name of the patient’s GP required on an in-hospital referral?

24 March 25

On an internal referral written by a Specialist/ Physician does the patients GP details have to be written as per the Health Insurance Regs Section 99. As it is an internal referral the patien…

Can nurse practitioners bulk bill public hospital outpatients if they do it under their own ABN?

10 March 25

I am a nurse practitioner (NP) and am locked in a debate with my public hospital employer/management about MBS billing of NP services provided to public hospital outpatients. Is this allowed?
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If Doctor A writes a named referral to Doctor B from Doctor A’s private rooms to a public hospital outpatient clinic and through the triage process Doctor A is assigned the patient to treat in the public hospital outpatient clinic can MBS be claimed?

3 March 25

If Doctor A writes a named referral to Doctor B from Doctor A’s private rooms to a public hospital outpatient clinic and through the triage process Doctor A is assigned the patient to treat in…

Can professional attendances rendered by a registrar be billed by a supervising specialist who does not physically attend the patient?

24 February 25

Can Category 1 Professional Attendance items (e.g., 104, 105, 110, 116) serviced by a registrar, be billed ‘on behalf of’ a specialist or consultant physician if the supervising provider i…

Can hospital administrators type change a patient from a valid private election back to being public without the patient’s consent?

3 February 25

What happens to billing of a private patient in a public hospital who undergoes solid organ (other than kidney) transplantation? There is no MBS item billable for this so it can’t be billed to…

If a referral is addressed to “Dr ABC or Dr XYZ” can both doctors use it when exercising a ROPP?

17 November 24

This question relates to medical specialists exercising rights of private practice in public hospital outpatient departments. The questioner wanted to know if both Dr ABC and XYZ can use the r…

Who is responsible for Medicare billings in private practice and is it different as between contractors and employees?

11 November 24

This question came from a psychologist but it applies to everyone who can bill to Medicare. No exceptions.

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Why are outpatient item numbers that attract 85% of the Medicare Schedule Fee not listed by the private health insurers?

3 October 24

The question was posed in the context of public hospital outpatient services where clinicians can bulk bill when exercising a Right of Private Practice providing all other criteria are met. Th…

Can a nurse practitioner bill Medicare for public outpatients when the nurse practitioner is simultaneously being paid by a hospital that does not have a section 19(2) exemption?

30 September 24

I’m a Nurse Practitioner working in a small rural centre. I am a public employee 4 days a week and work privately on one day in the co-located primary health clinic/urgent care centre, which I…

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MBS ANSWERS

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Public Hospital billing

Can you claim MBS items that have an “(H)” at the end of the description and no 85% rebate as outpatient services?

Is the name of the patient’s GP required on an in-hospital referral?

Can nurse practitioners bulk bill public hospital outpatients if they do it under their own ABN?

If Doctor A writes a named referral to Doctor B from Doctor A’s private rooms to a public hospital outpatient clinic and through the triage process Doctor A is assigned the patient to treat in the public hospital outpatient clinic can MBS be claimed?

Can professional attendances rendered by a registrar be billed by a supervising specialist who does not physically attend the patient?

Can hospital administrators type change a patient from a valid private election back to being public without the patient’s consent?

If a referral is addressed to “Dr ABC or Dr XYZ” can both doctors use it when exercising a ROPP?

Who is responsible for Medicare billings in private practice and is it different as between contractors and employees?

Why are outpatient item numbers that attract 85% of the Medicare Schedule Fee not listed by the private health insurers?

Can a nurse practitioner bill Medicare for public outpatients when the nurse practitioner is simultaneously being paid by a hospital that does not have a section 19(2) exemption?

MBS ANSWERS

Quick links

Topics

Specialities

Public Hospital billing

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