When (if ever) is it appropriate to bill multiple consultant physician attendances (MBS Items 110 & 116) on the same day?
17 March 25Can you please weigh in on the following question? I sent this to askMBS and got something of an unhelpful answer. — Dear Medicare Support Team,I am writing to seek formal clarification regarding the applicability of Medicare Benefits Schedule (MBS) Items 110 (initial attendance by a consultant physician) and 116 (subsequent attendance by a consultant physician) when multiple attendances occur on the same day for what appears to be a single clinical problem. ContextAccording to MBS Note AN.0.7, payment may be made for multiple attendances on the same day provided the subsequent attendances are not a continuation of the initial or earlier attendances. The guidance includes examples such as an eye examination followed by instillation of mydriatics, with a later refraction considered part of the same attendance. However, the examples in AN.0.7 typically describe scenarios where no new assessment or additional clinical decision-making is required.I am seeking confirmation on whether a different interpretation might apply in cases where a clear, distinct clinical decision needs to be made at a later time—thus constituting, in essence, a separate attendance. Example ScenarioInitial Attendance (MBS Item 110)A paediatrician assesses a child presenting with moderate asthma at 10:00 a.m. The assessment involves taking a history, performing an examination, and deciding on an initial treatment plan (e.g., bronchodilators, supportive measures).Subsequent Attendance (Potential MBS Item 116)Several hours later (e.g., 2:00 p.m.), the child is reviewed again. This visit requires reassessment of...
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