Healthier Medicare – removing obsolete services from the Medicare Benefits Schedule

This measure implements the first round of recommendations of the Medicare Benefits Schedule (MBS) Review Taskforce – part of the Government’s Healthier Medicare package. Twenty four items for diagnostic imaging, ear, nose and throat (ENT), gastroenterology, obstetrics and thoracic medicine will be removed from the MBS. Two diagnostic imaging items will be restricted to patients less than 16 years of age.

Page last updated: 03 May 2016

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Why is this important?

  • The use of MBS services is growing faster than the population. The MBS accounts for nearly a third of total health spending and five per cent of total Commonwealth government spending.
  • The Taskforce is an independent expert committee that provides advice to the Minister for Health.
  • The Taskforce is seeking to reduce the use of MBS services with limited clinical benefit, to enable resources to be redirected to new or existing services with proven benefit. This will ensure the MBS continues to fund quality health care.
  • These changes will improve the quality and safety of services funded through the MBS by removing a number of obsolete, redundant or unsafe treatments from the MBS (Tables 1–4).
  • However, savings will come from ceasing services to the MBS that provide no clinical benefit and reducing co-claiming, where some practitioners are billing these items as an adjunct to other MBS services.

Who will benefit?

  • The public and the sector have helped to inform these changes, which has been a genuinely clinician-led process, where doctors themselves make the case for change.
  • The removal of these items supports better patient care. Recommendations have been made after extensive public consultation.
  • There should be limited changes to patient out-of-pocket costs because patients obtain little or no benefit from the services being removed and, in some cases, should not be receiving them.
  • Patients will be better off because more appropriate treatments will remain available on the MBS.

How much will this cost?

This measure will save $5.1 million from 2016–17 to 2019–20.

Table 1: Obsolete Diagnostic Imaging MBS items

Item number DescriptionServices provided* (2014–15)Reason for removal/amendment MBS Item more appropriately claimed
58924/26Graham’s test is an x-ray of the gallbladder17Items superseded by ultrasound or computed tomography (CT) services The relevant ultrasound or CT service
59503/04Pelvimetry13Items superseded by ultrasound or computed tomography (CT) servicesThe relevant ultrasound or CT service
59736/37Vasoepididymography is an x-ray to assess obstruction of the seminal tract impacting on infertility-Items superseded by ultrasound or computed tomography (CT) servicesThe relevant ultrasound or CT service
59760/61Peritoneogram is a CT to diagnose occult hernia26Items superseded by ultrasound or computed tomography (CT) servicesThe relevant ultrasound or CT service
61465/711Venography is an x-ray to diagnose deep vein thrombosis2Items superseded by ultrasound or computed tomography (CT) servicesThe relevant ultrasound or CT service
59715/16Bronchography is an x-ray of the larynx, trachea or bronchi14Item to be restricted to patients less than 16 years of age. Ultrasound or computed tomography (CT) more appropriate in adult populationsThe relevant ultrasound or CT service

Table 2: Obsolete Ear Nose and Throat MBS items

Item number DescriptionServices provided* (2014–15)Reason for removal/amendment MBS Item more appropriately claimed
11321Klockoff’s test9No longer contemporary clinical practice Test has been superseded by other electronic vestibular function tests (eg 11318 audiogram)
18246Glossopharyngeal nerve injection 6,360Removed from the MBS on the basis of safety concernsInfiltration of anaesthetic covered under existing ENT items (eg 41786 – tonsillectomy)
41680Cryotherapy for nasal haemorrhage695No longer part of contemporary clinical practice41677 – arrest of nasal haemorrhage
41695Cryotherapy to nasal turbinates120No longer part of contemporary clinical practice41674 – cauterisation of septum, turbinates or pharynx
41758Division of pharyngeal adhesions3No longer part of contemporary clinical practice41674 – cauterisation of septum, turbinates or pharynx
41761Direct examination of larynx with biopsy7,341Item superseded by the use of endoscopic procedures. Service being claimed as an adjunct to other ENT procedures30473 – where endoscopic examination is used
41849Examination of the post nasal space472No longer part of contemporary clinical practice. Superseded by the use of endoscopes 41674 –cauterisation of septum, turbinates or pharynx or 41855 - microlaryngoscopy
41852Direct examination of larynx with removal of tumour36No longer part of contemporary clinical practice. Superseded by the use of endoscopes41674 – cauterisation of septum, turbinates or pharynx or 41855 - microlaryngoscopy
13500Gastric hypothermia in the absence of gastrointestinal haemorrhage9Service provides no clinical benefit
13503Gastric hypothermia for upper gastrointestinal haemorrhage -No longer part of contemporary clinical practice30478 – interventional/diagnostic oesophagoscopy
32078Sigmoidoscopy is an examination of the large intestine with diathermy or the removal of polyps151No longer part of contemporary clinical practice32087 – interventional/diagnostic sigmoidoscopy/ colonoscopy
32081Sigmoidoscopy is an examination of the large intestine with diathermy or the removal of polyps27No longer part of contemporary clinical practice32087 – interventiona/diagnosticl sigmoidoscopy/ colonoscopy

Table 3: Obsolete Obstetrics MBS items

Item number DescriptionServices provided* (2014–15)Reason for removal/amendment MBS Item more appropriately claimed
16504Injection of hormones to manage habitual miscarriage30No longer part of contemporary clinical practiceOther more contemporary management strategies are used

Table 4: Obsolete Thoracic Medicine MBS items

Item number DescriptionServices provided* (2014–15)Reason for removal/amendment MBS Item more appropriately claimed
11500Bronchospirometry for measuring lung function1,026Service being claimed as an adjunct to other procedures11503 – respiratory function test

16, 351 services were provided in 2014-15 for these items, costing $1.3 million in MBS benefits.