MBS Items for Aboriginal Community Controlled Health Services and Other Primary Health Care Providers

A list of Medicare Benefits Schedule (MBS) items for Aboriginal Community Controlled Health Services and Other Primary Health Care Providers. Benefits are based on the 1 January 2017 Medicare Benefits Schedule (MBS)

Page last updated: 06 April 2016

PDF version: MBS Items for Aboriginal Community Controlled Health Services and Other Primary Health Care Providers (PDF 93 KB)

Please Note: This table does not provide a comprehensive list of MBS items and should be read in conjunction with the item and explanatory notes set out in the Medicare Benefits Schedule book and supplement. The authoritative source of information about the MBS is at MBS Online

Frequently Claimed MBS Items

Consultation Items for Vocational Registration (VR) for General Practice (GP)
After–hours Consultation Items for Vocational Registration (VR) for General Practice (GP)
Urgent After–hours Consultation Items Vocational Registration (VR) for General Practice (GP)
Consultation items for Non–Vocational Registration (VR) for General Practice (GP)
After–hours Consultation Items for Non-Vocational Registration (VR) for General Practice (GP)
Urgent After–hours Consultation Items Non–Vocational Registration (VR) for General Practice (GP)
GP Attendance at a Residential Aged Care Facility
Miscellaneous Diagnostic Tests and Procedures
Bulk–Billed Services
Health Assessments
Follow–up Allied Health Items for people of Aboriginal and Torres Strait Islander descent (linked to Health Assessments)
Practice Nurse, Nurse Practitioner & Aboriginal and Torres Strait Islander Health Practitioner Items
Practice Incentive Items
Retinal Photography with a Non-Mydriatic Retinal Camera
Chronic Disease Management (CDM) Items and Case Conferences (CC)
Individual Allied Health Items for people with a chronic condition and complex care needs
Medication Management Review
Antenatal Consults
General Practice (GP) Mental Health Treatment

Consultation Items for VR GPs
No.
Item
Benefit
3
Consultation at consulting rooms, Level A
$16.95
4
Consultation at a place other than consulting rooms or a RACF, Level A
Formula
23
Consultation at consulting room, less than 20 mins, Level B
$37.05
24
Consultation at a place other than consulting rooms or a RACF, less than 20 mins, Level B
Formula
36
Consultation at consulting rooms, at least 20 mins, Level C
$71.70
37
Consultation at a place other than consulting rooms or a RACF, at least 20 mins, Level C
Formula
44
Consultation at consulting rooms, at least 40 mins, Level D
$105.55
47
Consultation at a place other than consulting rooms or a RACF, at least 40 mins, Level D
Formula
Top of page

After–hours Consultation Items for VR GPs
No.
Item
Benefit
5000
Consultation at consulting rooms, Level A
$29.00
5003
Consultation at a place other than consulting rooms or a RACF, Level A
Formula
5020
Consultation at consulting rooms, less than 20 mins, Level B
$49.00
5023
Consultation at a place other than consulting rooms, hospital or a RACF, less than 20 mins, Level B
Formula
5040
Consultation at consulting rooms at least 20 mins, Level C
$83.95
5043
Consultation at a place other than consultation rooms, hospital or a RACF, at least 20 mins, Level C
Formula
5060
Consultation at consulting rooms, at least 40 mins, Level D
$117.75
5063
Consultation at a place other than consulting rooms, hospital or a RACF, at least 40 mins, Level D
Formula
Top of page
Urgent After–hours Consultation Items VR GPs
No.
Item
Benefit
597
Urgent Attendance - after hours (other than between 11pm and 7am)
$129.80
599
Urgent attendance - unsociable hours (between 11pm and 7am)
$153.00
Top of page
Consultation items for Non–VR GPs
No.
Item
Benefit
52
Brief Consultation at consulting rooms, no more than 5 mins
$11.00
53
Standard Consultation at consulting rooms, 5-25 mins
$21.00
54
Long Consultation at consulting rooms, 25-45 mins
$38.00
57
Prolonged Consultation at consulting rooms, more than 45 mins
$61.00
58
Brief consultation at a place other than consulting rooms or RACF, not more than 5 mins
Formula
59
Standard consultation at a place other than consulting rooms or RACF, 5-25 mins
Formula
60
Long consultation at a place other than consulting rooms or RACF, 25-45 mins
Formula
65
Prolonged consultation at a place other than consulting rooms or RACF, more than 45 mins
Formula
Top of page
After-hours Consultation Items Non–VR GPs
No.
Item
Benefit
5200
Brief consultation at consulting rooms, not more than 5 mins
$21.00
5203
Standard consultation at consulting rooms, 5-25 min
$31.00
5207
Long consultation at consulting rooms, 25-45 mins
$48.00
5208
Prolonged consultation at consulting rooms, more than 45 mins
$71.00
5220
Brief consultation at a place other than consulting rooms, hospital or RACF, no more than 5 mins
Formula
5223
Standard consultation at a place other than consulting rooms, hospital or RACF, 5-25 mins
Formula
5227
Long consultation at a place other than consulting rooms, hospital or RACF, 25-45 mins
Formula
5228
Prolonged consultation at a place other than consulting rooms, hospital or RACF, more than 25 mins
Formula
Top of page
Urgent After–hours Consultation Items Non–VR GPs
No.
Item
Benefit
598
Non-VR urgent attendance - after hours (other than between 11pm and 7am)
$104.75
600
Non-VR urgent attendance - unsociable hours (between 11pm and 7am)
$124.25
Top of page
GP Attendance at a Residential Aged Care Facility
No.
Item
Benefit
20
Professional attendance, Level A
Formula
35
Professional attendance, Level B
Formula
43
Professional attendance, Level C
Formula
51
Professional attendance, Level D
Formula
Top of page
Miscellaneous Diagnostic Tests and Procedures
No.
Item
Benefit
11506
Measurement of respiratory function
85% = $17.50
11700
Twelve-lead electrocardiography, tracing and report
85% = $26.60
11701
Twelve-lead electrocardiography, report only
85% = $13.25
11702
Twelve-lead electrocardiography, tracing only
85% = $13.25
13757
Therapeutic Venesection (haemochromatosis, polycthaemia vera or porphyria cutanea tarda)
85% = $62.05
14203
Hormone or Living Tissue Implantation by direct implantation involving incision and suture
85% = $43.50
14206
Hormone or Living Tissue Implantation by cannula
85% = $30.30
73805
Microscopy of urine, whether stained or not, or catalase test
85% = $3.90
73806
Pregnancy Test by 1 or more immunochemical methods
85% = $8.65
73811
Mantoux test
85% = $9.55
30003
Dressing of Localised Burns (not involving grafting)
85% = $30.90
30006
Dressing of Extensive Burns, without Anaesthesia
(not involving grafting)
85% = $39.55
30026
Repair Skin Lac (not Face/Neck)<7cm, superficial
85% = $44.40
30029
Repair Skin Lac (not Face/Neck)<7cm, deep tissue
85% = $76.50
30032
Repair Skin Lac of Face/Neck<7cm, superficial
85% = $70.15
30035
Repair Skin Lac of Face/Neck<7cm, deep tissue
85% = $99.95
30038
Repair Skin Lac (not Face/Neck)>7cm, superficial
85% = $76.50
30041
Repair Skin Lac (not Face/Neck)>7cm, deep tissue
85% = $122.40
30045
Repair Skin Lac of Face/Neck >7cm, superficial
85% = $99.95
30048
Repair Skin Lac of Face/Neck>7cm, deep tissue
85% = $127.30
30061
Superficial foreign body removal (including from cornea or sclera), as an independent procedure
85% = $20.00
30064
Subcutaneous foreign body removal (incision and exploration)
85% = $93.45
30071
Biopsy of Skin or Muc Membranes, as an independent procedure
85% = $44.40
30192
Premalignant skin lesions (including solar keratoses), treatment of, by ablative technique (10 or more lesions)
85% = $33.65
30219
Haematoma, Furuncle, Small Abscess or Similar Lesion - incision with drainage
85% = $23.25
Top of page
Bulk–Billed Services
No.
Item
Benefit
10990
Additional payment for each bulk billed medical service provided to Commonwealth concession cardholders and children under 16 yrs
85% = $6.15
10991
Additional payment for each bulk-billed medical service provided to Commonwealth concession cardholders and children under 16 yrs- specified areas only
85% = $9.25
64990
Radiology bulk billing incentive (e.g. scans).
85% = $6.00
64991
Radiology bulk billing incentive (e.g. scans).
85% = $9.10
74990
Pathology bulk billing incentive
85% = $6.00
74991
Pathology bulk billing incentive
85% = $9.10
Top of page
Health Assessments
No.
Item
Benefit
701
Brief Health Assessment, less than 30 mins
$59.35
703
Standard Health Assessment, 30-45 mins
$137.90
705
Long Heath Assessment, 45-60 mins
$190.30
707
Prolonged Health Assessment, at least 60 mins
$268.80
715
Aboriginal and Torres Strait Islander peoples Health Assessment
$212.25
Top of page
Follow–up Allied Health Items for people of Aboriginal and Torres Strait Islander descent (linked to Health Assessments)
No.
Item
Benefit
81300
Aboriginal and Torres Strait Islander Health Service
85% = $52.95
81305
Diabetes Education Service
85% = $52.95
81310
Audiology Service
85% = $52.95
81315
Exercise Physiology Service
85% = $52.95
81320
Dietetics Service
85% = $52.95
81325
Mental Health Service
85% = $52.95
81330
Occupational Therapy Service
85% = $52.95
81335
Physiotherapy Service
85% = $52.95
81340
Podiatry Service
85% = $52.95
81345
Chiropractic Service
85% = $52.95
81350
Osteopathy Service
85% = $52.95
81355
Psychology Service
85% = $52.95
81360
Speech Pathology Service
85% = $52.95
Top of page
Practice Nurse, Nurse Practitioner & Aboriginal and Torres Strait Islander Health Practitioner Items
No
Item
Benefit
10987
Follow up for a patient who has received an Aboriginal and Torres Strait Islander peoples health assessment (Max 10 services per calendar year)
$24.00
10997
Monitoring and support for a person with a Chronic Disease Care Plan (Max 5 services per calendar year, practice nurse or Aboriginal and Torres Strait Islander Health Practitioner)
$12.00
10988
Immunisation (Aboriginal and Torres Strait Islander Health Practitioner)
$12.00
10989
Wound Management (Aboriginal and Torres Strait Islander Health Practitioner)
$12.00
82200
Brief consultation (Nurse Practitioner)
85% = $8.20
82205
Short consultation, less than 20 mins (Nurse Practitioner)
85% = $17.85
82210
Detailed consultation, at least 20 mins (Nurse Practitioner)
85% = $33.80
82215
Extensive consultation, at least 40 mins (Nurse Practitioner)
85% = $49.80
Top of page
Practice Incentive Items
No.
Item
Benefit
2501
Cervical smear, between 20-69 yrs & more than 4 yrs since last cervical smear, Level B
$37.05
2504
Cervical smear, between 20-69 yrs & more than 4 yrs since last cervical smear, Level C
$71.70
2507
Cervical smear, between 20-69 yrs & more than 4 yrs since last cervical smear, Level D
$105.55
2517
Annual cycle of care for diabetes, Level B
$37.05
2521
Annual cycle of care for diabetes, Level C
$71.70
2525
Annual cycle of care for diabetes, Level D
$105.55
2546
Completion of asthma cycle of care, Level B
$37.05
2552
Completion of asthma cycle of care, Level C
$71.70
2558
Completion of asthma cycle of care, Level D
$105.55
Top of page
Retinal Photography with a Non-Mydriatic Retinal Camera
No.
Item
Benefit
12325
Bilateral retinal photography to assess diabetic retinopathy (Aboriginal and Torres Strait Islander patients)
85% = $42.50
12326
Bilateral retinal photography to assess diabetic retinopathy
85% = $42.50
Top of page
Chronic Disease Management (CDM) Items and Case Conferences (CC)
No.
Item
Benefit
721
Prepare GP Management Plan
$144.25
723
Coordinate development of Team Care arrangements
$114.30
729
Contribution to a Multidisciplinary Care Plan or a Review of a Multidisciplinary Care Plan prepared by another provider
$70.40
731
Contribution to or review of multidisciplinary care plan prepared by RACF
$70.40
732
Review of GP Management Plan or Coordinate a Review of Team Care Arrangements
$72.05
739
Organise and coordinate a CC in a RACF; or a Community CC; or a Discharge CC, 20-40 mins
$120.95
743
Organise and coordinate a CC in a RACF; or a Community CC; or a Discharge CC, more than 40 mins
$201.65
747
Participate in a CC in a RACF; or a Community CC; or a Discharge CC as a member of a CC team, 15-20 mins
$51.90
750
Participate in a CC in a RACF; or a Community CC; or a Discharge CC as a member of a CC team, 20-40 mins
$89.00
758
Participate in a CC in a RACF; or a Community CC; or a Discharge CC as a member of a CC team, more than 40 mins
$148.20
Top of page
Individual Allied Health Items for people with a chronic condition and complex care needs (linked to CDM items 721 & 723)
No.
Item
Benefit
10950
Aboriginal and Torres Strait Islander Health Service
85% = $52.95
10951
Diabetes Education Service
85% = $52.95
10952
Audiology Service
85% = $52.95
10953
Exercise Physiology Service
85% = $52.95
10954
Dietetics Service
85% = $52.95
10956
Mental Health Service
85% = $52.95
10958
Occupational Therapy Service
85% = $52.95
10960
Physiotherapy Service
85% = $52.95
10962
Podiatry Service
85% = $52.95
10964
Chiropractic Service
85% = $52.95
10966
Osteopathy Service
85% = $52.95
10968
Psychology Service
85% = $52.95
10970
Speech Pathology Service
85% = $52.95
Top of page
Medication Management Review
No
Item
Benefit
900
Home medicines review
$154.80
Top of page
Antenatal Consults
No.
Item
Benefit
16400
Antenatal attendance (midwife, nurse or registered AHW
RRMA 3-7)
85% = $23.20
16500
Antenatal attendance
85% = $40.10
16502
Complicated Antenatal attendance
(each attendance that is not a routine attendance)
85% = $40.10
55703
Pregnancy ultrasound (uncertain dates less than 12 weeks)
85% = $29.75
55709
Pregnancy ultrasound (dating is 17 to 22 weeks)
85% = $32.30
Top of page
GP Mental Health Treatment
No.
Item
Benefit
2700
Prepare GP Mental Health Treatment Plan, lasting at least 20 mins
$71.70
2701
Prepare GP Mental Health Treatment Plan, lasting at least 40 mins
$105.55
2712
Review GP Mental Health Treatment Plan
$71.70
2713
Mental health consultation (not associated with a GP Mental Health Plan), lasting at least 20 mins
$71.70
2715
Prepare GP Mental Health Treatment Plan, lasting at least 20 mins (medical practitioners who have undertaken mental health skills training)
$91.05
2717
Prepare GP Mental Health Treatment Plan, lasting at least 40 mins (medical practitioners who have undertaken mental health skills training)
$134.10

Benefits are based on the 1 January 2017 Medicare Benefits Schedule

For Medicare Claiming enquiries, please phone the Department of Human Services Indigenous Access line on 1800 556 955

For feedback please email IHD 19.2 enquiries mailbox

Top of page