The 1 November 2018 MBS files (XML, DOC, PDF and ZIP) are now available to download

Page last updated: 31 October 2018

The 1 November MBS files (XML, DOC, PDF and ZIP) have been updated to reflect additional new items and can now be downloaded from the November downloads page.

The following changes will take effect from 1 November 2018:


Additional new items
894 896 898 2121 2150 2196 12254 12258 12261 12265 12268 12272 72814

New items
371 372 2729 2731 11505 11507 11508 12001 12002 12004 12005 12204 12205
12208 13105 13260 30191 31003 31004 31005 36671 36672 36673 42505 42588 45060
45061 45062 45523 51011 51012 51013 51014 51015 51020 51021 51022 51023 51024
51025 51026 51031 51032 51033 51034 51035 51036 51041 51042 51043 51044 51045
51051 51052 51053 51054 51055 51056 51057 51058 51059 51061 51062 51063 51064
51065 51066 51071 51072 51073 51102 51103 51110 51111 51112 51113 51114 51115
51120 51130 51131 51140 51141 51145 51150 51160 51165 51170 51171 56620 56626
56660 56666 57522 57523 57537 57540 59302 59305

Deleted items
11222 11225 11509 13112 14053 14109 14112 21981 30185 30186 30195 30197 30203
30205 30213 30214 30308 30309 30313 30321 32501 36500 40300 40301 40303 40306
40309 40312 40315 40316 40318 40321 40324 40327 40330 40331 40332 40333 40334
40335 40336 40339 40342 40345 40348 40351 42783 42786 42789 42792 45020 45552
45555 45557 45559 45586 45638 45639 47681 47684 47687 47690 47693 47696 47699
47702 47703 47705 47708 47711 47714 47717 47720 47723 48600 48603 48606 48612
48613 48615 48618 48621 48624 48627 48630 48632 48636 48639 48640 48642 48645
48648 48651 48654 48657 48660 48663 48666 48669 48672 48675 48678 48681 48684
48687 48690 48691 48692 48693 48694 53600 60100 60101

Description amended
11219 11221 11224 11503 11506 11512 11602 11604 11605 12000 12003 12203 12207
12210 12213 12215 12217 12250 13110 14050 14100 14106 14115 14118 14124 18360
21965 21997 30097 30176 30190 30196 30202 30207 30210 30310 30315 30317 30318
30320 30323 30324 31000 31001 31002 31340 31346 32520 32522 32523 32526 32528
32529 35533 35534 42587 42785 42791 42872 45018 45019 45051 45201 45520 45522
45524 45527 45528 45551 45553 45554 45556 45558 45584 45585 45587 45588 45617
45620 45623 45624 45632 45635 45641 45644 45650 45652 45659 45669 50608 50612
50620 50632 50636 50640 56619 56625 56659 56665 57518 57521 57535 57536 63513
63514 63560 63561 73805 82100

Fee amended
181 183 187 188 191 202 206 212 11820 11823 12003 14106 30310
30318 42705 45553 45641 72851 72852

EMSN amended
35533 45584 45585 45587 45659

Increase in Maximum Patient Gap
The maximum patient gap between the Medicare Benefits Schedule (MBS) fee and the benefits payable for out-of-hospital services increases to $83.40 as at 1 November 2018. The 85% benefit level will apply for all fees up to $556.30, after which benefits are calculated at the Schedule fee less $83.40.

Increase to sheduled fee for electon microscopy item 72851
An increase to the scheduled fee for this item.

Change to scheduled fee for electron microscopy item 72852
Increase to the scheduled fee for electron microscopy item 72852

Amendment to pathology services table item 73805
Change to wording to align with clinical best practice.

Interim items for breast tomosynthesis
- Two new interim items have been introduced for three dimensional breast tomosynthesis pending an application to, and assessment by, the Medical Services Advisory Committee.

- Additionally, two plain tomography items (60100 and 60101) will be removed following a recommendation of the Medicare Benefits Schedule Review Taskforce that these items are obsolete.

Amend MBS item 18360
MBS item 18360 is being amended to include Clostridium Botulinum Type A Toxin Haemagglutinin Complex (Dysport) as a drug that can be administered for the treatment of moderate to severe focal spasticity.

Revision of MBS fee for capsule endoscopy services
Changes to capsule endoscopy (MBS items 11820 and 11823) will see a reduction in the MBS fee to $1,229.35, to better reflect the current cost of providing this service. These changes were made after collaboration between the independent MBS Review Taskforce and the Medical Services Advisory Committee following a comprehensive review of capsule endoscopy services.

PD-L1 testing with access to pembrolizumab[
Immunohistochemical examination by immunoperoxidase or other labelled antibody techniques using the programmed cell death ligand 1 (PD-L1) antibody of tumour material from a patient diagnosed with non-small cell lung cancer, to determine if the requirements relating to PD-L1 status for access to pembrolizumab under the Pharmaceutical Benefits Scheme are fulfilled.

Dissolution of the Medicare Claims Review Panel (MCRP) and associated item amendments
The MCRP is currently responsible for assessing applications for 26 MBS items that explicitly require a clinical need to be demonstrated before Medicare benefits are payable. These items cover a range of specialties including plastic surgery, ophthalmology, anaesthesia and sleep studies.

From 1 November 2018, the MCRP will be dissolved and these items will be processed in the same manner as all other items under Medicare. The items will be amended (or deleted if obsolete) to assist medical practitioners in understanding the appropriate use of items and to minimise misuse. Changes will also be made to a number of related ophthalmology, vascular, and plastic and reconstructive surgery items to align them with appropriate clinical practice and ensure consistency with the MCRP changes.

New MBS Items for GPs and Medical Practitioners Delivering Focussed Psychological Strategies by Telehealth
From 1 November 2018, appropriately trained general practitioners and non-specialist medical practitioners will be able to provide focussed psychological strategies via telehealth under Medicare in rural and remote areas (Modified Monash areas 4 to 7).

The purpose of this is to support the mental health, well being and resilience of farming communities, and to support people in rural and remote communities who choose to complete their treatment using this channel.

Percutaneous tibial nerve stimulation treatment for the idiopathic overactive bladder
A new medical service to treat patients with idiopathic overactive bladder by percutaneous tibial nerve stimulation therapy (PTNS). There are three (3) new items numbers specific to each of treatment phases of the PTNS therapy.

New MBS item for Minimally Invasive Glaucoma Surgery (MIGS) device Removal / Replacement
For cases where there is failure of the original stent placement, the Medical Services advisory Committee (MSAC) has recommendeda single MBS item at a fee of $300.75 for stent removal regardless of whether it is undertaken with or without stent replacement.

Introduction of new item for haemodialysis in very remote areas
Introduction of a new MBS item to fund the provision of haemodialysis services in very remote regions.

The new MBS item will include:
• management of haemodialysis to a person with end-stage renal disease, provided by a registered nurse, Aboriginal and Torres Strait Islander health practitioner or Aboriginal health worker on behalf of a medical practitioner;
• the patient’s care also being managed by a nephrologist;
• the patient not being an admitted patient of a hospital; and the facility delivering the service being in a very remote area, defined by Modified Monash Model 7 (MMM7); and
• the service is provided in a primary care setting.

Permanent listing of insertion of Minimally invasive glaucoma surgery (MIGS) device in conjunction with cataract surgery
A new item for insertion of Minimally invasive glaucoma surgery (MIGS) device in conjunction with cataract surgery.

Expansion of MBS Item 11219 Optical Coherence Tomography
From 1 November 2018 MBS item 11219 will be amended to allow its use for the diagnosis of all ocular conditions for which a medication is listed on the Pharmaceutical Benefits Scheme for intraocular administration.

Implementation of recommendations from MBS Review in relation to knee imaging
- Patients under 16 will no longer be required to have an x-ray of the knee prior to receiving a magnetic imaging resonance (MRI) scan of the knee (63513, 63514).

- General practitioners (GPs) will no longer be able to request knee MRIs for patients aged 50 years of age and over (63560, 63561).

- Existing x-ray items for the lower limb (which currently encompass foot, ankle, leg, knee or femur) will be amended to remove the knee (57518, 57521, 57535, 57536) and four new items for x-ray imaging of the knee only will be created (57522, 57523, 57537, 57540).

- Note IN.0.1 amended to include new knee x-ray items 57523, 57540 in the list of items which dentists, podiatrists and nurse practitioners can request, following upcoming amendments to the Health Insurance Regulations 2018.

- Existing computed tomography (CT) items for imaging of the extremities will be amended to exclude imaging of the knee only (56619, 56625, 56659, 56665), and four new mirror items for CT imaging of the knee will be created (56620, 56626, 56660, 56666).

As additional amendments:
- Note IN.0.1 will be further amended to include comprehensive lists of the items that participating nurse practitioners and midwives may request, in accordance with forthcoming changes to the Health Insurance Regulations 2018.

- Note IN.0.15 will be amended to remove the phone number for the Australian Sonographer Accreditation Registry as this number is no longer correct. Sonographers will instead be referred to the ASAR website for current information.

Changes as a result of MBS Taskforce Review of Dermatology, Allergy and Immunology
As part of the 2018-19 Budget, the Government announced changes to Medical Benefts Schedule (MBS) items for dermatology, allergy and immunology to take effect from 1 November 2018.

These changes are the result of a review by the Dermatology, Allergy and Immunology Clinical Committee (DAICC) working under the MBS Review Taskforce.

The changes delete 12 items and change 28 items to remove unnecessary tests from the MBS, focus on encouraging best practice, and improve patient care and safety.

MBS Mental Health and Well-Being Telehealth Support Items for Patients in Drought-Affected Communities
Six new Medicare Benefits Schedule (MBS) items have been introduced to enable GPs and non-specialist medical practitioners to provide general mental health and well-being support services by video conference to patients in drought-affected areas.

MBS items 2121, 2150 and 2196 (for GPs) and MBS items 894, 896 and 898 (for non-specialist medical practitioners) may be used to provide telehealth services by doctors working in areas belonging to declared councils under the DCP, or in Modified Monash (MM) areas 3 to 7, where there is an existing relationship between the doctor and the patient.

The Mental Health and Well-Being Telehealth Support items replicate the requirements and MBS rebates for the current Level B to D general attendance items for services in consulting rooms that are available to GPs and non-specialist medical practitioners. The items also align with the existing MBS arrangements for video conference services, including the requirement that, at the time of the attendance, the patient must be at least 15 kilometres by road from the doctor providing the service.

Split of item 42587 for Trichiasis
To allow more accurate data to be captured on trachoma-related trichiasis surgery the National Trachoma Surveillance and Control Reference Group (NTSCRG) has requested that MBS Item 42587 is refined to distinguish whether the cause of the trichiasis is due to trachoma or other causes. Therefore item 32587 will be split into 2 items to delineate cause of trichiasis.

Minor Amendment of Midwifery Item 82100
As of 1 November 2018, Midwifery item 82100 will be amended to omit the reference to “section 2E of the Health Insurance Regulations 1975” and replace it with “section 6 of the Health Insurance Regulations 2018”.

New items for multiple sleep latency testing (MSLT) and maintenance of wakefulness testing (MWT)
From 1 November 2018, items 12254 to 12272 will be introduced for MSLT and MWTin adult and paediatric patients. The new items will enable practitioners to bill a single item for MSLT or MWT as opposed to a combination of items (e.g. 12203 and 11003).