RebateRight MBS Update

1st July 2025

Overview

Previous Updates

1st Mar 2025

The Medicare Benefits Schedule (MBS) is updated several times a year. We’re here to help you stay up to date with the changes. Our free overview makes it easy to understand the latest updates and what they mean for you.

1st Jan 2025

1st Nov 2024

5989

New MBS Item Total

Modified Benefit Types

5292

Modified Schedule Fee

New MBS Items

866

Modified Descriptions

Modified Eligible Age

Deleted Items

Modified Referral Requirements

Modified Derived Fee

5454

Modified Items

Modified Claim Frequency Limits

5292

New Schedule Fee Start Date

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New MBS Items: 54

Item Number: 125

Description: Professional attendance lasting at least 45 minutes at consulting rooms or hospital, by a specialist in the practice of the specialist’s specialty of gynaecology, following referral of the patient to the specialist by a referring practitioner—initial attendance in a single course of treatment, if: (a) the specialist takes a comprehensive history, including psychosocial history and medication review; and (b) the specialist undertakes any of the following that are clinically relevant: (i) a comprehensive multi-system physical examination; (ii) consideration of multiple complex diagnoses; (iii) discussion of all treatment options available; (iv) assessment of pros and cons of each treatment option given patient characteristics and medical history; (v) consideration, discussion and provision of necessary referrals for clinically appropriate investigations or treatment; (vi) communication of a patient-centred management plan; and (c) the specialist makes available to the patient or carer written documentation that outlines treatment options and information on associated risks and benefits; and (d) another attendance on the patient did not take place on the same day by the specialist in the same single course of treatment.

Schedule Fee: 178.70
Schedule Fee Start Date: 01.07.2025
Category: 1
Group: A3
Referral Requirements: This item should be referred by a Practitioner.
Benefit Type: _75_85
Item Start Date: 01.07.2025

Item Number: 126

Description: Professional attendance lasting at least 45 minutes at consulting rooms or hospital, by a specialist in the practice of the specialist’s specialty of gynaecology, following referral of the patient to the specialist by a referring practitioner—an attendance after the initial attendance in a single course of treatment, if: (a) the specialist takes a comprehensive history, including psychosocial history and medication review; and (b) the specialist reviews implemented management strategies; and (c) the specialist undertakes any of the following that are clinically relevant: (i) update of management plan; (ii) performance of a physical examination; (iii) discussion of treatment options; (iv) consideration, discussion and provision of necessary referrals; (v) provision of appropriate education; and (d) the specialist makes available to the patient or carer written documentation that outlines treatment options and information on associated risks and benefits; and (e) another attendance on the patient did not take place on the same day by the specialist in the same single course of treatment.

Schedule Fee: 89.40
Schedule Fee Start Date: 01.07.2025
Category: 1
Group: A3
Referral Requirements: This item should be referred by a Practitioner.
Benefit Type: _75_85
ItemStartDate: 01.07.2025

Item Number: 127

Description: Video attendance lasting at least 45 minutes by a specialist in the practice of the specialist’s specialty of gynaecology, following referral of the patient to the specialist by a referring practitioner—initial attendance in a single course of treatment, if: (a) the specialist takes a comprehensive history, including psycho-social history and medication review; and (b) the specialist undertakes any of the following that are clinically relevant: (i) arranging for necessary investigations which may include a detailed physical examination; (ii) consideration of multiple complex diagnoses; (iii) discussion of all treatment options available; (iv) assessment of pros and cons of each treatment option given patient characteristics and medical history; (v) consideration, discussion and provision of necessary referrals for clinically appropriate investigations or treatment; (vi) communication of a patient-centred management plan; and (c) the specialist makes available to the patient or carer written documentation that outlines treatment options and information on associated risks and benefits; and (d) an attendance on the patient did not take place on the same day by the same specialist gynaecologist in the same single course of treatment.

Schedule Fee: 174.50
Schedule Fee Start Date: 01.07.2025
Category: 1
Group: A3
Referral Requirements: This item should be referred by a Specialist obstetrician and gynaecologist.
Benefit Type: 85
Item Start Date: 01.07.2025

Item Number: 129

Description: Video attendance lasting at least 45 minutes by a specialist in the practice of the specialist’s speciality of gynaecology, following referral of the patient to the specialist by a referring practitioner - an attendance after the initial attendance in a single course of treatment if: (a) the specialist updates the patient’s comprehensive history, including psycho-social history and medication review; and (b) the specialist reviews implemented management strategies; and (c) the specialist undertakes any of the following that are clinically relevant: (i) update of management plan; (ii) arranging for necessary investigations which may include a detailed physical examination; (iii) discussion of treatment options; (iv) consideration, discussion and provision of necessary referrals; (v) provision of appropriate education; and (d) the specialist makes available to the patient or carer written documentation that outlines treatment options and information on associated risks and benefits; and (e) an attendance on the patient did not take place on the same day by the specialist for the same single course of treatment.

Schedule Fee: 87.30
Schedule Fee Start Date: 01.07.2025
Category: 1
Group: A3
Referral Requirements: This item should be referred by a Specialist Medical Practitioner.
Benefit Type: 85
Item Start Date: 01.07.2025

Item Number: 392

Description: Professional attendance by a prescribed medical practitioner to prepare a GP chronic condition management plan for a patient.

Schedule Fee: 125.30
Schedule FeeStart Date: 01.07.2025
Category: 1
Group: A7
SubGroup: 6
Referral Requirements: Having a referral for this Medicare item is optional.
Benefit Type: _75_100
Item Start Date: 01.07.2025

Item Number: 393

Description: Professional attendance by a prescribed medical practitioner to review a GP chronic condition management plan prepared by the prescribed medical practitioner or an associated medical practitioner.

Schedule Fee: 125.30
Schedule Fee Start Date: 01.07.2025
Category: 1
Group: A7
Sub Group: 6
Referral Requirements: Having a referral for this Medicare item is optional.
Benefit Type: _75_100
Item Start Date: 01.07.2025

ItemNumber: 695

Description: Menopause and Perimenopause Health Assessment Professional attendance on a patient for the assessment and management of menopause or perimenopause by a general practitioner lasting at least 20 minutes and including, but not limited to: a) collecting relevant information, including taking a patient history to determine pre-, peri- or post-menopausal status, patient wellbeing and contraindications for management; and b) undertaking a basic physical examination, including recording blood pressure, and review of height and weight; and c) initiating investigations and referrals as clinically indicated, with consideration given to the need for cervical screening, mammography and bone densitometry; and d) discussing management options including non-pharmacological and pharmacological strategies including risks and benefits; e) implementing a management plan which includes patient centred symptoms management; and f) providing the patient with preventative health care advice and information as clinically indicated, including advice on physical activity, smoking cessation, alcohol consumption, nutritional intake and weight management.

Schedule Fee: 101.90
Schedule Fee Start Date: 01.07.2025
Category: 1
Group: A14
Referral Requirements: Having a referral for this Medicare item is optional.
Benefit Type: 100
Item Start Date: 01.07.2025

ItemNumber: 965

Description: Professional attendance by a general practitioner to prepare a GP chronic condition management plan for a patient.

ScheduleFee: 156.55
ScheduleFeeStartDate: 01.07.2025
Category: 1
Group: A15
SubGroup: 1
ReferralRequirements: Having a referral for this Medicare item is optional.
BenefitType: _75_100
ItemStartDate: 01.07.2025

Item Number: 967

Description: Professional attendance by a general practitioner to review a GP chronic condition management plan prepared by the general practitioner or an associated medical practitioner.

Schedule Fee: 156.55
Schedule Fee Start Date: 01.07.2025
Category: 1
Group: A15
Sub Group: 1
Referral Requirements: Having a referral for this Medicare item is optional.
Benefit Type: _75_100
Item Start Date: 01.07.2025

Item Number: 19000

Description: Menopause and Perimenopause Health Assessment Professional attendance on a patient for the assessment and management of menopause or perimenopause by a prescribed medical practitioner lasting at least 20 minutes and including, but not limited to: a) collecting relevant information, including taking a patient history to determine pre-, peri- or post-menopausal status, patient wellbeing and contraindications for management; and b) undertaking a basic physical examination, including recording blood pressure, and review of height and weight; and c) initiating investigations and referrals as clinically indicated, with consideration given to the need for cervical screening, mammography and bone densitometry; and d) discussing management options including non-pharmacological and pharmacological strategies including risks and benefits; e) implementing a management plan which includes patient centred symptoms management; and f) providing the patient with preventative health care advice and information as clinically indicated, including advice on physical activity, smoking cessation, alcohol consumption, nutritional intake and weight management.

Schedule Fee: 81.50
Schedule Fee Start Date: 01.07.2025
Category: 1
Group: A7
Sub Group: 5
Referral Requirements: Having a referral for this Medicare item is optional.
Benefit Type: _100
Item Start Date: 01.07.2025

Item Number: 92029

Description: Video attendance by a general practitioner to prepare a GP chronic condition management plan for a patient.

Schedule Fee: 156.55
Schedule Fee Start Date: 01.07.2025
Category: 1
Group: A40
Sub Group: 13
Referral Requirements: Having a referral for this Medicare item is optional.
Benefit Type: 100
Item Start Date: 01.07.2025

Item Number: 92030

Description: Video attendance by a general practitioner to review a GP chronic condition management plan prepared by the general practitioner or an associated medical practitioner.

Item Number: 92060

Description: Video attendance by a prescribed medical practitioner to prepare a GP chronic condition management plan for a patient.

Schedule Fee: 125.30
Schedule Fee Start Date: 01.07.2025
Category: 1
Group: A40
Sub Group: 13
Referral Requirements: Having a referral for this Medicare item is optional.
Benefit Type: 100
Item Start Date: 01.07.2025

Item Number: 92061

Description: Video attendance by a prescribed medical practitioner to review a GP chronic condition management plan prepared by the prescribed medical practitioner or an associated medical practitioner.

Item Number: 92748

Description: Video attendance for a person by a consultant occupational physician in the practice of the consultant occupational physician's specialty of occupational medicine if: (a) the attendance follows referral of the patient to the consultant occupational physician (b) the attendance is of more than 5 minutes in duration; (c) the attendance is an initial attendance in a single course of treatment; and (d) the attendance on the patient, being an attendance to which item 385, 91822, or 104 applies did not take place on the same day by the same consultant occupational physician.

Schedule Fee: 101.30
Schedule Fee Start Date: 01.07.2025
Category: 1
Group: A40
Sub Group: 44
Referral Requirements: Having a referral for this Medicare item is optional.
Benefit Type: 85
Item Start Date: 01.07.2025

Item Number: 92749

Schedule Fee: 50.95
Schedule Fee Start Date: 01.07.2025
Category: 1
Group: A40
Sub Group: 44
Referral Requirements: Having a referral for this Medicare item is optional.
Benefit Type: 85
Item Start Date: 01.07.2025

Item Number: 92750

Description: Phone attendance for a person by a consultant occupational physician in the practice of the consultant occupational physician's specialty of occupational medicine if: (a) the attendance follows referral of the patient to the consultant occupational physician; (b) the attendance is of more than 5 minutes in duration; and (c) the attendance is after the first attendance in a single course of treatment.

Item Number: 92751

Description: Video attendance for a person by a specialist, or consultant physician, in the practice of the specialist's or consultant physician's specialty of pain medicine if: (a) the attendance follows referral of the patient to the specialist or consultant physician; (b) the attendance is of more than 5 minutes in duration; (c) the attendance is an initial attendance in a single course of treatment; and (d) the attendance on the patient, being an attendance to which item 2801, 91824 or 110 applies did not take place on the same day by the same pain medicine specialist or consultant physician.

Schedule Fee: 178.70
Schedule Fee Start Date: 01.07.2025
Category: 1
Group: A40
Sub Group: 44
Referral Requirements: This item should be referred by a Specialist Medical Practitioner.
Benefit Type: 85
Item Start Date: 01.07.2025

Item Number: 92752

Description: Video attendance for a person by a specialist, or consultant physician, in the practice of the specialist's or consultant physician's specialty of pain medicine if: (a) the attendance follows referral of the patient to the specialist or consultant physician; (b) the attendance is of more than 5 minutes in duration; and (c) the attendance is not a minor attendance after the first in a single course of treatment.

Schedule Fee: 89.40
Schedule Fee Start Date: 01.07.2025
Category: 1
Group: A40
Sub Group: 44
Referral Requirements: This item should be referred by a Practitioner.
Benefit Type: _85
Item Start Date: 01.07.2025

Item Number: 92753

Description: Video attendance for a person by a specialist, or consultant physician, in the practice of the specialist’s or consultant physician’s specialty of pain medicine if: (a) the attendance follows referral of the patient to the specialist or consultant physician; (b) the attendance is of more than 5 minutes in duration; and (c) the attendance is a minor attendance after the first in a single course of treatment.

Schedule Fee: 50.95
Schedule Fee Start Date: 01.07.2025
Category: 1
Group: A40
Sub Group: 44
Referral Requirements: This item should be referred by a Practitioner.
Benefit Type: _85
Item Start Date: 01.07.2025

Item Number: 92754

Description: Phone attendance for a person by a specialist or consultant physician in the practice of the specialist's or consultant physician's specialty of pain medicine if:
(a) the attendance follows referral of the patient to the specialist or consultant physician
(b) the attendance is of more than 5 minutes in duration
(c) the attendance is a minor attendance after the first of a single course of treatment.

Item Number: 92755

Description: Video attendance for a person by a specialist or consultant physician in the practice of the specialists’ or consultant physician’s specialty of palliative medicine if: (a) the attendance follows referral of the patient to the specialist or consultant physician (b) the attendance is of more than 5 minutes in duration (c) the attendance is an initial attendance in a single course of treatment (d) the attendance on the patient being an attendance to which item 3005 91824 or 110 applies did not take place on the same day by the same palliative medicine specialist or consultant physician.

Item Number: 92756

Description: Video attendance for a person by a specialist or consultant physician in the practice of the specialist's or consultant physician's specialty of palliative medicine if: (a) the attendance follows referral of the patient to the specialist or consultant physician (b) the attendance is of more than 5 minutes in duration and (c) the attendance is not a minor attendance after the first in a single course of treatment.

Item Number: 92757

Description: Video attendance for a person by a specialist or consultant physician in the practice of the specialist's or consultant physician's specialty of palliative medicine if: (a) the attendance follows referral of the patient to the specialist or consultant physician (b) the attendance is of more than 5 minutes in duration and (c) the attendance is a minor attendance after the first in a single course of treatment.

Item Number: 92758

Description: Phone attendance for a person by a specialist or consultant physician in the practice of the specialists’ or consultant physician’s specialty of palliative medicine if: (a) the attendance follows referral of the patient to the specialist or consultant physician (b) the attendance is of more than 5 minutes in duration and (c) the attendance is a minor attendance after the first in a single course of treatment.

Item Number: 92759

Description: Video attendance for a person by an addiction medicine specialist in the practice of the addiction medicine specialist's specialty if: (a) the attendance follows referral of the patient to the specialist (b) the attendance includes a comprehensive assessment (c) the attendance is the first or only time in a single course of treatment that a comprehensive assessment is provided and (d) an attendance on the patient being an attendance to which item 6018 91824 or 110 applies did not take place on the same day by the same addiction medicine specialist.

Item Number: 92760

Description: Video attendance for a person by an addiction medicine specialist in the practice of the addiction medicine specialist's specialty if:
(a) the attendance follows referral of the patient to the specialist
(b) the attendance is of more than 5 minutes in duration and
(c) the attendance is a patient assessment:
(i) before or after a comprehensive assessment under item 110 6018 91824 or 92759 in a single course of treatment
(ii) that follows an initial assessment under item 132 6023 92422 or 92762 in a single course of treatment
(iii) that follows a review under item 133 6024 92423 or 92763 in a single course of treatment.

Item Number: 92761

Description: Phone attendance for a person by an addiction medicine specialist in the practice of the addiction medicine specialist's specialty if:
(a) the attendance follows referral of the patient to the specialist
(b) the attendance is of more than 5 minutes in duration and
(c) the attendance is a minor attendance after the first in a single course of treatment.

Item Number: 92762

Description: Video attendance for a person by an addiction medicine specialist in the practice of the addiction medicine specialist's specialty of at least 45 minutes for an initial assessment of a patient with at least 2 morbidities following referral of the patient to the addiction medicine specialist by a referring practitioner if:
(a) an assessment is undertaken that covers:
(i) a comprehensive history including psychosocial history and medication review
(ii) a comprehensive multi or detailed single organ system assessment
(iii) the formulation of differential diagnoses
(b) an addiction medicine specialist treatment and management plan of significant complexity that includes the following is prepared and provided to the referring practitioner:
(i) an opinion on diagnosis and risk assessment
(ii) treatment options and decisions
(iii) medication recommendations
(c) an attendance on the patient to which item 104 105 110 116 119 91824 91825 91826 91836 92759 92760 92763 132 133 6018 6019 or 6023 applies did not take place on the same day by the same addiction medicine specialist
(d) neither this item nor item 6023 132 or 92422 has applied to an attendance on the patient in the preceding 12 months by the same addiction medicine specialist.

Schedule Fee: 312.45
Schedule Fee Start Date: 01.07.2025
Category: 1
Group: A40
Sub Group: 44
Claim History Limitation: Applicable according to description.
Referral Requirements: This item should be referred by a Specialist Medical Practitioner.
Benefit Type: 85
Item Start Date: 01.07.2025

Item Number: 92763

Description: Video attendance for a person by an addiction medicine specialist in the practice of the addiction medicine specialist's specialty of at least 20 minutes after the first attendance in a single course of treatment for a review of a patient with at least 2 morbidities if:
(a) a review is undertaken that covers:
(i) review of initial presenting problems and results of diagnostic investigations
(ii) review of responses to treatment and medication plans initiated at time of initial consultation
(iii) comprehensive multi or detailed single organ system assessment
(iv) review of original and differential diagnoses
(b) the modified addiction medicine specialist treatment and management plan is provided to the referring practitioner which involves if appropriate:
(i) a revised opinion on diagnosis and risk assessment
(ii) treatment options and decisions
(iii) revised medication recommendations
(c) an attendance on the patient to which item 104 105 110 116 119 132 133 6018 6019 91824 91825 91826 91836 92423 92759 or 6024 applies did not take place on the same day by the same addiction medicine specialist
(d) item 132 6023 92422 or 92762 applied to an attendance claimed in the preceding 12 months
(e) the attendance under this item is claimed by the same addiction medicine specialist who claimed item 132 6023 92422 or 92762 by locum tenens
(f) this item has not applied more than twice in any 12-month period.

Schedule Fee: 156.45
Schedule Fee Start Date: 01.07.2025
Category: 1
Group: A40
Sub Group: 44
Claim History Limitation: Applicable according to description.
Referral Requirements: This item should be referred by a Specialist Medical Practitioner.
Benefit Type: 85
Item Start Date: 01.07.2025

Item Number: 92764

Description: Video attendance for a person by a sexual health medicine specialist in the practice of the sexual health medicine specialist's specialty if:
(a) the attendance follows referral of the patient to the sexual health medicine specialist
(b) the attendance is of more than 5 minutes in duration and includes a comprehensive assessment
(c) the attendance is the first or only time in a single course of treatment
(d) an attendance on the patient being an attendance to which item 6051 91824 or 110 applies did not take place on the same day by the same sexual health medicine specialist.

Item Number: 92765

Description: Video attendance by a sexual health medicine specialist in the practice of the sexual health medicine specialist's specialty if:
(a) the attendance follows referral of the patient to the specialist
(b) the attendance is a patient assessment:
(i) before or after a comprehensive assessment under item 6051 91824 or 92764 in a single course of treatment
(ii) that follows an initial assessment under item 6057 or 92767 in a single course of treatment
(iii) that follows a review under item 6058 or 92768 in a single course of treatment.

Item Number: 92766

Description: Phone attendance for a person by a sexual health medicine specialist in the practice of the sexual health medicine specialist's specialty if:
(a) the attendance follows referral of the patient to the sexual health medicine specialist
(b) the attendance is of more than 5 minutes in duration
(c) the attendance is a minor attendance after the first in a single course of treatment.

Item Number: 92767

Description: Video attendance for a person by a sexual health medicine specialist in the practice of the sexual health medicine specialist's specialty of sexual health of at least 45 minutes for an initial assessment of a patient with at least 2 morbidities following referral of the patient to the sexual health medicine specialist by a referring practitioner if:
(a) an assessment is undertaken that covers:
(i) a comprehensive history including psychosocial history and medication review
(ii) a comprehensive multi or detailed single organ system assessment
(iii) the formulation of differential diagnoses
(b) a sexual health medicine specialist treatment and management plan of significant complexity that includes the following is prepared and provided to the referring practitioner:
(i) an opinion on diagnosis and risk assessment
(ii) treatment options and decisions
(iii) medication recommendations
(c) an attendance on the patient to which item 104 105 110 116 119 132 133 6051 6052 6057 91822 91823 91824 91825 91826 91833 91836 92422 92423 92764 or 92765 applies did not take place on the same day by the same sexual health medicine specialist
(d) neither this item nor items 6057 92422 or 132 has applied to an attendance on the patient in the preceding 12 months by the same sexual health medicine specialist.

Item Number: 92768

Description: Video attendance for a person by a sexual health medicine specialist in the practice of the sexual health medicine specialist's specialty of at least 20 minutes after the first attendance in a single course of treatment for a review of a patient with at least 2 morbidities if:
(a) a review is undertaken that covers:
(i) review of initial presenting problems and results of diagnostic investigations
(ii) review of responses to treatment and medication plans initiated at time of initial consultation
(iii) comprehensive multi or detailed single organ system assessment
(iv) review of original and differential diagnoses
(b) the modified sexual health medicine specialist treatment and management plan is provided to the referring practitioner which involves if appropriate:
(i) a revised opinion on diagnosis and risk assessment
(ii) treatment options and decisions
(iii) revised medication recommendations
(c) an attendance on the patient being an attendance to which item 104 105 110 116 119 132 133 6051 6052 91822 91823 91824 91825 91826 91836 92422 92423 92764 92765 or 6058 applies did not take place on the same day by the same sexual health medicine specialist
(d) item 6057 132 92422 or 92767 applied to an attendance claimed in the preceding 12 months
(e) the attendance under this item is claimed by the same sexual health medicine specialist who claimed item 6057 132 92422 or 92767 by locum tenens
(f) neither this item nor item 6058 has applied more than twice in any 12-month period.

Schedule Fee: 156.45
Schedule Fee Start Date: 01.07.2025
Category: 1
Group: A40
Sub Group: 44
Claim History Limitation: Applicable according to description.
Benefit Type: 85
Item Start Date: 01.07.2025

Item Number: 15990

Description: Proton beam dosimetry and proton-photon comparative plan reporting to assess eligibility for proton beam therapy via the Medical Treatment Overseas Program if:
(a) proton planning is required to calculate dose to single or multiple-target structures and requires a dose-volume histogram to complete the planning process
(b) the proton planning process optimises the differential between target dose organs at risk and normal tissue dose based on review and assessment by a radiation oncologist
(c) all relevant gross tumour volumes clinical target volumes and organs at risk are rendered as volumes and nominated with planning dose objectives
(d) organs at risk are nominated as planning dose constraints
(e) dose calculations and dose-volume histograms are generated in an inverse planned process using a specialised calculation algorithm with prescription and plan details approved and recorded with the plan
(f) a three-dimensional or four-dimensional image volume dataset is used for the relevant region to be planned and verified
(g) the final proton dosimetry plan is:
(i) validated by both the appropriately qualified radiation therapist and medical physicist using robust quality assurance processes (ii) approved by the radiation oncologist ensuring the plan is clinically realistic and assessed to be robust to expected uncertainties encountered in proton beam therapy
(h) a proton-photon comparative plan report is generated
(i) the service is bulk-billed

Schedule Fee: 7532.80
Schedule Fee Start Date: 01.07.2025
Category: 3
Group: T2
Sub Group: 15
Referral Requirements: Having a referral for this Medicare item is optional.
Benefit Type: _75_85
Item Start Date: 01.07.2024

Item Number: 16050

Description: Administration of Lutetium 177 PSMA followed within 36 hours by whole body Lu-PSMA SPECT for treatment of a patient with metastatic castrate resistant prostate cancer who is:
(a) PSMA-positive as determined by PSMA PET (defined as SUVmax >15 at a single site of disease and SUVmax >10 at all sites of measurable disease) after disease progression
(b) prior treatment includes at least one taxane chemotherapy and at least one androgen receptor signalling inhibitor
Applicable once per cycle up to a maximum of 2 cycles in the initial treatment phase.

Schedule Fee: 8000.00
Schedule Fee Start Date: 01.07.2025
Category: 3
Group: T3
Sub Group: 2
Claim History Limitation: Applicable according to description
Referral Requirements: Having a referral for this Medicare item is optional
Benefit Type: _75_85
Item Start Date: 01.07.2025

Item Number: 16055
Description: Administration of Lutetium 177 PSMA followed within 36 hours by whole body Lu-PSMA SPECT for treatment of a patient with metastatic castrate resistant prostate cancer if:
(a) a service to which item 16050 applies has been provided
(b) the patient has not developed disease progression while receiving Lutetium 177 PSMA for this condition
Applicable once per cycle up to a maximum of 4 cycles in the continuing treatment phase.

Item Number: 38326

Description: Use of optical coherence tomography (OCT) during transluminal insertion of stents to optimise procedural strategy appropriate stent size and assessment of stent apposition if:
(a) the patient is documented with:
(i) one or more lesions located at a bifurcation
(ii) a planned side branch at least 2.5 mm in diameter by angiographic visual estimation
or
(b) the patient is documented with stent thrombosis
or
(c) both:
(i) the patient is documented with one or more lesions at least 28mm in length
(ii) either of the following apply:
(A) a service to which this item applies is not performed in association with a service to which item 38325 applies because of paragraph (b) of that item
(B) a service to which this item applies is not performed in relation to a lesion in association with a service to which item 38325 applies because of paragraph (a) of that item performed in relation to the same lesion
If performed in association with a service to which item 38307, 38308, 38310, 38311, 38313, 38314, 38316, 38317, 38319, 38320, 38322 or 38323 applies
Applicable once per episode of care (for one or more lesions).

Schedule Fee: 539.15
Schedule Fee Start Date: 01.07.2025
Category: 3
Group: T8
Sub Group: 6
Claim History Limitation: Applicable according to description
Referral Requirements: Having a referral for this Medicare item is optional
Benefit Type: 75
Item Start Date: 01.07.2025

Item Number: 42750

Description: Subconjunctival injection of antifibrotic agent following glaucoma filtering surgery as an independent procedure.

Schedule Fee: 62.20
Schedule Fee Start Date: 01.07.2025
Category: 3
Group: T8
Sub Group: 9
Referral Requirements: Having a referral for this Medicare item is optional
Benefit Type: _75_85
Item Start Date: 01.07.2025

Item Number: 43030

Description: Paracentesis of anterior chamber or vitreous cavity or both for either or both of the following
(a) the injection of therapeutic substances
(b) the removal of aqueous or vitreous humours for diagnostic or therapeutic purposes
As an independent procedure of the left eye.

Schedule Fee: 350.85
Schedule Fee Start Date: 01.07.2025
Category: 3
Group: T8
Sub Group: 9
Referral Requirements: Having a referral for this Medicare item is optional
Benefit Type: _75_85
Item Start Date: 01.07.2025

Item Number: 43032

Item Number: 43034

Item Number: 43036

Item Number: 43038

Description: Intravitreal injection of therapeutic substances or the removal of vitreous humour for diagnostic purposes one or more of as a procedure associated with other intraocular surgery of the left eye (Anaes.)

Item Number: 43040

Item Number: 43050

Description: Choroidal detachment repair by external drainage (H) (Anaes.) (Assist.)

Schedule Fee: 786.50
Schedule Fee Start Date: 01.07.2025
Category: 3
Group: T8
Sub Group: 9
Referral Requirements: Having a referral for this Medicare item is optional
Benefit Type: _75
Item Start Date: 01.07.2025

Item Number: 57410

Description: Low-dose computed tomography (low-dose CT) scan of chest for the National Lung Cancer Screening Program without intravenous contrast medium where:
(a) the request states that the patient’s eligibility to participate in the National Lung Cancer Screening Program has been assessed and confirmed
(b) the service utilises the agreed nodule management protocol for standardised lung nodule identification classification and reporting
(c) the service is bulk-billed (R) (Anaes.)

Schedule Fee: 338.75
Schedule Fee Start Date: 01.07.2025
Category: 5
Group: I2
Sub Group: 14
Referral Requirements: This item should be referred by one of the following specialties: General Practitioner, Specialist Medical Practitioner
Benefit Type: _75_85
Item Start Date: 01.07.2025

Item Number: 57413

Description: Low-dose computed tomography (low-dose CT) scan of chest for the National Lung Cancer Screening Program without intravenous contrast medium where:
(a) the service is:
(i) performed as a clinical follow-up within 2 years of a screening low-dose CT scan of MBS item 57410
(ii) performed as a clinical follow-up to a previous interval low-dose CT scan of MBS item 57413 linked to MBS item 57410
(b) the service utilises the agreed nodule management protocol for standardised lung nodule identification classification and reporting.
(c) the service is bulk-billed (R) (Anaes.)

Item Number: 61528

Description: Whole body PSMA PET study performed for the assessment of suitability for Lutetium 177 PSMA therapy in a patient with metastatic castrate resistant prostate cancer after progressive disease has developed while undergoing prior treatment with at least one taxane chemotherapy and at least one androgen receptor signalling inhibitor (R) (Anaes.)

Schedule Fee: 1300.00
Schedule Fee Start Date: 01.07.2025
Category: 5
Group: I4
Sub Group: 2
Referral Requirements: This item should be referred by one of the following specialties General Practitioner, Specialist Medical Practitioner.
Benefit Type: _75_85
Item Start Date: 01.07.2025

Item Number: 66842

Description: Quantification of one or more of total vitamin B12 holotranscobalamin methylmalonic acid or homocysteine for a patient
a) who:
(i) is still experiencing symptoms of vitamin B12 deficiency 3 to 6 months after a service described in item 66838 or 66839 was rendered for the patient
(ii) obtained inconclusive results from a service described in item 66839
or
b) to whom one or more of the following applies
(i) the patient has a diet low in vitamin B12
(ii) the patient has a family history of vitamin B12 deficiency or an autoimmune condition
(iii) the patient has previously had abdominal or pelvic radiotherapy
(iv) the patient has previously had surgery involving the gastrointestinal tract
(v) the patient uses or has a recent history of using recreational nitrous oxide
(vi) the patient requires monitoring of vitamin B12 treatment
(vii) the patient uses vitamin B12-antagonistic medicines
(viii) the patient has one or more clinical conditions with a recognised risk of vitamin B12 deficiency

Schedule Fee: 23.60
Schedule Fee Start Date: 01.07.2025
Category: 6
Group: P2
Referral Requirements: Having a referral for this Medicare item is optional
Benefit Type: _75_85
Item Start Date: 01.07.2025

Item Number: 73319

Description: Detection in tumour tissue of isocitrate dehydrogenase 1 (IDH1) variant status in a patient with histologically confirmed cholangiocarcinoma to determine eligibility for a relevant treatment listed under the Pharmaceutical Benefits Scheme Applicable only once per lifetime.

Schedule Fee: 340.00
Schedule Fee Start Date: 01.07.2025
Category: 6
Group: P7
Claim History Limitation: Applicable according to description
Referral Requirements: Having a referral for this Medicare item is optional
Benefit Type: _75_85
Item Start Date: 01.07.2025

Item Number: 75010

Description: Orthodontic radiography – anteroposterior or lateral cephalometric radiography with cephalometric tracings and orthopantomography including any consultation on the same occasion.

Schedule Fee: 151.80
Schedule Fee Start Date: 01.07.2025
Category: 7
Group: C1
Referral Requirements: Having a referral for this Medicare item is optional
Benefit Type: _75_85
Item Start Date: 01.07.2025

Item Number: 75011

Description: Orthodontic radiography – anteroposterior and lateral cephalometric radiography with cephalometric tracings and orthopantomography including any consultation on the same occasion.

Schedule Fee: 197.90
Schedule Fee Start Date: 01.07.2025
Category: 7
Group: C1
Referral Requirements: Having a referral for this Medicare item is optional
Benefit Type: _75_85
Item Start Date: 01.07.2025

Deleted MBS Items: 34

Item Number: 229
Description: Attendance by a prescribed medical practitioner for preparation of a GP management plan for a patient (other than a service associated with a service to which any of items 235 to 240 and 735 to 758 apply)
Category: 1

Item Number: 230
Description: Attendance by a prescribed medical practitioner to coordinate the development of team care arrangements for a patient (other than a service associated with a service to which any of items 235 to 240 and 735 to 758 apply)
Category: 1

Item Number: 233
Description: Attendance by a prescribed medical practitioner: (a) to review a GP management plan prepared by a medical practitioner (or an associated medical practitioner); or (b) to coordinate a review of team care arrangements which have been coordinated by the medical practitioner (or the associated medical practitioner)
Category: 1

Item Number: 721
Description: Attendance by a general practitioner for preparation of a GP management plan for a patient (other than a service associated with a service to which any of items 735 to 758 apply)
Category: 1

Item Number: 723
Description: Attendance by a general practitioner to coordinate the development of team care arrangements for a patient (other than a service associated with a service to which any of items 735 to 758 apply)
Category: 1

Item Number: 732
Description: Attendance by a general practitioner to review or coordinate a review of: (a) a GP management plan prepared by a general practitioner (or an associated general practitioner) to which item 721 applies; or (b) team care arrangements which have been coordinated by the general practitioner (or an associated general practitioner) to which item 723 applies
Category: 1

Item Number: 10660
Description: Professional attendance by a general practitioner, if all of the following apply: (a) the service is associated with a service to which item 93644, 93645, 93653 or 93654 applies; (b) the service requires personal attendance by the general practitioner, lasting more than 10 minutes in duration, to provide in-depth clinical advice on the individual risks and benefits associated with receiving a COVID-19 vaccine; (c) one or both of the following is undertaken, where clinically relevant: (i) a detailed patient history; (ii) complex examination and management; (d) the service is bulk-billed
Category: 1

Item Number: 10661
Description: Professional attendance by a medical practitioner (other than a general practitioner), if all of the following apply: (a) the service is associated with a service to which item 93646, 93647, 93655 or 93656 applies; (b) the service requires personal attendance by the medical practitioner (other than a general practitioner), lasting more than 10 minutes in duration, to provide in-depth clinical advice on the individual risks and benefits associated with receiving a COVID-19 vaccine; (c) one or both of the following is undertaken, where clinically relevant: (i) a detailed patient history; (ii) complex examination and management; (d) the service is bulk-billed
Category: 1

Item Number: 90005
Description: A flag fall service to which item 93644, 93645, 93646, 93647, 93653, 93654, 93655, 93656, 93660 or 93661 applies. For the first patient attended during one attendance by a general practitioner or by a medical practitioner (other than a general practitioner) at: (a) one residential aged care facility, or at consulting rooms situated within such a complex, on one occasion; or (b) one residential disability setting facility, or at consulting rooms situated within such a complex, on one occasion; or (c) a person’s place of residence (other than a residential aged care facility) on one occasion.
Category: 1

Item Number: 92024
Description: Video attendance by a general practitioner, for preparation of a GP management plan for a patient (other than a service associated with a service to which any of items 235 to 240 or 735 to 758 of the general medical services table apply) NOTE: It is a legislative requirement that this service must be performed by the patient’s usual medical practitioner (please see Note AN.1.1 for the definition of ‘patient’s usual medical practitioner’ as some exemptions do apply)
Category: 1

Item Number: 92025
Description: Video attendance by a general practitioner, to coordinate the development of team care arrangements for a patient (other than a service associated with a service to which any of items 235 to 240 or 735 to 758 of the general medical services table apply) NOTE: It is a legislative requirement that this service must be performed by the patient’s usual medical practitioner (please see Note AN.1.1 for the definition of ‘patient’s usual medical practitioner’ as some exemptions do apply)
Category: 1

Item Number: 92028
Description: Video attendance by a general practitioner to review or coordinate a review of: (a) a GP management plan prepared by a general practitioner (or an associated general practitioner) to which items 229 or 721 of the general medical services table, or item 92024, 92055, 92068 or 92099 applies; (b) team care arrangements which have been coordinated by the general practitioner (or an associated general practitioner) to which items 230 or 723 of the general medical services table, or item 92025 or 92069 applies NOTE: It is a legislative requirement that this service must be performed by the patient’s usual medical practitioner (please see Note AN.1.1 for the definition of ‘patient’s usual medical practitioner’ as some exemptions do apply)
Category: 1

Item Number: 92055
Description: Video attendance by a medical practitioner (not including a general practitioner, specialist or consultant physician), for preparation of a GP management plan for a patient (other than a service associated with a service to which any of items 235 to 240 or 735 to 758 of the general medical services table apply) NOTE: It is a legislative requirement that this service must be performed by the patient’s usual medical practitioner (please see Note AN.1.1 for the definition of ‘patient’s usual medical practitioner’ as some exemptions do apply)
Category: 1

Item Number: 92056
Description: Video attendance by a medical practitioner (not including a general practitioner, specialist or consultant physician), to coordinate the development of team care arrangements for a patient (other than a service associated with a service to which any of items 235 to 240 or 735 to 758 of the general medical services table apply) NOTE: It is a legislative requirement that this service must be performed by the patient’s usual medical practitioner (please see Note AN.1.1 for the definition of ‘patient’s usual medical practitioner’ as some exemptions do apply)
Category: 1

Item Number: 92059
Description: Video attendance by a medical practitioner (not including a general practitioner, specialist or consultant physician) to review or coordinate a review of: (a) a GP management plan prepared by a medical practitioner (or an associated medical practitioner) to which item 721 or item 229 of the general medical services table or item 92024, 92055, 92068 or 92099 applies; or (b) team care arrangements which have been coordinated by the medical practitioner (or an associated medical practitioner) to which items 230 or 723 of the general medical services table or item 92025, 92056, 92069 or 92100 applies NOTE: It is a legislative requirement that this service must be performed by the patient’s usual medical practitioner (please see Note AN.1.1 for the definition of ‘patient’s usual medical practitioner’ as some exemptions do apply).
Category: 1

Item Number: 93644
Description: Professional attendance by a general practitioner for the purpose of assessing a patient’s suitability for a COVID-19 vaccine if all of the following apply: (a) one or both of the following is undertaken, where clinically relevant: (i) a short patient history; (ii) limited examination and management; (b) the service is bulk-billed; (c) the service is provided at, or from, a practice location in a Modified Monash 1 area
Category: 1

Item Number: 93645
Description: Professional attendance by a general practitioner for the purpose of assessing a patient’s suitability for a COVID-19 vaccine if all of the following apply: (a) one or both of the following is undertaken, where clinically relevant: (i) a short patient history; (ii) limited examination and management; (b) the service is bulk-billed; (c) the service is provided at, or from, a practice location in: (i) a Modified Monash 2 area; or (ii) a Modified Monash 3 area; or (iii) a Modified Monash 4 area; or (iv) a Modified Monash 5 area; or (v) a Modified Monash 6 area; or (vi) a Modified Monash 7 area
Category: 1

Item Number: 93646
Description: Professional attendance by a medical practitioner (other than a general practitioner) for the purpose of assessing a patient’s suitability for a COVID-19 vaccine if all of the following apply: (a) one or both of the following is undertaken, where clinically relevant: (i) a short patient history; (ii) limited examination and management; (b) the service is bulk-billed; (c) the service is provided at, or from, a practice location in a Modified Monash 1 area
Category: 1

Item Number: 93647
Description: Professional attendance by a medical practitioner (other than a general practitioner) for the purpose of assessing a patient’s suitability for a COVID-19 vaccine if all of the following apply: (a) one or both of the following is undertaken, where clinically relevant: (i) a short patient history; (ii) limited examination and management; (b) the service is bulk-billed; (c) the service is provided at, or from, a practice location in: (i) a Modified Monash 2 area; or (ii) a Modified Monash 3 area; or (iii) a Modified Monash 4 area; or (iv) a Modified Monash 5 area; or (v) a Modified Monash 6 area; or (vi) a Modified Monash 7 area
Category: 1

Item Number: 93653
Description: Professional attendance by a general practitioner for the purpose of assessing a patient’s suitability for a COVID-19 vaccine if all of the following apply: (a) one or both of the following is undertaken, where clinically relevant: (i) a short patient history; (ii) limited examination and management; (b) the service is bulk-billed; (c) the service is provided at, or from, a practice location in a Modified Monash 1 area; (d) the service is rendered in an after-hours period
Category: 1

Item Number: 93654
Description: Professional attendance by a general practitioner for the purpose of assessing a patient’s suitability for a dose of a COVID-19 vaccine if all of the following apply: (a) one or both of the following is undertaken, where clinically relevant: (i) a short patient history; (ii) limited examination and management; (b) the service is bulk-billed; (c) the service is provided at, or from, a practice location in: (i) a Modified Monash 2 area; or (ii) a Modified Monash 3 area; or (iii) a Modified Monash 4 area; or (iv) a Modified Monash 5 area; or (v) a Modified Monash 6 area; or (vi) a Modified Monash 7 area; (d) the service is rendered in an after-hours period
Category: 1

Item Number: 93655
Description: Professional attendance by a medical practitioner (other than a general practitioner) for the purpose of assessing a patient’s suitability for a COVID-19 vaccine if all of the following apply: (a) one or both of the following is undertaken, where clinically relevant: (i) a short patient history; (ii) limited examination and management; (b) the service is bulk-billed; (c) the service is provided at, or from, a practice location in a Modified Monash 1 area; (d) the service is rendered in an after-hours period
Category: 1

Item Number: 93656
Description: Professional attendance by a medical practitioner (other than a general practitioner) for the purpose of assessing a patient’s suitability for a COVID-19 vaccine if all of the following apply: (a) one or both of the following is undertaken, where clinically relevant: (i) a short patient history; (ii) limited examination and management; (b) the service is bulk-billed; (c) the service is provided at, or from, a practice location in: (i) a Modified Monash 2 area; or (ii) a Modified Monash 3 area; or (iii) a Modified Monash 4 area; or (iv) a Modified Monash 5 area; or (v) a Modified Monash 6 area; or (vi) a Modified Monash 7 area; (d) the service is rendered in an after-hours period
Category: 1

Item Number: 93660
Description: Attendance by a relevant health professional on behalf of a medical practitioner for the purpose of assessing a patient’s suitability for a dose of a COVID-19 vaccine if all of the following apply: (a) one or both of the following is undertaken, where clinically relevant: (i) a short patient history; (ii) limited examination and management; (b) the service is bulk-billed; (c) the service is not provided at a practice location; and (d) the service is provided from a practice location in a Modified Monash 1 area
Category: 1

Item Number: 93661
Description: Attendance by a relevant health professional on behalf of a medical practitioner for the purpose of assessing a patient’s suitability for a dose of a COVID-19 vaccine if all of the following apply: (a) one or both of the following is undertaken, where clinically relevant: (i) a short patient history; (ii) limited examination and management; (b) the service is bulk-billed; (c) the service is not provided at a practice location; and (d) the service is provided from a practice location in: (i) a Modified Monash 2 area; or (ii) a Modified Monash 3 area; or (iii) a Modified Monash 4 area; or (iv) a Modified Monash 5 area; or (v) a Modified Monash 6 area; or (vi) a Modified Monash 7 area
Category: 1

Item Number: 42524
Description: ORBIT, SKIN GRAFT TO, as a delayed procedure (Anaes.)
Category: 3

Item Number: 42593
Description: LACRIMAL GLAND, excision of palpebral lobe (Anaes.)
Category: 3

Item Number: 42738
Description: PARACENTESIS OF ANTERIOR CHAMBER OR VITREOUS CAVITY, or both, for the injection of therapeutic substances, or the removal of aqueous or vitreous humours for diagnostic or therapeutic purposes, 1 or more of, as an independent procedure.
Category: 3

Item Number: 42739
Description: PARACENTESIS OF ANTERIOR CHAMBER OR VITREOUS CAVITY, or both, for the injection of therapeutic substances, or the removal of aqueous or vitreous humours for diagnostic or therapeutic purposes, one or more of, as an independent procedure, for a patient requiring the administration of anaesthetic by an anaesthetist.
Category: 3

Item Number: 42740
Description: INTRAVITREAL INJECTION OF THERAPEUTIC SUBSTANCES, or the removal of vitreous humour for diagnostic purposes, 1 or more of, as a procedure associated with other intraocular surgery.
Category: 3

Item Number: 42741
Description: Posterior juxtascleral depot injection of a therapeutic substance, for the treatment of subfoveal choroidal neovascularisation due to age-related macular degeneration, 1 or more of
Category: 3

Item Number: 42806
Description: IRIS TUMOUR, laser photocoagulation of
Category: 3

Item Number: 42807
Description: PHOTOMYDRIASIS, laser
Category: 3

Item Number: 43023
Description: Infusion of Verteporfin for discontinued photodynamic therapy, where a session of therapy which would have been provided under item 43021 or 43022 has been discontinued on medical grounds.
Category: 3