Medicare Benefits Schedule - Note MN.14.17

Long-acting reversible contraceptive (LARC) services provided by participating nurse practitioners are covered by three MBS items.

The items provide for:

• an intra-uterine device (IUD) insertion (MBS item 82201)
• a hormonal implant removal (MBS item 82202)
• a hormonal implant implantation (MBS item 82203)

Additional information

• Applicable clinical practice guidelines are available from the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG).
• Item 82203 is not payable for artificial insemination or rendered in conjunction with assisted reproductive technology MBS services.
• The "(Anaes.)" annotation indicates that the MBS item can be provided with an anaesthetic service. Anaesthetic MBS items can be billed by the medical provider in conjunction with the participating nurse practitioner billing the LARC service procedure items. 

Loading Item

• Item 82204 provides a ‘loading’ of 40% of the fee for relevant LARC insertion/removal items, when a patient’s LARC insertion or removal service, and any associated services such as consultations, are bulk billed.

This item provides for:

• New loading item 82204 is intended to support bulk billing of patients who are having a LARC inserted or removed.
• For loading item 82204 to be payable, participating nurse practitioners must:
  • ensure all item requirements are met
  • bulk bill the patient for each MBS item they claim during the patient’s LARC appointment that is related to the LARC insertion/removal, including any other item in Subgroup 1 of Group M14 or items 73832 and 73833 applying to the service.

Services to which loading applies:

• MBS loading item 82204 only applies where a service meeting one or more of the following is performed:
  • An IUD insertion (MBS item 82201)
  • a hormonal implant removal (MBS item 82202)
  • a hormonal implant implantation (MBS item 82203)
• A removal and insertion item may both be claimed if these services are conducted on the same day in the same appointment (for example removal and insertion of a new hormonal implant).
• IUD removal as a standalone procedure can be billed under any appropriate MBS attendance item. In this case item 82204 will not apply.

Related Items: 82201 82202 82203 82204 82206

• Previous - Note MN.14.16
• Next - Note MN.14.18

Introduction of an intra-uterine device for abnormal uterine bleeding or contraception or for endometrial protection during oestrogen replacement therapy

(Anaes.)

Fee: $215.95 Benefit: 75% = $162.00 85% = $183.60

(See para MN.14.17, MN.14.18, MN.14.19 of explanatory notes to this Category)

Removal of etonogestrel subcutaneous implant

(Anaes.)

Fee: $105.15 Benefit: 75% = $78.90 85% = $89.40

(See para MN.14.17, MN.14.18, MN.14.19 of explanatory notes to this Category)

Hormone or living tissue implantation by cannula

Fee: $100.40 Benefit: 75% = $75.30 85% = $85.35

(See para MN.14.17 of explanatory notes to this Category)

A service rendered by a participating nurse practitioner to which item 82201, 82202 or 82203 applies, if the service is bulk‑billed in relation to the fees for:

(a) that item; and

(b) any other item in Subgroup 1 of Group M14 or item 73832 and 73833 applying to the service

40% of the fee for items 82201, 82202, or 82203.

(See para MN.14.17 of explanatory notes to this Category)

A procedure, being a service to which an item in Subgroup 4 of Group M14 would have applied had the procedure not been discontinued on clinical grounds, other than a service to which 82203 applies

50% of the fee which would have applied had the procedure not been discontinued

(See para MN.14.17, MN.14.18 of explanatory notes to this Category)