Medicare Benefits Schedule - Item 10988

Immunisation provided to a person by an Aboriginal and Torres Strait Islander health practitioner if:

(a)    the immunisation is provided on behalf of, and under the supervision of, a medical practitioner; and

(b)    the person is not an admitted patient of a hospital.

Fee: $14.35 Benefit: 100% = $14.35

(See para MN.12.1, MN.12.6 of explanatory notes to this Category)

Extended Medicare Safety Net Cap: $43.05

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• Next - Item 10989

Publication date: 1 July 2026

SUMMARY

This note outlines the requirements for item 10988 for the provision of immunisation services provided by an Aboriginal and Torres Strait Islander health practitioner on behalf of, and under the supervision of, a medical practitioner.

USE OF THE ITEM

Note: The requirements in this note must be met in addition to the requirements for ‘on behalf of’ items contained in MN.12.6.

This item is used to administer vaccinations to patients by an Aboriginal and Torres Strait Islander health practitioner on behalf of, and under the supervision of, a medical practitioner.

Health practitioners should refer to the Australian Immunisation Handbook and the National Immunisation Program Schedule for guidance when assessing patient vaccine eligibility and administering vaccinations to patients.

Can I charge the patient for the cost of the vaccine if this service is bulk billed?

Yes, under certain circumstances. Where the patient is bulk billed, an additional charge can only be raised against the patient by the practitioner where the patient is provided with a vaccine or vaccines from the practitioner's own supply held on the practitioner's premises.

If the cost of the vaccine supplied in connection with a service described in item 10988 is not subsidised by government (Commonwealth or State), the service is taken not to include the supply of that vaccine.

For example, it would not be acceptable to bulk bill an Aboriginal adult patient and levy a charge for the cost of an influenza vaccine as the vaccine is covered by the National Immunisation Program. However, if an influenza vaccine is administered for an adult who is not eligible under the National Immunisation Program (patient under the age of 65 years who is not of Aboriginal and Torres strait Islander descent, not pregnant and has no specified medical risk conditions) or relevant State subsidised vaccine program, the patient could be bulk billed and a charge levied for the cost of the vaccine if it is taken from the practitioner’s own supply.

Is it ever appropriate to co-claim the immunisation item and another item?

Yes. Co-claiming may be appropriate where the service provided by the Aboriginal and Torres Strait Islander health practitioner is a separate and clinically relevant service, all the requirements of each item has been independently met and there is no duplication of services.

However, where a patient receives more than one vaccine during the service, item 10988 may only be claimed once.

Can an Aboriginal and Torres Strait Islander health practitioner administer any vaccine under this item?

The service must be provided in accordance with any relevant Commonwealth, State and Territory laws. Aboriginal and Torres Strait Islander health practitioners and supervising medical practitioners should refer to relevant State and Territory laws for the regulation, control, supply and use of drugs and therapeutic goods for further information on vaccine administration arrangements.

ELIGIBLE PATIENTS

This item is available to all Medicare-eligible patients who require an immunisation, provided they are not admitted patients of a hospital.

ELIGIBLE PRACTITIONERS

These items are medical practitioner items. The services are delivered by an Aboriginal and Torres Strait Islander health practitioner on behalf of, and under the supervision of, a medical practitioner. The medical practitioner must claim the MBS item and retain responsibility for the health, safety and clinical outcomes for the patient.

The Aboriginal and Torres Strait Islander health practitioner delivering the service on behalf of the medical practitioner must be appropriately qualified and trained to deliver immunisation services.

The Health Insurance Act 1973 requires the person rendering the service to be in Australia. As the medical practitioner’s Medicare provider number is used to claim the service, they are considered to be the person who renders the service.

Information on supervision arrangements can be found in MN.12.6 (overarching note).

RECORD KEEPING AND REPORTING REQUIREMENTS

Providers are responsible for ensuring services claimed from Medicare using their provider number meet all legislative requirements and they may be required to submit evidence for compliance checks related to Medicare claims. Practitioners should ensure they keep adequate and contemporaneous records. For information on what constitutes adequate and contemporaneous records see GN.15.39.

RELEVANT LEGISLATION

Details about the legislative requirements of the MBS item(s) can be found on the Federal Register of Legislation at www.legislation.gov.au. This item is set out in the Health Insurance (General Medical Services Table) Regulations 2021.

Related Items: 10988

Publication date: 1 July 2026

SUMMARY

This note sets out the common requirements for MBS services that can be provided on behalf of a medical practitioner by practice nurses, Aboriginal and Torres Strait Islander health workers and/or Aboriginal and Torres Strait Islander health practitioners (items 10983, 10987, 10988, 10989, 10997, 93200, 93201, 93202, 93203).

The item requirements and health providers eligible to provide a service differs for each item. Details on item specific requirements are as follows:

USE OF THE ITEMS

Note: The requirements set out in this note must be met in addition to the requirements contained in each item’s relevant associated note. Refer to the table in the Summary section for the relevant associated notes.

These items are used by medical practitioners when specified services are provided on their behalf by eligible practice nurses, Aboriginal and Torres Strait Islander health workers and/or Aboriginal and Torres Strait Islander health practitioners to deliver relevant services to patients (as specified in each item).

Services delivered by the health practitioner must be within the accepted scope of practice of the health practitioner, in accordance with accepted medical practice and under the supervision of the medical practitioner.

These items may be claimed with a single bulk billing incentive when they are bulk billed. Information on bulk billing incentives is available in MN.1.1.

The regulations state that the service must be provided under the supervision of a medical practitioner. Does that mean the medical practitioner must be in the same room as the person delivering the service?

No. Supervision at a distance is acceptable. However, in order to claim Medicare benefits, the medical practitioner must be in Australia and be readily contactable to provide timely clinical advice as required. The medical practitioner retains overall responsibility for the patient’s care. 

I am qualified health professional (not a medical practitioner) and I am able to practice independently within my scope of practice. Why do I need supervision when providing these services?

The MBS considers these items to be medical practitioner items. This means the service can be provided by another health professional on behalf of the medical practitioner but the medical practitioner remains legally responsible for the service.

Supervision in these items refers to the legal responsibility under the MBS. MBS supervision requirements are distinct and separate to supervision requirements, including ability to practice independently, under the National Boards and the Australian health Practitioner Regulation Agency (Aphra).

The health practitioner that provides the service on behalf of the medical practitioner is still subject to their professional standards, scope of practice and State and Territory laws.

Can I provide remote supervision from overseas? 

No. The Health Insurance Act 1973 requires the person rendering the service to be in Australia. As the medical practitioner’s Medicare provider number is used to claim the service, they are considered to be the person who renders the service. 

We have a nurse practitioner at the practice. Can they provide practice nurse services under these items?

Yes. Nurse practitioners are registered nurses with an endorsement as a nurse practitioner. Therefore, provided they are working in general practice or a health service with a relevant section 19(2) exemption to the Health Insurance Act 1973, they meet the definition of a practice nurse for the purposes of these items.

Nurse practitioners may also provide services using nurse practitioner attendance items (see MN.14.12). If a nurse practitioner provides a service to a patient on behalf of a medical practitioner and an attendance service on the same day, the services must be independent services and clinically necessary. Both items cannot be claimed for the same service/time.

Is it ever appropriate to co-claim another item with an ‘on behalf of’ item during a patient’s visit?

Yes. Co-claiming may be appropriate where both services provided by the practitioner(s) are distinct and clinically relevant services consistent with the patient’s health needs, there is no duplication of services, the requirements of each item (including time requirements) are fully and independently met and there are no relevant co-claiming restrictions on the other item.

ELIGIBLE PATIENTS

Any patient who is eligible to receive Medicare benefits, is not an admitted patient of a hospital, and meets the criteria for one or more of the following items may receive one of these services, subject to the specified service limits:

ELIGIBLE PRACTITIONERS

These items are medical practitioner items. The services are delivered by an eligible practitioner on behalf of, and under the supervision of, a medical practitioner.

The medical practitioner must claim the MBS item and retains responsibility for the health, safety and clinical outcomes for the patient. The health practitioner delivering the service on behalf of the medical practitioner must be appropriately qualified and trained to deliver the service.

Services must be rendered according to the provisions of the relevant Commonwealth, State and Territory laws. For example, practitioners may only administer a vaccine where the service is in line with the provisions of relevant State and Territory laws for the regulation, control, supply and use of drugs and therapeutic goods.

As set out in the table below, depending on the item rendered, eligible providers may be practice nurses, Aboriginal and Torres Strait Islander health practitioners and/or Aboriginal and Torres Strait Islander health workers.

The terms ‘practice nurse’, ‘Aboriginal and Torres Strait Islander health worker’ and ‘Aboriginal and Torres Strait Islander health practitioner’ are defined in the Health Insurance (General Medical Services Table) Regulations 2021 (the Regulations).

The Regulations define a practice nurse as "a registered or an enrolled nurse who is employed by, or whose services are otherwise retained by, a general practice or by a health service to which a direction made under subsection 19(2) of the [Health Insurance] Act applies.”

The Regulations define an Aboriginal and Torres Strait Islander health worker as "a person:

1. who holds a qualification of Certificate III or higher in Aboriginal and/or Torres Strait Islander Primary Health Care from the Health (HLT) training package; and
2. who is engaged by a medical practitioner in a general practice or a health service to which a direction made under subsection 19(2) of the [Health Insurance] Act applies.”

The Regulations define an Aboriginal and Torres Strait Islander health practitioner as “a person:

1. who is registered under the national law in the Aboriginal and Torres Strait Islander health practice profession; and
2. who is employed by, or whose services are otherwise retained by, a medical practitioner in a general practice or a health service to which a direction made under subsection 19(2) of the [Health Insurance] Act applies.”

RECORD KEEPING AND REPORTING REQUIREMENTS

Providers are responsible for ensuring services claimed from Medicare using their provider number meet all legislative requirements and they may be required to submit evidence for compliance checks related to Medicare claims. Practitioners should ensure they keep adequate and contemporaneous records. For information on what constitutes adequate and contemporaneous records see GN.15.39.

RELEVANT LEGISLATION

Details about the legislative requirements of the MBS item(s) can be found on the Federal Register of Legislation at www.legislation.gov.au. These items are set out in the following regulatory instruments:

• Health Insurance (General Medical Services Table) Regulations 2021 – item 10983, 10987, 10988, 10989, 10997
• Health Insurance (Section 3C General Medical Services – Telehealth Attendances) Determination 2021 – items 93200, 93201, 93202, 93203
  

Related Items: 10983 10987 10988 10989 10997 93200 93201 93202 93203