View Associated Notes
Category 1 - PROFESSIONAL ATTENDANCES
301 - Additional Information
Professional attendance at consulting rooms lasting more than 60 minutes (other than a service to which any other item in this Schedule applies) by a prescribed medical practitioner in an eligible area—each attendance
Fee: $162.10 Benefit: 100% = $162.10
(See para AN.0.9, AN.0.72, AN.7.1, AN.7.2, MN.1.4, MN.1.5, MN.1.6, MN.1.7, MN.1.8 of explanatory notes to this Category)
Associated Notes
Category 1 - PROFESSIONAL ATTENDANCES
AN.0.9
Using time-tiered professional (general) attendance items
Publication Date: 1 July 2025
SUMMARY
This note sets out the key common principles that apply when using the time-tiered professional attendance (also referred to as general attendance, time-tiered attendance, and Level A-E attendance) MBS items for general practitioners (GPs), medical practitioners (who are not GPs) and prescribed medical practitioners (i.e. medical practitioners who are not GPs, specialists or consultant physicians). These items are usually claimed in a general practice setting.
Unless otherwise stated these principles apply to all general attendance items, regardless of location (in consulting rooms, out of consulting rooms or residential aged care facilities), time (business or after-hours), or mode (face to face or video or phone). For some categories of attendances e.g. telehealth (video or phone) additional requirements may apply.
Note: that within the general practice context, prescribed medical practitioners and medical practitioners who are not GPs are sometimes referred to as Other Medical Practitioners (OMPs) or non-vocationally registered (non-VR) GPs. References to OMPs in this Explanatory Note include both prescribed medical practitioners and medical practitioners who are not GPs.
Information on the definition of a GP for Medicare purposes is available in GN.4.13 and prescribed medical practitioners in AN.7.1.
Tables setting out the item numbers for the various time-tiers and locations, times of day and modes are available in Note AN.0.74 for GPs, and AN.7.2 for OMPs.
USE OF THE ITEMS
General attendance items are claimed for a professional attendance when no other MBS item applies. It is a general principle of the MBS that the item that best describes the service is the item that should be claimed. This means that where a more specific MBS items exists (for example a skin biopsy under MBS item 30071), the more specific item should be claimed. If no other MBS item accurately reflects the service provided, and the requirements of a general attendance item are met, the general attendance item is claimed.
General attendance items generally require that the medical practitioner attends the patient and does at least one of the following:
- taking a patient history
- performing a clinical examination
- arranging any necessary investigation
- implementing a management plan
- providing appropriate preventive health care.
Appropriate and contemporaneous records must be kept.
The time-tiers range from Level A short consultation for straightforward tasks to 60+ minute Level E consultations.
General attendance items are both professional and personal attendances.
What is a professional attendance?
The Regulations state that a professional attendance includes the "provision, for a patient, of any of the following services:
- evaluating the patient’s condition or conditions including, if applicable, evaluation using a health screening service mentioned in subsection 19(5) of the [Health Insurance] Act
- formulating a plan for the management and, if applicable, for the treatment of the patient’s condition or conditions
- giving advice to the patient about the patient’s condition or conditions and, if applicable, about treatment
- if authorised by the patient—giving advice to another person, or other persons, about the patient’s condition or conditions and, if applicable, about treatment
- providing appropriate preventive health care
- recording the clinical details of the service or services provided to the patient.”
Further information on professional attendances is at AN.0.3.
What is a personal attendance?
The Regulations specify that personal attendance items “apply to a service provided in the course of a personal attendance by a single medical practitioner on a single patient on a single occasion.” This means that:
- the patient must be present and only time spent with the patient counts towards the attendance
- another health practitioner (e.g. a practice nurse) cannot provide the service on behalf of a medical practitioner
- benefits are not payable if more than one medical practitioner provides an attendance on the same patient at the same time.
In the case of telehealth (video and phone) attendances this requirement is modified to be “a service that is an attendance by a single health professional on a single person”.
A guide on substantiating a patient’s attendance is available on the Department of Health, Disability and Ageing's website.
Further information on personal attendances is at AN.0.1.
How do I choose which general attendance item to use?
The correct general attendance item will depend on:
- practitioner type – GP, medical practitioner (excluding GPs) or prescribed medical practitioner
- length of time spent with the patient (i.e. the personal attendance time)
- location of the consultation – in consulting rooms, out of consulting rooms or residential aged care facility
- time of the consulting – business or after-hours
- mode of the consultation – face to face, phone or video, and
- for prescribed medical practitioners only – the location (by Modified Monash area) of the practice.
Reference tables setting out the relevant general attendance items are available at AN.0.74 for GPs and AN.7.2 for OMPs.
Can I address more than one issue in a general attendance?
Yes. All general attendance items can be claimed to address multiple issues with a patient.
When multiple issues are addressed in a single consultation, and more specific MBS items do not apply for any of these issues, medical practitioners should use the appropriate MBS general attendance item for the total time of the consultation. In these circumstances, medical practitioners should not claim each issue as a separate attendance.
What activities count towards the consultation time?
Only time spent with the patient (or on the telephone/video conference with the patient in the case of telehealth) performing clinically relevant tasks can be included in the consultation time. Clinically relevant tasks include, but are not limited to:
- undertaking any of the activities described in the item descriptor
- communicating with the patient (and where relevant their carer)
- writing clinical notes, prescriptions or referrals, completing forms, reports or other paperwork relating to the patient while the patient is present
- reviewing, creating or updating entries in the patient’s My Health Record while the patient is present.
Time taken to write clinical notes, complete forms, reports or other paperwork, upload records in My Health Record (or other systems), or talk to carers or relatives when the patient is not present cannot be included in the consultation time.
If the patient has particular needs that mean good communication takes longer than average can this time be included?
Yes, communicating effectively with patients is crucial to achieving clinical outcomes and a key part of a clinical service. A wide range of factors may affect the time needed to communicate effectively with a patient during a consultation. These include, but are not limited to, situations where a language barrier exists between the medical practitioner and patient (including when an interpreter is required), or when a patient has hearing problems, difficulty with speech, an intellectual disability, and/or dementia.
When claiming for time-tiered MBS items, the total consultation time includes the time required to communicate effectively with the patient. Where more time than usual is required to communicate effectively with a particular patient, it is considered reasonable to claim a longer attendance item than might otherwise be expected for the service. This applies to both face to face and telehealth services.
In such situations, medical practitioners and other providers should make a brief record in the patient’s notes including details about why the additional time was required. For example, stating ‘consultation extended due to use of interpreter’ and, if relevant, citing the Translating and Interpreting Service (TIS) job number.
Can I provide another medical service that is not a general attendance (e.g. a procedure or diagnostic test) and a general attendance to the same patient on the same day?
In general, yes. However, there are some limitations including:
- both services must be clinically relevant and distinct services
- the other item must not have restrictions on same day claiming as a general attendance item, and
- the other item is not listed in MBS Group T6 (Anaesthetics) or T9 (Assistance at Operation).
Where more than one service is provided to a patient on the same day, the time taken for the second service (e.g. a procedure) must not be included in the consultation time for the general attendance.
Procedural items include all necessary components required to provide the service. This would include obtaining informed procedural and financial consent, the procedure itself, a discussion of the results of the procedure and (unless stated otherwise) the provision of routine aftercare.
Where the results of a procedure inform a further consultation on management, the consultation may be eligible for a Medicare benefit.
Can I provide more than one general attendance service to the same patient on the same day?
Yes, provided that the subsequent attendance is not a continuation of the first attendance, both services are clinically relevant and distinct, and the item requirements are met for both attendances. Further information is available in AN.0.7.
Are there specific requirements for any of the general attendance items?
Yes, several general attendance items have additional, specific requirements:
- Telehealth (video and phone) – patients can only access these services through their “usual medical practitioner” with limited exemptions. See AN.1.1 for further information. Some longer telephone items also require the patient to be registered with MyMedicare and can only be claimed at their registered practice.
- After-hours attendance items – can only be claimed in specific time periods. See AN.0.19 (GPs) and AN.7.24 (OMPs) for further information.
- Out of consulting rooms attendance items – have derived fee structures that vary with the number of patients attended or, in the case of some residential aged care facilities items, may be co-claimed with a flag fall item. See AN.0.11 (derived fees) and AN.35.1 and AN.35.2 (flag falls) for further information.
- Residential aged care facility items – See AN.0.15, AN.35.1 and AN.35.2 for further information.
- Items 179, 185, 189, 203, 301, 91906, 91916, 19794, 91806, 91807, 91808, 91926 – can only be claimed when the service is provided at a practice located in a Modified Monash 2-7 area. Practice locations can be checked on the Health Workforce Locator.
Can I claim a general attendance for providing aftercare?
No, you cannot claim a general attendance item if you performed the procedure that resulted in the need for aftercare.
However, the Health Insurance (Subsection 3(5) General Practitioner Post-Operative Treatment) Direction 2017 allows a medical practitioner working in general practice to use a general attendance item to provide aftercare provided that they did not perform the initial service that caused the need for aftercare. See AN.0.71 for further information.
ELIGIBLE PATIENTS
Any patient who is eligible to receive Medicare benefits is eligible for face to face (in consulting rooms and out of consulting rooms) general attendance items (business hours or after-hours).
Residential aged care facility-specific items are only available to Medicare-eligible patients that are residents of a residential aged care facility.
Patients must meet the “usual medical practitioner” requirement to access video and phone items, unless an exemption applies (see AN.1.1 for more information). In the case of telephone items 91900, 91903, 91906, 91910, 91913, 91916, the patient must also be registered with the practice providing the service through MyMedicare.
ELIGIBLE PRACTITIONERS
General attendance items are available for different practitioner types:
- general practitioner items can be claimed by general practitioners only (see GN.4.13).
- medical practitioner items can be claimed by any medical practitioner that is not explicitly excluded in the relevant item descriptor.
- prescribed medical practitioner items can be claimed by prescribed medical practitioners only (see AN.7.1).
CO-CLAIMING RESTRICTIONS
To co-claim a general attendance item and another item both services must be clinically relevant and distinct services.
General attendance items and chronic condition management items 392, 393, 965, 967, 92029, 92030, 92060 and 92061 cannot be claimed on the same day for the same patient. This restriction is set out in clause 2.16.11 of the Health Insurance (General Medical Services Table) Regulations 2021.
Further information on co-claiming of general attendance items and other MBS items is available in the AskMBS Advisory – General Practice Services #2.
RECORD KEEPING AND REPORTING REQUIREMENTS
The department undertakes regular post payment auditing to ensure that MBS items are claimed appropriately. 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. Attendance items are set out in three regulatory instruments:
- Health Insurance (Section 3C General Medical Service – Other Medical Practitioner) Determination 2018 – items 733, 737, 741, 745, 761, 763, 766, 769, 772, 776, 788, 789, 2197, 2198, 2200
- Health Insurance (Section 3C General Medical Services – Telehealth Attendances) Determination 2021– video and phone attendance items.
- Health Insurance (General Medical Services Table) Regulations 2021 – all other attendance items.
Related Items: 3 4 23 24 36 37 44 47 52 53 54 57 58 59 60 65 123 124 151 165 179 181 185 187 189 191 203 206 301 303 733 737 741 745 761 763 766 769 772 776 788 789 2197 2198 2200 5000 5003 5010 5020 5023 5028 5040 5043 5049 5060 5063 5067 5071 5076 5077 5200 5203 5207 5208 5209 5220 5223 5227 5228 5260 5261 5262 5263 5265 5267 90020 90035 90043 90051 90054 90092 90093 90095 90096 90098 90183 90188 90202 90212 90215 91790 91792 91794 91800 91801 91802 91803 91804 91805 91806 91807 91808 91890 91891 91892 91893 91900 91903 91906 91910 91913 91916 91920 91923 91926
Category 1 - PROFESSIONAL ATTENDANCES
AN.0.72
Attendance services for complex neurodevelopmental disorders (such as autism)
Intention of this service under item 289 and video equivalent item 92434
Items 289 or video equivalent item 92434 are intended for complex conditions, characterised by multi-domain cognitive and functional impairment. Patient eligibility is for neurodevelopmental disorders (NDD), which are assessed to be complex and mean that individuals require support across multiple domains.
The intention of this service is to provide access to treatment, through the development of a treatment and management plan by a psychiatrist, for individuals under 25 years of age, diagnosed with a complex NDD. The development of the treatment and management plan, follows a comprehensive medical assessment, and provides the opportunity to refer to eligible allied health practitioners for up to a total of 20 MBS treatment services per patient’s lifetime (items 82015, 82020, 82025, 82035, 93035, 93036, 93043 or 93044). This item is claimable once in a patient’s lifetime.
Eligibility:
In the context of item 289 (or 92434), the diagnosis of a complex NDD requires evidence of requiring support and showing impairment across two or more neurodevelopmental domains. Complexity is characterised by multi-domain cognitive and functional disabilities, delay or clinically significant impairment.
Neurodevelopmental domains include:
- Cognition
- Language
- Social-emotional development
- Motor skills
- Adaptive behaviour: conceptual skills, practical skills, social skills or social communication skills
Referral pathways:
Early identification of, and intervention for, individuals with complex NDD is important in promoting positive longer-term outcomes. Symptoms can cause clinically significant impairment in social, occupational or other important areas of functioning.
Where neurodevelopmental concerns have been identified and brought to the attention of the patient’s GP to initially assess these concerns and the GP considers there are persisting indications that require more specialised assessment, they are encouraged to refer to either a consultant paediatrician or psychiatrist for a comprehensive assessment.
Diagnostic assessment:
The assessment and diagnosis of a complex NDD should be evaluated in the context of both a physical and developmental assessment. The psychiatrist may require a number of separate attendances (through usual time-tiered or subsequent attendance items 296 to 308, 310, 312, 314, 316, 318, 319 to 349, 91827 to 91831 or 91837 to 91839, 92437, 92455 to 92457) to complete a comprehensive accurate assessment and formulate a diagnosis, exclude other disorders or assess for co-occurring conditions.
Multi-disciplinary assistance with assessment and/or contribution to the treatment and management plan:
Depending on a range of factors, not limited to the patient’s age and nature of suspected disabilities, the consultant physician may require a multi-disciplinary approach to complete a comprehensive accurate assessment and formulate a diagnosis.
Where the psychiatrist determines the patient requires additional assessments to formulate a diagnosis, through the assistance of an allied health practitioner, they are able to refer the patient to an eligible allied health provider from standard attendance items (296 to 308, 310, 312, 314, 316, 318, 319 to 349 or telehealth (video and phone) items 91827 to 91831, 91837 to 91839, 92437, 92455 to 92457).
Whilst Medicare rebates provide for a total of 8 allied health assessment services per patient per lifetime, an eligible allied health practitioner can only provide up to 4 services before the need for a review (the type of review can be specified in the referral to the eligible allied health professional) by the referring psychiatrist, who must agree to the need for any additional allied health services prior to the delivery of the remaining 4 allied health assessment services.
Eligible allied health assessment practitioners include:
- Psychologist (MBS item 82000, 93032, 93040)
- Speech pathologist (MBS item 82005, 93033, 93041)
- Occupational therapist (82010, 93033, 93041)
- Audiologist, dietitian, exercise physiologist, optometrist, orthoptist, physiotherapist (MBS item 82030, 93033, 93041)
Requirements of the referral to allied health practitioners
The psychiatrist can refer to multiple eligible allied health practitioners concurrently, but a separate referral letter must be provided to each allied health practitioner. The referral should specify the intent of the assessment and if appropriate, specify the number of services to be provided. Where the number of sessions is not specified, each allied health practitioner can provide up to 4 assessment services without the need for review or agreement to provide further assessment services.
Review requirements following delivery of four (4) allied health assessment services
Whilst an eligible allied health practitioner has provided 4 assessment services (through items 82000, 82005, 82010, 82030, 93032, 93040, 93033 or 93041) and considers additional assessment services are required, they must ensure the referring psychiatrist undertakes a review. If the type of review is not specified by the referring psychiatrist an acceptable means of review includes: a case conference, phone call, written correspondence, secure online messaging exchange or attendance of the patient with the referring psychiatrist.
Inter-disciplinary allied health referral
Eligible allied health practitioners are also able to make inter-disciplinary referrals to other eligible allied health practitioners as clinically necessary to assist with the formulation of the diagnosis or contribute to the treatment and management plan. Inter-disciplinary referrals must be undertaken in consultation and agreement with the referring psychiatrist. Whilst they do not require the need for an attendance with the patient (face-to-face/video/phone) by the referring psychiatrist, they do require an agreement from the referring psychiatrist. This can be undertaken (but is not limited to) an exchange by phone, written communication or secure online messaging.
Contribution to the Treatment and Management Plan through allied health referral
In addition to referring to allied health practitioners for assistance with formulating a diagnosis, once a psychiatrist makes a complex NDD diagnosis, the psychiatrist may require the contribution of an eligible allied health practitioner to assist with the development of the Treatment and Management plan (before billing item 289 or 92434).
MBS items 82000, 82005, 82010, 82030, 93032, 93033, 93040 or 93041 provide a dual function for this purpose. It is important to note that the service limit of a total of 8 services per patient per lifetime apply regardless of whether the items are used for assistance with diagnosis or contribution to the treatment and management plan, and the referring psychiatrist should be mindful of this when referring to eligible allied health practitioners.
Development of the Treatment and Management Plan
Once the psychiatrist has made a diagnosis of a complex NDD, to complete the item requirements of item 289 or 92434 they must develop a treatment and management plan which includes:
- Written documentation of the patient’s confirmed diagnosis of a complex NDD, including any findings of assessments performed (which assisted with the formulation of the diagnosis or contributed to the treatment and management plan)
- A risk assessment which means assessment of:
- the risk to the patient of a contributing co‑morbidity and
- environmental, physical, social and emotional risk factors that may apply to the patient or to another individual.
- Treatment options which include:
- Recommendations using a biopsychosocial model
- Identifying major treatment goals and important milestones and objectives
- Recommendation/s and referral for treatment services provided by eligible allied health practitioners (where relevant) and who should provide this, specifying number of treatments recommended (to a maximum of 20 treatment services)
- Indications for review or episodes requiring escalation of treatment strategies
- Documenting the Treatment and Management plan and providing a copy to the referring medical practitioner and relevant allied health practitioner/s.
Referral for allied health treatment services
Once a treatment and management plan is in place (after item 289 or 92434 has been claimed) the psychiatrist can refer the individual to eligible allied health practitioners for the provision of treatment services. Treatment services address the functional impairments identified through the comprehensive medical assessment which are outlined in the treatment and management plan. Treatment services focus on interventions to address developmental delays/disabilities or impairments.
Eligible allied health treatment practitioners include:
- Psychologist (MBS items 82015, 93035, 93043)
- Speech pathologist (MBS items 82020, 93036, 93044)
- Occupational therapist (MBS items 82025, 93036, 93044)
- Audiologist, dietitian, exercise physiologist, optometrist, orthoptist, physiotherapist (MBS items 82035, 93036, 93044)
A total of 20 allied health treatment services per patient per lifetime are available through the MBS, which may consist of any combination of items 82015, 82020, 82025 or 82035 or equivalent video items. Whilst the psychiatrist can refer to multiple eligible allied health practitioners concurrently, a separate referral letter must be provided to each allied health practitioner.
The referral should specify the goals of the treatment and if appropriate, specify the number of services to be provided. It is the responsibility of the referring psychiatrist to allocate the number of treatment services (up to a maximum of 10 services per course of treatment) in keeping with the individual’s treatment and management plan.
It is important to note, that a benefit will not be paid for the MBS allied health treatment services unless the pre-requisite items (289 or 92434) have been processed through the Medicare claiming system.
On the completion of a “course of treatment” (specified by the referring psychiatrist, up to maximum of 10 services), the eligible allied health practitioner must provide a written report to the referring psychiatrist, which should include information on the treatment provided, recommendations for future management of the individual’s disorder and any advice to caregivers (such as parents, carers, school teachers). This written report will inform the referring psychiatrist’s decision to refer for further treatment services. Where subsequent courses of treatment after the initial 10 services are required (up to a maximum of 20 services per patient per lifetime) a new referral is required.
Inconclusive assessment:
Where a patient does not meet the diagnostic threshold of a complex NDD and where ongoing medical management is required, patients can be managed through psychiatry attendance items 300-308, 310, 312, 314, 316, 318 or telehealth equivalent items 91827-91831 (video) or 91837-91839 (phone).
Examples include where:
- Neurodevelopment assessment is incomplete or inconclusive
- Neurodevelopmental impairment is present in fewer than two domains
- Neurodevelopmental impairment is present in two or more domains, but individuals do not require sufficient support to meet criteria
- Comprehensive, age-appropriate neurodevelopmental assessment is impossible or unavailable (e.g. in infants or young children- particularly those under 6 years of age)
These individuals may be considered “at risk of a complex NDD” and require follow-up and reassessment in the future.
Related Items: 289 296 297 299 300 301 302 303 304 306 308 310 312 314 316 318 319 320 322 324 326 328 330 332 334 336 338 341 342 343 344 345 346 347 349 82000 82005 82010 82015 82020 82025 82030 82035 91827 91828 91829 91830 91831 91837 91838 91839 92434 92437 92455 92456 92457 93032 93033 93035 93036 93040 93041 93043 93044
Category 1 - PROFESSIONAL ATTENDANCES
AN.7.1
Prescribed Medical Practitioners
Last reviewed: 1 November 2023
A prescribed medical practitioner is a medical practitioner:
(a) who is not a general practitioner (see GN.4.13), specialist or consultant physician, and
(b) who:
a. is registered under section 3GA of the Act and is practising during the period, and in the location in respect of which the medical practitioner is registered, and insofar as the circumstances specified for paragraph 19AA(3)(b) of the Act apply; or
b. is covered by an exemption under subsection 19AB(3) of the Act; or
c. first became a medical practitioner before 1 November 1996.
Related Items: 179 181 185 187 189 191 203 206 214 215 218 219 220 221 222 223 228 231 232 235 236 237 238 239 240 243 244 245 249 272 276 277 279 281 282 283 285 286 287 301 303 733 737 741 745 761 763 766 769 772 776 788 789 792 2197 2198 2200 90092 90093 90095 90096 90098 90183 90188 90202 90212 90215
Category 1 - PROFESSIONAL ATTENDANCES
AN.7.2
GENERAL ATTENDANCE ITEMS – MEDICAL PRACTITIONERS AND PRESCRIBED MEDICAL PRACTITIONERS
GENERAL ATTENDANCE ITEMS – MEDICAL PRACTITIONERS1 (MPs) AND PRESCRIBED MEDICAL PRACTITIONERS2 (PMPs)
Publication date: 1 March 2025
Level A Straightforward |
Level B 5-25 minutes |
Level C 25+ minutes |
Level D 45+ minutes |
Level E 60+ minutes |
|
Business hours | |||||
In consulting rooms (MP)1 | 52 | 53 | 54 | 57 | 151 |
In consulting rooms (PMP)2 MM2-73 | 179 | 185 | 189 | 203 | 301 |
Out of consulting rooms (MP) | 58 | 59 | 60 | 65 | 165 |
Out of consulting rooms (PMP) MM2-7 | 181 | 187 | 191 | 206 | 303 |
RACF (MP) | 90092 | 90093 | 90095 | 90096 | 90098 |
RACF (PMP) MM2-7 | 90183 | 90188 | 90202 | 90212 | 90215 |
After-hours | |||||
In consulting rooms (MP) | 5200 | 5203 | 5207 | 5208 | 5209 |
In consulting rooms (PMP) | 733 | 737 | 741 | 745 | 2197 |
Out of consulting rooms (MP) | 5220 | 5223 | 5227 | 5228 | 5261 |
Out of consulting rooms (PMP) | 761 | 763 | 766 | 769 | 2198 |
RACF (MP) | 5260 | 5263 | 5265 | 5267 | 5262 |
RACF (PMP) | 772 | 776 | 788 | 789 | 2200 |
Telehealth (Video and Phone) | |||||
Video (MP) | 91792 | 91803 | 91804 | 91805 | 91923 |
Video (PMP) MM 2-7 | 91794 | 91806 | 91807 | 91808 | 91926 |
Phone (MP) | 91892 | 91893 | 919034 | 919134 | NA |
Phone (PMP) MM2-7 | 919064 | 919164 |
1MP items can be claimed by all MPs who are not general practitioners.
2PMP items can be claimed by medical practitioners that are not general practitioners, specialists or consultant physicians.
3MM means “Modified Monash”. The Modified Monash Model is how the department defines whether a location is metropolitan, rural, remote or very remote. The model measures remoteness and population size on a scale of Modified Monash (MM) categories MM 1 to MM 7. MM 1 is a major city and MM 7 is very remote.
4Available to patients enrolled in MyMedicare only.
Related Items: 52 53 54 57 58 59 60 65 151 165 179 181 185 187 189 191 203 206 301 303 733 737 741 745 761 763 766 769 772 776 788 789 2197 2198 2200 5200 5203 5207 5208 5209 5220 5223 5227 5228 5260 5261 5262 5263 5265 5267 90092 90093 90095 90096 90098 90183 90188 90202 90212 90215 91792 91794 91803 91804 91805 91806 91807 91808 91892 91893 91903 91906 91913 91916 91923 91926
Category 8 - MISCELLANEOUS SERVICES
MN.1.4
Bulk Billing Incentives for Eligible Patients in Modified Monash Area 2
Publication Date: 1 July 2025
General Practitioners1
Bulk billing incentives for eligible patients2 – Modified Monash 2 (Regional Centre)3
Applicable BBI Item | 10991 | 75871 | 75881 (MyMedicare enrolled patients only) |
Standard hours consultations - in consulting rooms | 3 | 23, 36, 44, 123 | |
Standard hours consultations - out of consulting rooms | 4 | 24, 37, 47, 124 | |
Standard hours consultations - residential aged care facility | 90020 | 90035, 90043, 90051, 90054 | |
Video consultations | 91790 (all)
91801, 91802, 91920 if not MyMedicare enrolled |
91800 | 91801, 91802, 91920 |
Phone consultations | 91890 | 91891 | 91900, 91910 |
After hours consultations - in consulting rooms | 5000 | 5020, 5040, 5060, 5071 | |
After hours consultations - out of consulting rooms | 5003 | 5023, 5043, 5063, 5076 | |
After hours consultations - residential aged care facility | 5010 | 5028, 5049, 5067, 5077 | |
Other | All other “unreferred services”4, including but not limited to: chronic condition management items, Better Access mental health items, health assessments, minor procedures etc. |
1 For the definition of GP for MBS purposes see GN.4.13
2 Bulk billing incentives can be claimed when you bulk bill a child under 16 or a Commonwealth Concession Card holder www.servicesaustralia.gov.au/concession-and-health-care-cards
3 Practice located in Modified Monash area www.health.gov.au/resources/apps-and-tools/health-workforce-locator/app
4 Bulk billing incentives cannot be claimed for the provision of COVID vaccine support services
Medical Practitioners1
Bulk billing incentives for eligible patients2 – Modified Monash 2 (Regional Centre)3
Applicable BBI Item | 10991 | 75871 | 75881 (MyMedicare enrolled patients only) |
Standard hours consultations - in consulting rooms | 52, 179 | 53, 54, 57, 151, 185, 189, 203, 301 | |
Standard hours consultations - out of consulting rooms | 58, 181 | 59, 60, 65, 165, 187, 191, 206, 303 | |
Standard hours consultations - residential aged care facility | 90092, 90183 | 90093, 90095, 90096, 90098, 90188, 90202, 90212, 90215 | |
Video consultations | 91792, 91794 (all) 91804, 91805, 91923, 91807, 91808, 91926 if not MyMedicare enrolled |
91803, 91806 | 91804, 91805, 91923, 91807, 91808, 91926 |
Phone consultations | 91892 | 91893 | 91903, 91913, 91906, 91916 |
After hours consultations - in consulting rooms | 5200, 733 | 5203, 5207, 5208, 5209, 737, 741, 745, 2197 | |
After hours consultations - out of consulting rooms | 5220, 761 | 5223, 5227, 5228, 5261, 763, 766, 769, 2198 | |
After hours consultations - residential aged care facility | 5260, 772 | 5263, 5265, 5267, 5262, 776, 788, 789, 2200 | |
Other | All other “unreferred services”4 Including but not limited to: chronic condition management items, Better Access mental health items, health assessments, minor procedures etc |
1 Items in italics can only be claimed by prescribed medical practitioners, that is, medical practitioners that are not GPs, specialists or consultant physicians. Other items can be claimed by medical practitioners that are not GPs.
2 Bulk billing incentives can be claimed when you bulk bill a child under 16 or a Commonwealth Concession Card holder www.servicesaustralia.gov.au/concession-and-health-care-cards
3 Practice located in Modified Monash area www.health.gov.au/resources/apps-and-tools/health-workforce-locator/app
4 Bulk billing incentives cannot be claimed for the provision of COVID vaccine support services
Related Items: 3 4 23 24 36 37 44 47 52 53 54 57 58 59 60 65 123 124 151 165 179 181 185 187 189 191 203 206 301 303 733 737 741 745 761 763 766 769 772 776 788 789 2197 2198 2200 5000 5003 5010 5020 5023 5028 5040 5043 5049 5060 5063 5067 5071 5076 5077 5200 5203 5207 5208 5209 5220 5223 5227 5228 5260 5261 5262 5263 5265 5267 10991 10992 75871 75881 90020 90035 90043 90051 90054 90092 90093 90095 90096 90098 90183 90188 90202 90212 90215 91790 91792 91794 91800 91801 91802 91803 91804 91805 91806 91807 91808 91890 91891 91892 91893 91900 91903 91906 91910 91913 91916 91920 91923 91926
Category 8 - MISCELLANEOUS SERVICES
MN.1.5
Bulk Billing Incentives for Eligible Patients in Modified Monash Area 3 and 4
Publication Date: 1 July 2025
General Practitioners1
Bulk billing incentives for eligible patients2 – Modified Monash 3 and 4 (Medium and Large Rural Towns)3
Applicable BBI Item | 75855 | 75873 | 75882 (MyMedicare enrolled patients only) |
Standard hours consultations - in consulting rooms | 3 | 23, 36, 44, 123 | |
Standard hours consultations - out of consulting rooms | 4 | 24. 37, 47, 124 | |
Standard hours consultations - residential aged care facility | 90020 | 90035, 90043, 90051, 90054 | |
Video consultation | 91790 (all) 91801, 91802, 91920 if not MyMedicare enrolled |
91800 | 91801, 91802, 91920 |
Phone consultation | 91890 | 91891 | 91900, 91910 |
After hours consultations - in consulting rooms | 5000 | 5020, 5040, 5060, 5071 | |
After hours consultations - out of consulting rooms | 5003 | 5023, 5043, 5063, 5076 | |
After hours consultations - residential aged care facility | 5010 | 5028, 5049, 5067, 5077 | |
Other | All other “unreferred services”4, including but not limited to: chronic condition management items, Better Access mental health items, health assessments, minor procedures etc. |
1 For the definition of GP for MBS purposes see GN.4.13
2 Bulk billing incentives can be claimed when you bulk bill a child under 16 or a Commonwealth Concession Card holder www.servicesaustralia.gov.au/concession-and-health-care-cards
3 Practice located in Modified Monash area www.health.gov.au/resources/apps-and-tools/health-workforce-locator/app
4 Bulk billing incentives cannot be claimed for the provision of COVID vaccine support services
Medical Practitioners1
Bulk billing incentives for eligible patients2 – Modified Monash 3 and 4 (Medium and Large Rural Towns)3
Applicable BBI Item | 75855 | 75873 | 75882 (MyMedicare enrolled patients only) |
Standard hours consultations - in consulting rooms | 52, 179 | 53, 54, 57, 151, 185, 189, 203, 301 | |
Standard hours consultations - out of consulting rooms | 58, 181 | 59, 60, 65, 165, 187, 191, 206, 303 | |
Standard hours consultations - residential aged care facility | 90092, 90183 | 90093, 90095, 90096, 90098, 90188, 90202, 90212, 90215 | |
Video consultations | 91792, 91794 (all)
91804, 91805, 91923, 91807, 91808, 91926 if not MyMedicare enrolled |
91803, 91806 | 91804, 91805, 91923, 91807, 91808, 91926 |
Phone consultations | 91892 | 91893 | 91903, 91913, 91906, 91916 |
After hours consultations - in consulting rooms | 5200, 733 | 5203, 5207, 5208, 5209, 737, 741, 745, 2197 | |
After hours consultations - out of consulting rooms | 5220, 761 | 5223, 5227, 5228, 5261, 763, 766, 769, 2198 | |
After hours consultations - residential aged care facility | 5260, 772 | 5263, 5265, 5267, 5262, 776, 788, 789, 2200 | |
Other | All other “unreferred services”4 Including but not limited to: chronic condition management items, Better Access mental health items, health assessments, minor procedures etc. |
1 Items in italics can only be claimed by prescribed medical practitioners, that is, medical practitioners that are not GPs, specialists or consultant physicians. Other items can be claimed by medical practitioners that are not GPs.
2 Bulk billing incentives can be claimed when you bulk bill a child under 16 or a Commonwealth Concession Card holder www.servicesaustralia.gov.au/concession-and-health-care-cards
3 Practice located in Modified Monash area www.health.gov.au/resources/apps-and-tools/health-workforce-locator/app
4 Bulk billing incentives cannot be claimed for the provision of COVID vaccine support services
Related Items: 3 4 23 24 36 37 44 47 52 53 54 57 58 59 60 65 123 124 151 165 179 181 185 187 189 191 203 206 301 303 733 737 741 745 761 763 766 769 772 776 788 789 2197 2198 2200 5000 5003 5010 5020 5023 5028 5040 5043 5049 5060 5063 5067 5071 5076 5077 5200 5203 5207 5208 5209 5220 5223 5227 5228 5260 5261 5262 5263 5265 5267 75855 75873 75882 90020 90035 90043 90051 90054 90092 90093 90095 90096 90098 90183 90188 90202 90212 90215 91790 91792 91794 91800 91801 91802 91803 91804 91805 91806 91807 91808 91890 91891 91892 91893 91900 91903 91906 91910 91913 91916 91920 91923 91926
Category 8 - MISCELLANEOUS SERVICES
MN.1.6
Bulk Billing Incentives for Eligible Patients in Modified Monash Area 5
Bulk Billing Incentives for Eligible Patients in Modified Monash Area 6
Publication Date: 1 July 2025
General Practitioners1
Bulk billing incentives for eligible patients2 – Modified Monash 5 (Small Rural Towns)3
Applicable BBI Item | 75856 | 75874 | 75883 (MyMedicare enrolled patients only) |
Standard hours consultations - in consulting rooms | 3 | 23, 36, 44, 123 | |
Standard hours consultations - out of consulting rooms | 4 | 24, 37, 47, 124 | |
Standard hours consultations - residential aged care facility | 90020 | 90035, 90043, 90051, 90054 | |
Video consultations | 91790 (all)
91801, 91802, 91920 if not MyMedicare enrolled |
91800 | 91801, 91802, 91920 |
Phone consultations | 91890 | 91891 | 91900, 91910 |
After hours consultations - in consulting rooms | 5000 | 5020, 5040, 5060, 5071 | |
After hours consultations - out of consulting rooms | 5003 | 5023, 5043, 5063, 5076 | |
After hours consultations - residential aged care facility | 5010 | 5028, 5049, 5067, 5077 | |
Other | All other “unreferred services”4, including but not limited to: chronic condition management items, Better Access mental health items, health assessments, minor procedures etc. |
1 For the definition of GP for MBS purposes see GN.4.13
2 Bulk billing incentives can be claimed when you bulk bill a child under 16 or a Commonwealth Concession Card holder www.servicesaustralia.gov.au/concession-and-health-care-cards
3 Practice located in Modified Monash area www.health.gov.au/resources/apps-and-tools/health-workforce-locator/app
4 Bulk billing incentives cannot be claimed for the provision of COVID vaccine support services
Medical Practitioners1
Bulk billing incentives for eligible patients2 – Modified Monash 5 (Small Rural Towns)3
Applicable BBI Item | 75856 | 75874 | 75883 (MyMedicare enrolled patients only) |
Standard hours consultations - in consulting rooms | 52, 179 | 53, 54, 57, 151, 185, 189, 203, 301 | |
Standard hours consultations - out of consulting rooms | 58, 181 | 59, 60, 65, 165, 187, 191, 206, 303 | |
Standard hours consultations - residential aged care facility | 90092, 90183 | 90093, 90095, 90096, 90098, 90188, 90202, 90212, 90215 | |
Video consultations | 91792, 91794 (all)
91804, 91805, 91923, 91807, 91808, 91926 if not MyMedicare enrolled |
91803, 91806 | 91804, 91805, 91923, 91807, 91808, 91926 |
Phone consultations | 91892 | 91893 | 91903, 91913, 91906, 91916 |
After hours consultations - in consulting rooms | 5200, 733 | 5203, 5207, 5208, 5209, 737, 741, 745, 2197 | |
After hours consultations - out of consulting rooms | 5220, 761 | 5223, 5227, 5228, 5261, 763, 766, 769, 2198 | |
After hours consultations - residential aged care facility | 5260, 772 | 5263, 5265, 5267, 5262, 776, 788, 789, 2200 | |
Other | All other “unreferred services”4 Including but not limited to: chronic condition management items, Better Access mental health items, health assessments, minor procedures etc. |
1 Items in italics can only be claimed by prescribed medical practitioners, that is, medical practitioners that are not GPs, specialists or consultant physicians. Other items can be claimed by medical practitioners that are not GPs.
2 Bulk billing incentives can be claimed when you bulk bill a child under 16 or a Commonwealth Concession Card holder www.servicesaustralia.gov.au/concession-and-health-care-cards
3 Practice located in Modified Monash area www.health.gov.au/resources/apps-and-tools/health-workforce-locator/app
4 Bulk billing incentives cannot be claimed for the provision of COVID vaccine support services
Related Items: 3 4 23 24 36 37 44 47 52 53 54 57 58 59 60 65 123 124 151 165 179 181 185 187 189 191 203 206 301 303 733 737 741 745 761 763 766 769 772 776 788 789 2197 2198 2200 5000 5003 5010 5020 5023 5028 5040 5043 5049 5060 5063 5067 5071 5076 5077 5200 5203 5207 5208 5209 5220 5223 5227 5228 5260 5261 5262 5263 5265 5267 75856 75874 75883 90020 90035 90043 90051 90054 90092 90093 90095 90096 90098 90183 90188 90202 90212 90215 91790 91792 91794 91800 91801 91802 91803 91804 91805 91806 91807 91808 91890 91891 91892 91893 91900 91903 91906 91910 91913 91916 91920 91923 91926
Category 8 - MISCELLANEOUS SERVICES
MN.1.7
Bulk Billing Incentives for Eligible Patients in Modified Monash Area 6
Publication Date: 1 July 2025
General Practitioners1
Bulk billing incentives for eligible patients2 – Modified Monash 6 (Remote Communities)3
Applicable BBI Item | 75857 | 75875 | 75884 (MyMedicare enrolled patients only) |
Standard hours consultations - in consulting rooms | 3 | 23, 36, 44, 123 | |
Standard hours consultations - out of consulting rooms | 4 | 24, 37, 47, 124 | |
Standard hours consultations - residential aged care facility | 90020 | 90035, 90043, 90051, 90054 | |
Telehealth - video | 91790 (all)
91801, 91802, 91920 if not MyMedicare enrolled |
91800 | 91801, 91802, 91920 |
Telehealth - phone | 91890 | 91891 | 91900, 91910 |
After hours consultations - in consulting rooms | 5000 | 5020, 5040, 5060, 5071 | |
After hours consultations - out of consulting rooms | 5003 | 5023, 5043, 5063, 5076 | |
After hours consultations - residential aged care facility | 5010 | 5028, 5049, 5067, 5077 | |
Other | All other “unreferred services”4, including but not limited to: chronic condition management items, Better Access mental health items, health assessments, minor procedures etc. |
1 For the definition of GP for MBS purposes see GN.4.13
2 Bulk billing incentives can be claimed when you bulk bill a child under 16 or a Commonwealth Concession Card holder www.servicesaustralia.gov.au/concession-and-health-care-cards
3 Practice located in Modified Monash area www.health.gov.au/resources/apps-and-tools/health-workforce-locator/app
4 Bulk billing incentives cannot be claimed for the provision of COVID vaccine support services
Medical Practitioners1
Bulk billing incentives for eligible patients2 – Modified Monash 6 (Remote Communities)3
Applicable BBI Item | 75857 | 75875 | 75884 (MyMedicare enrolled patients only) |
Standard hours consultations - in consulting rooms | 52, 179 | 53, 54, 57, 151, 185, 189, 203, 301 | |
Standard hours consultations - out of consulting rooms | 58, 181 | 59, 60, 65, 165, 187, 191, 206, 303 | |
Standard hours consultations - residential aged care facility | 90092, 90183 | 90093, 90095, 90096, 90098, 90188, 90202, 90212, 90215 | |
Telehealth - video | 91792, 91794 (all)
91804, 91805, 91923, 91807, 91808, 91926 if not MyMedicare enrolled |
91803, 91806 | 91804, 91805, 91923, 91807, 91808, 91926 |
Telehealth - phone | 91892 | 91893 | 91903, 91913, 91906, 91916 |
After hours consultations - in consulting rooms | 5200, 733 | 5203, 5207, 5208, 5209, 737, 741, 745, 2197 | |
After hours consultations - out of consulting rooms | 5220, 761 | 5223, 5227, 5228, 5261, 763, 766, 769, 2198 | |
After hours consultations - residential aged care facility | 5260, 772 | 5263, 5265, 5267, 5262, 776, 788, 789, 2200 | |
Other | All other “unreferred services”4 Including but not limited to: chronic condition management items, Better Access mental health items, health assessments, minor procedures etc. |
1 Items in italics can only be claimed by prescribed medical practitioners, that is, medical practitioners that are not GPs, specialists or consultant physicians. Other items can be claimed by medical practitioners that are not GPs.
2 Bulk billing incentives can be claimed when you bulk bill a child under 16 or a Commonwealth Concession Card holder www.servicesaustralia.gov.au/concession-and-health-care-cards
3 Practice located in Modified Monash area www.health.gov.au/resources/apps-and-tools/health-workforce-locator/app
4 Bulk billing incentives cannot be claimed for the provision of COVID vaccine support services
Related Items: 3 4 23 24 36 37 44 47 52 53 54 57 58 59 60 65 123 124 151 165 179 181 185 187 189 191 203 206 301 303 733 737 741 745 761 763 766 769 772 776 788 789 2197 2198 2200 5000 5003 5010 5020 5023 5028 5040 5043 5049 5060 5063 5067 5071 5076 5077 5200 5203 5207 5208 5209 5220 5223 5227 5228 5260 5261 5262 5263 5265 5267 75857 75875 75884 90020 90035 90043 90051 90054 90092 90093 90095 90096 90098 90183 90188 90202 90212 90215 91790 91792 91794 91800 91801 91802 91803 91804 91805 91806 91807 91808 91890 91891 91892 91893 91900 91903 91906 91910 91913 91916 91920 91923 91926
Category 8 - MISCELLANEOUS SERVICES
MN.1.8
Bulk Billing Incentives for Eligible Patients in Modified Monash Area 7
Bulk Billing Incentives for Eligible Patients in Modified Monash Area 7
Publication Date: 1 July 2025
General Practitioners1
Bulk billing incentives for eligible patients2 – Modified Monash 7 (Very Remote Communities)3
Applicable BBI Item | 75858 | 75876 | 75885 (MyMedicare enrolled patients only) |
Standard hours consultations - in consulting rooms | 3 | 23, 36, 44, 123 | |
Standard hours consultations - out of consulting rooms | 4 | 24, 37, 47, 124 | |
Standard hours consultations - residential aged care facility | 90020 | 90035, 90043, 90051, 90054 | |
Telehealth - video | 91790 (all)
91801, 91802, 91920 if not MyMedicare enrolled |
91800 | 91801, 91802, 91920 |
Telehealth - phone | 91890 | 91891 | 91900, 91910 |
After hours consultations - in consulting rooms | 5000 | 5020, 5040, 5060, 5071 | |
After hours consultations - out of consulting rooms | 5003 | 5023, 5043, 5063, 5076 | |
After hours consultations - residential aged care facility | 5010 | 5028, 5049, 5067, 5077 | |
Other | All other “unreferred services”4, including but not limited to: chronic condition management items, Better Access mental health items, health assessments, minor procedures etc. |
1 For the definition of GP for MBS purposes see GN.4.13
2 Bulk billing incentives can be claimed you bulk bill a child under 16 or a Commonwealth Concession Card holder www.servicesaustralia.gov.au/concession-and-health-care-cards
3 Practice located in Modified Monash area www.health.gov.au/resources/apps-and-tools/health-workforce-locator/app
4 Bulk billing incentives cannot be claimed for the provision of COVID vaccine support services
Medical Practitioners1
Bulk billing incentives for eligible patients2 – Modified Monash 7 (Very Remote communities)3
Applicable BBI Item | 75858 | 75876 | 75885 (MyMedicare enrolled patients only) |
Standard hours consultations - in consulting rooms | 52, 179 | 53, 54, 57, 151, 185, 189, 203, 301 | |
Standard hours consultations - out of consulting rooms | 58, 181 | 59, 60, 65, 165, 187, 191, 206, 303 | |
Standard hours consultations - residential aged care facilities | 90092, 90183 | 90093, 90095, 90096, 90098, 90188, 90202, 90212, 90215 | |
Telehealth - video | 91792, 91794 (all)
91804, 91805, 91923, 91807, 91808, 91926 if not MyMedicare enrolled |
91803, 91806 | 91804, 91805, 91923, 91807, 91808, 91926 |
Telehealth - phone | 91892 | 91893 | 91903, 91913, 91906, 91916 |
After hours consultations - in consulting rooms | 5200, 733 | 5203, 5207, 5208, 5209, 737, 741, 745, 2197 | |
After hours consultations - out of consulting rooms | 5220, 761 | 5223, 5227, 5228, 5261, 763, 766, 769, 2198 | |
After hours consultations - residential aged care facility | 5260, 772 | 5263, 5265, 5267, 5262, 776, 788, 789, 2200 | |
Other | All other “unreferred services”4 Including but not limited to: chronic condition management items, Better Access mental health items, health assessments, minor procedures etc. |
1 Items in italics can only be claimed by prescribed medical practitioners, that is, medical practitioners that are not GPs, specialists or consultant physicians. Other items can be claimed by medical practitioners that are not GPs.
2 Bulk billing incentives can be claimed when you bulk bill a child under 16 or a Commonwealth Concession Card holder www.servicesaustralia.gov.au/concession-and-health-care-cards
3 Practice located in Modified Monash area www.health.gov.au/resources/apps-and-tools/health-workforce-locator/app
4 Bulk billing incentives cannot be claimed for the provision of COVID vaccine support services
Related Items: 3 4 23 24 36 37 44 47 52 53 54 57 58 59 60 65 123 124 151 165 179 181 185 187 189 191 203 206 301 303 733 737 741 745 761 763 766 769 772 776 788 789 2197 2198 2200 5000 5003 5010 5020 5023 5028 5040 5043 5049 5060 5063 5067 5071 5076 5077 5200 5203 5207 5208 5209 5220 5223 5227 5228 5260 5261 5262 5263 5265 5267 75858 75876 75885 90020 90035 90043 90051 90054 90092 90093 90095 90096 90098 90183 90188 90202 90212 90215 91790 91792 91794 91800 91801 91802 91803 91804 91805 91806 91807 91808 91890 91891 91892 91893 91900 91903 91906 91910 91913 91916 91920 91923 91926
Legend
- Assist - Addition/Deletion of (Assist.)
- Amend - Amended Description
- Anaes - Anaesthetic Values Amended
- Emsn - EMSN Change
- Fee - Fee Amended
- Renum - Item Number Change (renumbered)
- New - New Item
- NewMin - New Item (previous Ministerial Determination)
- Qfe - QFE Change