Medicare Benefits Schedule - Item 747

Attendance by a general practitioner, as a member of a multidisciplinary case conference team, to participate in:

(a) a community case conference; or

(b) a multidisciplinary case conference in a residential aged care facility; or

(c) a multidisciplinary discharge case conference;

if the conference lasts for at least 15 minutes, but for less than 20 minutes (other than a service associated with a service to which items 721 to 732 apply)

Fee: $59.20 Benefit: 75% = $44.40 100% = $59.20

(See para AN.0.49 of explanatory notes to this Category)

Extended Medicare Safety Net Cap: $177.60

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Publication date: 1 March 2025

SUMMARY

This note covers services for general practitioners (GPs see GN.4.13), and prescribed medical practitioners (PMPs see AN.7.1) to organise and coordinate, or participate in, time-tiered multidisciplinary case conferences for:

• patients in the community, or
• patients being discharged into the community from hospital, or
• care recipients in residential aged care facilities.

For information on allied health practitioner and nurse practitioner participation in multidisciplinary case conferences see MN.3.2. For information on case conferencing items for consultant physicians see AN.0.51.

For information on GPs and PMPs organising and coordinating, or participating in a mental health case conference see AN.15.1. For information on cancer case conferences see AN.0.65.

USE OF THE ITEMS

Multidisciplinary case conference items for GPs and PMPs are time-tiered. There are separate items for organising and coordinating a multidisciplinary case conference and participating in a multidisciplinary case conference that has been organised by another person. The multidisciplinary case conference items can be used when:

• the patient is living in the community, or
• the patient is a resident in a residential aged care facility, or
• the case conference is for an admitted patient of a hospital prior to their discharge.

The requirements of multidisciplinary case conferences are set out in the Health Insurance (General Medical Service Table) Regulations 2021 (the Regulations).

What is a multidisciplinary case conference?

Clause 1.1.4 of the Regulations defines a multidisciplinary case conference as “a process by which a multidisciplinary case conference team carries out all of the following activities:

• discussing a patient’s history;
• identifying a patient’s multidisciplinary care needs;
• identifying outcomes to be achieved by members of the multidisciplinary case conference team giving care and service to the patient;
• identifying tasks that need to be undertaken to achieve these outcomes, and allocating those tasks to members of the multidisciplinary case conference team;
• assessing whether previously identified outcomes (if any) have been achieved.”

What is a multidisciplinary discharge case conference?

Clause 2.16.14 of the Regulations defines a multidisciplinary discharge case conference as “a multidisciplinary case conference carried out for a patient before the patient is discharged from a hospital.”

In accordance with the overarching MBS rule, where the patient is an admitted patient of a hospital the 75% benefit must be claimed.

What is a multidisciplinary case conference team?

A multidisciplinary case conference team must include, at a minimum, a medical practitioner and at least two (2) other members, one of whom may be another medical practitioner. Each member must provide a different kind of care or service to the patient.

Unpaid carers of the patient do not count towards the minimum participation requirements.

Is there a minimum number of participants for a multidisciplinary case conference?

Yes, there must be at least three (3) participants, none of whom can be an unpaid carer of the patient, and no more than two (2) can be a medical practitioner.

Is there a maximum number of participants?

No. Each member must provide a different kind of care or service to the patient. None can be an unpaid carer of the patient; and only two may be medical practitioners.

It would benefit my patient for more than two medical practitioners to participate as they are part of the team. Is this allowed?

Yes. However, while there is no limit on the number of medical practitioners who may participate as these items are for multidisciplinary case conferences, a maximum of two medical practitioners count towards the minimum participation requirements. That is, at least one member of the multidisciplinary team must be someone who is not a medical practitioner (and meets the requirements set out above).

Do all members of the multidisciplinary case conference team need to be health professionals?

No, not all members are required to be health professionals. It may be appropriate to include others involved in the patient’s care, including but not limited to education providers, “meals on wheels” providers, personal care workers and probation officers.

Do all members of a multidisciplinary case conference team have to provide services under the MBS?

No, for example members of the team who are not health professionals would not provide services under the MBS.

Do all members of a multidisciplinary case conference team have to meet the MBS item requirements?

Any team member who bills an MBS multidisciplinary case conference item must meet the requirements of the item.

Members of the team who do not bill these MBS items are not required to meet all item requirements.

Does the patient need to attend the multidisciplinary case conference?

No, the patient does not need to attend but may do so. However, the patient must consent to the case conference.

What does “organising and coordinating” a multidisciplinary case conference involve?

To organise and coordinate a conference the medical practitioner must meet the requirements of clause 2.16.15 of the Regulations which states that to organising and coordinating a case conference “means undertaking all of the following activities:

(a) explaining to the patient the nature of the conference;

(b) asking the patient whether the patient agrees to the conference taking place;

(c) recording the patient’s agreement to the conference;

(d) recording the day the conference was held and the times the conference started and ended;

(e) recording the names of the participants;

(f) recording the activities mentioned in the definition of multidisciplinary case conference in clause 1.1.4 and putting a copy of that record in the patient’s medical records;

(g) offering the patient and the patient’s carer (if any and if the practitioner considers appropriate and the patient agrees), and giving each other member of the team, a summary of the conference;

(h) discussing the outcomes of the conference with the patient and the patient’s carer (if any and if the practitioner considers appropriate and the patient agrees).”

What does “participating” in a multidisciplinary case conference involve?

To participate in a case conference the medical practitioner must meet the requirements of clause 2.16.16 of the Regulations which states that to participate:

“(a) does not include organising and coordinating the conference; and

 (b) involves undertaking all of the following activities in relation to the conference:

(i) explaining to the patient the nature of the conference;

(ii) asking the patient whether the patient agrees to the practitioner’s participation in the conference;

(iii) recording the patient’s agreement to the practitioner’s participation in the conference;

(iv) recording the day the conference was held and the times the conference started and ended;

(v) recording the names of the participants;

(vi) recording the matters mentioned in the definition of multidisciplinary case conference in clause 1.1.4 and putting a copy of that record in the patient’s medical records.”

I organised and coordinated the multidisciplinary case conference and participated in it. Can I claim both items for the same multidisciplinary case conference?

No. The item for organising and coordinating the multidisciplinary case conference includes participation in the conference.

I organised and coordinated a multidisciplinary case conference with two other members of the multidisciplinary care team but only one of them attended as the other was called to an emergency. Can I still claim the item?

No. To meet the requirements of the items at least three (3) participants who are not unpaid carers of the patient are required to attend. No more than two of the three can be medical practitioners.

Does a GP or PMP have to organise the multidisciplinary case conference? Can I still use the participation items if the multidisciplinary case conference is organised by a specialist, residential aged care facility or someone else?

No. A GP or PMP does not have to organise the case conference. The participation items can be used regardless of who organises the case conferences, provided all the requirements of the items are met.

Can I claim the organise and coordinate items if administrative or other staff assist, for example with diary coordination, room or IT set up?

Yes. Provided that the claiming GP or PMP meets all the requirements of the organising and coordinating items, they can claim those items regardless of whether someone else assists with establishing the case conference.

If the patient doesn’t have to attend the multidisciplinary case conference when do I explain the purpose and get their consent?

Generally, the need for a multidisciplinary case conference is established in a standard attendance. This would typically be the appropriate time to discuss the need for a multidisciplinary case conference and get patient consent. Alternatively, a practitioner could contact the patient to explain the nature and purpose of the case conference and obtain informed patient consent.

Do all members of the multidisciplinary care team have to meet in person for a multidisciplinary case conference?

No, team members can participate in a case conference in person, by video conference, by phone, or any combination of these. However, attendance of all participants must be synchronous.

Can I claim a multidisciplinary case conference item for a service associated with a GP management plan, team care agreement or multidisciplinary care plan?

No, a multidisciplinary case conference item cannot be used as part of the development or review of a GP management plan, team care agreement or multidisciplinary care plan.

However, if a multidisciplinary case conference is clinically relevant for a patient who has any of these plans, and is separate to developing or reviewing the plans, multidisciplinary case conference items may be used.

ELIGIBLE PATIENTS

All Medicare eligible patients are eligible for this service.

ELIGIBLE PRACTITIONERS

There are multidisciplinary case conference items for general practitioners (see GN.4.13) or prescribed medical practitioners (see AN.7.1).

Item	GP item number	Prescribed medical practitioner item number
Organise and coordinate
At least 15 minutes but less than 20 minutes	735	235
At least 20 minutes but less than 40 minutes	739	236
At least 40 minutes	743	237
Participate
At least 15 minutes but less than 20 minutes	747	238
At least 20 minutes but less than 40 minutes	750	239
At least 40 minutes	758	240

Noting that a multidisciplinary case conference may be a for a patient being discharged from hospital, the Regulations state that multidisciplinary care items can only be used by medical practitioners who:

• are not employed by the proprietor of a hospital that is not a private hospital, or
• are employed by the proprietor of a hospital that is not a private hospital and provides the service other than in the course of employment by that proprietor.

RECORD KEEPING AND REPORTING REQUIREMENTS

All Medicare claiming is subject to compliance checks and providers may be required to submit evidence about the services they bill. More information about the department’s compliance program can be found on its website at Medicare compliance. 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. Multidisciplinary case conference items for GPs and PMPs are set out in the Health Insurance (General Medical Service Table) Regulations 2021.

 

 

Related Items: 235 236 237 238 239 240 735 739 743 747 750 758