November Bulk Billing and Better Access changes – new resources now available

On this page:

Bulk billing incentive (BBI) expansion

BBI items can now be claimed for bulk billed services for all patients with a Medicare card. This expansion is not related to the bulk billing practice incentive program (BBPIP) and does not have any link with MyMedicare.

There have been no other updates to BBIs. This RACGP resource might be useful in determining which item applies to which service and whether its single or triple. Also see MBS Online Note MN.1.1

Bulk Billing Practice Incentive Program (BBPIP)

Practices can now register for the BBPIP. Some common queries we have heard and resources to support them include:

• Support for registering for MyMedicare: MYMEDM05-MyMedicare – Bulk Billing Practice Incentive Program (BBPIP)
• BBPIP exemption for non accredited practices: there is a specific exemption available to the MyMedicare accreditation requirement (screenshot below). Please be aware that practices utilising this exemption are not entitled to automatically participate in other MyMedicare linked initiatives.

• Adding bank details for providers: Manage your details in HPOS – Health professionals – Services Australia
• Claims queries: the below responses come from these two resources medicare-bulk-billing-and-additional-charges.pdf; https://www.cubiko.com.au/resources/bb-incentive-faq/ (53 minute mark).
  • Question: Can we bulk bill and charge a fee for consumables?
    Answer: No. If a service is bulk billed, additional charges cannot be imposed for that service, even if a separate invoice is used.
  • Question: Can a fee be charged for vaccines?
    Answer: Yes. The only exception to the above rule is to charge for a vaccine and still bulk bill the patient. 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. This only relates to vaccines that are not available to the patient free of charge through Commonwealth or State funding arrangements or available through the PBS. The additional charge must only be to cover the supply of the vaccine.
  • Question: How do we bill for Iron infusions?
    Answer: As there is no specific item number, currently practices would use a time based item with a co-payment. These are NRA so under BBPIP – an iron infusion would have to be a BB time-based item. Choices: fully private bill with no MBS or BB a time based item. They are advocating for an item number specific to iron infusions (but if this happens it won’t be any time soon).
  • Question: How do we bill skin checks and procedures?
    Answer: if a patient comes in for a skin check and something is found and a procedure is subsequently performed on the same day, you can bulk bill the consult and privately bill the procedure. If done on a separate day for this procedure, you would not claim a consultation item again and just privately bill the procedure.

For more information, you can visit our website or reach out for support at practicesupport@emphn.org.au

Better Access changes – new resources available

Changes to the Better Access initiative have now come into effect, including:

• The removal of mental health treatment plan (MHTP) reviews and mental health consultation items from the MBS. These items have been replaced with time-tiered items.
• Services must be provided by a patient’s usual provider, OR a GP at the practice in which they are registered for MyMedicare.
• MyMedicare and usual medical practitioner requirements will apply to GP and PMP MHTP telehealth items, with these services no longer exempt from the established clinical relationship rule.

An MBS user guide can be found here

The Department have also released some new resources, including:

• An updated FAQ about the Better Access initiative, including Nov 1 changes which can be found here
• A telehealth specific FAQ which can be accessed here
• A scenario outlining a patient’s journey
• An updated factsheet for patients which can be accessed here

MBS Online have also updated the Explanatory Note AN.0.78

For further information you can visit our website or reach out for support at practicesupport@emphn.org.au