Medicare Benefit Schedule

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• Medicare Benefit Schedule
• New item numbers
• From November 1 2006
• Fremantle GP Network
• Tuesday December 5 2006

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Changes to MBS Items 1 Nov 2006

• Non directive pregnancy support counselling
  services
• Pap smears taken by a Practice Nurse (PN)
• Asthma Cycle of Care

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Item 4001 Non directive pregnancy support
counselling services

• Provided to women who are concerned about a
  current pregnancy, or a pregnancy that occurred
  in the preceding 12 months
• 3 services per pregnancy by eligible GPs (rebate
  66.35)
• These services may also be provided by eligible
  psychologists, social workers mental health
  nurses on referral by a GP
• GPs ( allied health professionals) wishing to
  provide these services are required to complete
  non-directive pregnancy counselling training

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Items 10994 10995 Pap smears Preventive
Checks taken by a PN on behalf of a GP

• Item 10994
• A cervical smear preventive check provided on
  behalf of, and under supervision of, a medical
  practitioner.
• Can be used by all practices and applies to
  female patients of any age.
• Rebate 21.25
• Item 10995
• _ A cervical smear preventive check provided on
  behalf of, and under supervision of, a medical
  practitioner
• For women between 20 and 69 years who have not
  had a smear in the last 4 years (SIP applies)
• _ Rebate 21.25
• The GP is not required to see the patient or be
  present during the service to claim these items,
  but is required to order the pathology in most
  cases.
• The PN MUST be credentialled as qualified and
  trained to provide these services.

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Items 10998 10999 Pap smear ONLY taken by a
PN on behalf of a GP

• Item 10998
• A cervical smear provided on behalf of, and
  under supervision of, a medical practitioner.
• Can be used by all practices and applies to
  female patients of any age.
• Rebate 10.60
• Item 10999
• _ A cervical smear provided on behalf of, and
  under supervision of, a medical practitioner
• For women between 20 and 69 years who have not
  had a smear in the last 4 years (SIP applies)
• _ Rebate 10.60
• The GP is not required to see the patient or be
  present during the service to claim these items,
  but is required to order the pathology in most
  cases.
• The PN MUST be credentialled as qualified and
  trained to provide these services.

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Trigger Items 2546 2559, 2664 2667Asthma
cycle of care

• Replaces the Asthma 3 Plan
• Involves
• At least 2 visits over a 12 month period
• - Diagnosis of severity level of control
• - A written asthma action plan
• - Information Patient self management
  education
• - Review of asthma management action plan
• SIP can be claimed on the 2nd visit (100)

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SIP

• Asthma Cycle of Care SIP item numbers can still
  be used with a GPMP /-TCA if the Patient has
  another chronic disease,
• HOWEVER,
• these items cannot be used with a GPMP Review and
  
• should not be claimed within 3 months of each
  other
• Asthma Cycle of Care items CANNOT be used with a
  GPMP on its own, if the Patient has Asthma alone.

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Thank youAny Questions?