New items using blue-light cystoscopy (BLC) with hexaminolevulinate (HAL) for improved diagnosis, treatment and management of non-muscle invasive bladder cancer (NMIBC)

New Items Using Blue-Light Cystoscopy (BLC) (PDF 40 KB)
New Items Using Blue-Light Cystoscopy (BLC) (DOC 501 KB)


What are the changes?

From 1 May 2019, Medicare rebates will be available for four new items (36504, 36505, 36507 and 36508) for BLC with HAL (two investigative services and two therapeutic services). The new items are reflective of the current services for white light cystoscopy (WLC) billed under Medicare Benefits Schedule (MBS) items 36836, 36812, 36840, and 36845. The Schedule fee for the new services are the same as the current Schedule fees for the WLC MBS items, plus an additional $65 for the instillation of the HAL as recommended by the Medical Services Advisory Committee (MSAC).

Why are the changes being made?

The listing of this item was recommended by the Medical Services Advisory Committee (MSAC) in March 2018. Further details about the MSAC Application can be found at the MSAC website. The Government agreed to this recommendation and provided funding in the 2018-19 Mid-Year Economic and Fiscal Outlook under the Guaranteeing Medicare - strengthening primary care measure.

What does this mean for providers?

Specialists and consultant physicians will be able to bill new items for blue-light cystoscopy with hexaminolevulinate (HAL) as an adjunct to standard white light cystoscopy, for the diagnosis, treatment and management of NMIBC.

What does this mean for patients?

Specialists and consultant physicians will now be able to inform their patients with NMIBC that there are rebates available for MBS services for blue-light cystoscopy using hexaminolevulinate. These services detect and surgically remove bladder cancers. They also allow better identification of a patient's risk and improved detection of recurrent lesions.

When will this change be reviewed?

The Department of Health regularly reviews the usage of new and amended MBS items in consultation with the profession.

All MBS items may be subject to compliance processes and activities, including random and targeted audits which may require a provider to submit information about the services claimed.

Significant variation from forecasted expenditure may warrant review and amendment of fees, and incorrect use of MBS items can result in penalties including the health professional being asked to repay monies that have been incorrectly received.

Where can I find more information?

The full item descriptor and information on other changes to the MBS can be found at the MBS Online website or by calling the Department of Human Services on 132 150.

New items

(Draft wording of items to be finalised through regulatory amendments)