The November 2020 MBS files are available on the November 2020 downloads page.
Summary of Changes for 1 November 2020
Blood Products
In the Mid-Year Economic and Fiscal Outlook (MYEFO) 2019-20, under the Guaranteeing Medicare — Medicare Benefits Schedule Review measure, the Government announced changes to blood product services listed on the MBS.
Item 13703 is being amended to include intra operative normovolaemic haemodilution as a part of the service. This change will update the item in line with clinical best practice, restricting its use to the intention of the procedure, which is for use in patients undergoing surgery or invasive procedures in which blood loss is anticipated. This change will align the service with the National Blood Authority guidelines.
Item 13709 will cease as this item is obsolete and there are other MBS services that provide support for blood transfusion procedures.
Item 13760 is being amended to clarify the malignant conditions where there is evidence for treatment by stem cell therapies in combination with high dose chemotherapy. This amendment is in line with international guidelines for stem cell transplantation, and best clinical practice.
Chemotherapy Services
In the Mid-Year Economic and Fiscal Outlook (MYEFO) 2019-20, under the Guaranteeing Medicare — Medicare Benefits Schedule Review measure, the Government announced changes to chemotherapy services listed on the MBS.
Chemotherapy items 13915 to 13948 will be replaced with new item 13950. Item 13950 is for the parenteral administration of antineoplastic agents (cytotoxic chemotherapy or monoclonal antibody therapy) but not agents used in anti resorptive bone therapy or hormonal therapy. The service can be performed by a specialist or consultant physician, or under appropriate supervision of this practitioner. In addition, item 14221 will be amended to remove the reference to deleted item 13945 and insert a reference to new item 13950.
Further information is available on the Chemotherapeutic Procedures Factsheet page.
Following support from the Medical Services Advisory Committee (MSAC) two new items will be added to the Medicare Benefits Schedule (MBS) for the treatment of cutaneous T-cell lymphoma (CTCL) with extracorporeal photopheresis (ECP), including: Item 14247: ECP for the first six months of treatment for cutaneous T-cell lymphoma administered under the supervision of a specialist or consultant physician in the speciality of haematology and Item 14249: ECP for after the first six months of treatment for cutaneous T-cell lymphoma administered under the supervision of a specialist or consultant physician in the speciality of haematology.
Neurology and Neurosurgery Services
Changes to the neurology and neurosurgery services are to align the items with best clinical practice and reduce inappropriate claiming. These changes are a result of the MBS Review Taskforce recommendations and consultation with stakeholders.
The revised structure includes: 16 new items; 37 amended items; and 42 items ceasing. There are also amendments made to private health insurance classifications, existing explanatory notes, and a number of new explanatory notes will be introduced to better guide practitioners and patients.
Urology Services
The MBS items for urology services are changing to reflect contemporary practice. These changes are a result of the MBS Review Taskforce recommendations and consultation with stakeholders.
MBS services pertaining to general urology, urological oncology (including treatment for benign prostatic hyperplasia), endo-urology and renal stone disease, paediatric genitourinary and reconstructive urology, incontinence and urogynaecology will be changed. The revised structure includes: 20 new items; 96 amended items; and 13 items ceasing. There are also amendments made to private health insurance classifications, existing explanatory notes, and a number of new explanatory notes will be introduced to better guide practitioners and patients.
Further information is available on the Urology Services Factsheet page.
Minor Changes for 1 November 2020
Psychiatry
Item 293 is being amended to clarify that it should not be billed if item 359 has been provided in the preceding 12 months.Radiation Oncology
A consequential amendment to brachytherapy item 15338 will be made to update the item in line with the amendments to urology item 37220.Diagnostic Imaging
One new item (57357) for computed tomography (CT) angiography of the pulmonary artery for an initial investigation for pulmonary embolism.
Nine imaging items have been amended to remove the co-claiming restriction between items 55248, 55252, 55274, 55276, 55278, 55280, 55282, 55284 and 55292 and 55880, 55881, 55882, 55883, 55884, 55885, 55886, 55887, 55888, 55889, 55890, 55891, 55892, 55893, 55894 or 55895. This will allow (where clinically appropriate) for these items to be claimed.
Greatest Permissible Gap
The Greatest Permissible Gap (GPG) amount is indexed annually on 1 November in line with the Consumer Price Index (CPI) ( (June quarter). From 1 November 2020, the amount remains at $84.70 as the CPI was not a positive increase. The GPG amount applies to all MBS items that have an MBS fee of greater than $565.00.
Item Changes
| New Items from 1 November 2020 (40) | 13950, 14234, 14237, 14247, 14249, 30629, 30630, 35552, 36610, 36611, 36822, 36823, 37015, 37016, 37018, 37019, 37021, 37039, 37046, 37048, 37213, 37214, 37216, 37344, 37388, 39007, 39113, 39604, 39610, 39638, 39639, 39641, 39651, 39710, 39720, 39801, 40004, 40104, 40119, 57357 |
| Amended Items from 1 November 2020 (149) | 293, 11000, 11003, 11004, 11005, 11919, 13703, 13760, 14221, 15338, 30450, 30635, 30642, 30643, 30644, 30654, 30658, 35551, 35599, 36516, 36519, 36522, 36525, 36528, 36529, 36531, 36532, 36533, 36543, 36549, 36561, 36564, 36567, 36570, 36576, 36579, 36604, 36607, 36608, 36609, 36615, 36624, 36627, 36633, 36636, 36639, 36649, 36650, 36803, 36806, 36809, 36811, 36812, 36818, 36821, 36824, 36827, 36833, 36840, 36842, 36845, 36863, 37008, 37011, 37040, 37042, 37043, 37044, 37200, 37203, 37206, 37210, 37211, 37215, 37217, 37218, 37219, 37220, 37221, 37224, 37230, 37233, 37245, 37318, 37324, 37338, 37339, 37340, 37341, 37372, 37415, 37417, 37418, 37423, 37438, 37604, 37607, 37610, 37833, 37834, 37842, 37845, 37848, 37851, 37854, 39015, 39018, 39109, 39503, 39612, 39615, 39638, 39639, 39654, 39656, 39700, 39703, 39712, 39715, 39718, 39803, 39818, 39821, 39900, 39903, 39906, 40012, 40106, 40109, 40112, 40600, 40700, 40703, 40706, ,40709, 40712, 40801, 40803, 40905, 45018, 55248, 55252, 55274, 55276, 55278, 55280, 55282, 55284, 55292 |
| Fees amended from 1 November 2020 (33) | 11009, 30642, 35551, 35599, 37219, 37340, 37372, 37607, 37610, 39018, 39109, 39615, 39654, 39656, 39700, 39703, 39712, 39715, 39718, 39803, 39818, 39821, 39900, 39903, 40012, 40106, 40109, 40112, 40700, 40703, 40706, 40709, 40712 |
| Ceased Items from 1 November 2020 (68) | 11006, 13709, 13915, 13918, 13921, 13924, 13927, 13930, 13933, 13936, 13939, 13942, 13945, 13948, 14230, 14233, 14236, 14239, 14242, 36526, 36527, 36540, 36605, 36630, 36642, 36648, 36825, 36857, 37212, 37315, 37420, 37444, 39003, 39006, 39009, 39012, 39106, 39112, 39500, 39600, 39603, 39606, 39609, 39640, 39642, 39646, 39650, 39653, 39658, 39660, 39662, 39706, 39709, 39721, 39800, 39806, 39812, 40000, 40003, 40006, 40009, 40015, 40100, 40103, 40115, 40118, 40800, 40903 |
Relevant Legislation
Health Insurance Legislation Amendment (2020 Measures No. 2) Regulations 2020
The purpose of the legislative instrument is to give effect to MBS changes from 1 November 2020.
Health Insurance (Section 3C General Medical Services – Botox Injection) Determination 2020
The purpose of the legislative instrument is to continue to provide the legal basis for Medicare Benefits Schedule item 18361, which is for the injection of botox for the treatment of moderate to severe spasticity of the upper limb due to cerebral palsy, from 1 November 2020.
Health Insurance (Section 3C Diagnostic Imaging Services – Computed Tomography Angiography) Determination 2020
The purpose of the legislative instrument is to list one new item (57357) for computed tomography (CT) angiography of the pulmonary artery for an initial investigation for pulmonary embolism from 1 November 2020
Health Insurance (Section 3C General Medical Services – Extracorporeal Photopheresis) Determination 2020
The purpose of the legislative instrument is to list two new items (14247 and 14249) - ECP for cutaneous T-cell lymphoma administered under the supervision of a specialist or consultant physician in the speciality of haematology from 1 November 2020