1405 - MBS Item Number for Pulmonary Rehabilitation

Page last updated: 14 June 2016

Application Detail

Status

Open

Description of Medical Service

MSAC Application 1405 seeks five (5) new MBS items:
(Phase 1)
One new respiratory GPMP item number created to:
enable GPs to refer directly to a pulmonary rehabilitation program, without the need to additionally complete a TCA
Two new Allied Health MBS Item numbers:
A one-on-one (45min) consultation item number ($65) covering two (2) one-on-one assessments:
a pre-assessment – develop a complete patient medical history and plan sessions. The assessment will include but will not be limited to: testing of functional exercise capacity (6 min walk distance); assessments of health status (Quality of Life) and a psychosocial assessment questionnaires; and
a post-assessment – retesting functional exercise capacity; assessments of health status (Quality of Life) and psychosocial assessment to measure patient outcomes after completion of Group Exercise sessions below.

One Group Exercise item number ($25) to enable 16 x 1hr sessions for small group sizes - due to complexity of patients (maximum 8 participants).

(Phase 2) (proposed maintenance option ):
One Group exercise maintenance item number (1hr) at a reduced cost ($10) to enable those with severe disease and low-socioeconomic and/or multi-morbidity to attend one session per week for a total of 16 sessions. This is important in order to extend the benefits of the pulmonary rehabilitation program into the second year.
Phase 3
Eligibility: Patients would be eligible for Pulmonary Rehabilitation Maintenance every 2 years or following any hospitalisation for an acute exacerbation, or if a major change in clinical condition.
One Pulmonary Rehabilitation Maintenance item number (16 x 1hr sessions) – annually.

The proposed new MBS items would be in addition to the usual GPMP (Item 721) for the management of other co-morbidities that can be common in this patient group, other than emphysema, chronic bronchitis and chronic asthma that isn’t fully reversible, interstitial lung diseases, bronchiectasis and lung cancer which are covered under the proposed new GPMP item

Description of Medical Condition

The diseases relevant to this service are the chronic lung diseases, including chronic obstructive pulmonary disease (COPD is an umbrella term for a group of diseases including emphysema, chronic bronchitis and chronic asthma that isn’t fully reversible) interstitial lung diseases, bronchiectasis and lung cancer

Reason for Application

New MBS item

Medical Service Type

Therapeutic

Previous Application Number

Not Applicable

Associated Documentation

Application Form

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PICO Confirmation

Final Protocol (PDF 4011 KB)
Final Protocol (Word 585 KB)

Assessment Report

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Public Summary Document

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Meetings for this Application

PASC

13 - 14 August 2015
10 December 2015

ESC

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MSAC

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