Medicare changes: what they mean for your practice and patients

It’s the biggest shakeup to the Medicare Benefits Schedule (MBS) in over a decade. Over 900 items were added, removed, or allocated a new rebate amount. As one of the handful of financial institutions who are signed on to deliver Medicare Easyclaim, let’s unpack what it all means for you. 

What changes have been made to the Medicare Benefits Schedule?

Many of the changes will see rebates rise, though this is not the case across the board.

New items

Newly added items reflect advances in treatments. For example, Repetitive Transcranial Magnetic Stimulation (rTMS), ambulatory blood pressure monitoring, and some reconstructive surgery procedures are included in the MBS for the first time. Other new items are specific to GPs, including video or phone consultations about blood-borne viruses and sexual or reproductive health concerns.

Item descriptors

Item descriptors have been updated and some surgical procedures have been combined. Other changes affect who can access certain item numbers (for example, heart health assessments are now only available for patients aged 30 or over).

Telehealth

In a move welcomed by many in light of advances to telehealth services during the COVID-19 pandemic is a simplified system for telehealth items. There will also be removal of the requirement for telehealth items, whether phone or video, to be bulk billed.

Timing

The changes are not consistent in their timing, with some changes taking place on 1 July 2021, while others not changing until 1 November 2021 or 1 January 2022. The changes have also coincided with the annual indexation of most general medical MBS items which, for this year, is 0.9%.

Why have the changes been made?

Medical and surgical procedures change over time as a result of new technology, new treatment options, and research findings being put into practice – some procedures are no longer used and others are newly developed.

The costs of procedures also change over time, whether as a result of the price of medical devices or how long procedures take. Even basic tools of the trade, like swabs, scalpels and tubes, change price over time. So it’s not surprising that the MBS is periodically reviewed, entailing a detailed and comprehensive process.

This review saw an independent advisory group of medical professionals, academics, and consumers brought together across a five-year period, as well as engagement with peak body stakeholders.

What do the changes mean for your practice and patients?

One of the stated aims of the review is to simplify the schedule for doctors and patients. In the short-term, however, the wide-ranging changes may not be without challenges. Over one-sixth of the 5,500 item numbers have been altered in some way. Fortunately for medical practices, not all items will be relevant to their services.

The Australian Medical Association (AMA) has broadly welcomed the MBS changes, though it is concerned that the short timelines between notification and implementation could create difficulty for practices and patients, especially those with surgery booked for soon after the changes. 

Practice staff can help patients understand the changes by explaining the review’s rationale as well as directing them to resources such as the Australian Government Department of Health’s Medical Costs Finder.

What you need to know about Medicare Easyclaim

Tyro is one of only five authorised providers of Medicare Easyclaim. It can help you process Medicare rebates simply and free up more time for patient support. Some of the other benefits of a Tyro EFTPOS solution include:

• Integrates with most Practice Management Software (PMS)
• Helps to reduce queues and create a more efficient front desk experience
• No need for multiple EFTPOS machines for multiple practitioners

For more information on the MBS changes, search for relevant fact sheets provided by MBS online: http://www.mbsonline.gov.au/internet/mbsonline/publishing.nsf/Content/factsheet-current

Could Medicare Easyclaim help your practice and patients?

To learn more, visit Tyro Health or contact Tyro today on 1300 00 TYRO (8976).