Final Administrative Position Statements (APS)
All Final APS shall be reviewed at least every 12 months (from the date of release) by Medicare Australia. In certain circumstances such as legislative changes and amendments, or adjusted business processes, APS will be reviewed prior to the review date and will be archived.
| Reference number | APS Question | Final APS | Date of effect |
|---|---|---|---|
| FPM02/09 | Is a benefit payable for MBS Item 30071 if the biopsy specimen sent for pathological examination confirms the lesion is a seborrheic keratosis? |
Medicare benefits are payable for MBS Item 30071 if the biopsy specimen is sent for pathological examination, regardless of the diagnosis. This means that if a biopsy of skin is taken and pathological examination shows that the lesion is a seborrheic keratosis, Medicare benefits are payable under MBS Item 30071. |
12/04/2010 |
| FPM01/09 | What is meant by ‘personal attendance’ in relation to MBS items 12000 and 12003? |
In relation to MBS items 12000 and 12003 (skin prick testing) the rendering practitioner must personally attend the patient, whether or not another person provides essential assistance to the medical practitioner in accordance with accepted medical practice. Medicare Australia considers personal attendance of skin prick testing to be satisfied if the medical practitioner:
|
12/04/2010 |
| FPM10/08 | What are the supervision requirements for MBS items 12012, 12015, 12018 and 12021? |
MBS items 12012, 12015, 12018 and 12021 (Patch Allergy Testing items) must be performed in accordance with accepted medical practice, under the supervision of the rendering medical practitioner. Medicare Australia considers that the supervision requirements for MBS items 12012, 12015, 12018 and 12021 will be met if the supervising practitioner:
|
12/04/2010 |
| FPM12/08 | Is malformation, disease or trauma of the breast required to be present in both breasts or just one breast to enable Medicare benefits for a bilateral mammaplasty under MBS Item 45528? |
If it is clinically relevant to do bilateral augmentation mammaplasty, Medicare benefits will be payable under Item 45528 if there is malformation (excluding hypomastia), disease or trauma of one or both breasts. Note: Claims for benefits for Item 45528 should be lodged with the MCRP Officer. The MCRP Officer |
27/11/2009 |
| FPM09/08 | Is a benefit payable under Medicare for pachymetry? |
Medicare benefits are not payable for a pachymetry service. Pachymetry is not listed as an eligible service in the Health Insurance (General Medical Services Table) Regulations 2008. Pachymetry, of itself, would not constitute a professional attendance (because it is a measurement only) and would not meet the requirement for Item 10900. Payment for a service that is not eligible for benefits under Medicare is a private matter between the practitioner and the patient. An optometrist is therefore able to charge a private fee for a pachymetry service without breaching the Common Form of Undertaking for Optometrists. |
27/11/2009 |
| FPM08/08 | What are the practitioner supervision requirements for Psoralen Ultraviolet Light A therapy (PUVA) and Ultraviolet Light B phototherapy (UVB) treatments (MBS items 14050 and 14053)? |
MBS items 14050 and 14053 (Psoralen Ultraviolet Light A therapy (PUVA) and Ultraviolet Light B phototherapy (UVB) items) must be performed in accordance with accepted medical practice, under the supervision of the rendering medical practitioner. Medicare Australia considers that the supervision requirements for MBS items 14050 and 14053 will be met if the supervising practitioner is available for consultation at the time a service is provided to a patient. The supervising practitioner may not necessarily be on site, but must always be in Australia and contactable during the service. |
27/11/2009 |
| FPM07/08 | Can Item 11222/11225 be claimed where patients are monitored for ocular disease or disease of the visual pathways irrespective of suspected drug toxicity, glaucoma or a neurological disease? |
Benefits under items 11222/11225 are payable for full quantitative computerised perimetry, bilateral/unilateral, where patients are monitored for ocular disease or disease of the visual pathways and where more than 2 services are required in a 12 month period. Items 11222/11225 do not necessarily require the presence of systemic drug toxicity, glaucoma or neurological disease for benefits to be payable. |
31/03/2009 |
| FPM03/08 | Can MBS Item 10997 be billed on the same day as MBS item 721, 723, 725, 727, 729 or 731? |
Medicare benefits are payable for an MBS Item 10997 service rendered on the same day as an item 721, 723, 725, 727, 729 or 731 service if the person has a GP Management Plan (GPMP), Team Care Arrangements (TCA) or Multidisciplinary Care Plan (MCP) in place. |
31/03/2009 |
| FPM02/08 | In relation to MBS items 19, 33, 40, 50, 87, 89, 90 and 91 what is considered to be the meaning of ‘one occasion’? |
In regard to MBS items 19, 33, 40, 50, 87, 89, 90 and 91, Medicare Australia considers that an occasion is either of the following:
|
17/02/2009 |
Some documents on this page may require the free Adobe PDF reader.
Last updated: 2 August, 2010