What's new?

July 2014

Improvements will be made to the way some PBS medicines are processed under the Highly Specialised Drugs Programme from 1 July 2015.

For health professionals

Information on this site is moving to the new health professionals websiteExternal link. We will improve the content, navigation and search functions during this process. Your patience is appreciated as these changes occur.

Health Professional News

Closure of the Medicare Teen Dental Plan

The Medicare Teen Dental Plan closed on 31 December 2013. The Medicare Teen Dental Plan was replaced by the Child Dental Benefits Schedule on 1 January 2014.

DVA Health Cards

From 1 June 2014 all eligible DVA clients will be receiving new health cards irrespective of their card expiry as part of the 2014 bulk card reissue. This will occur during the month of June.

For further information please view full details on the Department of Veterans' Affairs websiteExternal link.

Time limits to lodgement of Medicare bulk bill claims

Under Section 20B of the Health Insurance Act 1973, you are required to submit Medicare bulk bill claims within 2 years from the date of service. You can save time and paperwork by lodging claims electronically. Lodging claims on time ensures you will receive the Medicare benefit the patient has assigned to you.

Adjustment to a previously paid bulk bill claim

Requests for adjustments to previously paid bulk bill claims must be made within 2 years from the original claim. This is consistent with Section 20B of the Health Insurance Act 1973.

When a patient agrees to assign their Medicare benefit to you they confirm they received the service as set out on the Medicare assignment of benefit form. When you submit bulk bill claims you declare the details on the Medicare assignment of benefit form are correct. It’s important to get it right the first time. It ensures you receive the correct Medicare benefit and patients’ medical records are up-to-date.

From 2 June 2014, new processes apply to:

  • Omitted bulk bill incentive or Patient Episode Initiation (PEI) items
  • Requesting an adjustment to an item number for a previously paid bulk bill claim

Read more about the Bulk bill claim adjustments and late lodgements - FAQ

Child Dental Benefits Schedule

The Child Dental Benefits Schedule provides capped benefit entitlement for basic dental services for children aged 2-17 in families who meet a means test. The means test will be the same as the existing Medicare Teen Dental Plan, which requires receipt of Family Tax Benefit Part A or other certain government payments.

Services for basic essential dental treatment, such as check-ups, x-rays, fillings and extractions will be included, and patients will have access to dental benefit entitlements capped (indexed annually) over a two calendar year period.  For 2014, the benefit is capped at $1000 per child.

Medicare Billing Assurance Toolkit Trial

May 2014 update

We have received a high level of interest from large practices wishing to participate in the Medicare Billing Assurance Toolkit trial. Nominations have now closed.

For more information go to the Medicare Billing Assurance Toolkit Trial webpage.

If you have renewed your Medicare PKI certificate make sure you install the software

If you have renewed your Medicare PKI certificate, you must install the software on the CD that was sent with your certificate for it to work.

Find out how to install a PKI individual certificate.

Ordering PBS stationery

The Camerons Group is the contracted supplier of PBS stationery.

If you order stationery through us, continue to do so using the same PBS stationery ordering contact details.

If you're an approved community pharmacy, private hospital pharmacy or participating public hospital and order directly through the stationery supplier, you can order or make enquiries through The Camerons Group. Their contact details are on the PBS page.

If you’re a stoma association or paraquad association, you can fax your order to The Camerons Group.

For more information about ordering PBS stationery go to the PBS page.

The eHealth record system can help deliver more efficient health care

The personally controlled electronic health record system (eHealth) gives you an electronic summary of your patient’s key health information, taken from their existing records.

The eHealth record system will give you better access to patient information like medications, test results and allergies or treatments—meaning better, safer and more efficient care.

MBS items are available for use in the creation of shared health and event summaries. Health professionals will be able to bill the MBS for preparing both shared health summaries and event summaries as part of a consultation. In deciding which item to bill, health professionals will only have to consider the reasonable time it would take—not the complexity of the consultation.

To register your practice for the eHealth record system, go to the eHealthExternal link website.

Access through HPOS

If your practice is registered for the Healthcare Identifiers (HI) Service and has an active Healthcare Provider Identifier—Organisation (HPI-O) number, you can use HPOSExternal link to access the eHealth record system organisation registration services.

Note: HI Service Responsible Officers (ROs) and Seed Organisation Maintenance Officers (OMOs) must have either performed an Evidence of Identity check with the HI Service or be recorded as a known customer to perform these functions.

As a HI RO or Seed OMO, you can:

  • apply to register your organisation for the eHealth record system
  • set access flags against registered organisations for the eHealth record system, and
  • accept the eHealth record system organisation participation agreement

As a HI Service RO or OMO, you can give health professionals, with a Healthcare Provider Identifier-Individual number, access to the eHealth Record Provider Portal by recording an authorisation link.

Note: OMOs must have authorisation rights over an organisation to perform this function.

For more information about the eHealth Record System go to the eHealthExternal link website or read the HPOS user guides.

Check System Status

The system status pages that are accessible via the links below will assist you to identify whether the relevant systems are currently available at Medicare Australia. Each of the status pages contain a Service Announcements section for important messages and a section on how to interpret the details of the status page.

Provider percentile charts

Provider percentile charts show the number of services billed by peer groups for selected MBS items. You can use these charts to compare your billing data with your peers.

Last updated: 10 September, 2014