December 2009—Australian Optometry article
Benefit not payable for pachymetry service
Medicare Australia has issued an Administrative Position Statement (APS) clarifying whether a benefit is payable for pachymetry under the Medicare Benefits Scheme.
An APS is an authorised and documented position held by Medicare Australia in relation to the interpretation of a specific MBS item or in relation to the administration of the MBS or Pharmaceutical Benefits Scheme (PBS), particularly where there is ambiguity.
The APS relating to pachymetry states that 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. It does not constitute a professional attendance because it is a measurement only and does not meet the requirement for Item 10900.
Payment for a service that is not eligible for a benefit under Medicare is a private matter between the optometrist and the patient. An optometrist is able to charge a private fee for a pachymetry service without breaching the Common Form of Undertaking for optometrists.
Optometrists are invited to suggest APS topics for consideration.
Last updated: 22 March, 2012