The RACGP has prepared an overview of the MBS items available to assess patients for their suitability to receive a COVID-19 vaccine.
Visit RACGP's MBS webpage for full item descriptors and rebates.
Winter dose funding and reporting for in-reach services
The DoH are encouraging general practices to continue to support their local Residential Aged Care Facilities, Disability Support Services, and other priority populations to provide in-reach services to ensure eligible people received their winter dose of the COVID-19 vaccine.
Payments for the winter dose remain the same as for the administration of other booster doses, as outlined in this DoH factsheet.
When providing in reach services, to verify claims for the Practice Incentive Program (PIP) in-reach payment, you will need to complete the Clinic Summary Report, have it signed by a representative at the facility and scan/email to your PHN. Further information on reporting requirements is outlined in this DoH factsheet.
Please contact you PHN if you require any assistance with facilitation, coordination, or reporting.
Providing a COVID-19 vaccine and flu vaccine during the same consultation
ATAGI has advised it is no longer necessary to wait two weeks between a COVID-19 vaccination and an influenza vaccination; you can provide these services during the same consultation.
Although you are under no obligation to bulk bill a patient receiving a flu vaccination, a patient who also receives a COVID-19 vaccination during the same appointment must be bulk billed for the MBS COVID-19 vaccine suitability assessment component.
If another attendance is provided on the same day as the vaccine suitability assessment service, which is separate and/or unrelated to the vaccine service, the patient’s invoice/account or Medicare claim should be annotated (‘additional service [MBS item] is clinically relevant but not related to the vaccine suitability assessment service [MBS item]’) to help with the assessment of the claim.
For more information on the MBS COVID-19 vaccine suitability assessment items, visit MBS Online
Additional funding announced for administration of third and booster doses
Following National Cabinet on Wednesday 22 December 2021, Prime Minister Scott Morrison announced that general practices will receive an additional $10 per COVID-19 booster dose administered.
As per MBS online:
- Commencing 23 December 2021, a new temporary Medicare Benefits Schedule (MBS) item has been made available to support medical practitioners providing vaccine suitability assessment services to patients who require booster vaccinations.
- MBS item 93666 provides an incentive payment of $10 per eligible vaccine suitability assessment service to patients receiving a COVID-19 third dose or booster vaccination.
- The incentive will be paid in conjunction with COVID-19 vaccine suitability assessment services provided to patients receiving a third dose or booster dose of a COVID-19 vaccine.
- The item will not be paid for patients receiving a second dose service.
- The MBS item is available until 30 June 2022.
Read the MBS Factsheet: COVID-19 Booster Incentive Payment
Remote supervision vaccine MBS items
On 1 January 2022, two new MBS items were introduced to allow qualified health professionals (eg nurses) to provide vaccine-suitability assessments outside a medical practice without onsite supervision by a medical practitioner.
Item 93660 is for MMM1 areas and item 93661 is for MMM2–7 areas. These new items target the provision of COVID-19 vaccines to vulnerable people who may have difficulty travelling to a medical practice. Like all MBS COVID-19 vaccine items, these items must be bulk billed.
The medical practitioner retains responsibility for the health, safety and clinical outcomes of the patient. They must be satisfied that the relevant health professional is appropriately qualified and trained to provide the service.
Billing COVID-19 vaccine appointments
MBS COVID-19 vaccination services cannot be made contingent on any other service or fee. This includes, but is not limited to:
- patient registration fees for patients new to a practice
- bookkeeping or registration fees for the appointment
- general health checks (these should be incorporated into the bulk billed patient eligibility assessment or bulk billed in-depth patient assessment)
- any other service which the practice or practitioner requires before any COVID-19 MBS item.
In almost all cases, co-claiming will only be permitted where another GP or other medical practitioner (OMP) service is provided that is unrelated to the vaccine assessment item. However, where a patient suffers a significant adverse reaction to a COVID-19 vaccine, the GP or OMP is permitted to provide another MBS-rebateable service in order to provide appropriate treatment.
A significant adverse reaction includes, but is not limited to, systemic reactions such as syncopal episodes and severe allergic reactions such as anaphylaxis. It may also include a strong, adverse mental/emotional reaction to the vaccination. Severe adverse reactions are expected to be rare.
Services provided to a patient suffering a significant adverse reaction should be bulk billed.
For more information on billing requirements for vaccine appointments, visit MBS Online.
Practice Incentives Program (PIP) – COVID-19 vaccine general practice incentive
An accredited general practice that has completed two vaccine suitability assessment services for the same patient is eligible for a $10 payment (payable only once per patient) under the Practice Incentives Program (PIP).
The Australian Government has released guidelines for the Practice Incentives Program (PIP) – COVID-19 Vaccine General Practice Incentive
Educational resources for providers administering COVID-19 vaccines on MBS billing
Services Australia has published tailored infographics to support providers billing MBS COVID-19 vaccine suitability assessment items.
The infographics clarify billing requirements for:
A list of vaccine suitability assessment items for use by GPs and other medical practitioners can be viewed here.
For more information on changes for health professionals during the COVID-19 response, visit the Coronavirus information for health professionals page.
The Health Professional Education Resources Gateway has a designated page for the COVID-19 vaccine rollout. It contains a range of educational resources to support you with the rollout of the COVID-19 vaccine. Follow these steps to access the resources:
In your browser search medicareaust.com/index
Select play to continue
Select the Health Professional Education Resources Gateway link
Select the COVID-19 Vaccine Rollout menu tab on the left
If you would like to provide feedback on any of these resources, you can email Medicare.Education@servicesaustralia.gov.au