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.
MBS funding for third vaccine doses
Individuals who are severely immunocompromised are now recommended to receive a third dose of the COVID-19 vaccine as part of the primary course.
Assessment of suitability for these third doses are eligible for MBS reimbursement with the same rules as suitability assessments for second doses. The same second dose MBS items are used, including when a medical practitioner performs a suitability assessment for a patient and determines they are not suitable for a third vaccine dose.
Flag fall and in-depth patient assessments may also be claimed if all other eligibility requirements are met (in-depth patient assessments can only be claimed once per patient). The additional Practice Incentives Program (PIP) payment for administering COVID-19 vaccines is not claimable for a third dose. It remains payable only when the first and second vaccine doses are administered at the same general practice.
More information on MBS support for COVID-19 vaccines is available on MBS Online and the RACGP website.
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
Practice incentive payment for proving in-reach residential aged care and disability support worker COVID-19 vaccinations
If your practice is, or has been, providing dedicated in-reach COVID-19 vaccination services for workers in residential aged care or disability care settings, additional funding is available.
This funding includes:
These payments are in addition to existing MBS flag fall arrangements, the MBS COVID-19 vaccine suitability assessment items and other practice incentive payments associated with COVID-19 vaccines.
To receive the payment, report any clinics you conducted between 29 April 2021 and 31 October 2021 through the ‘In Reach Vaccination Reporting’ tab now live on the COVID-19 Vaccine Administration System.
You can find out more about the new payments on the Department of Health website.
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