Changes to COVID-19 vaccine items from 1 February 2023
In 2023 COVID-19 vaccines will remain free for everyone in Australia with the ongoing requirement for the services to be bulk billed/free of co-payment.
From 1 February 2023, COVID-19 vaccine suitability assessment and associated MBS item number structures have been streamlined as per the summary chart below.
Changes include:
- the combination of vaccine suitability services for all approved COVID-19 vaccine doses into the corresponding item number that had been for second and subsequent COVID-19 doses (93644 and equivalents),
- an increase in the benefits to incorporate the former booster incentive payment into the vaccine suitability assessment item,
- an increase to the flag-fall payment for vaccine suitability assessment services paid once for each visit to a residential aged care facility, residential disability facility, or a patient’s home and
- an adjustment to the descriptors for the in-depth vaccine suitability assessment services in line with the removal of first dose vaccine suitability assessment services.
For more information on these changes, review the
MBS factsheet.
Changes to Medicare Benefit Schedule from 1 February 2023
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Previous Primary Care Payment
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Payment from 1 February 2023
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Dose 1
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Dose 2 (and subsequent)
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Booster incentive
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GP COVID-19 PIP^
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MBS - business hours - suitability assessment items
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GP
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MMM1
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$31.55
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$24.85
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$10.20 (booster incentive payment in addition to Dose 2 payment through MBS)
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$10 for each patient who has received 1st and 2nd doses at the same practice
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$35.10
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MMM2-7
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$38.25
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$28.25
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$38.50
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OMP
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MMM1
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$24.60
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$17.95
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$28.20
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MMM2-7
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$34.65
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$24.60
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$34.80
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MBS– after hours – suitability assessment items
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GP
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MMM1
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$43.95
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$37.35
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$47.60
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MMM2-7
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$50.75
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$40.70
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$50.95
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OMP
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MMM1
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$34.85
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$28.15
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$38.40
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MMM2-7
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$44.60
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$34.55
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$44.80
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MBS - Remote supervision items
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GP/OMP
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MMM1
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$21.35
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$21.35
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MMM2-7
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$24.40
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$24.40
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Flagfall *
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GP/OMP
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MMM1-7
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$58.15 (until 31 January 2023) $118.15 (from 1 February 2023)
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Flagfall
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Community Pharmacy
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MMM1-7
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$58.15 (until 31 January 2023) $118.15 (from 1 February 2023)
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MBS – in-depth vaccine assessment item **
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GP
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MMM1-7
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$39.70
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OMP
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MMM1-7
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$31.80
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^2nd administration (where both doses were provided by the same pharmacy, otherwise the benefit remained as per first dose benefit)
* can be claimed once per attendance where a vaccine assessment service has been conducted in a person’s place of residence
** can be claimed once per patient
Simplified descriptors - GPs in Modified Monash Area 1 - Click item number for full descriptor
93644 – suitability assessment service during business hours
93653 – suitability assessment service after-hours
93660 – suitability assessment service on behalf of a GP/OMP by a suitably qualified health professional on their behalf
10660 – in-depth patient assessment, co-claimed with 93644 or 93653
90005 – flag fall for services in a residential aged care facility, residential disability facility or patient’s home, co-claimed with 93644 or 93653
Simplified descriptors - GPs in Modified Monash Areas 2 to 7 - Click item number for full descriptor
93645 – suitability assessment service during business hours
93654 – suitability assessment service after-hours
93661 – suitability assessment service on behalf of a GP/OMP by a suitably qualified health professional on their behalf
10660 – in-depth patient assessment, co-claimed with 93645 or 93654
90005 – flag fall for services in a residential aged care facility, residential disability facility or patient’s home, co-claimed with 93645 or 93654
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