Changes to rural bulk billing incentives


An overview of changes to rural bulk billing incentives from 1 January 2022

Medicare Benefits Schedule (MBS) bulk billing incentives for GPs in rural and remote areas will be increased from 1 January 2022. There will not be any changes to bulk billing incentive items for doctors in metropolitan areas (10990, 64990, 74990).

Existing rural bulk billing incentive items (10991, 64991, 74991) will remain in place for doctors in Modified Monash Model (MMM) area 2. The fees for these items will remain at 150% of the fee for the relevant metropolitan area item.

The after-hours bulk billing incentive item (10992) will be amended to specify that the item applies to a service rendered in an MMM 2–7 area if the medical practitioner has travelled from a practice location outside those areas (i.e. a metropolitan area).

New items will be created for doctors in:

  • MMM areas 3–4 (75855, 64992, 75861), valued at 160% of the fee for the relevant metropolitan area item/s
  • MMM area 5 (75856, 64993, 75862), valued at 170% of the fee for the relevant metropolitan area item/s
  • MMM area 6 (75857, 64994, 75863), valued at 180% of the fee for the relevant metropolitan area item/s
  • MMM area 7 (75858, 64995, 75864), valued at 190% of the fee for the relevant metropolitan area item/s.

These changes recognise the challenges of providing care to patients in rural and remote areas, including higher operating costs, smaller patient populations and the increased scope of clinical practice.

Visit MBS Online for more information.

Changes to the Rural Veterans’ Access Payment Incentive

The increase to MBS rural bulk billing incentives will also apply to the Veterans’ Access Payment (VAP) for services provided to Department of Veterans’ Affairs (DVA) clients.

The MBS VAP Incentive items are unable to be claimed in conjunction with telehealth services provided to DVA clients. From 1 January 2022, DVA is introducing additional item numbers to allow GPs to claim the VAP which are detailed in the table below.

VAP Face-to-face item

VAP DVA telehealth item

MMM classification

DVA fee

10990

MT89

MMM 1

$7.65

10991

MT88

MMM 2

$11.60

10992

MT87

MMM 2–7 (after-hours)

$11.60

75855

MT86

MMM 3–4

$12.30

75856

MT85

MMM 5

$13.10

75857

MT84

MMM 6

$13.85

75858

MT83

MMM 7

$14.65

From 1 January 2022, GPs will need to claim the VAP using the DVA item in conjunction with any telehealth services provided to their DVA patients. If a practice utilises third party software which allows them to automatically claim the VAP incentive with eligible items, they should contact their software vendor to determine the best way to claim under these arrangements.

Details about the new DVA items will be published on the DVA website and included in the Department of Veterans’ Affairs Fee Schedules for Medical Services as soon as possible. If you have further questions about this change, please contact Health Approvals on health.approval@dva.gov.au or call 1800 550 457 (option 3 then option 1).

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