MBS COVID-19 vaccine suitability assessment service


New items from March 2021

From March 2021, 16 new MBS items will be available to enable GPs and suitably qualified health professionals to assess patients for their suitability to receive a COVID-19 vaccine. The MBS COVID-19 vaccine suitability assessment service is free to Medicare eligible patients and the MBS items must be bulk billed for all patients.

Bulk billing incentives (double for dose one, single for dose two) are incorporated into the value of the items, meaning the new items cannot be co-claimed with bulk billing incentive items 10990, 10991 or 10992. An accredited general practice that has completed two vaccine suitability assessment services for the same patient in a clinically appropriate timeframe is also eligible for a $10 payment under the Practice Incentives Program (payable only once per patient).

Detailed information on the new items is available on MBS Online. This fact sheet includes scenarios which offer examples of how the MBS items can be billed, what to do when patients present with multiple clinical matters, and guidance on issues such as co-claiming.

Descriptors and rebates for the items are listed below.

GP items

Item number

Descriptor

Rebate

93624

Professional attendance by a general practitioner for the purpose of assessing a patient’s suitability for the first dose of a COVID-19 vaccine if all of the following apply:

  1. one or both of the following is undertaken, where clinically relevant:
    1. a short patient history;
    2. limited examination and management;
  2. the patient is eligible for a COVID-19 vaccine;
  3. the service is bulk-billed;
  4. the service is provided at, or from, a practice location in a Modified Monash 1 area

$30.75

93625

Professional attendance by a general practitioner for the purpose of assessing a patient’s suitability for the first dose of a COVID-19 vaccine if all of the following apply:

  1. one or both of the following is undertaken, where clinically relevant:
    1. a short patient history;
    2. limited examination and management;
  2. the patient is eligible for a COVID-19 vaccine;
  3. the service is bulk-billed;
  4. the service is provided at, or from, a practice location in:
    1. a Modified Monash 2 area; or
    2. a Modified Monash 3 area; or
    3. a Modified Monash 4 area; or
    4. a Modified Monash 5 area; or
    5. a Modified Monash 6 area; or
    6. a Modified Monash 7 area

$37.35

93634

Professional attendance by a general practitioner for the purpose of assessing a patient’s suitability for the first dose of a COVID-19 vaccine if all of the following apply:

  1. one or both of the following is undertaken, where clinically relevant:
    1. a short patient history;
    2. limited examination and management;
  2. the patient is eligible for a COVID-19 vaccine;
  3. the service is bulk-billed;
  4. the service is provided at, or from, a practice location in a Modified Monash 1 area;
  5. the service is rendered in an after-hours period

$42.90

93635

Professional attendance by a general practitioner for the purpose of assessing a patient’s suitability for the first dose of a COVID-19 vaccine if all of the following apply:

  1. one or both of the following is undertaken, where clinically relevant:
    1. a short patient history;
    2. limited examination and management;
  2. the patient is eligible for a COVID-19 vaccine;
  3. the service is bulk-billed;
  4. the service is provided at, or from, a practice location in:
    1. a Modified Monash 2 area; or
    2. a Modified Monash 3 area; or
    3. a Modified Monash 4 area; or
    4. a Modified Monash 5 area; or
    5. a Modified Monash 6 area; or
    6. a Modified Monash 7 area;
  5. the service is rendered in an after-hours period

$49.50

93644

Professional attendance by a general practitioner for the purpose of assessing a patient’s suitability for the second or subsequent dose of a COVID-19 vaccine if all of the following apply:

  1. one or both of the following is undertaken, where clinically relevant:
    1. a short patient history;
    2. limited examination and management;
  2. the patient is eligible for a COVID-19 vaccine;
  3. the service is bulk-billed;
  4. the service is provided at, or from, a practice location in a Modified Monash 1 area

$24.25

93645

Professional attendance by a general practitioner for the purpose of assessing a patient’s suitability for the second or subsequent dose of a COVID-19 vaccine if all of the following apply:

  1. one or both of the following is undertaken, where clinically relevant:
    1. a short patient history;
    2. limited examination and management;
  2. the patient is eligible for a COVID-19 vaccine;
  3. the service is bulk-billed;
  4. the service is provided at, or from, a practice location in:
    1. a Modified Monash 2 area; or
    2. a Modified Monash 3 area; or
    3. a Modified Monash 4 area; or
    4. a Modified Monash 5 area; or
    5. a Modified Monash 6 area; or
    6. a Modified Monash 7 area

$27.55

93653

Professional attendance by a general practitioner for the purpose of assessing a patient’s suitability for the second or subsequent dose of a COVID-19 vaccine if all of the following apply:

  1. one or both of the following is undertaken, where clinically relevant:
    1. a short patient history;
    2. limited examination and management;
  2. the patient is eligible for a COVID-19 vaccine;
  3. the service is bulk-billed;
  4. the service is provided at, or from, a practice location in a Modified Monash 1 area;
  5. the service is rendered in an after-hours period

$36.40

93654

Professional attendance by a general practitioner for the purpose of assessing a patient’s suitability for the second or subsequent dose of a COVID-19 vaccine if all of the following apply:

  1. one or both of the following is undertaken, where clinically relevant:
    1. a short patient history;
    2. limited examination and management;
  2. the patient is eligible for a COVID-19 vaccine;
  3. the service is bulk-billed;
  4. the service is provided at, or from, a practice location in:
    1. a Modified Monash 2 area; or
    2. a Modified Monash 3 area; or
    3. a Modified Monash 4 area; or
    4. a Modified Monash 5 area; or
    5. a Modified Monash 6 area; or
    6. a Modified Monash 7 area;
  5. the service is rendered in an after-hours period

$39.70

Other medical practitioner items

Item number

Descriptor

Rebate

93626

Professional attendance by a medical practitioner (other than a general practitioner) for the purpose of assessing a patient’s suitability for the first dose of a COVID-19 vaccine if all of the following apply:

  1. one or both of the following is undertaken, where clinically relevant:
    1. a short patient history;
    2. limited examination and management;
  2. the patient is eligible for a COVID-19 vaccine;
  3. the service is bulk-billed;
  4. the service is provided at, or from, a practice location in a Modified Monash 1 area

$24.00

93627

Professional attendance by a medical practitioner (other than a general practitioner) for the purpose of assessing a patient’s suitability for the first dose of a COVID-19 vaccine if all of the following apply:

  1. one or both of the following is undertaken, where clinically relevant:
    1. a short patient history;
    2. limited examination and management;
  2. the patient is eligible for a COVID-19 vaccine;
  3. the service is bulk-billed;
  4. the service is provided at, or from, a practice location in:
    1. a Modified Monash 2 area; or
    2. a Modified Monash 3 area; or
    3. a Modified Monash 4 area; or
    4. a Modified Monash 5 area; or
    5. a Modified Monash 6 area; or
    6. a Modified Monash 7 area

$33.80

93636

Professional attendance by a medical practitioner (other than a general practitioner) for the purpose of assessing a patient’s suitability for the first dose of a COVID-19 vaccine if all of the following apply:

  1. one or both of the following is undertaken, where clinically relevant:
    1. a short patient history;
    2. limited examination and management;
  2. the patient is eligible for a COVID-19 vaccine;
  3. the service is bulk-billed;
  4. the service is provided at, or from, a practice location in a Modified Monash 1 area;
  5. the service is rendered in an after-hours period

$34.00

93637

Professional attendance by a medical practitioner (other than a general practitioner) for the purpose of assessing a patient’s suitability for the first dose of a COVID-19 vaccine if all of the following apply:

  1. one or both of the following is undertaken, where clinically relevant:
    1. a short patient history;
    2. limited examination and management;
  2. the patient is eligible for a COVID-19 vaccine;
  3. the service is bulk-billed;
  4. the service is provided at, or from, a practice location in:
    1. a Modified Monash 2 area; or
    2. a Modified Monash 3 area; or
    3. a Modified Monash 4 area; or
    4. a Modified Monash 5 area; or
    5. a Modified Monash 6 area; or
    6. a Modified Monash 7 area;
  5. the service is rendered in an after-hours period

$43.50

93646

Professional attendance by a medical practitioner (other than a general practitioner) for the purpose of assessing a patient’s suitability for the second or subsequent dose of a COVID-19 vaccine if all of the following apply:

  1. one or both of the following is undertaken, where clinically relevant:
    1. a short patient history;
    2. limited examination and management;
  2. the patient is eligible for a COVID-19 vaccine;
  3. the service is bulk-billed;
  4. the service is provided at, or from, a practice location in a Modified Monash 1 area

$17.50

93647

Professional attendance by a medical practitioner (other than a general practitioner) for the purpose of assessing a patient’s suitability for the second or subsequent dose of a COVID-19 vaccine if all of the following apply:

  1. one or both of the following is undertaken, where clinically relevant:
    1. a short patient history;
    2. limited examination and management;
  2. the patient is eligible for a COVID-19 vaccine;
  3. the service is bulk-billed;
  4. the service is provided at, or from, a practice location in:
    1. a Modified Monash 2 area; or
    2. a Modified Monash 3 area; or
    3. a Modified Monash 4 area; or
    4. a Modified Monash 5 area; or
    5. a Modified Monash 6 area; or
    6. a Modified Monash 7 area

$24.00

93655

Professional attendance by a medical practitioner (other than a general practitioner) for the purpose of assessing a patient’s suitability for the second or subsequent dose of a COVID-19 vaccine if all of the following apply:

  1. one or both of the following is undertaken, where clinically relevant:
    1. (i) a short patient history;
    2. (ii) limited examination and management;
  2. (b) the patient is eligible for a COVID-19 vaccine;
  3. (c) the service is bulk-billed;
  4. (d) the service is provided at, or from, a practice location in a Modified Monash 1 area;
  5. (e) the service is rendered in an after-hours period

$27.50

93656

Professional attendance by a medical practitioner (other than a general practitioner) for the purpose of assessing a patient’s suitability for the second or subsequent dose of a COVID-19 vaccine if all of the following apply:

  1. one or both of the following is undertaken, where clinically relevant:
    1. a short patient history;
    2. limited examination and management;
  2. the patient is eligible for a COVID-19 vaccine;
  3. the service is bulk-billed;
  4. the service is provided at, or from, a practice location in:
    1. a Modified Monash 2 area; or
    2. a Modified Monash 3 area; or
    3. a Modified Monash 4 area; or
    4. a Modified Monash 5 area; or
    5. a Modified Monash 6 area; or
    6. a Modified Monash 7 area;
  5. the service is rendered in an after-hours period

$33.70