MBS ITEM NUMBERS
Residential Aged Care
Please note - Aged Care Funding is dependent upon General Practitioners evidence. Access to Allied health
services and the Dental Health Scheme needs GP support; this support is evidenced by the ITEM
numbers used. GP Documentation must be comprehensive and specific.
Health Assessments GROUP 14
Item
Amount
Paid
Time Required
701
$59.35 Brief 30 min.
703
$137.90 Standard 30
min to 45 min.
705
$190.30 Long than 45
min to 60min.
707
$268.80 Prolonged
more than 60
min.
Number per
year
Benefit
Description
1 per 12
Comprehensive
month period, Medical
or at a major Assessments
change in
health
Terms and Conditions
See A.14. Subgroup 1
A full systems review, must include:
a Detailed & relevant medical history
b Comprehensive medical assessment
c List of diagnoses & problems
d Summary of outcomes for provision of care
e Referral for a RMMR; outcomes and medication
summarised for the reviewing pharmacist.
Regulatory requirements: A 30…
Care Planning GROUP 15, Subgroup 1
Item
731
732
Amount
Paid
Time Required
$70.40 NO set time
required.
$72.05 NO set time
required.
Number per
year
Benefit
Description
Claimable
every 3
months.
Contribution to a
Multidisciplinary
Care Plan
Claimable
every 3
months.
Review
Multidisciplinary
Care Plan /
Multidisciplinary
Discharge Plan
Terms and Conditions
* Enables referral to Allied Health Services &
Dental Services.
Contribution to a Multidisciplinary Care Plan
prepared by that Facility; or a review of such plan.
The GP must:
a Prepare part of plan or amendments
b Add copy of plan to medical records
c Give advice to the person who prepares or
reviews the plan AND record that advice.
CAN also be used for a resident of an RACF when
being discharged from Hospital back to Facility or to
a review of a discharge plan.
Regulatory requirements: A 37…
Case Conferencing GROUP 15, Subgroup 2
Item
735
Amount
Paid
Time Required
$70.65 15 to 20 mins.
739
$120.95 20 to 40 mins.
743
$201.65 More than 40
mins.
747
$51.90 15 to 20 mins.
750
$89.00 20 to 40 mins.
758
$148.20 More than 40
mins.
Number per
year
No more than
5 per year
No more than
5 per year
Benefit
Description
Organise
Case Conference
(Following a CMA
and a process for
ongoing review and
management of a
Resident)
* Can be used to
contribute to a
731.
Terms and Conditions
Medical conditions must have existed for at least 6
months or be terminal.
GP to organise and coordinate
Case conference process must include:
a Discussion of patient history
b Identify multi-disciplinary care needs
c Identify outcomes from care and service by care
team
d Identify tasks to achieve outcomes and allocate
to Care team members
e Assessing whether previous outcomes have
been achieved
Participate
Medical conditions must have existed for at least 6
months or be terminal.
Case Conference
(Following a CMA GP to participate
and a process for
ongoing review and
management of a
Resident)
Items current as at June 2015
Consultation at a RACF GROUP A22
Item
Fee
After Hours
Time and
Conditions
Descriptor
Item
Fee
5010
Item 5000 plus $46.70 divided by
the number of patients
20
Item 3 plus $46.70 divided by the
number of patients
Level A
35
Item 23 plus $46.70
divided by number of patients
Level B
Less than 20 mins.
5028
Item 5020 plus $46.70 divided by
number of patients
43
Item 36 plus $46.70 divided by
number of patients
Level C
At least 20 mins.
5049
Item 5040 plus $46.70 divided by
number of patients
51
Item 44 plus $46.70 divided by
number of patients
Level D
At least 40 mins.
5067
Item 5060 plus $46.70 divided by
number of patients
Other non-referred Consultations at a RACF GROUP A23
Item
Fee
After Hours
Time and
Conditions
Descriptor
Item
Fee
92
$8.50 plus $27.95 divided by
number of patients
Brief Consult
Less than 5 mins.
5260
$18.50 plus $27.95 divided by
number of patients
93
$16.00 plus $31.55 divided by
number of patients
Standard
Consult
More than 5 mins.
less than 25 mins.
5263
$26.00 plus $31.55 divided by
number of patients
95
$35.50 plus $27.95 divided by
number of patients
Long Consult
More than 25 mins. 5265
less than 45 mins.
$45.50 plus $27.95 divided by
number of patients
96
$57.50 plus $27.95 divided by
number of patients
Prolonged
Consult
More than 45 mins. 5267
$67.50 plus $27.95 divided by
number of patients
Medication Management GROUP A17
Item
903
Fee
Per year
Descriptor
$106.00 1 per 12 months or
RMMR
major change in health Residential Medication
Management review
Conditions





Collaborates with reviewing Pharmacist
Provides input from the CMA
Discusses findings with Pharmacist
Develops and or revises written medication plan
Discusses medication management with resident
and carers
Supplementary Information
ACAI- PIP
Aged Care Access Initiative Practice Incentive Payment
The PIP General Practitioner Aged Care Access Incentive (ACAI) aims to encourage GPs to provide
increased and continuing services in RACFs.
The PIP GP ACAI payments are based on a GP providing a required number of eligible Medicare Benefits
Schedule (MBS) services in RACFs in a financial year.
http://www.medicareaustralia.gov.au/provider/incentives/pip/files/gp-aged-care-access-incentiveguidelines.pdf
ACFI
Aged Care Funding Instrument (ACFI)
The ACFI is based primarily on the resident’s dependency (need for care) rather than on care planning or
care provided by an aged care home.
The ACFI consists of twelve care need questions. Diagnostic information about mental and behavioural
disorders and other medical conditions is required. This information is used to categorise residents as
having low, medium or high care needs in each of the following care domains: Activities of daily living
(ADLs) ,Behaviour and Complex Health Care.
NB: Use of the CMA – best presents the evidence required.
http://www.health.gov.au/internet/main/publishing.nsf/Content/ageing-acfi-using-conducting.htm
Templates
CSAPHN Website