New temporary MBS items for residents in residential aged care facilities

  4 February 2021  Dr Jeannie Knapp, GP and NWMPHN Primary Health Care Improvement GP Adviser

On 10 December 2020, new temporary Medicare Benefits Schedule (MBS) items were introduced to support the mental and physical health of care recipients in residential aged care facilities (RACFs) who have been affected by the COVID-19 pandemic.

This measure is an outcome of the Royal Commission into Aged Care Quality and Safety and will be available until 30 June 2022.

Mental health

The Australian Government has temporarily expanded eligibility requirements for the Better Access mental health initiative. This gives aged care residents with access up to 20 Medicare subsidised individual psychological services each calendar year. These changes are in place from 10 December 2020 until 30 June 2022.

The expansion recognises the impact of the COVID-19 pandemic on the mental health and wellbeing of people in residential aged care, and addresses recommendations from the Royal Commission into Aged Care Quality and Safety’s aged care and COVID-19 report. The expansion allows RACF residents to access the same mental health service rebates as the general population.

The new item numbers have also expanded the claiming of the ‘flag fall’ fee for face-to-face attendances that include the mental health items. These also apply to focused psychological strategies.

MBS factsheet

Service RACF face-to-face RACF video RACF phone Rebate
GP without training prepare a mental health treatment plan (MHTP) 20-39 minutes 93400 93404 93408 $73.95
GP without training prepare a MHTP > 40 minutes 93401 93405 93409 $108.85
GP with training prepare a MHTP 20-39 minutes 93402 93406 93410 $93.90
GP with training prepare a MHTP >40 minutes 93403 93407 93411 $138.30
Review of GP mental health plan 93421 93422 93423 $73.95
Aged care flag fall item (90001) can be claimed for the first resident attended for face-to-face mental health items.

Allied health

Temporary MBS items are also available to improve access to multidisciplinary care for residents of RACFs during the COVID-19 pandemic. These changes are also in place from 10 December 2020 until 30 June 2022.

Under the new items, allied health providers may claim a call-out or ‘flag-fall’ fee to cover their costs to travel to a RACF to provide a face-to-face service. Existing flag-fall fees for GP and Other Medical Practitioner (OMP) services have also been expanded. These fees now include face-to-face attendances in RACFs for contribution to multidisciplinary care plans and Aboriginal and Torres Strait Islander Health Assessments.

MBS factsheet

Service Existing items Temporary item RACF Face to Face (F2F) Only Rebate
Professional attendance by a general practitioner at a residential aged care facility to prepare or amend a multidisciplinary care plan 731 93469 $72.60
Professional attendance by a general practitioner at a residential aged care facility to perform a health assessment of a resident who is of Aboriginal or Torres Strait Islander descent 715 93470 $218.90
Flag fall fee can be claimed for face-to-face attendances under new item numbers.

More information

Disclaimer: NWMPHN provides Medicare information as a guide only and recommends general practitioners familiarise themselves with the detailed descriptions contained in the MBS, available at mbsonline.gov.au. Under the Health Insurance Act 1973 practitioners are legally responsible for services billed to Medicare under their Medicare provider number or in their name.