Education guide - Practice nurse items

Information about how to claim services provided by a practice nurse on behalf of a general practitioner.

We recommend you also read the relevant Medicare Benefits Schedule (MBS) item descriptors and explanatory notes available on the MBS Online website.

Patient and claiming eligibility

The key requirements to claim a service provided by a practice nurse, on behalf of a general practitioner (GP), are listed below.

These items do not apply to patients admitted to hospital and they must be provided under GP supervision.

Item Service Patient and claiming eligibility Item requirements
10983 Telehealth patient-end clinical support At the time of consultation the patient must be outside an inner metropolitan area. There are exceptions for patients receiving a service from an:
  • Aboriginal Medical Service, or
  • eligible Aboriginal Community Controlled Health Service
A practice nurse provides clinical support to a patient participating in an eligible video conferencing consultation with a specialist, consultant physician or psychiatrist.

The decision to provide clinical support to the patient must be made in consultation with the specialist, consultant physician or psychiatrist.
10984 Telehealth patient-end clinical support at residential aged care facility At the time of consultation the patient must be a care recipient in a residential aged care service, excluding persons in self - contained units.
The consultation may also occur at consulting rooms located within a residential aged care service.
A practice nurse provides clinical support to a patient participating in an eligible video conferencing consultation with a specialist, consultant physician or psychiatrist.
The decision to provide clinical support to the patient must be made in consultation with the specialist, consultant physician or psychiatrist.
10987 Health assessment follow up This service is available to Aboriginal and Torres Strait Islander People who have received a health assessment, including MBS item 715.
It is also available to children who have received a health check as part of the Northern Territory Emergency Response.
Each calendar year the item can be claimed up to 10 times per patient.
A practice nurse provides the service consistent with the needs identified in the patient's health check.
The service can be provided between further consultation with the patient's GP and may include:
  • checks on clinical progress and service access
  • education on medication compliance and monitoring
  • examinations or interventions as identified by the health check
  • taking a medical history
  • education, monitoring and counselling activities and lifestyle advice
  • prevention advice for chronic conditions, and associated follow up
10997 Chronic disease monitoring and support The service is available to patients with a GP Management Plan, Team Care Arrangements or Multidisciplinary Care Plan in place under MBS items 721, 723, 729, 731 or 732.
Each calendar year the item can be claimed up to 5 times per patient.
A practice nurse provides monitoring and support to an eligible patient consistent with the care plan. It is provided between more structured reviews of the care plan by the patient’s usual GP.
This can include:
  • checks on clinical progress
  • monitoring medication compliance
  • self management advice
  • collection of information to support GP reviews of care plans
16400 Antenatal service This item cannot be claimed together with another antenatal attendance item for the same patient, on the same day, by the same practitioner.

This item can be claimed up to 10 times per patient, per pregnancy.
A practice nurse provides an antenatal service at, or from, an eligible practice location in a regional, rural or remote area.

Billing a GP attendance item and practice nurse item

In some instances, where the GP decides they also need to see the patient, both a practice nurse item and GP attendance item can be claimed. The duration of a GP attendance item does not include the time a patient spends receiving a service from the practice nurse.

Exceptions

Telehealth attendances

If, during a telehealth consultation, the practice nurse requests the attendance of the GP or vice versa, only 1 item is billable – either the GP attendance or practice nurse attendance item. If a telehealth patient - end GP attendance item is claimed, the duration of a GP attendance item does not include the time a patient spends receiving a service from a practice nurse.

Antenatal attendances

If consultation with the medical practitioner has taken place before or following an antenatal service by a practice nurse, the medical practitioner can claim for their own professional service. However, in these circumstances, the practice nurse item cannot be claimed.

More information

Online:

Contact us for Medicare provider enquiries.

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Page last updated: 15 September 2016

This information was printed Friday 9 December 2016 from humanservices.gov.au/health-professionals/enablers/education-guide-practice-nurse-items It may not include all of the relevant information on this topic. Please consider any relevant site notices at humanservices.gov.au/siteinformation when using this material.