New MBS rebate structure for non-VR GPs

New MBS rebate structure for non-vocationally recognised general practitioners from 1 July 2018

The Australian Government is introducing new Medicare Benefits Schedule (MBS) item fee arrangements for non-vocationally recognised general practitioners (non-VR GPs). The new arrangements will affect claims for services provided by these doctors from 1 July 2018.

The changes will ensure that MBS fees payable reflect recognised levels of expertise, reward and incentivise investment in postgraduate specialist qualifications, and encourage more doctors to work where they are needed most.

Non-VR GPs already participating on one of the Other Medical Practitioner (OMPs) Programs will be largely unaffected by the changes at this stage due to grandfathering arrangements. The OMPs programs will, however, be closed to new entrants in late 2018.

There are no changes to the MBS fees payable to specialist GPs or to registrars training on the Australian General Practice Training Program, the Remote Vocational Training Scheme or the Australian College of Rural and Remote Medicine Independent Pathway.

Outline of the changes

Information about the new fee arrangements is provided in the attached Q&A Sheet. The main changes are: 

  • A new MBS item group (A7), which will sit alongside the existing A2 and A19 item groups.
  • New rebate differentials of 80% and 60% tied to item access eligibility.

The application of these changes to individual doctors will depend on their practice location, based on the Modified Monash (MM) classification system.

Non-VR GPs practising in regional, rural and remote areas (MM2-7)

Non-VR GPs practising in locations with an MM2-7 classification will have access to all items in the new A7 item group, which are set at a standard 80% of the equivalent GP item. (Note that some of these items, such as Mental Health, require the practitioner to have undertaken specific training).      

Non-VR GPs practising in major cities (MM 1)

Non-VR GPs practising in locations with an MM1 classification will be restricted to the existing A2 items for standard GP services, and A19 items for attendances associated with Practice Incentive Payments. These A2 and A19 items will attract rebates at the current 60% of the VR rate. For all other services they will be able to access the relevant items in the new A7 item group with an 80% rebate.

Non-VR GPs registered on OMPs programs (MM1-7)

Non-VR GPs who are currently registered on one of the Other Medical Practitioner programs (AHOMPs, MOMPs, OMOMPs, ROMPs) will be able to continue to access the MBS items they are currently billing until 30 June 2023. In addition, for services that are not covered under the OMPs arrangements, these doctors will now be able to access the new non-VR items listed under A7.

Further information

Cristy Houghton