Further details on Medicare changes to be implemented from 1 March 2025

As part of the Federal Budget 2024-25, the Commonwealth Government announced it would implement the majority of the recommendations made by the MBS Review Taskforce relating to optometry items. The Government has now confirmed changes to be implemented from 1 March 2025, as below. Optometry Australia will share greater detail as it becomes available. 

Recommendations reflect changes Optometry Australia actively advocated for, though not all changes sought will be implemented.  

‘It’s pleasing to see that the association’s advocacy has been impactful. These are positive changes, particularly the introduction of a third annual visual field item, the removal of the same practice requirement for billing 10912 and 10913, and removal of co-claiming restrictions on domiciliary visits. Further changes to better align optometry MBS fees with the cost of providing care are sorely needed and remain a focus of our ongoing advocacy,’ said Optometry Australia CEO, Skye Cappuccio.  

Changes confirmed to come into effect from 1 March 2025 are: 

• Comprehensive consultations: Combine items 10912 and 10913 and remove the same practice restriction.  
• Visual fields: Introduce a third computerised perimetry test in a 12-month period where indicated by the presence of glaucoma with a high risk of clinically significant progression. Reword the explanatory notes to emphasise the need for providers to clearly document the rationale underlying the need for the practitioner to perform a computerised perimetry test. 
• Domiciliary visits: Items 10931 to 10933 will be replaced with a single item covering all domiciliary visits. The co-claiming restrictions on domiciliary visits will be removed, enabling the billing of a short consultation (10916 and 10918) and computerised perimetry (10940 and 10941) at domiciliary visits. 
• Contact lenses: Combine items 10921, 10922, 10923 and 10925 into one item number and reword the explanatory notes to remove the requirement to deliver the lens. 
• Foreign body removal: Amend the descriptor for item 10944 to clarify the requirement for complete removal of the rust ring with a ferrous embedded foreign body, and to provide more clarity around when this item can be claimed.  
• Residual vision: Amend Item 10942 to reflect current best practice for testing of residual vision.  

Optometry Australia continues to advocate for an increase to the domiciliary item fee to better reflect the true cost of travelling and providing care outside of practice. Optometry Australia is also working with relevant experts to consider MBS changes necessary to support effective myopia management.   

Do you have a Medicare question? Attend our upcoming webcast 

For a broader discussion on upcoming MBS changes and Medicare billing, please join our ‘MBS review and your Medicare billing questions answered’ webcast on Tuesday, 11 June 2024, presented by Optometry Australia’s Chief Clinical Officer, Luke Arundel. Luke will also answer many of the frequently asked questions received by our Optometry Advisor Help Desk and explore Medicare’s new guidance for use of item 10905.

Register for the webcast here.

If you have a question that you would like answered at this session, please email cpd@optometry.org.au.