Can You Bill Item 23 and Item 10997 Together?
Yes, you can bill Item 23 and Item 10997 together. Item 10997, part of the Medicare Benefits Schedule (MBS), can be co-billed with any other item on the MBS schedule, including Item 23, without restrictions. So far, no official guidelines are preventing the co-billing of these items.
What is Item 23?
- Item 23 is a standard GP consultation item. It covers a GP’s general medical services, such as consultations for health advice, assessments, or treatments for non-complex cases.
What is Item 10997?
- Item 10997 allows for ongoing care for patients with chronic diseases who have a care plan in place. This item can be used to provide necessary follow-up care, particularly by a practice nurse or Aboriginal health worker.
Co-Billing 10997 with Other Items
- You can co-bill Item 10997 with most other MBS items, including:
- Item 23: General GP consultation.
- Item 732: Review of a care plan.
- Item 2713: Mental health consultation.
The flexibility of Item 10997 allows GPs and their teams to manage chronic disease patients more comprehensively, as long as it’s billed appropriately alongside other services.
Caution: When Billing with 721 and 723
- While not prohibited, it is highly discouraged to bill Item 10997 with Items 721 and 723. These items are part of care planning services (721 for creating a care plan and 723 for coordinating team care). The reason behind this caution is the potential overlap of services, which may lead to scrutiny of co-billing practices.
In summary, you can bill Item 10997 with most items in the MBS, including Item 23, without any restrictions. However, to avoid potential issues, it’s essential to be mindful of combining it with care planning items such as 721 and 723.
Source: Services Australia, https://www9.health.gov.au/mbs/fullDisplay.cfm?type=note&qt=NoteID&q=MN.12.4. Last accessed 05/09/24
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