Medicare Item Numbers for ADHD and Lung Cancer Screening – Common Questions Answered
Q: Is there a specific Medicare item number for ADHD consults in general practice?
A:
No, there isn’t a dedicated MBS item number just for ADHD consultations. General practitioners can manage ADHD under existing consultation and care plan item numbers, depending on the nature of the visit.
For routine follow-ups, medication reviews, or symptom management, use standard GP attendance items (3, 23, 36, 44, or 123) based on the time and complexity of the appointment.
If the patient’s ADHD is managed as a mental health condition, you can prepare a GP Mental Health Treatment Plan (GPMHTP):
- 2700 / 2701 – for GPs without mental health skills training (20–39 min / ≥40 min)
- 2715 / 2717 – for GPs with mental health skills training (20–39 min / ≥40 min)
These plans allow referral for psychology sessions under the Better Access program.
Note: As of 1 November 2025, review and follow-up mental health consultation items (items 2712 and 2713) will be removed. Reviews after that date should use the relevant standard attendance item.
Q: Can ADHD care be billed under a neurodevelopmental disorder plan?
A:
Only in limited cases.
Medicare items 139 (face-to-face) and 92142 (telehealth) apply when a GP prepares a treatment and management plan for a patient under 25 years old who has been diagnosed with a recognised complex neurodevelopmental disorder or eligible disability.
These items cover conditions such as autism spectrum disorder, Fragile X syndrome, cerebral palsy, Rett syndrome, or intellectual disability.
ADHD on its own does not qualify unless it coexists with one of these eligible conditions and causes significant functional impairment. For most ADHD patients, GPs should use standard attendance, mental health, or chronic condition management items instead.
(Reference: MBS Note AR.29.1)
Q: Are there new care plan item numbers replacing the old chronic disease management (CDM) items?
A:
Yes. From 1 July 2025, new GP Chronic Condition Management Plan items replace the older 721/723 CDM structure:
- 965 – for preparing a GP Chronic Condition Management Plan
- 967 – for reviewing that plan
(Video equivalents: 92029 / 92030)
If ADHD or associated comorbidities require structured, ongoing care and coordination, these may be applicable.
Q: What about lung cancer screening – is there a GP item number for that?
A:
There’s no dedicated GP consultation item for lung cancer screening eligibility checks or referrals. GPs use standard attendance items (3, 23, 36, 44, or 123) for these visits.
However, the screening itself is billed under specific radiology items as part of the National Lung Cancer Screening Program (NLCSP):
- 57410 – for the initial low-dose CT scan (every 2 years for eligible 50- to 70-year-olds)
- 57413 – for an interval low-dose CT scan when follow-up is required
These imaging services must be bulk-billed and performed according to program criteria.
Q: What’s the GP’s role in the Lung Cancer Screening Program?
A:
GPs identify eligible patients, assess their smoking and exposure history, discuss risks and benefits, and refer to an approved screening site for a low-dose CT.
The radiology provider claims the scan item (57410 or 57413).
The GP uses a standard consult item for the initial discussion, enrolment, or results review.
Q: What’s changing in 2025–2026 regarding ADHD and other conditions?
A:
The Parliamentary Budget Office has proposed new MBS items for ADHD and autism assessments across different provider types, expected from 1 July 2026.
Until then, GPs continue using existing attendance, mental health, or chronic condition items as outlined above.
Key takeaway
- ADHD: no single dedicated MBS item; use standard, mental health, or chronic condition items as appropriate.
- Lung cancer screening: GP uses a standard consultation for referral; imaging is billed as 57410 or 57413 by the diagnostic imaging clinic.
- Always confirm eligibility and program rules through mbsonline.gov.au or servicesaustralia.gov.au
If you work in general practice — as a GP, practice manager, nurse, receptionist or owner — you can tap into a complimentary Q&A service designed just for your team. This service offers you to submit any questions about general practice management, Medicare billing, or practice workflow. Your question is answered by experts and then published anonymously (so your team can benefit too). The turnaround time is typically 2-3 business days. General Practice Training
It’s a handy resource for keeping up to date with rules, clarifying tricky items and improving your practice’s efficiency.
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