You can usually bill an MBS attendance item when you administer an immunisation to your patient. You can do this if the administration is not funded under a mass immunisation.
If you address an unrelated medical issue on the same occasion as administering a funded immunisation, you can bill an MBS attendance item for the time spent managing the unrelated medical condition.
As MBS items only cover medical services, you can’t bill Medicare for the vaccine itself.
For more information on this topic, refer to note GN.12.32 in the MBS.
What is a mass immunisation?
A mass immunisation is a program that immunises a number of people and is funded by:
- Commonwealth or State Government, or
- an international or private organisation
Billing scenarios
Scenario 1
You see a patient to administer an influenza vaccination. Your patient isn’t covered for the influenza vaccine under the National Immunisation Program (NIP).
After taking a short patient history, you administer the vaccine to the patient.
You can bill the appropriate MBS attendance item for the administration of the vaccine.
You can charge your patient a separate amount for the cost of the vaccine.
Scenario 2
You see a patient to administer an influenza vaccination. Your patient is covered for the influenza vaccine under the NIP. The NIP covers the provision of the vaccine, but not the administration of it.
After taking a short patient history, you administer the vaccine to the patient. You can bill the appropriate attendance item for the medical service provided. You can’t charge the patient a separate amount for the cost of the vaccine. The NIP covers it.
Scenario 3
You’re employed by a State or Territory community health centre to administer vaccines and provide no additional medical services.
You can’t bill a Medicare item. You’re administering a vaccine under an arrangement with the State or Territory. The service is not eligible for Medicare benefits as it’s a mass immunisation.