Changes to COVID-19 vaccine items from 1 February 2023
In 2023 COVID-19 vaccines will remain free for everyone in Australia with the ongoing requirement for the services to be bulk billed/free of co-payment.
From 1 February 2023, COVID-19 vaccine suitability assessment and associated MBS item number structures have been streamlined as per the summary chart below.
Changes include:
- the combination of vaccine suitability services for all approved COVID-19 vaccine doses into the corresponding item number that had been for second and subsequent COVID-19 doses (93644 and equivalents),
- an increase in the benefits to incorporate the former booster incentive payment into the vaccine suitability assessment item,
- an increase to the flag-fall payment for vaccine suitability assessment services paid once for each visit to a residential aged care facility, residential disability facility, or a patient’s home and
- an adjustment to the descriptors for the in-depth vaccine suitability assessment services in line with the removal of first dose vaccine suitability assessment services.
For more information on these changes, review the .
Changes to Medicare Benefit Schedule from 1 February 2023
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Previous Primary Care Payment
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Payment from 1 February 2023
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Dose 1
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Dose 2 (and subsequent)
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Booster incentive
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GP COVID-19 PIP^
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MBS - business hours - suitability assessment items
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GP
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MMM1
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$31.55
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$24.85
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$10.20 (booster incentive payment in addition to Dose 2 payment through MBS)
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$10 for each patient who has received 1st and 2nd doses at the same practice
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$35.10
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MMM2-7
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$38.25
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$28.25
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$38.50
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OMP
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MMM1
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$24.60
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$17.95
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$28.20
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MMM2-7
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$34.65
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$24.60
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$34.80
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MBS– after hours – suitability assessment items
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GP
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MMM1
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$43.95
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$37.35
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$47.60
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MMM2-7
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$50.75
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$40.70
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$50.95
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OMP
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MMM1
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$34.85
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$28.15
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$38.40
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MMM2-7
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$44.60
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$34.55
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$44.80
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MBS - Remote supervision items
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GP/OMP
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MMM1
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$21.35
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$21.35
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MMM2-7
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$24.40
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$24.40
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Flagfall *
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GP/OMP
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MMM1-7
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$58.15 (until 31 January 2023) $118.15 (from 1 February 2023)
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Flagfall
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Community Pharmacy
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MMM1-7
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$58.15 (until 31 January 2023) $118.15 (from 1 February 2023)
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MBS – in-depth vaccine assessment item **
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GP
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MMM1-7
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$39.70
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OMP
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MMM1-7
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$31.80
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^2nd administration (where both doses were provided by the same pharmacy, otherwise the benefit remained as per first dose benefit)
* can be claimed once per attendance where a vaccine assessment service has been conducted in a person’s place of residence
** can be claimed once per patient
Simplified descriptors - GPs in Modified Monash Area 1 - Click item number for full descriptor
– suitability assessment service during business hours
– suitability assessment service after-hours
– suitability assessment service on behalf of a GP/OMP by a suitably qualified health professional on their behalf
– in-depth patient assessment, co-claimed with 93644 or 93653
– flag fall for services in a residential aged care facility, residential disability facility or patient’s home, co-claimed with 93644 or 93653
Simplified descriptors - GPs in Modified Monash Areas 2 to 7 - Click item number for full descriptor
– suitability assessment service during business hours
– suitability assessment service after-hours
– suitability assessment service on behalf of a GP/OMP by a suitably qualified health professional on their behalf
– in-depth patient assessment, co-claimed with 93645 or 93654
– flag fall for services in a residential aged care facility, residential disability facility or patient’s home, co-claimed with 93645 or 93654
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