Funding Best Practise Orthopaedics Surgery Services

The Australian Government is making changes to Medicare-funded orthopaedic surgery services to support high-value care, reflect current medical practice and improve quality of care and safety for patients. These changes follow recommendations from the Medicare Benefits Schedule (MBS) Review Taskforce.

Page last updated: 08 October 2020

Funding Best Practise Orthopaedics Surgery Services (PDF 151 KB)
Funding Best Practise Orthopaedics Surgery Services (Word 78 KB)

What are the changes?

From 1 July 2021, changes to the orthopaedic surgery MBS items will include amended item descriptors to improve clarity about appropriate usage; creating new, more logical and streamlined groups of items for orthopaedic sub-specialties (to replace existing items) and MBS fees reflecting the level of service involved in line with contemporary clinical practice.

Why are these changes being made?

The changes are the outcome of the Government agreeing to the recommendations from the MBS Review Taskforce following discussion with key stakeholders as part of a clinician-led review of the orthopaedic MBS items. These discussions identified the key priorities needed to modernise the orthopaedic surgery section of the MBS.

The Taskforce reviewed 599 orthopaedic surgery services across six specialty areas, recommending changes to 440 items, and the creation of 120 new items. The changes will support more streamlined groups of items for orthopaedic subspecialties, and remove ambiguity in the interpretation of MBS items to support appropriate claiming.

What does this mean for patients?

Patients will benefit from more standardised billing consistency for a range of different types of orthopaedic surgery services.

Patients will receive more comparable MBS benefits for similar services and will benefit from services that align with contemporary best practice.

What does this mean for providers?

Providers will benefit as Medicare funding will align with contemporary clinical practice for each orthopaedic subspecialty and improve quality of care for patients. The changes will provide greater clarity about claiming appropriate items and increase billing transparency.

Providers affected by these changes will receive further information closer to the implementation date.

Further detail will be available on the MBS Online website.