New MBS item for diabetes diagnosis and the PIP Diabetes Incentive

18 Dec 2014

GPs claiming the PIP Diabetes Incentive will be interested in recent Department of Human Services advice that the new Medicare Benefits Schedule (MBS) item 66841 introduced on 1 November, which enables GPs to diagnose diabetes in high-risk patients according to elevated HbA1c only, will not be used to calculate the number of diabetic patients for the purposes of the Practice Incentives Program (PIP). 
  
The PIP will continue to calculate the number of people with diabetes based on the use of the existing MBS items (66551 and 66554), which are available for the measurement of HbA1c for patients with established diabetes. 
  
The MBS introduced the additional item to provide an alternative testing method for the diagnosis of diabetes. It is restricted to once per patient per year, with an HbA1c of ≥6.5% (48mmol/mol) required for a diagnosis.

The Department states that, although the new MBS item is not designed for HbA1c measurement in patients with established diabetes, it recognises that the existence of the new item may impact on the frequency and timing by which practitioners utilise the existing items. As such, the Department will monitor changes in usage of the new item (66841), as well as the existing items (66551 and 66554), over the next several months. If necessary, changes to the PIP Diabetes Incentive will be considered by the Department after this time. 
    
For information practices can contact the Department of Human Services via email (pip@humanservices.gov.au) or phone 1800 222 032.