MBS item scrutiny profile
MBS Item 105 — PSR scrutiny profile
Appears in 5 published determinations since 2021, with related issues and repayments shown only where recorded.
Scrutiny profile
Co-occurring issue categories
- Inadequate documentation4
- Referral / request requirement3
- MBS requirement breach2
- Delegation / supervision1
- Excessive servicing1
- Procedural consent1
- Systemic inappropriate billing and reporting1
Specialties involved
- Radiology3
- Dermatology1
- diagnostic radiology1
Repayment range
Calculated only across the 5 published cases where a repayment amount is recorded.
Published cases mentioning item 105
Section 92 Agreement with Radiologist (diagnostic radiology)
Practitioner acknowledged inappropriate practice; agreed to repay $3,600,000; reprimanded and counselled by Director; disqualified from providing certain MBS items for 12 months
$3,600,000
Agreement 10: Radiologist (Second)
Section 92 agreement with repayment
$150,000
Agreement 9: Radiologist
Section 92 agreement with repayment
$160,000
Agreement 1: Radiologist
Section 92 agreement with repayment
$800,000
Final determination: Dermatologist - HIGHEST REPAYMENT
Final determination with repayment and disqualification
$1,946,352
What survives review
Documentation has to stand alone
The note should show the presenting problem, assessment, clinical reasoning, time or complexity when relevant, and the plan without relying on memory.
Referral / request requirement
Keep the source record clear enough for an external peer to connect the patient need, the service provided, and the item claimed.
MBS requirement breach
Keep the source record clear enough for an external peer to connect the patient need, the service provided, and the item claimed.
Delegation / supervision
Keep the source record clear enough for an external peer to connect the patient need, the service provided, and the item claimed.
Educational disclaimer
This educational module is based on publicly available PSR case-outcome material. It is general educational information only and does not constitute legal advice, billing advice, or a substitute for reviewing the MBS, PSR material, or obtaining professional advice.