MBS item scrutiny profile
MBS Item 10964 — PSR scrutiny profile
Appears in 3 published determinations since 2023, with related issues and repayments shown only where recorded.
Scrutiny profile
Co-occurring issue categories
- Delegation / supervision2
- Clinical appropriateness1
- Inadequate documentation1
- Incorrect item use1
- MBS requirement breach1
Specialties involved
- Chiropractic3
Repayment range
Calculated only across the 3 published cases where a repayment amount is recorded.
Published cases mentioning item 10964
Final determination: Chiropractor
Final determination with repayment and disqualification
$25,000
Final determination: Chiropractor 2 (Corporate Services)
Final determination with repayment and disqualification
$325,000
Final determination: Chiropractor 1 (Corporate Services)
Final determination with repayment and disqualification
$340,000
What survives review
Delegation / supervision
Keep the source record clear enough for an external peer to connect the patient need, the service provided, and the item claimed.
Show the clinical input
For higher-value or repeated services, the record should make the practitioner contribution visible rather than just recording an administrative event.
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.
Tie the note back to the descriptor
The record should show the facts that made the item available, including patient status, service content, timing and any required review cycle.
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.