MBS item scrutiny profile
MBS Item 133 — 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 documentation5
- Clinical appropriateness4
- MBS requirement breach4
- Excessive servicing3
- Time based billing2
- Duplicate billing1
- Procedural consent1
- Referral / request requirement1
Specialties involved
- Cardiology3
- Neurology1
- Other1
Repayment range
Calculated only across the 5 published cases where a repayment amount is recorded.
Published cases mentioning item 133
Agreement 12: Endocrinologist
Section 92 agreement with repayment
$225,000
Agreement 1: Cardiologist
Section 92 agreement with repayment
$250,000
Agreement 10: Cardiologist (Specialist Services)
Section 92 agreement with repayment
$50,000
Agreement 8: Neurologist
Section 92 agreement with repayment
$42,000
Agreement 3: Cardiologist
Section 92 agreement with repayment
$330,000
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.
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.
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.
Excessive servicing
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.