MBS item scrutiny profile
MBS Item 2713 — PSR scrutiny profile
Appears in 12 published determinations since 2021, with related issues and repayments shown only where recorded.
Scrutiny profile
Co-occurring issue categories
- Mental health treatment plan10
- Clinical appropriateness9
- Inadequate documentation9
- PBS prescribing6
- Chronic disease management5
- Excessive servicing4
- MBS requirement breach4
- Time based billing4
Specialties involved
- General Practice9
- Unknown2
- Mental Health1
Repayment range
Calculated only across the 12 published cases where a repayment amount is recorded.
Published cases mentioning item 2713
Section 92 Agreement with General Practitioner for Inappropriate Billing and Prescribing
Practitioner acknowledged inappropriate practice; agreed to repay $400,000; reprimanded and counselled by Associate Director; disqualified from providing certain MBS items for 12 months
$400,000
Section 92 agreement with General Practitioner for inappropriate MBS item claims
Practitioner agreed to repay $340,000 to the Commonwealth, be counselled by the Associate Director, and be disqualified from providing MBS items 967, 965, 92029 and 92030 for 3 months.
$340,000
Agreement 1: General Practitioner (High-Prescriber)
Section 92 agreement with repayment
$120,000
Agreement 6: Medical Practitioner (Surgical and Procedural Services)
Section 92 agreement with repayment
$209,000
Agreement 11: General Practitioner (Mental Health Services and Pattern)
Section 92 agreement with repayment
$9,500
Agreement 7: General Practitioner (Mental Health and Diagnostic Services)
Section 92 agreement with repayment
$611,000
Agreement 1: Medical Practitioner (High-Volume Services)
Section 92 agreement with repayment
$200,000
Agreement 4: General Practitioner
Section 92 agreement with repayment
$120,000
Final determination: General Practitioner - Health Assessments
Final determination with repayment and disqualification
$262,500
Final determination: General Practitioner - Brief Consultations
Final determination with repayment
$15,000
Final determination: General Practitioner - Multiple Issues
Final determination with repayment and disqualification
$544,800
Final determination: General Practitioner - Mental Health
Final determination with repayment and disqualification
$140,000
What survives review
Mental health treatment plan
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.
PBS prescribing
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.