MBS item scrutiny profile
MBS Item 66716 — PSR scrutiny profile
Appears in 3 published determinations since 2022, with related issues and repayments shown only where recorded.
Scrutiny profile
Co-occurring issue categories
- Inadequate documentation3
- After-hours billing2
- Chronic disease management2
- Clinical appropriateness2
- MBS requirement breach2
- Excessive servicing1
- Mental health treatment plan1
- PBS prescribing1
Specialties involved
- General Practice3
Repayment range
Calculated only across the 3 published cases where a repayment amount is recorded.
Published cases mentioning item 66716
Agreement 7: General Practitioner (Mental Health and Diagnostic Services)
Section 92 agreement with repayment
$611,000
Final determination: PSRC 1396 - General Practitioner
Final determination with repayment and disqualification
$424,965
Final determination: General Practitioner - Multiple Services
Final determination with repayment
$262,895
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.
After-hours billing
Keep the source record clear enough for an external peer to connect the patient need, the service provided, and the item claimed.
Chronic disease management
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.
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.