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MBS item scrutiny profile

MBS Item 66900 — PSR scrutiny profile

Appears in 1 published determination since 2022. No percentages are shown on a single-case denominator.

Scrutiny profile

Determinations
1
Date range
2 Aug 2022
Recorded repayment median
$424,965
Specialties involved
1

Co-occurring issue categories

  1. Chronic disease management1
  2. Clinical appropriateness1
  3. Inadequate documentation1
  4. MBS requirement breach1

Specialties involved

  1. General Practice1

Repayment range

Calculated only across the 1 published case where a repayment amount is recorded.

Low
$424,965
Median
$424,965
High
$424,965

Published cases mentioning item 66900

What survives review

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.

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.

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.

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.

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