MBS item scrutiny profile
MBS Item 715 — 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
- Chronic disease management1
- Clinical appropriateness1
- Excessive servicing1
- MBS requirement breach1
- Mental health treatment plan1
- PBS prescribing1
Specialties involved
- Unknown2
- General Practice1
Repayment range
Calculated only across the 3 published cases where a repayment amount is recorded.
Published cases mentioning item 715
Section 92 Agreement with General Practitioner for Excessive and Inappropriate MBS Item Use
Practitioner agreed to repay $240,000 to the Commonwealth; disqualified from providing MBS items 699, 705, 965, 967, 92029, 92030 for 12 months; disqualified from providing MBS item 30192 for 6 months
$240,000
Section 92 agreement with General Practitioner over templated records and mental health plan claims
Practitioner acknowledged inappropriate practice; agreed to repay $700,000; reprimanded and counselled by Associate Director; disqualified from providing certain MBS items for 6 to 12 months
$700,000
Agreement 1: Medical Practitioner (High-Volume Services)
Section 92 agreement with repayment
$200,000
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.
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.
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.