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MBS item scrutiny profile

MBS Item 82215 — PSR scrutiny profile

Appears in 2 published determinations since 2022, with related issues and repayments shown only where recorded.

Scrutiny profile

Determinations
2
Date range
2 Aug 2022 - 27 Sept 2024
Recorded repayment median
$238,414
Specialties involved
1

Co-occurring issue categories

  1. Inadequate documentation2
  2. MBS requirement breach2
  3. Time based billing2
  4. Clinical appropriateness1

Specialties involved

  1. Nurse Practitioner2

Repayment range

Calculated only across the 2 published cases where a repayment amount is recorded.

Low
$45,000
Median
$238,414
High
$431,827

Published cases mentioning item 82215

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.

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.

Time based billing

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.

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