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MBS item scrutiny profile

MBS Item 903 — PSR scrutiny profile

Appears in 2 published determinations since 2025, with related issues and repayments shown only where recorded.

Scrutiny profile

Determinations
2
Date range
11 Sept 2025 - 1 Mar 2026
Recorded repayment median
$295,000
Specialties involved
2

Co-occurring issue categories

  1. Clinical appropriateness1
  2. Excessive billing of MBS items1
  3. Inadequate documentation1
  4. PBS prescribing1
  5. Time based billing1

Specialties involved

  1. General Practice1
  2. Unknown1

Repayment range

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

Low
$190,000
Median
$295,000
High
$400,000

Published cases mentioning item 903

What survives review

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.

Tie the note back to the descriptor

The record should show the facts that made the item available, including patient status, service content, timing and any required review cycle.

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.

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