MBS item scrutiny profile
MBS Item 92127 — PSR scrutiny profile
Appears in 2 published determinations since 2023, with related issues and repayments shown only where recorded.
Scrutiny profile
Co-occurring issue categories
- After-hours billing1
- Chronic disease management1
- Clinical appropriateness1
- Excessive servicing1
- Inadequate documentation1
- Inappropriate billing and documentation1
- MBS requirement breach1
- Mental health treatment plan1
Specialties involved
- General Practice1
- Unknown1
Repayment range
Calculated only across the 2 published cases where a repayment amount is recorded.
Published cases mentioning item 92127
Section 92 agreement with General Practitioner for inappropriate MBS item claims
Practitioner agreed to repay $340,000 to the Commonwealth, be counselled by the Associate Director, and be disqualified from providing MBS items 967, 965, 92029 and 92030 for 3 months.
$340,000
Agreement 7: General Practitioner (Mental Health and Diagnostic Services)
Section 92 agreement with repayment
$611,000
What survives review
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.
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.