Optometry Australia (OA) has welcomed changes to Medicare rebates that come into effect on 1 March 2025, but says there is more to be done.
The changes are being implemented in response to recommendations made by the MBS Review Taskforce relating to optometry items, announced as part of the Federal Budget 2024-25.
In a special announcement,1 Skye Cappuccio, OA’s Chief Executive Officer, said while many of the changes align with the Association’s advocacy efforts, “not all the changes we sought have been implemented”.
“Whilst there has been an increase to the domiciliary item fee, this increase is insufficient and we will continue to advocate for a fee that better reflects the true cost of travelling and providing care outside of practice,” she said.
Changes From 1 March 2025
• Comprehensive consultations: Items 10912 and 10913 will combine into one item number, 10913, and the previous ‘same practice’ restrictions will be removed.
• Visual fields: A third computerised perimetry test in a 12-month period, where indicated by the presence of glaucoma with a high risk of clinically significant progression, will be introduced. Explanatory notes will be reworded to emphasise the need for providers to clearly document the rationale underlying the need for the practitioner to perform a computerised perimetry test. The two new items that will be introduced are:
o 10938 (bilateral) – $72.55 scheduled fee.
o 10939 (monocular) – $43.80 scheduled fee.
• Domiciliary visits: Items 10931 to 10933 will be replaced with a single item number, 10931, which covers all domiciliary visits. The scheduled fee is $43.75. The co-claiming restrictions on domiciliary visits will be removed, enabling the billing of a short consultation (10916 or 10918) and computerised perimetry (10940 or 10941) at domiciliary visits.
• Contact lenses: Items 10921, 10922, 10923 and 10925 will combine into one item number, 10921, and the explanatory notes reworded to remove the requirement to deliver the lens.
• Foreign body removal: Item 10944 will be amended to clarify the requirement for complete removal of the rust ring with a ferrous embedded foreign body, and to provide more clarity around when this item can be claimed.
• Residual vision: Item 10942 will be amended to reflect current best practice for testing of residual vision.
New Item Numbers and Descriptors
Reference
Cappuccio, S. Medicare changes to be implemented from 1 March 2025. Available at: optometry.org.au/medicare_private_billing/medicare-changes-to-be-implemented-from-1-march-2025. Accessed February 2025.
