MBS optometry item numbers

Professional attendance >15 min, first in a course of attention, where the patient was referred by another optometrist who is not associated with the optometrist to whom the patient is referred.

Professional attendance >15 min, first in a course of attention, if the patient has attended another optometrist for a service to which item 10905, 10910, 10911, 10913, 10914 or 10915 applies — within 36 months (age <65) or 12 months (age ≥65).

Professional attendance >15 min, first in a course of attention, for a patient under 65 years of age who has not received a service to which item 10905, 10907, 10913, 10914 or 10915 applies within the previous 36 months.

Professional attendance >15 min, first in a course of attention, for a patient aged 65 or older who has not received a service to which item 10905, 10907, 10910, 10913, 10914 or 10915 applies within the previous 12 months.

Professional attendance >15 min, first in a new course of attention, if the patient has suffered a significant change of visual function or has new signs or symptoms, unrelated to the earlier course of attention, requiring comprehensive reassessment.

Professional attendance >15 min, first in a course of attention, for a patient with a progressive disorder (excluding presbyopia) requiring comprehensive reassessment within the applicable period.

Professional attendance >15 min, first in a course of attention, involving examination of the eyes with instillation of a mydriatic, for a patient with diabetes mellitus requiring comprehensive reassessment.

Professional attendance, being the first in a course of attention, of not more than 15 minutes duration. Not applicable when co-claimed with items 10938, 10939, 10940, 10941, 10942 or 10943.

Professional attendance, being the second or subsequent in a course of attention, unrelated to the prescription and fitting of contact lenses. Not applicable when associated with computerised perimetry items 10940 or 10941.

All professional attendances after the first, regarded as a single service, in a course of attention involving prescription and fitting of contact lenses — for patients with myopia ≥5.0D, hyperopia ≥5.0D, astigmatism ≥3.0D, or anisometropia ≥3.0D in at least one eye.

All professional attendances after the first, as a single service, in a course of attention involving contact lens prescription and fitting for patients with irregular astigmatism confirmed by keratometry/topography — where BCVA with spectacles is worse than 0.3 logMAR (6/12) and a contact lens would improve it by ≥0.1 logMAR.

All professional attendances after the first, as a single service, in a course of attention involving contact lens fitting for patients with corrected VA of 0.7 logMAR (6/30) or worse in both eyes, for whom a contact lens is prescribed as part of a telescopic system.

All professional attendances after the first, as a single service, in a course of attention involving prescription and fitting of a wholly or segmentally opaque contact lens for alleviation of dazzle, distortion or diplopia caused by pathological mydriasis, aniridia, coloboma of the iris, pupillary malformation, significant ocular deformity, or corneal opacity.

All professional attendances after the first, as a single service, in a course of attention involving contact lens fitting for patients who, because of physical deformity, are unable to wear spectacles.

All professional attendances after the first, as a single service, in a course of attention involving contact lens fitting for patients with a medical or optical condition (other than myopia, hyperopia, astigmatism, anisometropia, or conditions covered by 10926–10928) requiring contact lens use — with condition specified on account. Not claimable for appearance, sporting, work or psychological reasons.

All professional attendances as a single service in a course of attention involving CL fitting where the patient already meets criteria for an item in range 10921–10929 and requires a change in contact lens material or basic lens parameters (not a simple power change) due to a structural or functional change in the eye or an allergic response — within 36 months of the original fitting.

Full quantitative computerised perimetry (automated absolute static threshold), bilateral assessment and report — for glaucoma patients with a high risk of clinically significant progression who have already received two perimetry services (10940 or 10941) in the previous 12 months.

Full quantitative computerised perimetry (automated absolute static threshold), unilateral assessment and report — for glaucoma patients with a high risk of clinically significant progression who have already received two perimetry services (10940 or 10941) in the previous 12 months.

Full quantitative computerised perimetry (automated absolute static threshold), bilateral assessment and report — indicated by relevant ocular disease or suspected pathology of the visual pathways or brain. Not multifocal multichannel. Performed by optometrist. Patient has fewer than 2 perimetry services (10940/10941) in the current 12-month period.

Full quantitative computerised perimetry (automated absolute static threshold), unilateral assessment and report — indicated by relevant ocular disease or suspected pathology of the visual pathways or brain. Not multifocal multichannel. Performed by optometrist. Patient has fewer than 2 perimetry services (10940/10941) in the current 12-month period.

Testing of residual vision to provide optimum visual performance for a patient who has best corrected VA of 6/15 or N12 or worse at 40cm in the better eye, or a horizontal visual field of less than 110 degrees. May include spectacle correction, contrast sensitivity, glare sensitivity, or magnification aid prescription.

Additional testing to confirm diagnosis of, or establish a treatment regime for, a significant binocular or accommodative dysfunction in a patient aged 3–14 years. Includes assessment of accommodation, ocular motility, vergences, fusional reserves, or cycloplegic refraction. Not for assessment of learning difficulties.

Complete removal of an embedded foreign body (including rust ring, if present) from the cornea — not more than once on the same day by the same optometrist, excluding aftercare. Claimable when fully removed, or when patient is referred to an ophthalmologist after partial removal at second attendance.

Flag fall item applicable once per visit to a domiciliary location (home visit, residential aged care facility, or institution) and billable only for the first patient seen at that location on that occasion, regardless of number of patients seen.

Professional attendance of less than 15 minutes by an optometrist providing clinical support to a patient participating in a videoconference consultation with an ophthalmologist — where the patient is in a telehealth-eligible area (≥15km by road from the specialist) or is a patient of an ACCHO.

Professional attendance of at least 15 minutes (whether or not continuous) by an optometrist providing clinical support to a patient participating in a videoconference consultation with an ophthalmologist — where the patient is in a telehealth-eligible area (≥15km from the specialist) or is an ACCHO patient.