MBS claiming for the National Cervical Screening Program

24 June 2019

There have been a number of enquiries regarding billing for women who present for follow up of a prior Intermediate Risk cervical screening test result. Women who are due to have a 12 month follow-up test are sent communications by the NCSR nine months following the original screen date.

Please note that 12 month follow up HPV tests are supported by the Medicare Benefits Schedule (MBS) by claiming MBS item number 73072.

Unlike item number 73070, which is intended for primary screening of asymptomatic women, MBS Item number 73072 does not have a time restrictor and can therefore be performed at any time after the date of the original cervical screening test and be eligible for an MBS rebate. Clinical experts have advised the NCSP that a minimum of nine months should separate the follow-up test from the initial screening test.

These two items and the relevant descriptors are provided and highlighted below for your reference.

MBS Item 73070

Descriptor:

A test, including partial genotyping, for oncogenic human papillomavirus that may be associated with cervical pre cancer or cancer:

(a) performed on a liquid based cervical specimen; and
(b) for an asymptomatic patient who is at least 24 years and 9 months of age

For any particular patient, once only in a 57 month period

Fee and benefit:

Fee - $35.00

Benefit - 75% = $26.25, 85% = $29.75

MBS Item 73072

Descriptor:

73072 A test, including partial genotyping, for oncogenic human papillomavirus, performed on a liquid based cervical specimen:

(a) for the investigation of a patient in a specific population that appears to have a higher risk of cervical pre cancer or cancer; or

(b) for the follow up management of a patient with a previously detected oncogenic human papillomavirus infection or cervical pre cancer or cancer; or

(c) for the investigation of a patient with symptoms suggestive of cervical cancer; or

(d) for the follow up management of a patient after treatment of high grade squamous intraepithelial lesions or adenocarcinoma in situ of the cervix; or

(e) for the follow up management of a patient with glandular abnormalities; or

(f) for the follow up management of a patient exposed to diethylstilboestrol in utero

Fee and benefit:

Fee - $35.00

Benefit - 75% = $26.25, 85% = $29.75