GP banned from claiming item 23 for 3 years

Medicare watchdog makes rare move of prohibiting doctor from billing Level B attendances
Medicare

A GP with “deficient” records has been banned from billing Level B attendances through Medicare and ordered to repay $650,000, after the watchdog found they couldn’t prove they had been meeting the appropriate requirements.

The Professional Services Review (PSR) has made the rare move of prohibiting the GP for three years from claiming Medicare item 23 — the standard GP consult — in a ruling published this week.

The GP did not keep satisfactory records or provide “adequate clinical input” according to the ruling, which was revealed on Wednesday in the PSR’s December update.

“Many of the general practitioner’s records were so deficient that it was difficult for the Committee to discern what had transpired in consultations and whether the relevant regulatory requirements had been met,” the PSR said.