Key Takeaways
- Three MBS changes took effect on 1 March 2026, each requiring GP practices to review billing workflows and clinical documentation.
- New Patient-End Support (PES) items allow GPs, prescribed medical practitioners (PMPs), and participating nurse practitioners (NPs) to bill a face-to-face attendance for supporting a patient through a specialist video consultation.
- PES items are time-based, using the same time descriptors as standard attendance items. The specialist must also claim an eligible MBS video consultation item for the PES item to be claimable. The GP need not be present for the full consultation, only for as long as is clinically relevant.
- ECG item 11714 was restored to GP access from 1 March 2026, after being restricted since September 2020. The schedule fee is $28.25, with a Medicare benefit of $24.05 (85% of the schedule fee).
- Item 11714 requires a contemporaneous clinical note generated by the GP. Automated analysis produced by ECG machine software does not satisfy the item descriptor.
- Aboriginal and Torres Strait Islander health assessment items (715, 218, 92004, 92011, and associated telehealth equivalents) were updated to remove age-based clinical activity requirements. Assessments are now clinician-guided and holistic across all ages.
- The 9-month frequency rule for Aboriginal and Torres Strait Islander health assessments is unchanged.
Three MBS changes took effect on 1 March 2026. Individually, none of them rewrites billing practice from scratch. Together, they affect routine GP workflows across telehealth support, in-practice ECG, and Aboriginal and Torres Strait Islander health assessments.
By April 2026, these changes have been live for almost two months. Practices that have not reviewed their billing systems since February may already be missing PES revenue they are entitled to claim, under-documenting ECG claims in a way that creates audit exposure, or continuing to apply age-stratified clinical activity checklists to health assessments that no longer require them.
This guide covers each change in operational detail: what the item covers, who can claim, what the documentation requirement means, and where the audit risk sits. Practices managing these obligations alongside accreditation and other compliance deadlines will find the ClinicComply compliance calendar useful for keeping active MBS obligations visible in one place.
Patient-End Support Items: Billing for the GP's Role in Specialist Video Consults
A Patient-End Support (PES) service is a face-to-face attendance by a GP, PMP, or participating NP with a patient at the same time the patient has a video consultation with a specialist or consultant physician. The attending GP supports the patient through the video consult: helping them communicate their history and symptoms, facilitating clinical hand-over, and enabling a more thorough and productive specialist engagement than the patient could manage remotely and alone.
PES items for optometry and ophthalmology video consults already existed in the MBS. From 1 March 2026, the model extends to GP and NP attendances at the patient end of specialist video consultations more broadly.
What Qualifies as a PES Service
For a PES item to be claimable, all of the following must apply:
- A Medicare-eligible specialist or consultant physician must claim an eligible MBS video consultation item for the same service.
- The GP (or PMP or NP) must be present with the patient face-to-face for at least part of that consultation.
- The entire service must be rendered in Australia.
- The GP's attendance must be clinically necessary for the delivery of the specialist service.
The GP does not need to be present for the entire video consultation. Attendance is required only for as long as is clinically relevant, which can be established in advance with the specialist. Time spent with the patient does not need to be continuous. The MBS fee payable is based on the total duration of the GP's attendance with the patient, not the full length of the specialist consultation.
Practice nurses, Aboriginal and Torres Strait Islander health workers, and ATSI health practitioners can also provide PES services on behalf of a supervising GP or PMP. When they do, the supervising GP or PMP claims the item.
Why This Matters for GP Practices
Before these items existed, a GP who attended with a patient for their specialist video consult was providing clinical value with no mechanism to bill for it. These items close that gap.
For practices coordinating care for patients with complex needs, including patients who benefit from clinical support to engage effectively with remote specialist consultations, PES items make that coordination reimbursable. The practical effect is most visible for patients who are elderly, have communication difficulties, or are managing multiple comorbidities that require contextualisation during the specialist encounter.
For the broader telehealth billing framework within which these items sit, including MyMedicare requirements and the items most frequently reviewed in Medicare compliance audits, see our guide to telehealth Medicare billing compliance.
ECG Item 11714: Restored, With a Documentation Condition Your Practice Must Understand
The Background
In September 2020, MBS Review changes removed GPs' access to item 11714 for 12-lead ECG with clinical interpretation. GPs were left with item 11707, which covers ECG tracing without the clinical interpretation component and carries a lower schedule fee. The restriction drew sustained criticism from the RACGP and the AMA, who argued it was clinically illogical to separate the trace from the interpretation and failed to recognise the skilled clinical judgement GPs apply when assessing an ECG in the context of a patient's presentation.
Following a review by the MBS Review Advisory Committee and sustained advocacy by the AMA, the government reversed the restriction. From 1 March 2026, GPs and PMPs can again claim item 11714 for 12-lead electrocardiography that produces both a trace and a documented clinical interpretation.
What Item 11714 Covers and What It Pays
Item 11714 covers 12-lead ECG services that produce a trace and a contemporaneous clinical note from the attending clinician. The schedule fee is $28.25. At 85% of the schedule fee, the Medicare benefit is $24.05.
Nurses, allied health practitioners, and other support staff can assist with the mechanical process of obtaining the trace. The clinical requirement is what the GP does after the trace is produced: reviewing the trace, applying clinical judgement about the patient's history and presentation, and recording a clinical note that demonstrates that a human clinician has interpreted the result.
The Documentation Requirement
This is the part of the change where audit exposure arises if practices have not updated their workflows.
Automated analysis generated by ECG machine software does not satisfy the item descriptor for item 11714. Many modern ECG devices produce a machine-generated interpretation on the printout itself. That printout, even if clinically accurate, does not constitute the required clinical note.
The GP must record a contemporaneous clinical note that reflects their own interpretation and clinical decision-making. In practical terms, this means a note in the patient record that documents the GP's assessment of the trace in the context of the clinical presentation, not simply a notation that an ECG was performed or that the machine printout was filed.
The clinical note does not need to be lengthy. It must be dated contemporaneously with the service and must reflect the GP's own clinical thinking. For practices that previously attached the machine printout and moved on under item 11707, the shift to item 11714 requires a documentation habit change before the pattern becomes entrenched.
Practices managing Medicare audit risk across billing items will find it useful to review their ECG documentation templates now. Our guide to Medicare compliance and the 80/20 rule covers how the Department of Health uses billing pattern analysis to flag practices for review.
Aboriginal and Torres Strait Islander Health Assessments: What Removing Age Restrictions Means
The Change
From 1 March 2026, the Aboriginal and Torres Strait Islander health assessment items (715, 218, 92004, 92011, and their associated telehealth equivalents) were updated to remove age-based clinical activity requirements.
Previously, the assessment framework included specific clinical activities tied to age groups: certain screenings and checks were listed as requirements for children, adults in defined age bands, and older persons. The update removes these age-stratified activity lists and replaces them with a clinician-guided, holistic approach.
The Department of Health's stated intent is to support delivery of care tailored to each patient's individual health needs and clinical circumstances throughout their life, rather than prescribing activities by age bracket.
What This Means in Practice
GPs conducting Aboriginal and Torres Strait Islander health assessments from 1 March 2026 are not required to complete a fixed checklist of age-linked clinical activities. The assessment should be clinician-guided: what is clinically relevant for this patient, at this point in their life, given their individual circumstances.
This brings the health assessment structure closer to the way a thorough holistic clinical consultation actually works and reduces the risk of assessments becoming checkbox exercises to satisfy age-based criteria rather than genuinely addressing the patient's health.
What does not change: the eligibility criterion (the patient must identify as being of Aboriginal and/or Torres Strait Islander descent and would benefit from the assessment), the frequency restriction (no more than once in a 9-month period per eligible patient), and the requirement that the assessment be comprehensive and documented appropriately.
Practices should update their health assessment templates and clinical workflows to reflect the holistic approach rather than continuing to use age-stratified checklists that no longer correspond to the item descriptors. For practices with MyMedicare obligations that intersect with health assessment billing, including enrolled patient status requirements for certain GP items, see our MyMedicare compliance guide.
How ClinicComply Helps
Keeping billing compliance current as MBS items change requires more than reading the MBS Online newsletter. It requires updating practice policies, workflow documents, and clinical templates so that what happens at the point of care matches what the item descriptor requires.
ClinicComply's policy library lets you store updated billing guidance, ECG documentation checklists, and health assessment templates against the specific MBS obligations they address. When an item changes, you update the relevant policy, assign a review task to the responsible team member, and track completion through the dashboard. Automated reminders flag upcoming compliance review dates so that March 2026 changes are not still unaddressed in August.
The compliance calendar view keeps all active obligations visible in one place, including MBS billing changes, RACGP accreditation deadlines, and regulatory requirements across the frameworks your practice operates under. The template recommender can point you to policy templates relevant to your practice type and compliance situation.
See how ClinicComply supports GP billing compliance at cliniccomply.com.au/features, or start a free 30-day trial at cliniccomply.com.au/signup.
Frequently Asked Questions
What is a Patient-End Support item under the MBS?
A Patient-End Support (PES) item is an MBS billing item for a GP, prescribed medical practitioner, or nurse practitioner who attends with a patient face-to-face while the patient has a video consultation with a specialist or consultant physician. The attending practitioner bills the PES item; the specialist bills their own eligible MBS video consultation item. From 1 March 2026, PES items are available for GP and NP attendances at the patient end of specialist video consults, extending a model that previously existed for optometry and ophthalmology video consultations.
Who can claim Patient-End Support items from 1 March 2026?
GPs, prescribed medical practitioners, and participating nurse practitioners can claim PES items directly. Practice nurses, Aboriginal and Torres Strait Islander health workers, and ATSI health practitioners can also provide PES services on behalf of a supervising GP or PMP, in which case the supervising practitioner claims the item. The specialist conducting the video consultation claims their own separate MBS item for the same service.
Does the GP need to stay for the full video consultation to claim a PES item?
No. The GP must attend for as long as their presence is clinically relevant, which can be established in consultation with the specialist before the appointment. The time spent with the patient does not need to be continuous. The MBS fee is determined by the total duration of the GP's attendance with the patient, not the total length of the specialist consultation.
Who can bill MBS item 11714 from 1 March 2026?
GPs and prescribed medical practitioners can claim item 11714 from 1 March 2026. The item was restricted from GP access in September 2020 following MBS Review changes, leaving GPs with only item 11707 (ECG trace without clinical interpretation). The restoration followed a review by the MBS Review Advisory Committee and advocacy by the AMA and RACGP.
Does automated ECG machine analysis satisfy the clinical interpretation requirement for item 11714?
No. The contemporaneous clinical note required for item 11714 must be generated by the clinician and must reflect human interpretation and clinical decision-making. The automated analysis printout produced by an ECG machine does not satisfy the item descriptor, even if that analysis is clinically accurate. The GP must review the trace, apply their own clinical judgement in the context of the patient's presentation and history, and document that assessment in the patient record.
What documentation is required when claiming item 11714?
The GP must record a contemporaneous clinical note demonstrating their interpretation of the ECG trace. The note should reflect the GP's clinical assessment in the context of the patient's history and presentation, not simply record that an ECG was performed. The note must be dated at the time of the service. A machine-generated ECG printout filed in the patient record, without a separate clinician-authored note, does not satisfy the documentation requirement.
What changed for Aboriginal and Torres Strait Islander health assessments from 1 March 2026?
The age-based clinical activity requirements were removed from the item descriptors for items 715, 218, 92004, 92011, and their associated telehealth equivalents. Previously, assessments included age-stratified lists of required clinical activities for different life stages. From 1 March 2026, assessments are clinician-guided and holistic, tailored to the individual patient's health needs and clinical circumstances rather than a prescribed age-linked activity checklist.
Can Aboriginal and Torres Strait Islander health assessments now be claimed for any age?
Yes. Any patient who identifies as being of Aboriginal and/or Torres Strait Islander descent and would benefit from a health assessment is eligible. The removal of age-based clinical activity requirements means the assessment content is no longer stratified by age group. The clinician determines what is clinically relevant and appropriate for each individual patient.
How often can an Aboriginal and Torres Strait Islander health assessment be claimed?
The frequency restriction is unchanged from 1 March 2026. A health assessment for persons of Aboriginal and Torres Strait Islander descent cannot be claimed more than once in a 9-month period per eligible patient. This rule applies across all the relevant items, including the standard and telehealth variants.
What are the audit risks associated with these March 2026 MBS changes?
The primary audit risks are ECG documentation and PES co-claiming. For item 11714, the risk is claiming the item without a contemporaneous GP-authored clinical note that demonstrates human interpretation of the trace. For PES items, the risk is claiming without the specialist having also claimed an eligible video consultation item, or claiming PES time that was not clinically necessary for the specialist service. The Department of Health uses billing pattern analysis to identify outliers, and newly restored or introduced items attract early review attention as practices adjust to revised descriptors. Reviewing clinical templates and billing workflows now, while these changes are recent, is the most effective way to manage that exposure.