Billing Guidelines

Anaesthetic invoices are prepared using item numbers from the Medical Benefits Schedule (MBS) with a Relative Value Guide (RVG) unit value to reflect the service's complexity and time taken.

An anaesthetic invoice consists of 7 sections:

  • Consultation (if attended) - in-hospital consultation with the patient before surgery. Item numbers 17610 - 17625.

  • Base units - representing the degree of complexity of the procedure. Item numbers 20100 - 21997 or 22900 to 22095 if you are the anaesthetist, 25200 - 25205 if you are the assistant anaesthetist, and 22060 if you are the perfusionist.

  • Time units- based on the total anaesthetic time. Item numbers 23010 - 24136.

  • Age modifiers - for patients under the age of 4 years or over 75 years. Item numbers 25013 if the patient is under 4 years of age or 25014 if the patient is over 75 years of age.

  • Emergency modifiers - when a patient requires immediate treatment otherwise resulting in a significant threat to life or body part. Item numbers 25025 if in normal hours, 25025 after hours if you are the anaesthetist, 25030 after hours if you are the assistant anaesthetist, and 25050 after hours if you are the perfusionist.

  • Physical status modifiers - can be applied to recognise the added complexities associated with the patient’s physical status. Item numbers 25000 - 25010

  • Therapeutic and diagnostic services - extra services used in conjunction with anaesthesia. Item numbers 22002 - 22051 if you are the anaesthetist, assistant anaesthetist or the perfusionist and 22055, 22065 or 22075 if you are the perfusionist

A basic invoice would include a minimum of 3 item numbers (consultation, base unit, time unit) as per the example below for a colonoscopy:

17610 (2 RVG units) - Consultation not more than 15 minutes

20810 (4 RVG units) - Anaesthesia for a lower intestinal endoscopic procedure

23025 (2 RVG units) - Anaesthesia time 16minutes - 30 minutes

An invoice for a more complex procedure, such as a lumbar fusion, may include some additional item numbers, such as:

17615 (4 RVG units) - Consultation involving a selective history and an extensive examination and the formulation of a written patient management plan - and of more than 15 minutes but not more than 30 minutes duration

20670 (13 RVG units) - Anaesthesia for extensive spine and/or spinal cord procedures

23220 (26 RVG units) - Anaesthesia time 4:51 hours - 5:00 hours

22012 (3 RVG units) - Arterial blood pressure monitoring

22025 (4 RVG units) - Intra-arterial cannulation

If in doubt regarding the appropriate item numbers to use in your billing, ask a colleague or your billing agent, but remember that, ultimately, you are responsible for ensuring that all billing submitted is correct and reflects the complexity of the procedure.

Further information can be found at Services Australia.