Aftercare or post-operative treatment

Check the rules for billing Medicare Benefit Schedule (MBS) items for aftercare or post-operative treatment and how to apply them

Read the relevant item descriptions, fact sheets and explanatory notes at MBS Online.

About aftercare

Aftercare is the post-operative care and treatment provided to your patients after an operation.

This includes all attendances until recovery and the final check or examination. Aftercare services can take place at a hospital, private rooms or your patient’s home.

MBS fees for most surgical items in MBS Group T8 include an aftercare component.

Some MBS services don’t include aftercare. This is noted in their description. Group T8 items not containing this note include aftercare.

Aftercare for a cosmetic procedure or non-Medicare services don’t attract Medicare benefits. This applies to normal and not normal aftercare services.

Aftercare periods

You determine an aftercare period based on your patient’s needs. The type and duration of aftercare may vary between patients even if they’ve had the same operation.

Some surgical items include a minimum period of aftercare. This will be noted in the item’s descriptor or explanatory notes of the MBS.

We set aftercare periods for surgical items to help us accurately assess attendance items claimed after your patient’s operation. These periods don’t determine if a service you’ve provided is aftercare.

Attendances in the aftercare period

Schedule fees for most surgical items include normal post-operative care. This means you can’t bill attendance items for normal aftercare. However, if the MBS description of the surgical item you performed excludes aftercare in the items description, you can bill attendance items for providing aftercare.

General practitioner attendances and aftercare

If your patient can’t return to the same practitioner who performed the surgical item for aftercare, a different practitioner can bill attendance items for the aftercare they provide.

Specialists and consultant physicians can’t bill an attendance for normal aftercare services in this same situation.

Not normal aftercare

You can bill an attendance item during an aftercare period if the service isn’t normal aftercare.

A service isn’t normal aftercare if you see your patient for either:

  • an unrelated condition
  • complications from the operation.

If an attendance you bill isn’t normal aftercare, you need to tell us by either:

  • setting the Aftercare Override Indicator in your software
  • referencing not normal aftercare in the service text, such as ‘Not Normal Aftercare’, ‘NNAC’ or ‘NNA’.

Delegation of aftercare

You can choose to hand over aftercare services to another specialist or consultant physician.

For example, you may hand over aftercare to another specialist if your patient lives in a rural or remote area and can’t return for aftercare services.

If another specialist or consultant physician provides aftercare, they can split the Medicare benefit with the original practitioner.

Public patient in a public hospital

Public patients can access in-patient aftercare free of charge as part of the public hospital service. This includes normal and not normal aftercare.

If a public patient chooses to see a different practitioner privately for aftercare, any post-operative care provided can be billed under an attendance item.

Page last updated: 15 June 2024.
QC 74102