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Aftercare services for Medicare

How to handle aftercare exceptions in Tyro Health Online

Nick avatar
Written by Nick
Updated over a year ago

What is aftercare?

Aftercare is the post-operative care and treatment provided to 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 a 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 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 items descriptor or explanatory notes of the MBS.

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

GP attendances and aftercare

If a 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

If the service is eligible for a Medicare benefit and the service is not normal aftercare, you may still be able to bill for an attendance item.

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

  • an unrelated condition, or

  • complications arising from the operation.

How to process ‘Not Normal Aftercare’ in Tyro Health Online

Raise your Payment Request as normal, but when you enter your Item codes, for the service that has 'Not Normal Aftercare', choose to view the Advanced Options:

From the list of options, choose 'Not normal aftercare' from the Aftercare Override drop down list:

Complete your payment request in the usual manner.

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