Medicare compliance update

20 October 2025

In April this year, we communicated with members in relation to upcoming Medicare compliance activities.

The Department has provided an update in relation to the timing of planned activities:

• Claiming MBS services while overseas - the department anticipates commencement of a large education campaign for specialists in November 2025. An audit program will also commence for specialists whose claiming while overseas demonstrates a more routine nature.
• MBS items 132 and 133 – the department is currently finalising treatment design for this claiming. We anticipate a significant education focus with only a small number of enforcement activities.

For both of these activities, ASA will receive notification about 2 weeks prior to the commencement of any contact with members and we will communicate that to members.

The Department has provided an overview on the background to these compliance activities, which includes data on claiming of the treatment and management plan items by sleep and respiratory physicians. Read the overview

More information about the claiming of sleep study item numbers while overseas is included in the April update article. 

For further information on this topic, please contact the CEO, Marcia Balzer.