PMP contribution to a multidisciplinary care plan (non-RACF, video telehealth)

Video attendance by a prescribed medical practitioner (PMP) contributing to a multidisciplinary care plan prepared by another provider, or to a review of such a plan, where the patient is not a resident of an aged care facility. Video-telehealth equivalent of in-person item 231. PMP-only — not for GPs (use 92026), specialists, or consultant physicians. No phone equivalent.

Plain-English summary. See MBS Online for the verbatim descriptor of each item.

Time

Not specified

Frequency

Once per 3-month period (exceptions for significant clinical changes documented as exceptional circumstances).

Referral

Not required

Profession

Prescribed Medical Practitioner

Requirements to bill

Conditions imposed by the descriptor that must be met to claim this item.

1All requirements for in-person item 231 (multidisciplinary plan prepared by another provider, non-RACF patient, PMP — not GP, specialist, or consultant physician).
2Service must be by videoconference — a clinically appropriate audio + visual link must be used.
3An established clinical relationship with the patient is required for telehealth delivery.
4Patient must not have received a GP chronic condition management plan service (965 / 967 / 92029 / 92030) within the preceding 12 months — the GPCCMP framework excludes 92057 contribution claims during the same care episode.
5At least 3 months must have elapsed since the previous 231 / 92057 claim, unless exceptional circumstances apply.

Your notes must show

Documentation tests — what clinical notes need to demonstrate to survive a PSR audit.

All documentation elements required by item 231 (lead provider identification, PMP contribution, communication evidence, frequency-cap dates).
Modality — videoconference, with confirmation that audio + visual link was clinically appropriate.
Confirmation that the practitioner billing is a prescribed medical practitioner (not a GP, specialist, or consultant physician).
Established clinical relationship — date the patient was first seen by this PMP, or the most recent prior face-to-face attendance.

Common audit failures

Patterns the Professional Services Review scheme and Medicare audits flag.

Phone-only attendance billed as 92057 — 92057 requires audio + video.
Item 92057 claimed by a GP — should be 92026.
Item 92057 claimed by a specialist or consultant physician — neither is eligible.
Item billed for a RACF resident or hospital-discharge planning — those scenarios use 92058.
Item billed for a patient with no established clinical relationship with the claiming PMP.

Related MBS items

231

PMP contribution to a multidisciplinary care plan (non-RACF, face-to-face)

92026

GP contribution to a multidisciplinary care plan (non-RACF, video telehealth)

92058

PMP contribution to a multidisciplinary care plan (RACF / hospital discharge, video telehealth)

In-depth reading in the Library

Medicare Audit-Ready Documentation: A GP's Guide to MBS Item Number Compliance

Professional Services Review audits can result in repayment demands, exclusion from Medicare, and public referral. Your clinical notes are the primary evidence in any PSR investigation. This guide details exactly what your documentation must contain to withstand scrutiny.

Source authority

Documentation tests on this page reference the descriptor conditions and PSR-audit patterns covered in our existing Library guides. Always confirm current rules against the official descriptor.

Item 92057 on MBS Online

Keep reading