Funding to implement a raft of recommendations from a review of optometry Medicare items – most notably an additional visual field test within a 12-month period – has been granted by the Federal Government.
As part of its Federal Budget 2024-25, handed down in May 2024, the government revealed it had accepted the majority of the recommendations made by the MBS Review Taskforce relating to optometry items; the latest in a process that has taken several years.
The changes will come into effect from 1 March 2025 and are a win for the sector, said Optometry Australia, which had been “actively advocating” for the changes.
One of the biggest changes is a new item for a third visual field test in a 12-month period for patients with a high risk of glaucoma progression.
“It’s pleasing to see that the association’s advocacy has been impactful,” said OA CEO Ms Skye Cappuccio.
“These are positive changes, particularly the introduction of a third annual visual field item, the removal of the same practice requirement for billing 10912 and 10913, and removal of co-claiming restrictions on domiciliary visits.” (See breakout box below more details).
However, further changes were “sorely needed” to better align optometry Medicare fees with the cost of providing care. OA’s estimates drawn from analysis of practice costs indicate the actual cost of providing a comprehensive consultation in a sustainable business model is over $50 more than the Medicare scheduled fee.
Cappuccio said this remained a focus of OA’s ongoing advocacy.
OA would also continue to push for an increase to the domiciliary item fee to better reflect the true cost of travelling and providing care outside of practice, she said. The organisation believes increasing the optometric domiciliary loading to $85.00 per visit (paid proportionally for multiple patients) would ensure the ongoing provision of timely and affordable access to eyecare for elderly Australians in aged care.
Currently, a domiciliary visit performed on one patient at a single location on one occasion (item 10931) attracts a fee of $25.65 and a benefit of $21.85 (85%).
Additionally, OA said it was working with relevant experts to consider Medicare changes necessary to support effective myopia management.
Addressing ‘placement poverty’
In other Federal Budget announcements, the government established the Commonwealth Prac Program, effective July 2025, to provide students studying teaching, nursing, midwifery and social work funding for placement experience.
Expected to benefit 68,000 students in these professions with a $320 weekly payment during their mandatory placements, the measure excluded optometry – a profession on the 2023 Skills Priority List.
Allied Health Professionals Australia (AHPA) CEO Ms Bronwyn Morris-Donovan said it was a step in the right direction but highlighted that optometry was among jobs listed on the 2023 Skills Priority List that would not receive this funding.
“’Placement poverty’ is real for many students of other allied health disciplines where mandatory placements are just as extensive, if not more,” she said.
Cappuccio said OA recognised the challenge of maintaining a liveable income confronted many optometry students on placements and it was advocating for this program to be extended to support the profession.
Other highlights from the health budget affecting the ophthalmic sector include funding to support the government’s commitment to index Medicare items from 1 July 2024.
There’s also a one-year freeze on maximum PBS co-payments, affecting patients who access eye drops for glaucoma and dry eye, among other diseases, as well as intravitreal injections for macular disease. It means the price will remain at $31.60, or $7.70 per medicine for concession card holders and pensioners.
“So, medicines stay cheaper, instead of rising with inflation,” Federal Health Minister Mr Mark Butler said.
“This is a win-win policy, with an approximate 20% health levy on sugary drinks raising around $1 billion each year.”
Regarding public hospitals – where cataract surgery wait times remain an ongoing issue – the government will provide more funding to state-run facilities from 2025–2030, increasing the Commonwealth contribution to the cost of care to 45%, from around 40%, over the next 10 years.
Overall, Australian Medical Association (AMA) president Professor Steve Robson said there was little that was new in this year’s budget, representing “a real loss of momentum” towards a more efficient and sustainable health system.
He cited preventive health as one of the biggest losers, with a missed opportunity to raise billions of dollars by introducing a sugar tax on sweetened drinks. It’s a move the Australian Society of Ophthalmologists supports due to the impact of type 2 diabetes on vision loss.
“This is a win-win policy, with an approximate 20% health levy on sugary drinks raising around $1 billion each year – money that could be invested into measures that reduce pressure on our stretched health system,” Robson said.
More reading
Ophthalmic sector highlights from Federal Budget 2024/25
Optometry Australia’s 2024-25 budget focus
Federal Budget 2023/24 focuses on Medicare rebuild
