PSA Testing Medicare Benefit Schedule Item Changes as of 1 November 2023
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Effective from 1st November 2023, the MBS requirements for prostate-specific antigen (PSA) testing have changed.
The new items better align with the NHMRC-endorsed guidelines put forward by the Prostate Cancer Foundation of Australia and the Cancer Council of Australia in 2016.1
The general recommendation is for those men who decide to have PSA tests to assist in the early detection of prostate cancer to have a PSA blood test every two years from age 50 to 69 years.
PSA testing may also be useful in other situations, such as prostatitis and in the follow-up of patients with known prostate disease.
The importance of having a significant family history of prostate cancer is also recognised in the guidelines.
The percentage Free PSA can also be helpful in evaluating a raised PSA and in the management of known prostate disease.
The new items descriptors for PSA are:
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Item No |
Description | Time Restriction |
| PSA |
||
| 66655 | PSA quantitation | Not more than one in 23 months |
|
66654 |
PSA quantitation in the monitoring of high-risk patients | Not more than one in 11 months |
| 66656 | PSA quantitation in the monitoring of previously diagnosed prostatic disease (including prostate cancer, prostatitis or a premalignant condition such as atypical small acinar proliferation) | None |
|
Free PSA Percentage |
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| 66659 | in the follow up of a PSA result under item 66654 or 66655 that lies at: (a) more than 2.0 ug/L but less than or equal to 5.5 ug/L for patients with a family history of prostate cancer; or (b) more than 3.0 ug/L but less than or equal to 5.5 ug/L for patients who are at least 50 years of age but under 70 years of age; or (c) more than 5.5 ug/L but less than or equal to 10.0 ug/L for patients who are at least 70 years of age |
Not more than one in 11 months |
| 66660 | the monitoring of previously diagnosed prostatic disease, if the current PSA level lies at: (a) more than 2.0 ug/L but less than or equal to 5.5 ug/L for patients with a family history of prostate cancer; or (b) more than 3.0 ug/L but less than or equal to 5.5 ug/L for patients who are at least 50 years of age but under 70 years of age; or (c) more than 5.5 ug/L but less than or equal to 10.0 ug/L for patients who are at least 70 years of age |
Not more than 4 times in 11 months |
New MBS Items for PSA tests
How to order
Request “PSA” on our general Clinical Labs request form.
It is important that the laboratory knows if the patient is at increased risk for prostate cancer (such as with a strong family history or previous high PSA levels) or has known prostate disease so that they can be billed correctly under the new Medicare item numbers.
If the clinical information is not provided, or the patient is not eligible under these item numbers, then a private bill may be generated.
References
1. See ‘PSA-Testing-Guidelines.pdf’ (pcfa.org.au): https://www.pcfa.org.au/media/612113/PSA-Testing-Guidelines.pdf
About the author:
Dr David Deam
MBBS MAACB FRCPA
Lab: Clayton
Speciality: Chemical Pathology
Areas of Interest: Endocrine function testing, protein abnormalities, laboratory automation
Phone: (03) 9538 6777
Email: david.deam@clinicallabs.com.au
Dr Deam graduated with Honours in Medicine from Monash University in 1978 and obtained his FRCPA in 1985, following postgraduate training in Biochemistry at the Royal Melbourne Hospital. After several posts in Chemical Pathology at the Royal Melbourne Hospital and the Royal Women’s Hospital, he was appointed Head of Chemical Pathology at the Royal Melbourne in 1996. He joined Gribbles Pathology (now Australian Clinical Labs) in 1998. Dr Deam has played an active role in teaching scientific, nursing and medical staff at both undergraduate and postgraduate levels and has been an examiner for the Australasian Association of Clinical Biochemists as well as the Royal College of Pathologists of Australasia. Dr Deam’s research interests and publications include work on thyroid function testing, various aspects of diagnostic protein measurement and the rational use of biochemical tests.
Local pathologists near you:
Dr Wessel Jenner
BSc MBChB FRCPA
Lab: Bella Vista
Speciality: Biochemistry, Chemical Pathology
Areas of Interest: Chemical pathology, endocrinology and proteins
Phone: (02) 8887 9999
Email: wessel.jenner@clinicallabs.com.au
Dr Jenner began training in Chemical Pathology in 2001 and obtained Fellowship from the Colleges of Medicine of South Africa in 2004, as well as a Master’s degree in Chemical Pathology from the University of Pretoria in 2005. He has worked as a senior registrar in Clinical Biochemistry at the Royal Infirmary of Edinburgh, as a consultant clinical biochemist at the NHS Borders Hospital (Scotland), and as a consultant chemical pathologist in private practice in South Africa. In 2012, Dr Jenner relocated to Australia and worked as a senior registrar at the Royal Brisbane and Women’s Hospital. He obtained his Fellowship from the Royal College of Pathologists of Australasia in 2013 and joined Australian Clinical Labs in early 2014.
Dr Tony Mak
MBBS MBA FRCPA FRCPath
Lab: Osborne Park
Speciality: Chemical Pathology
Areas of Interest: Toxicology
Phone: (09) 9442 7663
Email: tony.mak@clinicallabs.com.au
Dr Tony Mak is a chemical pathologist who graduated from the medical school of the Chinese University of Hong Kong. Before migrating to Australia, Tony worked as a consultant chemical pathologist at Princess Margaret Hospital – a major acute district general hospital in Hong Kong. Tony founded, developed, and operated the highest level clinical toxicology laboratory in Hong Kong. He led his team to develop numerous useful analyses to solve many difficult clinical toxicology problems with public health implications, including Chinese medicine related poisoning, plant-related poisoning, novel psychoactive substances, slimming agents and related problems, drug adulteration and counterfeit drugs. Tony held numerous management roles in Hong Kong including Head of the Department of Pathology, Service Director (Quality and Safety) and Deputy Hospital Chief Executive. He has published more than 100 articles in international peer-reviewed academic journals and a number of books. We are excited to announce Tony’s new role as Clinical Director, Chemical Pathology for Clinical Labs in WA.