Bupa has always had a policy of paying only the Medicare schedule fee for perfusion items, except in special cases. Arrangements for a higher fee were made with specific doctors who worked at particular hospitals. This required a manual account to be sent to Bupa. In late 2010, there were about 30 providers in 12 hospitals where this fee was being paid. Bupa has taken this position because in most Australian hospitals, clinical perfusionists perform the perfusion service. Bupa will only pay the higher fee at hospitals which do not employ clinical perfusionists where they can be confident that the anaesthetist is actually performing the perfusion.

 

Prior to 2016, claims for the higher fee could not be sent via Eclipse, so manual accounts were required. Since approximately March 2016, Bupa will pay the higher rate on Eclipse claims, so the higher figure has been added in to the latest items update. The fee varies from state to state – NSW, QLD, WA $754.95, VIC $505.00, other states MBS fee of $396.00 (March 2016). Note that you need to have an individual arrangement with Bupa to be eligible for this higher rate. Contact Bupa Provider Operations if you want to make further enquiries.