Some customers may not see the full suite of historical services due to limited access to the data for certain metrics.
Historical billing opportunities are lists of services that may have been provided by the team but never billed, so your practice can review them and claim what’s still claimable.
To find them, go to Essential actions > Billing actions > Missed Billing Opportunities.
How the metrics work
Each page compares your appointments and patient records with what was invoiced, then lists anything that looks like it’s missing a billing item. Every list works the same way:
- For an item to show in these lists, the appointment status needs to be marked as Completed in the PMS. See the Uncompleted patient appointments metric for help keeping your data clean and uncovering historical billing opportunities.
- Each metric has information in the About this page tile, including links to MBS and related resources.
- Use the Filters to focus on certain data within the metric, such as Practitioners, dates or appointment types. Find out more about Cubiko filters.
- Deceased and inactive patients are excluded by default. Tick the checkbox in the filters to include them.
- Some pages have an extra toggle in the filters. On Historical 10997 opportunities and Historical bulk billing incentive opportunities, appointments where chronic disease management or care plan items were billed on the same day are hidden by default, so tick the toggle to include them. On Historical 10987 opportunities, patients who are also eligible for a 10997 are shown by default, so tick the checkbox to hide them.
- Use the Actions column or download the .CSV to print and work through the list in your practice management software. Find out more about Printing and downloading data in Cubiko.
❗Always check with the treating practitioner before billing these services, as not every patient listed will be billable.
TOP TIP! Regular review of the historical billing opportunities can mean recovered income for your practice for work provided.
What each page finds
NOTE: Medicare’s claiming time limit is 12 months. Check the service date before you start. See MBS note MN.14.11 for the details.
| Page | What it finds | Good to know | PMS |
|---|---|---|---|
| Historical 10997 opportunities | Completed nurse appointments where a 10997 may have been performed but not billed |
Patients need a qualifying chronic condition management item on file. Patients who’ve reached five 10997s this calendar year are excluded |
BP, MD, ZM |
| Historical 10987 opportunities | Completed nurse appointments where a 10987 may have been performed but not billed | For Aboriginal and Torres Strait Islander patients with a previous 715 health assessment. Patients who’ve reached ten 10987s this calendar year are excluded. | BP, MD, ZM |
| Historical flu vaccine opportunities | Flu vaccinations given in the PMS, with no matching invoice | Patients who attended and had a flu vaccination marked as given at this practice in the PMS, but no invoice for that date of service. A second tab lists vaccines that were invoiced, so you can double-check privately purchased stock was billed correctly for patients not eligible for the NIP vaccine. |
BP only |
| Historical ECG opportunities (Beta) |
Patients who potentially had an ECG completed during their appointment but had no ECG item billed on the same date |
Appointments where an ECG document has been added to a patient's record in BP (Correspondence In or Clinical Images) but no ECG item was billed on the same day. Visit MBS Online for more information regarding ECG MBS items. |
BP only |
| Historical bulk billing incentive opportunities | Patients who may have been eligible for a bulk billing incentive that wasn’t billed via PMS |
From 1 November 2025, this covers all patients with a valid Medicare card. Earlier dates follow the previous rules |
BP, MD, ZM |
| Historical 93666 opportunities |
Completed appointments where a vaccine suitability assessment was billed during a COVID-19 booster visit, but the COVID-19 Vaccine Booster Incentive (93666) wasn’t |
NOTE: Item 93666 was discontinued on 1 February 2023, so you may not find anything claimable here. | BP only |
| Unbilled COVID-19 vax appointments | Completed COVID-19 vaccination appointments with no matching invoice for service |
COVID-19 vaccination appointments with no associated billing on the service date. NOTE: This includes all appointment types that are marked as Covax in Appointment Settings. |
BP only |
| Historical MT83 - MT89 opportunities |
Telephone and telehealth services provided to DVA patients where the incentive wasn’t claimed NOTE: MT83-MT89 can no longer be claimed for services provided after 1 November 2023, so you may not find anything claimable here. |
Eligibility is based on invoices that were billed to DVA and include telehealth or telephone services but do not already have a bulk billing incentive attached. This list will only include invoices that have a service date in the selected date range. |
BP and MD |
TOP TIP! Create a dedicated appointment type for items like 10997 or 10987, so nurses can book it and you can filter the lists by Appt Type.