MBS guide for GPs and primary care teams working in Aboriginal and Torres Strait Islander health

Level A

Professional attendance at consulting rooms (other than a service to which another item applies) by a general practitioner for an obvious problem characterised by the straightforward nature of the task that requires a short patient history and, if required, limited examination and management-each attendance

0.00

 

18.85

0

0

False

18.85

$0.00

Level C 20–40 minutes

Professional attendance by a general practitioner at consulting rooms (other than a service to which another item in the table applies), lasting at least 20 minutes and including any of the following that are clinically relevant: (a) taking a detailed patient history; (b) performing a clinical examination; (c) arranging any necessary investigation; (d) implementing a management plan; (e) providing appropriate preventive health care; for one or more health-related issues, with appropriate documentation-each attendance

0

 

79.70

0

0

False

79.70

$0.00

Level A

Telehealth attendance by a general practitioner for an obvious problem characterised by the straightforward nature of the task that requires a short patient history and, if required, limited management. NOTE: It is a legislative requirement thatthis service must be performed by the patient’s usual medical practitioner (please see Note AN.1.1 for the definition of ‘patient’s usual medical practitioner’ as some exemptions do apply).

0.00

 

18.85

0

0

False

18.85

$0.00

Level C 20–40 minutes

Telehealth attendance by a general practitioner lasting at least 20 minutes if the attendance includes any of the following that are clinically relevant: (a) taking a detailed patient history; (b) arranging any necessary investigation; (c) implementing a management plan; (d) providing appropriate preventative health care. NOTE: It is a legislative requirement that this service must be performed by the patient’s usual medical practitioner (please see Note AN.1.1 for the definition of ‘patient’s usual medical practitioner’ as some exemptions do apply).

0.00

 

79.70

0

0

False

79.70

$0.00

Level A <6 minutes

Phone attendance by a general practitioner lasting less than 6 minutes for an obvious problem characterised by the straightforward nature of the task that requires a short patient history and, if required, limited management

0.00

 

18.85

0

0

False

18.85

$0.00

Level C >20 minutes (eligibility for COVID-19 antivirals)

Phone attendance by a general practitioner lasting at least 20 minutes for the assessment and management of a person with COVID‑19 infection of recent onset, for the purposes of determining the patient’s eligibility for receiving a COVID-19 oral antiviral treatment, where the service includes any of the following that are clinically relevant: (a) taking a detailed patient history;(b) arranging any necessary investigation;(c) implementing a management plan, including follow up arrangements;(d) providing any necessary treatment, including prescribing a COVID-19 oral antiviral treatment;(e) providing appropriate preventive health care for one or more related issues; with appropriate documentation

0.00

 

0

79.70

0

False

79.70

$0.00

Level A

Professional attendance by a general practitioner (other than attendance at consulting rooms or a residential aged care facility or a service to which another item in the table applies) that requires a short patient history and, if necessary, limited examination and management-an attendance on one or more patients at one place on one occasion-each patient

44.90

The fee for item 3, plus $28.85 divided by the number of patients seen, up to a maximum of six patients. For seven or more patients - the fee for item 3 plus $2.30 per patient.

0

0

0

False

44.90

$0.00

Level C 20–40 minutes

Professional attendance by a general practitioner (other than attendance at consulting rooms or a residential aged care facility or a service to which another item in the table applies), lasting at least 20 minutes and including any of the following that are clinically relevant: (a) taking a detailed patient history; (b) performing a clinical examination; (c) arranging any necessary investigation; (d) implementing a management plan; (e) providing appropriate preventive health care; for one or more health-related issues, with appropriate documentation-an attendance on one or more patients at one place on one occasion-each patient

102.20

The fee for item 36, plus $28.85 divided by the number of patients seen, up to a maximum of six patients. For seven or more patients - the fee for item 36 plus $2.30 per patient.

0

0

0

False

102.20

$0.00

Level A

Professional attendance at consulting rooms (other than a service to which another item applies) by a general practitioner for an obvious problem characterised by the straightforward nature of the task that requires a short patient history and, if required, limited examination and management-each attendance

0

 

31.75

0

0

False

31.75

$0.00

Level C 20–40 minutes

Professional attendance by a general practitioner at consulting rooms (other than a service to which another item in the table applies), lasting at least 20 minutes and including any of the following that are clinically relevant: (a) taking a detailed patient history; (b) performing a clinical examination; (c) arranging any necessary investigation; (d) implementing a management plan; (e) providing appropriate preventive health care; for one or more health-related issues, with appropriate documentation-each attendance

0

 

92.00

0

0

False

92.00

$0.00

Level A

Professional attendance by a general practitioner (other than attendance at consulting rooms, a hospital or a residential aged care facility or a service to which another item in the table applies) that requires a short patient history and, if necessary, limited examination and management-an attendance on one or more patients on one occasion-each patient

56.65

The fee for item 5000, plus $28.45 divided by the number of patients seen, up to a maximum of six patients. For seven or more patients - the fee for item 5000 plus $2.25 per patient.

0

0

0

False

56.65

$0.00

Level C 20–40 minutes

Professional attendance by a general practitioner (other than attendance at consulting rooms, a hospital or a residential aged care facility or a service to which another item in the table applies), lasting at least 20 minutes and including any of the following that are clinically relevant: (a) taking a detailed patient history; (b) performing a clinical examination; (c) arranging any necessary investigation; (d) implementing a management plan; (e) providing appropriate preventive health care; for one or more health-related issues, with appropriate documentation-an attendance on one or more patients on one occasion-each patient

113.35

The fee for item 5040, plus $28.45 divided by the number of patients seen, up to a maximum of six patients. For seven or more patients - the fee for item 5040 plus $2.25 per patient.

0

0

0

False

113.35

$0.00

Outside 11.00 pm – 7.00 am (first patient)

Professional attendance by a general practitioner on one patient on one occasion—each attendance (other than an attendance in unsociable hours) in an after-hours period if: (a) the attendance is requested by the patient or a responsible person in the same unbroken after-hours period; and (b) the patient’s medical condition requires urgent assessment; and (c) if the attendance is at consulting rooms—it is necessary for the practitioner to return to, and specially open, the consulting rooms for the attendance

0

 

142.20

0

106.65

False

142.20

$0.00

Between 11.00 pm – 7.00 am

Telehealth attendance by a general practitioner on not more than one patient on one occasion—each attendance in unsociable hours if: (a) the attendance is requested by the patient or a responsible person in the same unbroken after‑hours period; and (b) the patient’s medical condition requires urgent assessment.

0.00

 

167.55

0

0

False

167.55

$0.00

Aboriginal and Torres Strait Islander peoples’ health assessment

Professional attendance by a general practitioner at consulting rooms or in another place other than a hospital or residential aged care facility, for a health assessment of a patient who is of Aboriginal or Torres Strait Islander descent-not more than once in a 9 month period

0

 

232.50

0

0

False

232.50

$0.00

Aboriginal and Torres Strait Islander peoples’ health assessment

Telehealth attendance by a general practitioner for a health assessment of a patient - this item or items 93470 or 93479 not more than once in a 9 month period.  NOTE: It is a legislative requirement that this service must be performed by the patient’s usual medical practitioner (please see Note AN.1.1 for the definition of ‘patient’s usual medical practitioner’ as some exemptions do apply).

0.00

 

232.50

0

0

False

232.50

$0.00

Aboriginal and Torres Strait Islander health service

ABORIGINAL AND TORRES STRAIT ISLANDER HEALTH SERVICE provided to a person who is of Aboriginal and Torres Strait Islander descent by an eligible Aboriginal health worker or eligible Aboriginal and Torres Strait Islander health practitioner if: (a)either: a medical practitioner has undertaken a health assessment and identified a need for follow-up allied health services; or the person's shared care plan identifies the need for follow-up allied health services; and (b)the person is referred to the eligible Aboriginal health worker or eligible Aboriginal and Torres Strait Islander health practitioner by a medical practitioner using a referral form that has been issued by the Department or a referral form that substantially complies with the form issued by the Department; and (c)the person is not an admitted patient of a hospital; and (d)the service is provided to the person individually and in person; and (e)the service is of at least 20 minutes duration; and (f)after the service, the eligible Aboriginal health worker or eligible Aboriginal and Torres Strait Islander health practitioner gives a written report to the referring medical practitioner mentioned in paragraph (b): (i) if the service is the only service under the referral - in relation to that service; or (ii) if the service is the first or the last service under the referral - in relation to the service; or (iii) if neither subparagraph (i) nor (ii) applies but the service involves matters that the referring medical practitioner would reasonably be expected to be informed of - in relation to those matters - to a maximum offive services (including services to which items 81300 to 81360, 93048, 93061,93546 to 93558 and 93579 to 93593inclusive apply) in a calendar year

0.00

 

0

58.00

0

False

58.00

$0.00

Audiology service

AUDIOLOGY HEALTH SERVICE provided to a person who is of Aboriginal or Torres Strait Islander descent by an eligible audiologist if: (a)either: a medical practitioner has undertaken a health assessment and identified a need for follow-up allied health services; or the person's shared care plan identifies the need for follow-up allied health services; and (b)the person is referred to the eligible audiologist by the medical practitioner using a referral form that has been issued by the Department or a referral form that substantially complies with the form issued by the Department; and (c)the person is not an admitted patient of a hospital; and (d)the service is provided to the person individually and in person; and (e)the service is of at least 20 minutes duration; and (f)after the service, the eligible audiologist gives a written report to the referring medical practitioner mentioned in paragraph (b): (i) if the service is the only service under the referral - in relation to that service; or (ii) if the service is the first or the last service under the referral - in relation to the service; or (iii) if neither subparagraph (i) nor (ii) applies but the service involves matters that the referring medicalpractitioner would reasonably be expected to be informed of - in relation to those matters; - to a maximum offive services (including services to which items 81300 to 81360, 93048, 93061, 93546 to 93558 and 93579 to 93593 inclusive apply) in a calendar year

0.00

 

0

58.00

0

False

58.00

$0.00

Dietetics service

DIETETICS HEALTH SERVICE provided to a person who is of Aboriginal or Torres Strait Islander descent by an eligible dietitian if: (a)either: a medical practitioner has undertaken a health assessment and identified a need for follow-up allied health services; or the person's shared care plan identifies the need for follow-up allied health services; and (b)the person is referred to the eligible dietitian by a medical practitioner using a referral form that has been issued by the Department or a referral form that substantially complies with the form issued by the Department; and (c)the person is not an admitted patient of a hospital; and (d)the service is provided to the person individually and in person; and (e)the service is of at least 20 minutes duration; and (f)after the service, the eligible dietitian gives a written report to the referring medical practitioner mentioned in paragraph (b): (i) if the service is the only service under the referral - in relation to that service; or (ii) if the service is the first or the last service under the referral - in relation to the service; or (iii) if neither subparagraph (i) nor (ii) applies but the service involves matters that the referring medical practitioner would reasonably be expected to be informed of - in relation to those matters - to a maximum offive services (including services to which items 81300 to 81360, 93048, 93061, 93546 to 93558 and 93579 to 93593 inclusive apply) in a calendar year

0.00

 

0

58.00

0

False

58.00

$0.00

Occupational therapy service

OCCUPATIONAL THERAPY HEALTH SERVICE provided to a person who is of Aboriginal or Torres Strait Islander descent by an eligible occupational therapist if (a)either: a medical practitioner has undertaken a health assessment and identified a need for follow-up allied health services; or the person's shared care plan identifies the need for follow-up allied health services; and (b)the person is referred to the eligible occupational therapist by a medical practitioner using a referral form that has been issued by the Department or a referral form that substantially complies with the form issued by the Department; and (c)the person is not an admitted patient of a hospital; and (d)the service is provided to the person individually and in person; and (e)the service is of at least 20 minutes duration; and (f)after the service, the eligible occupational therapist gives a written report to the referring medical practitioner mentioned in paragraph (b): (i) if the service is the only service under the referral - in relation to that service; or (ii) if the service is the first or the last service under the referral - in relation to the service; or (iii) if neither subparagraph (i) nor (ii) applies but the service involves matters that the referring medical practitioner would reasonably be expected to be informed of - in relation to those matters - to a maximum offive services (including services to which items 81300 to 81360, 93048, 93061, 93546 to 93558 and 93579 to 93593 inclusive apply) in a calendar year

0.00

 

0

58.00

0

False

58.00

$0.00

Podiatry service

PODIATRY HEALTH SERVICE provided to a person who is of Aboriginal or Torres Strait Islander descent by an eligible podiatrist if: (a)either: a medical practitioner has undertaken a health assessment and identified a need for follow-up allied health services; or the person’s shared care plan identifies the need for follow-up allied health services; and (b)the person is referred to the eligible podiatrist by a medical practitioner using a referral form that has been issued by the Department or a referral form that substantially complies with the form issued by the Department; and (c)the person is not an admitted patient of a hospital; and (d)the service is provided to the person individually and in person; and (e)the service is of at least 20 minutes duration; and (f)after the service, the eligible podiatrist gives a written report to the referring medical practitioner mentioned in paragraph (b): (i) if the service is the only service under the referral - in relation to that service; or (ii) if the service is the first or the last service under the referral - in relation to the service; or (iii) if neither subparagraph (i) nor (ii) applies but the service involves matters that the referring medical practitioner would reasonably be expected to be informed of - in relation to those matters - to a maximum offive services (including services to which items 81300 to 81360, 93048, 93061, 93546 to 93558 and 93579 to 93593 inclusive apply) in a calendar year

0.00

 

0

58.00

0

False

58.00

$0.00

Osteopathy service

OSTEOPATHY HEALTH SERVICE provided to a person who is of Aboriginal or Torres Strait Islander descent by an eligible osteopath if: (a)either: a medical practitioner has undertaken a health assessment and identified a need for follow-up allied health services; or the person’s shared care plan identifies the need for follow-up allied health services; and (b)the person is referred to the eligible osteopath by a medical practitioner using a referral form that has been issued by the Department or a referral form that substantially complies with the form issued by the Department; and (c)the person is not an admitted patient of a hospital; and (d)the service is provided to the person individually and in person; and (e)the service is of at least 20 minutes duration; and (f)after the service, the eligible osteopath gives a written report to the referring medical practitioner mentioned in paragraph (b): (i) if the service is the only service under the referral - in relation to that service; or (ii) if the service is the first or the last service under the referral - in relation to the service; or (iii) if neither subparagraph (i) nor (ii) applies but the service involves matters that the referring medical practitioner would reasonably be expected to be informed of - in relation to those matters - to a maximum offive services (including services to which items 81300 to 81360, 93048, 93061, 93546 to 93558 and 93579 to 93593 inclusive apply) in a calendar year

0.00

 

0

58.00

0

False

58.00

$0.00

Speech pathology service

SPEECH PATHOLOGY HEALTH SERVICE provided to a person who is of Aboriginal or Torres Strait Islander descent by an eligible speech pathologist if: (a)either: a medical practitioner has undertaken a health assessment and identified a need for follow-up allied health services; or the person’s shared care plan identifies the need for follow-up allied health services; and (b)the person is referred to the eligible speech pathologist by a medical practitioner using a referral form that has been issued by the Department or a referral form that substantially complies with the form issued by the Department; and (c)the person is not an admitted patient of a hospital; and (d)the service is provided to the person individually and in person; and (e)the service is of at least 20 minutes duration; and (f)after the service, the eligible speech pathologist gives a written report to the referring medical practitioner mentioned in paragraph (b): (i) if the service is the only service under the referral - in relation to that service; or (ii) if the service is the first or the last service under the referral - in relation to the service; or (iii) if neither subparagraph (i) nor (ii) applies but the service involves matters that the referring medical practitioner would reasonably be expected to be informed of - in relation to those matters - to a maximum offive services (including services to which items 81300 to 81360, 93048, 93061, 93546 to 93558 and 93579 to 93593 inclusive apply) in a calendar year

0.00

 

0

58.00

0

False

58.00

$0.00

All follow-up items

Telehealth attendance provided to a person who is of Aboriginal or Torres Strait Islander descent by an eligible allied health practitioner if: (a) a medical practitioner has undertaken a health assessment and identified a need for follow‑up allied health services; and (b) the person is referred to the eligible allied health practitioner by a medical practitioner using a referral form issued by the Department or a referral form that contains all the components of the form issued by the Department; and (c) the service is provided to the person individually; and (d) the service is of at least 20 minutes duration; and (e) after the service, the eligible allied health practitioner gives a written report to the referring medical practitioner mentioned in paragraph (b): (i) if the service is the only service under the referral—in relation to that service; or (ii) if the service is the first or the last service under the referral—in relation to that service; or (iii) if neither subparagraph (i) nor (ii) applies but the service involves matters that the referring medical practitioner would reasonably expect to be informed of—in relation to those matters; to a maximum of 5 services (including any services to which this item or 93061 or any item in Part 6 of Schedule 2 to the Allied Health Determination applies) in a calendar year

0.00

 

0

58.00

51.15

False

58.00

$0.00

All follow-up items

Phone attendance provided to a person who is of Aboriginal or Torres Strait Islander descent by an eligible allied health practitioner if: (a) a medical practitioner has undertaken a health assessment and identified a need for follow‑up allied health services; and (b) the person is referred to the eligible allied health practitioner by a medical practitioner using a referral form issued by the Department or a referral form that contains all the components of the form issued by the Department; and (c) the service is provided to the person individually; and (d) the service is of at least 20 minutes duration; and (e) after the service, the eligible allied health practitioner gives a written report to the referring medical practitioner mentioned in paragraph (b): (i) if the service is the only service under the referral—in relation to that service; or (ii) if the service is the first or the last service under the referral—in relation to that service; or (iii) if neither subparagraph (i) nor (ii) applies but the service involves matters that the referring medical practitioner would reasonably expect to be informed of—in relation to those matters; to a maximum of 5 services (including any services to which this item or item 93060 or any item in Part 6 of Schedule 2 to the Allied Health Determination applies) in a calendar year

0.00

 

0

58.00

0

False

58.00

$0.00

Any dose, MMM 1 (business hours)

Professional attendance by a general practitioner for the purpose of assessing a patient’s suitability for a COVID-19 vaccine if all of the following apply:(a) one or both of the following is undertaken, where clinically relevant: (i) a short patient history; (ii) limited examination and management;(b) the service is bulk-billed;(c) the service is provided at, or from, a practice location in a Modified Monash 1 area

0.00

 

0

36.35

0

False

36.35

$0.00

Any dose, MMM 1 (after-hours)

Professional attendance by a general practitioner for the purpose of assessing a patient’s suitability for a COVID-19 vaccine if all of the following apply: (a) one or both of the following is undertaken, where clinically relevant: (i) a short patient history; (ii) limited examination and management; (b) the service is bulk-billed; (c) the service is provided at, or from, a practice location in a Modified Monash 1 area; (d) the service is rendered in an after-hours period

0.00

 

0

49.30

0

False

49.30

$0.00

Attendance by a relevant health professional on behalf of a medical practitioner (MMM 1)

Attendance by a relevant health professional on behalf of a medical practitioner for the purpose of assessing a patient’s suitability for a dose of a COVID-19 vaccine if all of the following apply: (a) one or both of the following is undertaken, where clinically relevant: (i) a short patient history; (ii) limited examination and management; (b)the service is bulk-billed; (c) the service is not provided at a practice location; and (d) the service is provided from a practice location in a Modified Monash 1 area

0.00

 

0

22.10

0

False

22.10

$0.00

Flag fall item – initial attendance at an aged care/disability facility or a person's home

A flag fall service to which item 93644, 93645, 93646, 93647, 93653, 93654, 93655, 93656, 93660 or 93661 applies. For the first patient attended during one attendance by a general practitioner or by a medical practitioner (other than a general practitioner) at: (a) one residential aged care facility, or at consulting rooms situated within such a complex, on one occasion; or(b) one residential disability setting facility, or at consulting rooms situated within such a complex, on one occasion; or (c) a person’s place of residence (other than a residential aged care facility) on one occasion.

0.00

 

0

122.40

0

False

122.40

$0.00

Preparation of a GPMP

Attendance by a general practitioner for preparation of a GP management plan for a patient (other than a service associated with a service to which any of items 735 to 758 apply)

0

 

158.00

0

118.50

False

158.00

$0.00

Review of a GPMP or TCA

Attendance by a general practitioner to review or coordinate a review of: (a) a GP management plan prepared by a general practitioner (or an associated general practitioner) to which item 721 applies; or (b) team care arrangements which have been coordinated by the general practitioner (or an associated general practitioner) to which item 723 applies

0.00

 

78.90

0

59.20

False

78.90

$0.00

Contribution to review of multidisciplinary care plan prepared by another provider (patient in RACF or being discharged from hospital)

Contribution by a general practitioner to: (a) a multidisciplinary care plan for a patient in a residential aged care facility, prepared by that facility, or to a review of such a plan prepared by such a facility; or (b) a multidisciplinary care plan prepared for a patient by another provider before the patient is discharged from a hospital, or to a review of such a plan prepared by another provider (other than a service associated with a service to which items 735 to 758 apply)

0

 

77.10

0

0

False

77.10

$0.00

Preparation of a GPMP

Telehealth attendance by a general practitioner, for preparation of a GP management plan for a patient (other than a service associated with a service to which any of items 735 to 758, items 92074 to 92078 or items 92030 to 92034 apply) NOTE: It is a legislative requirement thatthis service must be performed by the patient’s usual medical practitioner (please see Note AN.1.1 for thedefinition of ‘patient’s usual medical practitioner’ as some exemptions do apply).

0.00

 

158.00

0

0

False

158.00

$0.00

Review of a GPMP or TCA

Telehealth attendance by a general practitioner to review or coordinate a review of: (a) a GP management plan prepared by a general practitioner (or an associated general practitioner) to which item 721 of the general medical services table, or item 229or item 92024 or 92068 applies; or (b) team care arrangements which have been coordinated by the general practitioner (or an associated general practitioner) to which item 723 of the general medical services table, oritem 230or item 92025 or 92069 or items applies NOTE: It is a legislative requirement thatthis service must be performed by the patient’s usual medical practitioner (please see Note AN.1.1 for the definition of ‘patient’s usual medical practitioner’ as some exemptions do apply).

0.00

 

78.90

0

0

False

78.90

$0.00

Contribution to review of multidisciplinary care plan prepared by another provider (patient in RACF or being discharged from hospital)

Telehealth contribution by a general practitioner, to: (a) a multidisciplinary care plan for a patient in a residential aged care facility, prepared by that facility, or to a review of such a plan prepared by such a facility; or (b) a multidisciplinary care plan prepared for a patient by another provider before the patient is discharged from a hospital, or to a review of such a plan prepared by another provider (other than a service associated with a service to which items 735 to 758, items 92074 to 92078 or items 92030 to 92034 apply) NOTE: It is a legislative requirement thatthis service must be performed by the patient’s usual medical practitioner (please see Note AN.1.1 for thedefinition of ‘patient’s usual medical practitioner’ as some exemptions do apply).

0.00

 

77.10

0

0

False

77.10

$0.00

Aboriginal and Torres Strait Islander health service

ABORIGINAL AND TORRES STRAIT ISLANDER HEALTH SERVICE Aboriginal or Torres Strait Islander health service provided to a person by an eligible Aboriginal health worker or eligible Aboriginal and Torres Strait Islander health practitioner if: (a)the service is provided to a person who has: a chronic condition; and complex care needs being managed by a medical practitioner (including a general practitioner, but not a specialist or consultant physician) under a shared care plan or under both a GP Management Plan and Team Care Arrangements or, if the person is a resident of an aged care facility, the person's medical practitioner has contributed to a multidisciplinary care plan; and (b)the service is recommended in the person's Team Care Arrangements, multidisciplinary care plan or shared care plan as part of the management of the person's chronic condition and complex care needs; and (c)the person is referred to the eligible Aboriginal health worker or eligible Aboriginal and Torres Strait Islander health practitioner by the medical practitioner using a referral form that has been issued by the Department or a referral form that contains all the components of the form issued by the Department; and (d)the person is not an admitted patient of a hospital; and (e)the service is provided to the person individually and in person; and (f)the service is of at least 20 minutes duration; and (g)after the service, the eligible Aboriginal health worker or eligible Aboriginal and Torres Strait Islander health practitioner gives a written report to the referring medical practitioner mentioned in paragraph (c): (i) if the service is the only service under the referral - in relation to that service; or (ii) if the service is the first or the last service under the referral - in relation to that service; or (iii) if neither subparagraph (i) nor (ii) applies but the service involves matters that the referring medical practitioner would reasonably expect to be informed of - in relation to those matters; and (h)for a service for which a private health insurance benefit is payable - the person who incurred the medical expenses for the service has elected to claim the Medicare benefit for the service, and not the private health insurance benefit; - to a maximum of five services (including any services to which items 10950 to 10970, 93000, 93013, 93501 to 93513 and 93524 to 93538apply) in a calendar year

0.00

 

0

58.00

0

False

58.00

$0.00

Audiology service

AUDIOLOGY Audiology health service provided to a person by an eligible audiologist if: (a)the service is provided to a person who has: a chronic condition; and complex care needs being managed by a medical practitioner (including a general practitioner, but not a specialist or consultant physician) under a shared care plan or under both a GP Management Plan and Team Care Arrangements or, if the person is a resident of an aged care facility, the person's medical practitioner has contributed to a multidisciplinary care plan; and (b)the service is recommended in the person's Team Care Arrangements, multidisciplinary care plan or shared can plan as part of the management of the person's chronic condition and complex care needs; and (c)the person is referred to the eligible audiologist by the medical practitioner using a referral form that has been issued by the Department or a referral form that contains all the components of the form issued by the Department; and (d)the person is not an admitted patient of a hospital; and (e)the service is provided to the person individually and in person; and (f)the service is of at least 20 minutes duration; and (g)after the service, the eligible audiologist gives a written report to the referring medical practitioner mentioned in paragraph (c): (i) if the service is the only service under the referral - in relation to that service; or (ii) if the service is the first or the last service under the referral - in relation to that service; or (iii) if neither subparagraph (i) nor (ii) applies but the service involves matters that the referring medical practitioner would reasonably expect to be informed of - in relation to those matters; and (h)for a service for which a private health insurance benefit is payable - the person who incurred the medical expenses for the service has elected to claim the Medicare benefit for the service, and not the private health insurance benefit; - to a maximum offive services (including any services to which items 10950 to 10970, 93000, 93013, 93501 to 93513 and 93524 to 93538apply) in a calendar year

0.00

 

0

58.00

0

False

58.00

$0.00

Dietetics service

DIETETICS SERVICES Dietetics health service provided to a person by an eligible dietician if: (a)the service is provided to a person who has: a chronic condition; and complex care needs being managed by a medical practitioner (including a general practitioner, but not a specialist or consultant physician) under a shared care plan or under both a GP Management Plan and Team Care Arrangements or, if the person is a resident of an aged care facility, the person's medical practitioner has contributed to a multidisciplinary care plan; and (b)the service is recommended in the person's Team Care Arrangements, multidisciplinary care plan or shared care plan as part of the management of the person's chronic condition and complex care needs; and (c)the person is referred to the eligible dietician by the medical practitioner using a referral form that has been issued by the Department or a referral form that contains all the components of the form issued by the Department; and (d)the person is not an admitted patient of a hospital; and (e)the service is provided to the person individually and in person; and (f)the service is of at least 20 minutes duration; and (g)after the service, the eligible dietician gives a written report to the referring medical practitioner mentioned in paragraph (c): (i) if the service is the only service under the referral - in relation to that service; or (ii) if the service is the first or the last service under the referral - in relation to that service; or (iii) if neither subparagraph (i) nor (ii) applies but the service involves matters that the referring medical practitioner would reasonably expect to be informed of - in relation to those matters; and (h)for a service for which a private health insurance benefit is payable - the person who incurred the medical expenses for the service has elected to claim the Medicare benefit for the service, and not the private health insurance benefit; - to a maximum offive services (including any services to which items 10950 to 10970, 93000, 93013, 93501 to 93513 and 93524 to 93538apply) in a calendar year

0.00

 

0

58.00

0

False

58.00

$0.00

Occupational therapy service

OCCUPATIONAL THERAPY Occupational therapy health service provided to a person by an eligible occupational therapist if: (a)the service is provided to a person who has: a chronic condition; and complex care needs being managed by a medical practitioner (including a general practitioner, but not a specialist or consultant physician) under a shared care plan or under both a GP Management Plan and Team Care Arrangements or, if the person is a resident of an aged care facility, the person's medical practitioner has contributed to a multidisciplinary care plan; and (b)the service is recommended in the person's Team Care Arrangements, multidisciplinary care plan or shared care plan as part of the management of the person's chronic condition and complex care needs; and (c)the person is referred to the eligible occupational therapist by the medical practitioner using a referral form that has been issued by the Department or a referral form that contains all the components of the form issued by the Department; and (d)the person is not an admitted patient of a hospital; and (e)the service is provided to the person individually and in person; and (f)the service is of at least 20 minutes duration; and (g)after the service, the eligible occupational therapist gives a written report to the referring medical practitioner mentioned in paragraph (c): (i) if the service is the only service under the referral - in relation to that service; or (ii) if the service is the first or the last service under the referral - in relation to that service; or (iii) if neither subparagraph (i) nor (ii) applies but the service involves matters that the referring medical practitioner would reasonably expect to be informed of - in relation to those matters; and (h)for a service for which a private health insurance benefit is payable - the person who incurred the medical expenses for the service has elected to claim the Medicare benefit for the service, and not the private health insurance benefit; - to a maximum offive services (including any services to which items 10950 to 10970, 93000, 93013, 93501 to 93513 and 93524 to 93538apply) in a calendar year

0.00

 

0

58.00

0

False

58.00

$0.00

Podiatry service

PODIATRY Podiatry health service provided to a person by an eligible podiatrist if: (a)the service is provided to a person who has: a chronic condition; and complex care needs being managed by a medical practitioner (including a general practitioner, but not a specialist or consultant physician) under a shared care plan or under both a GP Management Plan and Team Care Arrangements or, if the person is a resident of an aged care facility, the person's medical practitioner has contributed to a multidisciplinary care plan; and (b)the service is recommended in the person's Team Care Arrangements,multidisciplinary care plan or shared care plan as part of the management of the person's chronic condition and complex care needs; and (c)the person is referred to the eligible podiatrist by the medical practitioner using a referral form that has been issued by the Department or a referral form that contains all the components of the form issued by the Department; and (d)the person is not an admitted patient of a hospital; and (e)the service is provided to the person individually and in person; and (f)the service is of at least 20 minutes duration; and (g)after the service, the eligible podiatrist gives a written report to the referring medical practitioner mentioned in paragraph (c): (i) if the service is the only service under the referral - in relation to that service; or (ii) if the service is the first or the last service under the referral - in relation to that service; or (iii) if neither subparagraph (i) nor (ii) applies but the service involves matters that the referring medical practitioner would reasonably expect to be informed of - in relation to those matters; and (h)for a service for which a private health insurance benefit is payable - the person who incurred the medical expenses for the service has elected to claim the Medicare benefit for the service, and not the private health insurance benefit; - to a maximum offive services (including any services to which items 10950 to 10970, 93000, 93013, 93501 to 93513 and 93524 to 93538apply) in a calendar year

0.00

 

0

58.00

0

False

58.00

$0.00

Osteopathy service

OSTEOPATHY Osteopathy health service provided to a person by an eligible osteopath if: (a)the service is provided to a person who has: a chronic condition; and complex care needs being managed by a medical practitioner (including a general practitioner, but not a specialist or consultant physician) under a shared care plan or under both a GP Management Plan and Team Care Arrangements or, if the person is a resident of an aged care facility, the person's medical practitioner has contributed to a multidisciplinary care plan; and (b)the service is recommended in the person's Team Care Arrangements, multidisciplinary care plan or shared care plan as part of the management of the person's chronic condition and complex care needs; and (c)the person is referred to the eligible osteopath by the medical practitioner using a referral form that has been issued by the Departmentor a referral form that contains all the components of the form issued by the Department; and (d)the person is not an admitted patient of a hospital; and (e)the service is provided to the person individually and in person; and (f)the service is of at least 20 minutes duration; and (g)after the service, the eligible osteopath gives a written report to the referring medical practitioner mentioned in paragraph (c): (i) if the service is the only service under the referral - in relation to that service; or (ii) if the service is the first or the last service under the referral - in relation to that service; or (iii) if neither subparagraph (i) nor (ii) applies but the service involves matters that the referring medical practitioner would reasonably expect to be informed of - in relation to those matters; and (h)for a service for which a private health insurance benefit is payable - the person who incurred the medical expenses for the service has elected to claim the Medicare benefit for the service, and not the private health insurance benefit; - to a maximum offive services (including any services to which items 10950 to 10970, 93000, 93013, 93501 to 93513 and 93524 to 93538apply) in a calendar year

0.00

 

0

58.00

0

False

58.00

$0.00

Speech pathology service

SPEECH PATHOLOGY Speech pathology health service provided to a person by an eligible speech pathologist if: (a)the service is provided to a person who has: a chronic condition; and complex care needs being managed by a medical practitioner (including a general practitioner, but not a specialist or consultant physician) under a shared care plan or under both a GP Management Plan and Team Care Arrangements or, if the person is a resident of an aged care facility, the person's medical practitioner has contributed to a multidisciplinary care plan; and (b)the service is recommended in the person's Team Care Arrangements, multidisciplinary care plan or shared care plan as part of the management of the person's chronic condition and complex care needs; and (c)the person is referred to the eligible speech pathologist by the medical practitioner using a referral form that has been issued by the Department or a referral form that contains all the components of the form issued by the Department; and (d)the person is not an admitted patient of a hospital; and (e)the service is provided to the person individually and in person; and (f)the service is of at least 20 minutes duration; and (g)after the service, the eligible speech pathologist gives a written report to the referring medical practitioner mentioned in paragraph (c): (i) if the service is the only service under the referral - in relation to that service; or (ii) if the service is the first or the last service under the referral - in relation to that service; or (iii) if neither subparagraph (i) nor (ii) applies but the service involves matters that the referring medical practitioner would reasonably expect to be informed of - in relation to those matters; and (h)for a service for which a private health insurance benefit is payable - the person who incurred the medical expenses for the service has elected to claim the Medicare benefit for the service, and not the private health insurance benefit; - to a maximum offive services (including any services to which items 10950 to 10970, 93000, 93013, 93501 to 93513 and 93524 to 93538apply) in a calendar year

0.00

 

0

58.00

0

False

58.00

$0.00

All allied health chronic disease management services

Telehealth attendance by an eligible allied health practitioner if: (a) the service is provided to a person who has: (i) a chronic condition; and (ii) complex care needs being managed by a medical practitioner (including a general practitioner, but not a specialist or consultant physician) under both a GP Management Plan and Team Care Arrangements or, if the person is a resident of an aged care facility, the person’s medical practitioner has contributed to a multidisciplinary care plan; and (b) the service is recommended in the person’s Team Care Arrangements or multidisciplinary care plan as part of the management of the person’s chronic condition and complex care needs; and (c) the person is referred to the eligible allied health practitioner by the medical practitioner using a referral form that has been issued by the Department or a referral form that contains all the components of the form issued by the Department; and (d) the service is provided to the person individually; and (e) the service is of at least 20 minutes duration; and (f) after the service, the eligible allied health practitioner gives a written report to the referring medical practitioner mentioned in paragraph (c): (i) if the service is the only service under the referral—in relation to that service; or (ii) if the service is the first or last service under the referral—in relation to that service; or (iii) if neither subparagraph (i) nor (ii) applies but the service involves matters that the referring medical practitioner would reasonably expect to be informed of —in relation to those matters; to a maximum of 5 services (including any services to which this item, item 93013 or any item in Part 1 of the Schedule to the Allied Health Determination applies) in a calendar year

0.00

 

0

58.00

0

False

58.00

$0.00

All allied health chronic disease management services

Phone attendance by an eligible allied health practitioner if: (a) the service is provided to a person who has: (i) a chronic condition; and (ii) complex care needs being managed by a medical practitioner (including a general practitioner, but not a specialist or consultant physician) under both a GP Management Plan and Team Care Arrangements or, if the person is a resident of an aged care facility, the person’s medical practitioner has contributed to a multidisciplinary care plan; and (b) the service is recommended in the person’s Team Care Arrangements or multidisciplinary care plan as part of the management of the person’s chronic condition and complex care needs; and (c) the person is referred to the eligible allied health practitioner by the medical practitioner using a referral form that has been issued by the Department or a referral form that contains all the components of the form issued by the Department; and (d) the service is provided to the person individually; and (e) the service is of at least 20 minutes duration; and (f) after the service, the eligible allied health practitioner gives a written report to the referring medical practitioner mentioned in paragraph (c): (i) if the service is the only service under the referral—in relation to that service; or (ii) if the service is the first or last service under the referral—in relation to that service; or (iii) if neither subparagraph (i) nor (ii) applies but the service involves matters that the referring medical practitioner would reasonably expect to be informed of —in relation to those matters; to a maximum of 5 services (including any services to which this item, item 93000 or any item in Part 1 of the Schedule to the Allied Health Determination applies) in a calendar year

0.00

 

0

58.00

0

False

58.00

$0.00

Organise and coordinate, 15–20 minutes

Attendance by a general practitioner, as a member of a multidisciplinary case conference team, to organise and coordinate: (a) a community case conference; or (b) a multidisciplinary case conference in a residential aged care facility; or (c) a multidisciplinary discharge case conference; if the conference lasts for at least 15 minutes, but for less than 20 minutes (other than a service associated with a service to which items 721 to 732 apply)

0.00

 

77.45

0

58.10

False

77.45

$0.00

Organise and coordinate, 20–40 minutes

Attendance by a general practitioner, as a member of a multidisciplinary case conference team, to organise and coordinate: (a) a community case conference; or (b) a multidisciplinary case conference in a residential aged care facility; or (c) a multidisciplinary discharge case conference; if the conference lasts for at least 20 minutes, but for less than 40 minutes (other than a service associated with a service to which items 721 to 732 apply)

0.00

 

132.45

0

99.35

False

132.45

$0.00

Organise and coordinate, at least 40 minutes

Attendance by a general practitioner, as a member of a multidisciplinary case conference team, to organise and coordinate: (a) a community case conference; or (b) a multidisciplinary case conference in a residential aged care facility; or (c) a multidisciplinary discharge case conference; if the conference lasts for at least 40 minutes (other than a service associated with a service to which items 721 to 732 apply)

0.00

 

220.80

0

165.60

False

220.80

$0.00

15–20 minutes

Attendance by an eligible allied health practitioner, as a member of a multidisciplinary case conference team, to participate in: (a) a community case conference; or (b) a multidisciplinary case conference in a residential aged care facility; if the conference lasts for at least 15 minutes, but for less than 20 minutes (other than a service associated with a service to which another item in this Group applies)

0.00

 

0

45.50

0

False

45.50

$0.00

>40 minutes

Attendance by an eligible allied health practitioner, as a member of a multidisciplinary case conference team, to participate in: (a) a community case conference; or (b) a multidisciplinary case conference in a residential aged care facility; if the conference lasts for at least 40 minutes (other than a service associated with a service to which another item in this Group applies)

0.00

 

0

129.80

0

False

129.80

$0.00

15–20 minutes

Attendance by an eligible allied health practitioner, as a member of a multidisciplinary case conference team, to participate in a community case conference if the conference lasts for at least 15 minutes, but for less than 20 minutes (other than a service associated with a service to which another item in this Group applies)

0.00

 

0

45.50

0

False

45.50

$0.00

>40 minutes

Attendance by an eligible allied health practitioner, as a member of a multidisciplinary case conference team, to participate in a community case conference if the conference lasts for at least 40 minutes (other than a service associated with a service to which another item in this Group applies)

0.00

 

0

129.80

0

False

129.80

$0.00

Domiciliary medication management review

Participation by a general practitioner in a Domiciliary Medication Management Review (DMMR) for a patient living in a community setting, in which the general practitioner, with the patient’s consent: (a) assesses the patient as: (i) having a chronic medical condition or a complex medication regimen; and (ii) not having their therapeutic goals met; and (b) following that assessment: (i) refers the patient to a community pharmacy or an accredited pharmacist for the DMMR; and (ii) provides relevant clinical information required for the DMMR; and (c) discusses with the reviewing pharmacist the results of the DMMR including suggested medication management strategies; and (d) develops a written medication management plan following discussion with the patient; and (e) provides the written medication management plan to a community pharmacy chosen by the patient For any particular patient—applicable not more than once in each 12 month period, except if there has been a significant change in the patient’s condition or medication regimen requiring a new DMMR

0

 

169.60

0

0

False

169.60

$0.00

Preparation of General Practitioner Mental Health Treatment Plan (GP MHTP) 20–40 minutes (without mental health skills training)

Professional attendance by a general practitioner (including a general practitioner who has not undertaken mental health skills training) of at least 20 minutes but less than 40 minutes in duration for the preparation of a GP mental health treatment plan for a patient

0

 

78.55

0

58.95

False

78.55

$0.00

Preparation of GP MHTP 20–40 minutes (with mental health skills training)

Professional attendance by a general practitioner (including a general practitioner who has undertaken mental health skills training of at least 20 minutes but less than 40 minutes in duration for the preparation of a GP mental health treatment plan for a patient

0

 

99.70

0

74.80

False

99.70

$0.00

Review of GP MHTP

Professional attendance by a general practitioner to review a GP mental health treatment plan which he or she, or an associated general practitioner has prepared, or to review a Psychiatrist Assessment and Management Plan

0

 

78.55

0

58.95

False

78.55

$0.00

Preparation of General Practitioner Mental Health Treatment Plan (GP MHTP) 20–40 minutes (without mental health skills training)

Telehealth attendance, by a general practitioner who has not undertaken mental health skills training (and not including a specialist or consultant physician), of at least 20 minutes but less than 40 minutes in duration for the preparation of a GP mental health treatment plan for a patient.

0.00

 

78.55

0

0

False

78.55

$0.00

Preparation of GP MHTP 20–40 minutes (with mental health skills training)

Telehealth attendance, by a general practitioner who has undertaken mental health skills training, of at least 20 minutes but less than 40 minutes in duration for the preparation of a GP mental health treatment plan for a patient.

0.00

 

99.70

0

0

False

99.70

$0.00

Review of GP MHTP

Telehealth attendance by a general practitionerto review a GP mental health treatment plan which the general practitioner, or an associated general practitioner has prepared, or to review a Psychiatrist Assessment and Management Plan.

0.00

 

78.55

0

0

False

78.55

$0.00

Review of GP MHTP

Phone attendance by a general practitioner to review a GP mental health treatment plan which the general practitioner, or an associated general practitioner has prepared, or to review a Psychiatrist Assessment and Management Plan.

0.00

 

78.55

0

0

False

78.55

$0.00

Level A

Telehealth attendance for the provision of services related to blood borne viruses, sexual or reproductive health by a general practitioner of not more than 5 minutes if the attendance includes any of the following that are clinically relevant: (a) taking a short patient history; (b) arranging any necessary investigation; (c) implementing a management plan; (d) providing appropriate preventive health care Note: Consultations related to assisted reproductive technology and antenatal care are outside the scope of these items and cannot be rendered under these items.

0.00

 

18.85

0

0

False

18.85

$0.00

Level C 20–40 minutes

Telehealth attendance for the provision of services related to blood borne viruses, sexual or reproductive health by a general practitioner of more than 20 minutes in duration but not more than 40 minutes if the attendance includes any of the following that are clinically relevant: (a) taking a detailed patient history; (b) arranging any necessary investigation; (c) implementing a management plan; (d) providing appropriate preventive health care Note: Consultations related to assisted reproductive technology and antenatal care are outside the scope of these items and cannot be rendered under these items.

0.00

 

79.70

0

0

False

79.70

$0.00

Level A

Phone attendance for the provision of services related to blood borne viruses, sexual or reproductive health by a general practitioner of not more than 5 minutes if the attendance includes any of the following that are clinically relevant: (a) taking a short patient history; (b) arranging any necessary investigation; (c) implementing a management plan; (d) providing appropriate preventive health care Note: Consultations related to assisted reproductive technology and antenatal care are outside the scope of these items and cannot be rendered under these items.

0.00

 

18.85

0

0

False

18.85

$0.00

Level C 20–40 minutes

Phone attendance for the provision of services related to blood borne viruses, sexual or reproductive health by a general practitioner of more than 20 minutes in duration but not more than 40 minutes if the attendance includes any of the following that are clinically relevant: (a) taking a detailed patient history; (b) arranging any necessary investigation; (c) implementing a management plan; (d) providing appropriate preventive health care Note:Consultations related to assisted reproductive technology and antenatal care are outside the scope of these items and cannot be rendered under these items.

0.00

 

79.70

0

0

False

79.70

$0.00

Level B <20 minutes

Professional attendance for nicotine and smoking cessation counselling, care and advice by a general practitioner at consulting rooms lasting less than 20 minutes and must include any of the following: (a) taking a patient history, aimed at identifying disease risk factors attributable to nicotine use and smoking dependence, and/or identifying barriers and enablers to cessation; and (b) completing an assessment of the patient’s nicotine dependence, including where clinically appropriate a basic physical examination; and (c) initiating interventions and referrals for the cessation of nicotine, if required; and (d) implementing a management plan for appropriate treatment; and (e) providing the patient with nicotine and smoking cessation advice and information, including modifiable lifestyle factors; with appropriate documentation

0.00

 

41.20

0

0

False

41.20

$0.00

Level B <20 minutes

Telehealth attendance for nicotine and smoking cessation counselling, care and advice by a general practitioner lasting less than 20 minutes and must include any of the following: (a) taking a patient history, aimed at identifying disease risk factors attributable to nicotine use and smoking dependence, and/or identifying barriers and enablers to cessation; and (b) completing an assessment of the patient’s nicotine dependence, including where clinically appropriate a basic physical examination; and (c) initiating interventions and referrals for the cessation of nicotine, if required; and (d) implementing a management plan for appropriate treatment; and (e) providing the patient with nicotine and smoking cessation advice and information, including modifiable lifestyle factors; with appropriate documentation.

0.00

 

41.20

0

0

False

41.20

$0.00

Level B <20 minutes

Phone attendance for nicotine and smoking cessation counselling, care and advice by a general practitioner lasting less than 20 minutes and must include any of the following: (a) taking a patient history, aimed at identifying disease risk factors attributable to nicotine use and smoking dependence, and/or identifying barriers and enablers to cessation; and (b) completing an assessment of the patient’s nicotine dependence, including where clinically appropriate a basic physical examination; and (c) initiating interventions and referrals for the cessation of nicotine, if required; and (d) implementing a management plan for appropriate treatment; and (e) providing the patient with nicotine and smoking cessation advice and information, including modifiable lifestyle factors; with appropriate documentation.

0.00

 

41.20

0

0

False

41.20

$0.00

Antenatal service by midwife/nurse (Rural Remote Metropolitan Area [RRMA] 3–7)

ANTENATAL CARE Antenatal service provided by a midwife, nurse or an Aboriginal and Torres Strait Islander health practitionerif: (a) the service is provided on behalf of, and under the supervision of, a medical practitioner; (b) the service is provided at, or from, a practice location in a regional, rural or remote area; (c) the service is not performed in conjunction with another antenatal attendance item (same patient, same practitioner on the same day); (d) the service is not provided for an admitted patient of a hospital; and to a maximum of 10 service per pregnancy

0

 

0

25.40

0

False

25.40

$0.00

Attendance (hospital) – complicated pregnancy treated with oral medication or bed rest

POLYHYDRAMNIOS, UNSTABLE LIE, MULTIPLE PREGNANCY, PREGNANCY COMPLICATED BY DIABETES OR ANAEMIA, THREATENED PREMATURE LABOUR treated by bed rest only or oral medication, requiring admission to hospitaleach attendance that is not a routine antenatal attendance, to a maximum of 1 visit per day

0.00

 

0

43.95

38.75

False

43.95

$0.00

Pregnancy ultrasound (dating is 17 to 22 weeks)

Pelvis or abdomen, pregnancy related or pregnancy complication, fetal development and anatomy, ultrasound (the current ultrasound) scan of, by any or all approaches, with measurement of all parameters for dating purposes, if: (a) the dating of the pregnancy (as confirmed by the current ultrasound) is 17 to 22 weeks of gestation; and (b) the current ultrasound: (i) is not performed in the same pregnancy as item 55706; and (ii) is not performed on the same patient within 24 hours of a service mentioned in item 55757 or 55758 (NR)

0.00

 

0

34.80

30.70

False

34.80

$0.00

Antenatal service by midwife/nurse (Rural Remote Metropolitan Area [RRMA] 3–7)

Antenatal telehealth service provided by a practice midwife, nurse or an Aboriginal and Torres Strait Islander health practitioner, to a maximum of 10 services per pregnancy, if: (a) the service is provided on behalf of, and under the supervision of, a medical practitioner; and (b) the service is not performed in conjunction with another antenatal attendance item in Group T4 for the same patient on the same day by the same practitioner.

0.00

 

0

25.40

0

False

25.40

$0.00

Antenatal service by midwife/nurse (RRMA 3–7)

Antenatal phone service provided by a practice midwife, nurse or an Aboriginal and Torres Strait Islander health practitioner, to a maximum of 10 services per pregnancy, if: (a) the service is provided on behalf of, and under the supervision of, a medical practitioner; and (b) the service is not performed in conjunction with another antenatal attendance item in Group T4 for the same patient on the same day by the same practitioner.

0.00

 

0

25.40

0

False

25.40

$0.00

Spirometry before and after bronchodilator, each occasion at which recordings are made

Measurement of spirometry, that: (a) involves a permanently recorded tracing, performed before and after inhalation of a bronchodilator; and (b) is performed to: (i) confirm diagnosis of chronic obstructive pulmonary disease (COPD); or (ii) assess acute exacerbations of asthma; or (iii) monitor asthma and COPD; or (iv) assess other causes of obstructive lung disease or the presence of restrictive lung disease; each occasion at which recordings are made

0

 

0

19.20

16.95

False

19.20

$0.00

Therapeutic venesection

THERAPEUTIC VENESECTION for the management of haemochromatosis, polycythemia vera or porphyria cutanea tarda

0.00

 

0

67.95

59.95

False

67.95

$0.00

Hormone implant by cannula (including Implanon)

HORMONE OR LIVING TISSUE IMPLANTATIONby cannula

0.00

 

0

33.15

29.25

False

33.15

$0.00

Subcutaneous foreign body

SUBCUTANEOUS FOREIGN BODY, removal of, requiring incision and exploration, including closure of wound if performed, as an independent procedure (Anaes.)

0

 

0

102.30

90.30

False

102.30

$0.00

Intrauterine contraceptive device – removal

Intra-uterine device, removal of under general anaesthesia, for a retained or embedded device, not being a service associated with a service to which another item in this Group applies (other than a service described in item 35503) (Anaes.)

0

 

0

50.00

44.10

False

50.00

$0.00

Pregnancy test

Pregnancy test by 1 or more immunochemical methods

0

 

0

8.65

7.65

False

8.65

$0.00

Quantitation of glycated haemoglobin (HbA1c) – Nurse practitioner item

Quantitation of glycated haemoglobin (HbA1c) performed by a participating nurse practitioner in the management of established diabetes when performed: (a) as a point‑of‑care test; and (b) by a nurse practitioner who works in a general practice that is accredited against the point of care testing accreditation module under the National General Practice Accreditation Scheme; and (c) using a method and instrument certified by the National Glycohemoglobin Standardization Program (NGSP), if the instrument has a total coefficient variation less than 3.0% at 48 mmol/mol (6.5%). Applicable not more than 3 times per 12 months per patient.

0.00

 

0

10.05

8.85

False

10.05

$0.00

Quantitation of glycosylated haemoglobin for diabetes monitoring (QAAMS)

Quantitation of glycosylated haemoglobin performed in the management of established diabetes – each test to a maximum of 4 tests in a 12 month period. (Item is subject to restrictions in rulePR.9.1 of explanatory notes to this category)

0.00

 

0

14.45

12.75

False

14.45

$0.00

Assessment of visual acuity and bilateral retinal photography with a non-mydriatic retinal camera (for Aboriginal and Torres Strait Islander patients)

Assessment of visual acuity and bilateral retinal photography with a non mydriatic retinal camera, including analysis and reporting of the images for initial or repeat assessment for presence or absence of diabetic retinopathy, in a patient with medically diagnosed diabetes, if: (a)the patient is of Aboriginal and Torres Strait Islander descent; and (b)the assessment is performed by the medical practitioner (other than an optometrist or ophthalmologist) providing the primary glycaemic management of the patient's diabetes; and (c)this item and item 12326 have not applied to the patient in the preceding 12 months; and (d)the patient does not have: (i)an existing diagnosis of diabetic retinopathy; or (ii)visual acuity of less than 6/12 in either eye; or (iii) a difference of more than 2 lines of vision between the 2 eyes at the time of presentation

0.00

 

0

46.55

41.10

False

46.55

$0.00

Health services provided by a practice nurse or registered Aboriginal health worker (on behalf of a medical practitioner) for an Aboriginal or Torres Strait Islander person who has received a health assessment

Follow up service provided by a practice nurse or Aboriginal and Torres Strait Islander health practitioner, on behalf of a medical practitioner, for an Indigenous person who has received a health assessment if: a)The service is provided on behalf of and under the supervision of a medical practitioner; and b)the person is not an admitted patient of a hospital; and c)the service is consistent with the needs identified through the health assessment; -to a maximum of 10 services per patient in a calendar year

0.00

 

26.25

0

0

False

26.25

$0.00

Immunisation (Aboriginal and Torres Strait Islander health practitioner)

Immunisation provided to a person by an Aboriginal and Torres Strait Islander health practitioner if: (a)the immunisation is provided on behalf of, and under the supervision of, a medical practitioner; and (b)the person is not an admitted patient of a hospital.

0.00

 

13.15

0

0

False

13.15

$0.00

Haemodialysis for a patient with end-stage renal disease if the service is provided by a registered nurse, an Aboriginal health worker or an Aboriginal and Torres Strait Islander health practitioner on behalf of a medical practitioner in an MMM 7 area

Haemodialysis for a patient with end‑stage renal disease if: (a) the service is provided by a registered nurse, an Aboriginal health worker or an Aboriginal and Torres Strait Islander health practitioner on behalf of a medical practitioner; and (b) the service is supervised by the medical practitioner (either in person or remotely); and (c) the patient’s care is managed by a nephrologist; and (d) the patient is treated or reviewed by the nephrologist every 3 to 6 months (either in person or remotely); and (e) the patient is not an admitted patient of a hospital; and (f) the service is provided in a Modified Monash 7 area

0.00

 

648.35

0

0

False

648.35

$0.00

Level A

Professional attendance by a participating nurse practitioner for an obvious problem characterised by the straightforward nature of the task that requires a short patient history and, if required, limited examination and management.

0.00

 

0

8.95

0

False

8.95

$0.00

Level C 20–40 minutes

Professional attendance by a participating nurse practitioner lasting at least 20 minutes and including any of the following: a)taking a detailed history; b)undertaking clinical examination; c)arranging any necessary investigation; d)implementing a management plan; e)providing appropriate preventive health care, for 1 or more health related issues, with appropriate documentation.

0.00

 

0

37.00

0

False

37.00

$0.00

Health services provided by a practice nurse or registered Aboriginal health worker (on behalf of a medical practitioner) for an Aboriginal or Torres Strait Islander person who has received a health assessment

Follow‑up telehealth attendance provided by a practice nurse or an Aboriginal and Torres Strait Islander health practitioner, on behalf of a medical practitioner, for an Indigenous person who has received a health check if: (a) the service is provided on behalf of and under the supervision of a medical practitioner; and (b) the service is consistent with the needs identified through the health assessment.

0.00

 

0

26.25

0

False

26.25

$0.00

Level A

Telehealth attendance by a participating nurse practitioner for an obvious problem characterised by the straightforward nature of the task that requires a short patient history and, if required, limited management.

0.00

 

0

8.95

0

False

8.95

$0.00

Level C 20–40 minutes

Telehealth attendance by a participating nurse practitioner lasting at least 20 minutes if the attendance includes any of the following that are clinically relevant: (a) taking a detailed history; (b) arranging any necessary investigation; (c) implementing a management plan; (d) providing appropriate preventive health care.

0.00

 

0

37.00

0

False

37.00

$0.00

Health services provided by a practice nurse or registered Aboriginal health worker (on behalf of a medical practitioner) for an Aboriginal or Torres Strait Islander person who has received a health assessment

Follow‑up phone attendance provided by a practice nurse or an Aboriginal and Torres Strait Islander health practitioner, on behalf of a medical practitioner, for an Indigenous person who has received a health check if: (a) the service is provided on behalf of and under the supervision of a medical practitioner; and (b) the service is consistent with the needs identified through the health assessment.

0.00

 

0

26.25

0

False

26.25

$0.00

Level A

Phone attendance by a participating nurse practitioner for an obvious problem characterised by the straightforward nature of the task that requires a short patient history and, if required, limited management.

0.00

 

0

8.95

0

False

8.95

$0.00

Level C 20–40 minutes

Phone attendance by a participating nurse practitioner lasting at least 20 minutes if the attendance includes any of the following that are clinically relevant: (a) taking a detailed history; (b) arranging any necessary investigation; (c) implementing a management plan; (d) providing appropriate preventive health care.

0.00

 

0

37.00

0

False

37.00

$0.00