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


About

This guide is intended to be used by GPs providing care to Aboriginal and Torres Strait Islander people. It includes MBS items commonly used in general practice, as well as items used by other health professionals such as allied health providers and nurse practitioners. The MBS Online Tool Terms of Use can be viewed here.

Please note out-of-pocket expenses only relate to services provided within a general practice. All Medicare services provided by Aboriginal Community Controlled Health Organisations (ACCHOs) are bulk billed.
 

How to use this tool

  • Click on the arrow in the Item column to read the full descriptor for the item and view any associated explanatory notes on MBS Online.
  • Click on values in the Clinic Fee column to enter fees for services provided in your practice. Each time you enter a clinic fee, click anywhere else on the page. The tool will then calculate the patient out-of-pocket contribution based on the MBS rebate for the service.
  • Some items have different rebates depending on the number of patients seen (derived fee items). For these items, the patient out-of-pocket contribution is calculated based on the rebate value for one patient. To view the rebates for more than one patient, click on ‘Derived fee’ in the Rebate column.
  • Click on the ‘Save as Excel’ and ‘Save as PDF’ buttons to save to your computer and print the guide.
  • Items that you don't use in your practice can be deleted from the downloaded Excel file.
 

Note on rebate values

  • The rebate amounts listed in this tool reflect the rebate payable rather than the MBS fee. This will either be 100% or 85% of the fee. 75% rebates have not been included due to their relatively low application in general practice.

MBS guide for GPs

  
Standard attendances – Face-to-face
 
ItemDescriptionClinic FeeRebateOut of pocket
3
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
Level A
0.00
 
17.90
0
0
$0.00
False
17.90
$17.90
$0.00
23
Level B <20 minutes
Professional attendance by a general practitioner at consulting rooms (other than a service to which another item in the table applies), lasting less than 20 minutes and including any of the following that are clinically relevant: (a) taking a 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
Level B <20 minutes
0
 
39.10
0
0
$0.00
False
39.10
$39.10
$0.00
36
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
Level C 20–40 minutes
0
 
75.75
0
0
$0.00
False
75.75
$75.75
$0.00
44
Level D >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 40 minutes and including any of the following that are clinically relevant: (a) taking an extensive 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
Level D >40 minutes
0
 
111.50
0
0
$0.00
False
111.50
$111.50
$0.00
Standard attendances – Videoconference
 
ItemDescriptionClinic FeeRebateOut of pocket
91790
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).
Level A
0.00
 
0
17.90
0
$0.00
False
17.90
$17.90
$0.00
91800
Level B <20 minutes
Telehealth attendance by a general practitioner lasting less than 20 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 preventative health care. 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).
Level B <20 minutes
0.00
 
0
39.10
0
$0.00
False
39.10
$39.10
$0.00
91801
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).
Level C 20–40 minutes
0.00
 
0
75.75
0
$0.00
False
75.75
$75.75
$0.00
91802
Level D >40 minutes
Telehealth attendance by a general practitioner lasting at least 40 minutes if the attendance includes any of the following that are clinically relevant: (a) taking an extensive 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).
Level D >40 minutes
0.00
 
0
111.50
0
$0.00
False
111.50
$111.50
$0.00
Standard attendances – Telephone
 
ItemDescriptionClinic FeeRebateOut of pocket
91890
Short consultation <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
Short consultation <6 minutes
0.00
 
0
17.90
0
$0.00
False
17.90
$17.90
$0.00
91891
Longer consultation >6 minutes
Phone attendance by a general practitioner lasting at least 6 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 preventative health care
Longer consultation >6 minutes
0.00
 
0
39.10
0
$0.00
False
39.10
$39.10
$0.00
92746
Consultation >20 minutes (COVID-19 hotspots)
Phone attendance by a general practitioner lasting at least 20 minutes in duration, if; (a) the service is performed on: (i) a person who is in a COVID-19 Commonwealth declared hotspot; or (ii) a person who is in COVID-19 isolation because of a State or Territory public health order; or (iii) a person who is in COVID-19 quarantine because of a State or Territory public health order; and (b) the attendance includes any of the following that are clinically relevant: (i) taking a detailed patient history; (ii) arranging any necessary investigation; (iii) implementing a management plan; (iv) providing appropriate preventative health care
Consultation >20 minutes (COVID-19 hotspots)
0.00
 
0
75.75
0
$0.00
False
75.75
$75.75
$0.00
Attendances at a place other than consulting rooms or a residential aged care facility (RACF)
 
ItemDescriptionClinic FeeRebateOut of pocket
4
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
Level A
44.90
The fee for item 3, plus $27.40 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 $2.15 per patient.
0
0
0
$0.00
False
44.90
$44.90
Derived fee
$0.00
24
Level B <20 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 less than 20 minutes and including any of the following that are clinically relevant: (a) taking a 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
Level B <20 minutes
65.90
The fee for item 23, plus $27.40 divided by the number of patients seen, up to a maximum of six patients. For seven or more patients - the fee for item 23 plus $2.15 per patient.
0
0
0
$0.00
False
65.90
$65.90
Derived fee
$0.00
37
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
Level C 20–40 minutes
102.20
The fee for item 36, plus $27.40 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 $2.15 per patient.
0
0
0
$0.00
False
102.20
$102.20
Derived fee
$0.00
47
Level D >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 40 minutes and including any of the following that are clinically relevant: (a) taking an extensive 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
Level D >40 minutes
137.65
The fee for item 44, plus $27.40 divided by the number of patients seen, up to a maximum of six patients. For seven or more patients - the fee for item 44 plus $2.15 per patient.
0
0
0
$0.00
False
137.65
$137.65
Derived fee
$0.00
After-hours attendances at consulting rooms
 
ItemDescriptionClinic FeeRebateOut of pocket
5000
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
Level A
0
 
30.15
0
0
$0.00
False
30.15
$30.15
$0.00
5020
Level B <20 minutes
Professional attendance by a general practitioner at consulting rooms (other than a service to which another item in the table applies), lasting less than 20 minutes and including any of the following that are clinically relevant: (a) taking a 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
Level B <20 minutes
0
 
51.00
0
0
$0.00
False
51.00
$51.00
$0.00
5040
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
Level C 20–40 minutes
0
 
87.40
0
0
$0.00
False
87.40
$87.40
$0.00
5060
Level D >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 40 minutes and including any of the following that are clinically relevant: (a) taking an extensive 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
Level D >40 minutes
0
 
122.55
0
0
$0.00
False
122.55
$122.55
$0.00
After-hours attendances at a place other than consulting rooms or a RACF
 
ItemDescriptionClinic FeeRebateOut of pocket
5003
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
Level A
56.65
The fee for item 5000, plus $27.00 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 $2.10 per patient.
0
0
0
$0.00
False
56.65
$56.65
Derived fee
$0.00
5023
Level B <20 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 less than 20 minutes and including any of the following that are clinically relevant: (a) taking a 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
Level B <20 minutes
77.30
The fee for item 5020, plus $27.00 divided by the number of patients seen, up to a maximum of six patients. For seven or more patients - the fee for item 5020 plus $2.10 per patient.
0
0
0
$0.00
False
77.30
$77.30
Derived fee
$0.00
5043
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
Level C 20–40 minutes
113.35
The fee for item 5040, plus $27.00 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 $2.10 per patient.
0
0
0
$0.00
False
113.35
$113.35
Derived fee
$0.00
5063
Level D >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 40 minutes and including any of the following that are clinically relevant: (a) taking an extensive 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
Level D >40 minutes
148.20
The fee for item 5060, plus $27.00 divided by the number of patients seen, up to a maximum of six patients. For seven or more patients - the fee for item 5060 plus $2.10 per patient.
0
0
0
$0.00
False
148.20
$148.20
Derived fee
$0.00
Urgent after-hours attendances at consulting rooms
 
ItemDescriptionClinic FeeRebateOut of pocket
585
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
Outside 11.00 pm – 7.00 am (first patient)
0
 
135.10
0
101.35
$0.00
False
135.10
$135.10
$0.00
599
Between 11.00 pm – 7.00 am
Professional 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; 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
Between 11.00 pm – 7.00 am
0
 
159.20
0
119.40
$0.00
False
159.20
$159.20
$0.00
Urgent after-hours attendances – Videoconference
 
ItemDescriptionClinic FeeRebateOut of pocket
92210
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.
Between 11.00 pm – 7.00 am
0.00
 
0
159.20
0
$0.00
False
159.20
$159.20
$0.00
Health assessments – Face-to-face
 
ItemDescriptionClinic FeeRebateOut of pocket
715
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
Aboriginal and Torres Strait Islander peoples’ health assessment
0
 
220.85
0
0
$0.00
False
220.85
$220.85
$0.00
93470
Aboriginal and Torres Strait Islander peoples' health assessment at a RACF
Professional face-to-face attendance by a general practitioner at a residential aged care facility to perform a health assessment of a person who is: (a) of Aboriginal or Torres Strait Islander descent; and (b) a care recipient in a residential aged care facility not more than once in a 9 month period
Aboriginal and Torres Strait Islander peoples' health assessment at a RACF
0.00
 
0
220.85
0
$0.00
False
220.85
$220.85
$0.00
699
Heart health assessment >20 minutes
Professional attendance on a patient who is 30 years of age or over for a heart health assessment by a general practitioner at consulting roomslasting at least 20 minutes and including: collection of relevant information, including taking a patient history; and a basic physical examination, which must include recording blood pressure and cholesterol; and initiating interventions and referrals as indicated; and implementing a management plan; and providing the patient with preventative health care advice and information.
Heart health assessment >20 minutes
0
 
75.75
0
0
$0.00
False
75.75
$75.75
$0.00
Health assessments – Videoconference
 
ItemDescriptionClinic FeeRebateOut of pocket
92004
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).
Aboriginal and Torres Strait Islander peoples’ health assessment
0.00
 
0
220.85
0
$0.00
False
220.85
$220.85
$0.00
Follow-up allied health items for people of Aboriginal and Torres Strait Islander descent (linked to health assessments) – Face-to-face
 
ItemDescriptionClinic FeeRebateOut of pocket
81300
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
Aboriginal and Torres Strait Islander health service
0.00
 
0
55.10
0
$0.00
False
55.10
$55.10
$0.00
81305
Diabetes education service
DIABETES EDUCATION HEALTH SERVICE provided to a person who is of Aboriginal or Torres Strait Islander descent by an eligible diabetes educator if: (a)either: a medical practitioner has 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 diabetes educator 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 diabetes educator 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
Diabetes education service
0.00
 
0
55.10
0
$0.00
False
55.10
$55.10
$0.00
81310
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
Audiology service
0.00
 
0
55.10
0
$0.00
False
55.10
$55.10
$0.00
81315
Exercise physiology service
EXERCISE PHYSIOLOGY HEALTH SERVICE provided to a person who is of Aboriginal or Torres Strait Islander descent by an eligible exercise physiologist 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 exercise physiologist 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 exercise physiologist 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
Exercise physiology service
0.00
 
0
55.10
0
$0.00
False
55.10
$55.10
$0.00
81320
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
Dietetics service
0.00
 
0
55.10
0
$0.00
False
55.10
$55.10
$0.00
81325
Mental health service
MENTAL HEALTH SERVICE provided to a person who is of Aboriginal or Torres Strait Islander descent by an eligible mental health worker 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 mental health worker 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 mental health worker 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
Mental health service
0.00
 
0
55.10
0
$0.00
False
55.10
$55.10
$0.00
81330
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
Occupational therapy service
0.00
 
64.80
0
48.60
$0.00
False
64.80
$64.80
$0.00
81335
Physiotherapy service
PHYSIOTHERAPY HEALTH SERVICE provided to a person who is of Aboriginal or Torres Strait Islander descent by an eligible physiotherapist 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 physiotherapist 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 physiotherapist 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
Physiotherapy service
0.00
 
0
55.10
0
$0.00
False
55.10
$55.10
$0.00
81340
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
Podiatry service
0.00
 
0
55.10
0
$0.00
False
55.10
$55.10
$0.00
81345
Chiropractic service
CHIROPRACTIC HEALTH SERVICE provided to a person who is of Aboriginal or Torres Strait Islander descent by an eligible chiropractor 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 chiropractor 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 chiropractor 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
Chiropractic service
0.00
 
0
55.10
0
$0.00
False
55.10
$55.10
$0.00
81350
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
Osteopathy service
0.00
 
0
55.10
0
$0.00
False
55.10
$55.10
$0.00
81355
Psychology service
PSYCHOLOGY HEALTH SERVICE provided to a person who is of Aboriginal or Torres Strait Islander descent by an eligible psychologist 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 psychologist 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 psychologist 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
Psychology service
0.00
 
0
55.10
0
$0.00
False
55.10
$55.10
$0.00
81360
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
Speech pathology service
0.00
 
0
55.10
0
$0.00
False
55.10
$55.10
$0.00
Follow-up allied health items for people of Aboriginal and Torres Strait Islander descent (linked to health assessments) – Videoconference
 
ItemDescriptionClinic FeeRebateOut of pocket
93048
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) either: (i) a medical practitioner has undertaken a health assessment and identified a need for follow-up allied health services; or (ii)the person’s shared care plan identifies the 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 Health Insurance (Allied Health Services) Determination 2014 applies) in a calendar year
All follow-up items
0.00
 
0
55.10
48.60
$0.00
False
55.10
$55.10
$0.00
Follow-up allied health items for people of Aboriginal and Torres Strait Islander descent (linked to health assessments) – Telephone
 
ItemDescriptionClinic FeeRebateOut of pocket
93061
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) either: (i) a medical practitioner has undertaken a health assessment and identified a need for follow-up allied health services; or (ii) the person’s shared care plan identifies the 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 Health Insurance (Allied Health Services) Determination 2014applies) in a calendar year
All follow-up items
0.00
 
0
55.10
0
$0.00
False
55.10
$55.10
$0.00
COVID-19 vaccine suitability assessment service (must be bulk billed)
 
ItemDescriptionClinic FeeRebateOut of pocket
93624
Dose 1, MMM 1 (business hours)
Professional attendance by a general practitioner for the purpose of assessing a patient’s suitability for the first 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 provided at, or from, a practice location in a Modified Monash 1 area Note: Effective 31 May 2021, age restrictions on the use of this item have been removed.
Dose 1, MMM 1 (business hours)
0.00
 
0
31.05
0
$0.00
False
31.05
$31.05
$0.00
93625
Dose 1, MMM 2–7 (business hours)
Professional attendance by a general practitioner for the purpose of assessing a patient’s suitability for the first 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 provided at, or from, a practice location in: (i) a Modified Monash 2 area; or (ii) a Modified Monash 3 area; or (iii) a Modified Monash 4 area; or (iv) a Modified Monash 5 area; or (v) a Modified Monash 6 area; or (vi) a Modified Monash 7 area Note: Effective 31 May 2021, age restrictions on the use of this item have been removed.
Dose 1, MMM 2–7 (business hours)
0.00
 
0
37.70
0
$0.00
False
37.70
$37.70
$0.00
93634
Dose 1, MMM 1 (after-hours)
Professional attendance by a general practitioner for the purpose of assessing a patient’s suitability for the first 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 provided at, or from, a practice location in a Modified Monash 1 area; (d) the service is rendered in an after-hours period Note: Effective 31 May 2021, age restrictions on the use of this item have been removed.
Dose 1, MMM 1 (after-hours)
0.00
 
0
43.30
0
$0.00
False
43.30
$43.30
$0.00
93635
Dose 1, MMM 2–7 (after-hours)
Professional attendance by a general practitioner for the purpose of assessing a patient’s suitability for the first 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 provided at, or from, a practice location in: (i) a Modified Monash 2 area; or (ii) a Modified Monash 3 area; or (iii) a Modified Monash 4 area; or (iv) a Modified Monash 5 area; or (v) a Modified Monash 6 area; or (vi) a Modified Monash 7 area; (d) the service is rendered in an after-hours period Note: Effective 31 May 2021, age restrictions on the use of this item have been removed.
Dose 1, MMM 2–7 (after-hours)
0.00
 
0
49.90
0
$0.00
False
49.90
$49.90
$0.00
93644
Dose 2, MMM 1 (business hours)
Professional attendance by a general practitioner for the purpose of assessing a patient’s suitability for the second or subsequent 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 provided at, or from, a practice location in a Modified Monash 1 area Note: Effective 31 may 2021, age restrictions on the use of this item have been removed
Dose 2, MMM 1 (business hours)
0.00
 
0
24.45
0
$0.00
False
24.45
$24.45
$0.00
93645
Dose 2, MMM 2–7 (business hours)
Professional attendance by a general practitioner for the purpose of assessing a patient’s suitability for the second or subsequent 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 provided at, or from, a practice location in: (i) a Modified Monash 2 area; or (ii) a Modified Monash 3 area; or (iii) a Modified Monash 4 area; or (iv) a Modified Monash 5 area; or (v) a Modified Monash 6 area; or (vi) a Modified Monash 7 area Note: Effective 31 may 2021, age restrictions on the use of this item have been removed
Dose 2, MMM 2–7 (business hours)
0.00
 
0
27.80
0
$0.00
False
27.80
$27.80
$0.00
93653
Dose 2, MMM 1 (after-hours)
Professional attendance by a general practitioner for the purpose of assessing a patient’s suitability for the second or subsequent 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 provided at, or from, a practice location in a Modified Monash 1 area; (d) the service is rendered in an after-hours period. Note: Effective 31 may 2021, age restrictions on the use of this item have been removed
Dose 2, MMM 1 (after-hours)
0.00
 
0
36.75
0
$0.00
False
36.75
$36.75
$0.00
93654
Dose 2, MMM 2–7 (after-hours)
Professional attendance by a general practitioner for the purpose of assessing a patient’s suitability for the second or subsequent 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 provided at, or from, a practice location in: (i) a Modified Monash 2 area; or (ii) a Modified Monash 3 area; or (iii) a Modified Monash 4 area; or (iv) a Modified Monash 5 area; or (v) a Modified Monash 6 area; or (vi) a Modified Monash 7 area; (d) the service is rendered in an after-hours period. Note: Effective 31 may 2021, age restrictions on the use of this item have been removed
Dose 2, MMM 2–7 (after-hours)
0.00
 
0
40.05
0
$0.00
False
40.05
$40.05
$0.00
10660
Vaccine counselling >10 minutes
Professional attendance by a general practitioner, if all of the following apply: (a) the service is associated with a service to which item 93624, 93625, 93634, 93635, 93644, 93645, 93653 or 93654 applies; (b) the service requires personal attendance by the general practitioner, lasting more than 10 minutes in duration, to provide in-depth clinical advice on the individual risks and benefits associated with receiving a COVID-19 vaccine;(c) one or both of the following is undertaken, where clinically relevant: (i) a detailed patient history; (ii) complex examination and management; (d) the service is bulk-billed Note: Effective 29 June2021, age restrictions on the use of this item have been removed.
Vaccine counselling >10 minutes
0.00
 
0
39.10
0
$0.00
False
39.10
$39.10
$0.00
90005
Flag fall item – initial attendance at an aged care/disability facility or a person's home
A flag fall service to which item 93624, 93625, 93626, 93627, 93634, 93635, 93636, 93637, 93644, 93645, 93646, 93647, 93653, 93654, 93655 or 93656 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; orb. 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.
Flag fall item – initial attendance at an aged care/disability facility or a person's home
0.00
 
0
57.25
0
$0.00
False
57.25
$57.25
$0.00
Chronic disease management – Face-to-face
 
ItemDescriptionClinic FeeRebateOut of pocket
721
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)
Preparation of a GPMP
0
 
150.10
0
112.60
$0.00
False
150.10
$150.10
$0.00
723
Coordination of a TCA
Attendance by a general practitioner to coordinate the development of team care arrangements for a patient (other than a service associated with a service to which any of items 735 to 758 apply)
Coordination of a TCA
0
 
118.95
0
89.25
$0.00
False
118.95
$118.95
$0.00
732
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
Review of a GPMP or TCA
0.00
 
74.95
0
56.25
$0.00
False
74.95
$74.95
$0.00
729
Contribution to review of multidisciplinary care plan prepared by another provider
Contribution by a general practitioner to a multidisciplinary care plan prepared by another provider or a review of a multidisciplinary care plan prepared by another provider (other than a service associated with a service to which any of items 735 to 758 apply)
Contribution to review of multidisciplinary care plan prepared by another provider
0
 
73.25
0
0
$0.00
False
73.25
$73.25
$0.00
731
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)
Contribution to review of multidisciplinary care plan prepared by another provider (patient in RACF ...
0
 
73.25
0
0
$0.00
False
73.25
$73.25
$0.00
Chronic disease management – Videoconference
 
ItemDescriptionClinic FeeRebateOut of pocket
92024
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 items735 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).
Preparation of a GPMP
0.00
 
0
150.10
0
$0.00
False
150.10
$150.10
$0.00
92025
Coordination of a TCA
Telehealth attendance by a general practitioner, to coordinate the development of team care arrangements for a patient (other than a service associated with a service to which any of items735 to 758, items 92074 to 92078 or items 92030 to 92034apply) 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).
Coordination of a TCA
0.00
 
0
118.95
0
$0.00
False
118.95
$118.95
$0.00
92028
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 item721 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 item723 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).
Review of a GPMP or TCA
0.00
 
0
74.95
0
$0.00
False
74.95
$74.95
$0.00
92026
Contribution to review of multidisciplinary care plan prepared by another provider
Telehealth contribution by a general practitioner, to a multidisciplinary care plan prepared by another provider or a review of a multidisciplinary care plan prepared by another provider (other than a service associated with a service to which any of items735 to 758, items 92074 to 92078 or items 92030 to 92034apply) 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).
Contribution to review of multidisciplinary care plan prepared by another provider
0.00
 
0
73.25
0
$0.00
False
73.25
$73.25
$0.00
92027
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 items735 to 758, items 92074 to 92078 or items 92030 to 92034apply) 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).
Contribution to review of multidisciplinary care plan prepared by another provider (patient in RACF ...
0.00
 
0
73.25
0
$0.00
False
73.25
$73.25
$0.00
Individual allied health items for people with a chronic condition and complex care needs – Face-to-face
 
ItemDescriptionClinic FeeRebateOut of pocket
10950
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
Aboriginal and Torres Strait Islander health service
0.00
 
0
55.10
0
$0.00
False
55.10
$55.10
$0.00
10951
Diabetes education service
DIABETES EDUCATION SERVICE Diabetes education health service provided to a person by an eligible diabetes educator 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 diabetes educator 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 diabetes educator 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
Diabetes education service
0.00
 
0
55.10
0
$0.00
False
55.10
$55.10
$0.00
10952
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
Audiology service
0.00
 
0
55.10
0
$0.00
False
55.10
$55.10
$0.00
10953
Exercise physiology service
EXERCISE PHYSIOLOGY Exercise physiology service provided to a person by an eligible exercise physiologist 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 underboth 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 exercise physiologist 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 exercise physiologist 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
Exercise physiology service
0.00
 
0
55.10
0
$0.00
False
55.10
$55.10
$0.00
10954
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
Dietetics service
0.00
 
0
55.10
0
$0.00
False
55.10
$55.10
$0.00
10956
Mental health service
MENTAL HEALTH SERVICE Mental health service provided to a person by an eligible mental health worker 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 mental health worker 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 mental health worker 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
Mental health service
0.00
 
0
55.10
0
$0.00
False
55.10
$55.10
$0.00
10958
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
Occupational therapy service
0.00
 
0
55.10
0
$0.00
False
55.10
$55.10
$0.00
10960
Physiotherapy service
PHYSIOTHERAPY Physiotherapy health service provided to a person by an eligible physiotherapist 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 planas part of the management of the person's chronic condition andcomplex care needs; and (c)the person is referred to the eligible physiotherapist 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 physiotherapist 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
Physiotherapy service
0.00
 
0
55.10
0
$0.00
False
55.10
$55.10
$0.00
10962
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
Podiatry service
0.00
 
0
55.10
0
$0.00
False
55.10
$55.10
$0.00
10964
Chiropractic service
CHIROPRACTIC SERVICE Chiropractic health service provided to a person by an eligible chiropractor 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 underboth 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 chiropractor 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 chiropractor 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
Chiropractic service
0.00
 
0
55.10
0
$0.00
False
55.10
$55.10
$0.00
10966
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
Osteopathy service
0.00
 
0
55.10
0
$0.00
False
55.10
$55.10
$0.00
10968
Psychology service
PSYCHOLOGY Psychology health service provided to a person by an eligible psychologist 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 psychologist 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 psychologist 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
Psychology service
0.00
 
0
55.10
0
$0.00
False
55.10
$55.10
$0.00
10970
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
Speech pathology service
0.00
 
0
55.10
0
$0.00
False
55.10
$55.10
$0.00
Allied health chronic disease management – Videoconference
 
ItemDescriptionClinic FeeRebateOut of pocket
93000
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 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 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 Health Insurance (Allied Health Services) Determination 2014 applies) in a calendar year.
All allied health chronic disease management services
0.00
 
0
55.10
0
$0.00
False
55.10
$55.10
$0.00
Allied health chronic disease management – Telephone
 
ItemDescriptionClinic FeeRebateOut of pocket
93013
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 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 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 Health Insurance (Allied Health Services) Determination 2014 applies) in a calendar year.
All allied health chronic disease management services
0.00
 
0
55.10
0
$0.00
False
55.10
$55.10
$0.00
Multidisciplinary case conferences
 
ItemDescriptionClinic FeeRebateOut of pocket
735
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)
Organise and coordinate, 15–20 minutes
0.00
 
73.55
0
55.20
$0.00
False
73.55
$73.55
$0.00
747
Participate, 15–20 minutes
Attendance by a general 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; 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)
Participate, 15–20 minutes
0.00
 
54.05
0
40.55
$0.00
False
54.05
$54.05
$0.00
739
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)
Organise and coordinate, 20–40 minutes
0.00
 
125.85
0
94.40
$0.00
False
125.85
$125.85
$0.00
750
Participate, 20–40 minutes
Attendance by a general 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; 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)
Participate, 20–40 minutes
0.00
 
92.60
0
69.45
$0.00
False
92.60
$92.60
$0.00
743
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)
Organise and coordinate, at least 40 minutes
0.00
 
209.80
0
157.35
$0.00
False
209.80
$209.80
$0.00
758
Participate, at least 40 minutes
Attendance by a general 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; 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)
Participate, at least 40 minutes
0.00
 
154.20
0
115.65
$0.00
False
154.20
$154.20
$0.00
Medication management review
 
ItemDescriptionClinic FeeRebateOut of pocket
900
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
Domiciliary medication management review
0
 
161.10
0
0
$0.00
False
161.10
$161.10
$0.00
Mental health care – Face-to-face
 
ItemDescriptionClinic FeeRebateOut of pocket
2700
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
Preparation of General Practitioner Mental Health Treatment Plan (GP MHTP) 20–40 minutes (without me...
0
 
74.60
0
55.95
$0.00
False
74.60
$74.60
$0.00
2701
Preparation of GP MHTP >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 40 minutes in duration for the preparation of a GP mental health treatment plan for a patient
Preparation of GP MHTP >40 minutes (without mental health skills training)
0
 
109.85
0
82.40
$0.00
False
109.85
$109.85
$0.00
2715
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
Preparation of GP MHTP 20–40 minutes (with mental health skills training)
0
 
94.75
0
71.10
$0.00
False
94.75
$94.75
$0.00
2717
Preparation of GP MHTP >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 40 minutes in duration for the preparation of a GP mental health treatment plan for a patient
Preparation of GP MHTP >40 minutes (with mental health skills training)
0
 
139.55
0
104.70
$0.00
False
139.55
$139.55
$0.00
2712
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
Review of GP MHTP
0
 
74.60
0
55.95
$0.00
False
74.60
$74.60
$0.00
2713
Attendance related to mental disorder >20 minutes
Professional attendance by a general practitioner in relation to a mental disorder and of at least 20 minutes in duration, involving taking relevant history and identifying the presenting problem (to the extent not previously recorded), providing treatment and advice and, if appropriate, referral for other services or treatments, and documenting the outcomes of the consultation
Attendance related to mental disorder >20 minutes
0
 
74.60
0
0
$0.00
False
74.60
$74.60
$0.00
Mental health care – Videoconference
 
ItemDescriptionClinic FeeRebateOut of pocket
92112
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.
Preparation of General Practitioner Mental Health Treatment Plan (GP MHTP) 20–40 minutes (without me...
0.00
 
0
74.60
0
$0.00
False
74.60
$74.60
$0.00
92113
Preparation of GP MHTP >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 40 minutes in duration for the preparation of a GP mental health treatment plan for a patient.
Preparation of GP MHTP >40 minutes (without mental health skills training)
0.00
 
0
109.85
0
$0.00
False
109.85
$109.85
$0.00
92116
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.
Preparation of GP MHTP 20–40 minutes (with mental health skills training)
0.00
 
0
94.75
0
$0.00
False
94.75
$94.75
$0.00
92117
Preparation of GP MHTP >40 minutes (with mental health skills training)
Telehealth attendance, by a general practitioner who has undertaken mental health skills training, of at least 40 minutes in duration for the preparation of a GP mental health treatment plan for a patient.
Preparation of GP MHTP >40 minutes (with mental health skills training)
0.00
 
0
139.55
0
$0.00
False
139.55
$139.55
$0.00
92114
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.
Review of GP MHTP
0.00
 
0
74.60
0
$0.00
False
74.60
$74.60
$0.00
92115
Attendance related to mental disorder >20 minutes
Telehealth attendance by a general practitioner in relation to a mental disorder and of at least 20 minutes in duration, involving taking relevant history and identifying the presenting problem (to the extent not previously recorded), providing treatment and advice and, if appropriate, referral for other services or treatments, and documenting the outcomes of the consultation.
Attendance related to mental disorder >20 minutes
0.00
 
0
74.60
0
$0.00
False
74.60
$74.60
$0.00
Mental health care – Telephone
 
ItemDescriptionClinic FeeRebateOut of pocket
92126
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.
Review of GP MHTP
0.00
 
0
74.60
0
$0.00
False
74.60
$74.60
$0.00
92127
Attendance related to mental disorder >20 minutes
Phone attendance by a general practitioner in relation to a mental disorder and of at least 20 minutes in duration, involving taking relevant history and identifying the presenting problem (to the extent not previously recorded), providing treatment and advice and, if appropriate, referral for other services or treatments, and documenting the outcomes of the consultation.
Attendance related to mental disorder >20 minutes
0.00
 
0
74.60
0
$0.00
False
74.60
$74.60
$0.00
Blood borne viruses, sexual or reproductive health services – Videoconference
 
ItemDescriptionClinic FeeRebateOut of pocket
92715
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
Level A
0.00
 
0
17.90
0
$0.00
False
17.90
$17.90
$0.00
92718
Level B <20 minutes
Telehealth attendance for the provision of services related to blood borne viruses, sexual or reproductive health by a general practitioner of more than 5 minutes in duration but not more than 20 minutes if the attendance includes any of the following that are clinically relevant: (a) taking a patient history; (b) arranging any necessary investigation; (c) implementing a management plan; (d) providing appropriate preventive health care
Level B <20 minutes
0.00
 
0
39.10
0
$0.00
False
39.10
$39.10
$0.00
92721
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
Level C 20–40 minutes
0.00
 
0
75.75
0
$0.00
False
75.75
$75.75
$0.00
92724
Level D >40 minutes
Telehealth attendance for the provision of services related to blood borne viruses, sexual or reproductive health by a general practitioner lasting at least 40 minutes in duration 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
Level D >40 minutes
0.00
 
0
111.50
0
$0.00
False
111.50
$111.50
$0.00
Blood borne viruses, sexual or reproductive health services – Telephone
 
ItemDescriptionClinic FeeRebateOut of pocket
92731
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
Level A
0.00
 
0
17.90
0
$0.00
False
17.90
$17.90
$0.00
92734
Level B <20 minutes
Phone attendance for the provision of services related to blood borne viruses, sexual or reproductive health by a general practitioner of more than 5 minutes in duration but not more than 20 minutes if the attendance includes any of the following that are clinically relevant: (a) taking a patient history; (b) arranging any necessary investigation; (c) implementing a management plan; (d) providing appropriate preventive health care
Level B <20 minutes
0.00
 
0
39.10
0
$0.00
False
39.10
$39.10
$0.00
92737
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
Level C 20–40 minutes
0.00
 
0
75.75
0
$0.00
False
75.75
$75.75
$0.00
92740
Level D >40 minutes
Phone attendance for the provision of services related to blood borne viruses, sexual or reproductive health by a general practitioner lasting at least 40 minutes in duration if the attendance includes any of the following that are clinically relevant: (a) taking an extensive patient history; (b) arranging any necessary investigation; (c) implementing a management plan; (d) providing appropriate preventive health care
Level D >40 minutes
0.00
 
0
111.50
0
$0.00
False
111.50
$111.50
$0.00
Smoking cessation services – Face-to-face
 
ItemDescriptionClinic FeeRebateOut of pocket
93680
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
Level B <20 minutes
0.00
 
0
39.10
0
$0.00
False
39.10
$39.10
$0.00
93683
Level C 20–40 minutes
Professional attendance for nicotine and smoking cessation counselling, care and advice by a general practitioner at consulting rooms lasting at least 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
Level C 20–40 minutes
0.00
 
0
75.75
0
$0.00
False
75.75
$75.75
$0.00
Smoking cessation services – Videoconference
 
ItemDescriptionClinic FeeRebateOut of pocket
93690
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.
Level B <20 minutes
0.00
 
0
39.10
0
$0.00
False
39.10
$39.10
$0.00
93693
Level C 20–40 minutes
Telehealth attendance for nicotine and smoking cessation counselling, care and advice by a general practitioner lasting at least 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.
Level C 20–40 minutes
0.00
 
0
75.75
0
$0.00
False
75.75
$75.75
$0.00
Smoking cessation services – Telephone
 
ItemDescriptionClinic FeeRebateOut of pocket
93700
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.
Level B <20 minutes
0.00
 
0
39.10
0
$0.00
False
39.10
$39.10
$0.00
93703
Level C 20–40 minutes
Phone attendance for nicotine and smoking cessation counselling, care and advice by a general practitioner lasting at least 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.
Level C 20–40 minutes
0.00
 
0
75.75
0
$0.00
False
75.75
$75.75
$0.00
Pregnancy care – Face-to-face
 
ItemDescriptionClinic FeeRebateOut of pocket
16400
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
Antenatal service by midwife/nurse (Rural Remote Metropolitan Area [RRMA] 3–7)
0
 
0
24.10
0
$0.00
False
24.10
$24.10
$0.00
16500
Antenatal attendance
ANTENATAL ATTENDANCE
Antenatal attendance
0.00
 
0
41.70
36.80
$0.00
False
41.70
$41.70
$0.00
16502
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
Attendance (hospital) – complicated pregnancy treated with oral medication or bed rest
0.00
 
0
41.70
36.80
$0.00
False
41.70
$41.70
$0.00
55703
Pregnancy ultrasound (uncertain dates less than 12 weeks)
Pelvis or abdomen, pregnancy related or pregnancy complication, ultrasound scan of, by any or all approaches, for determining the gestation, location, viability or number of foetuses, if the dating of the pregnancy (as confirmed by ultrasound) is less than 12 weeks of gestation (NR)
Pregnancy ultrasound (uncertain dates less than 12 weeks)
0.00
 
0
30.45
26.85
$0.00
False
30.45
$30.45
$0.00
55709
Pregnancy ultrasound (dating is 17 to 22 weeks)
Pelvis or abdomen, pregnancy related or pregnancy complication, fetal development and anatomy, 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 ultrasound) is 17 to 22 weeks of gestation; and(b the service is not performed in the same pregnancy as item 55706 (NR)
Pregnancy ultrasound (dating is 17 to 22 weeks)
0.00
 
0
33.10
29.20
$0.00
False
33.10
$33.10
$0.00
Pregnancy care – Videoconference
 
ItemDescriptionClinic FeeRebateOut of pocket
91850
Antenatal service by midwife/nurse (Rural Remote Metropolitan Area [RRMA] 3–7)
Antenatal telehealth service provided by a 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 provided at, or from, a practice location in a regional, rural or remote area; and (c) 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.
Antenatal service by midwife/nurse (Rural Remote Metropolitan Area [RRMA] 3–7)
0.00
 
0
24.10
0
$0.00
False
24.10
$24.10
$0.00
91853
Antenatal attendance
Antenatal telehealth attendance.
Antenatal attendance
0.00
 
0
41.70
0
$0.00
False
41.70
$41.70
$0.00
Pregnancy care – Telephone
 
ItemDescriptionClinic FeeRebateOut of pocket
91855
Antenatal service by midwife/nurse (RRMA 3–7)
Antenatal phone service provided by a 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 provided at, or from, a practice location in a regional, rural or remote area; and (c) 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.
Antenatal service by midwife/nurse (RRMA 3–7)
0.00
 
0
24.10
0
$0.00
False
24.10
$24.10
$0.00
91858
Antenatal attendance
Antenatal phone attendance.
Antenatal attendance
0.00
 
0
41.70
0
$0.00
False
41.70
$41.70
$0.00
Miscellaneous tests and procedures
 
ItemDescriptionClinic FeeRebateOut of pocket
11506
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
Spirometry before and after bronchodilator, each occasion at which recordings are made
0
 
0
18.20
16.05
$0.00
False
18.20
$18.20
$0.00
11707
ECG (12-lead), tracing only
Twelve‑lead electrocardiography, trace only, by a medical practitioner, if: (a) the trace: (i) is required to inform clinical decision making; and (ii) is reviewed in a clinically appropriate timeframe to identify potentially serious or life‑threatening abnormalities; and (iii) does not need to be fully interpreted or reported on; and (b) the service is not associated with a service to which item12203, 12204, 12205, 12207, 12208, 12210, 12213, 12215, 12217 or 12250 applies Applicable not more than twice on the same day Note: the service is not provided to the patient as part of an episode of: hospital treatment; or hospital-substitute treatment.
ECG (12-lead), tracing only
0
 
0
16.30
0
$0.00
False
16.30
$16.30
$0.00
13757
Therapeutic venesection
THERAPEUTIC VENESECTION for the management of haemochromatosis, polycythemia vera or porphyria cutanea tarda
Therapeutic venesection
0.00
 
0
64.55
56.95
$0.00
False
64.55
$64.55
$0.00
14203
Hormone implant by direct implantation
HORMONE OR LIVING TISSUE IMPLANTATION, by direct implantation involving incision and suture (Anaes.)
Hormone implant by direct implantation
0
 
0
45.25
39.90
$0.00
False
45.25
$45.25
$0.00
14206
Hormone implant by cannula (including Implanon)
HORMONE OR LIVING TISSUE IMPLANTATIONby cannula
Hormone implant by cannula (including Implanon)
0.00
 
0
31.50
27.80
$0.00
False
31.50
$31.50
$0.00
30061
Superficial foreign body, including from cornea or sclera
SUPERFICIAL FOREIGN BODY, REMOVAL OF, (including from cornea or sclera), as an independent procedure (Anaes.)
Superficial foreign body, including from cornea or sclera
0
 
0
20.80
18.35
$0.00
False
20.80
$20.80
$0.00
30064
Subcutaneous foreign body
SUBCUTANEOUS FOREIGN BODY, removal of, requiring incision and exploration, including closure of wound if performed, as an independent procedure (Anaes.)
Subcutaneous foreign body
0
 
0
97.20
85.75
$0.00
False
97.20
$97.20
$0.00
35503
Intrauterine contraceptive device – introduction
Intra uterine contraceptive device, introduction of, if the service is not associated with a service to which another item in this Group applies (other than a service mentioned in item 30062) (Anaes.)
Intrauterine contraceptive device – introduction
0
 
0
47.35
41.80
$0.00
False
47.35
$47.35
$0.00
35506
Intrauterine contraceptive device – removal
INTRAUTERINE CONTRACEPTIVE DEVICE, REMOVAL OF UNDER GENERAL ANAESTHESIA, not being a service associated with a service to which another item in this Group applies (Anaes.)
Intrauterine contraceptive device – removal
0
 
0
47.50
41.90
$0.00
False
47.50
$47.50
$0.00
73805
Microscopy of urine
Microscopy of urine, excluding dipstick testing.
Microscopy of urine
0
 
0
3.90
3.45
$0.00
False
3.90
$3.90
$0.00
73806
Pregnancy test
Pregnancy test by 1 or more immunochemical methods
Pregnancy test
0
 
0
8.65
7.65
$0.00
False
8.65
$8.65
$0.00
73839
Quantitation of HbA1c (glycated haemoglobin) for diagnosis (Quality Assurance in Aboriginal Medical Services [QAAMS] Program)
Quantitation of HbA1c (glycated haemoglobin) performed for the diagnosis of diabetes in asymptomatic patients at high risk - not more than once in a 12 month period. (Item is subject to restrictions in rulePR.9.1 of explanatory notes to this category)
Quantitation of HbA1c (glycated haemoglobin) for diagnosis (Quality Assurance in Aboriginal Medical ...
0.00
 
0
14.30
12.60
$0.00
False
14.30
$14.30
$0.00
73840
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)
Quantitation of glycosylated haemoglobin for diabetes monitoring (QAAMS)
0.00
 
0
14.45
12.75
$0.00
False
14.45
$14.45
$0.00
73844
Quantitation of urinary microalbumin (QAAMS)
Quantitation of urinary microalbumin as determined by urine albumin excretion on a timed overnight urine sample or urine albumin/creatinine ratio as determined on a first morning urine sample in the management of established diabetes. (Item is subject to restrictions in rulePR.9.1 of explanatory notes to this category)
Quantitation of urinary microalbumin (QAAMS)
0.00
 
0
17.30
15.30
$0.00
False
17.30
$17.30
$0.00
12325
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
Assessment of visual acuity and bilateral retinal photography with a non-mydriatic retinal camera (f...
0.00
 
0
44.20
39.00
$0.00
False
44.20
$44.20
$0.00
Services provided on behalf of a medical practitioner – Face-to-face
 
ItemDescriptionClinic FeeRebateOut of pocket
10987
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
Health services provided by a practice nurse or registered Aboriginal health worker (on behalf of a ...
0.00
 
24.95
0
0
$0.00
False
24.95
$24.95
$0.00
10997
Service to patient with a chronic disease by a practice nurse or registered Aboriginal health worker
Service provided to a person with a chronic disease by a practice nurse or an Aboriginal and Torres Strait Islander health practitioner 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 person has a GP Management Plan, Team Care Arrangements or Multidisciplinary Care Plan in place; and (d) the service is consistent with the GP Management Plan, Team Care Arrangements or Multidisciplinary Care Plan to a maximum of 5 services per patient in a calendar year
Service to patient with a chronic disease by a practice nurse or registered Aboriginal health worker
0
 
12.50
0
0
$0.00
False
12.50
$12.50
$0.00
10988
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.
Immunisation (Aboriginal and Torres Strait Islander health practitioner)
0.00
 
12.50
0
0
$0.00
False
12.50
$12.50
$0.00
10989
Wound management (Aboriginal and Torres Strait Islander health practitioner)
Treatment of a person's wound (other than normal aftercare) provided by an Aboriginal and Torres Strait Islander health practitioner if: (a)the treatment 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.
Wound management (Aboriginal and Torres Strait Islander health practitioner)
0.00
 
12.50
0
0
$0.00
False
12.50
$12.50
$0.00
13105
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
Haemodialysis for a patient with end-stage renal disease if the service is provided by a registered ...
0.00
 
615.95
0
0
$0.00
False
615.95
$615.95
$0.00
Nurse practitioner services – Face-to-face
 
ItemDescriptionClinic FeeRebateOut of pocket
82200
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.
Level A
0.00
 
0
8.50
0
$0.00
False
8.50
$8.50
$0.00
82205
Level B <20 minutes
Professional attendance by a participating nurse practitioner lasting less than 20 minutes and including any of the following: a)taking a 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.
Level B <20 minutes
0.00
 
0
18.55
0
$0.00
False
18.55
$18.55
$0.00
82210
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.
Level C 20–40 minutes
0.00
 
0
35.15
0
$0.00
False
35.15
$35.15
$0.00
82215
Level D >40 minutes
Professional attendance by a participating nurse practitioner lasting at least 40 minutes and including any of the following: a)taking an extensive 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.
Level D >40 minutes
0.00
 
0
51.85
0
$0.00
False
51.85
$51.85
$0.00
Services provided on behalf of a medical practitioner – Videoconference
 
ItemDescriptionClinic FeeRebateOut of pocket
93200
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.
Health services provided by a practice nurse or registered Aboriginal health worker (on behalf of a ...
0.00
 
0
24.95
0
$0.00
False
24.95
$24.95
$0.00
93201
Service to patient with a chronic disease by a practice nurse or registered Aboriginal health worker
Telehealth attendance provided by a practice nurse or an Aboriginal and Torres Strait Islander health practitioner to a person with a chronic disease if: (a) the service is provided on behalf of and under the supervision of a medical practitioner; and (b) the person has a GP management plan, team care arrangements or multidisciplinary care plan in place and the service is consistent with the plan or arrangements.
Service to patient with a chronic disease by a practice nurse or registered Aboriginal health worker
0.00
 
0
12.50
0
$0.00
False
12.50
$12.50
$0.00
Nurse practitioner services – Videoconference
 
ItemDescriptionClinic FeeRebateOut of pocket
91192
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.
Level A
0.00
 
0
8.50
0
$0.00
False
8.50
$8.50
$0.00
91178
Level B <20 minutes
Telehealth attendance by a participating nurse practitioner lasting less than 20 minutes if the attendance includes any of the following that are clinically relevant: (a) taking a short history; (b) arranging any necessary investigation; (c) implementing a management plan; (d) providing appropriate preventive health care.
Level B <20 minutes
0.00
 
0
18.55
0
$0.00
False
18.55
$18.55
$0.00
91179
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.
Level C 20–40 minutes
0.00
 
0
35.15
0
$0.00
False
35.15
$35.15
$0.00
91180
Level D >40 minutes
Telehealth attendance by a participating nurse practitioner lasting at least 40 minutes if the attendance includes any of the following that are clinically relevant: (a) taking an extensive history; (b) arranging any necessary investigation; (c) implementing a management plan; (d) providing appropriate preventive health care.
Level D >40 minutes
0.00
 
0
51.85
0
$0.00
False
51.85
$51.85
$0.00
Services provided on behalf of a medical practitioner – Telephone
 
ItemDescriptionClinic FeeRebateOut of pocket
93202
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.
Health services provided by a practice nurse or registered Aboriginal health worker (on behalf of a ...
0.00
 
0
24.95
0
$0.00
False
24.95
$24.95
$0.00
93203
Service to patient with a chronic disease by a practice nurse or registered Aboriginal health worker
Phone attendance provided by a practice nurse or an Aboriginal and Torres Strait Islander health practitioner to a person with a chronic disease if: (a) the service is provided on behalf of and under the supervision of a medical practitioner; and (b) the person has a GP management plan, team care arrangements or multidisciplinary care plan in place and the service is consistent with the plan or arrangements.
Service to patient with a chronic disease by a practice nurse or registered Aboriginal health worker
0.00
 
0
12.50
0
$0.00
False
12.50
$12.50
$0.00
Nurse practitioner services – Telephone
 
ItemDescriptionClinic FeeRebateOut of pocket
91193
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.
Level A
0.00
 
0
8.50
0
$0.00
False
8.50
$8.50
$0.00
91189
Level B <20 minutes
Phone attendance by a participating nurse practitioner lasting less than 20 minutes if the attendance includes any of the following that are clinically relevant: (a) taking a short history; (b) arranging any necessary investigation; (c) implementing a management plan; (d) providing appropriate preventive health care.
Level B <20 minutes
0.00
 
0
18.55
0
$0.00
False
18.55
$18.55
$0.00
91190
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.
Level C 20–40 minutes
0.00
 
0
35.15
0
$0.00
False
35.15
$35.15
$0.00
91191
Level D >40 minutes
Phone attendance by a participating nurse practitioner lasting at least 40 minutes if the attendance includes any of the following that are clinically relevant: (a) taking an extensive history; (b) arranging any necessary investigation; (c) implementing a management plan; (d) providing appropriate preventive health care.
Level D >40 minutes
0.00
 
0
51.85
0
$0.00
False
51.85
$51.85
$0.00
Bulk billing incentive items
 
ItemDescriptionClinic FeeRebateOut of pocket
10990
General medical services
A medical service to which an item in this Schedule (other than this item or item10991 or 10992) applies if: (a) the service is an unreferred service; and (b) the service is provided to a patient who is under the age of 16 or is a concessional beneficiary; and (c) the patient is not an admitted patient of a hospital; and (d) the service is bulk‑billed in relation to the fees for: (i) this item; and (ii) the other item in this Schedule applying to the service
General medical services
0
 
0
6.55
0
$0.00
False
6.55
$6.55
$0.00
10991
General medical services in Modified Monash Model (MMM) areas 2–7
A medical service to which an item in this Schedule (other than this item or item10990 or 10992) applies if: (a) the service is an unreferred service; and (b) the service is provided to a patient who is under the age of 16 or is a concessional beneficiary; and (c) the patient is not an admitted patient of a hospital; and (d) the service is bulk‑billed in relation to the fees for: (i) this item; and (ii) the other item in this Schedule applying to the service; and (e) the service is provided at, or from, a practice location in: (i) a Modified Monash 2 area; or (ii) a Modified Monash 3 area; or (iii) a Modified Monash 4 area; or (iv) a Modified Monash 5 area; or (v) a Modified Monash 6 area; or (vi) a Modified Monash 7 area
General medical services in Modified Monash Model (MMM) areas 2–7
0
 
0
9.90
0
$0.00
False
9.90
$9.90
$0.00
64990
Radiology bulk billing incentive
A diagnostic imaging service to which an item in this table (other than this item or item 64991) applies if: (a)the service is an unreferred service; and (b)the service is provided to a person who is under the age of 16 or is a Commonwealth concession card holder; and (c)the person is not an admitted patient of a hospital; and (d)the service is bulk-billed in respect of the fees for: (i)this item; and (ii)the other item in this table applying to the service
Radiology bulk billing incentive
0.00
 
0
6.15
0
$0.00
False
6.15
$6.15
$0.00
64991
Radiology bulk billing incentive in MMM areas 2–7
A diagnostic imaging service to which an item in this table (other than this item or item 64990) applies if: (a)the service is an unreferred service; and (b)the service is provided to a person who is under the age of 16 or is a Commonwealth concession card holder; and (c)the person is not an admitted patient of a hospital; and (d)the service is bulk-billed in respect of the fees for: (i)this item; and (ii)the other item in this table applying to the service; and (e)the service is provided at, or from, a practice location within Modified Monash areas 2 to 7.
Radiology bulk billing incentive in MMM areas 2–7
0.00
 
0
9.30
0
$0.00
False
9.30
$9.30
$0.00
74990
Unreferred pathology services
A pathology service to which an item in this table (other than this item or item 74991) applies if: (a)the service is an unreferred service; and (b)the service is provided to a person who is under the age of 16 or is a Commonwealth concession card holder;and (c)the person is not an admitted patient of a hospital; and (d)the service is bulk-billed in respect of the fees for: (i)this item; and (ii)the other item in this table applying to the service
Unreferred pathology services
0.00
 
0
6.15
0
$0.00
False
6.15
$6.15
$0.00
74991
Unreferred pathology services in MMM areas 2–7
A pathology service to which an item in this table (other than this item or item 74990) applies if: (a)the service is an unreferred service; and (b)the service is provided to a person who is under the age of 16 or is a Commonwealth concession card holder; and (c)the person is not an admitted patient of a hospital; and (d)the service is bulk-billed in respect of the fees for: (i)this item; and (ii)the other item in this table applying to the service; and (e) the service is provided at, or from, a practice location within Modified Monash areas 2 to 7.
Unreferred pathology services in MMM areas 2–7
0.00
 
0
9.30
0
$0.00
False
9.30
$9.30
$0.00
Support for telehealth consultations with non-GP specialists and consultant physicians
 
ItemDescriptionClinic FeeRebateOut of pocket
10983
Attendance by a practice nurse or an Aboriginal health worker on behalf of, and under the supervision of, a medical practitioner
Attendance by a practice nurse, an Aboriginal health worker or an Aboriginal and Torres Strait Islander health practitioner on behalf of, and under the supervision of, a medical practitioner, to provide clinical support to a patient who: (a)is participating in a video conferencing consultation with a specialist, consultant physician or psychiatrist; and (b)is not an admitted patient; and (c)either: (i) is located both: (A) within a telehealth eligible area; and (B) at the time of the attendance-at least 15 kms by road from the specialist, physician or psychiatrist mentioned in paragraph (a); or (ii) is a patient of: (A) an Aboriginal Medical Service; or (B) an Aboriginal Community Controlled Health Service for which a direction made under subsection 19 (2) of the Act applies
Attendance by a practice nurse or an Aboriginal health worker on behalf of, and under the supervisio...
0.00
 
33.70
0
0
$0.00
False
33.70
$33.70
$0.00
10984
Attendance by a practice nurse or an Aboriginal health worker on behalf of, and under the supervision of, a medical practitioner at a RACF
Service by a practice nurse or Aboriginal health worker or Aboriginal and Torres Strait Islander health practitioner provided on behalf of, and under the supervision of, a medical practitioner that requires the provision of clinical support to a patient who is: a)a care recipient receiving care in a residential aged care service (other than a self-contained unit); or b)at consulting rooms situated within such a complex if the patient is a care recipient receiving care in a residential aged care service (excluding accommodation in a self-contained unit); and who is participating in a video consultation with a specialist or consultant physician.
Attendance by a practice nurse or an Aboriginal health worker on behalf of, and under the supervisio...
0.00
 
33.70
0
0
$0.00
False
33.70
$33.70
$0.00