MBS Category 1
Professional attendances: MBS items and fees.
All 689 items in Category 1, with each item’s schedule fee and Medicare benefits, from the MBS edition of 1 November 2026.
Source: the MBS XML file of 1 November 2026, published by the Department of Health, Disability and Ageing. We update these pages for each MBS edition.
A1 General Practitioner Attendances To Which No Other Item Applies
10 items
| Item | Description | Fee and benefits |
|---|---|---|
| 3 | 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 | $20.55 100% benefit $20.55 |
| 4 | New wording on 1 November 2026Professional attendance by a general practitioner (other than attendance at consulting rooms or a residential care home or a service to which another item in this Schedule 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 Derived fee: The fee for item 3, plus $31.50 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 $2.50 per patient. | Derived |
| 23 | Professional attendance by a general practitioner at consulting rooms (other than a service to which another item in this Schedule applies), lasting at least 6 minutes and 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 | $45.05 100% benefit $45.05 |
| 24 | New wording on 1 November 2026Professional attendance by a general practitioner (other than attendance at consulting rooms or a residential care home or a service to which another item in this Schedule applies), lasting at least 6 minutes and 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 Derived fee: The fee for item 23, plus $31.50 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 $2.50 per patient. | Derived |
| 36 | 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 | $87.10 100% benefit $87.10 |
| 37 | New wording on 1 November 2026Professional attendance by a general practitioner (other than attendance at consulting rooms or a residential care home or a service to which another item in this Schedule 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 Derived fee: The fee for item 36, plus $31.50 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 $2.50 per patient. | Derived |
| 44 | 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 | $128.35 100% benefit $128.35 |
| 47 | New wording on 1 November 2026Professional attendance by a general practitioner (other than attendance at consulting rooms or a residential care home or a service to which another item in this Schedule 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 Derived fee: The fee for item 44, plus $31.50 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 $2.50 per patient. | Derived |
| 123 | Professional attendance by a general practitioner at consulting rooms (other than a service to which another item in this Schedule applies), lasting at least 60 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 | $207.90 100% benefit $207.90 |
| 124 | New wording on 1 November 2026Professional attendance by a general practitioner (other than attendance at consulting rooms or a residential care home or a service to which another item in this Schedule applies), lasting at least 60 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 Derived fee: The fee for item 123, plus $31.50 divided by the number of patients seen, up to a maximum of six patients. For seven or more patients - the fee for item 123 plus $2.50 per patient. | Derived |
A2 Other Non-Referred Attendances To Which No Other Item Applies
10 items
| Item | Description | Fee and benefits |
|---|---|---|
| 52 | Professional attendance at consulting rooms of not more than 5 minutes in duration (other than a service to which any other item applies)-each attendance, by: (a) a medical practitioner (who is not a general practitioner); or (b) a Group A1 disqualified general practitioner, as defined in the dictionary of the General Medical Services Table (GMST). | $11.00 100% benefit $11.00 |
| 53 | Professional attendance at consulting rooms of more than 5 minutes in duration but not more than 25 minutes (other than a service to which any other item applies)-each attendance, by: (a) a medical practitioner (who is not a general practitioner); or (b) a Group A1 disqualified general practitioner, as defined in the dictionary of the General Medical Services Table (GMST). | $21.00 100% benefit $21.00 |
| 54 | Professional attendance at consulting rooms of more than 25 minutes in duration but not more than 45 minutes (other than a service to which any other item applies)-each attendance, by: (a) a medical practitioner (who is not a general practitioner); or (b) a Group A1 disqualified general practitioner, as defined in the dictionary of the General Medical Services Table (GMST). | $38.00 100% benefit $38.00 |
| 57 | Professional attendance at consulting rooms lasting more than 45 minutes, but not more than 60 minutes (other than a service to which any other item applies) by:(a) a medical practitioner who is not a general practitioner; or(b) a Group A1 disqualified general practitioner | $61.00 100% benefit $61.00 |
| 58 | New wording on 1 November 2026Professional attendance (other than an attendance at consulting rooms or a residential care home or a service to which any other item in the table applies), not more than 5 minutes in duration-an attendance on one or more patients at one place on one occasion-each patient, by:(a) a medical practitioner (who is not a general practitioner); or (b) a Group A1 disqualified general practitioner, as defined in the dictionary of the General Medical Services Table (GMST). Derived fee: An amount equal to $8.50, plus $15.50 divided by the number of patients seen, up to a maximum of six patients. For seven or more patients - an amount equal to $8.50 plus $.70 per patient | Derived |
| 59 | New wording on 1 November 2026Professional attendance (other than an attendance at consulting rooms or a residential care home or a service to which any other item in the table applies) of more than 5 minutes in duration but not more than 25 minutes-an attendance on one or more patients at one place on one occasion-each patient, by:(a) a medical practitioner (who is not a general practitioner); or (b) a Group A1 disqualified general practitioner, as defined in the dictionary of the General Medical Services Table (GMST). Derived fee: An amount equal to $16.00, plus $17.50 divided by the number of patients seen, up to a maximum of six patients. For seven or more patients - an amount equal to $16.00 plus $.70 per patient | Derived |
| 60 | New wording on 1 November 2026Professional attendance (other than an attendance at consulting rooms or a residential care home or a service to which any other item in the table applies) of more than 25 minutes in duration but not more than 45 minutes-an attendance on one or more patients at one place on one occasion-each patient, by:(a) a medical practitioner (who is not a general practitioner); or (b) a Group A1 disqualified general practitioner, as defined in the dictionary of the General Medical Services Table (GMST). Derived fee: An amount equal to $35.50, plus $15.50 divided by the number of patients seen, up to a maximum of six patients. For seven or more patients - an amount equal to $35.50 plus $.70 per patient | Derived |
| 65 | New wording on 1 November 2026Professional attendance (other than an attendance at consulting rooms or a residential care home or a service to which any other item in this Schedule applies) lasting more than 45 minutes but not more than 60 minutes —an attendance on one or more patients at one place on one occasion—each patient, by:(a) a medical practitioner who is not a general practitioner; or(b) a Group A1 disqualified general practitioner Derived fee: An amount equal to $57.50, plus $15.50 divided by the number of patients seen, up to a maximum of six patients. For seven or more patients - an amount equal to $57.50 plus $0.70 per patient | Derived |
| 151 | Professional attendance at consulting rooms lasting more than 60 minutes (other than a service to which any other item applies) by:(a) a medical practitioner who is not a general practitioner; or(b) a Group A1 disqualified general practitioner | $98.40 100% benefit $98.40 |
| 165 | New wording on 1 November 2026Professional attendance (other than an attendance at consulting rooms or a residential care home or a service to which any other item in this Schedule applies) lasting more than 60 minutes—an attendance on one or more patients at one place on one occasion—each patient, by:(a) a medical practitioner who is not a general practitioner; or(b) a Group A1 disqualified general practitioner Derived fee: An amount equal to $88.20, plus $15.50 divided by the number of patients seen, up to a maximum of six patients. For seven or more patients - an amount equal to $88.20 plus $0.70 per patient | Derived |
A3 Specialist Attendances To Which No Other Item Applies
12 items
| Item | Description | Fee and benefits |
|---|---|---|
| 104 | Professional attendance at consulting rooms or hospital by a specialist in the practice of the specialist’s specialty after referral of the patient to the specialist—initial attendance in a single course of treatment, other than a service to which item 106, 109, 125 or 16401 applies | $103.95 75% benefit $78.00 85% benefit $88.40 |
| 105 | Professional attendance by a specialist in the practice of the specialist’s specialty following referral of the patient to the specialist—an attendance after the initial attendance in a single course of treatment, if that attendance is at consulting rooms or hospital, other than a service to which item 126 or 16404 applies | $52.25 75% benefit $39.20 85% benefit $44.45 |
| 106 | Professional attendance by a specialist in the practice of the specialist's specialty of ophthalmology and following referral of the patient to the specialist-an attendance (other than a second or subsequent attendance in a single course of treatment) at which the only service provided is refraction testing for the issue of a prescription for spectacles or contact lenses, if that attendance is at consulting rooms or hospital (other than a service to which any of items 104, 109 and 10801 to 10816 applies) | $86.25 75% benefit $64.70 85% benefit $73.35 |
| 107 | Professional attendance by a specialist in the practice of the specialist's specialty following referral of the patient to the specialist-an attendance (other than a second or subsequent attendance in a single course of treatment), if that attendance is at a place other than consulting rooms or hospital | $152.50 75% benefit $114.40 85% benefit $129.65 |
| 108 | Professional attendance by a specialist in the practice of the specialist's specialty following referral of the patient to the specialist-each attendance after the first in a single course of treatment, if that attendance is at a place other than consulting rooms or hospital | $96.55 75% benefit $72.45 85% benefit $82.10 |
| 109 | Professional attendance by a specialist in the practice of the specialist's specialty of ophthalmology following referral of the patient to the specialist-an attendance (other than a second or subsequent attendance in a single course of treatment) at which a comprehensive eye examination, including pupil dilation, is performed on: (a) a patient aged 9 years or younger; or (b) a patient aged 14 years or younger with developmental delay; (other than a service to which any of items 104, 106 and 10801 to 10816 applies) | $234.25 75% benefit $175.70 85% benefit $199.15 |
| 111 | Professional attendance at consulting rooms or in hospital by a specialist in the practice of the specialist's specialty following referral of the patient to the specialist by a referring practitioner-an attendance after the first attendance in a single course of treatment, if: (a) during the attendance, the specialist determines the need to perform an operation on the patient that had not otherwise been scheduled; and (b) the specialist subsequently performs the operation on the patient, on the same day; and (c) the operation is a service to which an item in Group T8 applies; and (d) the amount specified in the item in Group T8 as the fee for a service to which that item applies is $359.05 or more For any particular patient, once only on the same day | $52.25 75% benefit $39.20 85% benefit $44.45 |
| 115 | Professional attendance at consulting rooms or in hospital on a day by a medical practitioner (the attending practitioner) who is a specialist or consultant physician in the practice of the attending practitioner’s specialty after referral of the patient to the attending practitioner by a referring practitioner—an attendance after the initial attendance in a single course of treatment, if: (a) the attending practitioner performs a scheduled operation on the patient on the same day; and (b) the operation is a service to which an item in Group T8 applies; and (c) the amount specified in the item in Group T8 as the fee for a service to which that item applies is $359.05 or more; and (d) the attendance is unrelated to the scheduled operation; and (e) it is considered a clinical risk to defer the attendance to a later day For any particular patient, once only on the same day | $52.25 75% benefit $39.20 85% benefit $44.45 |
| 125 | Professional attendance lasting at least 45 minutes at consulting rooms or hospital, by a specialist in the practice of the specialist’s specialty of gynaecology, following referral of the patient to the specialist by a referring practitioner—initial attendance in a single course of treatment, if: (a) the specialist takes a comprehensive history, including psychosocial history and medication review; and (b) the specialist undertakes any of the following that are clinically relevant: (i) a comprehensive multi-system physical examination; (ii) consideration of multiple complex diagnoses; (iii) discussion of all treatment options available; (iv) assessment of pros and cons of each treatment option given patient characteristics and medical history; (v) consideration, discussion and provision of necessary referrals for clinically appropriate investigations or treatment; (vi) communication of a patient-centred management plan; and (c) the specialist makes available to the patient or carer written documentation that outlines treatment options and information on associated risks and benefits; and (d) another attendance on the patient did not take place on the same day by the specialist in the same single course of treatment | $183.35 75% benefit $137.55 85% benefit $155.85 |
| 126 | Professional attendance lasting at least 45 minutes at consulting rooms or hospital, by a specialist in the practice of the specialist’s specialty of gynaecology, following referral of the patient to the specialist by a referring practitioner—an attendance after the initial attendance in a single course of treatment, if: (a) the specialist takes a comprehensive history, including psychosocial history and medication review; and (b) the specialist reviews implemented management strategies; and (c) the specialist undertakes any of the following that are clinically relevant: (i) update of management plan; (ii) performance of a physical examination; (iii) discussion of treatment options; (iv) consideration, discussion and provision of necessary referrals; (v) provision of appropriate education; and (d) the specialist makes available to the patient or carer written documentation that outlines treatment options and information on associated risks and benefits; and (e) another attendance on the patient did not take place on the same day by the specialist in the same single course of treatment | $91.70 75% benefit $68.80 85% benefit $77.95 |
| 127 | Video attendance lasting at least 45 minutes by a specialist in the practice of the specialist’s specialty of gynaecology, following referral of the patient to the specialist by a referring practitioner—initial attendance in a single course of treatment, if: (a) the specialist takes a comprehensive history, including psycho-social history and medication review; and (b) the specialist undertakes any of the following that are clinically relevant: (i) arranging for necessary investigations which may include a detailed physical examination; (ii) consideration of multiple complex diagnoses; (iii) discussion of all treatment options available; (iv) assessment of pros and cons of each treatment option given patient characteristics and medical history; (v) consideration, discussion and provision of necessary referrals for clinically appropriate investigations or treatment; (vi) communication of a patient-centred management plan; and (c) the specialist makes available to the patient or carer written documentation that outlines treatment options and information on associated risks and benefits; and (d) an attendance on the patient did not take place on the same day by the same specialist gynaecologist in the same single course of treatment. | $183.35 85% benefit $155.85 |
| 129 | Video attendance lasting at least 45 minutes by a specialist in the practice of the specialist’s speciality of gynaecology, following referral of the patient to the specialist by a referring practitioner - an attendance after the initial attendance in a single course of treatment if: (a) the specialist updates the patient’s comprehensive history, including psycho-social history and medication review; and (b) the specialist reviews implemented management strategies; and (c) the specialist undertakes any of the following that are clinically relevant: (i) update of management plan; (ii) arranging for necessary investigations which may include a detailed physical examination; (iii) discussion of treatment options; (iv) consideration, discussion and provision of necessary referrals; (v) provision of appropriate education; and (d) the specialist makes available to the patient or carer written documentation that outlines treatment options and information on associated risks and benefits; and (e) an attendance on the patient did not take place on the same day by the specialist for the same single course of treatment. | $91.70 85% benefit $77.95 |
A4 Consultant Physician Attendances To Which No Other Item Applies
10 items
| Item | Description | Fee and benefits |
|---|---|---|
| 110 | Professional attendance at consulting rooms or hospital, by a consultant physician in the practice of the consultant physician's specialty (other than psychiatry) following referral of the patient to the consultant physician by a referring practitioner-initial attendance in a single course of treatment | $183.35 75% benefit $137.55 85% benefit $155.85 |
| 116 | Professional attendance at consulting rooms or hospital, by a consultant physician in the practice of the consultant physician's specialty (other than psychiatry) following referral of the patient to the consultant physician by a referring practitioner-each attendance (other than a service to which item 119 applies) after the first in a single course of treatment | $91.70 75% benefit $68.80 85% benefit $77.95 |
| 117 | Professional attendance at consulting rooms or in hospital, by a consultant physician in the practice of the consultant physician's specialty (other than psychiatry) following referral of the patient to the consultant physician by a referring practitioner-an attendance after the first attendance in a single course of treatment, if: (a) the attendance is not a minor attendance; and (b) during the attendance, the consultant physician determines the need to perform an operation on the patient that had not otherwise been scheduled; and (c) the consultant physician subsequently performs the operation on the patient, on the same day; and (d) the operation is a service to which an item in Group T8 applies; and (e) the amount specified in the item in Group T8 as the fee for a service to which that item applies is $359.05 or more For any particular patient, once only on the same day | $91.70 75% benefit $68.80 85% benefit $77.95 |
| 119 | Professional attendance at consulting rooms or hospital, by a consultant physician in the practice of the consultant physician's specialty (other than psychiatry) following referral of the patient to the consultant physician by a referring practitioner-each minor attendance after the first in a single course of treatment | $52.25 75% benefit $39.20 85% benefit $44.45 |
| 120 | Professional attendance at consulting rooms or in hospital by a consultant physician in the practice of the consultant physician’s specialty (other than psychiatry) following referral of the patient to the consultant physician by a referring practitioner—minor attendance, if: (a) during the attendance, the consultant physician determines the need to perform an operation on the patient that had not otherwise been scheduled; and (b) the consultant physician subsequently performs the operation on the patient, on the same day; and (c) the operation is a service to which an item in Group T8 applies; and (d) the amount specified in the item in Group T8 as the fee for a service to which that item applies is $359.05 or more For any particular patient, once only on the same day | $52.25 75% benefit $39.20 85% benefit $44.45 |
| 122 | Professional attendance at a place other than consulting rooms or hospital, by a consultant physician in the practice of the consultant physician's specialty (other than psychiatry) following referral of the patient to the consultant physician by a referring practitioner-initial attendance in a single course of treatment | $222.40 75% benefit $166.80 85% benefit $189.05 |
| 128 | Professional attendance at a place other than consulting rooms or hospital, by a consultant physician in the practice of the consultant physician's specialty (other than psychiatry) following referral of the patient to the consultant physician by a referring practitioner-each attendance (other than a service to which item 131 applies) after the first in a single course of treatment | $134.50 75% benefit $100.90 85% benefit $114.35 |
| 131 | Professional attendance at a place other than consulting rooms or hospital, by a consultant physician in the practice of the consultant physician's specialty (other than psychiatry) following referral of the patient to the consultant physician by a referring practitioner-each minor attendance after the first in a single course of treatment | $96.90 75% benefit $72.70 85% benefit $82.40 |
| 132 | Professional attendance by a consultant physician in the practice of the consultant physician's specialty (other than psychiatry) lasting at least 45 minutes for an initial assessment of a patient with at least 2 morbidities (which may include complex congenital, developmental and behavioural disorders) following referral of the patient to the consultant physician by a referring practitioner, if: (a) an assessment is undertaken that covers: (i) a comprehensive history, including psychosocial history and medication review; and (ii) comprehensive multi or detailed single organ system assessment; and (iii) the formulation of differential diagnoses; and (b) a consultant physician treatment and management plan of significant complexity is prepared and provided to the referring practitioner, which involves: (i) an opinion on diagnosis and risk assessment; and (ii) treatment options and decisions; and (iii) medication recommendations; and (c) an attendance on the patient to which item 110, 116, 119, 91824, 91825, 91826, 91836 or 92440 applies did not take place on the same day by the same consultant physician; and (d) a service to which this item or item 92422 applies has not been provided to the patient by the same consultant physician in the preceding 12 months | $320.55 75% benefit $240.45 85% benefit $272.50 |
| 133 | Professional attendance by a consultant physician in the practice of the consultant physician’s specialty (other than psychiatry) lasting at least 20 minutes after the initial attendance in a single course of treatment for a review of a patient with at least 2 morbidities (which may include complex congenital, developmental and behavioural disorders) if: (a) a review is undertaken that covers: (i) review of initial presenting problems and results of diagnostic investigations; and (ii) review of responses to treatment and medication plans initiated at time of initial consultation; and (iii) comprehensive multi or detailed single organ system assessment; and (iv) review of original and differential diagnoses; and (b) the modified consultant physician treatment and management plan is provided to the referring practitioner, which involves, if appropriate: (i) a revised opinion on the diagnosis and risk assessment; and (ii) treatment options and decisions; and (iii) revised medication recommendations; and (c) an attendance on the patient to which item 110, 116, 119, 91824, 91825, 91826, 91836 or 92440 applies did not take place on the same day by the same consultant physician; and (d) a service to which item 132 or 92422 applies was provided to the patient by the same consultant physician or a locum tenens in the preceding 12 months; and (e) not more than 2 services to which this item or item 92423 or 92443 applies have been provided to the patient by the same consultant physician or a locum tenens in any 12 month period | $160.50 75% benefit $120.40 85% benefit $136.45 |
A29 Attendance services for complex neurodevelopmental disorder or disability
3 items
| Item | Description | Fee and benefits |
|---|---|---|
| 135 | Professional attendance lasting at least 45 minutes by a consultant physician in the practice of the consultant physician’s specialty of paediatrics, following referral of the patient to the consultant paediatrician by a referring practitioner, for a patient aged under 25, if the consultant paediatrician: (a) undertakes, or has previously undertaken in prior attendances, a comprehensive assessment in relation to which a diagnosis of a complex neurodevelopmental disorder (such as autism spectrum disorder) is made (if appropriate, using information provided by an eligible allied health provider); and (b) develops a treatment and management plan, which must include: (i) documentation of the confirmed diagnosis; and (ii) findings of any assessments performed for the purposes of formulation of the diagnosis or contribution to the treatment and management plan; and (iii) a risk assessment; and (iv) treatment options (which may include biopsychosocial recommendations); and (c) provides a copy of the treatment and management plan to: (i) the referring practitioner; and (ii) one or more allied health providers, if appropriate, for the treatment of the patient; (other than attendance on a patient for whom payment has previously been made under this item or item 137, 139, 289, 92140, 92141, 92142 or 92434) Applicable only once per lifetime | $320.55 75% benefit $240.45 85% benefit $272.50 |
| 137 | Professional attendance lasting at least 45 minutes by a specialist or consultant physician (not including a general practitioner), following referral of the patient to the specialist or consultant physician by a referring practitioner, for a patient aged under 25, if the specialist or consultant physician: (a) undertakes, or has previously undertaken in prior attendances, a comprehensive assessment in relation to which a diagnosis of an eligible disability is made (if appropriate, using information provided by an eligible allied health provider); and (b) develops a treatment and management plan, which must include: (i) documentation of the confirmed diagnosis; and (ii) findings of any assessments performed for the purposes of formulation of the diagnosis or contribution to the treatment and management plan; and (iii) a risk assessment; and (iv) treatment options (which may include biopsychosocial recommendations); and (c) provides a copy of the treatment and management plan to: (i) the referring practitioner; and (ii) one or more allied health providers, if appropriate, for the treatment of the patient; (other than attendance on a patient for whom payment has previously been made under this item or item 135, 139, 289, 92140, 92141, 92142 or 92434) Applicable only once per lifetime | $320.55 75% benefit $240.45 85% benefit $272.50 |
| 139 | Professional attendance lasting at least 45 minutes, at a place other than a hospital, by a general practitioner (not including a specialist or consultant physician), for a patient aged under 25, if the general practitioner: (a) undertakes, or has previously undertaken in prior attendances, a comprehensive assessment in relation to which a diagnosis of an eligible disability is made (if appropriate, using information provided by an eligible allied health provider); and (b) develops a treatment and management plan, which must include: (i) documentation of the confirmed diagnosis; and (ii) findings of any assessments performed for the purposes of formulation of the diagnosis or contribution to the treatment and management plan; and (iii) a risk assessment; and (iv) treatment options (which may include biopsychosocial recommendations); and (c) provides a copy of the treatment and management plan to one or more allied health providers, if appropriate, for the treatment of the patient; (other than attendance on a patient for whom payment has previously been made under this item or item 135, 137, 289, 92140, 92141, 92142 or 92434) Applicable only once per lifetime | $161.05 100% benefit $161.05 |
A28 Geriatric Medicine
4 items
| Item | Description | Fee and benefits |
|---|---|---|
| 141 | Professional attendance lasting more than 60 minutes at consulting rooms or hospital by a consultant physician or specialist in the practice of the consultant physician's or specialist's specialty of geriatric medicine, if: (a) the patient is at least 65 years old and referred by a medical practitioner practising in general practice (including a general practitioner, but not including a specialist or consultant physician) or a participating nurse practitioner; and (b) the attendance is initiated by the referring practitioner for the provision of a comprehensive assessment and management plan; and (c) during the attendance: (i) the medical, physical, psychological and social aspects of the patient's health are evaluated in detail using appropriately validated assessment tools if indicated (the assessment); and (ii) the patient's various health problems and care needs are identified and prioritised (the formulation); and (iii) a detailed management plan is prepared (the management plan) setting out: (A) the prioritised list of health problems and care needs; and (B) short and longer term management goals; and (C) recommended actions or intervention strategies to be undertaken by the patient's general practitioner or another relevant health care provider that are likely to improve or maintain health status and are readily available and acceptable to the patient and the patient's family and carers; and (iv) the management plan is explained and discussed with the patient and, if appropriate, the patient's family and any carers; and (v) the management plan is communicated in writing to the referring practitioner; and (d) an attendance to which item 104, 105, 107, 108, 110, 116, 119, 91825 or 92440 applies has not been provided to the patient on the same day by the same practitioner; and (e) an attendance to which this item or item 145 applies has not been provided to the patient by the same practitioner in the preceding 12 months | $549.90 75% benefit $412.45 85% benefit $467.45 |
| 143 | Professional attendance lasting more than 30 minutes at consulting rooms or hospital by a consultant physician or specialist in the practice of the consultant physician's or specialist's specialty of geriatric medicine to review a management plan previously prepared by that consultant physician or specialist under item 141 or 145, if: (a) the review is initiated by the referring medical practitioner practising in general practice or a participating nurse practitioner; and (b) during the attendance: (i) the patient's health status is reassessed; and (ii) a management plan prepared under item 141 or 145 is reviewed and revised; and (iii) the revised management plan is explained to the patient and (if appropriate) the patient's family and any carers and communicated in writing to the referring practitioner; and (c) an attendance to which item 104, 105, 107, 108, 110, 116, 119, 91825 or 92440 applies was not provided to the patient on the same day by the same practitioner; and (d) an attendance to which item 141 or 145 applies has been provided to the patient by the same practitioner in the preceding 12 months; and (e) an attendance to which this item or item 147, 92448 or 92624 applies has not been provided to the patient in the preceding 12 months, unless there has been a significant change in the patient's clinical condition or care circumstances that requires a further review | $343.75 75% benefit $257.85 85% benefit $292.20 |
| 145 | Professional attendance lasting more than 60 minutes at a place other than consulting rooms or hospital by a consultant physician or specialist in the practice of the consultant physician's or specialist's specialty of geriatric medicine, if: (a) the patient is at least 65 years old and referred by a medical practitioner practising in general practice (including a general practitioner, but not including a specialist or consultant physician) or a participating nurse practitioner; and (b) the attendance is initiated by the referring practitioner for the provision of a comprehensive assessment and management plan; and (c) during the attendance: (i) the medical, physical, psychological and social aspects of the patient's health are evaluated in detail utilising appropriately validated assessment tools if indicated (the assessment); and (ii) the patient's various health problems and care needs are identified and prioritised (the formulation); and (iii) a detailed management plan is prepared (the management plan) setting out: (A) the prioritised list of health problems and care needs; and (B) short and longer term management goals; and (C) recommended actions or intervention strategies, to be undertaken by the patient's general practitioner or another relevant health care provider that are likely to improve or maintain health status and are readily available and acceptable to the patient, the patient's family and any carers; and (iv) the management plan is explained and discussed with the patient and, if appropriate, the patient's family and any carers; and (v) the management plan is communicated in writing to the referring practitioner; and (d) an attendance to which item 104, 105, 107, 108, 110, 116, 119, 91825 or 92440 applies has not been provided to the patient on the same day by the same practitioner; and (e) an attendance to which this item or item 141 applies has not been provided to the patient by the same practitioner in the preceding 12 months | $666.75 85% benefit $566.75 |
| 147 | Professional attendance lasting more than 30 minutes at a place other than consulting rooms or hospital by a consultant physician or specialist in the practice of the consultant physician's or specialist's specialty of geriatric medicine to review a management plan previously prepared by that consultant physician or specialist under items 141 or 145, if: (a) the review is initiated by the referring medical practitioner practising in general practice or a participating nurse practitioner; and (b) during the attendance: (i) the patient's health status is reassessed; and (ii) a management plan that was prepared under item 141 or 145 is reviewed and revised; and (iii) the revised management plan is explained to the patient and (if appropriate) the patient's family and any carers and communicated in writing to the referring practitioner; and (c) an attendance to which item 104, 105, 107, 108, 110, 116, 119, 91825 or 92440 applies has not been provided to the patient on the same day by the same practitioner; and (d) an attendance to which item 141 or 145 applies has been provided to the patient by the same practitioner in the preceding 12 months; and (e) an attendance to which this item or item 143, 92448 or 92624 applies has not been provided by the same practitioner in the preceding 12 months, unless there has been a significant change in the patient's clinical condition or care circumstances that requires a further review | $416.75 85% benefit $354.25 |
A5 Prolonged Attendances To Which No Other Item Applies
5 items
| Item | Description | Fee and benefits |
|---|---|---|
| 160 | Professional attendance by a general practitioner, specialist or consultant physician for a period of not less than 1 hour but less than 2 hours (other than a service to which another item applies) on a patient in imminent danger of death | $265.15 75% benefit $198.90 100% benefit $265.15 |
| 161 | Professional attendance by a general practitioner, specialist or consultant physician for a period of not less than 2 hours but less than 3 hours (other than a service to which another item applies) on a patient in imminent danger of death | $441.85 75% benefit $331.40 100% benefit $441.85 |
| 162 | Professional attendance by a general practitioner, specialist or consultant physician for a period of not less than 3 hours but less than 4 hours (other than a service to which another item applies) on a patient in imminent danger of death | $618.35 75% benefit $463.80 100% benefit $618.35 |
| 163 | Professional attendance by a general practitioner, specialist or consultant physician for a period of not less than 4 hours but less than 5 hours (other than a service to which another item applies) on a patient in imminent danger of death | $795.40 75% benefit $596.55 100% benefit $795.40 |
| 164 | Professional attendance by a general practitioner, specialist or consultant physician for a period of 5 hours or more (other than a service to which another item applies) on a patient in imminent danger of death | $883.80 75% benefit $662.85 100% benefit $883.80 |
A6 Group Therapy
3 items
| Item | Description | Fee and benefits |
|---|---|---|
| 170 | Professional attendance for the purpose of group therapy of not less than 1 hour in duration given under the direct continuous supervision of a general practitioner, specialist or consultant physician (other than a consultant physician in the practice of the consultant physician's specialty of psychiatry) involving members of a family and persons with close personal relationships with that family-each group of 2 patients | $140.70 75% benefit $105.55 100% benefit $140.70 |
| 171 | Professional attendance for the purpose of group therapy of not less than 1 hour in duration given under the direct continuous supervision of a general practitioner, specialist or consultant physician (other than a consultant physician in the practice of the consultant physician's specialty of psychiatry) involving members of a family and persons with close personal relationships with that family-each group of 3 patients | $148.25 75% benefit $111.20 100% benefit $148.25 |
| 172 | Professional attendance for the purpose of group therapy of not less than 1 hour in duration given under the direct continuous supervision of a general practitioner, specialist or consultant physician (other than a consultant physician in the practice of the consultant physician's specialty of psychiatry) involving members of a family and persons with close personal relationships with that family-each group of 4 or more patients | $180.35 75% benefit $135.30 100% benefit $180.35 |
A7 Acupuncture and Non-Specialist Practitioner Items
89 items
| Item | Description | Fee and benefits |
|---|---|---|
| 177 | Professional attendance on a patient who is 30 years of age or over for a heart health assessment by a prescribed medical practitioner at consulting rooms lasting at least 20 minutes and including: (a) collection of relevant information, including taking a patient history; and (b) a basic physical examination, which must include recording blood pressure and cholesterol; and (c) initiating interventions and referrals as indicated; and (d) implementing a management plan; and (e) providing the patient with preventative health care advice and information. | $69.70 100% benefit $69.70 |
| 179 | Professional attendance at consulting rooms lasting not more than 5 minutes (other than a service to which any other item applies) by a prescribed medical practitioner in an eligible area—each attendance | $16.50 100% benefit $16.50 |
| 181 | New wording on 1 November 2026Professional attendance (other than an attendance at consulting rooms or a residential care home or a service to which any other item applies) lasting not more than 5 minutes—an attendance on one or more patients at one place on one occasion by a prescribed medical practitioner in an eligible area—each patient Derived fee: The fee for item 179, plus $25.25 divided by the number of patients seen, up to a maximum of six patients. For seven or more patients - the fee for item 179 plus $2.00 per patient. | Derived |
| 185 | Professional attendance at consulting rooms lasting more than 5 minutes but not more than 25 minutes (other than a service to which any other item applies) by a prescribed medical practitioner in an eligible area—each attendance | $35.95 100% benefit $35.95 |
| 187 | New wording on 1 November 2026Professional attendance (other than an attendance at consulting rooms or a residential care home or a service to which any other item applies) lasting more than 5 minutes but not more than 25 minutes—an attendance on one or more patients at one place on one occasion by a prescribed medical practitioner in an eligible area—each patient Derived fee: The fee for item 185, plus $25.25 divided by the number of patients seen, up to a maximum of six patients. For seven or more patients - the fee for item 185 plus $2.00 per patient. | Derived |
| 189 | Professional attendance at consulting rooms lasting more than 25 minutes but not more than 45 minutes (other than a service to which any other applies) by a prescribed medical practitioner in an eligible area—each attendance | $69.70 100% benefit $69.70 |
| 191 | New wording on 1 November 2026Professional attendance (other than an attendance at consulting rooms or a residential care home or a service to which any other item applies) lasting more than 25 minutes but not more than 45 minutes—an attendance on one or more patients at one place on one occasion by a prescribed medical practitioner in an eligible area—each patient Derived fee: The fee for item 189, plus $25.25 divided by the number of patients seen, up to a maximum of six patients. For seven or more patients - the fee for item 189 plus $2.00 per patient. | Derived |
| 193 | Professional attendance by a medical practitioner who holds endorsement of registration for acupuncture with the Medical Board of Australia or is registered by the Chinese Medicine Board of Australia as an acupuncturist, at a place other than a hospital, for treatment 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, at which acupuncture is performed by the medical practitioner by the application of stimuli on or through the skin by any means, including any consultation on the same occasion and another attendance on the same day related to the condition for which the acupuncture is performed | $44.30 100% benefit $44.30 |
| 195 | Professional attendance by a medical practitioner who holds endorsement of registration for acupuncture with the Medical Board of Australia or is registered by the Chinese Medicine Board of Australia as an acupuncturist, on one or more patients at a hospital, for treatment 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, at which acupuncture is performed by the medical practitioner by the application of stimuli on or through the skin by any means, including any consultation on the same occasion and another attendance on the same day related to the condition for which the acupuncture is performed Derived fee: The fee for item 193, plus $31.10 divided by the number of patients seen, up to a maximum of six patients. For seven or more patients - the fee for item 193 plus $2.45 per patient. | Derived |
| 197 | Professional attendance by a medical practitioner who holds endorsement of registration for acupuncture with the Medical Board of Australia or is registered by the Chinese Medicine Board of Australia as an acupuncturist, at a place other than a hospital, for treatment 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, at which acupuncture is performed by the medical practitioner by the application of stimuli on or through the skin by any means, including any consultation on the same occasion and another attendance on the same day related to the condition for which the acupuncture is performed | $85.80 100% benefit $85.80 |
| 199 | Professional attendance by a medical practitioner who holds endorsement of registration for acupuncture with the Medical Board of Australia or is registered by the Chinese Medicine Board of Australia as an acupuncturist, at a place other than a hospital, for treatment 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, at which acupuncture is performed by the medical practitioner by the application of stimuli on or through the skin by any means, including any consultation on the same occasion and another attendance on the same day related to the condition for which the acupuncture is performed | $126.35 100% benefit $126.35 |
| 203 | Professional attendance at consulting rooms lasting more than 45 minutes but not more than 60 minutes (other than a service to which any other item applies) by a prescribed medical practitioner in an eligible area—each attendance | $102.65 100% benefit $102.65 |
| 206 | New wording on 1 November 2026Professional attendance (other than an attendance at consulting rooms or a residential care home or a service to which any other item applies) lasting more than 45 minutes but not more than 60 minutes—an attendance on one or more patients at one place on one occasion by a prescribed medical practitioner in an eligible area—each patient Derived fee: The fee for item 203, plus $25.25 divided by the number of patients seen, up to a maximum of six patients. For seven or more patients - the fee for item 203 plus $2.00 per patient. | Derived |
| 214 | Professional attendance by a prescribed medical practitioner for a period of not less than one hour but less than 2 hours (other than a service to which another item applies) on a patient in imminent danger of death | $212.20 75% benefit $159.15 100% benefit $212.20 |
| 215 | Professional attendance by a prescribed medical practitioner for a period of not less than 2 hours but less than 3 hours (other than a service to which another item applies) on a patient in imminent danger of death | $353.55 75% benefit $265.20 100% benefit $353.55 |
| 218 | Professional attendance by a prescribed medical practitioner for a period of not less than 3 hours but less than 4 hours (other than a service to which another item applies) on a patient in imminent danger of death | $494.65 75% benefit $371.00 100% benefit $494.65 |
| 219 | Professional attendance by a prescribed medical practitioner for a period of not less than 4 hours but less than 5 hours (other than a service to which another item applies) on a patient in imminent danger of death | $636.40 75% benefit $477.30 100% benefit $636.40 |
| 220 | Professional attendance by a prescribed medical practitioner for a period of 5 hours or more (other than a service to which another item applies) on a patient in imminent danger of death | $707.00 75% benefit $530.25 100% benefit $707.00 |
| 221 | Professional attendance for the purpose of Group therapy lasting at least one hour given under the direct continuous supervision of a prescribed medical practitioner, involving members of a family and persons with close personal relationships with that family—each Group of 2 patients | $112.50 75% benefit $84.40 100% benefit $112.50 |
| 222 | Professional attendance for the purpose of Group therapy lasting at least one hour given under the direct continuous supervision of a prescribed medical practitioner, involving members of a family and persons with close personal relationships with that family—each Group of 3 patients | $118.60 75% benefit $88.95 100% benefit $118.60 |
| 223 | Professional attendance for the purpose of Group therapy lasting at least one hour given under the direct continuous supervision of a prescribed medical practitioner, involving members of a family and persons with close personal relationships with that family—each Group of 4 or more patients | $144.30 75% benefit $108.25 100% benefit $144.30 |
| 224 | Professional attendance by a prescribed medical practitioner to perform a brief health assessment, lasting not more than 30 minutes and including:(a) collection of relevant information, including taking a patient history; and(b) a basic physical examination; and(c) initiating interventions and referrals as indicated; and(d) providing the patient with preventive health care advice and information | $56.85 100% benefit $56.85 |
| 225 | Professional attendance by a prescribed medical practitioner to perform a standard health assessment, lasting more than 30 minutes but less than 45 minutes, including:(a) detailed information collection, including taking a patient history; and(b) an extensive physical examination; and(c) initiating interventions and referrals as indicated; and(d) providing a preventive health care strategy for the patient | $132.05 100% benefit $132.05 |
| 226 | Professional attendance by a prescribed medical practitioner to perform a long health assessment, lasting at least 45 minutes but less than 60 minutes, including:(a) comprehensive information collection, including taking a patient history; and(b) an extensive examination of the patient’s medical condition and physical function; and(c) initiating interventions and referrals as indicated; and(d) providing a basic preventive health care management plan for the patient | $182.15 100% benefit $182.15 |
| 227 | Professional attendance by a prescribed medical practitioner to perform a prolonged health assessment, lasting at least 60 minutes, including:(a) comprehensive information collection, including taking a patient history; and(b) an extensive examination of the patient’s medical condition, and physical, psychological and social function; and(c) initiating interventions and referrals as indicated; and(d) providing a comprehensive preventive health care management plan for the patient | $257.40 100% benefit $257.40 |
| 228 | New wording on 1 November 2026Professional attendance by a prescribed medical practitioner at consulting rooms or in a place other than a hospital or a residential care home:(a) for a health assessment of a patient who is of Aboriginal or Torres Strait Islander descent; and (b) that includes the following: (i) recognising the patient’s health priorities; (ii) taking the patient’s medical history; (iii) undertaking any relevant physical examinations; (iv) undertaking or arranging any required investigations; (v) assessing the patient using the information gained in the health assessment; (vi) initiating any necessary interventions and referrals; (vii) developing and documenting a plan to manage the patient’s health, including for follow‑up, based on the health assessment and the patient’s priorities; (viii) offering the patient (or the patient’s carer (if any) if the practitioner considers it appropriate and the patient agrees) a written report of the health assessment, with recommendations on matters covered by the health assessment and a strategy for the patient’s good health; (ix) if the offer referred to in subparagraph (viii) is accepted—giving the report to the patient or the patient’s carer (as applicable); (x) adding a record of the health assessment to the patient’s medical records Applicable only if a service to which this item or item 715, 92004 or 92011 applies has not been provided to the patient in the preceding 9 months Note: For items 92004 and 92011, see the Telehealth Attendance Determination. | $203.25 100% benefit $203.25 |
| 231 | Either:(a) contribution to a multidisciplinary care plan, for a patient, prepared by another provider; or(b) contribution to a review of a multidisciplinary care plan, for a patient, prepared by another provider;by a prescribed medical practitioner, other than a service associated with a service to which any of items 235 to 240, 735, 739, 743, 747, 750 or 758 apply | $67.40 75% benefit $50.55 100% benefit $67.40 |
| 232 | New wording on 1 November 2026Either:(a) contribution to a multidisciplinary care plan, for a patient in a residential care home, prepared by that residential care home, or contribution to a review of a multidisciplinary care plan, for a patient, prepared by such a residential care home; or(b) contribution to a multidisciplinary care plan, for a patient, prepared by another provider before the patient is discharged from a hospital or contribution to a review of a multidisciplinary care plan, for a patient, prepared by another provider;by a prescribed medical practitioner, other than a service associated with a service to which any of items 235 to 240, 735, 739, 743, 747, 750 or 758 apply | $67.40 75% benefit $50.55 100% benefit $67.40 |
| 235 | New wording on 1 November 2026Attendance by a prescribed medical 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 care home; or(c) a multidisciplinary discharge case conference;if the conference lasts for at least 15 minutes but less than 20 minutes, other than a service associated with a service to which any of items 231, 232, 392, 393, 729, 731, 965, 967, 92029, 92030, 92033, 92034, 92060, 92061, 92063 or 92064 apply | $67.75 75% benefit $50.85 100% benefit $67.75 |
| 236 | New wording on 1 November 2026Attendance by a prescribed medical 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 care home; or(c) a multidisciplinary discharge case conference;if the conference lasts for at least 20 minutes but less than 40 minutes, other than a service associated with a service to which any of items 231, 232, 392, 393, 729, 731, 965, 967, 92029, 92030, 92033, 92034, 92060, 92061, 92063 or 92064 apply | $115.85 75% benefit $86.90 100% benefit $115.85 |
| 237 | New wording on 1 November 2026Attendance by a prescribed medical 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 care home; or(c) a multidisciplinary discharge case conference;if the conference lasts at least 40 minutes, other than a service associated with a service to which any of items 231, 232, 392, 393, 729, 731, 965, 967, 92029, 92030, 92033, 92034, 92060, 92061, 92063 or 92064 apply | $193.00 75% benefit $144.75 100% benefit $193.00 |
| 238 | New wording on 1 November 2026Attendance by a prescribed medical 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 care home; or(c) a multidisciplinary discharge case conference;if the conference lasts for at least 15 minutes but less than 20 minutes, other than a service associated with a service to which any of items 231, 232, 392, 393, 729, 731, 965, 967, 92029, 92030, 92033, 92034, 92060, 92061, 92063 or 92064 apply | $49.75 75% benefit $37.35 100% benefit $49.75 |
| 239 | New wording on 1 November 2026Attendance by a prescribed medical 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 care home; or(c) a multidisciplinary discharge case conference;if the conference lasts for at least 20 minutes but less than 40 minutes, other than a service associated with a service to any of items 231, 232, 392, 393, 729, 731, 965, 967, 92029, 92030, 92033, 92034, 92060, 92061, 92063 or 92064 apply | $85.25 75% benefit $63.95 100% benefit $85.25 |
| 240 | New wording on 1 November 2026Attendance by a prescribed medical 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 care home; 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 any of items 231, 232, 392, 393, 729, 731, 965, 967, 92029, 92030, 92033, 92034, 92060, 92061, 92063 or 92064 apply | $141.90 75% benefit $106.45 100% benefit $141.90 |
| 243 | Attendance by a prescribed medical practitioner, as a member of a case conference team, to lead and coordinate a multidisciplinary case conference on a patient with cancer, to develop a multidisciplinary treatment plan, if the case conference lasts at least 10 minutes, with a multidisciplinary team of at least 3 other medical practitioners from different areas of medical practice (which may include general practice), and, in addition, allied health or other relevant health professionals | $66.35 75% benefit $49.80 100% benefit $66.35 |
| 244 | Attendance by a prescribed medical practitioner, as a member of a case conference team, to participate in a multidisciplinary case conference on a patient with cancer, to develop a multidisciplinary treatment plan, if the case conference lasts at least 10 minutes, with a multidisciplinary team of at least 4 medical practitioners from different areas of medical practice (which may include general practice), and, in addition, allied health or other relevant health professionals | $30.95 75% benefit $23.25 100% benefit $30.95 |
| 245 | Participation by a prescribed medical practitioner in a Domiciliary Medication Management Review (DMMR) for a patient living in a community setting, in which the prescribed medical 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 the patient’s 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 patientFor any particular patient—applicable not more than once in each 12 month period, and only if item 900 does not apply in the same 12 month period, except if there has been a significant change in the patient’s condition or medication regimen requiring a new DMMR | $148.25 100% benefit $148.25 |
| 249 | New wording on 1 November 2026Participation by a prescribed medical practitioner in a residential medication management review (RMMR) for a patient who is a care recipient in a residential care home—other than an RMMR for a resident in relation to whom, in the preceding 12 months, this item or item 903 has applied, unless there has been a significant change in the resident’s medical condition or medication management plan requiring a new RMMR | $101.45 100% benefit $101.45 |
| 272 | Professional attendance by a prescribed medical practitioner (who has not undertaken mental health skills training), lasting at least 20 minutes but less than 40 minutes, for the preparation of a GP mental health treatment plan for a patient | $68.65 75% benefit $51.50 100% benefit $68.65 |
| 276 | Professional attendance by a prescribed medical practitioner (who has not undertaken mental health skills training), lasting at least 40 minutes, for the preparation of a GP mental health treatment plan for a patient | $101.05 75% benefit $75.80 100% benefit $101.05 |
| 281 | Professional attendance by a prescribed medical practitioner (who has undertaken mental health skills training), lasting at least 20 minutes but less than 40 minutes, for the preparation of a GP mental health treatment plan for a patient | $87.15 75% benefit $65.40 100% benefit $87.15 |
| 282 | Professional attendance by a prescribed medical practitioner (who has undertaken mental health skills training), lasting at least 40 minutes, for the preparation of a GP mental health treatment plan for a patient | $128.45 75% benefit $96.35 100% benefit $128.45 |
| 283 | Professional attendance at consulting rooms by a prescribed medical practitioner, registered with the Chief Executive Medicare as meeting the credentialling requirements for provision of this service:(a) for providing focussed psychological strategies for mental disorders that have been assessed by a medical practitioner; and(b) lasting at least 30 minutes but less than 40 minutes | $88.85 100% benefit $88.85 |
| 285 | Professional attendance at a place other than consulting rooms by a prescribed medical practitioner, registered with the Chief Executive Medicare as meeting the credentialling requirements for provision of this service:(a) for providing focussed psychological strategies for mental disorders that have been assessed by a medical practitioner; and(b) lasting at least 30 minutes but less than 40 minutes Derived fee: The fee for item 283, plus $24.90 divided by the number of patients seen, up to a maximum of six patients. For seven or more patients - the fee for item 283 plus $1.95 per patient. | Derived |
| 286 | Professional attendance at consulting rooms by a prescribed medical practitioner, registered with the Chief Executive Medicare as meeting the credentialling requirements for provision of this service:(a) for providing focussed psychological strategies for mental disorders that have been assessed by a medical practitioner; and(b) lasting at least 40 minutes | $127.10 100% benefit $127.10 |
| 287 | Professional attendance at a place other than consulting rooms by a prescribed medical practitioner, registered with the Chief Executive Medicare as meeting the credentialling requirements for provision of this service:(a) for providing focussed psychological strategies for mental disorders that have been assessed by a medical practitioner; and(b) lasting at least 40 minutes Derived fee: The fee for item 286, plus $24.90 divided by the number of patients seen, up to a maximum of six patients. For seven or more patients - the fee for item 286 plus $1.95 per patient. | Derived |
| 301 | Professional attendance at consulting rooms lasting more than 60 minutes (other than a service to which any other item in this Schedule applies) by a prescribed medical practitioner in an eligible area—each attendance | $166.30 100% benefit $166.30 |
| 303 | New wording on 1 November 2026Professional attendance (other than an attendance at consulting rooms or a residential care home or a service to which any other item applies) lasting more than 60 minutes—an attendance on one or more patients at one place on one occasion by a prescribed medical practitioner in an eligible area—each patient Derived fee: The fee for item 301, plus $25.25 divided by the number of patients seen, up to a maximum of six patients. For seven or more patients - the fee for item 301 plus $2.00 per patient. | Derived |
| 309 | Professional attendance at consulting rooms by a prescribed medical practitioner, registered with the Chief Executive Medicare as meeting the credentialling requirements for provision of this service:(a) for providing focussed psychological strategies for assessed mental disorders to a person other than the patient, if the service is part of the patient’s treatment; and(b) lasting at least 30 minutes but less than 40 minutes | $88.85 100% benefit $88.85 |
| 311 | Professional attendance at a place other than consulting rooms by a prescribed medical practitioner, registered with the Chief Executive Medicare as meeting the credentialling requirements for provision of this service:(a) for providing focussed psychological strategies for assessed mental disorders to a person other than the patient, if the service is part of the patient’s treatment; and(b) lasting at least 30 minutes but less than 40 minutes Derived fee: The fee for item 309, plus $24.90 divided by the number of patients seen, up to a maximum of six patients. For seven or more patients - the fee for item 309 plus $1.95 per patient. | Derived |
| 313 | Professional attendance at consulting rooms by a prescribed medical practitioner, registered with the Chief Executive Medicare as meeting the credentialling requirements for provision of this service:(a) for providing focussed psychological strategies for assessed mental disorders to a person other than the patient, if the service is part of the patient’s treatment; and(b) lasting at least 40 minutes | $127.10 100% benefit $127.10 |
| 315 | Professional attendance at a place other than consulting rooms by a prescribed medical practitioner, registered with the Chief Executive Medicare as meeting the credentialling requirements for provision of this service:(a) for providing focussed psychological strategies for assessed mental disorders to a person other than the patient, if the service is part of the patient’s treatment; and(b) lasting at least 40 minutes Derived fee: The fee for item 313, plus $24.90 divided by the number of patients seen, up to a maximum of six patients. For seven or more patients - the fee for item 313 plus $1.95 per patient. | Derived |
| 373 | Professional attendance by a prescribed medical practitioner, at consulting rooms, lasting more than 5 minutes but not more than 25 minutes, if:(a) the attendance is to provide clinical support to a patient to whom a specialist or consultant physician is providing a service, to which another item applies, by way of a video conferencing consultation; and(b) the patient is not an admitted patient; and(c) the prescribed medical practitioner is located in the same room as the patient for the whole of the attendance | $56.50 100% benefit $56.50 |
| 374 | New wording on 1 November 2026Professional attendance by a prescribed medical practitioner, at a place other than consulting rooms, lasting more than 5 minutes but not more than 25 minutes, if:(a) the attendance is to provide clinical support to a patient to whom a specialist or consultant physician is providing a service, to which another item applies, by way of a video conferencing consultation; and(b) the patient is not an admitted patient; and(c) the patient is not a care recipient in a residential care home; and(d) the prescribed medical practitioner is located in the same room as the patient for the whole of the attendance | $81.70 100% benefit $81.70 |
| 375 | New wording on 1 November 2026Professional attendance by a prescribed medical practitioner, at a residential care home, lasting more than 5 minutes but not more than 25 minutes, if:(a) the attendance is to provide clinical support to a patient to whom a specialist or consultant physician is providing a service, to which another item applies, by way of a video conferencing consultation; and(b) the patient is not an admitted patient; and(c) the patient is a care recipient in the residential care home; and(d) the prescribed medical practitioner is located in the same room as the patient for the whole of the attendance | $56.50 100% benefit $56.50 |
| 376 | Professional attendance by a prescribed medical practitioner, at consulting rooms, lasting more than 25 minutes but not more than 45 minutes, if:(a) the attendance is to provide clinical support to a patient to whom a specialist or consultant physician is providing a service, to which another item applies, by way of a video conferencing consultation; and(b) the patient is not an admitted patient; and(c) the prescribed medical practitioner is located in the same room as the patient for the whole of the attendance | $90.25 100% benefit $90.25 |
| 377 | New wording on 1 November 2026Professional attendance by a prescribed medical practitioner, at a place other than consulting rooms, lasting more than 25 minutes but not more than 45 minutes, if:(a) the attendance is to provide clinical support to a patient to whom a specialist or consultant physician is providing a service, to which another item applies, by way of a video conferencing consultation; and(b) the patient is not an admitted patient; and(c) the patient is not a care recipient in a residential care home; and(d) the prescribed medical practitioner is located in the same room as the patient for the whole of the attendance | $102.85 100% benefit $102.85 |
| 378 | New wording on 1 November 2026Professional attendance by a prescribed medical practitioner, at a residential care home, lasting more than 25 minutes but not more than 45 minutes, if:(a) the attendance is to provide clinical support to a patient to whom a specialist or consultant physician is providing a service, to which another item applies, by way of a video conferencing consultation; and(b) the patient is not an admitted patient; and(c) the patient is a care recipient in the residential care home; and(d) the prescribed medical practitioner is located in the same room as the patient for the whole of the attendance | $90.25 100% benefit $90.25 |
| 379 | Professional attendance by a prescribed medical practitioner, at consulting rooms, lasting more than 45 minutes but not more than 60 minutes, if:(a) the attendance is to provide clinical support to a patient to whom a specialist or consultant physician is providing a service, to which another item applies, by way of a video conferencing consultation; and(b) the patient is not an admitted patient; and(c) the prescribed medical practitioner is located in the same room as the patient for the whole of the attendance | $123.15 100% benefit $123.15 |
| 380 | New wording on 1 November 2026Professional attendance by a prescribed medical practitioner, at a place other than consulting rooms, lasting more than 45 minutes but not more than 60 minutes, if:(a) the attendance is to provide clinical support to a patient to whom a specialist or consultant physician is providing a service, to which another item applies, by way of a video conferencing consultation; and(b) the patient is not an admitted patient; and(c) the patient is not a care recipient in a residential care home; and(d) the prescribed medical practitioner is located in the same room as the patient for the whole of the attendance | $148.40 100% benefit $148.40 |
| 381 | New wording on 1 November 2026Professional attendance by a prescribed medical practitioner, at a residential care home, lasting more than 45 minutes but not more than 60 minutes, if:(a) the attendance is to provide clinical support to a patient to whom a specialist or consultant physician is providing a service, to which another item applies, by way of a video conferencing consultation; and(b) the patient is not an admitted patient; and(c) the patient is a care recipient in the residential care home; and(d) the prescribed medical practitioner is located in the same room as the patient for the whole of the attendance | $123.15 100% benefit $123.15 |
| 382 | Professional attendance by a prescribed medical practitioner, at consulting rooms, lasting more than 60 minutes, if:(a) the attendance is to provide clinical support to a patient to whom a specialist or consultant physician is providing a service, to which another item applies, by way of a video conferencing consultation; and(b) the patient is not an admitted patient; and(c) the prescribed medical practitioner is located in the same room as the patient for the whole of the attendance | $186.85 100% benefit $186.85 |
| 390 | New wording on 1 November 2026Professional attendance by a prescribed medical practitioner, at a place other than consulting rooms, lasting more than 60 minutes, if:(a) the attendance is to provide clinical support to a patient to whom a specialist or consultant physician is providing a service, to which another item applies, by way of a video conferencing consultation; and(b) the patient is not an admitted patient; and(c) the patient is not a care recipient in a residential care home; and(d) the prescribed medical practitioner is located in the same room as the patient for the whole of the attendance | $212.05 100% benefit $212.05 |
| 391 | New wording on 1 November 2026Professional attendance by a prescribed medical practitioner, at a residential care home, lasting more than 60 minutes, if:(a) the attendance is to provide clinical support to a patient to whom a specialist or consultant physician is providing a service, to which another item applies, by way of a video conferencing consultation; and(b) the patient is not an admitted patient; and(c) the patient is a care recipient in the residential care home; and(d) the prescribed medical practitioner is located in the same room as the patient for the whole of the attendance | $186.85 100% benefit $186.85 |
| 392 | Professional attendance by a prescribed medical practitioner to prepare a GP chronic condition management plan for a patient | $128.55 75% benefit $96.45 100% benefit $128.55 |
| 393 | Professional attendance by a prescribed medical practitioner to review a GP chronic condition management plan prepared by the prescribed medical practitioner or an associated medical practitioner | $128.55 75% benefit $96.45 100% benefit $128.55 |
| 733 | Professional attendance at consulting rooms of not more than 5 minutes in duration (other than a service to which another item applies) by a prescribed medical practitioner—each attendance | $27.75 100% benefit $27.75 |
| 737 | Professional attendance at consulting rooms of more than 5 minutes in duration but not more than 25 minutes in duration (other than a service to which another item applies) by a prescribed medical practitioner—each attendance | $46.85 100% benefit $46.85 |
| 741 | Professional attendance at consulting rooms of more than 25 minutes in duration but not more than 45 minutes in duration (other than a service to which another item applies) by a prescribed medical practitioner—each attendance | $80.45 100% benefit $80.45 |
| 745 | Professional attendance at consulting rooms of more than 45 minutes in duration but not more than 60 minutes (other than a service to which another item applies) by a prescribed medical practitioner—each attendance | $112.80 100% benefit $112.80 |
| 761 | New wording on 1 November 2026Professional attendance by a prescribed medical practitioner (other than attendance at consulting rooms, a hospital or a residential care home or a service to which another item in the table applies), lasting not more than 5 minutes—an attendance on one or more patients on one occasion—each patient Derived fee: The fee for item 733, plus $24.90 divided by the number of patients seen, up to a maximum of six patients. For seven or more patients - the fee for item 733 plus $1.95 per patient. | Derived |
| 763 | New wording on 1 November 2026Professional attendance by a prescribed medical practitioner (other than attendance at consulting rooms, a hospital or a residential care home or a service to which another item in the table applies), lasting more than 5 minutes, but not more than 25 minutes—an attendance on one or more patients on one occasion—each patient Derived fee: The fee for item 737, plus $24.90 divided by the number of patients seen, up to a maximum of six patients. For seven or more patients - the fee for item 737 plus $1.95 per patient. | Derived |
| 766 | New wording on 1 November 2026Professional attendance by a prescribed medical practitioner (other than attendance at consulting rooms, a hospital or a residential care home or a service to which another item in the table applies), lasting more than 25 minutes, but not more than 45 minutes—an attendance on one or more patients on one occasion—each patient Derived fee: The fee for item 741, plus $24.90 divided by the number of patients seen, up to a maximum of six patients. For seven or more patients - the fee for item 741 plus $1.95 per patient. | Derived |
| 769 | New wording on 1 November 2026Professional attendance by a prescribed medical practitioner (other than attendance at consulting rooms, a hospital or a residential care home or a service to which another item in the table applies), lasting more than 45 minutes, but not more than 60 minutes—an attendance on one or more patients on one occasion—each patient. Derived fee: The fee for item 745, plus $24.90 divided by the number of patients seen, up to a maximum of six patients. For seven or more patients - the fee for item 745 plus $1.95 per patient. | Derived |
| 772 | New wording on 1 November 2026Professional attendance (other than a service to which another item applies) at a residential care home (other than a professional attendance at a self‑contained unit) or professional attendance at consulting rooms situated within such a complex if the patient is accommodated in the residential care home (other than accommodation in a self‑contained unit) of not more than 5 minutes in duration by a prescribed medical practitioner—an attendance on one or more patients at one residential care home on one occasion—each patient Derived fee: The fee for item 733, plus $44.75 divided by the number of patients seen, up to a maximum of six patients. For seven or more patients - the fee for item 733 plus $3.15 per patient. | Derived |
| 776 | New wording on 1 November 2026Professional attendance (other than a service to which another item applies) at a residential care home (other than a professional attendance at a self‑contained unit) or professional attendance at consulting rooms situated within such a complex if the patient is accommodated in the residential care home (other than accommodation in a self‑contained unit) of more than 5 minutes in duration but not more than 25 minutes in duration by a prescribed medical practitioner—an attendance on one or more patients at one residential care home on one occasion—each patient Derived fee: The fee for item 737, plus $44.75 divided by the number of patients seen, up to a maximum of six patients. For seven or more patients - the fee for item 737 plus $3.15 per patient. | Derived |
| 788 | New wording on 1 November 2026Professional attendance (other than a service to which another item applies) at a residential care home (other than a professional attendance at a self‑contained unit) or professional attendance at consulting rooms situated within such a complex if the patient is accommodated in the residential care home (other than accommodation in a self‑contained unit) of more than 25 minutes in duration but not more than 45 minutes by a prescribed medical practitioner—an attendance on one or more patients at one residential care home on one occasion—each patient Derived fee: The fee for item 741, plus $44.75 divided by the number of patients seen, up to a maximum of six patients. For seven or more patients - the fee for item 741 plus $3.15 per patient. | Derived |
| 789 | New wording on 1 November 2026Professional attendance (other than a service to which another item applies) at a residential care home (other than a professional attendance at a self-contained unit) or professional attendance at consulting rooms situated within such a complex if the patient is accommodated in the residential care home (other than accommodation in a self-contained unit) of more than 45 minutes but not more than 60 minutes in duration by a prescribed medical practitioner—an attendance on one or more patients at one residential care home on one occasion—each patient Derived fee: The fee for item 745, plus $44.75 divided by the number of patients seen, up to a maximum of six patients. For seven or more patients - the fee for item 745 plus $3.15 per patient. | Derived |
| 792 | Professional attendance at consulting rooms by a prescribed medical practitioner, registered with the Chief Executive Medicare as meeting the credentialling requirements for provision of this service, lasting at least 20 minutes, for the purpose of providing non-directive pregnancy support counselling to a person who:(a) is currently pregnant; or(b) has been pregnant in the 12 months preceding the provision of the first service to which this item, or item 4001, 81000, 81005, 81010, 92136, 92137, 92138, 92139, 93026 or 93029, applies in relation to that pregnancy | $73.35 100% benefit $73.35 |
| 969 | Attendance by a prescribed medical practitioner, as a member of a multidisciplinary case conference team, to organise and coordinate a mental health case conference if the conference lasts for at least 15 minutes, but for less than 20 minutes | $67.75 75% benefit $50.85 100% benefit $67.75 |
| 971 | Attendance by a prescribed medical practitioner, as a member of a multidisciplinary case conference team, to organise and coordinate a mental health case conference if the conference lasts for at least 20 minutes, but for less than 40 minutes | $115.85 75% benefit $86.90 100% benefit $115.85 |
| 972 | Attendance by a prescribed medical practitioner, as a member of a multidisciplinary case conference team, to organise and coordinate a mental health case conference if the conference lasts for at least 40 minutes | $193.05 75% benefit $144.80 100% benefit $193.05 |
| 973 | Attendance by a prescribed medical practitioner, as a member of a multidisciplinary case conference team, to participate in a mental health case conference if the conference lasts for at least 15 minutes, but for less than 20 minutes | $49.75 75% benefit $37.35 100% benefit $49.75 |
| 975 | Attendance by a prescribed medical practitioner, as a member of a multidisciplinary case conference team, to participate in a mental health case conference if the conference lasts for at least 20 minutes, but for less than 40 minutes | $85.25 75% benefit $63.95 100% benefit $85.25 |
| 986 | Attendance by a prescribed medical practitioner, as a member of a multidisciplinary case conference team, to participate in a mental health case conference if the conference lasts for at least 40 minutes | $141.90 75% benefit $106.45 100% benefit $141.90 |
| 2197 | Professional attendance at consulting rooms of more than 60 minutes in duration (other than a service to which another item applies) by a prescribed medical practitioner—each attendance. | $191.60 100% benefit $191.60 |
| 2198 | New wording on 1 November 2026Professional attendance by a prescribed medical practitioner (other than attendance at consulting rooms, a hospital or a residential care home or a service to which another item in the table applies), lasting more than 60 minutes—an attendance on one or more patients on one occasion—each patient. Derived fee: The fee for item 2197, plus $24.90 divided by the number of patients seen, up to a maximum of six patients. For seven or more patients - the fee for item 2197 plus $1.95 per patient. | Derived |
| 2200 | New wording on 1 November 2026Professional attendance (other than a service to which another item applies) at a residential care home (other than a professional attendance at a self‑contained unit) or professional attendance at consulting rooms situated within such a complex if the patient is accommodated in the residential care home (other than accommodation in a self‑contained unit) of more than 60 minutes in duration by a prescribed medical practitioner—an attendance on one or more patients at one residential care home on one occasion—each patient. Derived fee: The fee for item 2197, plus $44.75 divided by the number of patients seen, up to a maximum of six patients. For seven or more patients - the fee for item 2197 plus $3.15 per patient. | Derived |
| 19000 | Menopause and Perimenopause Health Assessment Professional attendance on a patient for the assessment and management of menopause or perimenopause by a prescribed medical practitioner lasting at least 20 minutes and including, but not limited to: a) collecting relevant information, including taking a patient history to determine pre-, peri- or post-menopausal status, patient wellbeing and contraindications for management; and b) undertaking a basic physical examination, including recording blood pressure, and review of height and weight; and c) initiating investigations and referrals as clinically indicated, with consideration given to the need for cervical screening, mammography and bone densitometry; and d) discussing management options including non-pharmacological and pharmacological strategies including risks and benefits; e) implementing a management plan which includes patient centred symptoms management; and f) providing the patient with preventative health care advice and information as clinically indicated, including advice on physical activity, smoking cessation, alcohol consumption, nutritional intake and weight management. | $83.60 100% benefit $83.60 |
A8 Consultant Psychiatrist Attendances To Which No Other Item Applies
36 items
| Item | Description | Fee and benefits |
|---|---|---|
| 289 | Professional attendance lasting at least 45 minutes, by a consultant physician in the practice of the consultant physician’s specialty of psychiatry, following referral of the patient to the consultant psychiatrist by a referring practitioner, for a patient aged under 25, if the consultant psychiatrist: (a) undertakes, or has previously undertaken in prior attendances, a comprehensive assessment in relation to which a diagnosis of a complex neurodevelopmental disorder (such as autism spectrum disorder) is made (if appropriate, using information provided by an eligible allied health provider); and (b) develops a treatment and management plan, which must include: (i) documentation of the confirmed diagnosis; and (ii) findings of any assessments performed for the purposes of formulation of the diagnosis or contribution to the treatment and management plan; and (iii) a risk assessment; and (iv) treatment options (which may include biopsychosocial recommendations); and (c) provides a copy of the treatment and management plan to: (i) the referring practitioner; and (ii) one or more allied health providers, if appropriate, for the treatment of the patient; (other than attendance on a patient for whom payment has previously been made under this item or item 135, 137, 139, 92140, 92141, 92142 or 92434) Applicable only once per lifetime | $320.55 75% benefit $240.45 85% benefit $272.50 |
| 291 | Professional attendance lasting more than 45 minutes at consulting rooms by a consultant physician in the practice of the consultant physician’s specialty of psychiatry, if: (a) the attendance follows referral of the patient to the consultant, by a medical practitioner in general practice (including a general practitioner, but not a specialist or consultant physician) or a participating nurse practitioner, for an assessment or management; and (b) during the attendance, the consultant: (i) if it is clinically appropriate to do so—uses an appropriate outcome tool; and (ii) carries out a mental state examination; and (iii) undertakes a comprehensive diagnostic assessment; and (c) the consultant decides that it is clinically appropriate for the patient to be managed by the referring practitioner without ongoing management by the consultant; and (d) within 2 weeks after the attendance, the consultant prepares and gives to the referring practitioner a written report, which includes: (i) the comprehensive diagnostic assessment of the patient; and (ii) a management plan for the patient for the next 12 months that comprehensively evaluates the patient’s biopsychosocial factors and makes recommendations to the referring practitioner to manage the patient’s ongoing care in a biopsychosocial model; and (e) if clinically appropriate, the consultant explains the diagnostic assessment and management plan, and gives a copy, to: (i) the patient; and (ii) the patient’s carer (if any), if the patient agrees; and (f) in the preceding 12 months, a service to which this item or item 92435 applies has not been provided to the patient | $549.90 85% benefit $467.45 |
| 293 | Professional attendance lasting more than 30 minutes, but not more than 45 minutes, at consulting rooms by a consultant physician in the practice of the consultant physician’s specialty of psychiatry, if: (a) the patient is being managed by a medical practitioner or a participating nurse practitioner in accordance with a management plan prepared by the consultant in accordance with item 291 or item 92435; and (b) the attendance follows referral of the patient to the consultant, by the medical practitioner or participating nurse practitioner managing the patient, for review of the management plan and the associated comprehensive diagnostic assessment; and (c) during the attendance, the consultant: (i) if it is clinically appropriate to do so—uses an appropriate outcome tool; and (ii) carries out a mental state examination; and (iii) reviews the comprehensive diagnostic assessment and undertakes additional assessment as required; and (iv) reviews the management plan; and (d) within 2 weeks after the attendance, the consultant prepares and gives to the referring practitioner a written report, which includes: (i) the revised comprehensive diagnostic assessment of the patient; and (ii) a revised management plan including updated recommendations to the referring practitioner to manage the patient’s ongoing care in a biopsychosocial model; and (e) if clinically appropriate, the consultant explains the diagnostic assessment and management plan, and gives a copy, to: (i) the patient; and (ii) the patient’s carer (if any), if the patient agrees; and (f) in the preceding 12 months, a service to which item 291 or item 92435 applies has been provided to the patient; and (g) in the preceding 12 months, a service to which this item or item 92436 or 92444 applies has not been provided to the patient | $343.75 85% benefit $292.20 |
| 294 | New wording on 1 November 2026Professional attendance on a patient by a consultant physician practising in the consultant physician’s specialty of psychiatry if:(a) the attendance is by video conference; and (b) except for the requirement for the attendance to be at consulting rooms—item 291, 293, 296, 300, 302, 304, 306, 308, 310, 312, 314, 316, 318 or 319 would otherwise apply to the attendance; and (c) the patient is not an admitted patient; and (d) the patient is bulk‑billed; and (e) the patient: (i) is located: (A) within a Modified Monash 2, 3, 4, 5, 6 or 7 area; and (B) at the time of the attendance—at least 15 km by road from the physician; or (ii) is a care recipient in a residential care home; or (iii) 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 Derived fee: 50% of the fee for item 291, 293, 296, 300, 302, 304, 306, 308, 310, 312, 314, 316, 318 or 319. | Derived |
| 296 | Professional attendance lasting more than 45 minutes by a consultant physician in the practice of the consultant physician’s speciality of psychiatry following referral of the patient to the consultant physician by a referring practitioner—an attendance at consulting rooms if the patient: (a) is a new patient for this consultant physician; or (b) has not received a professional attendance from this consultant physician in the preceding 24 months; other than attendance on a patient in relation to whom this item or any of items 297, 299, 300, 302, 304, 306, 308, 91827 to 91831, 91837 to 91839, 92437 and 92478 to 92483 has applied in the preceding 24 months | $316.30 85% benefit $268.90 |
| 297 | Professional attendance lasting more than 45 minutes by a consultant physician in the practice of the consultant physician's speciality of psychiatry following referral of the patient to the consultant physician by a referring practitioner—an attendance at hospital if the patient: (a) is a new patient for this consultant physician; or (b) has not received a professional attendance from this consultant physician in the preceding 24 months; other than attendance on a patient in relation to whom this item, or any of items 296, 299, 300, 302, 304, 306, 308, 91827 to 91831, 91837 to 91839, 92437 and 92478 to 92483 has applied in the preceding 24 months (H) | $316.30 75% benefit $237.25 |
| 299 | Professional attendance lasting more than 45 minutes by a consultant physician in the practice of the consultant physician's speciality of psychiatry following referral of the patient to the consultant physician by a referring practitioner - an attendance at a place other than consulting rooms or a hospital if the patient: (a) is a new patient for this consultant physician; or (b) has not received a professional attendance from this consultant physician in the preceding 24 months; other than attendance on a patient in relation to whom this item, or any of items 296, 297, 300, 302, 304, 306, 308, 91827 to 91831, 91837 to 91839, 92437 and 92478 to 92483 has applied in the preceding 24 months | $378.15 85% benefit $321.45 |
| 300 | Professional attendance by a consultant physician in the practice of the consultant physician’s specialty of psychiatry following referral of the patient to the consultant physician by a referring practitioner—an attendance lasting not more than 15 minutes at consulting rooms, if that attendance and another attendance to which any of items 296, 297, 299, 300, 302, 304, 306, 308, 91827 to 91831, 91837 to 91839 and 92437 applies have not exceeded 50 attendances in a calendar year for the patient | $52.65 85% benefit $44.80 |
| 302 | Professional attendance by a consultant physician in the practice of the consultant physician’s specialty of psychiatry following referral of the patient to the consultant physician by a referring practitioner—an attendance lasting more than 15 minutes, but not more than 30 minutes, at consulting rooms, if that attendance and another attendance to which any of items 296, 297, 299, 300, 302, 304, 306, 308, 91827 to 91831, 91837 to 91839 and 92437 applies have not exceeded 50 attendances in a calendar year for the patient | $105.05 85% benefit $89.30 |
| 304 | Professional attendance by a consultant physician in the practice of the consultant physician’s specialty of psychiatry following referral of the patient to the consultant physician by a referring practitioner—an attendance lasting more than 30 minutes, but not more than 45 minutes, at consulting rooms, if that attendance and another attendance to which any of items 296, 297, 299, 300, 302, 304, 306, 308, 91827 to 91831, 91837 to 91839 and 92437 applies have not exceeded 50 attendances in a calendar year for the patient | $161.70 85% benefit $137.45 |
| 306 | Professional attendance by a consultant physician in the practice of the consultant physician’s specialty of psychiatry following referral of the patient to the consultant physician by a referring practitioner—an attendance lasting more than 45 minutes, but not more than 75 minutes, at consulting rooms, if that attendance and another attendance to which any of items 296, 297, 299, 300, 302, 304, 306, 308, 91827 to 91831, 91837 to 91839 and 92437 applies have not exceeded 50 attendances in a calendar year for the patient | $223.15 85% benefit $189.70 |
| 308 | Professional attendance by a consultant physician in the practice of the consultant physician’s specialty of psychiatry following referral of the patient to the consultant physician by a referring practitioner—an attendance lasting more than 75 minutes at consulting rooms, if that attendance and another attendance to which any of items 296, 297, 299, 300, 302, 304, 306, 308, 91827 to 91831, 91837 to 91839 and 92437 applies have not exceeded 50 attendances in a calendar year for the patient | $258.95 85% benefit $220.15 |
| 310 | Professional attendance by a consultant physician in the practice of the consultant physician’s specialty of psychiatry following referral of the patient to the consultant physician by a referring practitioner—an attendance lasting not more than 15 minutes at consulting rooms, if that attendance and another attendance to which any of items 296, 297, 299, 300, 302, 304, 306, 308, 91827 to 91831, 91837 to 91839 and 92437 applies exceed 50 attendances in a calendar year for the patient | $26.20 85% benefit $22.30 |
| 312 | Professional attendance by a consultant physician in the practice of the consultant physician’s specialty of psychiatry following referral of the patient to the consultant physician by a referring practitioner—an attendance lasting more than 15 minutes, but not more than 30 minutes, at consulting rooms, if that attendance and another attendance to which any of items 296, 297, 299, 300, 302, 304, 306, 308, 91827 to 91831, 91837 to 91839 and 92437 applies exceed 50 attendances in a calendar year for the patient | $52.65 85% benefit $44.80 |
| 314 | Professional attendance by a consultant physician in the practice of the consultant physician’s specialty of psychiatry following referral of the patient to the consultant physician by a referring practitioner—an attendance lasting more than 30 minutes, but not more than 45 minutes, at consulting rooms, if that attendance and another attendance to which any of items 296, 297, 299, 300, 302, 304, 306, 308, 91827 to 91831, 91837 to 91839 and 92437 applies exceed 50 attendances in a calendar year for the patient | $81.05 85% benefit $68.90 |
| 316 | Professional attendance by a consultant physician in the practice of the consultant physician’s specialty of psychiatry following referral of the patient to the consultant physician by a referring practitioner—an attendance lasting more than 45 minutes, but not more than 75 minutes, at consulting rooms, if that attendance and another attendance to which any of items 296, 297, 299, 300, 302, 304, 306, 308, 91827 to 91831, 91837 to 91839 and 92437 applies exceed 50 attendances in a calendar year for the patient | $111.70 85% benefit $94.95 |
| 318 | Professional attendance by a consultant physician in the practice of the consultant physician’s specialty of psychiatry following referral of the patient to the consultant physician by a referring practitioner—an attendance lasting more than 75 minutes at consulting rooms, if that attendance and another attendance to which any of items 296, 297, 299, 300, 302, 304, 306, 308, 91827 to 91831, 91837 to 91839 and 92437 applies exceed 50 attendances in a calendar year for the patient | $129.50 85% benefit $110.10 |
| 319 | Professional attendance by a consultant physician in the practice of the consultant physician’s specialty of psychiatry following referral of the patient to the consultant physician by a referring practitioner—an attendance lasting more than 45 minutes at consulting rooms, if: (a) the formulation of the patient’s clinical presentation indicates intensive psychotherapy is a clinically appropriate and indicated treatment; and (b) that attendance and another attendance to which any of items 296, 297, 299, 300, 302, 304, 306, 308, 91827 to 91831, 91837 to 91839, 91873 and 92437 applies have not exceeded 160 attendances in a calendar year for the patient | $223.15 85% benefit $189.70 |
| 320 | Professional attendance by a consultant physician in the practice of the consultant physician’s specialty of psychiatry following referral of the patient to the consultant physician by a referring practitioner—an attendance lasting not more than 15 minutes at hospital (H) | $52.65 75% benefit $39.50 |
| 322 | Professional attendance by a consultant physician in the practice of the consultant physician’s specialty of psychiatry following referral of the patient to the consultant physician by a referring practitioner—an attendance lasting more than 15 minutes, but not more than 30 minutes, at hospital (H) | $105.05 75% benefit $78.80 |
| 324 | Professional attendance by a consultant physician in the practice of the consultant physician’s specialty of psychiatry following referral of the patient to the consultant physician by a referring practitioner—an attendance lasting more than 30 minutes, but not more than 45 minutes, at hospital (H) | $161.70 75% benefit $121.30 |
| 326 | Professional attendance by a consultant physician in the practice of the consultant physician’s specialty of psychiatry following referral of the patient to the consultant physician by a referring practitioner—an attendance lasting more than 45 minutes, but not more than 75 minutes, at hospital (H) | $223.15 75% benefit $167.40 |
| 328 | Professional attendance by a consultant physician in the practice of the consultant physician’s specialty of psychiatry following referral of the patient to the consultant physician by a referring practitioner—an attendance lasting more than 75 minutes at hospital (H) | $258.95 75% benefit $194.25 |
| 330 | Professional attendance by a consultant physician in the practice of the consultant physician’s specialty of psychiatry following referral of the patient to the consultant physician by a referring practitioner—an attendance lasting not more than 15 minutes if that attendance is at a place other than consulting rooms or hospital | $96.65 85% benefit $82.20 |
| 332 | Professional attendance by a consultant physician in the practice of the consultant physician’s specialty of psychiatry following referral of the patient to the consultant physician by a referring practitioner—an attendance lasting more than 15 minutes, but not more than 30 minutes, if that attendance is at a place other than consulting rooms or hospital | $151.35 85% benefit $128.65 |
| 334 | Professional attendance by a consultant physician in the practice of the consultant physician’s specialty of psychiatry following referral of the patient to the consultant physician by a referring practitioner—an attendance lasting more than 30 minutes, but not more than 45 minutes, if that attendance is at a place other than consulting rooms or hospital | $220.60 85% benefit $187.55 |
| 336 | Professional attendance by a consultant physician in the practice of the consultant physician’s specialty of psychiatry following referral of the patient to the consultant physician by a referring practitioner—an attendance lasting more than 45 minutes, but not more than 75 minutes, if that attendance is at a place other than consulting rooms or hospital | $266.90 85% benefit $226.90 |
| 338 | Professional attendance by a consultant physician in the practice of the consultant physician’s specialty of psychiatry following referral of the patient to the consultant physician by a referring practitioner—an attendance lasting more than 75 minutes if that attendance is at a place other than consulting rooms or hospital | $303.20 85% benefit $257.75 |
| 341 | An interview, lasting not more than 15 minutes, of a person other than the patient when the patient is not in attendance, by a consultant physician in the practice of the consultant physician’s specialty of psychiatry following referral of the patient to the consultant physician by a referring practitioner, for the purposes of: (a) initial diagnostic evaluation; or (b) continuing management of the patient; if that service and another service to which this item or any of items 343, 345, 347, 349, 91874 to 91878 and 91882 to 91884 applies have not exceeded 15 services in a calendar year in relation to the patient | $52.65 75% benefit $39.50 85% benefit $44.80 |
| 342 | Group psychotherapy (including any associated consultations with a patient taking place on the same occasion and relating to the condition for which group therapy is conducted) of not less than 1 hour in duration given under the continuous direct supervision of a consultant physician in the practice of the consultant physician's specialty of psychiatry, involving a group of 2 to 9 unrelated patients or a family group of more than 3 patients, each of whom is referred to the consultant physician by a referring practitioner-each patient | $59.85 75% benefit $44.90 85% benefit $50.90 |
| 343 | An interview, lasting more than 15 minutes but not more than 30 minutes, of a person other than the patient when the patient is not in attendance, by a consultant physician in the practice of the consultant physician’s specialty of psychiatry following referral of the patient to the consultant physician by a referring practitioner, for the purposes of: (a) initial diagnostic evaluation; or (b) continuing management of the patient; if that service and another service to which this item or any of items 341, 345, 347, 349, 91874 to 91878 and 91882 to 91884 applies have not exceeded 15 services in a calendar year in relation to the patient | $105.05 75% benefit $78.80 85% benefit $89.30 |
| 344 | Group psychotherapy (including any associated consultations with a patient taking place on the same occasion and relating to the condition for which group therapy is conducted) of not less than 1 hour in duration given under the continuous direct supervision of a consultant physician in the practice of the consultant physician's specialty of psychiatry, involving a family group of 3 patients, each of whom is referred to the consultant physician by a referring practitioner-each patient | $79.45 75% benefit $59.60 85% benefit $67.55 |
| 345 | An interview, lasting more than 30 minutes but not more than 45 minutes, of a person other than the patient when the patient is not in attendance, by a consultant physician in the practice of the consultant physician’s specialty of psychiatry following referral of the patient to the consultant physician by a referring practitioner, for the purposes of: (a) initial diagnostic evaluation; or (b) continuing management of the patient; if that service and another service to which this item or any of items 341, 343, 347, 349, 91874 to 91878 and 91882 to 91884 applies have not exceeded 15 services in a calendar year in relation to the patient | $161.70 75% benefit $121.30 85% benefit $137.45 |
| 346 | Group psychotherapy (including any associated consultations with a patient taking place on the same occasion and relating to the condition for which group therapy is conducted) of not less than 1 hour in duration given under the continuous direct supervision of a consultant physician in the practice of the consultant physician's specialty of psychiatry, involving a family group of 2 patients, each of whom is referred to the consultant physician by a referring practitioner-each patient | $117.65 75% benefit $88.25 85% benefit $100.05 |
| 347 | An interview, lasting more than 45 minutes but not more than 75 minutes, of a person other than the patient when the patient is not in attendance, by a consultant physician in the practice of the consultant physician’s specialty of psychiatry following referral of the patient to the consultant physician by a referring practitioner, for the purposes of: (a) initial diagnostic evaluation; or (b) continuing management of the patient; if that service and another service to which this item or any of items 341, 343, 345, 349, 91874 to 91878 and 91882 to 91884 applies have not exceeded 15 services in a calendar year in relation to the patient | $223.15 75% benefit $167.40 85% benefit $189.70 |
| 349 | An interview, lasting more than 75 minutes, of a person other than the patient when the patient is not in attendance, by a consultant physician in the practice of the consultant physician’s specialty of psychiatry following referral of the patient to the consultant physician by a referring practitioner, for the purposes of: (a) initial diagnostic evaluation; or (b) continuing management of the patient; if that service and another service to which this item or any of items 341, 343, 345, 347, 91874 to 91878 and 91882 to 91884 applies have not exceeded 15 services in a calendar year in relation to the patient | $258.95 75% benefit $194.25 85% benefit $220.15 |
A12 Consultant Occupational Physician Attendances To Which No Other Item Applies
4 items
| Item | Description | Fee and benefits |
|---|---|---|
| 385 | Professional attendance at consulting rooms or hospital by a consultant occupational physician in the practice of the consultant occupational physician's specialty of occupational medicine following referral of the patient to the consultant occupational physician by a referring practitioner-initial attendance in a single course of treatment | $103.95 75% benefit $78.00 85% benefit $88.40 |
| 386 | Professional attendance at consulting rooms or hospital by a consultant occupational physician in the practice of the consultant occupational physician's specialty of occupational medicine following referral of the patient to the consultant occupational physician by a referring practitioner-each attendance after the first in a single course of treatment | $52.25 75% benefit $39.20 85% benefit $44.45 |
| 387 | Professional attendance at a place other than consulting rooms or hospital by a consultant occupational physician in the practice of the consultant occupational physician's specialty of occupational medicine following referral of the patient to the consultant occupational physician by a referring practitioner-initial attendance in a single course of treatment | $152.50 75% benefit $114.40 85% benefit $129.65 |
| 388 | Professional attendance at a place other than consulting rooms or hospital by a consultant occupational physician in the practice of the consultant occupational physician's specialty of occupational medicine following referral of the patient to the consultant occupational physician by a referring practitioner-each attendance after the first in a single course of treatment | $96.55 75% benefit $72.45 85% benefit $82.10 |
A13 Public Health Physician Attendances To Which No Other Item Applies
8 items
| Item | Description | Fee and benefits |
|---|---|---|
| 410 | LEVEL AProfessional attendance at consulting rooms by a public health physician in the practice of his or her specialty of public health medicine 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. | $23.75 75% benefit $17.85 85% benefit $20.20 |
| 411 | LEVEL BProfessional attendance by a public health physician in the practice of his or her specialty of public health medicine at consulting rooms lasting less than 20 minutes, 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; in relation to 1 or more health-related issues, with appropriate documentation. | $51.90 75% benefit $38.95 85% benefit $44.15 |
| 412 | LEVEL CProfessional attendance by a public health physician in the practice of his or her specialty of public health medicine at consulting rooms lasting at least 20 minutes, 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; in relation to 1 or more health-related issues, with appropriate documentation. | $100.50 75% benefit $75.40 85% benefit $85.45 |
| 413 | LEVEL DProfessional attendance by a public health physician in the practice of his or her specialty of public health medicine at consulting rooms lasting at least 40 minutes, 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; in relation to 1 or more health-related issues, with appropriate documentation. | $147.95 75% benefit $111.00 85% benefit $125.80 |
| 414 | Professional attendance at other than consulting rooms by a public health physician in the practice of the public health physician’s specialty of public health medicine—attendance 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 Derived fee: The fee for item 410, plus $31.00 divided by the number of patients seen, up to a maximum of six patients. For seven or more patients - the fee for item 410 plus $2.45 per patient. | Derived |
| 415 | Professional attendance by a public health physician in the practice of the public health physician’s specialty of public health medicine at other than consulting rooms, 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 Derived fee: The fee for item 411, plus $31.00 divided by the number of patients seen, up to a maximum of six patients. For seven or more patients - the fee for item 411 plus $2.45 per patient. | Derived |
| 416 | Professional attendance by a public health physician in the practice of the public health physician’s specialty of public health medicine at other than consulting rooms, 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 Derived fee: The fee for item 412, plus $31.00 divided by the number of patients seen, up to a maximum of six patients. For seven or more patients - the fee for item 412 plus $2.45 per patient. | Derived |
| 417 | Professional attendance by a public health physician in the practice of the public health physician’s specialty of public health medicine at other than consulting rooms, 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 Derived fee: The fee for item 413, plus $31.00 divided by the number of patients seen, up to a maximum of six patients. For seven or more patients - the fee for item 413 plus $2.45 per patient. | Derived |
A11 Urgent Attendance After Hours
6 items
| Item | Description | Fee and benefits |
|---|---|---|
| 585 | 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 | $155.40 75% benefit $116.55 100% benefit $155.40 |
| 588 | Professional attendance by a medical practitioner (other than 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) the attendance is in an after-hours rural area; and (d) 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 | $155.40 75% benefit $116.55 100% benefit $155.40 |
| 591 | Professional attendance by a medical practitioner (other than 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) the attendance is not in an after-hours rural area; and (d) 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 | $107.75 75% benefit $80.85 100% benefit $107.75 |
| 594 | Professional attendance by a medical practitioner—each additional patient at an attendance that qualifies for item 585, 588 or 591 in relation to the first patient | $50.20 75% benefit $37.65 100% benefit $50.20 |
| 599 | 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 | $183.15 75% benefit $137.40 100% benefit $183.15 |
| 600 | Professional attendance by a medical practitioner (other than 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 | $146.35 75% benefit $109.80 100% benefit $146.35 |
A14 Health Assessments
7 items
| Item | Description | Fee and benefits |
|---|---|---|
| 695 | Menopause and Perimenopause Health Assessment Professional attendance on a patient for the assessment and management of menopause or perimenopause by a general practitioner lasting at least 20 minutes and including, but not limited to: a) collecting relevant information, including taking a patient history to determine pre-, peri- or post-menopausal status, patient wellbeing and contraindications for management; and b) undertaking a basic physical examination, including recording blood pressure, and review of height and weight; and c) initiating investigations and referrals as clinically indicated, with consideration given to the need for cervical screening, mammography and bone densitometry; and d) discussing management options including non-pharmacological and pharmacological strategies including risks and benefits; e) implementing a management plan which includes patient centred symptoms management; and f) providing the patient with preventative health care advice and information as clinically indicated, including advice on physical activity, smoking cessation, alcohol consumption, nutritional intake and weight management. | $104.55 100% benefit $104.55 |
| 699 | Professional attendance on a patient who is 30 years of age or over for a heart health assessment by a general practitioner at consulting rooms lasting 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. | $87.10 100% benefit $87.10 |
| 701 | Professional attendance by a general practitioner to perform a brief health assessment, lasting not more than 30 minutes and including: (a) collection of relevant information, including taking a patient history; and (b) a basic physical examination; and (c) initiating interventions and referrals as indicated; and (d) providing the patient with preventive health care advice and information | $71.00 100% benefit $71.00 |
| 703 | Professional attendance by a general practitioner to perform a standard health assessment, lasting more than 30 minutes but less than 45 minutes, including: (a) detailed information collection, including taking a patient history; and (b) an extensive physical examination; and (c) initiating interventions and referrals as indicated; and (d) providing a preventive health care strategy for the patient | $165.05 100% benefit $165.05 |
| 705 | Professional attendance by a general practitioner to perform a long health assessment, lasting at least 45 minutes but less than 60 minutes, including: (a) comprehensive information collection, including taking a patient history; and (b) an extensive examination of the patient's medical condition and physical function; and (c) initiating interventions and referrals as indicated; and (d) providing a basic preventive health care management plan for the patient | $227.75 100% benefit $227.75 |
| 707 | Professional attendance by a general practitioner to perform a prolonged health assessment (lasting at least 60 minutes) including: (a) comprehensive information collection, including taking a patient history; and (b) an extensive examination of the patient's medical condition, and physical, psychological and social function; and (c) initiating interventions or referrals as indicated; and (d) providing a comprehensive preventive health care management plan for the patient | $321.75 100% benefit $321.75 |
| 715 | New wording on 1 November 2026Professional attendance by a general practitioner, at consulting rooms or in a place other than a hospital or a residential care home:(a) for a health assessment of a patient who is of Aboriginal or Torres Strait Islander descent; and (b) that includes the following: (i) recognising the patient’s health priorities; (ii) taking the patient’s medical history; (iii) undertaking any relevant physical examinations; (iv) undertaking or arranging any required investigations; (v) assessing the patient using the information gained in the health assessment; (vi) initiating any necessary interventions and referrals; (vii) developing and documenting a plan to manage the patient’s health, including for follow‑up, based on the health assessment and the patient’s priorities; (viii) offering the patient (or the patient’s carer (if any) if the practitioner considers it appropriate and the patient agrees) a written report of the health assessment, with recommendations on matters covered by the health assessment and a strategy for the patient’s good health; (ix) if the offer referred to in subparagraph (viii) is accepted—giving the report to the patient or the patient’s carer (as applicable); (x) adding a record of the health assessment to the patient’s medical records Applicable only if a service to which this item or item 228, 92004 or 92011 applies has not been provided to the patient in the preceding 9 months Note: For items 92004 and 92011, see the Telehealth Attendance Determination. | $254.10 100% benefit $254.10 |
A15 GP chronic condition management plans, multidisciplinary care plans and case conferences
43 items
| Item | Description | Fee and benefits |
|---|---|---|
| 729 | Contribution by a general practitioner (not including a specialist or consultant physician) 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 item 735, 739, 743, 747, 750 or 758 applies) | $84.25 100% benefit $84.25 |
| 731 | New wording on 1 November 2026Contribution by a general practitioner (not including a specialist or consultant physician) to:(a) a multidisciplinary care plan for a patient in a residential care home, prepared by that residential care home, or to a review of such a plan prepared by such a residential care home; 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 item 735, 739, 743, 747, 750 or 758 applies) | $84.25 100% benefit $84.25 |
| 735 | New wording on 1 November 2026Attendance by a general practitioner (not including a specialist or consultant physician), as a member of a multidisciplinary case conference team, to organise and coordinate:(a) a community case conference; or (b) a multidisciplinary case conference carried out for a care recipient in a residential care home; 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 item 729, 731, 965, 967, 231, 232, 392, 393, 92026, 92027, 92029, 92030, 92033, 92034, 92057, 92058, 92060, 92061, 92063 or 92064 applies) | $84.65 75% benefit $63.50 100% benefit $84.65 |
| 739 | New wording on 1 November 2026Attendance by a general practitioner (not including a specialist or consultant physician), as a member of a multidisciplinary case conference team, to organise and coordinate:(a) a community case conference; or (b) a multidisciplinary case conference carried out for a care recipient in a residential care home; 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 item 729, 731, 965, 967, 231, 232, 392, 393, 92026, 92027, 92029, 92030, 92033, 92034, 92057, 92058, 92060, 92061, 92063 or 92064 applies) | $144.70 75% benefit $108.55 100% benefit $144.70 |
| 743 | New wording on 1 November 2026Attendance by a general practitioner (not including a specialist or consultant physician), as a member of a multidisciplinary case conference team, to organise and coordinate:(a) a community case conference; or (b) a multidisciplinary case conference carried out for a care recipient in a residential care home; 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 item 729, 731, 965, 967, 231, 232, 392, 393, 92026, 92027, 92029, 92030, 92033, 92034, 92057, 92058, 92060, 92061, 92063 or 92064 applies) | $241.25 75% benefit $180.95 100% benefit $241.25 |
| 747 | New wording on 1 November 2026Attendance by a general practitioner (not including a specialist or consultant physician), as a member of a multidisciplinary case conference team, to participate in:(a) a community case conference; or (b) a multidisciplinary case conference carried out for a care recipient in a residential care home; 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 item 729, 731, 965, 967, 231, 232, 392, 393, 92026, 92027, 92029, 92030, 92033, 92034, 92057, 92058, 92060, 92061, 92063 or 92064 applies) | $62.20 75% benefit $46.65 100% benefit $62.20 |
| 750 | New wording on 1 November 2026Attendance by a general practitioner (not including a specialist or consultant physician), as a member of a multidisciplinary case conference team, to participate in:(a) a community case conference; or (b) a multidisciplinary case conference carried out for a care recipient in a residential care home; 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 item 729, 731, 965, 967, 231, 232, 392, 393, 92026, 92027, 92029, 92030, 92033, 92034, 92057, 92058, 92060, 92061, 92063 or 92064 applies) | $106.60 75% benefit $79.95 100% benefit $106.60 |
| 758 | New wording on 1 November 2026Attendance by a general practitioner (not including a specialist or consultant physician), as a member of a multidisciplinary case conference team, to participate in:(a) a community case conference; or (b) a multidisciplinary case conference carried out for a care recipient in a residential care home; 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 item 729, 731, 965, 967, 231, 232, 392, 393, 92026, 92027, 92029, 92030, 92033, 92034, 92057, 92058, 92060, 92061, 92063 or 92064 applies) | $177.35 75% benefit $133.05 100% benefit $177.35 |
| 820 | Attendance by a consultant physician in the practice of the consultant physician's specialty, as a member of a case conference team, to organise and coordinate a community case conference of at least 15 minutes but less than 30 minutes, with a multidisciplinary team of at least 3 other formal care providers of different disciplines | $168.95 75% benefit $126.75 85% benefit $143.65 |
| 822 | Attendance by a consultant physician in the practice of the consultant physician's specialty, as a member of a case conference team, to organise and coordinate a community case conference of at least 30 minutes but less than 45 minutes, with a multidisciplinary team of at least 3 other formal care providers of different disciplines | $253.60 75% benefit $190.20 85% benefit $215.60 |
| 823 | Attendance by a consultant physician in the practice of the consultant physician's specialty, as a member of a case conference team, to organise and coordinate a community case conference of at least 45 minutes, with a multidisciplinary team of at least 3 other formal care providers of different disciplines | $337.80 75% benefit $253.35 85% benefit $287.15 |
| 825 | Attendance by a consultant physician in the practice of the consultant physician's specialty, as a member of a multidisciplinary case conference team of at least 2 other formal care providers of different disciplines, to participate in a community case conference (other than to organise and coordinate the conference) of at least 15 minutes but less than 30 minutes, with the multidisciplinary case conference team | $121.30 75% benefit $91.00 85% benefit $103.15 |
| 826 | Attendance by a consultant physician in the practice of the consultant physician's specialty, as a member of a multidisciplinary case conference team of at least 2 other formal care providers of different disciplines, to participate in a community case conference (other than to organise and coordinate the conference) of at least 30 minutes but less than 45 minutes, with the multidisciplinary case conference team | $193.55 75% benefit $145.20 85% benefit $164.55 |
| 828 | Attendance by a consultant physician in the practice of the consultant physician's specialty, as a member of a multidisciplinary case conference team of at least 2 other formal care providers of different disciplines, to participate in a community case conference (other than to organise and coordinate the conference) of at least 45 minutes, with the multidisciplinary case conference team | $265.75 75% benefit $199.35 85% benefit $225.90 |
| 830 | Attendance by a consultant physician in the practice of the consultant physician’s specialty, as a member of a case conference team, to organise and coordinate a discharge case conference of at least 15 minutes but less than 30 minutes, with a multidisciplinary team of at least 3 other formal care providers of different disciplines (H) | $168.95 75% benefit $126.75 |
| 832 | Attendance by a consultant physician in the practice of the consultant physician's specialty, as a member of a case conference team, to organise and coordinate a discharge case conference of at least 30 minutes but less than 45 minutes, with a multidisciplinary team of at least 3 other formal care providers of different disciplines (H) | $253.60 75% benefit $190.20 |
| 834 | Attendance by a consultant physician in the practice of the consultant physician's specialty, as a member of a case conference team, to organise and coordinate a discharge case conference of at least 45 minutes, with a multidisciplinary team of at least 3 other formal care providers of different disciplines (H) | $337.80 75% benefit $253.35 |
| 835 | Attendance by a consultant physician in the practice of the consultant physician's specialty, as a member of a case conference team, to participate in a discharge case conference (other than to organise and coordinate the conference) of at least 15 minutes but less than 30 minutes, with a multidisciplinary team of at least 2 other formal care providers of different disciplines (H) | $121.30 75% benefit $91.00 |
| 837 | Attendance by a consultant physician in the practice of the consultant physician's specialty, as a member of a case conference team, to participate in a discharge case conference (other than to organise and coordinate the conference) of at least 30 minutes but less than 45 minutes, with a multidisciplinary team of at least 2 other formal care providers of different disciplines (H) | $193.55 75% benefit $145.20 |
| 838 | Attendance by a consultant physician in the practice of the consultant physician's specialty, as a member of a case conference team, to participate in a discharge case conference (other than to organise and coordinate the conference) of at least 45 minutes, with a multidisciplinary team of at least 2 other formal care providers of different disciplines (H) | $265.75 75% benefit $199.35 |
| 855 | Attendance by a consultant physician in the practice of the consultant physician's specialty of psychiatry, as a member of a multidisciplinary case conference team of at least 2 other formal care providers of different disciplines, to organise and coordinate a community case conference of at least 15 minutes but less than 30 minutes, with the multidisciplinary case conference team | $168.95 75% benefit $126.75 85% benefit $143.65 |
| 857 | Attendance by a consultant physician in the practice of the consultant physician's specialty of psychiatry, as a member of a multidisciplinary case conference team of at least 2 other formal care providers of different disciplines, to organise and coordinate a community case conference of at least 30 minutes but less than 45 minutes, with the multidisciplinary case conference team | $253.60 75% benefit $190.20 85% benefit $215.60 |
| 858 | Attendance by a consultant physician in the practice of the consultant physician's specialty of psychiatry, as a member of a multidisciplinary case conference team of at least 2 other formal care providers of different disciplines, to organise and coordinate a community case conference of at least 45 minutes, with the multidisciplinary case conference team | $337.80 75% benefit $253.35 85% benefit $287.15 |
| 861 | Attendance by a consultant physician in the practice of the consultant physician's specialty of psychiatry, as a member of a case conference team, to organise and coordinate a discharge case conference of at least 15 minutes but less than 30 minutes, with a multidisciplinary team of at least 2 other formal care providers of different disciplines (H) | $168.95 75% benefit $126.75 |
| 864 | Attendance by a consultant physician in the practice of the consultant physician's specialty of psychiatry, as a member of a case conference team, to organise and coordinate a discharge case conference of at least 30 minutes but less than 45 minutes, with a multidisciplinary team of at least 2 other formal care providers of different disciplines (H) | $253.60 75% benefit $190.20 |
| 866 | Attendance by a consultant physician in the practice of the consultant physician's specialty of psychiatry, as a member of a case conference team, to organise and coordinate a discharge case conference of at least 45 minutes, with a multidisciplinary team of at least 2 other formal care providers of different disciplines (H) | $337.80 75% benefit $253.35 |
| 871 | Attendance by a general practitioner, specialist or consultant physician as a member of a case conference team, to lead and coordinate a multidisciplinary case conference on a patient with cancer to develop a multidisciplinary treatment plan, if the case conference is of at least 10 minutes, with a multidisciplinary team of at least 3 other medical practitioners from different areas of medical practice (which may include general practice), and, in addition, allied health or other relevant health professionals | $97.55 75% benefit $73.20 85% benefit $82.95 |
| 872 | Attendance by a general practitioner, specialist or consultant physician as a member of a case conference team, to participate in a multidisciplinary case conference on a patient with cancer to develop a multidisciplinary treatment plan, if the case conference is of at least 10 minutes, with a multidisciplinary team of at least 4 medical practitioners from different areas of medical practice (which may include general practice), and, in addition, allied health or other relevant health professionals | $45.45 75% benefit $34.10 85% benefit $38.65 |
| 880 | Attendance by a specialist, or consultant physician, in the practice of the specialist's or consultant physician's specialty of geriatric or rehabilitation medicine, as a member of a case conference team, to coordinate a case conference of at least 10 minutes but less than 30 minutes—for any particular patient, one attendance only in a 7 day period (other than attendance on the same day as an attendance for which item 832, 834, 835, 837 or 838 was applicable in relation to the patient) (H) | $59.10 75% benefit $44.35 |
| 930 | Attendance by a general practitioner, as a member of a multidisciplinary case conference team, to organise and coordinate a mental health case conference, if the conference lasts for at least 15 minutes, but for less than 20 minutes | $84.65 75% benefit $63.50 100% benefit $84.65 |
| 933 | Attendance by a general practitioner, as a member of a multidisciplinary case conference team, to organise and coordinate a mental health case conference, if the conference lasts for at least 20 minutes, but for less than 40 minutes | $144.70 75% benefit $108.55 100% benefit $144.70 |
| 935 | Attendance by a general practitioner, as a member of a multidisciplinary case conference team, to organise and coordinate a mental health case conference, if the conference lasts for at least 40 minutes | $241.25 75% benefit $180.95 100% benefit $241.25 |
| 937 | Attendance by a general practitioner, as a member of a multidisciplinary case conference team, to participate in a mental health case conference, if the conference lasts for at least 15 minutes, but for less than 20 minutes | $62.20 75% benefit $46.65 100% benefit $62.20 |
| 943 | Attendance by a general practitioner, as a member of a multidisciplinary case conference team, to participate in a mental health case conference, if the conference lasts for at least 20 minutes, but for less than 40 minutes | $106.60 75% benefit $79.95 100% benefit $106.60 |
| 945 | Attendance by a general practitioner, as a member of a multidisciplinary case conference team, to participate in a mental health case conference, if the conference lasts for at least 40 minutes | $177.35 75% benefit $133.05 100% benefit $177.35 |
| 946 | Attendance by a consultant physician in the practice of the consultant physician’s specialty of psychiatry or paediatrics, as a member of a multidisciplinary case conference team, to organise and coordinate a mental health case conference of at least 15 minutes but less than 30 minutes, with the multidisciplinary case conference team | $168.95 75% benefit $126.75 85% benefit $143.65 |
| 948 | Attendance by a consultant physician in the practice of the consultant physician’s specialty of psychiatry or paediatrics, as a member of a multidisciplinary case conference team, to organise and coordinate a mental health case conference of at least 30 minutes but less than 45 minutes, with the multidisciplinary case conference team | $253.60 75% benefit $190.20 85% benefit $215.60 |
| 959 | Attendance by a consultant physician in the practice of the consultant physician’s specialty of psychiatry or paediatrics, as a member of a multidisciplinary case conference team, to organise and coordinate a mental health case conference of at least 45 minutes, with the multidisciplinary case conference team | $337.80 75% benefit $253.35 85% benefit $287.15 |
| 961 | Attendance by a consultant physician in the practice of the consultant physician’s specialty of psychiatry or paediatrics, as a member of a multidisciplinary case conference team, to participate in a mental health case conference of at least 15 minutes but less than 30 minutes, with the multidisciplinary case conference team | $121.30 75% benefit $91.00 85% benefit $103.15 |
| 962 | Attendance by a consultant physician in the practice of the consultant physician’s specialty of psychiatry or paediatrics, as a member of a multidisciplinary case conference team, to participate in a mental health case conference of at least 30 minutes but less than 45 minutes, with the multidisciplinary case conference team | $193.55 75% benefit $145.20 85% benefit $164.55 |
| 964 | Attendance by a consultant physician in the practice of the consultant physician’s specialty of psychiatry or paediatrics, as a member of a multidisciplinary case conference team, to participate in a mental health case conference of at least 45 minutes, with the multidisciplinary case conference team | $265.75 75% benefit $199.35 85% benefit $225.90 |
| 965 | Professional attendance by a general practitioner to prepare a GP chronic condition management plan for a patient | $160.60 75% benefit $120.45 100% benefit $160.60 |
| 967 | Professional attendance by a general practitioner to review a GP chronic condition management plan prepared by the general practitioner or an associated medical practitioner | $160.60 75% benefit $120.45 100% benefit $160.60 |
A17 Domiciliary And Residential Management Reviews
2 items
| Item | Description | Fee and benefits |
|---|---|---|
| 900 | Participation by a general practitioner (not including a specialist or consultant physician) 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 patientFor any particular patient—applicable not more than once in each 12 month period, and only if item 245 does not apply in the same 12 month period, except if there has been a significant change in the patient’s condition or medication regimen requiring a new DMMR | $185.35 100% benefit $185.35 |
| 903 | New wording on 1 November 2026Participation by a general practitioner (not including a specialist or consultant physician) in a residential medication management review (RMMR) for a patient who is a care recipient in a residential care home—other than an RMMR for a resident in relation to whom, in the preceding 12 months, this item or item 249 has applied, unless there has been a significant change in the resident’s medical condition or medication management plan requiring a new RMMR. | $126.90 100% benefit $126.90 |
A48 General practitioner attendances—telehealth related
12 items
| Item | Description | Fee and benefits |
|---|---|---|
| 2484 | Professional attendance by a general practitioner, at consulting rooms, lasting at least 6 minutes but less than 20 minutes, if:(a) the attendance is to provide clinical support to a patient to whom a specialist or consultant physician is providing a service, to which another item applies, by way of a video conferencing consultation; and(b) the patient is not an admitted patient; and(c) the medical practitioner is located in the same room as the patient for the whole of the attendance | $65.55 100% benefit $65.55 |
| 2485 | New wording on 1 November 2026Professional attendance by a general practitioner, at a place other than consulting rooms, lasting at least 6 minutes but less than 20 minutes, if:(a) the attendance is to provide clinical support to a patient to whom a specialist or consultant physician is providing a service, to which another item applies, by way of a video conferencing consultation; and(b) the patient is not an admitted patient; and(c) the patient is not a care recipient in a residential care home; and(d) the medical practitioner is located in the same room as the patient for the whole of the attendance | $76.10 100% benefit $76.10 |
| 2486 | New wording on 1 November 2026Professional attendance by a general practitioner, at a residential care home, lasting at least 6 minutes but less than 20 minutes, if:(a) the attendance is to provide clinical support to a patient to whom a specialist or consultant physician is providing a service, to which another item applies, by way of a video conferencing consultation; and(b) the patient is not an admitted patient; and(c) the patient is a care recipient in the residential care home; and(d) the medical practitioner is located in the same room as the patient for the whole of the attendance | $65.55 100% benefit $65.55 |
| 2487 | Professional attendance by a general practitioner, at consulting rooms, lasting at least 20 minutes but less than 40 minutes, if:(a) the attendance is to provide clinical support to a patient to whom a specialist or consultant physician is providing a service, to which another item applies, by way of a video conferencing consultation; and(b) the patient is not an admitted patient; and(c) the medical practitioner is located in the same room as the patient for the whole of the attendance | $107.65 100% benefit $107.65 |
| 2488 | New wording on 1 November 2026Professional attendance by a general practitioner, at a place other than consulting rooms, lasting at least 20 minutes but less than 40 minutes, if:(a) the attendance is to provide clinical support to a patient to whom a specialist or consultant physician is providing a service, to which another item applies, by way of a video conferencing consultation; and(b) the patient is not an admitted patient; and(c) the patient is not a care recipient in a residential care home; and(d) the medical practitioner is located in the same room as the patient for the whole of the attendance | $118.15 100% benefit $118.15 |
| 2489 | New wording on 1 November 2026Professional attendance by a general practitioner, at a residential care home, lasting at least 20 minutes but less than 40 minutes, if:(a) the attendance is to provide clinical support to a patient to whom a specialist or consultant physician is providing a service, to which another item applies, by way of a video conferencing consultation; and(b) the patient is not an admitted patient; and(c) the patient is a care recipient in the residential care home; and(d) the medical practitioner is located in the same room as the patient for the whole of the attendance | $107.65 100% benefit $107.65 |
| 2490 | Professional attendance by a general practitioner, at consulting rooms, lasting at least 40 minutes but less than 60 minutes, if:(a) the attendance is to provide clinical support to a patient to whom a specialist or consultant physician is providing a service, to which another item applies, by way of a video conferencing consultation; and(b) the patient is not an admitted patient; and(c) the medical practitioner is located in the same room as the patient for the whole of the attendance | $148.85 100% benefit $148.85 |
| 2491 | New wording on 1 November 2026Professional attendance by a general practitioner, at a place other than consulting rooms, lasting at least 40 minutes but less than 60 minutes, if:(a) the attendance is to provide clinical support to a patient to whom a specialist or consultant physician is providing a service, to which another item applies, by way of a video conferencing consultation; and(b) the patient is not an admitted patient; and(c) the patient is not a care recipient in a residential care home; and(d) the medical practitioner is located in the same room as the patient for the whole of the attendance | $156.70 100% benefit $156.70 |
| 2492 | New wording on 1 November 2026Professional attendance by a general practitioner, at a residential care home, lasting at least 40 minutes but less than 60 minutes, if:(a) the attendance is to provide clinical support to a patient to whom a specialist or consultant physician is providing a service, to which another item applies, by way of a video conferencing consultation; and(b) the patient is not an admitted patient; and(c) the patient is a care recipient in the residential care home; and(d) the medical practitioner is located in the same room as the patient for the whole of the attendance | $148.85 100% benefit $148.85 |
| 2493 | Professional attendance by a general practitioner, at consulting rooms, lasting at least 60 minutes, if:(a) the attendance is to provide clinical support to a patient to whom a specialist or consultant physician is providing a service, to which another item applies, by way of a video conferencing consultation; and(b) the patient is not an admitted patient; and(c) the medical practitioner is located in the same room as the patient for the whole of the attendance | $228.45 100% benefit $228.45 |
| 2494 | New wording on 1 November 2026Professional attendance by a general practitioner, at a place other than consulting rooms, lasting at least 60 minutes, if:(a) the attendance is to provide clinical support to a patient to whom a specialist or consultant physician is providing a service, to which another item applies, by way of a video conferencing consultation; and(b) the patient is not an admitted patient; and(c) the patient is not a care recipient in a residential care home; and(d) the medical practitioner is located in the same room as the patient for the whole of the attendance | $238.95 100% benefit $238.95 |
| 2495 | New wording on 1 November 2026Professional attendance by a general practitioner, at a residential care home, lasting at least 60 minutes, if:(a) the attendance is to provide clinical support to a patient to whom a specialist or consultant physician is providing a service, to which another item applies, by way of a video conferencing consultation; and(b) the patient is not an admitted patient; and(c) the patient is a care recipient in the residential care home; and(d) the medical practitioner is located in the same room as the patient for the whole of the attendance | $228.45 100% benefit $228.45 |
A20 GP Mental Health Treatment
12 items
| Item | Description | Fee and benefits |
|---|---|---|
| 2700 | 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 | $85.80 75% benefit $64.35 100% benefit $85.80 |
| 2701 | 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 | $126.35 75% benefit $94.80 100% benefit $126.35 |
| 2715 | 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 | $108.95 75% benefit $81.75 100% benefit $108.95 |
| 2717 | 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 | $160.50 75% benefit $120.40 100% benefit $160.50 |
| 2721 | Professional attendance at consulting rooms by a general practitioner, for providing focussed psychological strategies for assessed mental disorders by a general practitioner registered with the Chief Executive Medicare as meeting the credentialling requirements for provision of this service, and lasting at least 30 minutes, but less than 40 minutes | $111.00 100% benefit $111.00 |
| 2723 | Professional attendance at a place other than consulting rooms by a general practitioner (not including a specialist or a consultant physician), for providing focussed psychological strategies for assessed mental disorders by a medical practitioner registered with the Chief Executive Medicare as meeting the credentialling requirements for provision of this service, and lasting at least 30 minutes, but less than 40 minutes Derived fee: The fee for item 2721, plus $31.10 divided by the number of patients seen, up to a maximum of six patients. For seven or more patients - the fee for item 2721 plus $2.45 per patient. | Derived |
| 2725 | Professional attendance at consulting rooms by a general practitioner, for providing focussed psychological strategies for assessed mental disorders by a general practitioner registered with the Chief Executive Medicare as meeting the credentialling requirements for provision of this service, and lasting at least 40 minutes | $158.90 100% benefit $158.90 |
| 2727 | Professional attendance at a place other than consulting rooms by a general practitioner (not including a specialist or a consultant physician), for providing focussed psychological strategies for assessed mental disorders by a medical practitioner registered with the Chief Executive Medicare as meeting the credentialling requirements for provision of this service, and lasting at least 40 minutes Derived fee: The fee for item 2725, plus $31.10 divided by the number of patients seen, up to a maximum of six patients. For seven or more patients - the fee for item 2725 plus $2.45 per patient. | Derived |
| 2739 | Professional attendance at consulting rooms by a general practitioner (not including a specialist or a consultant physician) registered with the Chief Executive Medicare as meeting the credentialling requirements for provision of this service: (a) for providing focussed psychological strategies to a person other than the patient, if the service is part of the patient’s treatment; and (b) lasting at least 30 minutes, but less than 40 minutes | $111.00 100% benefit $111.00 |
| 2741 | Professional attendance at a place other than consulting rooms by a general practitioner (not including a specialist or a consultant physician) registered with the Chief Executive Medicare as meeting the credentialling requirements for provision of this service: (a) for providing focussed psychological strategies to a person other than the patient, if the service is part of the patient’s treatment; and (b) lasting at least 30 minutes, but less than 40 minutes Derived fee: The fee for item 2739, plus $31.10 divided by the number of patients seen, up to a maximum of six patients. For seven or more patients - the fee for item 2739 plus $2.45 per patient. | Derived |
| 2743 | Professional attendance at consulting rooms by a general practitioner (not including a specialist or a consultant physician) registered with the Chief Executive Medicare as meeting the credentialling requirements for provision of this service: (a) for providing focussed psychological strategies to a person other than the patient, if the service is part of the patient’s treatment; and (b) lasting at least 40 minutes | $158.90 100% benefit $158.90 |
| 2745 | Professional attendance at a place other than consulting rooms by a general practitioner (not including a specialist or a consultant physician) registered with the Chief Executive Medicare as meeting the credentialling requirements for provision of this service: (a) for providing focussed psychological strategies to a person other than the patient, if the service is part of the patient’s treatment; and (b) lasting at least 40 minutes Derived fee: The fee for item 2743, plus $31.10 divided by the number of patients seen, up to a maximum of six patients. For seven or more patients - the fee for item 2743 plus $2.45 per patient. | Derived |
A24 Pain And Palliative Medicine
36 items
| Item | Description | Fee and benefits |
|---|---|---|
| 2801 | Professional attendance at consulting rooms or hospital by a specialist, or consultant physician, in the practice of the specialist's or consultant physician's specialty of pain medicine following referral of the patient to the specialist or consultant physician by a referring practitioner-initial attendance in a single course of treatment | $183.35 75% benefit $137.55 85% benefit $155.85 |
| 2806 | Professional attendance at consulting rooms or hospital by a specialist, or consultant physician, in the practice of the specialist's or consultant physician's specialty of pain medicine following referral of the patient to the specialist or consultant physician by a referring practitioner-each attendance (other than a service to which item 2814 applies) after the first in a single course of treatment | $91.70 75% benefit $68.80 85% benefit $77.95 |
| 2814 | Professional attendance at consulting rooms or hospital by a specialist, or consultant physician, in the practice of the specialist's or consultant physician's specialty of pain medicine following referral of the patient to the specialist or consultant physician by a referring practitioner-each minor attendance after the first attendance in a single course of treatment | $52.25 75% benefit $39.20 85% benefit $44.45 |
| 2824 | Professional attendance at a place other than consulting rooms or hospital by a specialist, or consultant physician, in the practice of the specialist's or consultant physician's specialty of pain medicine following referral of the patient to the specialist or consultant physician by a referring practitioner-initial attendance in a single course of treatment | $222.40 85% benefit $189.05 |
| 2832 | Professional attendance at a place other than consulting rooms or hospital by a specialist, or consultant physician, in the practice of the specialist's or consultant physician's specialty of pain medicine following referral of the patient to the specialist or consultant physician by a referring practitioner-each attendance (other than a service to which item 2840 applies) after the first in a single course of treatment | $134.50 85% benefit $114.35 |
| 2840 | Professional attendance at a place other than consulting rooms or hospital by a specialist, or consultant physician, in the practice of the specialist's or consultant physician's specialty of pain medicine following referral of the patient to the specialist or consultant physician by a referring practitioner-each minor attendance after the first attendance in a single course of treatment | $96.90 85% benefit $82.40 |
| 2946 | Attendance by a specialist, or consultant physician, in the practice of the specialist's or consultant physician's specialty of pain medicine, as a member of a multidisciplinary case conference team, to organise and coordinate a community case conference of at least 15 minutes but less than 30 minutes | $168.95 75% benefit $126.75 85% benefit $143.65 |
| 2949 | Attendance by a specialist, or consultant physician, in the practice of the specialist's or consultant physician's specialty of pain medicine, as a member of a multidisciplinary case conference team, to organise and coordinate a community case conference of at least 30 minutes but less than 45 minutes | $253.60 75% benefit $190.20 85% benefit $215.60 |
| 2954 | Attendance by a specialist, or consultant physician, in the practice of the specialist's or consultant physician's specialty of pain medicine, as a member of a multidisciplinary case conference team, to organise and coordinate a community case conference of at least 45 minutes | $337.80 75% benefit $253.35 85% benefit $287.15 |
| 2958 | Attendance by a specialist, or consultant physician, in the practice of the specialist's or consultant physician's specialty of pain medicine, as a member of a multidisciplinary case conference team, to participate in a community case conference (other than to organise and coordinate the conference) of at least 15 minutes but less than 30 minutes | $121.30 75% benefit $91.00 85% benefit $103.15 |
| 2972 | Attendance by a specialist, or consultant physician, in the practice of the specialist's or consultant physician's specialty of pain medicine, as a member of a multidisciplinary case conference team, to participate in a community case conference (other than to organise and coordinate the conference) of at least 30 minutes but less than 45 minutes | $193.55 75% benefit $145.20 85% benefit $164.55 |
| 2974 | Attendance by a specialist, or consultant physician, in the practice of the specialist's or consultant physician's specialty of pain medicine, as a member of a multidisciplinary case conference team, to participate in a community case conference (other than to organise and coordinate the conference) of at least 45 minutes | $265.75 75% benefit $199.35 85% benefit $225.90 |
| 2978 | Attendance by a specialist, or consultant physician, in the practice of the specialist's or consultant physician's specialty of pain medicine, as a member of a multidisciplinary case conference team, to organise and coordinate a discharge case conference of at least 15 minutes but less than 30 minutes, before the patient is discharged from a hospital (H) | $168.95 75% benefit $126.75 |
| 2984 | Attendance by a specialist, or consultant physician, in the practice of the specialist's or consultant physician's specialty of pain medicine, as a member of a multidisciplinary case conference team, to organise and coordinate a discharge case conference of at least 30 minutes but less than 45 minutes, before the patient is discharged from a hospital (H) | $253.60 75% benefit $190.20 85% benefit $215.60 |
| 2988 | Attendance by a specialist, or consultant physician, in the practice of the specialist's or consultant physician's specialty of pain medicine, as a member of a multidisciplinary case conference team, to organise and coordinate a discharge case conference of at least 45 minutes, before the patient is discharged from a hospital (H) | $337.80 75% benefit $253.35 85% benefit $287.15 |
| 2992 | Attendance by a specialist, or consultant physician, in the practice of the specialist's or consultant physician's specialty of pain medicine, as a member of a multidisciplinary case conference team, to participate in a discharge case conference (other than to organise and coordinate the conference) of at least 15 minutes but less than 30 minutes, before the patient is discharged from a hospital (H) | $121.30 75% benefit $91.00 85% benefit $103.15 |
| 2996 | Attendance by a specialist, or consultant physician, in the practice of the specialist's or consultant physician's specialty of pain medicine, as a member of a multidisciplinary case conference team, to participate in a discharge case conference (other than to organise and coordinate the conference) of at least 30 minutes but less than 45 minutes, before the patient is discharged from a hospital (H) | $193.55 75% benefit $145.20 85% benefit $164.55 |
| 3000 | Attendance by a specialist, or consultant physician, in the practice of the specialist's or consultant physician's specialty of pain medicine, as a member of a multidisciplinary case conference team, to participate in a discharge case conference (other than to organise and coordinate the conference) of at least 45 minutes, before the patient is discharged from a hospital (H) | $265.75 75% benefit $199.35 85% benefit $225.90 |
| 3005 | Professional attendance at consulting rooms or hospital by a specialist, or consultant physician, in the practice of the specialist's or consultant physician's specialty of palliative medicine following referral of the patient to the specialist or consultant physician by a referring practitioner-initial attendance in a single course of treatment | $183.35 75% benefit $137.55 85% benefit $155.85 |
| 3010 | Professional attendance at consulting rooms or hospital by a specialist, or consultant physician, in the practice of the specialist's or consultant physician's specialty of palliative medicine following referral of the patient to the specialist or consultant physician by a referring practitioner-each attendance (other than a service to which item 3014 applies) after the first in a single course of treatment | $91.70 75% benefit $68.80 85% benefit $77.95 |
| 3014 | Professional attendance at consulting rooms or hospital by a specialist, or consultant physician, in the practice of the specialist's or consultant physician's specialty of palliative medicine following referral of the patient to the specialist or consultant physician by a referring practitioner-each minor attendance after the first attendance in a single course of treatment | $52.25 75% benefit $39.20 85% benefit $44.45 |
| 3018 | Professional attendance at a place other than consulting rooms or hospital by a specialist, or consultant physician, in the practice of the specialist's or consultant physician's specialty of palliative medicine following referral of the patient to the specialist or consultant physician by a referring practitioner-initial attendance in a single course of treatment | $222.40 85% benefit $189.05 |
| 3023 | Professional attendance at a place other than consulting rooms or hospital by a specialist, or consultant physician, in the practice of the specialist's or consultant physician's specialty of palliative medicine following referral of the patient to the specialist or consultant physician by a referring practitioner-each attendance (other than a service to which item 3028 applies) after the first in a single course of treatment | $134.50 85% benefit $114.35 |
| 3028 | Professional attendance at a place other than consulting rooms or hospital by a specialist, or consultant physician, in the practice of the specialist's or consultant physician's specialty of palliative medicine following referral of the patient to the specialist or consultant physician by a referring practitioner-each minor attendance after the first attendance in a single course of treatment | $96.90 85% benefit $82.40 |
| 3032 | Attendance by a specialist, or consultant physician, in the practice of the specialist's or consultant physician's specialty of palliative medicine, as a member of a multidisciplinary case conference team, to organise and coordinate a community case conference of at least 15 minutes but less than 30 minutes | $168.95 75% benefit $126.75 85% benefit $143.65 |
| 3040 | Attendance by a specialist, or consultant physician, in the practice of the specialist's or consultant physician's specialty of palliative medicine, as a member of a multidisciplinary case conference team, to organise and coordinate a community case conference of at least 30 minutes but less than 45 minutes | $253.60 75% benefit $190.20 85% benefit $215.60 |
| 3044 | Attendance by a specialist, or consultant physician, in the practice of the specialist's or consultant physician's specialty of palliative medicine, as a member of a multidisciplinary case conference team, to organise and coordinate a community case conference of at least 45 minutes | $337.80 75% benefit $253.35 85% benefit $287.15 |
| 3051 | Attendance by a specialist, or consultant physician, in the practice of the specialist's or consultant physician's specialty of palliative medicine, as a member of a multidisciplinary case conference team, to participate in a community case conference (other than to organise and coordinate the conference) of at least 15 minutes but less than 30 minutes | $121.30 75% benefit $91.00 85% benefit $103.15 |
| 3055 | Attendance by a specialist, or consultant physician, in the practice of the specialist's or consultant physician's specialty of palliative medicine, as a member of a multidisciplinary case conference team, to participate in a community case conference (other than to organise and coordinate the conference) of at least 30 minutes but less than 45 minutes, with a multidisciplinary team of at least 2 other formal care providers of different disciplines | $193.55 75% benefit $145.20 85% benefit $164.55 |
| 3062 | Attendance by a specialist, or consultant physician, in the practice of the specialist's or consultant physician's specialty of palliative medicine, as a member of a multidisciplinary case conference team, to participate in a community case conference (other than to organise and coordinate the conference) of at least 45 minutes | $265.75 75% benefit $199.35 85% benefit $225.90 |
| 3069 | Attendance by a specialist, or consultant physician, in the practice of the specialist's or consultant physician's specialty of palliative medicine, as a member of a multidisciplinary case conference team, to organise and coordinate a discharge case conference of at least 15 minutes but less than 30 minutes, before the patient is discharged from a hospital (H) | $168.95 75% benefit $126.75 |
| 3074 | Attendance by a specialist, or consultant physician, in the practice of the specialist's or consultant physician's specialty of palliative medicine, as a member of a case conference team, to organise and coordinate a discharge case conference of at least 30 minutes but less than 45 minutes, before the patient is discharged from a hospital (H) | $253.60 75% benefit $190.20 |
| 3078 | Attendance by a specialist, or consultant physician, in the practice of the specialist's or consultant physician's specialty of palliative medicine, as a member of a multidisciplinary case conference team, to organise and coordinate a discharge case conference of at least 45 minutes, before the patient is discharged from a hospital (H) | $337.80 75% benefit $253.35 |
| 3083 | Attendance by a specialist, or consultant physician, in the practice of the specialist's or consultant physician's specialty of palliative medicine, as a member of a case conference team, to participate in a discharge case conference (other than to organise and coordinate the conference) of at least 15 minutes but less than 30 minutes, before the patient is discharged from a hospital (H) | $121.30 75% benefit $91.00 |
| 3088 | Attendance by a specialist, or consultant physician, in the practice of the specialist's or consultant physician's specialty of palliative medicine, as a member of a multidisciplinary case conference team, to participate in a discharge case conference (other than to organise and coordinate the conference) of at least 30 minutes but less than 45 minutes, before the patient is discharged from a hospital (H) | $193.55 75% benefit $145.20 |
| 3093 | Attendance by a specialist, or consultant physician, in the practice of the specialist's or consultant physician's specialty of palliative medicine, as a member of a multidisciplinary case conference team, to participate in a discharge case conference (other than to organise and coordinate the conference) of at least 45 minutes, before the patient is discharged from a hospital (H) | $265.75 75% benefit $199.35 |
A27 Pregnancy Support Counselling
1 item
| Item | Description | Fee and benefits |
|---|---|---|
| 4001 | Professional attendance of at least 20 minutes in duration at consulting rooms by a general practitioner who is registered with the Chief Executive Medicare as meeting the credentialing requirements for provision of this service for the purpose of providing non-directive pregnancy support counselling to a patient who: (a) is currently pregnant; or (b) has been pregnant in the 12 months preceding the provision of the first service to which this item or item 81000, 81005 or 81010 applies in relation to that pregnancy | $91.65 100% benefit $91.65 |
A22 General Practitioner After-Hours Attendances To Which No Other Item Applies
15 items
| Item | Description | Fee and benefits |
|---|---|---|
| 5000 | 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 | $34.70 100% benefit $34.70 |
| 5003 | New wording on 1 November 2026Professional attendance by a general practitioner (other than attendance at consulting rooms, a hospital or a residential care home or a service to which another item in this Schedule 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 Derived fee: The fee for item 5000, plus $31.10 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 $2.45 per patient. | Derived |
| 5010 | New wording on 1 November 2026Professional attendance (other than a service to which another item applies) at a residential care home (other than a professional attendance at a self‑contained unit) or professional attendance at consulting rooms situated within such a complex, if the patient is a care recipient in the residential care home who is not a resident of a self‑contained unit, 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—an attendance on one or more patients at one residential care home on one occasion—each patient Derived fee: The fee for item 5000, plus $55.95 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 $4.00 per patient. | Derived |
| 5020 | Professional attendance by a general practitioner at consulting rooms (other than a service to which another item in this Schedule applies), lasting at least 6 minutes and 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 | $58.65 100% benefit $58.65 |
| 5023 | New wording on 1 November 2026Professional attendance by a general practitioner (other than attendance at consulting rooms, a hospital or a residential care home or a service to which another item in this Schedule applies), lasting at least 6 minutes and 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 Derived fee: The fee for item 5020, plus $31.10 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 $2.45 per patient. | Derived |
| 5028 | New wording on 1 November 2026Professional attendance by a general practitioner (other than a service to which another item in this Schedule applies), on care recipients in a residential care home, lasting at least 6 minutes and 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 residential care home on one occasion—each patient Derived fee: The fee for item 5020, plus $55.95 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 $4.00 per patient. | Derived |
| 5040 | 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 | $100.55 100% benefit $100.55 |
| 5043 | New wording on 1 November 2026Professional attendance by a general practitioner (other than attendance at consulting rooms, a hospital or a residential care home or a service to which another item in this Schedule 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 Derived fee: The fee for item 5040, plus $31.10 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 $2.45 per patient. | Derived |
| 5049 | New wording on 1 November 2026Professional attendance by a general practitioner, on care recipients in a residential care home, other than a service to which another item in this Schedule 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 residential care home on one occasion—each patient Derived fee: The fee for item 5040, plus $55.95 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 $4.00 per patient. | Derived |
| 5060 | 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 | $140.95 100% benefit $140.95 |
| 5063 | New wording on 1 November 2026Professional attendance by a general practitioner (other than attendance at consulting rooms, a hospital or a residential care home or a service to which another item in this Schedule 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 Derived fee: The fee for item 5060, plus $31.10 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 $2.45 per patient. | Derived |
| 5067 | New wording on 1 November 2026Professional attendance by a general practitioner, on care recipients in a residential care home, other than a service to which another item in this Schedule 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 residential care home on one occasion—each patient Derived fee: The fee for item 5060, plus $55.95 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 $4.00 per patient. | Derived |
| 5071 | Professional attendance by a general practitioner at consulting rooms (other than a service to which another item in this Schedule applies), lasting at least 60 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 | $239.45 100% benefit $239.45 |
| 5076 | New wording on 1 November 2026Professional attendance by a general practitioner (other than attendance at consulting rooms, a hospital or a residential care home or a service to which another item in this Schedule applies), lasting at least 60 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 Derived fee: The fee for item 5071, plus $31.10 divided by the number of patients seen, up to a maximum of six patients. For seven or more patients - the fee for item 5071 plus $2.45 per patient. | Derived |
| 5077 | New wording on 1 November 2026Professional attendance by a general practitioner, on care recipients in a residential care home, other than a service to which another item in this Schedule applies, lasting at least 60 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 residential care home on one occasion—each patient Derived fee: The fee for item 5071, plus $55.95 divided by the number of patients seen, up to a maximum of six patients. For seven or more patients - the fee for item 5071 plus $4.00 per patient. | Derived |
A21 Professional Attendances at Recognised Emergency Departments of Private Hospitals
22 items
| Item | Description | Fee and benefits |
|---|---|---|
| 5001 | Professional attendance, on a patient aged 4 years or over but under 75 years old, at a recognised emergency department of a private hospital by a specialist in the practice of the specialist’s specialty of emergency medicine involving medical decision‑making of ordinary complexity | $70.25 75% benefit $52.70 85% benefit $59.75 |
| 5004 | Professional attendance, on a patient aged under 4 years, at a recognised emergency department of a private hospital by a specialist in the practice of the specialist’s specialty of emergency medicine involving medical decision-making of ordinary complexity | $117.95 75% benefit $88.50 85% benefit $100.30 |
| 5011 | Professional attendance, on a patient aged 75 years or over, at a recognised emergency department of a private hospital by a specialist in the practice of the specialist’s specialty of emergency medicine involving medical decision-making of ordinary complexity | $117.95 75% benefit $88.50 85% benefit $100.30 |
| 5012 | Professional attendance, on a patient aged 4 years or over but under 75 years old, at a recognised emergency department of a private hospital by a specialist in the practice of the specialist’s specialty of emergency medicine involving medical decision-making of complexity that is more than ordinary but is not high | $184.85 75% benefit $138.65 85% benefit $157.15 |
| 5013 | Professional attendance, on a patient aged under 4 years, at a recognised emergency department of a private hospital by a specialist in the practice of the specialist’s specialty of emergency medicine involving medical decision-making of complexity that is more than ordinary but is not high | $232.55 75% benefit $174.45 85% benefit $197.70 |
| 5014 | Professional attendance, on a patient aged 75 years or over, at a recognised emergency department of a private hospital by a specialist in the practice of the specialist’s specialty of emergency medicine involving medical decision-making of complexity that is more than ordinary but is not high | $232.55 75% benefit $174.45 85% benefit $197.70 |
| 5016 | Professional attendance, on a patient aged 4 years or over but under 75 years old, at a recognised emergency department of a private hospital by a specialist in the practice of the specialist’s specialty of emergency medicine involving medical decision-making of high complexity | $312.05 75% benefit $234.05 85% benefit $265.25 |
| 5017 | Professional attendance, on a patient aged under 4 years, at a recognised emergency department of a private hospital by a specialist in the practice of the specialist’s specialty of emergency medicine involving medical decision-making of high complexity | $359.80 75% benefit $269.85 85% benefit $305.85 |
| 5019 | Professional attendance, on a patient aged 75 years or over, at a recognised emergency department of a private hospital by a specialist in the practice of the specialist’s specialty of emergency medicine involving medical decision-making of high complexity | $359.80 75% benefit $269.85 85% benefit $305.85 |
| 5021 | Professional attendance, on a patient aged 4 years or over but under 75 years old, at a recognised emergency department of a private hospital by a medical practitioner (except a specialist in the practice of the specialist’s specialty of emergency medicine) involving medical decision-making of ordinary complexity | $52.65 75% benefit $39.50 85% benefit $44.80 |
| 5022 | Professional attendance, on a patient aged under 4 years, at a recognised emergency department of a private hospital by a medical practitioner (except a specialist in the practice of the specialist’s specialty of emergency medicine) involving medical decision-making of ordinary complexity | $88.45 75% benefit $66.35 85% benefit $75.20 |
| 5027 | Professional attendance, on a patient aged 75 years or over, at a recognised emergency department of a private hospital by a medical practitioner (except a specialist in the practice of the specialist’s specialty of emergency medicine) involving medical decision-making of ordinary complexity | $88.45 75% benefit $66.35 85% benefit $75.20 |
| 5030 | Professional attendance, on a patient aged 4 years or over but under 75 years old, at a recognised emergency department of a private hospital by a medical practitioner (except a specialist in the practice of the specialist’s specialty of emergency medicine) involving medical decision-making of complexity that is more than ordinary but is not high | $138.55 75% benefit $103.95 85% benefit $117.80 |
| 5031 | Professional attendance, on a patient aged under 4 years, at a recognised emergency department of a private hospital by a medical practitioner (except a specialist in the practice of the specialist’s specialty of emergency medicine) involving medical decision-making of complexity that is more than ordinary but is not high | $174.40 75% benefit $130.80 85% benefit $148.25 |
| 5032 | Professional attendance, on a patient aged 75 years or over, at a recognised emergency department of a private hospital by a medical practitioner (except a specialist in the practice of the specialist’s specialty of emergency medicine) involving medical decision-making of complexity that is more than ordinary but is not high | $174.40 75% benefit $130.80 85% benefit $148.25 |
| 5033 | Professional attendance, on a patient 4 years or over but under 75 years old, at a recognised emergency department of a private hospital by a medical practitioner (except a specialist in the practice of the specialist’s specialty of emergency medicine) involving medical decision-making of high complexity | $234.05 75% benefit $175.55 85% benefit $198.95 |
| 5035 | Professional attendance, on a patient aged under 4 years, at a recognised emergency department of a private hospital by a medical practitioner (except a specialist in the practice of the specialist’s specialty of emergency medicine) involving medical decision-making of high complexity | $269.90 75% benefit $202.45 85% benefit $229.45 |
| 5036 | Professional attendance, on a patient aged 75 years or over, at a recognised emergency department of a private hospital by a medical practitioner (except a specialist in the practice of the specialist’s specialty of emergency medicine) involving medical decision-making of high complexity | $269.90 75% benefit $202.45 85% benefit $229.45 |
| 5039 | Professional attendance at a recognised emergency department of a private hospital by a specialist in the practice of the specialist’s specialty of emergency medicine for preparation of goals of care by the specialist for a gravely ill patient lacking current goals of care if: (a) the specialist takes overall responsibility for the preparation of the goals of care for the patient; and (b) the attendance is the first attendance by the specialist for the preparation of the goals of care for the patient following the presentation of the patient to the emergency department; and (c) the attendance is in conjunction with, or after, an attendance on the patient by the specialist that is described in item 5001, 5004, 5011, 5012, 5013, 5014, 5016, 5017 or 5019 | $170.50 75% benefit $127.90 85% benefit $144.95 |
| 5041 | Professional attendance at a recognised emergency department of a private hospital by a specialist in the practice of the specialist’s specialty of emergency medicine for preparation of goals of care by the specialist for a gravely ill patient lacking current goals of care if: (a) the specialist takes overall responsibility for the preparation of the goals of care for the patient; and (b) the attendance is the first attendance by the specialist for the preparation of the goals of care for the patient following the presentation of the patient to the emergency department; and (c) the attendance is not in conjunction with, or after, an attendance on the patient by the specialist that is described in item 5001, 5004, 5011, 5012, 5013, 5014, 5016, 5017 or 5019; and (d) the attendance is for at least 60 minutes | $320.55 75% benefit $240.45 85% benefit $272.50 |
| 5042 | Professional attendance at a recognised emergency department of a private hospital by a medical practitioner (except a specialist in the practice of the specialist’s specialty of emergency medicine) for preparation of goals of care by the practitioner for a gravely ill patient lacking current goals of care if: (a) the practitioner takes overall responsibility for the preparation of the goals of care for the patient; and (b) the attendance is the first attendance by the practitioner for the preparation of the goals of care for the patient following the presentation of the patient to the emergency department; and (c) the attendance is in conjunction with, or after, an attendance on the patient by the practitioner that is described in item 5021, 5022, 5027, 5030, 5031, 5032, 5033, 5035 or 5036 | $127.95 75% benefit $96.00 85% benefit $108.80 |
| 5044 | Professional attendance at a recognised emergency department of a private hospital by a medical practitioner (except a specialist in the practice of the specialist’s specialty of emergency medicine) for preparation of goals of care by the practitioner for a gravely ill patient lacking current goals of care if: (a) the practitioner takes overall responsibility for the preparation of the goals of care for the patient; and (b) the attendance is the first attendance by the practitioner for the preparation of the goals of care for the patient following the presentation of the patient to the emergency department; and (c) the attendance is not in conjunction with, or after, an attendance on the patient by the practitioner that is described in item 5021, 5022, 5027, 5030, 5031, 5032, 5033, 5035 or 5036; and (d) the attendance is for at least 60 minutes | $240.45 75% benefit $180.35 85% benefit $204.40 |
A23 Other Non-Referred After-Hours Attendances To Which No Other Item Applies
15 items
| Item | Description | Fee and benefits |
|---|---|---|
| 5200 | Professional attendance at consulting rooms of not more than 5 minutes in duration (other than a service to which another item applies) by a medical practitioner (other than a general practitioner)-each attendance | $21.00 100% benefit $21.00 |
| 5203 | Professional attendance at consulting rooms of more than 5 minutes in duration but not more than 25 minutes in duration (other than a service to which another item applies) by a medical practitioner (other than a general practitioner)-each attendance | $31.00 100% benefit $31.00 |
| 5207 | Professional attendance at consulting rooms of more than 25 minutes in duration but not more than 45 minutes in duration (other than a service to which another item applies) by a medical practitioner (other than a general practitioner)-each attendance | $48.00 100% benefit $48.00 |
| 5208 | Professional attendance at consulting rooms lasting more than 45 minutes, but not more than 60 minutes, (other than a service to which another item applies) by a medical practitioner (other than a general practitioner) | $71.00 100% benefit $71.00 |
| 5209 | Professional attendance at consulting rooms lasting more than 60 minutes (other than a service to which another item applies) by a medical practitioner (other than a general practitioner) | $122.40 100% benefit $122.40 |
| 5220 | New wording on 1 November 2026Professional attendance by a medical practitioner who is not a general practitioner (other than attendance at consulting rooms, a hospital or a residential care home or a service to which another item in the table applies), lasting not more than 5 minutes-an attendance on one or more patients on one occasion-each patient Derived fee: An amount equal to $18.50, plus $15.50 divided by the number of patients seen, up to a maximum of six patients. For seven or more patients - an amount equal to $18.50 plus $.70 per patient | Derived |
| 5223 | New wording on 1 November 2026Professional attendance by a medical practitioner who is not a general practitioner (other than attendance at consulting rooms, a hospital or a residential care home or a service to which another item in the table applies), lasting more than 5 minutes, but not more than 25 minutes-an attendance on one or more patients on one occasion-each patient Derived fee: An amount equal to $26.00, plus $17.50 divided by the number of patients seen, up to a maximum of six patients. For seven or more patients - an amount equal to $26.00 plus $.70 per patient | Derived |
| 5227 | New wording on 1 November 2026Professional attendance by a medical practitioner who is not a general practitioner (other than attendance at consulting rooms, a hospital or a residential care home or a service to which another item in the table applies), lasting more than 25 minutes, but not more than 45 minutes-an attendance on one or more patients on one occasion-each patient Derived fee: An amount equal to $45.50, plus $15.50 divided by the number of patients seen, up to a maximum of six patients. For seven or more patients - an amount equal to $45.50 plus $.70 per patient | Derived |
| 5228 | New wording on 1 November 2026Professional attendance by a medical practitioner who is not a general practitioner (other than attendance at consulting rooms, a hospital or a residential care home or a service to which another item in this Schedule applies), lasting more than 45 minutes, but not more than 60 minutes—an attendance on one or more patients on one occasion—each patient Derived fee: An amount equal to $67.50, plus $15.50 divided by the number of patients seen, up to a maximum of six patients. For seven or more patients - an amount equal to $67.50 plus $0.70 per patient | Derived |
| 5260 | New wording on 1 November 2026Professional attendance (other than a service to which another item applies) at a residential care home (other than a professional attendance at a self-contained unit) or professional attendance at consulting rooms situated within such a complex if the patient is accommodated in the residential care home (other than accommodation in a self-contained unit) of not more than 5 minutes in duration by a medical practitioner (other than a general practitioner)-an attendance on one or more patients at one residential care home on one occasion-each patient Derived fee: An amount equal to $18.50, plus $27.95 divided by the number of patients seen, up to a maximum of six patients. For seven or more patients - an amount equal to $18.50 plus $1.25 per patient | Derived |
| 5261 | New wording on 1 November 2026Professional attendance by a medical practitioner who is not a general practitioner (other than attendance at consulting rooms, a hospital or a residential care home or a service to which another item in this Schedule applies), lasting more than 60 minutes—an attendance on one or more patients on one occasion—each patient Derived fee: An amount equal to $112.20, plus $15.50 divided by the number of patients seen, up to a maximum of six patients. For seven or more patients - an amount equal to $112.20 plus $0.70 per patient | Derived |
| 5262 | New wording on 1 November 2026Professional attendance (other than a service to which another item applies) at a residential care home (other than a professional attendance at a self-contained unit) or professional attendance at consulting rooms situated within such a complex, if the patient is a care recipient in the residential care home who is not a resident of a self-contained unit, lasting more than 60 minutes by a medical practitioner (other than a general practitioner)—an attendance on one or more patients at one residential care home on one occasion—each patient Derived fee: An amount equal to $112.20, plus $27.95 divided by the number of patients seen, up to a maximum of six patients. For seven or more patients - an amount equal to $112.20 plus $1.25 per patient | Derived |
| 5263 | New wording on 1 November 2026Professional attendance (other than a service to which another item applies) at a residential care home (other than a professional attendance at a self-contained unit) or professional attendance at consulting rooms situated within such a complex if the patient is accommodated in the residential care home (other than accommodation in a self-contained unit) of more than 5 minutes in duration but not more than 25 minutes in duration by a medical practitioner (other than a general practitioner)-an attendance on one or more patients at one residential care home on one occasion-each patient Derived fee: An amount equal to $26.00, plus $31.55 divided by the number of patients seen, up to a maximum of six patients. For seven or more patients - an amount equal to $26.00 plus $1.25 per patient | Derived |
| 5265 | New wording on 1 November 2026Professional attendance (other than a service to which another item applies) at a residential care home (other than a professional attendance at a self-contained unit) or professional attendance at consulting rooms situated within such a complex if the patient is accommodated in the residential care home (other than accommodation in a self-contained unit) of more than 25 minutes in duration but not more than 45 minutes by a medical practitioner (other than a general practitioner)-an attendance on one or more patients at one residential care home on one occasion-each patient Derived fee: An amount equal to $45.50, plus $27.95 divided by the number of patients seen, up to a maximum of six patients. For seven or more patients - an amount equal to $45.50 plus $1.25 per patient | Derived |
| 5267 | New wording on 1 November 2026Professional attendance (other than a service to which another item applies) at a residential care home (other than a professional attendance at a self-contained unit) or professional attendance at consulting rooms situated within such a complex, if the patient is a care recipient in the residential care home who is not a resident of a self-contained unit, lasting more than 45 minutes, but not more than 60 minutes, by a medical practitioner (other than a general practitioner)—an attendance on one or more patients at one residential care home on one occasion—each patient Derived fee: An amount equal to $67.50, plus $27.95 divided by the number of patients seen, up to a maximum of six patients. For seven or more patients - an amount equal to $67.50 plus $1.25 per patient | Derived |
A26 Neurosurgery Attendances To Which No Other Item Applies
5 items
| Item | Description | Fee and benefits |
|---|---|---|
| 6007 | Professional attendance by a specialist in the practice of neurosurgery following referral of the patient to the specialist-an attendance (other than a second or subsequent attendance in a single course of treatment) at consulting rooms or hospital | $157.40 75% benefit $118.05 85% benefit $133.80 |
| 6009 | Professional attendance by a specialist in the practice of neurosurgery following referral of the patient to the specialist-a minor attendance after the first in a single course of treatment at consulting rooms or hospital | $52.25 75% benefit $39.20 85% benefit $44.45 |
| 6011 | Professional attendance by a specialist in the practice of neurosurgery following referral of the patient to the specialist-an attendance after the first in a single course of treatment, involving an extensive and comprehensive examination, arranging any necessary investigations in relation to one or more complex problems and of more than 15 minutes in duration but not more than 30 minutes in duration at consulting rooms or hospital | $103.95 75% benefit $78.00 85% benefit $88.40 |
| 6013 | Professional attendance by a specialist in the practice of neurosurgery following referral of the patient to the specialist-an attendance after the first in a single course of treatment, involving a detailed and comprehensive examination, arranging any necessary investigations in relation to one or more complex problems and of more than 30 minutes in duration but not more than 45 minutes in duration at consulting rooms or hospital | $144.00 75% benefit $108.00 85% benefit $122.40 |
| 6015 | Professional attendance by a specialist in the practice of neurosurgery following referral of the patient to the specialist-an attendance after the first in a single course of treatment, involving an exhaustive and comprehensive examination, arranging any necessary investigations in relation to one or more complex problems and of more than 45 minutes in duration at consulting rooms or hospital | $183.35 75% benefit $137.55 85% benefit $155.85 |
A31 Addiction Medicine
13 items
| Item | Description | Fee and benefits |
|---|---|---|
| 6018 | Professional attendance by an addiction medicine specialist in the practice of the addiction medicine specialist's specialty following referral of the patient to the addiction medicine specialist by a referring practitioner, if the attendance: (a) includes a comprehensive assessment; and (b) is the first or only time in a single course of treatment that a comprehensive assessment is provided | $183.35 75% benefit $137.55 85% benefit $155.85 |
| 6019 | Professional attendance by an addiction medicine specialist in the practice of the addiction medicine specialist's specialty following referral of the patient to the addiction medicine specialist by a referring practitioner, if the attendance is a patient assessment: (a) before or after a comprehensive assessment under item 6018 in a single course of treatment; or (b) that follows an initial assessment under item 6023 in a single course of treatment; or (c) that follows a review under item 6024 in a single course of treatment | $91.70 75% benefit $68.80 85% benefit $77.95 |
| 6023 | Professional attendance by an addiction medicine specialist in the practice of the addiction medicine specialist's specialty of at least 45 minutes for an initial assessment of a patient with at least 2 morbidities, following referral of the patient to the addiction medicine specialist by a referring practitioner, if: (a) an assessment is undertaken that covers: (i) a comprehensive history, including psychosocial history and medication review; and (ii) a comprehensive multi or detailed single organ system assessment; and (iii) the formulation of differential diagnoses; and (b) an addiction medicine specialist treatment and management plan of significant complexity that includes the following is prepared and provided to the referring practitioner: (i) an opinion on diagnosis and risk assessment; (ii) treatment options and decisions; (iii) medication recommendations; and (c) an attendance on the patient to which item 104, 105, 110, 116, 119, 132, 133, 6018, 6019, 91825, 92422, 92423, 92440 or 92443 applies did not take place on the same day by the same addiction medicine specialist; and (d) a service to which this item or item 132 applies has not been provided to the patient by the same addiction medicine specialist in the preceding 12 months | $320.55 75% benefit $240.45 85% benefit $272.50 |
| 6024 | Professional attendance by an addiction medicine specialist in the practice of the addiction medicine specialist's specialty of at least 20 minutes, after the first attendance in a single course of treatment for a review of a patient with at least 2 morbidities if: (a) a review is undertaken that covers: (i) review of initial presenting problems and results of diagnostic investigations; and (ii) review of responses to treatment and medication plans initiated at time of initial consultation; and (iii) comprehensive multi or detailed single organ system assessment; and (iv) review of original and differential diagnoses; and (b) the modified addiction medicine specialist treatment and management plan is provided to the referring practitioner, which involves, if appropriate: (i) a revised opinion on diagnosis and risk assessment; and (ii) treatment options and decisions; and (iii) revised medication recommendations; and (c) an attendance on the patient to which item 104, 105, 110, 116, 119, 132, 133, 6018, 6019, 91825, 92422, 92423, 92440 or 92443 applies did not take place on the same day by the same addiction medicine specialist; and (d) a service to which item 6023 applies was provided to the patient by the same addiction medicine specialist or a locum tenens in the preceding 12 months; and (e) not more than 2 services to which this item applies have been provided to the patient by the same addiction medicine specialist or a locum tenens in any 12 month period | $160.50 75% benefit $120.40 85% benefit $136.45 |
| 6028 | Group therapy (including any associated consultation with a patient taking place on the same occasion and relating to the condition for which group therapy is conducted) of not less than 1 hour, given under the continuous direct supervision of an addiction medicine specialist in the practice of the addiction medicine specialist's specialty for a group of 2 to 9 unrelated patients, or a family group of more than 2 patients, each of whom is referred to the addiction medicine specialist by a referring practitioner-for each patient | $59.85 75% benefit $44.90 85% benefit $50.90 |
| 6029 | Attendance by an addiction medicine specialist in the practice of the addiction medicine specialist's specialty, as a member of a multidisciplinary case conference team of at least 2 other formal care providers of different disciplines, to organise and coordinate a community case conference of less than 15 minutes, with the multidisciplinary case conference team | $51.85 75% benefit $38.90 85% benefit $44.10 |
| 6031 | Attendance by an addiction medicine specialist in the practice of the addiction medicine specialist's specialty, as a member of a multidisciplinary case conference team of at least 2 other formal care providers of different disciplines, to organise and coordinate a community case conference of at least 15 minutes but less than 30 minutes, with the multidisciplinary case conference team | $91.70 75% benefit $68.80 85% benefit $77.95 |
| 6032 | Attendance by an addiction medicine specialist in the practice of the addiction medicine specialist's specialty, as a member of a multidisciplinary case conference team of at least 2 other formal care providers of different disciplines, to organise and coordinate a community case conference of at least 30 minutes but less than 45 minutes, with the multidisciplinary case conference team | $137.70 75% benefit $103.30 85% benefit $117.05 |
| 6034 | Attendance by an addiction medicine specialist in the practice of the addiction medicine specialist's specialty, as a member of a multidisciplinary case conference team of at least 2 other formal care providers of different disciplines, to organise and coordinate the multidisciplinary case conference of at least 45 minutes, with the multidisciplinary case conference team | $183.35 75% benefit $137.55 85% benefit $155.85 |
| 6035 | Attendance by an addiction medicine specialist in the practice of the addiction medicine specialist's specialty, as a member of a multidisciplinary case conference team of at least 2 other formal care providers of different disciplines, to participate in a community case conference (other than to organise and coordinate the conference) of less than 15 minutes, with the multidisciplinary case conference team | $41.50 75% benefit $31.15 85% benefit $35.30 |
| 6037 | Attendance by an addiction medicine specialist in the practice of the addiction medicine specialist's specialty, as a member of a multidisciplinary case conference team of at least 2 other formal care providers of different disciplines, to participate in a community case conference (other than to organise and coordinate the conference) of at least 15 minutes but less than 30 minutes, with the multidisciplinary case conference team | $73.40 75% benefit $55.05 85% benefit $62.40 |
| 6038 | Attendance by an addiction medicine specialist in the practice of the addiction medicine specialist's specialty, as a member of a multidisciplinary case conference team of at least 2 other formal care providers of different disciplines, to participate in a community case conference (other than to organise and coordinate the conference) of at least 30 minutes but less than 45 minutes, with the multidisciplinary case conference team | $110.10 75% benefit $82.60 85% benefit $93.60 |
| 6042 | Attendance by an addiction medicine specialist in the practice of the addiction medicine specialist's specialty, as a member of a multidisciplinary case conference team of at least 2 other formal care providers of different disciplines, to participate in a community case conference (other than to organise and coordinate the conference) of at least 45 minutes, with the multidisciplinary case conference team | $146.60 75% benefit $109.95 85% benefit $124.65 |
A32 Sexual Health Medicine
14 items
| Item | Description | Fee and benefits |
|---|---|---|
| 6051 | Professional attendance by a sexual health medicine specialist in the practice of the sexual health medicine specialist's specialty following referral of the patient to the sexual health medicine specialist by a referring practitioner, if the attendance: (a) includes a comprehensive assessment; and (b) is the first or only time in a single course of treatment that a comprehensive assessment is provided | $183.35 75% benefit $137.55 85% benefit $155.85 |
| 6052 | Professional attendance by a sexual health medicine specialist in the practice of the sexual health medicine specialist's specialty following referral of the patient to the sexual health medicine specialist by a referring practitioner, if the attendance is a patient assessment: (a) before or after a comprehensive assessment under item 6051 in a single course of treatment; or (b) that follows an initial assessment under item 6057 in a single course of treatment; or (c) that follows a review under item 6058 in a single course of treatment | $91.70 75% benefit $68.80 85% benefit $77.95 |
| 6057 | Professional attendance by a sexual health medicine specialist in the practice of the sexual health medicine specialist's specialty of at least 45 minutes for an initial assessment of a patient with at least 2 morbidities, following referral of the patient to the sexual health medicine specialist by a referring practitioner, if: (a) an assessment is undertaken that covers: (i) a comprehensive history, including psychosocial history and medication review; and (ii) a comprehensive multi or detailed single organ system assessment; and (iii) the formulation of differential diagnoses; and (b) a sexual health medicine specialist treatment and management plan of significant complexity that includes the following is prepared and provided to the referring practitioner: (i) an opinion on diagnosis and risk assessment; (ii) treatment options and decisions; (iii) medication recommendations; and (c) an attendance on the patient to which item 104, 105, 110, 116, 119, 132, 133, 6051, 6052, 91825, 92422, 92423, 92440 or 92443 applies did not take place on the same day by the same sexual health medicine specialist; and (d) a service to which this item or item 132 applies has not been provided to the patient by the same sexual health medicine specialist in the preceding 12 months | $320.55 75% benefit $240.45 85% benefit $272.50 |
| 6058 | Professional attendance by a sexual health medicine specialist in the practice of the sexual health medicine specialist's specialty of at least 20 minutes, after the first attendance in a single course of treatment for a review of a patient with at least 2 morbidities if: (a) a review is undertaken that covers: (i) review of initial presenting problems and results of diagnostic investigations; and (ii) review of responses to treatment and medication plans initiated at time of initial consultation; and (iii) comprehensive multi or detailed single organ system assessment; and (iv) review of original and differential diagnoses; and (b) the modified sexual health medicine specialist treatment and management plan is provided to the referring practitioner, which involves, if appropriate: (i) a revised opinion on diagnosis and risk assessment; and (ii) treatment options and decisions; and (iii) revised medication recommendations; and (c) an attendance on the patient, being an attendance to which item 104, 105, 110, 116, 119, 132, 133, 6051, 6052, 91825, 92422, 92423, 92440 or 92443 applies did not take place on the same day by the same sexual health medicine specialist; and (d) a service to which item 6057 applies was provided to the patient by the same sexual health medicine specialist or a locum tenens in the preceding 12 months; and (e) not more than 2 services to which this item applies have been provided to the patient by the same sexual health medicine specialist or a locum tenens in any 12 month period | $160.50 75% benefit $120.40 85% benefit $136.45 |
| 6062 | Professional attendance at a place other than consulting rooms or a hospital by a sexual health medicine specialist in the practice of the sexual health medicine specialist's specialty following referral of the patient to the sexual health medicine specialist by a referring practitioner-initial attendance in a single course of treatment | $222.40 85% benefit $189.05 |
| 6063 | Professional attendance at a place other than consulting rooms or a hospital by a sexual health medicine specialist in the practice of the sexual health medicine specialist's specialty following referral of the patient to the sexual health medicine specialist by a referring practitioner-each attendance after the attendance under item 6062 in a single course of treatment | $134.50 85% benefit $114.35 |
| 6064 | Attendance by a sexual health medicine specialist in the practice of the sexual health medicine specialist's specialty, as a member of a multidisciplinary case conference team of at least 2 other formal care providers of different disciplines, to organise and coordinate a community case conference of less than 15 minutes, with the multidisciplinary case conference team | $51.85 75% benefit $38.90 85% benefit $44.10 |
| 6065 | Attendance by a sexual health medicine specialist in the practice of the sexual health medicine specialist's specialty, as a member of a multidisciplinary case conference team of at least 2 other formal care providers of different disciplines, to organise and coordinate a community case conference of at least 15 minutes but less than 30 minutes, with the multidisciplinary case conference team | $91.70 75% benefit $68.80 85% benefit $77.95 |
| 6067 | Attendance by a sexual health medicine specialist in the practice of the sexual health medicine specialist's specialty, as a member of a multidisciplinary case conference team of at least 2 other formal care providers of different disciplines, to organise and coordinate a community case conference of at least 30 minutes but less than 45 minutes, with the multidisciplinary case conference team | $137.70 75% benefit $103.30 85% benefit $117.05 |
| 6068 | Attendance by a sexual health medicine specialist in the practice of the sexual health medicine specialist's specialty, as a member of a multidisciplinary case conference team of at least 2 other formal care providers of different disciplines, to organise and coordinate a community case conference of at least 45 minutes, with the multidisciplinary case conference team | $183.35 75% benefit $137.55 85% benefit $155.85 |
| 6071 | Attendance by a sexual health medicine specialist in the practice of the sexual health medicine specialist's specialty, as a member of a multidisciplinary case conference team of at least 2 other formal care providers of different disciplines, to participate in a community case conference (other than to organise and coordinate the conference) of less than 15 minutes, with the multidisciplinary case conference team | $41.50 75% benefit $31.15 85% benefit $35.30 |
| 6072 | Attendance by a sexual health medicine specialist in the practice of the sexual health medicine specialist's specialty, as a member of a multidisciplinary case conference team of at least 2 other formal care providers of different disciplines, to participate in a community case conference (other than to organise and coordinate the conference) of at least 15 minutes but less than 30 minutes, with the multidisciplinary case conference team | $73.40 75% benefit $55.05 85% benefit $62.40 |
| 6074 | Attendance by a sexual health medicine specialist in the practice of the sexual health medicine specialist's specialty, as a member of a multidisciplinary case conference team of at least 2 other formal care providers of different disciplines, to participate in a community case conference (other than to organise and coordinate the conference) of at least 30 minutes but less than 45 minutes, with the multidisciplinary case conference team | $110.10 75% benefit $82.60 85% benefit $93.60 |
| 6075 | Attendance by a sexual health medicine specialist in the practice of the sexual health medicine specialist's specialty, as a member of a multidisciplinary case conference team of at least 2 other formal care providers of different disciplines, to participate in a community case conference (other than to organise and coordinate the conference) of at least 45 minutes, with the multidisciplinary case conference team | $146.60 75% benefit $109.95 85% benefit $124.65 |
A33 Transcatheter Aortic Valve Implantation and Transcatheter Mitral Valve Replacement Case Conference.
4 items
| Item | Description | Fee and benefits |
|---|---|---|
| 6080 | Coordination of a TAVI Case Conference by a TAVI Practitioner where the TAVI Case Conference has a duration of 10 minutes or more. (Not payable more than once per patient in a five year period.) | $60.95 75% benefit $45.75 85% benefit $51.85 |
| 6081 | Attendance at a TAVI Case Conference by a specialist or consultant physician who does not also perform the service described in item 6080 for the same case conference where the TAVI Case Conference has a duration of 10 minutes or more. (Not payable more than twice per patient in a five year period.) | $45.45 75% benefit $34.10 85% benefit $38.65 |
| 6082 | Attendance at a TMVr suitability case conference, by a cardiothoracic surgeon or an interventional cardiologist, to coordinate the conference, if: (a) the attendance lasts at least 10 minutes; and (b) the surgeon or cardiologist is accredited by the TMVr accreditation committee to perform the service Applicable once each 5 years | $60.95 75% benefit $45.75 85% benefit $51.85 |
| 6084 | Attendance at a TMVr suitability case conference, by a specialist or consultant physician, other than to coordinate the conference, if the attendance lasts at least 10 minutes Applicable once each 5 years | $45.45 75% benefit $34.10 85% benefit $38.65 |
A9 Contact Lenses - Attendances
10 items
| Item | Description | Fee and benefits |
|---|---|---|
| 10801 | Attendance for the investigation and evaluation of a patient for the fitting of contact lenses, with keratometry and testing with trial lenses and the issue of a prescription-one service in any period of 36 months-patient with myopia of 5.0 dioptres or greater (spherical equivalent) in one eye | $147.85 75% benefit $110.90 85% benefit $125.70 |
| 10802 | Attendance for the investigation and evaluation of a patient for the fitting of contact lenses, with keratometry and testing with trial lenses and the issue of a prescription-one service in any period of 36 months-patient with manifest hyperopia of 5.0 dioptres or greater (spherical equivalent) in one eye | $147.85 75% benefit $110.90 85% benefit $125.70 |
| 10803 | Attendance for the investigation and evaluation of a patient for the fitting of contact lenses, with keratometry and testing with trial lenses and the issue of a prescription-one service in any period of 36 months-patient with astigmatism of 3.0 dioptres or greater in one eye | $147.85 75% benefit $110.90 85% benefit $125.70 |
| 10804 | Attendance for the investigation and evaluation of a patient for the fitting of contact lenses, with keratometry and testing with trial lenses and the issue of a prescription-one service in any period of 36 months-patient with irregular astigmatism in either eye, being a condition the existence of which has been confirmed by keratometric observation, if the maximum visual acuity obtainable with spectacle correction is worse than 0.3 logMAR (6/12) and if that corrected acuity would be improved by an additional 0.1 logMAR by the use of a contact lens | $147.85 75% benefit $110.90 85% benefit $125.70 |
| 10805 | Attendance for the investigation and evaluation of a patient for the fitting of contact lenses, with keratometry and testing with trial lenses and the issue of a prescription-one service in any period of 36 months-patient with anisometropia of 3.0 dioptres or greater (difference between spherical equivalents) | $147.85 75% benefit $110.90 85% benefit $125.70 |
| 10806 | Attendance for the investigation and evaluation of a patient for the fitting of contact lenses, with keratometry and testing with trial lenses and the issue of a prescription-one service in any period of 36 months-patient with corrected visual acuity of 0.7 logMAR (6/30) or worse in both eyes and for whom a contact lens is prescribed as part of a telescopic system | $147.85 75% benefit $110.90 85% benefit $125.70 |
| 10807 | Attendance for the investigation and evaluation of a patient for the fitting of contact lenses, with keratometry and testing with trial lenses and the issue of a prescription-one service in any period of 36 months-patient for whom a wholly or segmentally opaque contact lens is prescribed for the alleviation of dazzle, distortion or diplopia caused by pathological mydriasis, aniridia, coloboma of the iris, pupillary malformation or distortion, significant ocular deformity or corneal opacity-whether congenital, traumatic or surgical in origin | $147.85 75% benefit $110.90 85% benefit $125.70 |
| 10808 | Attendance for the investigation and evaluation of a patient for the fitting of contact lenses, with keratometry and testing with trial lenses and the issue of a prescription-one service in any period of 36 months-patient who, because of physical deformity, are unable to wear spectacles | $147.85 75% benefit $110.90 85% benefit $125.70 |
| 10809 | Attendance for the investigation and evaluation of a patient for the fitting of contact lenses, with keratometry and testing with trial lenses and the issue of a prescription-one service in any period of 36 months-patient with a medical or optical condition (other than myopia, hyperopia, astigmatism, anisometropia or a condition to which item 10806, 10807 or 10808 applies) requiring the use of a contact lens for correction, if the condition is specified on the patient's account | $147.85 75% benefit $110.90 85% benefit $125.70 |
| 10816 | Attendance for the refitting of contact lenses with keratometry and testing with trial lenses and the issue of a prescription, if the patient requires a change in contact lens material or basic lens parameters, other than simple power change, because of a structural or functional change in the eye or an allergic response within 36 months after the fitting of a contact lens to which items 10801 to 10809 apply | $147.85 75% benefit $110.90 85% benefit $125.70 |
A10 Optometrical Services
26 items
| Item | Description | Fee and benefits |
|---|---|---|
| 10905 | REFERRED COMPREHENSIVE INITIAL CONSULTATION Professional attendance of more than 15 minutes duration, being the first in a course of attention, where the patient has been referred by another optometrist who is not associated with the optometrist to whom the patient is referred | $79.80 85% benefit $67.85 |
| 10907 | Professional attendance of more than 15 minutes in duration, being the first in a course of attention if the patient has attended another optometrist for an attendance to which this item or item 10905, 10910, 10911, 10913, 10914 or 10915 applies: (a) for a patient who is less than 65 years of age-within the previous 36 months; or (b) for a patient who is at least 65 years or age-within the previous 12 months | $40.00 85% benefit $34.00 |
| 10910 | Professional attendance of more than 15 minutes in duration, being the first in a course of attention, if: (a) the patient is less than 65 years of age; and (b) the patient has not, within the previous 36 months, received a service to which this item or item 10905, 10907, 10913, 10914 or 10915 applies | $79.80 85% benefit $67.85 |
| 10911 | Professional attendance of more than 15 minutes in duration, being the first in a course of attention, if: (a) the patient is at least 65 years of age; and (b) the patient has not, within the previous 12 months, received a service to which this item, or item 10905, 10907, 10910, 10913, 10914 or 10915 applies | $79.80 85% benefit $67.85 |
| 10913 | Professional attendance of more than 15 minutes in duration, being the first in a course of attention, if the patient has suffered a significant change of visual function or has new signs or symptoms, unrelated to the earlier course of attention, requiring comprehensive reassessment:(a) for a patient who is less than 65 years of age—within 36 months of an initial consultation to which this item, or item 10905, 10907, 10910, 10914 or 10915 applies; or(b) for a patient who is at least 65 years of age—within 12 months of an initial consultation to which this item, or item 10905, 10907, 10910, 10911, 10914 or 10915 applies | $79.80 85% benefit $67.85 |
| 10914 | Professional attendance of more than 15 minutes in duration, being the first in a course of attention, if the patient has a progressive disorder (excluding presbyopia) requiring comprehensive reassessment:(a) for a patient who is less than 65 years of age—within 36 months of an initial consultation to which this item or item 10905, 10907, 10910, 10913 or 10915 applies; or(b) for a patient who is at least 65 years of age—within 12 months of an initial consultation to which this item or item 10905, 10907, 10910, 10911, 10913 or 10915 applies | $79.80 85% benefit $67.85 |
| 10915 | Professional attendance of more than 15 minutes duration, being the first in a course of attention involving the examination of the eyes, with the instillation of a mydriatic, of a patient with diabetes mellitus requiring comprehensive reassessment. | $79.80 85% benefit $67.85 |
| 10916 | Professional attendance, being the first in a course of attention, of not more than 15 minutes in duration (other than a service associated with a service to which item 10938, 10939, 10940, 10941, 10942 or 10943 applies) | $40.00 85% benefit $34.00 |
| 10918 | Professional attendance, being the second or subsequent in a course of attention and being unrelated to the prescription and fitting of contact lenses (other than a service associated with a service to which item 10938, 10939, 10940 or 10941 applies) | $40.00 85% benefit $34.00 |
| 10921 | All professional attendances after the first, being those attendances regarded as a single service, in a single course of attention involving the prescription and fitting of contact lenses for optical correction, being a course of attention for which the first attendance is a service to which item 10905, 10907, 10910, 10911, 10913, 10914, 10915 or 10916 appliesFor patients with any of the following:(a) myopia of 5.0 dioptres or greater (spherical equivalent) in at least one eye; (b) manifest hyperopia of 5.0 dioptres or greater (spherical equivalent) in at least one eye; (c) astigmatism of 3.0 dioptres or greater in at least one eye; (d) anisometropia of 3.0 dioptres or greater (difference between spherical equivalents)Applicable once for each condition in a period of 36 months | $198.50 85% benefit $168.75 |
| 10924 | All professional attendances after the first, being those attendances regarded as a single service, in a single course of attention involving the prescription and fitting of contact lenses, for patients with irregular astigmatism in either eye, being a condition the existence of which has been confirmed by keratometric observation, topographic or quantitative corneal morphology if:(a) the maximum visual acuity obtainable with spectacle correction is worse than 0.3 logMAR (6/12); and(b) if that corrected acuity would be improved by an additional 0.1 logMAR by the use of a contact lens;being a course of attention for which the first attendance is a service to which item 10905, 10907, 10910, 10911, 10913, 10914, 10915 or 10916 appliesApplicable once in a period of 36 months | $250.40 85% benefit $212.85 |
| 10926 | All professional attendances after the first, being those attendances regarded as a single service, in a single course of attention involving the prescription and fitting of contact lenses, for patients with corrected visual acuity of 0.7 logMAR (6/30) or worse in both eyes, being patients for whom a contact lens is prescribed as part of a telescopic system, being a course of attention for which the first attendance is a service to which item 10905, 10907, 10910, 10911, 10913, 10914, 10915 or 10916 appliesApplicable once in a period of 36 months | $198.50 85% benefit $168.75 |
| 10927 | All professional attendances after the first, being those attendances regarded as a single service, in a single course of attention involving the prescription and fitting of contact lenses, for patients for whom a wholly or segmentally opaque contact lens is prescribed for the alleviation of dazzle, distortion or diplopia caused by any of the following:(a) pathological mydriasis;(b) aniridia;(c) coloboma of the iris;(d) pupillary malformation or distortion;(e) significant ocular deformity; or(f) corneal opacity;whether congenital, traumatic or surgical in origin being a course of attention for which the first attendance is a service to which item 10905, 10907, 10910, 10911, 10913, 10914, 10915 or 10916 appliesApplicable once in a period of 36 months | $250.40 85% benefit $212.85 |
| 10928 | All professional attendances after the first, being those attendances regarded as a single service, in a single course of attention involving the prescription and fitting of contact lenses, for patients who, because of physical deformity, are unable to wear spectacles, being a course of attention for which the first attendance is a service to which item 10905, 10907, 10910, 10911, 10913, 10914, 10915 or 10916 appliesApplicable once in a period of 36 months | $198.50 85% benefit $168.75 |
| 10929 | All professional attendances after the first, being those attendances regarded as a single service, in a single course of attention involving the prescription and fitting of contact lenses, for patients who have a medical or optical condition (other than myopia, hyperopia, astigmatism, anisometropia or a condition to which item 10926, 10927 or 10928 applies) requiring the use of a contact lens for correction, if the condition is specified on the patient's account, being a course of attention for which the first attendance is a service to which:(a) item 10905, 10907, 10910, 10911, 10913, 10914, 10915 or 10916 applies; and(b) the contact lenses are not required for appearance, sporting, work or psychological reasons.Applicable once in a period of 36 months | $250.40 85% benefit $212.85 |
| 10930 | All professional attendances regarded as a single service in a single course of attention involving the prescription and fitting of contact lenses where the patient meets the requirements of an item in the range 10921-10929 and requires a change in contact lens material or basic lens parameters, other than a simple power change, because of a structural or functional change in the eye or an allergic response within 36 months of the fitting of a contact lens covered by item 10921 to 10929 | $198.50 85% benefit $168.75 |
| 10931 | New wording on 1 November 2026A flag fall service to which an item in Subgroup 1 of Group A10 applies (other than this item), if the service:(a) is provided: (i) during a home visit to a person; or (ii) in a residential care home; or (iii) in an institution; and(b) is provided to one or more patients at a single location on a single occasion; and(c) is: (i) bulk-billed for the fees for this item and another item applying to the service; or (ii) not bulk-billed for the fees for this item and another item applying to the serviceApplicable once per occasion a service is provided under paragraph (a) for each distinct location | $45.95 85% benefit $39.10 |
| 10938 | Full quantitative computerised perimetry (automated absolute static threshold), with bilateral assessment and report, where indicated by the presence of glaucoma with a high risk of clinically significant progression that: (a) is not a service involving multifocal multichannel objective perimetry; (b) is performed by an optometrist; and (c) is performed on a patient who has received two perimetry services to which item 10940 or 10941 applies in the previous 12 months other than a service associated with a service to which item 10916 or 10918 appliesApplicable once per patient (including any service to which item 10939 applies) in a 12-month period | $76.25 85% benefit $64.85 |
| 10939 | Full quantitative computerised perimetry (automated absolute static threshold) with unilateral assessment and report, where indicated by the presence of glaucoma with a high risk of clinically significant progression that: (a) is not a service involving multifocal multichannel objective perimetry; and (b) is performed by an optometrist (c) is performed on a patient who has received two perimetry services to which item 10940 or 10941 applies in the previous 12 monthsother than a service associated with a service to which item 10916 or 10918 appliesApplicable once per patient (including any service to which item 10938 applies) in a 12-month period | $46.00 85% benefit $39.10 |
| 10940 | Full quantitative computerised perimetry (automated absolute static threshold), with bilateral assessment and report, if indicated by the presence of relevant ocular disease or suspected pathology of the visual pathways or brain that:(a) is not a service involving multifocal multichannel objective perimetry; and(b) is performed by an optometrist; (c) the patient has received fewer than two perimetry services to which this item or item 10941 applies in a 12-month period other than a service associated with a service to which item 10916 or 10918 applies | $76.25 85% benefit $64.85 |
| 10941 | Full quantitative computerised perimetry (automated absolute static threshold) with unilateral assessment and report, if indicated by the presence of relevant ocular disease or suspected pathology of the visual pathways or brain that:(a) is not a service involving multifocal multichannel objective perimetry; and(b) is performed by an optometrist;(c) the patient has received fewer than two perimetry services to which this item or item 10940 applies in a 12-month period other than a service associated with a service to which item 10916 or 10918 applies | $46.00 85% benefit $39.10 |
| 10942 | Testing of residual vision to provide optimum visual performance for a patient who has best corrected visual acuity of 6/15 or N12 or worse at 40cm in the better eye or a horizontal visual field of less than 110 degrees and within 10 degrees above and below the horizontal midline, involving one or more of the following:(a) spectacle correction;(b) determination of contrast sensitivity;(c) determination of glare sensitivity;(d) prescription of magnification aids;other than a service associated with a service to which item 10916, 10921, 10924, 10926, 10927, 10928, 10929 or 10930 appliesApplicable twice per patient in a 12-month period | $40.00 85% benefit $34.00 |
| 10943 | Additional testing to confirm diagnosis of, or establish a treatment regime for, a significant binocular or accommodative dysfunction, in a patient aged 3 to 14 years, where the service:(a) includes assessment of one or more of the following: (i) accommodation; (ii) ocular motility; (iii) vergences; (iv) fusional reserves; (v) cycloplegic refraction; and(b) is not performed for the assessment of learning difficulties or learning disabilities;other than a service to which item 10916, 10921, 10924, 10926, 10927, 10928, 10929 or 10930 appliesApplicable once per patient in a 12-month period | $40.00 85% benefit $34.00 |
| 10944 | Complete removal of embedded foreign body (including a rust ring, if present) from the cornea—not more than once on the same day by the same optometrist (excluding after care). Only claimable when either fully removed, or if the patient is referred to an Ophthalmologist or other appropriately qualified practitioner for further assessment and management after second attendance results in partial removalOther than a service associated with a service to which items 10905, 10907, 10910, 10911, 10913, 10914, 10915, 10916 or 10918 applies | $86.35 85% benefit $73.40 |
| 10945 | A professional attendance of less than 15 minutes (whether or not continuous) by an attending optometrist that requires the provision of clinical support to a patient who: (a) is participating in a video conferencing consultation with a specialist practising in his or her speciality of ophthalmology; and (b) is not an admitted patient | $40.00 85% benefit $34.00 |
| 10946 | A professional attendance of at least 15 minutes (whether or not continuous) by an optometrist providing clinical support to a patient who: (a) is participating in a video conferencing consultation with a specialist practising in the speciality of ophthalmology; and (b) is not an admitted patient | $79.80 85% benefit $67.85 |
A35 Services For Patients in Residential Care Home
17 items
| Item | Description | Fee and benefits |
|---|---|---|
| 90001 | For the first patient attended during one attendance by a general practitioner at one residential aged care facility on one occasion, the fee for the medical service described in whichever of items 90020, 90035, 90043, 90051 or 90054 applies is the amount listed in the item plus $65.80. | $65.80 100% benefit $65.80 |
| 90002 | For the first patient attended during one attendance by a medical practitioner at one residential aged care facility on one occasion, the fee for the medical service described in whichever of items 90092, 90093, 90095, 90096, 90098, 90183, 90188, 90202, 90212 or 90215 applies is the amount listed in the item plus $47.80. | $47.80 100% benefit $47.80 |
| 90020 | New wording on 1 November 2026Professional attendance (other than a service to which another item applies) at a residential care home (other than a professional attendance at a self‑contained unit) or professional attendance at consulting rooms situated within such a complex if the patient is accommodated in a residential care home (other than accommodation in a self‑contained unit) 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—an attendance on one or more patients at one residential care home on one occasion - each patient. | $20.55 100% benefit $20.55 |
| 90035 | New wording on 1 November 2026Professional attendance by a general practitioner, on care recipients in a residential care home, other than a service to which another item applies, lasting at least 6 minutes and 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 residential care home on one occasion—each patient (subject to clause 2.30.1) | $45.05 100% benefit $45.05 |
| 90043 | New wording on 1 November 2026Professional attendance by a general practitioner at a residential care home to residents of the residential care home (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—an attendance on one or more patients at one residential care home on one occasion—each patient | $87.10 100% benefit $87.10 |
| 90051 | New wording on 1 November 2026Professional attendance by a general practitioner at a residential care home to residents of the residential care home (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—an attendance on one or more patients at one residential care home on one occasion—each patient | $128.35 100% benefit $128.35 |
| 90054 | New wording on 1 November 2026Professional attendance by a general practitioner, on care recipients in a residential care home, other than a service to which another item applies, lasting at least 60 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 residential care home on one occasion—each patient (subject to clause 2.30.1) | $207.90 100% benefit $207.90 |
| 90092 | New wording on 1 November 2026Professional attendance (other than a service to which any other item applies) at a residential care home (other than a professional attendance at a self‑contained unit) or professional attendance at consulting rooms situated within such a complex where the patient is accommodated in the residential care home (that is not accommodation in a self‑contained unit) of not more than 5 minutes in duration—an attendance on one or more patients at one residential care home on one occasion—each patient, by a medical practitioner who is not a general practitioner. | $8.50 100% benefit $8.50 |
| 90093 | New wording on 1 November 2026Professional attendance (other than a service to which any other item applies) at a residential care home (other than a professional attendance at a self‑contained unit) or professional attendance at consulting rooms situated within such a complex where the patient is accommodated in the residential care home (that is not accommodation in a self‑contained unit) of more than 5 minutes in duration but not more than 25 minutes—an attendance on one or more patients at one residential care home on one occasion—each patient, by a medical practitioner who is not a general practitioner. | $16.00 100% benefit $16.00 |
| 90095 | New wording on 1 November 2026Professional attendance (other than a service to which any other item applies) at a residential care home (other than a professional attendance at a self‑contained unit) or professional attendance at consulting rooms situated within such a complex where the patient is accommodated in the residential care home (that is not accommodation in a self‑contained unit) of more than 25 minutes in duration but not more than 45 minutes—an attendance on one or more patients at one residential care home on one occasion—each patient, by a medical practitioner who is not a general practitioner. | $35.50 100% benefit $35.50 |
| 90096 | New wording on 1 November 2026Professional attendance (other than a service to which any other item applies) at a residential care home (other than a professional attendance at a self-contained unit) or professional attendance at consulting rooms situated within such a complex, if the patient is a care recipient in the residential care home who is not a resident of a self-contained unit, lasting more than 45 minutes, but less than 60 minutes—an attendance on one or more patients at one residential care home on one occasion—each patient (subject to clause 2.30.1), by a medical practitioner who is not a general practitioner | $57.50 100% benefit $57.50 |
| 90098 | New wording on 1 November 2026Professional attendance (other than a service to which another item applies) at a residential care home (other than a professional attendance at a self-contained unit) or professional attendance at consulting rooms within such a complex, if the patient is a care recipient in the residential care home who is not a resident of a self-contained unit, lasting more than 60 minutes—an attendance on one or more patients at one residential care home on one occasion by a medical practitioner who is not a general practitioner—each patient (subject to subclause 2.30.1(2)) | $88.20 100% benefit $88.20 |
| 90183 | New wording on 1 November 2026Professional attendance (other than a service to which another item applies) at a residential care home (other than a professional attendance at a self-contained unit) or professional attendance at consulting rooms within such a complex, if the patient is a care recipient in the residential care home who is not a resident of a self-contained unit, lasting not more than 5 minutes—an attendance on one or more patients at one residential care home on one occasion by a prescribed medical practitioner in an eligible area—each patient (subject to subclause 2.30.1(2)) | $16.50 100% benefit $16.50 |
| 90188 | New wording on 1 November 2026Professional attendance (other than a service to which another item applies) at a residential care home (other than a professional attendance at a self-contained unit) or professional attendance at consulting rooms within such a complex, if the patient is a care recipient in the residential care home who is not a resident of a self-contained unit, lasting more than 5 minutes but not more than 25 minutes—an attendance on one or more patients at one residential care home on one occasion by a prescribed medical practitioner in an eligible area—each patient (subject to subclause 2.30.1(2)) | $35.95 100% benefit $35.95 |
| 90202 | New wording on 1 November 2026Professional attendance (other than a service to which another item applies) at a residential care home (other than a professional attendance at a self-contained unit) or professional attendance at consulting rooms within such a complex, if the patient is a care recipient in the residential care home who is not a resident of a self-contained unit, lasting more than 25 minutes but not more than 45 minutes—an attendance on one or more patients at one residential care home on one occasion by a prescribed medical practitioner in an eligible area—each patient (subject to subclause 2.30.1(2)) | $69.70 100% benefit $69.70 |
| 90212 | New wording on 1 November 2026Professional attendance (other than a service to which another item applies) at a residential care home (other than a professional attendance at a self-contained unit) or professional attendance at consulting rooms situated within such a complex, if the patient is a care recipient in the residential care home who is not a resident of a self-contained unit, lasting more than 45 minutes but not more than 60 minutes—an attendance on one or more patients at one residential care home on one occasion by a prescribed medical practitioner in an eligible area—each patient (subject to subclause 2.30.1(2)) | $102.65 100% benefit $102.65 |
| 90215 | New wording on 1 November 2026Professional attendance (other than a service to which another item applies) at a residential care home (other than a professional attendance at a self-contained unit) or professional attendance at consulting rooms situated within such a complex, if the patient is a care recipient in the residential care home who is not a resident of a self-contained unit, lasting more than 60 minutes—an attendance on one or more patients at one residential care home on one occasion by a prescribed medical practitioner in an eligible area—each patient (subject to subclause 2.30.1(2)) | $166.30 100% benefit $166.30 |
A36 Eating Disorder Services
22 items
| Item | Description | Fee and benefits |
|---|---|---|
| 90250 | Professional attendance by a general practitioner to prepare an eating disorder treatment and management plan, lasting at least 20 minutes but less than 40 minutes. | $85.80 100% benefit $85.80 |
| 90251 | Professional attendance by a general practitioner to prepare an eating disorder treatment and management plan, lasting at least 40 minutes | $126.35 100% benefit $126.35 |
| 90252 | Professional attendance by a general practitioner to prepare an eating disorder treatment and management plan, lasting at least 20 minutes but less than 40 minutes, if the practitioner has successfully completed mental health skills training. | $108.95 100% benefit $108.95 |
| 90253 | Professional attendance by a general practitioner to prepare an eating disorder treatment and management plan, lasting at least 40 minutes, if the practitioner has successfully completed mental health skills training. | $160.50 100% benefit $160.50 |
| 90254 | Professional attendance by a medical practitioner (other than a general practitioner, specialist or consultant physician) to prepare an eating disorder treatment and management plant, lasting at least 20 minutes but less than 40 minutes. | $68.65 100% benefit $68.65 |
| 90255 | Professional attendance by a medical practitioner (other than a general practitioner, specialist or consultant physician) to prepare an eating disorder treatment and management plan, lasting at least 40 minutes. | $101.05 100% benefit $101.05 |
| 90256 | Professional attendance by a medical practitioner (other than a general practitioner, specialist or consultant physician) to prepare an eating disorder treatment and management plan, lasting at least 20 minutes but less than 40 minutes, if the practitioner has successfully completed mental health skills training. | $87.15 100% benefit $87.15 |
| 90257 | Professional attendance by a medical practitioner (other than a general practitioner, specialist or consultant physician) to prepare an eating disorder treatment and management plan, lasting at least 40 minutes, if the practitioner has successfully completed mental health skills training. | $128.45 100% benefit $128.45 |
| 90260 | Professional attendance at consulting rooms by a consultant physician in the practice of the physician’s specialty of psychiatry to prepare an eating disorder treatment and management plan, if: (a) the patient is referred; and (b) the attendance lasts at least 45 minutes | $549.90 85% benefit $467.45 |
| 90261 | Professional attendance at consulting rooms by a consultant physician in the practice of the physician’s specialty of paediatrics to prepare an eating disorder treatment and management plan, if: (a) the patient is referred; and (b) the attendance lasts at least 45 minutes | $320.55 85% benefit $272.50 |
| 90264 | Professional attendance by a general practitioner to review an eating disorder treatment and management plan. | $85.80 100% benefit $85.80 |
| 90265 | Professional attendance by a medical practitioner (other than a general practitioner, specialist or consultant physician) to review an eating disorder treatment and management plan. | $68.65 100% benefit $68.65 |
| 90266 | Professional attendance at consulting rooms by a consultant physician in the practice of the physician’s specialty of psychiatry to review an eating disorder treatment and management plan, if: (a) the patient is referred; and (b) the attendance lasts at least 30 minutes | $343.75 85% benefit $292.20 |
| 90267 | Professional attendance at consulting rooms by a consultant physician in the practice of the physician’s specialty of paediatrics to review an eating disorder treatment and management plan, if: (a) the patient is referred; and (b) the attendance lasts at least 20 minutes | $160.50 85% benefit $136.45 |
| 90271 | Professional attendance at consulting rooms by a general practitioner to provide treatment under an eating disorder treatment and management plan, lasting at least 30 minutes but less than 40 minutes. | $111.00 100% benefit $111.00 |
| 90272 | Professional attendance at a place other than consulting rooms by a general practitioner to provide treatment under an eating disorder treatment and management plan, lasting at least 30 minutes but less than 40 minutes Derived fee: The fee for item 90271, plus $31.10 divided by the number of patients seen, up to a maximum of six patients. For seven or more patients - the fee for item 90271 plus $2.45 per patient. | Derived |
| 90273 | Professional attendance at consulting rooms by a general practitioner to provide treatment under an eating disorder treatment and management plan, lasting at least 40 minutes. | $158.90 100% benefit $158.90 |
| 90274 | Professional attendance at a place other than consulting rooms by a general practitioner to provide treatment under an eating disorder treatment and management plan, lasting at least 40 minutes Derived fee: The fee for item 90273, plus $31.10 divided by the number of patients seen, up to a maximum of six patients. For seven or more patients - the fee for item 90273 plus $2.45 per patient. | Derived |
| 90275 | Professional attendance at consulting rooms by a medical practitioner (other than a general practitioner, specialist or consultant physician) to provide treatment under an eating disorder treatment and management plan, lasting at least 30 minutes but less than 40 minutes. | $88.85 100% benefit $88.85 |
| 90276 | Professional attendance at a place other than consulting rooms by a medical practitioner (other than a general practitioner, specialist or consultant physician) to provide treatment under an eating disorder treatment and management plan, lasting at least 30 minutes but less than 40 minutes Derived fee: The fee for item 90275, plus $24.85 divided by the number of patients seen, up to a maximum of six patients. For seven or more patients - the fee for item 90275 plus $1.95 per patient. | Derived |
| 90277 | Professional attendance at consulting rooms by a medical practitioner (other than a general practitioner, specialist or consultant physician) to provide treatment under an eating disorder treatment and management plan, lasting at least 40 minutes. | $127.10 100% benefit $127.10 |
| 90278 | Professional attendance at a place other than consulting rooms by a medical practitioner (other than a general practitioner, specialist or consultant physician) to provide treatment under an eating disorder treatment and management plan, lasting at least 40 minutes Derived fee: The fee for item 90277, plus $24.85 divided by the number of patients seen, up to a maximum of six patients. For seven or more patients - the fee for item 90277 plus $1.95 per patient. | Derived |
A37 Cardiothoracic Surgeon Attendance for Lead Extraction
1 item
| Item | Description | Fee and benefits |
|---|---|---|
| 90300 | Professional attendance by a cardiothoracic surgeon in the practice of the surgeon’s speciality, if: (a) the service is: performed in conjunction with a service (the lead extraction service) to which item 38358 applies; or performed in conjunction with a service (the leadless pacemaker extraction service) to which item 38373 or 38374 applies; or performed in conjunction with a service (the TAVI intermediate or low surgical risk service) to which item 38514 or 38522 applies); and (b) the surgeon: is providing surgical backup for the provider (who is not a cardiothoracic surgeon) who is performing the lead extraction service, the leadless pacemaker extraction service or the TAVI intermediate or low surgical risk service; and is present for the duration of the lead extraction service, the leadless pacemaker extraction service or the TAVI intermediate or low surgical risk service, other than during the low risk pre and post extraction or transcatheter aortic valve implantation phases; and is able to immediately scrub in and perform a thoracotomy if major complications occur (H) | $1,029.75 75% benefit $772.35 |
A40 Telehealth attendance services
212 items
| Item | Description | Fee and benefits |
|---|---|---|
| 91790 | Video 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 that this service must be performed by the patient’s eligible telehealth practitioner (please see Note AN.1.1 for the definitions as some exemptions do apply) | $20.55 100% benefit $20.55 |
| 91792 | Video attendance by a medical practitioner (not including a general practitioner) of not more than 5 minutes NOTE: It is a legislative requirement that this service must be performed by the patient’s eligible telehealth practitioner (please see Note AN.1.1 for the definitions as some exemptions do apply) | $11.00 100% benefit $11.00 |
| 91794 | Video attendance by a medical practitioner (not including a general practitioner, specialist or consultant physician), in an eligible area, of not more than 5 minutes NOTE: It is a legislative requirement that this service must be performed by the patient’s eligible telehealth practitioner (please see Note AN.1.1 for the definitions as some exemptions do apply) | $16.50 100% benefit $16.50 |
| 91800 | Video attendance by a general practitioner lasting at least 6 minutes but 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 that this service must be performed by the patient’s eligible telehealth practitioner (please see Note AN.1.1 for the definitions as some exemptions do apply) | $45.05 100% benefit $45.05 |
| 91801 | Video 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 eligible telehealth practitioner (please see Note AN.1.1 for the definitions as some exemptions do apply) | $87.10 100% benefit $87.10 |
| 91802 | Video 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 eligible telehealth practitioner (please see Note AN.1.1 for the definitions as some exemptions do apply) | $128.35 100% benefit $128.35 |
| 91803 | Video attendance by a medical practitioner (not including a general practitioner) of more than 5 minutes in duration but not more than 25 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 that this service must be performed by the patient’s eligible telehealth practitioner (please see Note AN.1.1 for the definitions as some exemptions do apply) | $21.00 100% benefit $21.00 |
| 91804 | Video attendance by a medical practitioner (not including a general practitioner) of more than 25 minutes in duration but not more than 45 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 eligible telehealth practitioner (please see Note AN.1.1 for the definitions as some exemptions do apply) | $38.00 100% benefit $38.00 |
| 91805 | Video attendance by a medical practitioner (not including a general practitioner) of more than 45 minutes in duration but not more than 60 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 eligible telehealth practitioner (please see Note AN.1.1 for the definitions as some exemptions do apply) | $61.00 100% benefit $61.00 |
| 91806 | Video attendance by a medical practitioner (not including a general practitioner, specialist or consultant physician), in an eligible area, of more than 5 minutes in duration but not more than 25 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 that this service must be performed by the patient’s eligible telehealth practitioner (please see Note AN.1.1 for the definitions as some exemptions do apply) | $35.95 100% benefit $35.95 |
| 91807 | Video attendance by a medical practitioner (not including a general practitioner, specialist or consultant physician), in an eligible area, of more than 25 minutes in duration but not more than 45 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 eligible telehealth practitioner (please see Note AN.1.1 for the definitions as some exemptions do apply) | $69.70 100% benefit $69.70 |
| 91808 | Video attendance by a medical practitioner (not including a general practitioner, specialist or consultant physician), in an eligible area, of more than 45 minutes in duration but not more than 60 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 eligible telehealth practitioner (please see Note AN.1.1 for the definitions as some exemptions do apply) | $102.65 100% benefit $102.65 |
| 91818 | Video attendance by a general practitioner, for the purpose of providing focussed psychological strategies for assessed mental disorders if: (a) the practitioner is registered with the Chief Executive Medicare as meeting the credentialing requirements for provision of this service; and (b) the service lasts at least 30 minutes, but less than 40 minutes. | $111.00 100% benefit $111.00 |
| 91819 | Video attendance by a general practitioner, for the purpose of providing focussed psychological strategies for assessed mental disorders if: (a) the practitioner is registered with the Chief Executive Medicare as meeting the credentialing requirements for provision of this service; and (b) the service lasts at least 40 minutes | $158.90 100% benefit $158.90 |
| 91820 | Video attendance by a medical practitioner (not including a general practitioner, specialist or consultant physician), for the purpose of providing focussed psychological strategies for assessed mental disorders if: (a) the practitioner is registered with the Chief Executive Medicare as meeting the credentialing requirements for provision of this service; and (b) the service lasts at least 30 minutes, but less than 40 minutes | $88.85 100% benefit $88.85 |
| 91821 | Video attendance by a medical practitioner (not including a general practitioner, specialist or consultant physician), for the purpose of providing focussed psychological strategies for assessed mental disorders if: (a) the practitioner is registered with the Chief Executive Medicare as meeting the credentialing requirements for provision of this service; and (b) the service lasts at least 40 minutes | $127.10 100% benefit $127.10 |
| 91822 | Video attendance for a person by a specialist in the practice of the specialist’s specialty if: (a) the attendance follows referral of the patient to the specialist; and (b) the attendance was of more than 5 minutes in duration. Where the attendance was other than a second or subsequent attendance as part of a single course of treatment | $103.95 85% benefit $88.40 |
| 91823 | Video attendance for a person by a specialist in the practice of the specialist’s specialty if: (a) the attendance follows referral of the patient to the specialist; and (b) the attendance was of more than 5 minutes in duration. Where the attendance is after the first attendance as part of a single course of treatment | $52.25 85% benefit $44.45 |
| 91824 | Video attendance for a person by a consultant physician in the practice of the consultant physician’s specialty (other than psychiatry) if: (a) the attendance follows referral of the patient to the consultant physician; and (b) the attendance was of more than 5 minutes in duration; Where the attendance was other than a second or subsequent attendance as part of a single course of treatment | $183.35 85% benefit $155.85 |
| 91825 | Video attendance for a person by a consultant physician in the practice of the consultant physician’s specialty (other than psychiatry) if: (a) the attendance follows referral of the patient to the consultant physician; and (b) the attendance was of more than 5 minutes in duration; Where the attendance is not a minor attendance after the first as part of a single course of treatment | $91.70 85% benefit $77.95 |
| 91826 | Video attendance for a person by a consultant physician in the practice of the consultant physician’s specialty (other than psychiatry) if: (a) the attendance follows referral of the patient to the consultant physician; and (b) the attendance was of more than 5 minutes in duration; Where the attendance is a minor attendance after the first as part of a single course of treatment | $52.25 85% benefit $44.45 |
| 91827 | Video attendance for a person by a consultant psychiatrist; if: (a) the attendance follows a referral of the patient to the consultant psychiatrist by a referring practitioner; and (b) the attendance was not more than 15 minutes in duration; if that attendance and another attendance to which item 296, 297, 299 or any of items 300, 302, 304, 306, 308, 91828 to 91831, 91837 to 91839 and 92437 applies have not exceeded 50 attendances in a calendar year | $52.65 85% benefit $44.80 |
| 91828 | Video attendance for a person by a consultant psychiatrist; if: (a) the attendance follows a referral of the patient to the consultant psychiatrist by a referring practitioner; and (b) the attendance was at least 15 minutes, but not more than 30 minutes in duration; if that attendance and another attendance to which item 296, 297, 299, or any of items 300, 302, 304, 306 to 308, 91827, 91829 to 91831, 91837 to 91839 and 92437 applies have not exceeded 50 attendances in a calendar year | $105.05 85% benefit $89.30 |
| 91829 | Video attendance for a person by a consultant psychiatrist; if:(a) the attendance follows a referral of the patient to the consultant psychiatrist by a referring practitioner; and (b) the attendance was at least 30 minutes, but not more than 45 minutes in duration; if that attendance and another attendance to which item 296, 297, 299 or any of items 300, 302, 304, 306 to 308, 91827, 91828, 91830, 91831, 91837 to 91839 and 92437 applies have not exceeded 50 attendances in a calendar year | $161.70 85% benefit $137.45 |
| 91830 | Video attendance for a person by a consultant psychiatrist; if: (a) the attendance follows a referral of the patient to the consultant psychiatrist by a referring practitioner; and (b) the attendance was at least 45 minutes, but not more than 75 minutes in duration; if that attendance and another attendance to which item 296, 297, 299 or any of items 300, 302, 304, 306 to 308, 91827 to 91829, 91831, 91837 to 91839 and 92437 applies have not exceeded 50 attendances in a calendar year | $223.15 85% benefit $189.70 |
| 91831 | Video attendance for a person by a consultant psychiatrist; if: (a) the attendance follows a referral of the patient to the consultant psychiatrist by a referring practitioner; and (b) the attendance was at least 75 minutes in duration; if that attendance and another attendance to which item 296, 297, 299 or any of items 300, 302, 304, 306 to 308, 91827 to 91830, 91837 to 91839 and 92437 applies have not exceeded 50 attendances in a calendar year | $258.95 85% benefit $220.15 |
| 91833 | Phone attendance for a person by a specialist in the practice of the specialist’s specialty if: (a) the attendance follows referral of the patient to the specialist; and (b) the attendance was of more than 5 minutes in duration. Where the attendance is after the first attendance as part of a single course of treatment. | $52.25 85% benefit $44.45 |
| 91836 | Phone attendance for a person by a consultant physician in the practice of the consultant physician’s specialty (other than psychiatry) if: (a) the attendance follows referral of the patient to the consultant physician; and (b) the attendance was of more than 5 minutes in duration. Where the attendance is a minor attendance after the first as part of a single course of treatment. | $52.25 85% benefit $44.45 |
| 91837 | Phone attendance for a person by a consultant psychiatrist; if: (a) the attendance follows a referral of the patient to the consultant psychiatrist by a referring practitioner; and (b) the attendance was not more than 15 minutes duration; Where the attendance is after the first attendance as part of a single course of treatment, if that attendance and another attendance to which item 296, 297, 299 or any of items 300, 302, 304, 306 to 308, 91827 to 91831, 91838, 91839 and 92437 applies have not exceeded 50 attendances in a calendar year | $52.65 85% benefit $44.80 |
| 91838 | Phone attendance for a person by a consultant psychiatrist; if: (a) the attendance follows a referral of the patient to the consultant psychiatrist by a referring practitioner and (b) the attendance was at least 15 minutes, but not more than 30 minutes in duration; Where the attendance is after the first attendance as part of a single course of treatment, if that attendance and another attendance to which item 296, 297, 299 or any of items 300, 302, 304, 306 to 308, 91827 to 91831, 91837, 91839 and 92437 applies have not exceeded 50 attendances in a calendar year | $105.05 85% benefit $89.30 |
| 91839 | Phone attendance for a person by a consultant psychiatrist; if: (a) the attendance follows a referral of the patient to the consultant psychiatrist by a referring practitioner; and (b) the attendance was at least 30 minutes, but not more than 45 minutes in duration Where the attendance is after the first attendance as part of a single course of treatment, if that attendance and another attendance to which item 296, 297, 299 or any of items 300, 302, 304, 306 to 308, 91827 to 91831, 91837, 91838 and 92437 applies have not exceeded 50 attendances in a calendar year | $161.70 85% benefit $137.45 |
| 91842 | Phone attendance by a general practitioner, for the purpose of providing focussed psychological strategies for assessed mental disorders if: (a) the practitioner is registered with the Chief Executive Medicare as meeting the credentialing requirements for provision of this service; and (b) the service lasts at least 30 minutes, but less than 40 minutes. | $111.00 100% benefit $111.00 |
| 91843 | Phone attendance by a general practitioner, for the purpose of providing focussed psychological strategies for assessed mental disorders if: (a) the practitioner is registered with the Chief Executive Medicare as meeting the credentialing requirements for provision of this service; and (b) the service lasts at least 40 minutes. | $158.90 100% benefit $158.90 |
| 91844 | Phone attendance by a medical practitioner (not including a General Practitioner, Specialist or Consultant Physician), for the purpose of providing focussed psychological strategies for assessed mental disorders if: (a) the practitioner is registered with the Chief Executive Medicare as meeting the credentialing requirements for provision of this service; and (b) the service lasts at least 30 minutes, but less than 40 minutes | $88.85 100% benefit $88.85 |
| 91845 | Phone attendance by a medical practitioner (not including a General Practitioner, Specialist or Consultant Physician), for the purpose of providing focussed psychological strategies for assessed mental disorders if: (a) the practitioner is registered with the Chief Executive Medicare as meeting the credentialing requirements for provision of this service; and (b) the service lasts at least 40 minutes | $127.10 100% benefit $127.10 |
| 91859 | Video attendance by a general practitioner (not including a specialist or a consultant physician), registered with the Chief Executive Medicare as meeting the credentialling requirements for provision of this service: (a) for providing focussed psychological strategies for assessed mental disorders to a person other than the patient, if the service is part of the patient’s treatment; and (b) lasting at least 30 minutes but less than 40 minutes | $111.00 100% benefit $111.00 |
| 91861 | Video attendance by a general practitioner (not including a specialist or a consultant physician), registered with the Chief Executive Medicare as meeting the credentialling requirements for provision of this service: (a) for providing focussed psychological strategies for assessed mental disorders to a person other than the patient, if the service is part of the patient’s treatment; and (b) lasting at least 40 minutes | $158.90 100% benefit $158.90 |
| 91862 | Video attendance by a medical practitioner, registered with the Chief Executive Medicare as meeting the credentialling requirements for provision of this service: (a) for providing focussed psychological strategies for assessed mental disorders to a person other than the patient, if the service is part of the patient’s treatment; and (b) lasting at least 30 minutes but less than 40 minutes | $88.80 100% benefit $88.80 |
| 91863 | Video attendance by a medical practitioner, registered with the Chief Executive Medicare as meeting the credentialling requirements for provision of this service: (a) for providing focussed psychological strategies for assessed mental disorders to a person other than the patient, if the service is part of the patient’s treatment; and (b) lasting at least 40 minutes | $127.10 100% benefit $127.10 |
| 91864 | Phone attendance by a general practitioner (not including a specialist or a consultant physician), registered with the Chief Executive Medicare as meeting the credentialling requirements for provision of this service: (a) for providing focussed psychological strategies for assessed mental disorders to a person other than the patient, if the service is part of the patient’s treatment; and (b) lasting at least 30 minutes but less than 40 minutes | $111.00 100% benefit $111.00 |
| 91865 | Phone attendance by a general practitioner (not including a specialist or a consultant physician), registered with the Chief Executive Medicare as meeting the credentialling requirements for provision of this service: (a) for providing focussed psychological strategies for assessed mental disorders to a person other than the patient, if the service is part of the patient’s treatment; and (b) lasting at least 40 minutes | $158.90 100% benefit $158.90 |
| 91866 | Phone attendance by a medical practitioner, registered with the Chief Executive Medicare as meeting the credentialling requirements for provision of this service: (a) for providing focussed psychological strategies for assessed mental disorders to a person other than the patient, if the service is part of the patient’s treatment; and (b) lasting at least 30 minutes but less than 40 minutes | $88.80 100% benefit $88.80 |
| 91867 | Phone attendance by a medical practitioner, registered with the Chief Executive Medicare as meeting the credentialling requirements for provision of this service: (a) for providing focussed psychological strategies for assessed mental disorders to a person other than the patient, if the service is part of the patient’s treatment; and (b) lasting at least 40 minutes | $127.10 100% benefit $127.10 |
| 91868 | Video attendance by a consultant physician in the practice of the consultant physician’s specialty of psychiatry following referral of the patient to the consultant physician by a referring practitioner—an attendance of not more than 15 minutes in duration, if that attendance and another attendance to which item 296, 297, 299, 92437 or any of items 300, 302, 304, 306, 308, 91827, 91828, 91829, 91830, 91831, 91837, 91838, 91839, 91869, 91870, 91871, 91872, 91873 or 91879 to 91881 applies exceed 50 attendances in a calendar year for the patient | $26.20 85% benefit $22.30 |
| 91869 | Video attendance by a consultant physician in the practice of the consultant physician’s specialty of psychiatry following referral of the patient to the consultant physician by a referring practitioner—an attendance of more than 15 minutes but not more than 30 minutes in duration, if that attendance and another attendance to which item 296, 297, 299, 92437 or any of items 300, 302, 304, 306, 308, 91827, 91828, 91829, 91830, 91831, 91837, 91838, 91839, 91868, 91870, 91871, 91872, 91873 or 91879 to 91881 applies exceed 50 attendances in a calendar year for the patient | $52.65 85% benefit $44.80 |
| 91870 | Video attendance by a consultant physician in the practice of the consultant physician's specialty of psychiatry following referral of the patient to the consultant physician by a referring practitioner—an attendance of more than 30 minutes but not more than 45 minutes in duration, if that attendance and another attendance to which item 296, 297, 299, 92437 or any of items 300, 302, 304, 306, 308, 91827, 91828, 91829, 91830, 91831, 91837, 91838, 91839, 91868, 91869, 91871, 91872, 91873 or 91879 to 91881 applies exceed 50 attendances in a calendar year for the patient | $81.05 85% benefit $68.90 |
| 91871 | Video attendance by a consultant physician in the practice of the consultant physician’s specialty of psychiatry following referral of the patient to the consultant physician by a referring practitioner—an attendance of more than 45 minutes but not more than 75 minutes in duration, if that attendance and another attendance to which item 296, 297, 299, 92437 or any of items 300, 302, 304, 306, 308, 91827, 91828, 91829, 91830, 91831, 91837, 91838, 91839, 91868, 91869, 91870, 91872, 91873 or 91879 to 91881 applies exceed 50 attendances in a calendar year for the patient | $111.70 85% benefit $94.95 |
| 91872 | Video attendance by a consultant physician in the practice of the consultant physician’s specialty of psychiatry following referral of the patient to the consultant physician by a referring practitioner—an attendance of more than 75 minutes in duration, if that attendance and another attendance to which item 296, 297, 299, 92437 or any of items 300, 302, 304, 306, 308, 91827, 91828, 91829, 91830, 91831, 91837, 91838, 91839, 91868, 91869, 91870, 91871, 91873, or 91879 to 91881 applies exceed 50 attendances in a calendar year for the patient | $129.50 85% benefit $110.10 |
| 91873 | Video attendance lasting at least 45 minutes by a consultant physician in the practice of the consultant physician’s specialty of psychiatry, following referral of the patient to the psychiatrist by a referring practitioner, where the formulation of the patient’s clinical presentation indicates intensive psychotherapy is a clinically appropriate and indicated treatment, if that attendance and another attendance to which any of items 296, 297, 299 or any of items 300, 302, 304, 306, 308, 319, 92437, 91827, 91828, 91829, 91830, 91831, 91837, 91838, 91839, 91868, 91869, 91870, 91871, 91872 or 91879 to 91881 applies has not exceeded 160 attendances in a calendar year for the patient | $223.15 85% benefit $189.70 |
| 91874 | Video attendance involving an interview, lasting not more than 15 minutes, of a person other than the patient when the patient is not in attendance, by a consultant physician in the practice of the consultant physician’s specialty of psychiatry following referral of the patient to the consultant physician by a referring practitioner for the purposes of: (a) initial diagnostic evaluation; or (b) continuing management of the patient; if that attendance and another attendance to which any of items 341, 343, 345, 347, 349, 91875, 91876, 91877, 91878, 91882, 91883 or 91884 applies have not exceeded 15 in a calendar year for the patient | $52.65 75% benefit $39.50 85% benefit $44.80 |
| 91875 | Video attendance involving an interview, lasting more than 15 minutes but not more than 30 minutes, of a person other than the patient when the patient is not in attendance, by a consultant physician in the practice of the consultant physician’s specialty of psychiatry, following referral of the patient to the consultant physician by a referring practitioner for the purposes of: (a) initial diagnostic evaluation; or (b) continuing management of the patient; if that attendance and another attendance to which any of items 341, 343, 345, 347, 349, 91874, 91876, 91877, 91878, 91882, 91883 or 91884 applies have not exceeded 15 in a calendar year for the patient | $105.05 75% benefit $78.80 85% benefit $89.30 |
| 91876 | Video attendance involving an interview, lasting more than 30 minutes but not more than 45 minutes, of a person other than the patient when the patient is not in attendance, by a consultant physician in the practice of the consultant physician's specialty of psychiatry, following referral of the patient to the consultant physician by a referring practitioner for the purposes of: (a) initial diagnostic evaluation; or (b) continuing management of the patient; if that attendance and another attendance to which any of items 341, 343, 345, 347, 349, 91874, 91875, 91877, 91878, 91882, 91883 or 91884 applies have not exceeded 15 in a calendar year for the patient | $161.70 75% benefit $121.30 85% benefit $137.45 |
| 91877 | Video attendance involving an interview, lasting more than 45 minutes but not more than 75 minutes, of a person other than the patient when the patient is not in attendance, by a consultant physician in the practice of the consultant physician’s specialty of psychiatry, following referral of the patient to the consultant physician by a referring practitioner for the purposes of: (a) initial diagnostic evaluation; or (b) continuing management of the patient; if that attendance and another attendance to which any of items 341, 343, 345, 347, 349, 91874, 91875, 91876 91878, 91882, 91883 or 91884 applies have not exceeded 15 in a calendar year for the patient | $223.15 75% benefit $167.40 85% benefit $189.70 |
| 91878 | Video attendance involving an interview, lasting more than 75 minutes, of a person other than the patient, when the patient is not in attendance, by a consultant physician in the practice of the consultant physician’s specialty of psychiatry, following referral of the patient to the consultant physician by a referring practitioner for the purposes of: (a) initial diagnostic evaluation; or (b) continuing management of the patient; if that attendance and another attendance to which any of items 341, 343, 345, 347, 349, 91874, 91875, 91876, 91877, 91882, 91883 or 91884 applies have not exceeded 15 in a calendar year for the patient | $258.95 75% benefit $194.25 85% benefit $220.15 |
| 91879 | Phone attendance by a consultant physician in the practice of the consultant physician’s specialty of psychiatry following referral of the patient to the consultant physician by a referring practitioner—an attendance of not more than 15 minutes in duration, if that attendance and another attendance to which 296, 297, 299 or any of items 300, 302, 304, 306, 308, 91827 to 91831, 91837 to 91839, 91868 to 91873, 91880, 91881 or 92437 applies exceed 50 attendances in a calendar year for the patient | $26.20 85% benefit $22.30 |
| 91880 | Phone attendance by a consultant physician in the practice of the consultant physician’s specialty of psychiatry following referral of the patient to the consultant physician by a referring practitioner—an attendance of more than 15 minutes but not more than 30 minutes in duration, if that attendance and another attendance to which item 296, 297, 299 or any of items 300, 302, 304, 306, 308, 91827 to 91831, 91837 to 91839, 91868 to 91873, 91879, 91881 or 92437 applies exceed 50 attendances in a calendar year for the patient | $52.65 85% benefit $44.80 |
| 91881 | Phone attendance by a consultant physician in the practice of the consultant physician’s specialty of psychiatry following referral of the patient to the consultant physician by a referring practitioner—an attendance of more than 30 minutes but not more than 45 minutes in duration, if that attendance and another attendance to which item 296, 297, 299 or any of items 300, 302, 304, 306, 308, 91827 to 91831, 91837 to 91839, 91868 to 91873, 91879, 91880 or 92437 applies exceed 50 attendances in a calendar year for the patient | $81.05 85% benefit $68.90 |
| 91882 | Phone attendance involving an interview, lasting not more than 15 minutes, of a person other than the patient when the patient is not in attendance, by a consultant physician in the practice of the consultant physician’s specialty of psychiatry following referral of the patient to the consultant physician by a referring practitioner for the purposes of: (a) initial diagnostic evaluation; or (b) continuing management of the patient; if that attendance and another attendance to which any of items 341, 343, 345, 347, 349, 91874 to 91878, 91883 or 91884 applies have not exceeded 15 in a calendar year for the patient | $52.65 75% benefit $39.50 85% benefit $44.80 |
| 91883 | Phone attendance involving an interview, lasting more than 15 minutes but not more than 30 minutes, of a person other than the patient when the patient is not in attendance, by a consultant physician in the practice of the consultant physician’s specialty of psychiatry following referral of the patient to the consultant physician by a referring practitioner for the purposes of: (a) initial diagnostic evaluation; or (b) continuing management of the patient; if that attendance and another attendance to which any of items 341, 343, 345, 347, 349, 91874 to 91878, 91882 or 91884 applies have not exceeded 15 in a calendar year for the patient | $105.05 75% benefit $78.80 85% benefit $89.30 |
| 91884 | Phone attendance involving an interview, lasting more than 30 minutes but not more than 45 minutes, of a person other than the patient when the patient is not in attendance, by a consultant physician in the practice of the consultant physician’s specialty of psychiatry following referral of the patient to the consultant physician by a referring practitioner for the purposes of: (a) initial diagnostic evaluation; or (b) continuing management of the patient; if that attendance and another attendance to which any of items 341, 343, 345, 347, 349, 91874 to 91878, 91882 or 91883 applies have not exceeded 15 in a calendar year for the patient | $161.70 75% benefit $121.30 85% benefit $137.45 |
| 91890 | 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 NOTE: It is a legislative requirement that this service must be performed by the patient’s eligible telehealth practitioner (please see Note AN.1.1 for the definitions as some exemptions do apply) | $20.55 100% benefit $20.55 |
| 91891 | 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 NOTE: It is a legislative requirement that this service must be performed by the patient’s eligible telehealth practitioner (please see Note AN.1.1 for the definitions as some exemptions do apply) | $45.05 100% benefit $45.05 |
| 91892 | Phone attendance by a medical practitioner (not including a general practitioner, specialist or consultant physician) 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 NOTE: It is a legislative requirement that this service must be performed by the patient’s eligible telehealth practitioner (please see Note AN.1.1 for the definitions as some exemptions do apply) | $11.00 100% benefit $11.00 |
| 91893 | Phone attendance by a medical practitioner (not including a general practitioner, specialist or consultant physician) 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 NOTE: It is a legislative requirement that this service must be performed by the patient’s eligible telehealth practitioner (please see Note AN.1.1 for the definitions as some exemptions do apply) | $21.00 100% benefit $21.00 |
| 91900 | Phone attendance by a general practitioner to a patient registered under MyMedicare with the billing practice, 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; for one or more health related issues, with appropriate documentation | $87.10 100% benefit $87.10 |
| 91903 | Phone attendance by a medical practitioner (not including a general practitioner) to a patient registered under MyMedicare with the billing practice, of more than 25 minutes in duration but not more than 45 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; for one or more health related issues, with appropriate documentation | $38.00 100% benefit $38.00 |
| 91906 | Phone attendance by a medical practitioner (not including a general practitioner, specialist or consultant physician), in an eligible area, to a patient registered under MyMedicare with the billing practice, of more than 25 minutes in duration but not more than 45 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;for one or more health related issues, with appropriate documentation | $69.70 100% benefit $69.70 |
| 91910 | Phone attendance by a general practitioner, to a patient registered under MyMedicare with the billing practice, 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 preventive health care;for one or more health related issues, with appropriate documentation | $128.35 100% benefit $128.35 |
| 91913 | Phone attendance by a medical practitioner (not including a general practitioner), to a patient registered under MyMedicare with the billing practice, of more than 45 minutes in duration but not more than 60 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;for one or more health related issues, with appropriate documentation | $61.00 100% benefit $61.00 |
| 91916 | Phone attendance by a medical practitioner (not including a general practitioner, specialist or consultant physician), in an eligible area, to a patient registered under MyMedicare with the billing practice, of more than 45 minutes in duration but not more than 60 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;for one or more health related issues, with appropriate documentation | $102.65 100% benefit $102.65 |
| 91920 | Video attendance by a general practitioner, lasting at least 60 minutes and including 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; for one or more health‑related issues, with appropriate documentation NOTE: It is a legislative requirement that this service must be performed by the patient’s eligible telehealth practitioner (please see Note AN.1.1 for the definitions as some exemptions do apply) | $207.90 100% benefit $207.90 |
| 91923 | Video attendance by a medical practitioner (not including a general practitioner), of more than 60 minutes in duration and including 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; for one or more health related issues, with appropriate documentation NOTE: It is a legislative requirement that this service must be performed by the patient’s eligible telehealth practitioner (please see Note AN.1.1 for the definitions as some exemptions do apply) | $98.40 100% benefit $98.40 |
| 91926 | Video attendance by a medical practitioner (not including a general practitioner, specialist or consultant physician), in an eligible area, of more than 60 minutes in duration and including 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; for one or more health‑related issues, with appropriate documentation NOTE: It is a legislative requirement that this service must be performed by the patient’s eligible telehealth practitioner (please see Note AN.1.1 for the definitions as some exemptions do apply) | $166.30 100% benefit $166.30 |
| 92004 | Video attendance by a general practitioner for an Aboriginal and Torres Strait Islander health assessment:(a) for a patient who is of Aboriginal or Torres Strait Islander descent; and(b) that includes the following:(i) recognising the patient’s health priorities;(ii) taking the patient’s medical history;(iii) undertaking any relevant physical examinations;(iv) undertaking or arranging any required investigations;(v) assessing the patient using the information gained in the health assessment;(vi) initiating any necessary interventions and referrals;(vii) developing and documenting a plan to manage the patient’s health including for follow-up, based on the health assessment and the patient’s priorities;(viii) offering the patient (or the patient’s carer (if any) if the practitioner considers it appropriate and the patient agrees) a written report of the health assessment, with recommendations on matters covered by the health assessment and a strategy for the patient’s good health;(ix) if the offer referred to in subparagraph (viii) is accepted—giving the report to the patient or the patient’s carer (as applicable);(x) adding a record of the health assessment to the patient’s medical recordsApplicable only if a service to which this item or item 228, 715 or 92011 applies has not been provided to the patient in the preceding 9 months | $254.10 100% benefit $254.10 |
| 92011 | Video attendance by a prescribed medical practitioner for an Aboriginal and Torres Strait Islander health assessment:(a) for a patient who is of Aboriginal or Torres Strait Islander descent; and(b) that includes the following:(i) recognising the patient’s health priorities;(ii) taking the patient’s medical history;(iii) undertaking any relevant physical examinations;(iv) undertaking or arranging any required investigations;(v) assessing the patient using the information gained in the health assessment;(vi) initiating any necessary interventions and referrals;(vii) developing and documenting a plan to manage the patient’s health including for follow-up, based on the health assessment and the patient’s priorities;(viii) offering the patient (or the patient’s carer (if any) if the practitioner considers it appropriate and the patient agrees) a written report of the health assessment, with recommendations on matters covered by the health assessment and a strategy for the patient’s good health;(ix) if the offer referred to in subparagraph (viii) is accepted—giving the report to the patient or the patient’s carer (as applicable);(x) adding a record of the health assessment to the patient’s medical recordsApplicable only if a service to which this item or item 228, 715 or 92004 applies has not been provided to the patient in the preceding 9 months | $203.25 100% benefit $203.25 |
| 92026 | Contribution by a general practitioner by video, 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 235 to 240 or 735 to 758 of the general medical services table apply) NOTE: It is a legislative requirement that this service must be performed by the patient’s eligible telehealth practitioner (please see Note AN.1.1 for the definitions as some exemptions do apply) | $84.25 100% benefit $84.25 |
| 92027 | New wording on 1 November 2026Contribution by a general practitioner by video to:(a) a multidisciplinary care plan for a patient in a residential care home, prepared by that residential care home, or to a review of such a plan prepared by such a residential care home; 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 235 to 240 or 735 to 758 of the general medical services table apply)NOTE: It is a legislative requirement that this service must be performed by the patient’s eligible telehealth practitioner (please see Note AN.1.1 for the definitions as some exemptions do apply) | $84.25 100% benefit $84.25 |
| 92029 | Video attendance by a general practitioner to prepare a GP chronic condition management plan for a patient | $160.60 100% benefit $160.60 |
| 92030 | Video attendance by a general practitioner to review a GP chronic condition management plan prepared by the general practitioner or an associated medical practitioner | $160.60 100% benefit $160.60 |
| 92033 | New on 1 November 2026Phone attendance by a general practitioner to prepare a GP chronic condition management plan for a patient | $160.60 100% benefit $160.60 |
| 92034 | New on 1 November 2026Phone attendance by a general practitioner to review a GP chronic condition management plan prepared by the general practitioner or an associated medical practitioner | $160.60 100% benefit $160.60 |
| 92057 | Contribution by a medical practitioner (not including a general practitioner, specialist or consultant physician) by video 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 235 to 240 or 735 to 758 of the general medical services table apply) NOTE: It is a legislative requirement that this service must be performed by the patient’s eligible telehealth practitioner (please see Note AN.1.1 for the definitions as some exemptions do apply) | $67.40 100% benefit $67.40 |
| 92058 | New wording on 1 November 2026Contribution by a medical practitioner (not including a general practitioner, specialist or consultant physician) by video to:(a) a multidisciplinary care plan for a patient in a residential care home, prepared by that residential care home, or to a review of such a plan prepared by such a residential care home; 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 235 to 240 or 735 to 758 of the general medical services table apply)NOTE: It is a legislative requirement that this service must be performed by the patient’s eligible telehealth practitioner (please see Note AN.1.1 for the definitions as some exemptions do apply) | $67.40 100% benefit $67.40 |
| 92060 | Video attendance by a prescribed medical practitioner to prepare a GP chronic condition management plan for a patient | $128.55 100% benefit $128.55 |
| 92061 | Video attendance by a prescribed medical practitioner to review a GP chronic condition management plan prepared by the prescribed medical practitioner or an associated medical practitioner | $128.55 100% benefit $128.55 |
| 92063 | New on 1 November 2026Phone attendance by a prescribed medical practitioner to prepare a GP chronic condition management plan for a patient | $128.55 100% benefit $128.55 |
| 92064 | New on 1 November 2026Phone attendance by a prescribed medical practitioner to review a GP chronic condition management plan prepared by the prescribed medical practitioner or an associated medical practitioner | $128.55 100% benefit $128.55 |
| 92112 | Video 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 | $85.80 100% benefit $85.80 |
| 92113 | Video 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 | $126.35 100% benefit $126.35 |
| 92116 | Video 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 | $108.95 100% benefit $108.95 |
| 92117 | Video 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 | $160.50 100% benefit $160.50 |
| 92118 | Video attendance by a medical practitioner (not including a general practitioner, specialist or consultant physician), 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 | $68.65 100% benefit $68.65 |
| 92119 | Video attendance by a medical practitioner (not including a general practitioner, specialist or consultant physician), 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 | $101.05 100% benefit $101.05 |
| 92122 | Video attendance by a medical practitioner, (not including a general practitioner, specialist or consultant physician), 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 | $87.15 100% benefit $87.15 |
| 92123 | Video attendance by a medical practitioner, (not including a general practitioner, specialist or consultant physician), 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 | $128.45 100% benefit $128.45 |
| 92136 | Video attendance of at least 20 minutes in duration by a general practitioner who is registered with the Chief Executive Medicare as meeting the credentialing requirements for provision of this service for the purpose of providing non-directive pregnancy support counselling to a person who:(a) is currently pregnant; or(b) has been pregnant in the 12 months preceding the provision of the first service to which this item or items 792 or 4001 of the general medical services table, or item 81000, 81005 or 81010, or item 92137, 92138, 92139, 93026 or 93029 applies in relation to that pregnancy | $91.65 100% benefit $91.65 |
| 92137 | Video attendance of at least 20 minutes in duration by a medical practitioner (not including a general practitioner, specialist or consultant physician) who is registered with the Chief Executive Medicare as meeting the credentialing requirements for provision of this service for the purpose of providing non-directive pregnancy support counselling to a person who:(a) is currently pregnant; or(b) has been pregnant in the 12 months preceding the provision of the first service to which this item or items 792 or 4001 of the general medical services table, or item 81000, 81005 or 81010, or item 92136, 92138, 92139, 93026 or 93029 applies in relation to that pregnancy | $73.35 100% benefit $73.35 |
| 92138 | Phone attendance of at least 20 minutes in duration by a general practitioner who is registered with the Chief Executive Medicare as meeting the credentialing requirements for provision of this service for the purpose of providing non-directive pregnancy support counselling to a person who:(a) is currently pregnant; or(b) has been pregnant in the 12 months preceding the provision of the first service to which this item or item 792 or 4001 of the general medical services table, or item 81000, 81005 or 81010, or item 92136, 92137, 92139, 93026 or 93029 applies in relation to that pregnancy | $91.65 100% benefit $91.65 |
| 92139 | Phone attendance of at least 20 minutes in duration by a medical practitioner (not including a general practitioner, specialist or consultant physician) who is registered with the Chief Executive Medicare as meeting the credentialing requirements for provision of this service for the purpose of providing non-directive pregnancy support counselling to a person who:(a) is currently pregnant; or(b) has been pregnant in the 12 months preceding the provision of the first service to which this item or item 792 or 4001 of the general medical services table, or item 81000, 81005 or 81010 or item 92136, 92137, 92138, 93026 or 93029 applies in relation to that pregnancy | $73.35 100% benefit $73.35 |
| 92140 | Video attendance lasting at least 45 minutes by a consultant physician in the practice of the consultant physician’s specialty of paediatrics, following referral of the patient to the consultant paediatrician by a referring practitioner, for a patient aged under 25, if the consultant paediatrician: (a) undertakes, or has previously undertaken in prior attendances, a comprehensive assessment in relation to which a diagnosis of a complex neurodevelopmental disorder (such as autism spectrum disorder) is made (if appropriate, using information provided by an eligible allied health provider); and (b) develops a treatment and management plan, which must include: (i) documentation of the confirmed diagnosis; and (ii) findings of any assessments performed for the purposes of formulation of the diagnosis or contribution to the treatment and management plan; and (iii) a risk assessment; and (iv) treatment options (which may include biopsychosocial recommendations); and (c) provides a copy of the treatment and management plan to: (i) the referring practitioner; and (ii) one or more allied health providers, if appropriate, for the treatment of the patient; (other than attendance on a patient for whom payment has previously been made under this item or item 135, 137, 139, 289, 92141, 92142 or 92434) Applicable only once per lifetime | $320.55 85% benefit $272.50 |
| 92141 | Video attendance lasting at least 45 minutes by a specialist or consultant physician (not including a general practitioner), following referral of the patient to the specialist or consultant physician by a referring practitioner, for a patient aged under 25, if the specialist or consultant physician: (a) undertakes, or has previously undertaken in prior attendances, a comprehensive assessment in relation to which a diagnosis of an eligible disability is made (if appropriate, using information provided by an eligible allied health provider); and (b) develops a treatment and management plan, which must include: (i) documentation of the confirmed diagnosis; and (ii) findings of any assessments performed for the purposes of formulation of the diagnosis or contribution to the treatment and management plan; and (iii) a risk assessment; and (iv) treatment options (which may include biopsychosocial recommendations); and (c) provides a copy of the treatment and management plan to: (i) the referring practitioner; and (ii) one or more allied health providers, if appropriate, for the treatment of the patient; (other than attendance on a patient for whom payment has previously been made under this item or item 135, 137, 139, 289, 92140, 92142 or 92434) Applicable only once per lifetime | $320.55 85% benefit $272.50 |
| 92142 | Video attendance lasting at least 45 minutes by a general practitioner (not including a specialist or consultant physician), for a patient aged under 25, if the general practitioner: (a) undertakes, or has previously undertaken in prior attendances, a comprehensive assessment in relation to which a diagnosis of an eligible disability is made (if appropriate, using information provided by an eligible allied health provider); and (b) develops a treatment and management plan, which must include: (i) documentation of the confirmed diagnosis; and (ii) findings of any assessments performed for the purposes of formulation of the diagnosis or contribution to the treatment and management plan; and (iii) a risk assessment; and (iv) treatment options (which may include biopsychosocial recommendations); and (c) provides a copy of the treatment and management plan to one or more allied health providers, if appropriate, for the treatment of the patient; (other than attendance on a patient for whom payment has previously been made under this item or item 135, 137, 139, 289, 92140, 92141 or 92434) Applicable only once per lifetime NOTE: It is a legislative requirement that this service must be performed by the patient’s eligible telehealth practitioner (please see Note AN.1.1 for the definitions as some exemptions do apply) | $161.05 100% benefit $161.05 |
| 92146 | Video attendance by 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 written eating disorder treatment and management plan for an eligible patient, if: (a) the plan includes an opinion on diagnosis of the patient’s eating disorder; and (b) the plan includes treatment options and recommendations to manage the patient’s condition for the following 12 months; and (c) the plan includes an outline of the referral options to allied health professionals for mental health and dietetic services, and specialists, as appropriate; and (d) the general practitioner offers the patient and the patient’s carer (if any, and if the practitioner considers it appropriate and the patient agrees): (i) a copy of the plan; and (ii) suitable education about the eating disorder. | $85.80 100% benefit $85.80 |
| 92147 | Video attendance by a general practitioner who has not undertaken mental health skills training, of at least 40 minutes in duration for the preparation of a written eating disorder treatment and management plan for an eligible patient, if: (a) the plan includes an opinion on diagnosis of the patient’s eating disorder; and (b) the plan includes treatment options and recommendations to manage the patient’s condition for the following 12 months; and (c) the plan includes an outline of the referral options to allied health professionals for mental health and dietetic services, and specialists, as appropriate; and (d) the general practitioner offers the patient and the patient’s carer (if any, and if the practitioner considers it appropriate and the patient agrees): (i) a copy of the plan; and (ii) suitable education about the eating disorder. | $126.35 100% benefit $126.35 |
| 92148 | Video 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 written eating disorder treatment and management plan for an eligible patient, if: (a) the plan includes an opinion on diagnosis of the patient’s eating disorder; and (b) the plan includes treatment options and recommendations to manage the patient’s condition for the following 12 months; and (c) the plan includes an outline of the referral options to allied health professionals for mental health and dietetic services, and specialists, as appropriate; and (d) the general practitioner offers the patient and the patient’s carer (if any, and if the practitioner considers it appropriate and the patient agrees): (i) a copy of the plan; and (ii) suitable education about the eating disorder. | $108.95 100% benefit $108.95 |
| 92149 | Video attendance by a general practitioner who has undertaken mental health skills training, of at least 40 minutes in duration for the preparation of a written eating disorder treatment and management plan for an eligible patient, if: (a) the plan includes an opinion on diagnosis of the patient’s eating disorder; and (b) the plan includes treatment options and recommendations to manage the patient’s condition for the following 12 months; and (c) the plan includes an outline of the referral options to allied health professionals for mental health and dietetic services, and specialists, as appropriate; and (d) the general practitioner offers the patient and the patient’s carer (if any, and if the practitioner considers it appropriate and the patient agrees): (i) a copy of the plan; and (ii) suitable education about the eating disorder. | $160.50 100% benefit $160.50 |
| 92150 | Video attendance by a medical practitioner (not including a general practitioner, specialist or consultant physician) 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 written eating disorder treatment and management plan for an eligible patient, if: (a) the plan includes an opinion on diagnosis of the patient’s eating disorder; and (b) the plan includes treatment options and recommendations to manage the patient’s condition for the following 12 months; and (c) the plan includes an outline of the referral options to allied health professionals for mental health and dietetic services, and specialists, as appropriate; and (d) the medical practitioner offers the patient and the patient’s carer (if any, and if the practitioner considers it appropriate and the patient agrees): (i) a copy of the plan; and (ii) suitable education about the eating disorder | $68.65 100% benefit $68.65 |
| 92151 | Video attendance by a medical practitioner (not including a general practitioner, specialist or consultant physician) who has not undertaken mental health skills training, of at least 40 minutes in duration for the preparation of a written eating disorder treatment and management plan for an eligible patient, if: (a) the plan includes an opinion on diagnosis of the patient’s eating disorder; and (b) the plan includes treatment options and recommendations to manage the patient’s condition for the following 12 months; and (c) the plan includes an outline of the referral options to allied health professionals for mental health and dietetic services, and specialists, as appropriate; and (d) the medical practitioner offers the patient and the patient’s carer (if any, and if the practitioner considers it appropriate and the patient agrees): (i) a copy of the plan; and (ii) suitable education about the eating disorder | $101.05 100% benefit $101.05 |
| 92152 | Video attendance by a medical practitioner (not including a general practitioner, specialist or consultant physician) who has undertaken mental health skills training, of at least 20 minutes but less than 40 minutes in duration for the preparation of a written eating disorder treatment and management plan for an eligible patient, if: (a) the plan includes an opinion on diagnosis of the patient’s eating disorder; and (b) the plan includes treatment options and recommendations to manage the patient’s condition for the following 12 months; and (c) the plan includes an outline of the referral options to allied health professionals for mental health and dietetic services, and specialists, as appropriate; and (d) the medical practitioner offers the patient and the patient’s carer (if any, and if the practitioner considers it appropriate and the patient agrees): (i) a copy of the plan; and (ii) suitable education about the eating disorder | $87.15 100% benefit $87.15 |
| 92153 | Video attendance by a medical practitioner (not including a general practitioner, specialist or consultant physician) who has undertaken mental health skills training, of at least 40 minutes in duration for the preparation of a written eating disorder treatment and management plan for an eligible patient, if: (a) the plan includes an opinion on diagnosis of the patient’s eating disorder; and (b) the plan includes treatment options and recommendations to manage the patient’s condition for the following 12 months; and (c) the plan includes an outline of the referral options to allied health professionals for mental health and dietetic services, and specialists, as appropriate; and (d) the medical practitioner offers the patient and the patient’s carer (if any, and if the practitioner considers it appropriate and the patient agrees): (i) a copy of the plan; and (ii) suitable education about the eating disorder | $128.45 100% benefit $128.45 |
| 92162 | Video attendance of at least 45 minutes in duration by a consultant physician in the practice of the consultant physician’s specialty of psychiatry for the preparation of an eating disorder treatment and management plan for an eligible patient, if: (a) the patient has been referred by a referring practitioner; and (b) during the attendance, the consultant psychiatrist: (i) uses an outcome tool (if clinically appropriate); and (ii) carries out a mental state examination; and (iii) makes a psychiatric diagnosis; and (c) within 2 weeks after the attendance, the consultant psychiatrist: (i) prepares a written diagnosis of the patient; and (ii) prepares a written management plan for the patient that: (A) covers the next 12 months; and (B) is appropriate to the patient’s diagnosis; and (C) comprehensively evaluates the patient’s biological, psychological and social issues; and (D) addresses the patient’s diagnostic psychiatric issues; and (E) makes management recommendations addressing the patient’s biological, psychological and social issues; and (iii) gives the referring practitioner a copy of the diagnosis and the management plan; and (iv) if clinically appropriate, explains the diagnosis and management plan, and a gives a copy, to: (A) the patient; and (B) the patient’s carer (if any), if the patient agrees. | $549.90 85% benefit $467.45 |
| 92163 | Video attendance of at least 45 minutes in duration by a consultant physician in the practice of the consultant physician’s specialty of paediatrics for the preparation of an eating disorder treatment and management plan for an eligible patient, if: (a) the patient has been referred by a referring practitioner; and (b) during the attendance, the consultant paediatrician undertakes an assessment that covers: (i) a comprehensive history, including psychosocial history and medication review; and (ii) comprehensive multi or detailed single organ system assessment; and (iii) the formulation of diagnoses; and (c) within 2 weeks after the attendance, the consultant paediatrician: (i) prepares a written diagnosis of the patient; and (ii) prepares a written management plan for the patient that involves: (A) an opinion on diagnosis and risk assessment; and (B) treatment options and decisions; and (C) medication recommendations; and (iii) gives the referring practitioner a copy of the diagnosis and the management plan; and (iv) if clinically appropriate, explains the diagnosis and management plan, and a gives a copy, to: (A) the patient; and (B) the patient’s carer (if any), if the patient agrees. | $320.55 85% benefit $272.50 |
| 92170 | Video attendance by a general practitioner to review an eligible patient’s eating disorder treatment and management plan prepared by the general practitioner, an associated medical practitioner working in general practice, or a consultant physician practising in the specialty of psychiatry or paediatrics, if: (a) the general practitioner reviews the treatment efficacy of services provided under the eating disorder treatment and management plan, including a discussion with the patient regarding whether the eating disorders psychological treatment and dietetic services are meeting the patient’s needs; and (b) modifications are made to the eating disorder treatment and management plan, recorded in writing, including: (i) recommendations to continue with treatment options detailed in the plan; or (ii) recommendations to alter the treatment options detailed in the plan, with the new arrangements documented in the plan; and (c) initiates referrals for a review by a consultant physician practising in the specialty of psychiatry or paediatrics, where appropriate; and (d) the general practitioner offers the patient and the patient’s carer (if any, and if the practitioner considers it appropriate and the patient agrees): (i) a copy of the plan; and (ii) suitable education about the eating disorder. | $85.80 100% benefit $85.80 |
| 92171 | Video attendance by a medical practitioner (not including a general practitioner, specialist or consultant physician), to review an eligible patient’s eating disorder treatment and management plan prepared by the medical practitioner, an associated medical practitioner working in general practice, or a consultant physician practising in the speciality of psychiatry or paediatrics, if: (a) the medical practitioner reviews the treatment efficacy of services provided under the eating disorder treatment and management plan, including a discussion with the patient regarding whether the eating disorders psychological treatment and dietetic services are meeting the patient’s needs; and (b) modifications are made to the eating disorder treatment and management plan, recorded in writing, including: (i) recommendations to continue with treatment options detailed in the plan; or (ii) recommendations to alter the treatment options detailed in the plan, with the new arrangements documented in the plan; and (c) initiates referrals for a review by a consultant physician practising in the speciality of psychiatry or paediatrics, where appropriate; and (d) the medical practitioner offers the patient and the patient’s carer (if any, and if the practitioner considers it appropriate and the patient agrees): (i) a copy of the plan; and (ii) suitable education about the eating disorder | $68.65 100% benefit $68.65 |
| 92172 | Video attendance of at least 30 minutes in duration by a consultant physician in the practice of the consultant physician’s specialty of psychiatry for an eligible patient, if: (a) the consultant psychiatrist reviews the treatment efficacy of services provided under the eating disorder treatment and management plan, including a discussion with the patient regarding whether the eating disorders psychological treatment and dietetic services are meeting the patient’s needs; and (b) the patient has been referred by a referring practitioner; and (c) during the attendance, the consultant psychiatrist: (i) uses an outcome tool (if clinically appropriate); and (ii) carries out a mental state examination; and (iii) makes a psychiatric diagnosis; and (iv) reviews the eating disorder treatment and management plan; and (d) within 2 weeks after the attendance, the consultant psychiatrist: (i) prepares a written diagnosis of the patient; and (ii) revises the eating disorder treatment and management; and (iii) gives the referring practitioner a copy of the diagnosis and the revised management plan; and (iv) if clinically appropriate, explains the diagnosis and the revised management plan, and gives a copy, to: (A) the patient; and (B) the patient’s carer (if any), if the patient agrees. | $343.75 85% benefit $292.20 |
| 92173 | Video attendance of at least 20 minutes in duration by a consultant physician in the practice of the consultant physician’s specialty of paediatrics for an eligible patient, if: (a) the consultant paediatrician reviews the treatment efficacy of services provided under the eating disorder treatment and management plan, including a discussion with the patient regarding whether the eating disorders psychological treatment and dietetic services are meeting the patient’s needs; and (b) the patient has been referred by a referring practitioner; and (c) during the attendance, the consultant paediatrician: (i) uses an outcome tool (if clinically appropriate); and (ii) carries out a mental state examination; and (iii) makes a psychiatric diagnosis; and (iv) reviews the eating disorder treatment and management plan; and (d) within 2 weeks after the attendance, the consultant paediatrician: (i) prepares a written diagnosis of the patient; and (ii) revises the eating disorder treatment and management; and (iii) gives the referring practitioner a copy of the diagnosis and the revised management plan; and (iv) if clinically appropriate, explains the diagnosis and the revised management plan, and gives a copy, to: (A) the patient; and (B) the patient’s carer (if any), if the patient agrees | $160.50 85% benefit $136.45 |
| 92176 | Phone attendance by a general practitioner to review an eligible patient’s eating disorder treatment and management plan prepared by the general practitioner, an associated medical practitioner working in general practice, or a consultant physician practising in the specialty of psychiatry or paediatrics, if: (a) the general practitioner reviews the treatment efficacy of services provided under the eating disorder treatment and management plan, including a discussion with the patient regarding whether the eating disorders psychological treatment and dietetic services are meeting the patient’s needs; and (b) modifications are made to the eating disorder treatment and management plan, recorded in writing, including: (i) recommendations to continue with treatment options detailed in the plan; or (ii) recommendations to alter the treatment options detailed in the plan, with the new arrangements documented in the plan; and (c) initiates referrals for a review by a consultant physician practising in the specialty of psychiatry or paediatrics, where appropriate; and (d) the general practitioner offers the patient and the patient’s carer (if any, and if the practitioner considers it appropriate and the patient agrees): (i) a copy of the plan; and (ii) suitable education about the eating disorder. | $85.80 100% benefit $85.80 |
| 92177 | Phone attendance by a medical practitioner (not including a general practitioner, specialist or consultant physician) to review an eligible patient’s eating disorder treatment and management plan prepared by the medical practitioner, an associated medical practitioner working in general practice, or a consultant physician practising in the specialty of psychiatry or paediatrics, if: (a) the medical practitioner reviews the treatment efficacy of services provided under the eating disorder treatment and management plan, including a discussion with the patient regarding whether the eating disorders psychological treatment and dietetic services are meeting the patient’s needs; and (b) modifications are made to the eating disorder treatment and management plan, recorded in writing, including: (i) recommendations to continue with treatment options detailed in the plan; or (ii) recommendations to alter the treatment options detailed in the plan, with the new arrangements documented in the plan; and (c) initiates referrals for a review by a consultant physician practising in the specialty of psychiatry or paediatrics, where appropriate; and (d) the medical practitioner offers the patient and the patient’s carer (if any, and if the practitioner considers it appropriate and the patient agrees): (i) a copy of the plan; and (ii) suitable education about the eating disorder. | $68.65 100% benefit $68.65 |
| 92182 | Video attendance by a general practitioner, for providing eating disorder psychological treatment services by a general practitioner registered with the Chief Executive Medicare as meeting the credentialling requirements for provision of this service, and lasting at least 30 minutes but less than 40 minutes in duration, for an eligible patient if treatment is clinically indicated under an eating disorder treatment and management plan. | $111.00 100% benefit $111.00 |
| 92184 | Video attendance by a general practitioner, for providing eating disorder psychological treatment services by a general practitioner registered with the Chief Executive Medicare as meeting the credentialling requirements for provision of this service, and lasting at least 40 minutes in duration, for an eligible patient if treatment is clinically indicated under an eating disorder treatment and management plan. | $158.90 100% benefit $158.90 |
| 92186 | Video attendance by a medical practitioner (not including a general practitioner, specialist or consultant physician), for providing eating disorder psychological treatment services by a medical practitioner registered with the Chief Executive Medicare as meeting the credentialling requirements for provision of this service, and lasting at least 30 minutes but less than 40 minutes in duration, for an eligible patient if treatment is clinically indicated under an eating disorder treatment and management plan | $88.85 100% benefit $88.85 |
| 92188 | Video attendance by a medical practitioner (not including a general practitioner, specialist or consultant physician), for providing eating disorder psychological treatment services by a medical practitioner registered with the Chief Executive Medicare as meeting the credentialling requirements for provision of this service, and lasting at least 40 minutes in duration, for an eligible patient if treatment is clinically indicated under an eating disorder treatment and management plan | $127.10 100% benefit $127.10 |
| 92194 | Phone attendance by a general practitioner, for providing eating disorder psychological treatment services by a general practitioner registered with the Chief Executive Medicare as meeting the credentialling requirements for provision of this service, and lasting at least 30 minutes but less than 40 minutes in duration, for an eligible patient if treatment is clinically indicated under an eating disorder treatment and management plan. | $111.00 100% benefit $111.00 |
| 92196 | Phone attendance by a general practitioner, for providing eating disorder psychological treatment services by a general practitioner registered with the Chief Executive Medicare as meeting the credentialling requirements for provision of this service, and lasting at least 40 minutes in duration, for an eligible patient if treatment is clinically indicated under an eating disorder treatment and management plan. | $158.90 100% benefit $158.90 |
| 92198 | Phone attendance by a medical practitioner (not including a general practitioner, specialist or consultant physician), for providing eating disorder psychological treatment services by a medical practitioner registered with the Chief Executive Medicare as meeting the credentialling requirements for provision of this service, and lasting at least 30 minutes but less than 40 minutes in duration, for an eligible patient if treatment is clinically indicated under an eating disorder treatment and management plan | $88.85 100% benefit $88.85 |
| 92200 | Phone attendance by a medical practitioner (not including a general practitioner, specialist or consultant physician), for providing eating disorder psychological treatment services by a medical practitioner registered with the Chief Executive Medicare as meeting the credentialling requirements for provision of this service, and lasting at least 40 minutes in duration, for an eligible patient if treatment is clinically indicated under an eating disorder treatment and management plan. | $127.10 100% benefit $127.10 |
| 92210 | Video 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 | $183.15 100% benefit $183.15 |
| 92211 | Video attendance by a medical practitioner (other than 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 | $146.35 100% benefit $146.35 |
| 92422 | Video attendance by a consultant physician in the practice of the consultant physician’s specialty (other than psychiatry) of at least 45 minutes in duration for an initial assessment of a patient with at least 2 morbidities (which may include complex congenital, developmental and behavioural disorders) following referral of the patient to the consultant physician by a referring practitioner, if: (a) an assessment is undertaken that covers: (i) a comprehensive history, including psychosocial history and medication review; and (ii) comprehensive multi or detailed single organ system assessment; and (iii) the formulation of differential diagnoses; and (b) a consultant physician treatment and management plan of significant complexity is prepared and provided to the referring practitioner, which involves: (i) an opinion on diagnosis and risk assessment; and (ii) treatment options and decisions; and (iii) medication recommendations; and (c) an attendance on the patient to which item 110, 116 or 119 of the general medical services table or item 91824, 91825, 91826, 91836 or 92440 applies did not take place on the same day by the same consultant physician; and (d) this item, or item 132 of the general medical services table, has not applied to an attendance on the patient in the preceding 12 months by the same consultant physician | $320.55 85% benefit $272.50 |
| 92423 | Video attendance by a consultant physician in the practice of the consultant physician’s specialty (other than psychiatry) of at least 20 minutes in duration after the first attendance in a single course of treatment for a review of a patient with at least 2 morbidities (which may include complex congenital, developmental and behavioural disorders) if: (a) a review is undertaken that covers: (i) review of initial presenting problems and results of diagnostic investigations; and (ii) review of responses to treatment and medication plans initiated at time of initial consultation; and (iii) comprehensive multi or detailed single organ system assessment; and (iv) review of original and differential diagnoses; and (b) the modified consultant physician treatment and management plan is provided to the referring practitioner, which involves, if appropriate: (i) a revised opinion on the diagnosis and risk assessment; and (ii) treatment options and decisions; and (iii) revised medication recommendations; and (c) an attendance on the patient to which item 110, 116 or 119 of the general medical services table or item 91824, 91825, 91826, 91836 or 92440 applies did not take place on the same day by the same consultant physician; and (d) item 132 of the general medical services table or item 92422 applied to an attendance claimed in the preceding 12 months; and (e) the attendance under this item is claimed by the same consultant physician who claimed item 132 of the general medical services table or item 92422; and (f) this item, or item 133 of the general medical services table or item 92443 has not applied more than twice in any 12 month period | $160.50 85% benefit $136.45 |
| 92434 | Video attendance lasting at least 45 minutes by a consultant physician in the practice of the consultant physician’s specialty of psychiatry, following referral of the patient to the consultant psychiatrist by a referring practitioner, for a patient aged under 25, if the consultant psychiatrist: (a) undertakes, or has previously undertaken in prior attendances, a comprehensive assessment in relation to which a diagnosis of a complex neurodevelopmental disorder (such as autism spectrum disorder) is made (if appropriate, using information provided by an eligible allied health provider); and (b) develops a treatment and management plan, which must include: (i) documentation of the confirmed diagnosis; and (ii) findings of any assessments performed for the purposes of formulation of the diagnosis or contribution to the treatment and management plan; and (iii) a risk assessment; and (iv) treatment options (which may include biopsychosocial recommendations); and (c) provides a copy of the treatment and management plan to: (i) the referring practitioner; and (ii) one or more allied health providers, if appropriate, for the treatment of the patient; (other than attendance on a patient for whom payment has previously been made under this item or item 135, 137, 139, 289, 92140, 92141 or 92142) Applicable only once per lifetime | $320.55 85% benefit $272.50 |
| 92435 | Video attendance lasting more than 45 minutes by a consultant physician in the practice of the consultant physician’s specialty of psychiatry, if: (a) the attendance follows referral of the patient to the consultant, by a medical practitioner in general practice (including a general practitioner, but not a specialist or consultant physician) or a participating nurse practitioner for an assessment or management; and (b) during the attendance, the consultant: (i) if it is clinically appropriate to do so—uses an appropriate outcome tool; and (ii) carries out a mental state examination; and (iii) undertakes a comprehensive diagnostic assessment; and (c) the consultant decides that it is clinically appropriate for the patient to be managed by the referring practitioner without ongoing management by the consultant and (d) within 2 weeks after the attendance, the consultant prepares and gives the referring practitioner a written report, which includes: (i) a comprehensive diagnostic assessment of the patient; and (ii) a management plan for the patient for the next 12 months for the patient that comprehensively evaluates the patient’s biopsychosocial factors and makes recommendations to the referring practitioner to manage the patient’s ongoing care in a biopsychosocial model; and (e) if clinically appropriate, the consultant explains the diagnostic assessment and management plan, and a gives a copy, to: (i) the patient; and (ii) the patient’s carer (if any), if the patient agrees; and (f) in the preceding 12 months, a service to which this item or item 291 of the general medical services table applies has not been provided | $549.90 85% benefit $467.45 |
| 92436 | Video attendance lasting more than 30 minutes, but not more than 45 minutes, by a consultant physician in the practice of the consultant physician’s specialty of psychiatry, if: (a) the patient is being managed by a medical practitioner or a participating nurse practitioner in accordance with a management plan prepared by the consultant in accordance with item 291 or 92435; and (b) the attendance follows referral of the patient to the consultant, by the medical practitioner or participating nurse practitioner managing the patient, for review of the management plan and the associated comprehensive diagnostic assessment; and (c) during the attendance, the consultant: (i) if it is clinically appropriate to do so—uses an appropriate outcome tool; and (ii) carries out a mental state examination; and (iii) reviews the comprehensive diagnostic assessment and undertakes additional assessment as required; and (iv) reviews the management plan; and (d) within 2 weeks after the attendance, the consultant prepares and gives to the referring practitioner a written report, which includes: (i) a revised comprehensive diagnostic assessment of the patient; and (ii) a revised management plan including updated recommendations to the referring practitioner to manage the patient’s ongoing care in a biopsychosocial model; and (e) if clinically appropriate, the consultant explains the diagnostic assessment and the management plan, and gives a copy, to: (i) the patient; and (ii) the patient’s carer (if any), if the patient agrees; and (f) in the preceding 12 months, a service to which item 291 of the general medical services table or item 92435 applies has been provided; and (g) in the preceding 12 months, a service to which this item or item 293 of the general medical services table or item 92444 applies has not been provided | $343.75 85% benefit $292.20 |
| 92437 | Video attendance of more than 45 minutes in duration by a consultant physician in the practice of the consultant physician’s speciality of psychiatry following referral of the patient to the consultant physician by a referring practitioner: (a) if the patient: (i) is a new patient for this consultant physician; or (ii) has not received an attendance from this consultant physician in the preceding 24 months; and (b) the patient has not received an attendance under this item, or item 91827 to 91831, 91837 to 91839, 92455 to 92457, 91868 to 91873, 91879 to 91881 or item 296, 297, 299, 300, 302, 304, 306 to 308, 310, 312, 314, 316, 318, 319, 320, 322, 324, 326, 328, 330, 332, 334, 336, 338, 342, 344 or 346 of the general medical services table, in the preceding 24 months | $316.30 85% benefit $268.90 |
| 92440 | Phone attendance for a person by a consultant physician in the practice of the consultant physician's specialty (other than psychiatry) if:(a) the attendance follows referral of the patient to the consultant physician; and (b) the attendance was of more than 5 minutes in duration; where the attendance is after the first attendance as part of a single course of treatment | $91.70 85% benefit $77.95 |
| 92441 | Phone attendance of at least 30 minutes in duration by a consultant physician in the practice of the consultant physician’s specialty of psychiatry for an eligible patient, if:(a) the consultant psychiatrist reviews the treatment efficacy of services provided under the eating disorder treatment and management plan, including a discussion with the patient regarding whether the eating disorders psychological treatment and dietetic services are meeting the patient’s needs; and(b) the patient has been referred by a referring practitioner; and(c) during the attendance, the consultant psychiatrist: (i) uses an outcome tool (if clinically appropriate); and (ii) carries out a mental state examination; and (iii) makes a psychiatric diagnosis; and (iv) reviews the eating disorder treatment and management plan; and(d) within 2 weeks after the attendance, the consultant psychiatrist: (i) prepares a written diagnosis of the patient; and (ii) revises the eating disorder treatment and management; and (iii) gives the referring practitioner a copy of the diagnosis and the revised management plan; and (iv) if clinically appropriate, explains the diagnosis and the revised management plan, and gives a copy, to: (A) the patient; and (B) the patient’s carer (if any), if the patient agrees | $343.75 85% benefit $292.20 |
| 92442 | Phone attendance of at least 20 minutes in duration by a consultant physician in the practice of the consultant physician’s specialty of paediatrics for an eligible patient, if:(a) the consultant paediatrician reviews the treatment efficacy of services provided under the eating disorder treatment and management plan, including a discussion with the patient regarding whether the eating disorders psychological treatment and dietetic services are meeting the patient’s needs; and(b) the patient has been referred by a referring practitioner; and(c) during the attendance, the consultant paediatrician: (i) uses an outcome tool (if clinically appropriate); and (ii) carries out a mental state examination; and (iii) makes a psychiatric diagnosis; and (iv) reviews the eating disorder treatment and management plan; and(d) within 2 weeks after the attendance, the consultant paediatrician: (i) prepares a written diagnosis of the patient; and (ii) revises the eating disorder treatment and management; and (iii) gives the referring practitioner a copy of the diagnosis and the revised management plan; and (iv) if clinically appropriate, explains the diagnosis and the revised management plan, and gives a copy, to: (A) the patient; and (B) the patient’s carer (if any), if the patient agrees | $160.50 85% benefit $136.45 |
| 92443 | Phone attendance by a consultant physician in the practice of the consultant physician’s specialty (other than psychiatry) of at least 20 minutes in duration after the first attendance in a single course of treatment for a review of a patient with at least two morbidities (which may include complex congenital, developmental and behavioural disorders) if:(a) a review is undertaken that covers: (i) review of initial presenting problems and results of diagnostic investigations; and (ii) review of responses to treatment and medication plans initiated at time of initial consultation; and (iii) comprehensive multi or detailed single organ system assessment; and (iv) review of original and differential diagnoses; and(b) the modified consultant physician treatment and management plan is provided to the referring practitioner, which involves, if appropriate: (i) a revised opinion on the diagnosis and risk assessment; and (ii) treatment options and decisions; and (iii) revised medication recommendations; and(c) an attendance on the patient to which item 110, 116 or 119 of the general medical services table or item 91824, 91825, 91826, 91836 or 92440 applies did not take place on the same day by the same consultant physician; and(d) item 132 of the general medical services table or item 92422 applied to an attendance claimed in the preceding 12 months; and(e) the attendance under this item is claimed by the same consultant physician who claimed item 132 of the general medical services table or item 92422; and(f) this item, or item 133 of the general medical services table or item 92423 has not applied more than twice in any 12 month period | $160.50 85% benefit $136.45 |
| 92444 | Phone attendance lasting more than 30 minutes, but not more than 45 minutes, by a consultant physician in the practice of the consultant physician's specialty of psychiatry, if: (a) the patient is being managed by a medical practitioner or a participating nurse practitioner in accordance with a management plan prepared by the consultant in accordance with item 291 or 92435; and (b) the attendance follows referral of the patient to the consultant, by the medical practitioner or participating nurse practitioner managing the patient, for review of the management plan and the associated comprehensive diagnostic assessment; and (c) during the attendance, the consultant: (i) if it is clinically appropriate to do so—uses an appropriate outcome tool; and (ii) carries out a mental state examination; and (iii) reviews the comprehensive diagnostic assessment and undertakes additional assessment as required; and (iv) reviews the management plan; and (d) within 2 weeks after the attendance, the consultant prepares and gives to the referring practitioner a written report, which includes: (i) a revised comprehensive diagnostic assessment of the patient; and (ii) a revised management plan including updated recommendations to the referring practitioner to manage the patient's ongoing care in a biopsychosocial model; and (e) if clinically appropriate, the consultant explains the diagnostic assessment and the management plan, and gives a copy, to: (i) the patient; and (ii) the patient's carer (if any), if the patient agrees; and (f) in the preceding 12 months, a service to which item 291 of the general medical services table or item 92435 applies has been provided; and (g) in the preceding 12 months, a service to which this item or item 293 of the general medical services table or item 92436 applies has not been provided | $343.75 85% benefit $292.20 |
| 92445 | Phone attendance by a specialist in the practice of neurosurgery following referral of the patient to the specialist—an attendance after the first in a single course of treatment, involving arranging any necessary investigations in relation to one or more complex problems and of more than 15 minutes in duration but not more than 30 minutes in duration | $103.95 85% benefit $88.40 |
| 92446 | Phone attendance by a specialist in the practice of neurosurgery following referral of the patient to the specialist—an attendance after the first in a single course of treatment, involving arranging any necessary investigations in relation to one or more complex problems and of more than 30 minutes in duration but not more than 45 minutes in duration | $144.00 85% benefit $122.40 |
| 92447 | Phone attendance by a specialist in the practice of neurosurgery following referral of the patient to the specialist—an attendance after the first in a single course of treatment, involving arranging any necessary investigations in relation to one or more complex problems and of more than 45 minutes in duration | $183.35 85% benefit $155.85 |
| 92448 | Phone attendance of more than 30 minutes in duration by a consultant physician or specialist in the practice of the consultant physician’s or specialist’s specialty of geriatric medicine to review a management plan previously prepared by that consultant physician or specialist under item 141, 145 or 92623 if:(a) the review is initiated by the referring medical practitioner practising in general practice or a participating nurse practitioner; and (b) during the attendance: (i) the patient’s health status is reassessed; and (ii) a management plan prepared under item 141 or 145 of the general medical services table or items 92623 is reviewed and revised; and (iii) the revised management plan is explained to the patient and (if appropriate) the patient’s family and any carers and communicated in writing to the referring practitioner; and (c) an attendance to which item 104, 105, 107, 108, 110, 116 or 119 of the general medical services table or item 91822, 91823, 91833, 91824, 91825, 91826, 91836 or 92440 applies was not provided to the patient on the same day by the same practitioner; and (d) an attendance to which item 141 or 145 of the general medical services table, or item 92623 applies has been provided to the patient by the same practitioner in the preceding 12 months; and (e) an attendance to which this item, or item 143 or 147 of the general medical services table or item 92624 applies has not been provided to the patient in the preceding 12 months, unless there has been a significant change in the patient’s clinical condition or care circumstances that requires a further review | $343.75 85% benefit $292.20 |
| 92455 | Video attendance for group psychotherapy (including any associated consultations with a patient taking place on the same occasion and relating to the condition for which group therapy is conducted): (a) of not less than 1 hour in duration; and (b) given under the continuous direct supervision of a consultant physician in the practice of the consultant physician’s specialty of psychiatry; and (c) involving a group of 2 to 9 unrelated patients or a family group of more than 3 patients, each of whom is referred to the consultant physician by a referring practitioner; —each patient | $59.85 85% benefit $50.90 |
| 92456 | Video attendance for group psychotherapy (including any associated consultations with a patient taking place on the same occasion and relating to the condition for which group therapy is conducted): (a) of not less than 1 hour in duration; and (b) given under the continuous direct supervision of a consultant physician in the practice of the consultant physician’s specialty of psychiatry; and (c) involving a family group of 3 patients, each of whom is referred to the consultant physician by a referring practitioner; —each patient | $79.45 85% benefit $67.55 |
| 92457 | Video attendance for group psychotherapy (including any associated consultations with a patient taking place on the same occasion and relating to the condition for which group therapy is conducted): (a) of not less than 1 hour in duration; and (b) given under the continuous direct supervision of a consultant physician in the practice of the consultant physician’s specialty of psychiatry; and (c) involving a family group of 2 patients, each of whom is referred to the consultant physician by a referring practitioner; —each patient | $117.65 85% benefit $100.05 |
| 92478 | New wording on 1 November 2026Video attendance for an admitted patient by a consultant psychiatrist; if:(a) the attendance follows referral of the patient to the consultant psychiatrist by a referring practitioner; and (b) the patient is located at a hospital; and (c) the attendance is not more than 15 minutes duration; and (d) the patient has not received more than one service to which this item or item 92479, 92480, 92481, 92482 or 92483 applies in the last seven days (H) | $52.65 75% benefit $39.50 |
| 92479 | New wording on 1 November 2026Video attendance for an admitted patient by a consultant psychiatrist; if:(a) the attendance follows referral of the patient to the consultant psychiatrist by a referring practitioner; and (b) the patient is located at a hospital; and (c) the attendance is at least 15 minutes, but not more than 30 minutes in duration; and (d) the patient has not received more than one service to which this item or item 92478, 92480, 92481, 92482 or 92483 applies in the last seven days (H) | $105.05 75% benefit $78.80 |
| 92480 | New wording on 1 November 2026Video attendance for an admitted patient by a consultant psychiatrist; if:(a) the attendance follows referral of the patient to the consultant psychiatrist by a referring practitioner; and (b) the patient is located at a hospital; and (c) the attendance was at least 30 minutes, but not more than 45 minutes in duration; and (d) the patient has not received more than one service to which this item or item 92478, 92479, 92481, 92482 or 92483 applies in the last seven days (H) | $161.70 75% benefit $121.30 |
| 92481 | New wording on 1 November 2026Video attendance for an admitted patient by a consultant psychiatrist; if:(a) the attendance follows referral of the patient to the consultant psychiatrist by a referring practitioner; and (b) the patient is located at a hospital; and (c) the attendance was at least 45 minutes, but not more than 75 minutes in duration; and (d) the patient has not received more than one service to which this item or item 92478, 92479, 92480, 92482 or 92483 applies in the last seven days (H) | $223.15 75% benefit $167.40 |
| 92482 | New wording on 1 November 2026Video attendance for an admitted patient by a consultant psychiatrist; if:(a) the attendance follows referral of the patient to the consultant psychiatrist by a referring practitioner; and (b) the patient is located at a hospital; and (c) the attendance was at least 75 minutes in duration; and (d) the patient has not received more than one service to which this item or item 92478, 92479, 92480, 92481 or 92483 applies in the last seven days (H) | $258.95 75% benefit $194.25 |
| 92483 | Video attendance of more than 45 minutes by a consultant psychiatrist following referral of the patient to the consultant psychiatrist by a referring practitioner – an attendance on a patient located at a hospital if the patient: (a) is a new patient for this consultant psychiatrist; or (b) has not received a professional attendance from the consultant psychiatrist in the preceding 24 months; other than attendance on a patient in relation to whom this item, or any of items 296, 297, 299, 300, 302, 304, 306, 308, 91827 to 91831, 91837 to 91839, 92437 and 92478 to 92482 has applied in the preceding 24 months (H) | $316.30 75% benefit $237.25 |
| 92513 | Video attendance by a public health physician in the practice of the public health physician’s specialty of public health medicine—attendance for an obvious problem characterised by the straightforward nature of the task that requires a short patient history and, if required, limited management | $23.75 85% benefit $20.20 |
| 92514 | Video attendance by a public health physician in the practice of the public health physician’s specialty of public health medicine, lasting less than 20 minutes and including 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; for one or more health‑related issues, with appropriate documentation | $51.90 85% benefit $44.15 |
| 92515 | Video attendance by a public health physician in the practice of the public health physician’s specialty of public health medicine, lasting at least 20 minutes and including 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; for one or more health‑related issues, with appropriate documentation | $100.50 85% benefit $85.45 |
| 92516 | Video attendance by a public health physician in the practice of the public health physician’s specialty of public health medicine, lasting at least 40 minutes and including 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; for one or more health‑related issues, with appropriate documentation | $147.95 85% benefit $125.80 |
| 92521 | Phone attendance by a public health physician in the practice of the public health physician’s specialty of public health medicine—attendance for an obvious problem characterised by the straightforward nature of the task that requires a short patient history and, if required, limited management; Where the attendance is not the first attendance for that particular clinical indication | $23.75 85% benefit $20.20 |
| 92522 | Phone attendance by a public health physician in the practice of the public health physician’s specialty of public health medicine, lasting less than 20 minutes and including 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; for one or more health‑related issues, where the attendance is not the first attendance for those particular health‑related issues, with appropriate documentation | $51.90 85% benefit $44.15 |
| 92610 | Video attendance by a specialist in the practice of neurosurgery following referral of the patient to the specialist (other than a second or subsequent attendance in a single course of treatment) | $157.40 85% benefit $133.80 |
| 92611 | Video attendance by a specialist in the practice of neurosurgery following referral of the patient to the specialist—a minor attendance after the first in a single course of treatment | $52.25 85% benefit $44.45 |
| 92612 | Video attendance by a specialist in the practice of neurosurgery following referral of the patient to the specialist—an attendance after the first in a single course of treatment, involving arranging any necessary investigations in relation to one or more complex problems and of more than 15 minutes in duration but not more than 30 minutes in duration | $103.95 85% benefit $88.40 |
| 92613 | Video attendance by a specialist in the practice of neurosurgery following referral of the patient to the specialist—an attendance after the first in a single course of treatment, involving arranging any necessary investigations in relation to one or more complex problems and of more than 30 minutes in duration but not more than 45 minutes in duration | $144.00 85% benefit $122.40 |
| 92614 | Video attendance by a specialist in the practice of neurosurgery following referral of the patient to the specialist—an attendance after the first in a single course of treatment, involving arranging any necessary investigations in relation to one or more complex problems and of more than 45 minutes in duration | $183.35 85% benefit $155.85 |
| 92618 | Phone attendance by a specialist in the practice of neurosurgery following referral of the patient to the specialist—a minor attendance after the first in a single course of treatment. | $52.25 85% benefit $44.45 |
| 92623 | Video attendance of more than 60 minutes in duration by a consultant physician or specialist in the practice of the consultant physician’s or specialist’s specialty of geriatric medicine, if: (a) the patient is at least 65 years old and referred by a medical practitioner practising in general practice (not including a specialist or consultant physician) or a participating nurse practitioner; and (b) the attendance is initiated by the referring practitioner for the provision of a comprehensive assessment and management plan; and (c) during the attendance: (i) all relevant aspects of the patient’s health are evaluated in detail using appropriately validated assessment tools if indicated (the assessment); and (ii) the patient’s various health problems and care needs are identified and prioritised (the formulation); and (iii) a detailed management plan is prepared (the management plan) setting out: (A) the prioritised list of health problems and care needs; and (B) short and longer term management goals; and (C) recommended actions or intervention strategies to be undertaken by the patient’s general practitioner or another relevant health care provider that are likely to improve or maintain health status and are readily available and acceptable to the patient and the patient’s family and carers; and (iv) the management plan is explained and discussed with the patient and, if appropriate, the patient’s family and any carers; and (v) the management plan is communicated in writing to the referring practitioner; and (d) an attendance to which item 104, 105, 107, 108, 110, 116 or 119 of the general medical services table or item 91822, 91823, 91833, 91824, 91825, 91826, 91836 or 92440 applies has not been provided to the patient on the same day by the same practitioner; and (e) an attendance to which this item or item 145 of the general medical services table applies has not been provided to the patient by the same practitioner in the preceding 12 months | $549.90 85% benefit $467.45 |
| 92624 | Video attendance of more than 30 minutes in duration by a consultant physician or specialist in the practice of the consultant physician’s or specialist’s specialty of geriatric medicine to review a management plan previously prepared by that consultant physician or specialist under item 141, 145 or 92623, if: (a) the review is initiated by the referring medical practitioner practising in general practice or a participating nurse practitioner; and (b) during the attendance: (i) the patient’s health status is reassessed; and (ii) a management plan prepared under item 141, 145 or 92623 is reviewed and revised; and (iii) the revised management plan is explained to the patient and (if appropriate) the patient’s family and any carers and communicated in writing to the referring practitioner; and (c) an attendance to which item 104, 105, 107, 108, 110, 116 or 119 of the general medical services table or item 91822, 91823, 91833, 91824, 91825, 91826, 91836 or 92440 applies was not provided to the patient on the same day by the same practitioner; and (d) an attendance to which item 141 or 145 of the general medical services table, or item 92623 applies has been provided to the patient by the same practitioner in the preceding 12 months; and (e) an attendance to which this item, or item 143 or 147 of the general medical services table, or item 92448 applies has not been provided to the patient in the preceding 12 months, unless there has been a significant change in the patient’s clinical condition or care circumstances that requires a further review | $343.75 85% benefit $292.20 |
| 92701 | Video attendance by a medical practitioner in the practice of anaesthesia for a consultation on a patient undergoing advanced surgery or who has complex medical problems, involving a selective history and the formulation of a written patient management plan documented in the patient notes, and lasting more than 15 minutes (other than a service associated with a service to which any of items 2801 to 3000 of the general medical services table apply) | $103.95 85% benefit $88.40 |
| 92715 | Video attendance for the provision of services related to blood borne viruses, sexual or reproductive health by a general practitioner of not more than 5 minutes if the attendance includes any of the following that are clinically relevant: (a) taking a short patient history; (b) arranging any necessary investigation; (c) implementing a management plan; (d) providing appropriate preventive health care Note: Consultations related to assisted reproductive technology and antenatal care are outside the scope of these items and cannot be rendered under these items. | $20.55 100% benefit $20.55 |
| 92716 | Video attendance for the provision of services related to blood borne viruses, sexual or reproductive health by a medical practitioner (not including a general practitioner, specialist or consultant physician) of not more than 5 minutes if the attendance includes any of the following that are clinically relevant: (a) taking a short patient history; (b) arranging any necessary investigation; (c) implementing a management plan; (d) providing appropriate preventive health care Note: Consultations related to assisted reproductive technology and antenatal care are outside the scope of these items and cannot be rendered under these items. | $11.00 100% benefit $11.00 |
| 92717 | Video attendance for the provision of services related to blood borne viruses, sexual or reproductive health by a medical practitioner (not including a general practitioner, specialist or consultant physician), in an eligible area, of not more than 5 minutes if the attendance includes any of the following that are clinically relevant: (a) taking a short patient history; (b) arranging any necessary investigation; (c) implementing a management plan; (d) providing appropriate preventive health care Note: Consultations related to assisted reproductive technology and antenatal care are outside the scope of these items and cannot be rendered under these items | $16.50 100% benefit $16.50 |
| 92718 | Video 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 Note: Consultations related to assisted reproductive technology and antenatal care are outside the scope of these items and cannot be rendered under these items. | $45.05 100% benefit $45.05 |
| 92719 | Video attendance for the provision of services related to blood borne viruses, sexual or reproductive health by a medical practitioner (not including a general practitioner, specialist or consultant physician) 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 Note: Consultations related to assisted reproductive technology and antenatal care are outside the scope of these items and cannot be rendered under these items. | $21.00 100% benefit $21.00 |
| 92720 | Video attendance for the provision of services related to blood borne viruses, sexual or reproductive health by a medical practitioner (not including a general practitioner, specialist or consultant physician), in an eligible area, 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 Note: Consultations related to assisted reproductive technology and antenatal care are outside the scope of these items and cannot be rendered under these items | $35.95 100% benefit $35.95 |
| 92721 | Video attendance for the provision of services related to blood borne viruses, sexual or reproductive health by a general practitioner of more than 20 minutes in duration but not more than 40 minutes if the attendance includes any of the following that are clinically relevant: (a) taking a detailed patient history; (b) arranging any necessary investigation; (c) implementing a management plan; (d) providing appropriate preventive health care Note: Consultations related to assisted reproductive technology and antenatal care are outside the scope of these items and cannot be rendered under these items. | $87.10 100% benefit $87.10 |
| 92722 | Video attendance for the provision of services related to blood borne viruses, sexual or reproductive health by a medical practitioner (not including a general practitioner, specialist or consultant physician) of more than 20 minutes in duration but not more than 40 minutes if the attendance includes any of the following that are clinically relevant: (a) taking a detailed patient history; (b) arranging any necessary investigation; (c) implementing a management plan; (d) providing appropriate preventive health care Note: Consultations related to assisted reproductive technology and antenatal care are outside the scope of these items and cannot be rendered under these items. | $38.00 100% benefit $38.00 |
| 92723 | Video attendance for the provision of services related to blood borne viruses, sexual or reproductive health by a medical practitioner (not including a general practitioner, specialist or consultant physician), in an eligible area, of more than 20 minutes in duration but not more than 40 minutes if the attendance includes any of the following that are clinically relevant: (a) taking a detailed patient history; (b) arranging any necessary investigation; (c) implementing a management plan; (d) providing appropriate preventive health care Note: Consultations related to assisted reproductive technology and antenatal care are outside the scope of these items and cannot be rendered under these items | $69.70 100% benefit $69.70 |
| 92724 | Video 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 Note: Consultations related to assisted reproductive technology and antenatal care are outside the scope of these items and cannot be rendered under these items. | $128.35 100% benefit $128.35 |
| 92725 | Video attendance for the provision of services related to blood borne viruses, sexual or reproductive health by a medical practitioner (not including a general practitioner, specialist or consultant physician) 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 Note: Consultations related to assisted reproductive technology and antenatal care are outside the scope of these items and cannot be rendered under these items. | $61.00 100% benefit $61.00 |
| 92726 | Video attendance for the provision of services related to blood borne viruses, sexual or reproductive health by a medical practitioner (not including a general practitioner, specialist or consultant physician), in an eligible area, 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 Note: Consultations related to assisted reproductive technology and antenatal care are outside the scope of these items and cannot be rendered under these items | $102.65 100% benefit $102.65 |
| 92731 | Phone attendance for the provision of services related to blood borne viruses, sexual or reproductive health by a general practitioner of not more than 5 minutes if the attendance includes any of the following that are clinically relevant: (a) taking a short patient history; (b) arranging any necessary investigation; (c) implementing a management plan; (d) providing appropriate preventive health care Note: Consultations related to assisted reproductive technology and antenatal care are outside the scope of these items and cannot be rendered under these items. | $20.55 100% benefit $20.55 |
| 92732 | Phone attendance for the provision of services related to blood borne viruses, sexual or reproductive health by a medical practitioner (not including a general practitioner, specialist or consultant physician) of not more than 5 minutes if the attendance includes any of the following that are clinically relevant: (a) taking a short patient history; (b) arranging any necessary investigation; (c) implementing a management plan; (d) providing appropriate preventive health care Note: Consultations related to assisted reproductive technology and antenatal care are outside the scope of these items and cannot be rendered under these items. | $11.00 100% benefit $11.00 |
| 92733 | Phone attendance for the provision of services related to blood borne viruses, sexual or reproductive health by a medical practitioner (not including a general practitioner, specialist or consultant physician), in an eligible area, of not more than 5 minutes if the attendance includes any of the following that are clinically relevant: (a) taking a short patient history; (b) arranging any necessary investigation; (c) implementing a management plan; (d) providing appropriate preventive health care Note: Consultations related to assisted reproductive technology and antenatal care are outside the scope of these items and cannot be rendered under these items | $16.50 100% benefit $16.50 |
| 92734 | 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 Note: Consultations related to assisted reproductive technology and antenatal care are outside the scope of these items and cannot be rendered under these items. | $45.05 100% benefit $45.05 |
| 92735 | Phone attendance for the provision of services related to blood borne viruses, sexual or reproductive health by a medical practitioner (not including a general practitioner, specialist or consultant physician) 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 Note: Consultations related to assisted reproductive technology and antenatal care are outside the scope of these items and cannot be rendered under these items. | $21.00 100% benefit $21.00 |
| 92736 | Phone attendance for the provision of services related to blood borne viruses, sexual or reproductive health by a medical practitioner (not including a general practitioner, specialist or consultant physician), in an eligible area, 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 Note: Consultations related to assisted reproductive technology and antenatal care are outside the scope of these items and cannot be rendered under these items | $35.95 100% benefit $35.95 |
| 92737 | Phone attendance for the provision of services related to blood borne viruses, sexual or reproductive health by a general practitioner of more than 20 minutes in duration but not more than 40 minutes if the attendance includes any of the following that are clinically relevant: (a) taking a detailed patient history; (b) arranging any necessary investigation; (c) implementing a management plan; (d) providing appropriate preventive health care Note: Consultations related to assisted reproductive technology and antenatal care are outside the scope of these items and cannot be rendered under these items. | $87.10 100% benefit $87.10 |
| 92738 | Phone attendance for the provision of services related to blood borne viruses, sexual or reproductive health by a medical practitioner (not including a general practitioner, specialist or consultant physician) of more than 20 minutes in duration but not more than 40 minutes if the attendance includes any of the following that are clinically relevant: (a) taking a detailed patient history; (b) arranging any necessary investigation; (c) implementing a management plan; (d) providing appropriate preventive health care Note: Consultations related to assisted reproductive technology and antenatal care are outside the scope of these items and cannot be rendered under these items. | $38.00 100% benefit $38.00 |
| 92739 | Phone attendance for the provision of services related to blood borne viruses, sexual or reproductive health by a medical practitioner (not including a general practitioner, specialist or consultant physician), in an eligible area, of more than 20 minutes in duration but not more than 40 minutes if the attendance includes any of the following that are clinically relevant: (a) taking a detailed patient history; (b) arranging any necessary investigation; (c) implementing a management plan; (d) providing appropriate preventive health care Note: Consultations related to assisted reproductive technology and antenatal care are outside the scope of these items and cannot be rendered under these items | $69.70 100% benefit $69.70 |
| 92740 | 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 Note: Consultations related to assisted reproductive technology and antenatal care are outside the scope of these items and cannot be rendered under these items. | $128.35 100% benefit $128.35 |
| 92741 | Phone attendance for the provision of services related to blood borne viruses, sexual or reproductive health by a medical practitioner (not including a general practitioner, specialist or consultant physician) 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 Note: Consultations related to assisted reproductive technology and antenatal care are outside the scope of these items and cannot be rendered under these items. | $61.00 100% benefit $61.00 |
| 92742 | Phone attendance for the provision of services related to blood borne viruses, sexual or reproductive health by a medical practitioner (not including a general practitioner, specialist or consultant physician), in an eligible area, 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 Note: Consultations related to assisted reproductive technology and antenatal care are outside the scope of these items and cannot be rendered under these items | $102.65 100% benefit $102.65 |
| 92748 | Video attendance for a person by a consultant occupational physician in the practice of the consultant occupational physician's specialty of occupational medicine if: (a) the attendance follows referral of the patient to the consultant occupational physician (b) the attendance is of more than 5 minutes in duration; (c) the attendance is an initial attendance in a single course of treatment; and (d) an attendance on the patient, being an attendance to which item 385, 91822, or 104 applies did not take place on the same day by the same consultant occupational physician. | $103.95 85% benefit $88.40 |
| 92749 | Video attendance for a person by a consultant occupational physician in the practice of the consultant occupational physician's specialty of occupational medicine if: (a) the attendance follows referral of the patient to the consultant occupational physician; (b) the attendance is of more than 5 minutes in duration; and (c) the attendance is after the first in a single course of treatment. | $52.25 85% benefit $44.45 |
| 92750 | Phone attendance for a person by a consultant occupational physician in the practice of the consultant occupational physician's specialty of occupational medicine if: (a) the attendance follows referral of the patient to the consultant occupational physician; (b) the attendance is of more than 5 minutes in duration; and (c) the attendance is after the first attendance in a single course of treatment. | $52.25 85% benefit $44.45 |
| 92751 | Video attendance for a person by a specialist, or consultant physician, in the practice of the specialist's or consultant physician's specialty of pain medicine if: (a) the attendance follows referral of the patient to the specialist or consultant physician; (b) the attendance is of more than 5 minutes in duration; (c) the attendance is an initial attendance in a single course of treatment; and (d) an attendance on the patient, being an attendance to which item 2801, 91824 or 110 applies did not take place on the same day by the same pain medicine specialist or consultant physician. | $183.35 85% benefit $155.85 |
| 92752 | Video attendance for a person by a specialist, or consultant physician, in the practice of the specialist's or consultant physician's specialty of pain medicine if: (a) the attendance follows referral of the patient to the specialist or consultant physician; (b) the attendance is of more than 5 minutes in duration; and (c) the attendance is not a minor attendance after the first in a single course of treatment. | $91.70 85% benefit $77.95 |
| 92753 | Video attendance for a person by a specialist, or consultant physician, in the practice of the specialist’s or consultant physician’s specialty of pain medicine if: (a) the attendance follows referral of the patient to the specialist or consultant physician; (b) the attendance is of more than 5 minutes in duration; and (c) the attendance is a minor attendance after the first in a single course of treatment. | $52.25 85% benefit $44.45 |
| 92754 | Phone attendance for a person by a specialist, or consultant physician, in the practice of the specialist's or consultant physician's specialty of pain medicine if: (a) the attendance follows referral of the patient to the specialist or consultant physician; (b) the attendance is of more than 5 minutes in duration; and (c) the attendance is a minor attendance after the first of a single course of treatment. | $52.25 85% benefit $44.45 |
| 92755 | Video attendance for a person by a specialist, or consultant physician, in the practice of the specialist's or consultant physician’s specialty of palliative medicine if: (a) the attendance follows referral of the patient to the specialist or consultant physician; (b) the attendance is of more than 5 minutes in duration; (c) the attendance is an initial attendance in a single course of treatment; and (d) an attendance on the patient, being an attendance to which item 3005, 91824 or 110 applies did not take place on the same day by the same palliative medicine specialist or consultant physician. | $183.35 85% benefit $155.85 |
| 92756 | Video attendance for a person by a specialist, or consultant physician, in the practice of the specialist's, or consultant physician's, specialty of palliative medicine if: (a) the attendance follows referral of the patient to the specialist or consultant physician; (b) the attendance is of more than 5 minutes in duration; and (c) the attendance is not a minor attendance after the first in a single course of treatment. | $91.70 85% benefit $77.95 |
| 92757 | Video attendance for a person by a specialist, or consultant physician, in the practice of the specialist's or consultant physician's specialty of palliative medicine, if: (a) the attendance follows referral of the patient to the specialist or consultant physician; (b) the attendance is of more than 5 minutes in duration; and (c) the attendance is a minor attendance after the first in a single course of treatment. | $52.25 85% benefit $44.45 |
| 92758 | Phone attendance for a person by a specialist, or consultant physician, in the practice of the specialist’s or consultant physician’s specialty of palliative medicine if: (a) the attendance follows referral of the patient to the specialist or consultant physician; (b) the attendance is of more than 5 minutes in duration; and (c) the attendance is a minor attendance after the first in a single course of treatment. | $52.25 85% benefit $44.45 |
| 92759 | Video attendance for a person by an addiction medicine specialist in the practice of the addiction medicine specialist's specialty if: (a) the attendance follows referral of the patient to the specialist; (b) the attendance includes a comprehensive assessment; (c) the attendance is the first or only time in a single course of treatment that a comprehensive assessment is provided; and (d) an attendance on the patient, being an attendance to which item 6018, 91824 or 110 applies did not take place on the same day by the same addiction medicine specialist. | $183.35 85% benefit $155.85 |
| 92760 | Video attendance for a person by an addiction medicine specialist in the practice of the addiction medicine specialist's specialty if: (a) the attendance follows referral of the patient to the specialist; (b) the attendance is of more than 5 minutes in duration; and (c) the attendance is a patient assessment: (i) before or after a comprehensive assessment under item 110, 6018, 91824 or 92759 in a single course of treatment; or (ii) that follows an initial assessment under item 132, 6023, 92422 or 92762 in a single course of treatment; or (iii) that follows a review under item 133, 6024, 92423, 92763 or 92443 in a single course of treatment. | $91.70 85% benefit $77.95 |
| 92761 | Phone attendance for a person by an addiction medicine specialist in the practice of the addiction medicine specialist's specialty if: (a) the attendance follows referral of the patient to the specialist; (b) the attendance is of more than 5 minutes in duration; and (c) the attendance is a minor attendance after the first in a single course of treatment. | $52.25 85% benefit $44.45 |
| 92762 | Video attendance for a person by an addiction medicine specialist in the practice of the addiction medicine specialist's specialty of at least 45 minutes for an initial assessment of a patient with at least 2 morbidities, following referral of the patient to the addiction medicine specialist by a referring practitioner, if: (a) an assessment is undertaken that covers: (i) a comprehensive history, including psychosocial history and medication review; and (ii) a comprehensive multi or detailed single organ system assessment; and (iii) the formulation of differential diagnoses; and (b) an addiction medicine specialist treatment and management plan of significant complexity that includes the following is prepared and provided to the referring practitioner: (i) an opinion on diagnosis and risk assessment; (ii) treatment options and decisions; (iii) medication recommendations; and (c) an attendance on the patient to which item 104, 105, 110, 116, 119, 132, 133, 6018, 6019, 6023, 91824, 91825, 91826, 91836, 92422, 92423, 92440, 92443, 92759, 92760 or 92763 applies did not take place on the same day by the same addiction medicine specialist; and (d) neither this item nor item 6023, 132 or 92422 has applied to an attendance on the patient in the preceding 12 months by the same addiction medicine specialist | $320.55 85% benefit $272.50 |
| 92763 | Video attendance for a person by an addiction medicine specialist in the practice of the addiction medicine specialist's specialty of at least 20 minutes, after the first attendance in a single course of treatment for a review of a patient with at least 2 morbidities if: (a) a review is undertaken that covers: (i) review of initial presenting problems and results of diagnostic investigations; and (ii) review of responses to treatment and medication plans initiated at time of initial consultation; and (iii) comprehensive multi or detailed single organ system assessment; and (iv) review of original and differential diagnoses; and (b) the modified addiction medicine specialist treatment and management plan is provided to the referring practitioner, which involves, if appropriate: (i) a revised opinion on diagnosis and risk assessment; and (ii) treatment options and decisions; and (iii) revised medication recommendations; and (c) an attendance on the patient to which item 104, 105, 110, 116, 119, 132, 133, 6018, 6019, 6024, 91824, 91825, 91826, 91836, 92422, 92423, 92440, 92443, 92759, or 92760 applies did not take place on the same day by the same addiction medicine specialist; and (d) item 132, 6023, 92422 or 92762 applied to an attendance claimed in the preceding 12 months; and (e) the attendance under this item is claimed by the same addiction medicine specialist who claimed item 132, 6023, 92422, or 92762 or by a locum tenens; and (f) this item has not applied more than twice in any 12-month period. | $160.50 85% benefit $136.45 |
| 92764 | Video attendance for a person by a sexual health medicine specialist in the practice of the sexual health medicine specialist's specialty if: (a) the attendance follows referral of the patient to the sexual health medicine specialist; and (b) the attendance is of more than 5 minutes in duration, and includes a comprehensive assessment; and (c) the attendance is the first or only time in a single course of treatment; and (d) an attendance on the patient, being an attendance to which item 6051, 91824, or 110 applies did not take place on the same day by the same sexual health medicine specialist. | $183.35 85% benefit $155.85 |
| 92765 | Video attendance by a sexual health medicine specialist in the practice of the sexual health medicine specialist's specialty if: (a) the attendance follows referral of the patient to the specialist; (b) the attendance is a patient assessment: (i) before or after a comprehensive assessment under item 6051, 91824 or 92764 in a single course of treatment; or (ii) that follows an initial assessment under item 6057 or 92767 in a single course of treatment; or (iii) that follows a review under item 6058 or 92768 in a single course of treatment. | $91.70 85% benefit $77.95 |
| 92766 | Phone attendance for a person by a sexual health medicine specialist in the practice of the sexual health medicine specialist's specialty if: (a) the attendance follows referral of the patient to the sexual health medicine specialist; and (b) the attendance is of more than 5 minutes in duration; and (c) the attendance is a minor attendance after the first in a single course of treatment. | $52.25 85% benefit $44.45 |
| 92767 | Video attendance for a person by a sexual health medicine specialist in the practice of the sexual health medicine specialist's specialty of sexual health of at least 45 minutes for an initial assessment of a patient with at least 2 morbidities, following referral of the patient to the sexual health medicine specialist by a referring practitioner, if: (a) an assessment is undertaken that covers: (i) a comprehensive history, including psychosocial history and medication review; and (ii) a comprehensive multi or detailed single organ system assessment; and (iii) the formulation of differential diagnoses; and (b) a sexual health medicine specialist treatment and management plan of significant complexity that includes the following is prepared and provided to the referring practitioner: (i) an opinion on diagnosis and risk assessment; (ii) treatment options and decisions; (iii) medication recommendations; and (c) an attendance on the patient to which item 104, 105, 110, 116, 119, 132, 133, 6051, 6052, 6057, 91822, 91823, 91824, 91825, 91826, 91833, 91836, 92422, 92423, 92440, 92443, 92764, or 92765 applies did not take place on the same day by the same sexual health medicine specialist; and (d) neither this item nor items 6057, 92422 or 132 has applied to an attendance on the patient in the preceding 12 months by the same sexual health medicine specialist. | $320.55 85% benefit $272.50 |
| 92768 | Video attendance for a person by a sexual health medicine specialist in the practice of the sexual health medicine specialist's specialty of at least 20 minutes, after the first attendance in a single course of treatment for a review of a patient with at least two morbidities if: (a) a review is undertaken that covers: (i) review of initial presenting problems and results of diagnostic investigations; and (ii) review of responses to treatment and medication plans initiated at time of initial consultation; and (iii) comprehensive multi or detailed single organ system assessment; and (iv) review of original and differential diagnoses; and (b) the modified sexual health medicine specialist treatment and management plan is provided to the referring practitioner, which involves, if appropriate: (i) a revised opinion on diagnosis and risk assessment; and (ii) treatment options and decisions; and (iii) revised medication recommendations; and (c) an attendance on the patient, being an attendance to which item 104, 105, 110, 116, 119, 132, 133, 6051, 6052, 91822, 91823, 91824, 91825, 91826, 91836, 92422, 92423, 92440, 92443, 92764, 92765 or 6058 applies did not take place on the same day by the same sexual health medicine specialist; and (d) item 6057, 132, 92422 or 92767 applied to an attendance claimed in the preceding 12 months; and (e) the attendance under this item is claimed by the same sexual health medicine specialist who claimed item 6057, 132, 92422 or 92767 or by a locum tenens; and (f) neither this item nor item 6058 has not applied more than twice in any 12-month period. | $160.50 85% benefit $136.45 |
Check the item before you claim.
An eligibility check tests the patient and each MBS item against Medicare’s rules, so a ‘no’ comes back with the reason before the claim goes in.