MBS Category 6

Pathology services: MBS items and fees.

All 622 items in Category 6, with each item’s schedule fee and Medicare benefits, from the MBS edition of 1 November 2026.

Check an item for a patient Work out what Medicare pays

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.

P1 Haematology

48 items

ItemDescriptionFee and benefits
65060Haemoglobin, erythrocyte sedimentation rate, blood viscosity - 1 or more tests$8.25
75% benefit $6.20
85% benefit $7.05
65066Examination of: (a) a blood film by special stains to demonstrate Heinz bodies, parasites or iron; or (b) a blood film by enzyme cytochemistry for neutrophil alkaline phosphatase, alpha-naphthyl acetate esterase or chloroacetate esterase; or (c) a blood film using any other special staining methods including periodic acid Schiff and Sudan Black; or (d) a urinary sediment for haemosiderin including a service described in item 65072$10.95
75% benefit $8.25
85% benefit $9.35
65070Erythrocyte count, haematocrit, haemoglobin, calculation or measurement of red cell index or indices, platelet count, leucocyte count and manual or instrument generated differential count - not being a service where haemoglobin only is requested - one or more instrument generated sets of results from a single sample; and (if performed) (a) a morphological assessment of a blood film; (b) any service in item 65060 or 65072$17.80
75% benefit $13.35
85% benefit $15.15
65072Examination for reticulocytes including a reticulocyte count by any method - 1 or more tests$10.70
75% benefit $8.05
85% benefit $9.10
65075Haemolysis or metabolic enzymes - assessment by: (a) erythrocyte autohaemolysis test; or (b) erythrocyte osmotic fragility test; or (c) sugar water test; or (d) G-6-P D (qualitative or quantitative) test; or (e) pyruvate kinase (qualitative or quantitative) test; or (f) acid haemolysis test; or (g) quantitation of muramidase in serum or urine; or (h) Donath Landsteiner antibody test; or (i) other erythrocyte metabolic enzyme tests 1 or more tests$54.60
75% benefit $40.95
85% benefit $46.45
65078Tests for the diagnosis of thalassaemia consisting of haemoglobin electrophoresis or chromatography and at least 2 of: (a) examination for HbH; or (b) quantitation of HbA2; or (c) quantitation of HbF; including (if performed) any service described in item 65060 or 65070$94.75
75% benefit $71.10
85% benefit $80.55
65079Tests described in item 65078 if rendered by a receiving APP - 1 or more tests (Item is subject to rule 18)$94.75
75% benefit $71.10
85% benefit $80.55
65081Tests for the investigation of haemoglobinopathy consisting of haemoglobin electrophoresis or chromatography and at least 1 of: (a) heat denaturation test; or (b) isopropanol precipitation test; or (c) tests for the presence of haemoglobin S; or (d) quantitation of any haemoglobin fraction (including S, C, D, E); including (if performed) any service described in item 65060, 65070 or 65078$101.45
75% benefit $76.10
85% benefit $86.25
65082Tests described in item 65081 if rendered by a receiving APP - 1 or more tests (Item is subject to rule 18)$101.45
75% benefit $76.10
85% benefit $86.25
65084Bone marrow trephine biopsy - histopathological examination of sections of bone marrow and examination of aspirated material (including clot sections where necessary), including (if performed): any test described in item 65060, 65066 or 65070$174.25
75% benefit $130.70
85% benefit $148.15
65087Bone marrow - examination of aspirated material (including clot sections where necessary), including (if performed): any test described in item 65060, 65066 or 65070$87.30
75% benefit $65.50
85% benefit $74.25
65090Blood grouping (including back-grouping if performed) - ABO and Rh (D antigen)$11.70
75% benefit $8.80
85% benefit $9.95
65093Blood grouping - Rh phenotypes, Kell system, Duffy system, M and N factors or any other blood group system - 1 or more systems, including item 65090 (if performed)$23.15
75% benefit $17.40
85% benefit $19.70
65096Blood grouping (including back-grouping if performed), and examination of serum for Rh and other blood group antibodies, including: (a) identification and quantitation of any antibodies detected; and (b) (if performed) any test described in item 65060 or 65070$43.10
75% benefit $32.35
85% benefit $36.65
65099Compatibility tests by crossmatch - all tests performed on any 1 day for up to 6 units, including: (a) direct testing of donor red cells from each unit against the serum of the patient by one or more accepted crossmatching techniques; and (b) all grouping checks of the patient and donor; and (c) examination for antibodies, and if necessary identification of any antibodies detected; and (d) (if performed) any tests described in item 65060, 65070, 65090 or 65096 (Item is subject to rule 5)$114.40
75% benefit $85.80
85% benefit $97.25
65102Compatibility tests by crossmatch - all tests performed on any 1 day in excess of 6 units, including: (a) direct testing of donor red cells from each unit against serum of the patient by one or more accepted crossmatching techniques; and (b) all grouping checks of the patient and donor; and (c) examination for antibodies, and if necessary identification of any antibodies detected; and (d) (if performed) any tests described in item 65060, 65070, 65090, 65096, 65099 or 65105 (Item is subject to rule 5)$172.95
75% benefit $129.75
85% benefit $147.05
65105Compatibility testing using at least a 3 cell panel and issue of red cells for transfusion - all tests performed on any one day for up to 6 units, including: (a) all grouping checks of the patient and donor; and (b) examination for antibodies and, if necessary, identification of any antibodies detected; and (c) (if performed) any tests described in item 65060, 65070, 65090 or 65096 (Item is subject to rule 5)$114.40
75% benefit $85.80
85% benefit $97.25
65108Compatibility testing using at least a 3 cell panel and issue of red cells for transfusion - all tests performed on any one day in excess of 6 units, including: (a) all grouping checks of the patient and donor; and (b) examination for antibodies and, if necessary, identification of any antibodies detected; and (c) (if performed) any tests described in item 65060, 65070, 65090, 65096, 65099 or 65105 (Item is subject to rule 5)$172.95
75% benefit $129.75
85% benefit $147.05
65109Release of fresh frozen plasma or cryoprecipitate for the use in a patient for the correction of a coagulopathy - 1 release.$13.55
75% benefit $10.20
85% benefit $11.55
65110Release of compatible fresh platelets for the use in a patient for platelet support as prophylaxis to minimize bleeding or during active bleeding - 1 release.$13.55
75% benefit $10.20
85% benefit $11.55
65111Examination of serum for blood group antibodies (including identification and, if necessary, quantitation of any antibodies detected)$24.35
75% benefit $18.30
85% benefit $20.70
651141 or more of the following tests: (a) direct Coombs (antiglobulin) test; (b) qualitative or quantitative test for cold agglutinins or heterophil antibodies$9.55
75% benefit $7.20
85% benefit $8.15
651171 or more of the following tests: (a) Spectroscopic examination of blood for chemically altered haemoglobins; (b) detection of methaemalbumin (Schumm's test)$21.30
75% benefit $16.00
85% benefit $18.15
65120Prothrombin time (including INR where appropriate), activated partial thromboplastin time, thrombin time (including test for the presence of heparin), test for factor XIII deficiency (qualitative), Echis test, Stypven test, reptilase time, fibrinogen, or 1 of fibrinogen degradation products, fibrin monomer or D-dimer - 1 test$14.40
75% benefit $10.80
85% benefit $12.25
651232 tests described in item 65120$21.40
75% benefit $16.05
85% benefit $18.20
651263 tests described in item 65120$29.25
75% benefit $21.95
85% benefit $24.90
651294 or more tests described in item 65120$37.30
75% benefit $28.00
85% benefit $31.75
65137Test for the presence of lupus anticoagulant not being a service associated with any service to which items 65175, 65176, 65177, 65178 and 65179 apply$26.60
75% benefit $19.95
85% benefit $22.65
65142Confirmation or clarification of an abnormal or indeterminate result from a test described in item 65175, by testing a specimen collected on a different day - 1 or more tests$26.60
75% benefit $19.95
85% benefit $22.65
65144Platelet aggregation in response to ADP, collagen, 5HT, ristocetin or other substances; or heparin, low molecular weight heparins, heparinoid or other drugs - 1 or more tests$59.40
75% benefit $44.55
85% benefit $50.50
65147Quantitation of anti-Xa activity when monitoring is required for a patient receiving a low molecular weight heparin or heparinoid - 1 test$39.80
75% benefit $29.85
85% benefit $33.85
65150Assessment of von Willebrand factor, factor II, factor V, factor VII, factor VIII, factor IX, factor X, factor XI, factor XII, factor XIII, prekallikrein, high-molecular-weight kininogen, circulating coagulation factor inhibitors other than by Bethesda assay—one test$74.50
75% benefit $55.90
85% benefit $63.35
651532 tests described in item 65150 (Item is subject to rule 6 )$149.05
75% benefit $111.80
85% benefit $126.70
651563 or more tests described in item 65150 (Item is subject to rule 6 )$223.50
75% benefit $167.65
85% benefit $190.00
65157A test described in item 65150, if rendered by a receiving APP, where no tests in the item have been rendered by the referring APP - 1 test (Item is subject to rule 6 and 18)$74.50
75% benefit $55.90
85% benefit $63.35
65158Tests described in item 65150, other than that described in 65157, if rendered by a receiving APP - each test to a maximum of 2 tests (Item is subject to rule 6 and 18)$74.50
75% benefit $55.90
85% benefit $63.35
65159Quantitation of circulating coagulation factor inhibitors by Bethesda assay - 1 test$74.50
75% benefit $55.90
85% benefit $63.35
65162Examination of a maternal blood film for the presence of fetal red blood cells (Kleihauer test)$11.00
75% benefit $8.25
85% benefit $9.35
65165Detection and quantitation of fetal red blood cells in the maternal circulation by detection of red cell antigens using flow cytometric methods including (if performed) any test described in item 65070 or 65162$36.20
75% benefit $27.15
85% benefit $30.80
65166A test described in item 65165 if rendered by a receiving APP - 1 or more tests (Item is subject to rule 18)$36.20
75% benefit $27.15
85% benefit $30.80
65171Test for the presence of antithrombin III deficiency, protein C deficiency, protein S deficiency or activated protein C resistance in a first degree relative of a person who has a proven defect of any of the above - 1 or more tests$26.60
75% benefit $19.95
85% benefit $22.65
65175Test for the presence of antithrombin III deficiency, protein C deficiency, protein S deficiency, lupus anticoagulant, activated protein C resistance - where the request for the test(s) specifically identifies that the patient has a history of venous thromboembolism - quantitation by 1 or more techniques - 1 test (Item is subject to Rule 6)$26.60
75% benefit $19.95
85% benefit $22.65
651762 tests described in item 65175 (Item is subject to rule 6)$51.10
75% benefit $38.35
85% benefit $43.45
651773 tests described in item 65175 (Item is subject to rule 6)$75.60
75% benefit $56.70
85% benefit $64.30
651784 tests described in item 65175 (Item is subject to rule 6)$100.05
75% benefit $75.05
85% benefit $85.05
651795 tests described in item 65175 (Item is subject to rule 6)$124.50
75% benefit $93.40
85% benefit $105.85
65180A test described in item 65175, if rendered by a receiving APA, where no tests in the item have been rendered by the referring APA - 1 test (Item is subject to rule 6 and 18)$26.60
75% benefit $19.95
85% benefit $22.65
65181A test described in item 65175, if rendered by a receiving APP, if one or more tests described in the item have been rendered by the referring APP - one test (Item is subject to rule 6 and 18)$24.45
75% benefit $18.35
85% benefit $20.80

P2 Chemical

147 items

ItemDescriptionFee and benefits
66500Quantitation in serum, plasma, urine or other body fluid (except amniotic fluid), by any method except reagent tablet or reagent strip (with or without reflectance meter) of: acid phosphatase, alanine aminotransferase, albumin, alkaline phosphatase, ammonia, amylase, aspartate aminotransferase, bicarbonate, bilirubin (total), bilirubin (any fractions), C-reactive protein, calcium (total or corrected for albumin), chloride, creatine kinase, creatinine, gamma glutamyl transferase, globulin, glucose, lactate dehydrogenase, lipase, magnesium, phosphate, potassium, sodium, total protein, total cholesterol, triglycerides, urate or urea - 1 test$9.70
75% benefit $7.30
85% benefit $8.25
665032 tests described in item 66500$11.65
75% benefit $8.75
85% benefit $9.95
665063 tests described in item 66500$13.65
75% benefit $10.25
85% benefit $11.65
665094 tests described in item 66500$15.65
75% benefit $11.75
85% benefit $13.35
665125 or more tests described in item 66500$17.70
75% benefit $13.30
85% benefit $15.05
66517Quantitation of bile acids in blood in pregnancy. Applicable not more than 3 times in a pregnancy.$19.65
75% benefit $14.75
85% benefit $16.75
66518Investigation of cardiac or skeletal muscle damage by quantitative measurement of creatine kinase isoenzymes, troponin or myoglobin in blood - testing on 1 specimen in a 24 hour period$20.05
75% benefit $15.05
85% benefit $17.05
66519Investigation of cardiac or skeletal muscle damage by quantitative measurement of creatine kinase isoenzymes, troponin or myoglobin in blood - testing on 2 or more specimens in a 24 hour period$40.15
75% benefit $30.15
85% benefit $34.15
66520Fibroblast growth factor 23 quantification in serum or plasma, requested by a specialist or consultant physician to determine eligibility for a relevant treatment listed on the Pharmaceutical Benefits Scheme$90.00
75% benefit $67.50
85% benefit $76.50
66522Faecal calprotectin test for the diagnosis of inflammatory bowel disease, if all the following apply: the patient is under 50 years of age; the patient has gastrointestinal symptoms suggestive of inflammatory or functional bowel disease of more than 6 weeks’ duration; infectious causes have been excluded; the likelihood of malignancy has been assessed as low; no relevant clinical alarms are present$75.00
75% benefit $56.25
85% benefit $63.75
66523Faecal calprotectin test for the diagnosis of inflammatory bowel disease, if all the following apply: the results of a service to which item 66522 applies were inconclusive for the patient (that is, the results showed a faecal calprotectin level of more than 50 μg/g but not more than 100 μg/g); the patient has ongoing gastrointestinal symptoms suggestive of inflammatory or functional bowel disease; the service is requested by a specialist or consultant physician practising as a specialist gastroenterologist; the request indicates that an endoscopic examination is not initially required; no relevant clinical alarms are present$75.00
75% benefit $56.25
85% benefit $63.75
66525Faecal calprotectin test for the management of a symptomatic patient with diagnosed inflammatory bowel disease, requested by or on behalf of a specialist or consultant physician$75.00
75% benefit $56.25
85% benefit $63.75
66536Quantitation of HDL cholesterol$11.05
75% benefit $8.30
85% benefit $9.40
66539Electrophoresis of serum for demonstration of lipoprotein subclasses, if the cholesterol is >6.5 mmol/L and triglyceride >4.0 mmol/L or in the diagnosis of types III and IV hyperlipidaemia - (Item is subject to rule 25)$30.60
75% benefit $22.95
85% benefit $26.05
66542Oral glucose tolerance test for the diagnosis of diabetes mellitus that includes: (a) administration of glucose; and (b) at least 2 measurements of blood glucose; and (c) (if performed) any test described in item 66695$18.95
75% benefit $14.25
85% benefit $16.15
66545Oral glucose challenge test in pregnancy for the detection of gestational diabetes that includes: (a) administration of glucose; and (b) 1 or 2 measurements of blood glucose; and (c) (if performed) any test in item 66695$15.80
75% benefit $11.85
85% benefit $13.45
66548Oral glucose tolerance test in pregnancy for the diagnosis of gestational diabetes that includes: (a) administration of glucose; and (b) at least 3 measurements of blood glucose; and (c) any test in item 66695 (if performed)$19.90
75% benefit $14.95
85% benefit $16.95
66551Quantitation of glycated haemoglobin performed in the management of established diabetes (See para PR.2.2 of explanatory notes to this Category)$16.80
75% benefit $12.60
85% benefit $14.30
66554Quantitation of glycated haemoglobin performed in the management of pre-existing diabetes where the patient is pregnant - including a service in item 66551 (if performed) - (Item is subject to rule 25)$16.80
75% benefit $12.60
85% benefit $14.30
66557Quantitation of fructosamine performed in the management of established diabetes - each test to a maximum of 4 tests in a 12 month period$9.70
75% benefit $7.30
85% benefit $8.25
66560Microalbumin - quantitation in urine$20.10
75% benefit $15.10
85% benefit $17.10
66563Osmolality, estimation by osmometer, in serum or in urine - 1 or more tests$24.70
75% benefit $18.55
85% benefit $21.00
66566Quantitation of: (a) blood gases (including pO2, oxygen saturation and pCO2) ; and (b) bicarbonate and pH; including any other measurement (eg. haemoglobin, lactate, potassium or ionised calcium) or calculation performed on the same specimen - 1 or more tests on 1 specimen$33.70
75% benefit $25.30
85% benefit $28.65
66569Quantitation of blood gases, bicarbonate and pH as described in item 66566 on 2 specimens performed within any 1 day$42.60
75% benefit $31.95
85% benefit $36.25
66572Quantitation of blood gases, bicarbonate and pH as described in item 66566 on 3 specimens performed within any 1 day$51.55
75% benefit $38.70
85% benefit $43.85
66575Quantitation of blood gases, bicarbonate and pH as described in item 66566 on 4 specimens performed within any 1 day$60.45
75% benefit $45.35
85% benefit $51.40
66578Quantitation of blood gases, bicarbonate and pH as described in item 66566 on 5 specimens performed within any 1 day$69.35
75% benefit $52.05
85% benefit $58.95
66581Quantitation of blood gases, bicarbonate and pH as described in item 66566 on 6 or more specimens performed within any 1 day$78.25
75% benefit $58.70
85% benefit $66.55
66584Quantitation of ionised calcium (except if performed as part of item 66566) - 1 test$9.70
75% benefit $7.30
85% benefit $8.25
66585Quantification of laboratory‑based BNP or NT‑proBNP testing in a patient with systemic sclerosis (scleroderma) to assess risk of pulmonary arterial hypertension Maximum of 2 tests in a 12 month period$58.50
75% benefit $43.90
85% benefit $49.75
66586Quantification of BNP or NT-proBNP testing in a patient with diagnosed pulmonary arterial hypertension to monitor for disease progression Applicable 4 times in any 12-month period$58.50
75% benefit $43.90
85% benefit $49.75
66587Urine acidification test for the diagnosis of renal tubular acidosis including the administration of an acid load, and pH measurements on 4 or more urine specimens and at least 1 blood specimen$47.55
75% benefit $35.70
85% benefit $40.45
66590Calculus, analysis of 1 or more$30.60
75% benefit $22.95
85% benefit $26.05
66593Ferritin - quantitation, except if requested as part of iron studies$18.00
75% benefit $13.50
85% benefit $15.30
66596Iron studies, consisting of quantitation of: (a) serum iron; and (b) transferrin or iron binding capacity; and (c) ferritin$32.55
75% benefit $24.45
85% benefit $27.70
66605Vitamins - quantitation of vitamins B1, B2, B3, B6 or C in blood, urine or other body fluid - 1 or more tests$30.60
75% benefit $22.95
85% benefit $26.05
66606A test described in item 66605 if rendered by a receiving APP - 1 or more tests (Item is subject to rule 18 and 25)$30.60
75% benefit $22.95
85% benefit $26.05
66607Vitamins - quantitation of vitamins A or E in blood, urine or other body fluid - 1 or more tests within a 6 month period$75.75
75% benefit $56.85
85% benefit $64.40
66610A test described in item 66607 if rendered by a receiving APP - 1 or more tests$75.75
75% benefit $56.85
85% benefit $64.40
66623All qualitative and quantitative tests on blood, urine or other body fluid for: (a) a drug or drugs of abuse (including illegal drugs and legally available drugs taken other than in appropriate dosage); or (b) ingested or absorbed toxic chemicals; including a service described in item 66800, 66803, 66806, 66812 or 66815 (if performed), but excluding: (c) the surveillance of sports people and athletes for performance improving substances; and (d) the monitoring of patients participating in a drug abuse treatment program$41.50
75% benefit $31.15
85% benefit $35.30
66626Detection or quantitation or both (not including the detection of nicotine and metabolites in smoking withdrawal programs) of a drug, or drugs, of abuse or a therapeutic drug, on a sample collected from a patient participating in a drug abuse treatment program; but excluding the surveillance of sports people and athletes for performance improving substances; including all tests on blood, urine or other body fluid (Item is subject to rule 25)$24.10
75% benefit $18.10
85% benefit $20.50
66629Beta-2-microglobulin - quantitation in serum, urine or other body fluids - 1 or more tests$20.10
75% benefit $15.10
85% benefit $17.10
66632Caeruloplasmin, haptoglobins, or prealbumin - quantitation in serum, urine or other body fluids - 1 or more tests$20.10
75% benefit $15.10
85% benefit $17.10
66635Alpha-1-antitrypsin - quantitation in serum, urine or other body fluid - 1 or more tests$20.10
75% benefit $15.10
85% benefit $17.10
66638Isoelectric focussing or similar methods for determination of alpha-1-antitrypsin phenotype in serum - 1 or more tests$49.05
75% benefit $36.80
85% benefit $41.70
66639A test described in item 66638 if rendered by a receiving APP - 1 or more tests (Item is subject to rule 18)$29.20
75% benefit $21.90
85% benefit $24.85
66641Electrophoresis of serum or other body fluid to demonstrate: (a) the isoenzymes of lactate dehydrogenase; or (b) the isoenzymes of alkaline phosphatase; including the preliminary quantitation of total relevant enzyme activity - 1 or more tests$29.20
75% benefit $21.90
85% benefit $24.85
66642A test described in item 66641 if rendered by a receiving APP - 1 or more tests (Item is subject to rule 18)$29.20
75% benefit $21.90
85% benefit $24.85
66644C-1 esterase inhibitor - quantitation$20.15
75% benefit $15.15
85% benefit $17.15
66647C-1 esterase inhibitor - functional assay$45.10
75% benefit $33.85
85% benefit $38.35
66650Alpha-fetoprotein, CA-15.3 antigen (CA15.3), CA-125 antigen (CA125), CA-19.9 antigen (CA19.9), cancer associated serum antigen (CASA), carcinoembryonic antigen (CEA), human chorionic gonadotrophin (HCG), neuron specific enolase (NSE), thyroglobulin in serum or other body fluid, in the monitoring of malignancy or in the detection or monitoring of hepatic tumours, gestational trophoblastic disease or germ cell tumour - quantitation - 1 test (Item is subject to rule 6)$24.35
75% benefit $18.30
85% benefit $20.70
66651A test described in item 66650 if rendered by a receiving APP, where no tests in the item have been rendered by the referring APP - 1 test (Item is subject to rule 6 and 18)$24.35
75% benefit $18.30
85% benefit $20.70
66652A test described in item 66650 if rendered by a receiving APP - other than that described in 66651, if rendered by a receiving APP, 1 test (Item is subject to rule 6 and 18)$20.30
75% benefit $15.25
85% benefit $17.30
666532 or more tests described in item 66650 (Item is subject to rule 6)$44.60
75% benefit $33.45
85% benefit $37.95
66654Prostate specific antigen – quantitation in the monitoring of high-risk patients For any particular patient, applicable not more than once in 11 months$20.15
75% benefit $15.15
85% benefit $17.15
66655Prostate specific antigen—quantitation For any particular patient, applicable not more than once in 23 months$20.15
75% benefit $15.15
85% benefit $17.15
66656Prostate specific antigen (PSA) quantitation in the monitoring of previously diagnosed prostatic disease (including prostate cancer, prostatitis or a premalignant condition such as atypical small acinar proliferation)$20.15
75% benefit $15.15
85% benefit $17.15
66659Prostate specific antigen (PSA), quantitation of 2 or more fractions of PSA and any derived index, including, if performed, a test described in item 66656, in the follow up of a PSA result under item 66654 or 66655 that lies at: (a) more than 2.0 ug/L but less than or equal to 5.5 ug/L for patients with a family history of prostate cancer; or (b) more than 3.0 ug/L but less than or equal to 5.5 ug/L for patients who are at least 50 years of age but under 70 years of age; or (c) more than 5.5 ug/L but less than or equal to 10.0 ug/L for patients who are at least 70 years of age For any particular patient, applicable not more than once in 11 months$37.30
75% benefit $28.00
85% benefit $31.75
66660Prostate specific antigen (PSA), quantitation of 2 or more fractions of PSA and any derived index, in the monitoring of previously diagnosed prostatic disease, including, if performed, a test described in item 66656, if the current PSA level lies at: (a) more than 2.0 ug/L but less than or equal to 5.5 ug/L for patients with a family history of prostate cancer; or (b) more than 3.0 ug/L but less than or equal to 5.5 ug/L for patients who are at least 50 years of age but under 70 years of age; or (c) more than 5.5 ug/L but less than or equal to 10.0 ug/L for patients who are at least 70 years of age For any particular patient, applicable not more than 4 times in 11 months$37.30
75% benefit $28.00
85% benefit $31.75
66662Quantitation of hormone receptors on proven primary breast or ovarian carcinoma or a metastasis from a breast or ovarian carcinoma or a subsequent lesion in the breast - 1 or more tests$79.95
75% benefit $60.00
85% benefit $68.00
66663A test described in item 66662 if rendered by a receiving APP - 1 or more tests (Item is subject to rule 18)$79.95
75% benefit $60.00
85% benefit $68.00
66665Lead quantitation in blood or urine (other than for occupational health screening purposes) to a maximum of 3 tests in a 6 month period - each test$30.60
75% benefit $22.95
85% benefit $26.05
66666A test described in item 66665 if rendered by a receiving APP - 1 or more tests (Item is subject to rule 18)$30.60
75% benefit $22.95
85% benefit $26.05
66667Quantitation of serum zinc in a patient receiving intravenous alimentation - each test$30.60
75% benefit $22.95
85% benefit $26.05
66671Quantitation of serum aluminium in a patient in a renal dialysis program - each test$36.90
75% benefit $27.70
85% benefit $31.40
66674Quantitation of: (a) faecal fat; or (b) breath hydrogen in response to loading with disaccharides; 1 or more tests within a 28 day period$39.95
75% benefit $30.00
85% benefit $34.00
66677Test for tryptic activity in faeces in the investigation of diarrhoea of longer than 4 weeks duration in children under 6 years old$11.15
75% benefit $8.40
85% benefit $9.50
66680Quantitation of disaccharidases and other enzymes in intestinal tissue - 1 or more tests$74.45
75% benefit $55.85
85% benefit $63.30
66683Enzymes - quantitation in solid tissue or tissues other than blood elements or intestinal tissue - 1 or more tests$74.45
75% benefit $55.85
85% benefit $63.30
66686Performance of 1 or more of the following procedures: (a) growth hormone suppression by glucose loading; (b) growth hormone stimulation by exercise; (c) dexamethasone suppression test; (d) sweat collection by iontophoresis for chloride analysis; (e) pharmacological stimulation of growth hormone$50.65
75% benefit $38.00
85% benefit $43.10
66695Quantitation in blood or urine of hormones and hormone binding proteins - ACTH, aldosterone, androstenedione, C-peptide, calcitonin, cortisol, DHEAS, 11-deoxycortisol, dihydrotestosterone, FSH, gastrin, glucagon, growth hormone, hydroxyprogesterone, insulin, LH, oestradiol, oestrone, progesterone, prolactin, PTH, renin, sex hormone binding globulin, somatomedin C(IGF-1), free or total testosterone, urine steroid fraction or fractions, vasoactive intestinal peptide, - 1 test (Item is subject to rule 6)$30.50
75% benefit $22.90
85% benefit $25.95
66696A test described in item 66695, if rendered by a receiving APP - where no tests in the item have been rendered by the referring APP (Item is subject to rule 6 and 18)$30.50
75% benefit $22.90
85% benefit $25.95
66697Tests described in item 66695, other than that described in 66696, if rendered by a receiving APP - each test to a maximum of 4 tests (Item is subject to rule 6 and 18)$13.20
75% benefit $9.90
85% benefit $11.25
666982 tests described in item 66695 (Item is subject to rule 6)$43.70
75% benefit $32.80
85% benefit $37.15
667013 tests described in item 66695 (Item is subject to rule 6)$56.90
75% benefit $42.70
85% benefit $48.40
667044 tests described in item 66695 (This fee applies where 1 laboratory, or more than 1 laboratory belonging to the same APA, performs the only 4 tests specified on the request form or performs 4 tests and refers the rest to the laboratory of a separate APA) (Item is subject to rule 6)$70.15
75% benefit $52.65
85% benefit $59.65
667075 or more tests described in item 66695 (Item is subject to rule 6)$83.35
75% benefit $62.55
85% benefit $70.85
66711Quantitation in saliva of cortisol in: (a) the investigation of Cushing's syndrome; or (b) the management of children with congenital adrenal hyperplasia (Item is subject to rule 6)$30.15
75% benefit $22.65
85% benefit $25.65
66712Two tests described in item 66711 (Item is subject to rule 6)$43.05
75% benefit $32.30
85% benefit $36.60
66714A test described in item 66711, if rendered by a receiving APP, where no tests in the item have been rendered by the referring APP (Item is subject to rule 6 and 18)$30.15
75% benefit $22.65
85% benefit $25.65
66715Tests described in item 66711, other than that described in 66714, if rendered by a receiving APP, each test to a maximum of 1 test (Item is subject to rule 6 and 18)$12.85
75% benefit $9.65
85% benefit $10.95
66716TSH quantitation$25.05
75% benefit $18.80
85% benefit $21.30
66719Thyroid function tests (comprising the service described in item 66716 and either or both of a test for free thyroxine and a test for free T3) for a patient, if: (a) the patient has a level of TSH that is outside the normal reference range for the particular method of assay used to determine the level; or (b) the request from the requesting medical practitioner indicates that the tests are performed: (i) for the purpose of monitoring thyroid disease in the patient; or (ii) to investigate the sick euthyroid syndrome if the patient is an admitted patient; or (iii) to investigate dementia or psychiatric illness of the patient; or (iv) to investigate amenorrhoea or infertility of the patient; or (c) the request from the requesting medical practitioner indicates that the medical practitioner suspects the patient has a pituitary dysfunction; or (d) the request from the requesting medical practitioner indicates that the patient is on drugs that interfere with thyroid hormone metabolism or function$34.80
75% benefit $26.10
85% benefit $29.60
66722TSH quantitation described in item 66716 and 1 test described in item 66695 (This fee applies where 1 laboratory, or more than 1 laboratory belonging to the same APA, performs the only 2 tests specified on the request form or performs 2 tests and refers the rest to the laboratory of a separate APA) (Item is subject to rule 6)$37.90
75% benefit $28.45
85% benefit $32.25
66723Tests described in item 66722, that is, TSH quantitation and 1 test described in 66695, if rendered by a receiving APP, where no tests in the item have been rendered by the referring APP - 1 test (Item is subject to rule 6 and 18)$37.90
75% benefit $28.45
85% benefit $32.25
66724Tests described in item 66722, if rendered by a receiving APP, other than that described in 66723. It is to include a quantitation of TSH - each test to a maximum of 4 tests described in item 66695 (Item is subject to rule 6 and 18)$13.15
75% benefit $9.90
85% benefit $11.20
66725TSH quantitation described in item 66716 and 2 tests described in item 66695 (This fee applies where 1 laboratory, or more than 1 laboratory belonging to the same APA, performs the only 3 tests specified on the request form or performs 3 tests and refers the rest to the laboratory of a separate APA) (Item is subject to rule 6)$51.05
75% benefit $38.30
85% benefit $43.40
66728TSH quantitation described in item 66716 and 3 tests described in item 66695 (This fee applies where 1 laboratory, or more than 1 laboratory belonging to the same APA, performs the only 4 tests specified on the request form or performs 4 tests and refers the rest to the laboratory of a separate APA) (Item is subject to rule 6)$64.20
75% benefit $48.15
85% benefit $54.60
66731TSH quantitation described in item 66716 and 4 tests described in item 66695 (This fee applies where 1 laboratory, or more than 1 laboratory belonging to the same APA, performs the only 5 tests specified on the request form or performs 5 tests and refers the rest to the laboratory of a separate APA) (Item is subject to rule 6)$77.40
75% benefit $58.05
85% benefit $65.80
66734TSH quantitation described in item 66716 and 5 tests described in item 66695 (This fee applies where 1 laboratory, or more than 1 laboratory belonging to the same APA, performs 6 or more tests specified on the request form) (Item is subject to rule 6)$90.55
75% benefit $67.95
85% benefit $77.00
66743Quantitation of alpha-fetoprotein in serum or other body fluids during pregnancy except if requested as part of items 66750 or 66751$20.10
75% benefit $15.10
85% benefit $17.10
66749Amniotic fluid, spectrophotometric examination of, and quantitation of: (a) lecithin/sphingomyelin ratio; or (b) palmitic acid, phosphatidylglycerol or lamellar body phospholipid; or (c) bilirubin, including correction for haemoglobin 1 or more tests$32.95
75% benefit $24.75
85% benefit $28.05
66750Quantitation, in pregnancy, of any 2 of the following to detect foetal abnormality - total human chorionic gonadotrophin (total HCG), free alpha human chorionic gonadotrophin (free alpha HCG), free beta human chorionic gonadotrophin (free beta HCG), pregnancy associated plasma protein A (PAPP-A), unconjugated oestriol (uE3), alpha-fetoprotein (AFP) - including (if performed) a service described in item 73527 or 73529 - Applicable not more than once in a pregnancy$39.75
75% benefit $29.85
85% benefit $33.80
66751Quantitation, in pregnancy, of any three or more tests described in 66750 (Item is subject to rule 25)$55.25
75% benefit $41.45
85% benefit $47.00
66752Quantitation of acetoacetate, beta-hydroxybutyrate, citrate, oxalate, total free fatty acids, cysteine, homocysteine, cystine, lactate, pyruvate or other amino acids and hydroxyproline (except if performed as part of item 66773 or 66776) - 1 test$24.70
75% benefit $18.55
85% benefit $21.00
667552 or more tests described in item 66752$38.85
75% benefit $29.15
85% benefit $33.05
66756Quantitation of 10 or more amino acids for the diagnosis of inborn errors of metabolism - up to 4 tests in a 12 month period on specimens of plasma, CSF and urine.$98.30
75% benefit $73.75
85% benefit $83.60
66757Quantitation of 10 or more amino acids for monitoring of previously diagnosed inborn errors of metabolism in 1 tissue type.$98.30
75% benefit $73.75
85% benefit $83.60
66758Quantitation of angiotensin converting enzyme, or cholinesterase - 1 or more tests$24.70
75% benefit $18.55
85% benefit $21.00
66761Test for reducing substances in faeces by any method (except reagent strip or dipstick)$13.15
75% benefit $9.90
85% benefit $11.20
66764Examination for faecal occult blood (including tests for haemoglobin and its derivatives in the faeces except by reagent strip or dip stick methods) with a maximum of 3 examinations on specimens collected on separate days in a 28 day period$8.90
75% benefit $6.70
85% benefit $7.60
667672 examinations described in item 66764 performed on separately collected and identified specimens$17.85
75% benefit $13.40
85% benefit $15.20
667703 examinations described in item 66764 performed on separately collected and identified specimens$26.70
75% benefit $20.05
85% benefit $22.70
66773Quantitation of products of collagen breakdown or formation for the monitoring of patients with proven low bone mineral density, and if performed, a service described in item 66752 - 1 or more tests (Low bone densitometry is defined in the explanatory notes to Category 2 - Diagnostic Procedures and Investigations of the Medicare Benefits Schedule)$24.65
75% benefit $18.50
85% benefit $21.00
66776Quantitation of products of collagen breakdown or formation for the monitoring of patients with metabolic bone disease or Paget's disease of bone, and if performed, a service described in item 66752 - 1 or more tests$24.65
75% benefit $18.50
85% benefit $21.00
66779Adrenaline, noradrenaline, dopamine, histamine, hydroxyindoleacetic acid (5HIAA), hydroxymethoxymandelic acid (HMMA), homovanillic acid (HVA), metanephrines, methoxyhydroxyphenylethylene glycol (MHPG), phenylacetic acid (PAA) or serotonin quantitation - 1 or more tests$39.95
75% benefit $30.00
85% benefit $34.00
66780A test described in item 66779 if rendered by a receiving APP - 1 or more tests (Item is subject to rule 18)$39.95
75% benefit $30.00
85% benefit $34.00
66782Porphyrins or porphyrins precursors - detection in plasma, red cells, urine or faeces - 1 or more tests$13.15
75% benefit $9.90
85% benefit $11.20
66783A test described in item 66782 if rendered by a receiving APP - 1 or more tests (Item is subject to rule 18)$13.15
75% benefit $9.90
85% benefit $11.20
66785Porphyrins or porphyrins precursors - quantitation in plasma, red cells, urine or faeces - 1 test (Item is subject to rule 6)$39.95
75% benefit $30.00
85% benefit $34.00
66788Porphyrins or porphyrins precursors - quantitation in plasma, red cells, urine or faeces - 2 or more tests (Item is subject to rule 6)$65.85
75% benefit $49.40
85% benefit $56.00
66789A test described in item 66785 if rendered by a receiving APP, where no tests in the item have been rendered by the referring APP - 1 test (Item is subject to rule 6 and 18)$39.95
75% benefit $30.00
85% benefit $34.00
66790A test described in item 66785 other than that described in 66789, if rendered by a receiving APP - to a maximum of 1 test (Item is subject to rule 6 and 18)$25.90
75% benefit $19.45
85% benefit $22.05
66791Porphyrin biosynthetic enzymes - measurement of activity in blood cells or other tissues - 1 or more tests$74.45
75% benefit $55.85
85% benefit $63.30
66792A test described in item 66791 if rendered by a receiving APP - 1 or more tests (Item is subject to rule 18)$74.45
75% benefit $55.85
85% benefit $63.30
66800Quantitation in blood, urine or other body fluid by any method (except reagent tablet or reagent strip) of any of the following being used therapeutically by the patient from whom the specimen was taken: amikacin, carbamazepine, digoxin, disopyramide, ethanol, ethosuximide, gentamicin, lithium, lignocaine, netilmicin, paracetamol, phenobarbitone, primidone, phenytoin, procainamide, quinidine, salicylate, theophylline, tobramycin, valproate or vancomycin - 1 test (Item to be subject to rule 6)$18.15
75% benefit $13.65
85% benefit $15.45
668032 tests described in item 66800 (Item is subject to rule 6)$30.50
75% benefit $22.90
85% benefit $25.95
66804A test described in item 66800 if rendered by a receiving APP, where no tests in the item have been rendered by the referring APP - 1 test (Item is subject to rule 6 and 18)$18.15
75% benefit $13.65
85% benefit $15.45
66805A test described in item 66800 other than that described in 66804, if rendered by a receiving APP - each test to a maximum of 2 tests (Item is subject to rule 6 and 18)$12.35
75% benefit $9.30
85% benefit $10.50
668063 tests described in item 66800 (Item is subject to rule 6)$41.85
75% benefit $31.40
85% benefit $35.60
66812Quantitation, not elsewhere described in this Table by any method or methods, in blood, urine or other body fluid, of a drug being used therapeutically by the patient from whom the specimen was taken - 1 test (This fee applies where 1 laboratory performs the only test specified on the request form or performs 1 test and refers the rest to the laboratory of a separate APA) (Item is subject to rule 6)$34.80
75% benefit $26.10
85% benefit $29.60
668152 tests described in item 66812 (This fee applies where 1 laboratory, or more than 1 laboratory belonging to the same APA, performs the only 2 tests specified on the request form or performs 2 tests and refers the rest to the laboratory of a separate APA) (Item is subject to rule 6)$59.55
75% benefit $44.70
85% benefit $50.65
66816A test described in item 66812 if rendered by a receiving APP, where no tests in the item have been rendered by the referring APP - 1 test (Item is subject to rule 6 and 18)$34.80
75% benefit $26.10
85% benefit $29.60
66817A test described in item 66812, other than that described in 66816, if rendered by a receiving APP - to a maximum of 1 test (Item is subject to rule 6 and 18)$24.75
75% benefit $18.60
85% benefit $21.05
66819Quantitation of copper, manganese, selenium, or zinc (except if item 66667 applies), in blood, urine or other body fluid - 1 test. (Item is subject to rule 6, 22 and 25)$30.60
75% benefit $22.95
85% benefit $26.05
66820A test described in item 66819 if rendered by a receiving APP, where no tests in the item have been rendered by the referring APP - 1 test (Item is subject to rule 6, 18, 22 and 25)$30.60
75% benefit $22.95
85% benefit $26.05
66821A test described in item 66819 other than that described in 66820 if rendered by a receiving APP to a maximum of 1 test (Item is subject to rule 6, 18, 22 and 25)$21.80
75% benefit $16.35
85% benefit $18.55
66822Quantitation of copper, manganese, selenium, or zinc (except if item 66667 applies), in blood, urine or other body fluid - 2 or more tests. (Item is subject to rule 6, 22 and 25)$52.45
75% benefit $39.35
85% benefit $44.60
66825Quantitation of aluminium (except if item 66671 applies), arsenic, beryllium, cadmium, chromium, gold, mercury, nickel, or strontium, in blood, urine or other body fluid or tissue - 1 test. To a maximum of 3 of this item in a 6 month period (Item is subject to rule 6, 22 and 25)$30.60
75% benefit $22.95
85% benefit $26.05
66826A test described in item 66825 if rendered by a receiving APP where no tests have been rendered by the referring APP - 1 test (Item is subject to rules 6, 18, 22 and 25 )$30.60
75% benefit $22.95
85% benefit $26.05
66827A test described in item 66825, other than that described in 66826, if rendered by a receiving APP to a maximum of 1 test (Item is subject to rules 6, 18, 22 and 25)$21.80
75% benefit $16.35
85% benefit $18.55
66828Quantitation of aluminium (except if item 66671 applies), arsenic, beryllium, cadmium, chromium, gold, mercury, nickel, or strontium, in blood, urine or other body fluid or tissue - 2 or more tests. To a maximum of 3 of this item in a 6 month period (Item is subject to rule 6, 22 and 25)$52.45
75% benefit $39.35
85% benefit $44.60
66829Quantitation of BNP or NT‑proBNP for the exclusion of a diagnosis of heart failure in a patient presenting in a non‑hospital setting to assist in decision‑making regarding the clinical necessity of an echocardiogram, where heart failure is suspected based on signs and symptoms but diagnosis is uncertain Applicable once in any 12 month period$58.50
75% benefit $43.90
85% benefit $49.75
66830Quantitation of BNP or NT-proBNP for the diagnosis of heart failure in patients presenting with dyspnoea to a hospital Emergency Department (Item is subject to rule 25)$58.50
75% benefit $43.90
85% benefit $49.75
66831Quantitation of copper or iron in liver tissue biopsy$30.95
75% benefit $23.25
85% benefit $26.35
66832A test described in item 66831 if rendered by a receiving APP (Item is subject to rule 18A and 22)$30.95
75% benefit $23.25
85% benefit $26.35
6683325-hydroxyvitamin D, quantification in serum, for the investigation of a patient who: (a) has signs or symptoms of osteoporosis or osteomalacia; or (b) has increased alkaline phosphatase and otherwise normal liver function tests; or (c) has hyperparathyroidism, hypo- or hypercalcaemia, or hypophosphataemia; or (d) is suffering from malabsorption (for example, because the patient has cystic fibrosis, short bowel syndrome, inflammatory bowel disease or untreated coeliac disease, or has had bariatric surgery); or (e) has deeply pigmented skin, or chronic and severe lack of sun exposure for cultural, medical, occupational or residential reasons; or (f) is taking medication known to decrease 25OH-D levels (for example, anticonvulsants); or (g) has chronic renal failure or is a renal transplant recipient; or (h) is less than 16 years of age and has signs or symptoms of rickets; or (i) is an infant whose mother has established vitamin D deficiency; or (j) is a exclusively breastfed baby and has at least one other risk factor mentioned in a paragraph in this item; or (k) has a sibling who is less than 16 years of age and has vitamin D deficiency$30.05
75% benefit $22.55
85% benefit $25.55
66834A test described in item 66833 if rendered by a receiving APP (Item is subject to Rule 18)$30.05
75% benefit $22.55
85% benefit $25.55
668351, 25-dihydroxyvitamin D - quantification in serum, if the request for the test is made by, or on advice of, the specialist or consultant physician managing the treatment of the patient$39.05
75% benefit $29.30
85% benefit $33.20
668361, 25-dihydroxyvitamin D-quantification in serum, if: (a) the patient has hypercalcaemia; and (b) the request for the test is made by a general practitioner managing the treatment of the patient$39.05
75% benefit $29.30
85% benefit $33.20
66837A test described in item 66835 or 66836 if rendered by a receiving APP (Item is subject to Rule 18)$39.05
75% benefit $29.30
85% benefit $33.20
66838Quantification of either or both of total vitamin B12 and holotranscobalamin Applicable not more than once in 11 months$23.60
75% benefit $17.70
85% benefit $20.10
66839Quantification of methylmalonic acid or homocysteine, rendered in the same patient episode as a service to which item 66838 applies if the result of that service is inconclusive or abnormal Applicable not more than once in 11 months$42.95
75% benefit $32.25
85% benefit $36.55
66840Serum folate test and, if required, red cell folate test for a patient at risk of folate deficiency, including patients with malabsorption conditions, macrocytic anaemia or coeliac disease$23.60
75% benefit $17.70
85% benefit $20.10
66841Quantitation of HbA1c (glycated haemoglobin) performed for the diagnosis of diabetes in asymptomatic patients at high risk. (Item is subject to rule 25)$16.80
75% benefit $12.60
85% benefit $14.30
66842Quantification of one or more of total vitamin B12, holotranscobalamin, methylmalonic acid or homocysteine for a patient: a) who: (i) is still experiencing symptoms of vitamin B12 deficiency 3 to 6 months after a service described in item 66838 or 66839 was rendered for the patient; or(ii) obtained inconclusive results from a service described in item 66839; or b) to whom one or more of the following applies: (i) the patient has a diet low in vitamin B12;(ii) the patient has a family history of vitamin B12 deficiency or an autoimmune condition;(iii) the patient has previously had abdominal or pelvic radiotherapy;(iv) the patient has previously had surgery involving the gastrointestinal tract;(v) the patient uses, or has a recent history of using, recreational nitrous oxide;(vi) the patient requires monitoring of vitamin B12 treatment;(vii) the patient uses vitamin B12-antagonistic medicines;(viii) the patient has one or more clinical conditions with a recognised risk of vitamin B12 deficiency$23.60
75% benefit $17.70
85% benefit $20.10
66900CARBON-LABELLED UREA BREATH TEST using oral C-13 or C-14 urea, including the measurement of exhaled 13CO2 or 14CO2 (except if item 12533 applies) for either:- (a) the confirmation of Helicobacter pylori colonisation OR (b) the monitoring of the success of eradication of Helicobacter pylori.$77.65
75% benefit $58.25
85% benefit $66.05

P3 Microbiology

67 items

ItemDescriptionFee and benefits
69300Microscopy of wet film material other than blood, from 1 or more sites, obtained directly from a patient (not cultures) including: (a) differential cell count (if performed); or (b) examination for dermatophytes; or (c) dark ground illumination; or (d) stained preparation or preparations using any relevant stain or stains; 1 or more tests$12.50
75% benefit $9.40
85% benefit $10.65
69303Culture and (if performed) microscopy to detect pathogenic micro-organisms from nasal swabs, throat swabs, eye swabs and ear swabs (excluding swabs taken for epidemiological surveillance), including (if performed): (a) pathogen identification and antibiotic susceptibility testing; or (b) a service described in item 69300; specimens from 1 or more sites$22.00
75% benefit $16.50
85% benefit $18.70
69306Microscopy and culture to detect pathogenic micro-organisms from skin or other superficial sites, including (if performed): (a) pathogen identification and antibiotic susceptibility testing; or (b) a service described in items 69300, 69303, 69312, 69318; 1 or more tests on 1 or more specimens$33.75
75% benefit $25.35
85% benefit $28.70
69309Microscopy and culture to detect dermatophytes and other fungi causing cutaneous disease from skin scrapings, skin biopsies, hair and nails (excluding swab specimens) and including (if performed): (a) the detection of antigens not elsewhere specified in this Schedule; or (b) a service described in items 69300, 69303, 69306, 69312, 69318; 1 or more tests on 1 or more specimens$48.15
75% benefit $36.15
85% benefit $40.95
69312Microscopy and culture to detect pathogenic micro-organisms from urethra, vagina, cervix or rectum (except for faecal pathogens), including (if performed): (a) pathogen identification and antibiotic susceptibility testing; or (b) a service described in items 69300, 69303, 69306 and 69318; 1 or more tests on 1 or more specimens$33.75
75% benefit $25.35
85% benefit $28.70
69316Detection of Chlamydia trachomatis by any method - 1 test (Item is subject to rule 26)$28.65
75% benefit $21.50
85% benefit $24.40
693171 test described in item 69494 and a test described in 69316. (Item is subject to rule 26)$35.85
75% benefit $26.90
85% benefit $30.50
69318Microscopy and culture to detect pathogenic micro-organisms from specimens of sputum (except when part of items 69324, 69327 and 69330), including (if performed): (a) pathogen identification and antibiotic susceptibility testing; or (b) a service described in items 69300, 69303, 69306 and 69312; 1 or more tests on 1 or more specimens$33.75
75% benefit $25.35
85% benefit $28.70
693192 tests described in item 69494 and a test described in 69316. (Item is subject to rule 26)$42.95
75% benefit $32.25
85% benefit $36.55
69321Microscopy and culture of post-operative wounds, aspirates of body cavities, synovial fluid, CSF or operative or biopsy specimens, for the presence of pathogenic micro-organisms involving aerobic and anaerobic cultures and the use of different culture media, and including (if performed): (a) pathogen identification and antibiotic susceptibility testing; or (b) a service described in item 69300, 69303, 69306, 69312 or 69318; specimens from 1 or more sites$48.15
75% benefit $36.15
85% benefit $40.95
69324Microscopy (with appropriate stains) and culture for mycobacteria - 1 specimen of sputum, urine, or other body fluid or 1 operative or biopsy specimen, including (if performed): (a) microscopy and culture of other bacterial pathogens isolated as a result of this procedure; or (b) pathogen identification and antibiotic susceptibility testing; including a service described in item 69300$43.00
75% benefit $32.25
85% benefit $36.55
69325A test described in item 69324 if rendered by a receiving APP (Item is subject to rule 18)$43.00
75% benefit $32.25
85% benefit $36.55
69327Microscopy (with appropriate stains) and culture for mycobacteria - 2 specimens of sputum, urine, or other body fluid or 2 operative or biopsy specimens, including (if performed): (a) microscopy and culture of other bacterial pathogens isolated as a result of this procedure; or (b) pathogen identification and antibiotic susceptibility testing; including a service mentioned in item 69300$85.00
75% benefit $63.75
85% benefit $72.25
69328A test described in item 69327 if rendered by a receiving APP (Item is subject to rule 18)$85.00
75% benefit $63.75
85% benefit $72.25
69330Microscopy (with appropriate stains) and culture for mycobacteria - 3 specimens of sputum, urine, or other body fluid or 3 operative or biopsy specimens, including (if performed): (a) microscopy and culture of other bacterial pathogens isolated as a result of this procedure; or (b) pathogen identification and antibiotic susceptibility testing; including a service mentioned in item 69300$128.00
75% benefit $96.00
85% benefit $108.80
69331A test described in item 69330 if rendered by a receiving APP (Item is subject to rule 18)$128.00
75% benefit $96.00
85% benefit $108.80
69333Urine examination (including serial examinations), if: (a) the patient has symptoms of urinary tract infection or kidney disease, or is a clinically‑indicated asymptomatic patient who is: (i) pregnant; or (ii) less than 16 years of age; or (iii) a renal transplant recipient; or (iv) suffering from recurrent urinary tract infections; or (v) being investigated or monitored for kidney disease; or (vi) undergoing urinary tract instrumentation, a urological procedure or transurethral resection of the prostate; and (b) the examination is performed by any means other than simple culture by dip slide, including: (i) cell count; and (ii) culture; and (iii) colony count; and (iv) (if performed) stained preparations; and (v) (if performed) identification of cultured pathogens; and (vi) (if performed) antibiotic susceptibility testing; and (vii) (if performed) examination for pH, specific gravity, blood, protein, urobilinogen, sugar, acetone or bile salts$20.55
75% benefit $15.45
85% benefit $17.50
69336Microscopy of faeces for ova, cysts and parasites that must include a concentration technique, and the use of fixed stains or antigen detection for cryptosporidia and giardia - including (if performed) a service described in item 69300 - 1 of this item in any 7 day period$33.45
75% benefit $25.10
85% benefit $28.45
69339Microscopy of faeces for ova, cysts and parasites using concentration techniques examined subsequent to item 69336 on a separately collected and identified specimen collected within 7 days of the examination described in 69336 - 1 examination in any 7 day period$19.10
75% benefit $14.35
85% benefit $16.25
69345Culture and (if performed) microscopy without concentration techniques of faeces for faecal pathogens, using at least 2 selective or enrichment media and culture in at least 2 different atmospheres including (if performed): (a) pathogen identification and antibiotic susceptibility testing; and (b) the detection of clostridial toxins; and (c) a service described in item 69300; - 1 examination in any 7 day period$52.90
75% benefit $39.70
85% benefit $45.00
69354Blood culture for pathogenic micro-organisms (other than viruses), including sub-cultures and (if performed): (a) identification of any cultured pathogen; and (b) necessary antibiotic susceptibility testing; to a maximum of 3 sets of cultures - 1 set of cultures$30.75
75% benefit $23.10
85% benefit $26.15
693572 sets of cultures described in item 69354$61.45
75% benefit $46.10
85% benefit $52.25
693603 sets of cultures described in item 69354$92.20
75% benefit $69.15
85% benefit $78.40
69363Detection of Clostridium difficile or Clostridium difficile toxin (except if a service described in item 69345 has been performed) - one or more tests$28.65
75% benefit $21.50
85% benefit $24.40
69378Quantitation of HIV viral RNA load in plasma or serum in the monitoring of a HIV sero-positive patient not on antiretroviral therapy - 1 or more tests$180.25
75% benefit $135.20
85% benefit $153.25
69379A test described in item 69378 if rendered by a receiving APP - 1 or more tests (Item is subject to rule 18)$180.25
75% benefit $135.20
85% benefit $153.25
69380New 85% benefit on 1 November 2026Genotypic testing for HIV antiretroviral resistance in a patient with confirmed HIV infection if the patient's viral load is greater than 1,000 copies per ml at any of the following times: (a) at presentation; or (b) before antiretroviral therapy: or (c) when treatment with combination antiretroviral agents fails; maximum of 2 tests in a 12 month period$770.30
75% benefit $577.75
85% benefit $661.80 was $665.80
69381Quantitation of HIV viral RNA load in plasma or serum in the monitoring of antiretroviral therapy in a HIV sero-positive patient - 1 or more tests on 1 or more specimens$180.25
75% benefit $135.20
85% benefit $153.25
69382Quantitation of HIV viral RNA load in cerebrospinal fluid in a HIV sero-positive patient - 1 or more tests on 1 or more specimens$180.25
75% benefit $135.20
85% benefit $153.25
69383A test described in item 69381 if rendered by a receiving APP - 1 or more tests on 1 or more specimens (Item is subject to rule 18)$180.25
75% benefit $135.20
85% benefit $153.25
69384Quantitation of 1 antibody to microbial antigens not elsewhere described in the Schedule - 1 test (This fee applies where a laboratory performs the only antibody test specified on the request form or performs 1 test and refers the rest to the laboratory of a separate APA) (Item is subject to rule 6)$15.65
75% benefit $11.75
85% benefit $13.35
693872 tests described in item 69384 (This fee applies where 1 laboratory, or more than 1 laboratory belonging to the same APA, performs the only 2 estimations specified on the request form or performs 2 of the antibody estimations specified on the request form and refers the remainder to the laboratory of a separate APA) (Item is subject to rule 6)$29.00
75% benefit $21.75
85% benefit $24.65
693903 tests described in item 69384 (This fee applies where 1 laboratory, or more than 1 laboratory belonging to the same APA, performs the only 3 estimations specified on the request form or performs 3 of the antibody estimations specified on the request form and refers the remainder to the laboratory of a separate APA) (Item is subject to rule 6)$42.35
75% benefit $31.80
85% benefit $36.00
693934 tests described in item 69384 (This fee applies where 1 laboratory, or more than 1 laboratory belonging to the same APA, performs the only 4 estimations specified on the request form or performs 4 of the antibody estimations specified on the request form and refers the remainder to the laboratory of a separate APA) (Item is subject to rule 6)$55.70
75% benefit $41.80
85% benefit $47.35
693965 or more tests described in item 69384 (This fee applies where 1 laboratory, or more than 1 laboratory belonging to the same APA, performs the only 5 estimations specified on the request form or performs 5 of the antibody tests specified on the request form and refers the remainder to the laboratory of a separate APA) (Item is subject to rule 6)$69.10
75% benefit $51.85
85% benefit $58.75
69400A test described in item 69384, if rendered by a receiving APP, where no tests in the item have been rendered by the referring APP - 1 test (Item is subject to rules 6 and 18)$15.65
75% benefit $11.75
85% benefit $13.35
69401A test described in item 69384, other than that described in 69400, if rendered by a receiving APP - each test to a maximum of 4 tests (Item is subject to rule 6, 18 and 18A)$13.35
75% benefit $10.05
85% benefit $11.35
69405Microbiological serology during a pregnancy (except in the investigation of a clinically apparent intercurrent microbial illness or close contact with a patient suffering from parvovirus infection or varicella during that pregnancy) including: (a) the determination of 1 of the following - rubella immune status, specific syphilis serology, carriage of Hepatitis B, Hepatitis C antibody, HIV antibody and (b) (if performed) a service described in 1 or more of items 69384, 69475, 69478 and 69481$15.65
75% benefit $11.75
85% benefit $13.35
69408Microbiological serology during a pregnancy (except in the investigation of a clinically apparent intercurrent microbial illness or close contact with a patient suffering from parvovirus infection or varicella during that pregnancy) including: (a) the determination of 2 of the following - rubella immune status, specific syphilis serology, carriage of Hepatitis B, Hepatitis C antibody, HIV antibody and (b) (if performed) a service described in 1 or more of items 69384, 69475, 69478 and 69481$29.00
75% benefit $21.75
85% benefit $24.65
69411Microbiological serology during a pregnancy (except in the investigation of a clinically apparent intercurrent microbial illness or close contact with a patient suffering from parvovirus infection or varicella during that pregnancy) including: (a) the determination of 3 of the following - rubella immune status, specific syphilis serology, carriage of Hepatitis B, Hepatitis C antibody, HIV antibody and (b) (if performed) a service described in 1 or more of items 69384, 69475, 69478 and 69481$42.35
75% benefit $31.80
85% benefit $36.00
69413Microbiological serology during a pregnancy (except in the investigation of a clinically apparent intercurrent microbial illness or close contact with a patient suffering from parvovirus infection or varicella during that pregnancy) including: (a) the determination of 4 of the following - rubella immune status, specific syphilis serology, carriage of Hepatitis B, Hepatitis C antibody, HIV antibody and (b) (if performed) a service described in 1 or more of items 69384, 69475, 69478 and 69481$55.70
75% benefit $41.80
85% benefit $47.35
69415Microbiological serology during a pregnancy (except in the investigation of a clinically apparent intercurrent microbial illness or close contact with a patient suffering from parvovirus infection or varicella during that pregnancy) including: (a) the determination of all 5 of the following - rubella immune status, specific syphilis serology, carriage of Hepatitis B, Hepatitis C antibody, HIV antibody and (b) (if performed) a service described in 1 or more of items 69384, 69475, 69478 and 69481$69.10
75% benefit $51.85
85% benefit $58.75
69421Detection of respiratory pathogen nucleic acid from a nasal swab, throat swab, nasopharyngeal aspirate and/or lower respiratory tract sample Testing of 4 pathogens$78.25
75% benefit $58.70
85% benefit $66.55
69422Detection of respiratory pathogen nucleic acid from a nasal swab, throat swab, nasopharyngeal aspirate and/or lower respiratory tract sample, including a service described in item 69421 Testing of 5 or more pathogens$85.55
75% benefit $64.20
85% benefit $72.75
69445Detection of Hepatitis C viral RNA in a patient undertaking antiviral therapy for chronic HCV hepatitis (including a service described in item 69499) - 1 test. To a maximum of 4 of this item in a 12 month period (Item is subject to rule 25)$92.20
75% benefit $69.15
85% benefit $78.40
69451A test described in item 69445 if rendered by a receiving APP - 1 test. (Item is subject to rule 18 and 25)$92.20
75% benefit $69.15
85% benefit $78.40
69471Test of cell‑mediated immune response in blood for the detection of latent tuberculosis by interferon gamma release assay (IGRA) in the following people: (a) a person who has been exposed to a confirmed case of active tuberculosis; (b) a person who is infected with human immunodeficiency virus; (c) a person who is to commence, or has commenced, tumour necrosis factor (TNF) inhibitor therapy; (d) a person who is to commence, or has commenced, renal dialysis; (e) a person with silicosis; (f) a person who is, or is about to become, immunosuppressed because of a disease, or a medical treatment, not mentioned in paragraphs (a) to (e)$34.90
75% benefit $26.20
85% benefit $29.70
69472Detection of antibodies to Epstein Barr Virus using specific serology - 1 test$15.65
75% benefit $11.75
85% benefit $13.35
69474Detection of antibodies to Epstein Barr Virus using specific serology - 2 or more tests$28.65
75% benefit $21.50
85% benefit $24.40
69475One test for hepatitis antigen or antibodies to determine immune status or viral carriage following exposure or vaccination to Hepatitis A, Hepatitis B, Hepatitis C or Hepatitis D (Item subject to rule 11)$15.65
75% benefit $11.75
85% benefit $13.35
694782 tests described in 69475 (Item subject to rule 11)$29.25
75% benefit $21.95
85% benefit $24.90
69481Investigation of infectious causes of acute or chronic hepatitis - 3 tests for hepatitis antibodies or antigens, (Item subject to rule 11)$40.55
75% benefit $30.45
85% benefit $34.50
69482Quantitation of Hepatitis B viral DNA in patients who are Hepatitis B surface antigen positive and have chronic hepatitis B, but are not receiving antiviral therapy - 1 test (Item is subject to rule 25)$152.10
75% benefit $114.10
85% benefit $129.30
69483Quantitation of Hepatitis B viral DNA in patients who are Hepatitis B surface antigen positive and who have chronic hepatitis B and are receiving antiviral therapy - 1 test (Item is subject to rule 25)$152.10
75% benefit $114.10
85% benefit $129.30
69484Supplementary testing for Hepatitis B surface antigen or Hepatitis C antibody using a different assay on the specimen which yielded a reactive result on initial testing (Item is subject to rule 18)$17.10
75% benefit $12.85
85% benefit $14.55
69488Quantitation of HCV RNA load in plasma or serum in: (a) the pre-treatment evaluation, of a patient with chronic HCV hepatitis, for antiviral therapy; or (b) the assessment of efficacy of antiviral therapy for such a patient (including a service in item 69499 or 69445) (Item is subject to rule 18 and 25)$180.25
75% benefit $135.20
85% benefit $153.25
69489A test described in item 69488 if rendered by a receiving APP (Item is subject to rule 18 and 25)$180.25
75% benefit $135.20
85% benefit $153.25
69491Nucleic acid amplification and determination of Hepatitis C virus (HCV) genotype if the patient is HCV RNA positive and is being evaluated for antiviral therapy of chronic HCV hepatitis. To a maximum of 1 of this item in a 12 month period$204.80
75% benefit $153.60
85% benefit $174.10
69492A test described in item 69491 if rendered by a receiving APP - 1 test (Item is subject to rule 18 and 25)$204.80
75% benefit $153.60
85% benefit $174.10
69494Detection of a virus or microbial antigen or microbial nucleic acid (not elsewhere specified) 1 test (Item is subject to rule 6 and 26)$28.65
75% benefit $21.50
85% benefit $24.40
694952 tests described in 69494 (Item is subject to rule 6 and 26)$35.85
75% benefit $26.90
85% benefit $30.50
694963 or more tests described in 69494 (Item is subject to rule 6 and 26)$43.05
75% benefit $32.30
85% benefit $36.60
69497A test described in item 69494, if rendered by a receiving APP, where no tests in the item have been rendered by the referring APP - 1 test (Item is subject to rule 6, 18 and 26)$28.65
75% benefit $21.50
85% benefit $24.40
69498A test described in item 69494, other than that described in 69497, if rendered by a receiving APP - each test to a maximum of 2 tests (Item is subject to rule 6, 18 and 26)$7.20
75% benefit $5.40
85% benefit $6.15
69499Detection of hepatitis C viral RNA if: (a) the patient is hepatitis C seropositive; or (aa) the patient's hepatitis C serological status is uncertain after an inconclusive serology test result; or (b) the test is performed for the purpose of: (i) determining the hepatitis C status of an immunosuppressed or immunocompromised patient; or (ii) the detection of acute hepatitis C prior to seroconversion if considered necessary for the clinical management of the patient (Item is subject to rule 25 - not more than once in a 12-month period in total for both items 69499 and 69500)$92.20
75% benefit $69.15
85% benefit $78.40
69500A test described in item 69499 if the test is performed by a receiving APP (Item is subject to rules 18 and 25)$92.20
75% benefit $69.15
85% benefit $78.40
69505Sequencing and analysis of the genome of mycobacterium tuberculosis complex from an isolate or nucleic acid extract: (a) to speciate the organism: (i) at the time of a patient’s initial diagnosis and commencement of initial empiric therapy; or (ii) following recurrence of a patient’s symptoms or a patient’s failure to respond to treatment within the expected timeframe; and (b) for the purpose of: (i) genome‑wide determination of the antimicrobial resistance markers (resistome) of the isolate; and (ii) individualising the patient’s treatment Applicable once at initial diagnosis and once per episode of disease recurrence$150.00
75% benefit $112.50
85% benefit $127.50

P4 Immunology

78 items

ItemDescriptionFee and benefits
71057Electrophoresis, quantitative and qualitative, of serum, urine or other body fluid all collected within a 28 day period, to demonstrate: (a) protein classes; or (b) presence and amount of paraprotein; including the preliminary quantitation of total protein, albumin and globulin - 1 specimen type$34.60
75% benefit $25.95
85% benefit $29.45
71058Examination as described in item 71057 of 2 or more specimen types$53.05
75% benefit $39.80
85% benefit $45.10
71059Immunofixation or immunoelectrophoresis or isoelectric focusing of: (a) urine for detection of Bence Jones proteins; or (b) serum, plasma or other body fluid; and characterisation of a paraprotein or cryoglobulin - examination of 1 specimen type (eg. serum, urine or CSF)$37.45
75% benefit $28.10
85% benefit $31.85
71060Examination as described in item 71059 of 2 or more specimen types$46.25
75% benefit $34.70
85% benefit $39.35
71062Electrophoresis and immunofixation or immunoelectrophoresis or isoelectric focussing of CSF for the detection of oligoclonal bands and including if required electrophoresis of the patient's serum for comparison purposes - 1 or more tests$46.25
75% benefit $34.70
85% benefit $39.35
71064Detection and quantitation of cryoglobulins or cryofibrinogen - 1 or more tests$21.80
75% benefit $16.35
85% benefit $18.55
71066Quantitation of total immunoglobulin A by any method in serum, urine or other body fluid - 1 test$15.30
75% benefit $11.50
85% benefit $13.05
71068Quantitation of total immunoglobulin G by any method in serum, urine or other body fluid - 1 test$15.30
75% benefit $11.50
85% benefit $13.05
710692 tests described in items 71066, 71068, 71072 or 71074$23.90
75% benefit $17.95
85% benefit $20.35
710713 or more tests described in items 71066, 71068, 71072 or 71074$32.50
75% benefit $24.40
85% benefit $27.65
71072Quantitation of total immunoglobulin M by any method in serum, urine or other body fluid - 1 test$15.30
75% benefit $11.50
85% benefit $13.05
71073Quantitation of all 4 immunoglobulin G subclasses$111.55
75% benefit $83.70
85% benefit $94.85
71074Quantitation of total immunoglobulin D by any method in serum, urine or other body fluid - 1 test$15.30
75% benefit $11.50
85% benefit $13.05
71075Quantitation of immunoglobulin E (total), 1 test. (Item is subject to rule 25)$24.15
75% benefit $18.15
85% benefit $20.55
71076A test described in item 71073 if rendered by a receiving APP - 1 test (Item is subject to rule 18)$111.55
75% benefit $83.70
85% benefit $94.85
71077Quantitation of immunoglobulin E (total) in the follow up of a patient with proven immunoglobulin-E-secreting myeloma, proven congenital immunodeficiency or proven allergic bronchopulmonary aspergillosis, 1 test. (Item is subject to rule 25)$28.40
75% benefit $21.30
85% benefit $24.15
71079Detection of specific immunoglobulin E antibodies to single or multiple potential allergens, 1 test (Item is subject to rule 25)$28.15
75% benefit $21.15
85% benefit $23.95
71081Quantitation of total haemolytic complement$42.60
75% benefit $31.95
85% benefit $36.25
71083Quantitation of complement components C3 and C4 or properdin factor B - 1 test$21.20
75% benefit $15.90
85% benefit $18.05
710852 tests described in item 71083$30.40
75% benefit $22.80
85% benefit $25.85
710873 or more tests described in item 71083$39.60
75% benefit $29.70
85% benefit $33.70
71089Quantitation of complement components or breakdown products of complement proteins not elsewhere described in an item in this Schedule - 1 test (Item is subject to rule 6)$30.65
75% benefit $23.00
85% benefit $26.10
71090A test described in item 71089, if rendered by a receiving APP, where no tests in the item have been rendered by the referring APP - 1 test (Item is subject to rule 6 and 18)$30.65
75% benefit $23.00
85% benefit $26.10
710912 tests described in item 71089 (Item is subject to rule 6)$55.50
75% benefit $41.65
85% benefit $47.20
71092Tests described in item 71089, other than that described in 71090, if rendered by a receiving APP - each test to a maximum of 2 tests (Item is subject to rule 6 and 18)$24.90
75% benefit $18.70
85% benefit $21.20
710933 or more tests described in item 71089 (Item is subject to rule 6)$80.35
75% benefit $60.30
85% benefit $68.30
71095Quantitation of serum or plasma eosinophil cationic protein, or both, to a maximum of 3 assays in 1 year, for monitoring the response to therapy in corticosteroid treated asthma, in a child aged less than 12 years$42.60
75% benefit $31.95
85% benefit $36.25
71096A test described in item 71095 if rendered by a receiving APP. (Item is subject to rule 18)$42.60
75% benefit $31.95
85% benefit $36.25
71097Antinuclear antibodies - detection in serum or other body fluids, including quantitation if required$25.70
75% benefit $19.30
85% benefit $21.85
71099New wording on 1 November 2026Double-stranded DNA antibodies - quantitation by one or more methods$27.85
75% benefit $20.90
85% benefit $23.70
71101Antibodies to 1 or more extractable nuclear antigens - detection in serum or other body fluids$18.25
75% benefit $13.70
85% benefit $15.55
71103Characterisation of an antibody detected in a service described in item 71101 (including that service)$54.70
75% benefit $41.05
85% benefit $46.50
71106Rheumatoid factor - detection by any technique in serum or other body fluids, including quantitation if required$11.85
75% benefit $8.90
85% benefit $10.10
71119Antibodies to tissue antigens not elsewhere specified in this Table - detection, including quantitation if required, of 1 antibody$18.20
75% benefit $13.65
85% benefit $15.50
71121Detection of 2 antibodies specified in item 71119$21.85
75% benefit $16.40
85% benefit $18.60
71123Detection of 3 antibodies specified in item 71119$25.50
75% benefit $19.15
85% benefit $21.70
71125Detection of 4 or more antibodies specified in item 71119$29.05
75% benefit $21.80
85% benefit $24.70
71127Functional tests for lymphocytes - quantitation other than by microscopy of: (a) proliferation induced by 1 or more mitogens; or (b) proliferation induced by 1 or more antigens; or (c) estimation of 1 or more mixed lymphocyte reactions; including a test described in item 65066 or 65070 (if performed), 1 of this item to a maximum of 2 in a 12 month period$185.30
75% benefit $139.00
85% benefit $157.55
711292 tests described in item 71127$228.90
75% benefit $171.70
85% benefit $194.60
711313 or more tests described in item 71127$272.45
75% benefit $204.35
85% benefit $231.60
71133Investigation of recurrent infection by qualitative assessment for the presence of defects in oxidative pathways in neutrophils by the nitroblue tetrazolium (NBT) reduction test$10.95
75% benefit $8.25
85% benefit $9.35
71134Investigation of recurrent infection by quantitative assessment of oxidative pathways by flow cytometric techniques, including a test described in 71133 (if performed)$109.30
75% benefit $82.00
85% benefit $92.95
71135Quantitation of neutrophil function, comprising at least 2 of the following: (a) chemotaxis; (b) phagocytosis; (c) oxidative metabolism; (d) bactericidal activity; including any test described in items 65066, 65070, 71133 or 71134 (if performed), 1 of this item to a maximum of 2 in a 12 month period$218.50
75% benefit $163.90
85% benefit $185.75
71137Quantitation of cell-mediated immunity by multiple antigen delayed type hypersensitivity intradermal skin testing using a minimum of 7 antigens, 1 of this item to a maximum of 2 in a 12 month period$31.80
75% benefit $23.85
85% benefit $27.05
71139Characterisation of 3 or more leucocyte surface antigens by immunofluorescence or immunoenzyme techniques to assess lymphoid or myeloid cell populations, including a total lymphocyte count or total leucocyte count by any method, on 1 or more specimens of blood, CSF or serous fluid$109.30
75% benefit $82.00
85% benefit $92.95
71141Characterisation of 3 or more leucocyte surface antigens by immunofluorescence or immunoenzyme techniques to assess lymphoid or myeloid cell populations on 1 or more disaggregated tissue specimens$207.35
75% benefit $155.55
85% benefit $176.25
71143Characterisation of 6 or more leucocyte surface antigens by immunofluorescence or immunoenzyme techniques to assess lymphoid or myeloid cell populations for the diagnosis (but not monitoring) of an immunological or haematological malignancy, including a service described in 1 or both of items 71139 and 71141 (if performed), on a specimen of blood, CSF, serous fluid or disaggregated tissue$273.15
75% benefit $204.90
85% benefit $232.20
71145Characterisation of 6 or more leucocyte surface antigens by immunofluorescence or immunoenzyme techniques to assess lymphoid or myeloid cell populations for the diagnosis (but not monitoring) of an immunological or haematological malignancy, including a service described in 1 or more of items 71139, 71141 and 71143 (if performed), on 2 or more specimens of disaggregated tissues or 1 specimen of disaggregated tissue and 1 or more specimens of blood, CSF or serous fluid$446.00
75% benefit $334.50
85% benefit $379.10
71146Enumeration of CD34+ cells, only for the purposes of autologous or directed allogeneic haemopoietic stem cell transplantation, including a total white cell count on the pherisis collection$109.30
75% benefit $82.00
85% benefit $92.95
71147HLA-B27 typing (Item is subject to rule 27)$42.60
75% benefit $31.95
85% benefit $36.25
71148A test described in item 71147 if rendered by a receiving APP. (Item is subject to rule 18 and 27)$42.60
75% benefit $31.95
85% benefit $36.25
71149Complete tissue typing for 4 HLA-A and HLA-B Class I antigens (including any separation of leucocytes), including (if performed) a service described in item 71147$113.75
75% benefit $85.35
85% benefit $96.70
71151Tissue typing for HLA-DR, HLA-DP and HLA-DQ Class II antigens (including any separation of leucocytes) - phenotyping or genotyping of 2 or more antigens$124.85
75% benefit $93.65
85% benefit $106.15
71153Investigations in the assessment or diagnosis of systemic inflammatory disease or vasculitis - antineutrophil cytoplasmic antibody immunofluorescence (ANCA test), antineutrophil proteinase 3 antibody (PR-3 ANCA test), antimyeloperoxidase antibody (MPO ANCA test) or antiglomerular basement membrane antibody (GBM test) - detection of 1 antibody (Item is subject to rule 6 and 23)$36.30
75% benefit $27.25
85% benefit $30.90
71154A test described in item 71153, if rendered by a receiving APP, where no tests in the item have been rendered by the referring APP - 1 test. (Item is subject to rule 6, 18 and 23)$36.30
75% benefit $27.25
85% benefit $30.90
71155Detection of 2 antibodies described in item 71153 (Item is subject to rule 6 and 23)$49.85
75% benefit $37.40
85% benefit $42.40
71156Tests described in item 71153, other than that described in 71154, if rendered by a receiving APP - each test to a maximum of 3 tests (Item is subject to rule 6, 18 and 23)$13.50
75% benefit $10.15
85% benefit $11.50
71157Detection of 3 antibodies described in item 71153 (Item is subject to rule 6 and 23)$63.35
75% benefit $47.55
85% benefit $53.85
71159Detection of 4 or more antibodies described in item 71153 (Item is subject to rule 6 and 23)$76.85
75% benefit $57.65
85% benefit $65.35
71163Detection of one of the following antibodies (of 1 or more class or isotype) in the assessment or diagnosis of coeliac disease or other gluten hypersensitivity syndromes and including a service described in item 71066 (if performed): a) Antibodies to gliadin; or b) Antibodies to endomysium; or c) Antibodies to tissue transglutaminase; - 1 test$26.00
75% benefit $19.50
85% benefit $22.10
71164Two or more tests described in 71163 and including a service described in 71066 (if performed)$41.90
75% benefit $31.45
85% benefit $35.65
71165Antibodies to tissue antigens (acetylcholine receptor, adrenal cortex, heart, histone, insulin, insulin receptor, intrinsic factor, islet cell, lymphocyte, neuron, ovary, parathyroid, platelet, salivary gland, skeletal muscle, skin basement membrane and intercellular substance, thyroglobulin, thyroid microsome or thyroid stimulating hormone receptor) - detection, including quantitation if required, of 1 antibody (Item is subject to rule 6)$36.30
75% benefit $27.25
85% benefit $30.90
71166Detection of 2 antibodies described in item 71165 (Item is subject to rule 6)$49.85
75% benefit $37.40
85% benefit $42.40
71167Detection of 3 antibodies described in item 71165 (Item is subject to rule 6)$63.35
75% benefit $47.55
85% benefit $53.85
71168Detection of 4 or more antibodies described in item 71165 (Item is subject to rule 6)$76.85
75% benefit $57.65
85% benefit $65.35
71169A test described in item 71165, if rendered by a receiving APP, where no tests in the item have been rendered by the referring APP - 1 test (Item is subject to rule 6 and 18)$36.30
75% benefit $27.25
85% benefit $30.90
71170Tests described in item 71165, other than that described in 71169, if rendered by a receiving APP - each test to a maximum of 3 tests (Item is subject to rule 6 and 18)$13.50
75% benefit $10.15
85% benefit $11.50
71175A test, requested by a specialist or consultant physician, to diagnose neuromyelitis optica spectrum disorder (NMOSD) or myelin oligodendrocyte glycoprotein antibody‑related demyelination (MARD), by the detection of one or more antibodies, for a patient: suspected of having NMOSD or MARD; and with any of the following: recurrent, bilateral or severe optic neuritis; recurrent longitudinal extensive transverse myelitis (LETM); area postrema syndrome (unexplained hiccups, nausea or vomiting); acute brainstem syndrome; symptomatic narcolepsy or acute diencephalic clinical syndrome with typical NMOSD magnetic resonance imaging lesions; symptomatic cerebral syndrome with typical NMOSD magnetic resonance imaging lesions; monophasic neuromyelitis optica (no recurrence, and simultaneous or closely related optic neuritis and LETM within 30 days of each other); acute disseminated encephalomyelitis; aseptic meningitis and encephalomyelitis; poor recovery from multiple sclerosis relapses Applicable not more than 4 times in 12 months$52.55
75% benefit $39.45
85% benefit $44.70
71180Antibody to cardiolipin or beta-2 glycoprotein I - detection, including quantitation if required; one antibody specificity (IgG or IgM)$36.30
75% benefit $27.25
85% benefit $30.90
71183Detection of two antibodies described in item 71180$49.85
75% benefit $37.40
85% benefit $42.40
71186Detection of three or more antibodies described in item 71180$63.35
75% benefit $47.55
85% benefit $53.85
71189Detection of specific IgG antibodies to 1 or more respiratory disease allergens not elsewhere specified.$16.25
75% benefit $12.20
85% benefit $13.85
711922 items described in item 71189.$29.80
75% benefit $22.35
85% benefit $25.35
711953 or more items described in item 71189.$42.05
75% benefit $31.55
85% benefit $35.75
71198Estimation of serum tryptase for the evaluation of unexplained acute hypotension or suspected anaphylactic event, assessment of risk in stinging insect anaphylaxis, exclusion of mastocytosis, monitoring of known mastocytosis.$42.60
75% benefit $31.95
85% benefit $36.25
71200Detection and quantitation, if present, of free kappa and lambda light chains in serum for the diagnosis or monitoring of amyloidosis, myeloma or plasma cell dyscrasias.$62.65
75% benefit $47.00
85% benefit $53.30
71202Measurable residual disease (MRD) testing by flow cytometry, performed on bone marrow from a patient diagnosed with acute lymphoblastic leukaemia, for the purpose of determining baseline MRD, or facilitating the determination of MRD following combination chemotherapy or after salvage therapy, requested by a specialist or consultant physician practising as a haematologist or oncologist$577.85
75% benefit $433.40
85% benefit $491.20
71203Determination of HLAB5701 status by flow cytometry or cytotoxity assay prior to the initiation of Abacavir therapy including item 73323 if performed.$42.60
75% benefit $31.95
85% benefit $36.25

P5 Tissue Pathology

28 items

ItemDescriptionFee and benefits
72813Examination of complexity level 2 biopsy material with 1 or more tissue blocks, including specimen dissection, all tissue processing, staining, light microscopy and professional opinion or opinions - 1 or more separately identified specimens (Item is subject to rule 13)$75.10
75% benefit $56.35
85% benefit $63.85
72814Immunohistochemical examination by immunoperoxidase or other labelled antibody techniques using the programmed cell death ligand 1 (PD‑L1) antibody of tumour material from a patient diagnosed with: (a) non‑small cell lung cancer; or (b) recurrent or metastatic squamous cell carcinoma of the oral cavity, pharynx or larynx; or (c) locally recurrent unresectable or metastatic triple-negative breast cancer.$78.30
75% benefit $58.75
85% benefit $66.60
72816Examination of complexity level 3 biopsy material with 1 or more tissue blocks, including specimen dissection, all tissue processing, staining, light microscopy and professional opinion or opinions - 1 separately identified specimen (Item is subject to rule 13)$90.70
75% benefit $68.05
85% benefit $77.10
72817Examination of complexity level 3 biopsy material with 1 or more tissue blocks, including specimen dissection, all tissue processing, staining, light microscopy and professional opinion or opinions - 2 to 4 separately identified specimens (Item is subject to rule 13)$101.70
75% benefit $76.30
85% benefit $86.45
72818Examination of complexity level 3 biopsy material with 1 or more tissue blocks, including specimen dissection, all tissue processing, staining, light microscopy and professional opinion or opinions - 5 or more separately identified specimens (Item is subject to rule 13)$112.45
75% benefit $84.35
85% benefit $95.60
72823Examination of complexity level 4 biopsy material with 1 or more tissue blocks, including specimen dissection, all tissue processing, staining, light microscopy and professional opinion or opinions - 1 separately identified specimen (Item is subject to rule 13)$102.10
75% benefit $76.60
85% benefit $86.80
72824Examination of complexity level 4 biopsy material with 1 or more tissue blocks, including specimen dissection, all tissue processing, staining, light microscopy and professional opinion or opinions - 2 to 4 separately identified specimens (Item is subject to rule 13)$148.50
75% benefit $111.40
85% benefit $126.25
72825Examination of complexity level 4 biopsy material with 1 or more tissue blocks, including specimen dissection, all tissue processing, staining, light microscopy and professional opinion or opinions - 5 to 7 separately identified specimens (Item is subject to rule 13)$189.40
75% benefit $142.05
85% benefit $161.00
72826Examination of complexity level 4 biopsy material with 1 or more tissue blocks, including specimen dissection, all tissue processing, staining, light microscopy and professional opinion or opinions - 8 to 11 separately identified specimens (Item is subject to rule 13)$204.45
75% benefit $153.35
85% benefit $173.80
72827Examination of complexity level 4 biopsy material with 1 or more tissue blocks, including specimen dissection, all tissue processing, staining, light microscopy and professional opinion or opinions - 12 to 17 separately identified specimens (Item is subject to Rule 13)$219.50
75% benefit $164.65
85% benefit $186.60
72828Examination of complexity level 4 biopsy material with 1 or more tissue blocks, including specimen dissection, all tissue processing, staining, light microscopy and professional opinion or opinions - 18 or more separately identified specimens (Item is subject to Rule 13)$234.60
75% benefit $175.95
85% benefit $199.45
72830Examination of complexity level 5 biopsy material with 1 or more tissue blocks, including specimen dissection, all tissue processing, staining, light microscopy and professional opinion or opinions - 1 or more separately identified specimens (Item is subject to rule 13)$288.05
75% benefit $216.05
85% benefit $244.85
72836Examination of complexity level 6 biopsy material with 1 or more tissue blocks, including specimen dissection, all tissue processing, staining, light microscopy and professional opinion or opinions - 1 or more separately identified specimens (Item is subject to rule 13)$438.30
75% benefit $328.75
85% benefit $372.60
72838Examination of complexicity level 7 biopsy material with multiple tissue blocks, including specimen dissection, all tissue processing, staining, light microscopy and professional opinion or opinions - 1 or more separately identified specimens. (Item is subject to rule 13)$490.50
75% benefit $367.90
85% benefit $416.95
72844Enzyme histochemistry of skeletal muscle for investigation of primary degenerative or metabolic muscle diseases or of muscle abnormalities secondary to disease of the central or peripheral nervous system - 1 or more tests$32.30
75% benefit $24.25
85% benefit $27.50
72846Immunohistochemical examination of biopsy material by immunofluorescence, immunoperoxidase or other labelled antibody techniques with multiple antigenic specificities per specimen - 1 to 3 antibodies except those listed in 72848 (Item is subject to rule 13)$62.65
75% benefit $47.00
85% benefit $53.30
72847Immunohistochemical examination of biopsy material by immunofluorescence, immunoperoxidase or other labelled antibody techniques with multiple antigenic specificities per specimen - 4-6 antibodies (Item is subject to rule 13)$93.95
75% benefit $70.50
85% benefit $79.90
72848Immunohistochemical examination of biopsy material by immunofluorescence, immunoperoxidase or other labelled antibody techniques with multiple antigenic specificities per specimen - 1 to 3 of the following antibodies - oestrogen, progesterone and c-erb-B2 (HER2) (Item is subject to rule 13)$78.30
75% benefit $58.75
85% benefit $66.60
72849Immunohistochemical examination of biopsy material by immunofluorescence, immunoperoxidase or other labelled antibody techniques with multiple antigenic specificities per specimen - 7-10 antibodies (Item is subject to rule 13)$109.60
75% benefit $82.20
85% benefit $93.20
72850Immunohistochemical examination of biopsy material by immunofluorescence, immunoperoxidase or other labelled antibody techniques with multiple antigenic specificities per specimen - 11 or more antibodies (Item is subject to rule 13)$125.20
75% benefit $93.90
85% benefit $106.45
72851Electron microscopic examination of biopsy material - 1 separately identified specimen (Item is subject to rule 13)$593.60
75% benefit $445.20
85% benefit $504.60
72852New 85% benefit on 1 November 2026Electron microscopic examination of biopsy material - 2 or more separately identified specimens (Item is subject to rule 13)$791.10
75% benefit $593.35
85% benefit $682.60 was $686.60
72855Intraoperative consultation and examination of biopsy material by frozen section or tissue imprint or smear - 1 separately identified specimen (Item is subject to rule 13)$193.65
75% benefit $145.25
85% benefit $164.65
72856Intraoperative consultation and examination of biopsy material by frozen section or tissue imprint or smear - 2 to 4 separately identified specimens (Item is subject to rule 13)$258.25
75% benefit $193.70
85% benefit $219.55
72857Intraoperative consultation and examination of biopsy material by frozen section or tissue imprint or smear - 5 or more separately identified specimens (Item is subject to rule 13)$301.30
75% benefit $226.00
85% benefit $256.15
72858A second opinion, provided in a written report, where the opinion and report together require no more than 30 minutes to complete, on a patient specimen, requested by a treating practitioner, where further information is needed for accurate diagnosis and appropriate patient management.$189.10
75% benefit $141.85
85% benefit $160.75
72859A second opinion, provided in a written report, where the opinion and report together require more than 30 minutes to complete, on a patient specimen, requested by a treating practitioner, where further information is needed for accurate diagnosis and appropriate patient management.$388.75
75% benefit $291.60
85% benefit $330.45
72860Retrieval and review of one or more archived formalin fixed paraffin embedded blocks to determine the appropriate samples for the purpose of conducting genetic testing, other than: (a) a service associated with a service to which item 72858 or 72859 applies; or (b) a service associated with, and rendered in the same patient episode as, a service to which an item in Group P5, P6, P10 or P11 applies Applicable not more than once in a patient episode$89.30
75% benefit $67.00
85% benefit $75.95

P6 Cytology

20 items

ItemDescriptionFee and benefits
73043Cytology (including serial examinations) of nipple discharge or smears from skin, lip, mouth, nose or anus for detection of precancerous or cancerous changes 1 or more tests$24.00
75% benefit $18.00
85% benefit $20.40
73045Cytology (including serial examinations) for malignancy (other than an examination mentioned in item 73076); and including any Group P5 service, if performed on: (a) specimens resulting from washings or brushings from sites not specified in item 73043; or (b) a single specimen of sputum or urine; or (c) 1 or more specimens of other body fluids; 1 or more tests$51.05
75% benefit $38.30
85% benefit $43.40
73047Cytology of a series of 3 sputum or urine specimens for malignant cells$99.45
75% benefit $74.60
85% benefit $84.55
73049Cytology of material obtained directly from a patient by fine needle aspiration of solid tissue or tissues - 1 identified site$71.60
75% benefit $53.70
85% benefit $60.90
73051Cytology of material obtained directly from a patient at one identified site by fine needle aspiration of solid tissue or tissues if a recognized pathologist: (a) performs the aspiration; or (b) attends the aspiration and performs cytological examination during the attendance$179.00
75% benefit $134.25
85% benefit $152.15
73059Immunocytochemical examination of material obtained by procedures described in items 73045, 73047, 73049, 73051, 73062, 73063, 73066 and 73067 for the characterisation of a malignancy by immunofluorescence, immunoperoxidase or other labelled antibody techniques with multiple antigenic specificities per specimen - 1 to 3 antibodies except those listed in 73061 (Item is subject to rule 13)$45.20
75% benefit $33.90
85% benefit $38.45
73060Immunocytochemical examination of material obtained by procedures described in items 73045, 73047, 73049, 73051, 73062, 73063, 73066 and 73067 for the characterisation of a malignancy by immunofluorescence, immunoperoxidase or other labelled antibody techniques with multiple antigenic specificities per specimen - 4 to 6 antibodies (Item is subject to rule 13)$60.30
75% benefit $45.25
85% benefit $51.30
73061Immunocytochemical examination of material obtained by procedures described in items 73045, 73047, 73049, 73051, 73062, 73063, 73066 and 73067 for the characterisation of a malignancy by immunofluorescence, immunoperoxidase or other labelled antibody techniques with multiple antigenic specificities per specimen - 1 to 3 of the following antibodies - oestrogen, progesterone and c-erb-B2 (HER2) (Item is subject to rule 13)$53.80
75% benefit $40.35
85% benefit $45.75
73062Cytology of material obtained directly from a patient by fine needle aspiration of solid tissue or tissues - 2 or more separately identified sites.$93.50
75% benefit $70.15
85% benefit $79.50
73063Cytology of material obtained directly from a patient at one identified site by fine needle aspiration of solid tissue or tissues if an employee of an approved pathology authority attends the aspiration for confirmation of sample adequacy$104.40
75% benefit $78.30
85% benefit $88.75
73064Immunocytochemical examination of material obtained by procedures described in items 73045, 73047, 73049, 73051, 73062, 73063, 73066 and 73067 for the characterisation of a malignancy by immunofluorescence, immunoperoxidase or other labelled antibody techniques with multiple antigenic specificities per specimen - 7 to 10 antibodies (Item is subject to rule 13)$75.30
75% benefit $56.50
85% benefit $64.05
73065Immunocytochemical examination of material obtained by procedures described in items 73045, 73047, 73049, 73051, 73062, 73063, 73066 and 73067 for the characterisation of a malignancy by immunofluorescence, immunoperoxidase or other labelled antibody techniques with multiple antigenic specificities per specimen - 11 or more antibodies (Item is subject to rule 13)$90.35
75% benefit $67.80
85% benefit $76.80
73066Cytology of material obtained directly from a patient at 2 or more separately identified sites by fine needle aspiration of solid tissue or tissues if a recognized pathologist: (a) performs the aspiration; or (b) attends the aspiration and performs cytological examination during the attendance$232.65
75% benefit $174.50
85% benefit $197.80
73067Cytology of material obtained directly from a patient at 2 or more separately identified sites by fine needle aspiration of solid tissue or tissues if an employee of an approved pathology authority attends the aspiration for confirmation of sample adequacy$135.70
75% benefit $101.80
85% benefit $115.35
7307073070 A test, including partial genotyping, for oncogenic human papillomavirus that may be associated with cervical pre‑cancer or cancer: (a) performed on a liquid based cervical specimen; and (b) for an asymptomatic patient who is at least 24 years and 9 months of age For any particular patient, once only in a 57 month period$36.80
75% benefit $27.60
85% benefit $31.30
73071A test, including partial genotyping, for oncogenic human papillomavirus that may be associated with cervical pre‑cancer or cancer, if performed: (a) on a self‑collected vaginal specimen; and (b) for an asymptomatic patient who is at least 24 years and 9 months of age For any particular patient, applicable once in 57 months$36.80
75% benefit $27.60
85% benefit $31.30
73072A test, including partial genotyping, for oncogenic human papillomavirus: (a) for the investigation of a patient in a specific population that appears to have a higher risk of cervical pre‑cancer or cancer; or (b) for the follow‑up management of a patient with a previously detected oncogenic human papillomavirus infection or cervical pre‑cancer or cancer; or (c) for the investigation of a patient with symptoms suggestive of cervical cancer; or (d) for the follow‑up management of a patient after treatment of high grade squamous intraepithelial lesions or adenocarcinoma in situ of the cervix; or (e) for the follow‑up management of a patient with glandular abnormalities; or (f) for the follow‑up management of a patient exposed to diethylstilboestrol in utero; or (g) for a patient previously treated for a genital tract malignancy when performed as a co-test for both human papillomavirus (HPV) and liquid-based cytology (LBC).$36.80
75% benefit $27.60
85% benefit $31.30
73074A test, including partial genotyping, for oncogenic human papillomavirus, for the investigation of a patient following a total hysterectomy.$36.80
75% benefit $27.60
85% benefit $31.30
73075A test, including partial genotyping, for oncogenic human papillomavirus, if: (a) the test is a repeat of a test to which item 73070, 73071, 73072, 73074 or this item applies; and (b) the specimen collected for the previous test is unsatisfactory$36.80
75% benefit $27.60
85% benefit $31.30
73076Cytology of a liquid‑based cervical or vaginal vault specimen, where the stained cells are examined microscopically or by automated image analysis by or on behalf of a pathologist, if: (a) the cytology is associated with the detection of oncogenic human papillomavirus infection by: (i) a test to which item 73070, 73071, 73074 or 73075 applies; or (ii) a test to which item 73072 applies for a patient mentioned in paragraph (a) or (b) of that item; or (b) the cytology is associated with a test to which item 73072 applies for a patient mentioned in paragraph (c), (d), (e) or (f) of that item; or (c) the cytology is associated with a test to which item 73074 applies; or (d) the test is a repeat of a test to which this item applies, if the specimen collected for the previous test is unsatisfactory; or (e) the cytology is for the follow‑up management of a patient treated for endometrial adenocarcinoma$48.30
75% benefit $36.25
85% benefit $41.10

P7 Genetics

165 items

ItemDescriptionFee and benefits
73287The study of the whole of every chromosome by cytogenetic or other techniques, performed on 1 or more of any tissue or fluid except blood (including a service mentioned in item 73293, if performed) - 1 or more tests$394.55
75% benefit $295.95
85% benefit $335.40
73289The study of the whole of every chromosome by cytogenetic or other techniques, performed on blood (including a service mentioned in item 73293, if performed) - 1 or more tests$358.95
75% benefit $269.25
85% benefit $305.15
73290The study of the whole of each chromosome by cytogenetic or other techniques, performed on blood or bone marrow, in the diagnosis and monitoringof haematological malignancy (including a service in items 73287 or 73289, if performed). - 1 or more tests.$394.55
75% benefit $295.95
85% benefit $335.40
73291Analysis of one or more chromosome regions for specific constitutional genetic abnormalities of blood or fresh tissue in a) diagnostic studies of a person with developmental delay, intellectual disability, autism, or at least two congenital abnormalities, in whom cytogenetic studies (item 73287 or 73289) are either normal or have not been performed; or b) studies of a relative for an abnormality previously identified in such an affected person. - 1 or more tests.$230.95
75% benefit $173.25
85% benefit $196.35
73292Analysis of chromosomes by genome-wide micro-array including targeted assessment of specific regions for constitutional genetic abnormalities in diagnostic studies of a person with developmental delay, intellectual disability, autism, or at least two congenital abnormalities (including a service in items 73287, 73289 or 73291, if performed) - 1 or more tests.$589.90
75% benefit $442.45
85% benefit $501.45
73293Analysis of one or more regions on all chromosomes for specific constitutional genetic abnormalities of fresh tissue in diagnostic studies of the products of conception, including exclusion of maternal cell contamination. - 1 or more tests.$230.95
75% benefit $173.25
85% benefit $196.35
73294Analysis of the PMP22 gene for constitutional genetic abnormalities causing peripheral neuropathy, either as: a) diagnostic studies of an affected person; or b) studies of a relative for an abnormality previously identified in an affected person - 1 or more tests.$230.95
75% benefit $173.25
85% benefit $196.35
73295New 85% benefit on 1 November 2026Detection of germline BRCA1 or BRCA2 pathogenic or likely pathogenic gene variants, requested by a specialist or consultant physician, to determine eligibility for a relevant treatment under the Pharmaceutical Benefits Scheme (PBS), in a patient with: (a) advanced (FIGO III‑IV) high‑grade serous or high‑grade epithelial ovarian, fallopian tube or primary peritoneal cancer for whom testing of tumour tissue is not feasible; or (b) breast cancer. Applicable once per lifetime$1,200.00
75% benefit $900.00
85% benefit $1,091.50 was $1,095.50
73296New 85% benefit on 1 November 2026Characterisation of germline gene variants, including copy number variation where appropriate, requested by a specialist or consultant physician: (a) in genes associated with breast, ovarian, fallopian tube or primary peritoneal cancer, which must include at least: (i) BRCA1 and BRCA 2 genes; and (ii) one or more other relevant genes; and (b) in a patient: (i) with breast, ovarian, fallopian tube or primary peritoneal cancer; and (ii) for whom clinical and family history criteria place the patient at greater than 10% risk of having a pathogenic or likely pathogenic gene associated with breast, ovarian, fallopian tube or primary peritoneal cancer Once per cancer diagnosis$1,200.00
75% benefit $900.00
85% benefit $1,091.50 was $1,095.50
73297Characterisation of germline gene variants, including copy number variation where appropriate, requested by a specialist or consultant physician: (a) in genes associated with breast, ovarian, fallopian tube or primary peritoneal cancer, which may include the following genes: (i) BRCA1 or BRCA2; (ii) one or more other relevant genes; and (b) in a patient: (i) who has a biological relative who has had a pathogenic or likely pathogenic gene variant identified in one or more of the genes mentioned in paragraph (a); and (ii) who has not previously received a service to which item 73295, 73296 or 73302 applies Once per variant$400.00
75% benefit $300.00
85% benefit $340.00
73298New 85% benefit on 1 November 2026Characterisation of germline gene variants in the following genes: (a) COL4A3; and (b) COL4A4; and (c) COL4A5; in a patient for whom clinical and relevant family history criteria have been assessed by a specialist or consultant physician, who requests the service to be strongly suggestive of Alport syndrome.$1,200.00
75% benefit $900.00
85% benefit $1,091.50 was $1,095.50
73299Characterisation of germline gene variants: (a) in the following genes: (i) COL4A3; and (ii) COL4A4; and (iii) COL4A5; (b) in a patient who: (i) is a first degree biological relative of a patient who has had a pathogenic mutation identified in one or more of the genes mentioned in subparagraphs (a)(i), (ii) and (iii); and (ii) has not previously received a service which item 73298 applies; requested by a specialist or consultant physician.$400.00
75% benefit $300.00
85% benefit $340.00
73300Detection of mutation of the FMR1 gene where: (a) the patient exhibits intellectual disability, ataxia, neurodegeneration, or premature ovarian failure consistent with an FMRI mutation; or (b) the patient has a relative with a FMR1 mutation 1 or more tests$101.30
75% benefit $76.00
85% benefit $86.15
73301New 85% benefit on 1 November 2026A test of tumour tissue from a patient with advanced (FIGO III-IV), high grade serous or high grade epithelial ovarian, fallopian tube or primary peritoneal cancer, requested by a specialist or consultant physician, to determine eligibility relating to BRCA status for access to treatment with a poly (adenosine diphosphate [ADP]-ribose) polymerase (PARP) inhibitor under the Pharmaceutical Benefits Scheme (PBS) Applicable once per primary tumour diagnosis$1,200.00
75% benefit $900.00
85% benefit $1,091.50 was $1,095.50
73302Characterisation of germline gene variants including copy number variants, in BRCA1 or BRCA2 genes, in a patient who has had a pathogenic or likely pathogenic variant identified in either gene by tumour testing and who has not previously received a service to which items 73295, 73296 or 73297 applies, requested by a specialist or consultant physician. Applicable once per primary tumour diagnosis$400.00
75% benefit $300.00
85% benefit $340.00
73303New 85% benefit on 1 November 2026A test of tumour tissue from a patient with metastatic castration-resistant prostate cancer, including subsequent characterisation of germline gene variants should tumour tissue testing undertaken during the same service be inconclusive, requested by a specialist or consultant physician, to determine eligibility relating to BRCA status for access to a relevant treatment under the Pharmaceutical Benefits Scheme; Applicable once per primary tumour diagnosis$1,000.00
75% benefit $750.00
85% benefit $891.50 was $895.50
73304New 85% benefit on 1 November 2026Detection of germline BRCA1 or BRCA2 pathogenic or likely pathogenic gene variants, in a patient with metastatic castration‑resistant prostate cancer, for whom testing of tumour tissue is not clinically feasible, requested by a specialist or consultant physician, to determine eligibility for a relevant treatment under the Pharmaceutical Benefits Scheme; Applicable once per lifetime$1,000.00
75% benefit $750.00
85% benefit $891.50 was $895.50
73305Detection of mutation of the FMR1 gene by Southern Blot analysis where the results in item 73300 are inconclusive$202.65
75% benefit $152.00
85% benefit $172.30
73306New 85% benefit on 1 November 2026Gene expression profiling testing using EndoPredict, for the purpose of profiling gene expression in formalin‑fixed, paraffin‑embedded primary breast cancer tissue from core needle biopsy or surgical tumour sample to estimate the risk of distant recurrence of breast cancer within 10 years, if: (a) the sample is from a new primary breast cancer, which is suitable for adjuvant chemotherapy; and (b) the sample has been determined to be oestrogen receptor positive and HER2 negative by IHC and ISH respectively on surgically removed tumour; and (c) the sample is axillary node negative or positive (up to 3 nodes) with a tumour size of at least 1 cm and no more than 5 cm determined by histopathology on surgically removed tumour; and (d) the sample has no evidence of distal metastasis; and (e) pre‑testing of intermediate risk of distant metastases has shown that the tumour is defined by at least one of the following characteristics: (i) histopathological grade 2 or 3; (ii) one to 3 lymph nodes involved in metastatic disease (including micrometastases but not isolated tumour cells); and (f) the service is not administered for the purpose of altering treatment decisions Applicable once per new primary breast cancer diagnosis for any particular patient$1,200.00
75% benefit $900.00
85% benefit $1,091.50 was $1,095.50
73307New 85% benefit on 1 November 2026A test of tumour tissue from a patient with advanced (FIGO III-IV), high-grade serous or other high-grade ovarian, fallopian tube or primary peritoneal carcinoma, requested by a specialist or consultant physician, if the test is: (a) to determine eligibility with respect to homologous recombination deficiency (HRD) status, including BRCA1 or BRCA2 status, to provide access to poly (adenosine diphosphate [ADP]-ribose) polymerase (PARP) inhibitor therapy under the Pharmaceutical Benefits Scheme; and (b) including a service described in item 73301 Applicable once per primary tumour diagnosis$3,000.00
75% benefit $2,250.00
85% benefit $2,891.50 was $2,895.50
73308Characterisation of the genotype of a patient for Factor V Leiden gene mutation, or detection of the other relevant mutations in the investigation of proven venous thrombosis or pulmonary embolism - 1 or more tests$36.45
75% benefit $27.35
85% benefit $31.00
73309A test described in item 73308, if rendered by a receiving APP - 1 or more tests (Item is subject to rule 18)$36.45
75% benefit $27.35
85% benefit $31.00
73310New 85% benefit on 1 November 2026Measurable residual disease (MRD) testing by next-generation sequencing, performed on bone marrow (or a peripheral blood sample if bone marrow cannot be collected) from a patient diagnosed with acute lymphoblastic leukaemia, for the purpose of determining baseline MRD, or facilitating the determination of MRD following combination chemotherapy or after salvage therapy, requested by a specialist or consultant physician practising as a haematologist or oncologist$1,550.00
75% benefit $1,162.50
85% benefit $1,441.50 was $1,445.50
73311Characterisation of the genotype of a person who is a first degree relative of a person who has proven to have 1 or more abnormal genotypes under item 73308 - 1 or more tests$36.45
75% benefit $27.35
85% benefit $31.00
73312A test described in item 73311, if rendered by a receiving APP - 1 or more tests (Item is subject to rule 18)$36.45
75% benefit $27.35
85% benefit $31.00
73313New 85% benefit on 1 November 2026Development of a quantitative patient‑specific molecular assay for measurable residual disease (MRD) testing performed on bone marrow (or a peripheral blood sample if bone marrow cannot be collected) from a patient diagnosed with acute lymphoblastic leukaemia treated with combination chemotherapy or after salvage therapy, including the first service described in item 73316 performed on that bone marrow or peripheral blood sample, requested by a specialist or consultant physician practising as a haematologist or oncologist Applicable once per patient per episode of disease or per relapse$3,000.00
75% benefit $2,250.00
85% benefit $2,891.50 was $2,895.50
73314Characterisation of gene rearrangement or the identification of mutations within a known gene rearrangement, in the diagnosis and monitoring of patients with laboratory evidence of: (a) acute myeloid leukaemia; or (b) acute promyelocytic leukaemia; or (c) acute lymphoid leukaemia; or (d) chronic myeloid leukaemia;$230.95
75% benefit $173.25
85% benefit $196.35
73315A test described in item 73314, if rendered by a receiving APP - 1 or more tests (Item is subject to rule 18)$230.95
75% benefit $173.25
85% benefit $196.35
73316New 85% benefit on 1 November 2026Measurable residual disease (MRD) testing by a quantitative patient-specific molecular assay performed on bone marrow (or, in a patient with T-cell acute lymphoblastic leukaemia, performed on a peripheral blood sample if bone marrow cannot be collected) from a patient diagnosed with acute lymphoblastic leukaemia treated with combination chemotherapy or after salvage therapy, requested by a specialist or consultant physician practising as a haematologist or oncologist, other than a service associated with a service to which item 73313 applies$780.00
75% benefit $585.00
85% benefit $671.50 was $675.50
73317Detection of the C282Y genetic mutation of the HFE gene and, if performed, detection of other mutations for haemochromatosis where: (a) the patient has an elevated transferrin saturation or elevated serum ferritin on testing of repeated specimens; or (b) the patient has a first degree relative with haemochromatosis; or (c) the patient has a first degree relative with homozygosity for the C282Y genetic mutation, or with compound heterozygosity for recognised genetic mutations for haemochromatosis (Item is subject to rule 20)$36.45
75% benefit $27.35
85% benefit $31.00
73318A test described in item 73317, if rendered by a receiving APP - 1 or more tests (Item is subject to rule 18 and 20)$36.45
75% benefit $27.35
85% benefit $31.00
73319Detection in tumour tissue of isocitrate dehydrogenase 1 (IDH1) variant status, in a patient with histologically confirmed cholangiocarcinoma, to determine eligibility for a relevant treatment listed under the Pharmaceutical Benefits Scheme. Applicable only once per lifetime$340.00
75% benefit $255.00
85% benefit $289.00
73320Detection of HLA-B27 by nucleic acid amplification includes a service described in 71147 unless the service in item 73320 is rendered as a pathologist determinable service. (Item is subject to rule 27)$40.55
75% benefit $30.45
85% benefit $34.50
73321A test described in item 73320, if rendered by a receiving APP - 1 or more tests. (Item is subject to rule 18 and 27)$40.55
75% benefit $30.45
85% benefit $34.50
73322Genetic testing in the DPYD gene to diagnose or predict fluoropyrimidine-induced toxicity in a patient, if: (a) the service is requested by a specialist or consultant physician; and (b) the service is rendered before, during or after systemic administration of chemotherapy or radio-sensitisation, with a fluoropyrimidine, to the patient; and (c) genotyping is performed to detect DPYD variants linked to reduced or absent dihydropyrimidine dehydrogenase activity Applicable once per lifetime$186.75
75% benefit $140.10
85% benefit $158.75
73323Determination of HLAB5701 status by molecular techniques prior to the initiation of Abacavir therapy including item 71203 if performed.$40.55
75% benefit $30.45
85% benefit $34.50
73324A test described in item 73323 if rendered by a receiving APP 1 or more tests (Item is subject to Rule 18)$40.95
75% benefit $30.75
85% benefit $34.85
73325Determination of JAK2 V617F variant allele frequency in the diagnostic work‑up by, or on behalf of, a specialist or consultant physician, for a patient with clinical and laboratory evidence of a myeloproliferative neoplasm$90.00
75% benefit $67.50
85% benefit $76.50
73326Characterisation of the gene rearrangement FIP1L1-PDGFRA in the diagnostic work-up and management of a patient with laboratory evidence of: a) mast cell disease; or b) idiopathic hypereosinophilic syndrome; or c) chronic eosinophilic leukaemia;. 1 or more tests$230.95
75% benefit $173.25
85% benefit $196.35
73327Detection of genetic polymorphisms in the Thiopurine S-methyltransferase gene for the prevention of dose-related toxicity during treatment with thiopurine drugs; including (if performed) any service described in item 65075. 1 or more tests$51.95
75% benefit $39.00
85% benefit $44.20
73329New 85% benefit on 1 November 2026A nucleic acid-based multi-gene panel test of tumour tissue from a patient with cholangiocarcinoma requested by, or on behalf of, a specialist or consultant physician, if the test is to: (a) detect at least IDH1 variant status, and (b) detect the fusion or rearrangement status of at least FGFR2; and (c) determine eligibility for a relevant treatment under the Pharmaceutical Benefits Scheme including a service described in item 73319. Applicable once per lifetime.$800.00
75% benefit $600.00
85% benefit $691.50 was $695.50
73331A test of tumour tissue from a patient with histologically confirmed medullary thyroid cancer requested by, or on behalf of, a specialist or consultant physician if the test is:(a) to detect variants relating to at least the RET gene activating variant status, and (b) to determine eligibility for a relevant treatment listed on the Pharmaceutical Benefits Scheme$400.00
75% benefit $300.00
85% benefit $340.00
73332An in situ hybridization (ISH) test of tumour tissue from a patient with breast cancer requested by, or on the advice of, a specialist or consultant physician who manages the treatment of the patient to determine if the requirements relating to human epidermal growth factor receptor 2 (HER2) gene amplification for access to trastuzumab under the Pharmaceutical Benefits Scheme (PBS) or the Herceptin Program are fulfilled.$315.40
75% benefit $236.55
85% benefit $268.10
73333Detection of germline mutations of the von Hippel‑Lindau (VHL) gene: (a) in a patient who has a clinical diagnosis of VHL syndrome and: (i) a family history of VHL syndrome and one of the following: (A) haemangioblastoma (retinal or central nervous system); (B) phaeochromocytoma; (C) renal cell carcinoma; or (ii) 2 or more haemangioblastomas; or (iii) one haemangioblastoma and a tumour or a cyst of: (A) the adrenal gland; or (B) the kidney; or (C) the pancreas; or (D) the epididymis; or (E) a broad ligament (other than epididymal and single renal cysts, which are common in the general population); or (b) in a patient presenting with one or more of the following clinical features suggestive of VHL syndrome: (i) haemangiblastomas of the brain, spinal cord, or retina; (ii) phaeochromocytoma; (iii) functional extra‑adrenal paraganglioma$600.00
75% benefit $450.00
85% benefit $510.00
73334Detection of germline mutations of the von Hippel-Lindau (VHL) gene in biological relatives of a patient with a known mutation in the VHL gene$340.00
75% benefit $255.00
85% benefit $289.00
73335Detection of somatic mutations of the von Hippel-Lindau (VHL) gene in a patient with: (a) 2 or more tumours comprising: (i) 2 or more haemangioblastomas, or (ii) one haemangioblastoma and a tumour of: (A) the adrenal gland; or (B) the kidney; or (C) the pancreas; or (D) the epididymis; and (b) no germline mutations of the VHL gene identified by genetic testing$470.00
75% benefit $352.50
85% benefit $399.50
73336A test of tumour tissue from a patient with stage III or stage IV metastatic cutaneous melanoma, requested by, or on behalf of, a specialist or consultant physician, to determine if the requirements relating to BRAF V600 mutation status for access to dabrafenib, vemurafenib or encorafenib under the Pharmaceutical Benefits Scheme are fulfilled.$230.95
75% benefit $173.25
85% benefit $196.35
73337A test of tumour tissue from a patient with a new diagnosis of non-small cell lung cancer, requested by, or on behalf of, a specialist or consultant physician, if the test is: (a) for epidermal growth factor receptor (EGFR) status to determine eligibility for a relevant treatment under the Pharmaceutical Benefits Scheme; and (b) not associated with a service to which item 73437 or 73438 applies$397.35
75% benefit $298.05
85% benefit $337.75
73338A test of tumour tissue from a patient with metastatic colorectal cancer (stage IV), requested by a specialist or consultant physician, to determine if: (a) requirements relating to rat sarcoma oncogene (RAS) gene variant status for access to cetuximab or panitumumab under the Pharmaceutical Benefits Scheme are fulfilled, if: the test is conducted for all clinically relevant mutations on KRAS exons 2, 3 and 4 and NRAS exons 2, 3, and 4; or a clinically-relevant RAS variant is detected; and, in cases where no RAS variant is detected (b) the requirements relating to BRAF V600 gene variant status for access to encorafenib under the Pharmaceutical Benefits Scheme are fulfilled.$362.60
75% benefit $271.95
85% benefit $308.25
73339Detection of germline mutations in the RET gene in patients with a suspected clinical diagnosis of multiple endocrine neoplasia type 2 (MEN2) requested by a specialist or consultant physician who manages the treatment of the patient. One test. (Item is subject to rule 25)$400.00
75% benefit $300.00
85% benefit $340.00
73340Detection of a known mutation in the RET gene in an asymptomatic relative of a patient with a documented pathogenic germline RET mutation requested by a specialist or consultant physician who manages the treatment of the patient. One test. (Item is subject to rule 25)$200.00
75% benefit $150.00
85% benefit $170.00
73341Fluorescence in situ hybridisation (FISH) test of tumour tissue from a patient with a new diagnosis of non-small cell lung cancer, requested by a specialist or consultant physician, if the test is: (a) for ALK gene rearrangement status to determine eligibility for a relevant treatment under the Pharmaceutical Benefits Scheme; and (b) not associated with a service to which item 73437 or 73439 applies$400.00
75% benefit $300.00
85% benefit $340.00
73342An in situ hybridisation (ISH) test of tumour tissue from a patient with metastatic adenocarcinoma of the stomach or gastro-oesophageal junction, with documented evidence of human epidermal growth factor receptor 2 (HER2) overexpression by immunohistochemical (IHC) examination giving a staining intensity score of 2+ or 3+ on the same tumour tissue sample, requested by, or on the advice of, a specialist or consultant physician who manages the treatment of the patient to determine if the requirements relating to HER2 gene amplification for access to trastuzumab under the Pharmaceutical Benefits Scheme are fulfilled.$315.40
75% benefit $236.55
85% benefit $268.10
73343Detection of 17p chromosomal deletions, in a patient with chronic lymphocytic leukaemia or small lymphocytic lymphoma, on a peripheral blood, bone marrow or lymph node sample, requested by a specialist or consultant physician For any particular patient: (a) at initial diagnosis; or (b) at disease relapse; or (c) on disease progression; but only where initiation of, or change in, therapy is anticipated$589.90
75% benefit $442.45
85% benefit $501.45
73344Fluorescence in situ hybridization (FISH) test of tumour tissue from a patient with a new diagnosis of non-small cell lung cancer, requested by a specialist or consultant physician, if the test is: (a) for ROS1 gene arrangement status to determine eligibility for a relevant treatment under the Pharmaceutical Benefits Scheme; and (b) not associated with a service to which item 73437 or 73439 applies$400.00
75% benefit $300.00
85% benefit $340.00
73345Testing of a patient for pathogenic cystic fibrosis transmembrane conductance regulator variants for the purpose of investigating, making or excluding a diagnosis of cystic fibrosis or a cystic fibrosis transmembrane conductance regulator related disorder when requested by a specialist or consultant physician who manages the treatment of the patient, not being a service associated with a service to which item 73347, 73348, or 73349 applies. The patient must have clinical or laboratory findings suggesting there is a high probability suggestive of cystic fibrosis or a cystic fibrosis transmembrane conductance regulator related disorder.$500.00
75% benefit $375.00
85% benefit $425.00
73346Testing of a pregnant patient whose carrier status for pathogenic cystic fibrosis transmembrane conductance regulator variants, as well as their reproductive partner carrier status is unknown, for the purpose of determining whether pathogenic cystic fibrosis transmembrane conductance regulator variants are present in the fetus, in order to make or exclude a diagnosis of cystic fibrosis or a cystic fibrosis transmembrane conductance regulator related disorder in the fetus when requested by a specialist or consultant physician who manages the treatment of the patient, not being a service associated with a service to which item 73350 applies. The fetus must have ultrasonic findings of echogenic gut, with unknown familial cystic fibrosis transmembrane conductance regulator variants.$500.00
75% benefit $375.00
85% benefit $425.00
73347Testing of a prospective parent for pathogenic cystic fibrosis transmembrane conductance regulator variants for the purpose of determining the risk of their fetus having pathogenic cystic fibrosis transmembrane conductance regulator variants. This is indicated when the fetus has ultrasonic evidence of echogenic gut when requested by a specialist or consultant physician who manages the treatment of the patient, not being a service associated with a service to which item 73345, 73348, or 73349 applies.$500.00
75% benefit $375.00
85% benefit $425.00
73348Testing of a patient with a laboratory-established family history of pathogenic cystic fibrosis transmembrane conductance regulator variants, for the purpose of determining whether the patient is an asymptomatic genetic carrier of the pathogenic cystic fibrosis transmembrane conductance regulator variants that have been laboratory established in the family history, not being a service associated with a service to which item 73345, 73347, or 73349 applies. The patient must have a positive family history, confirmed by laboratory findings of pathogenic cystic fibrosis transmembrane conductance regulator variants, with a personal risk of being a heterozygous genetic carrier of at least 6%. (This includes family relatedness of: parents, children, full-siblings, half-siblings, grand-parents, grandchildren, aunts, uncles, first cousins, and first cousins once-removed, but excludes relatedness of second cousins or more distant relationships).$250.00
75% benefit $187.50
85% benefit $212.50
73349Testing of a patient for pathogenic cystic fibrosis transmembrane conductance regulator variants for the purpose of determining the reproductive risk of the patient with their reproductive partner because their reproductive partner is already known to have pathogenic cystic fibrosis transmembrane conductance regulator variants requested by a specialist or consultant physician who manages the treatment of the patient, not being a service associated with a service to which item 73345, 73347, or 73348 applies.$500.00
75% benefit $375.00
85% benefit $425.00
73350Testing of a pregnant patient, where one or both prospective parents are known to be a genetic carrier of pathogenic cystic fibrosis transmembrane conductance regulator variants for the purpose of determining whether pathogenic cystic fibrosis transmembrane conductance regulator variants are present in the fetus in order to make or exclude a diagnosis of cystic fibrosis or a cystic fibrosis transmembrane conductance regulator related disorder in the fetus, when requested by a specialist or consultant physician who manages the treatment of the patient, not being a service associated with a service to which item 73346 applies. The fetus must be at 25% or more risk of cystic fibrosis or a cystic fibrosis transmembrane conductance regulator related disorder because of known familial cystic fibrosis transmembrane conductance regulator variants.$250.00
75% benefit $187.50
85% benefit $212.50
73351A test of tumour tissue that is derived from a new sample from a patient with locally advanced (Stage IIIb) or metastatic (Stage IV) non-small cell lung cancer (NSCLC), who has progressed on or after treatment with an epidermal growth factor receptor tyrosine kinase inhibitor (EGFR TKI). The test is to be requested by a specialist or consultant physician, to determine if the requirements relating to EGFR T790M gene status for access to osimertinib under the Pharmaceutical Benefits Scheme are fulfilled.$397.35
75% benefit $298.05
85% benefit $337.75
73352New 85% benefit on 1 November 2026Characterisation of germline variants causing familial hypercholesterolaemia (which must include the LDLR, PCSK9 and APOB genes), requested by a specialist or consultant physician, for a patient: (a) for whom no familial mutation has been identified; and (b) who has any of the following: (i) a Dutch Lipid Clinic Network score of at least 6; (ii) an LDL-cholesterol level of at least 6.5 mmol/L in the absence of secondary causes; (iii) an LDL-cholesterol level of between 5.0 and 6.5 mmol/L with signs of premature or accelerated atherogenesis Applicable only once per lifetime$1,200.00
75% benefit $900.00
85% benefit $1,091.50 was $1,095.50
73353Detection of a familial mutation for a patient who has a first- or second-degree relative with a documented pathogenic germline gene variant for familial hypercholesterolaemia Applicable only once per lifetime$400.00
75% benefit $300.00
85% benefit $340.00
73354New 85% benefit on 1 November 2026Characterisation of germline gene variants, including copy number variation, in the MLH1, MSH2, MSH6, PMS2 and EPCAM genes, requested by a specialist or consultant physician, for:(a) a patient with suspected Lynch syndrome following immunohistochemical examination of neoplastic tissue that has demonstrated loss of expression of one or more mismatch repair proteins; or (b) a patient: (i) who has endometrial cancer; and (ii) who is assessed by the specialist or consultant physician as being at a risk of more than 10% of having Lynch syndrome, on the basis of clinical and family history criteria$1,200.00
75% benefit $900.00
85% benefit $1,091.50 was $1,095.50
73355New 85% benefit on 1 November 2026Characterisation of germline gene variants, including copy number variation, in the APC and MUTYH genes, requested by a specialist or consultant physician, for a patient: (a) who has adenomatous polyposis; and (b) who is assessed by the specialist or consultant physician as being at a risk of more than 10% of having either of the following, on the basis of clinical and family history criteria: (i) familial adenomatous polyposis; (ii) MUTYH-associated polyposis$1,200.00
75% benefit $900.00
85% benefit $1,091.50 was $1,095.50
73356New 85% benefit on 1 November 2026Characterisation of germline gene variants, including copy number variation, in the SMAD4, BMPR1A, STK11 and GREM1 genes, requested by a specialist or consultant physician, for a patient: (a) who has non-adenomatous polyposis; and (b) who is assessed by the specialist or consultant physician as being at a risk of more than 10% of having any of the following, on the basis of clinical and family history criteria: (i) juvenile polyposis syndrome; (ii) Peutz-Jeghers syndrome; (iii) hereditary mixed polyposis syndrome$1,200.00
75% benefit $900.00
85% benefit $1,091.50 was $1,095.50
73357Characterisation of germline gene variants, including copy number variation, in the genes mentioned in item 73354, 73355 or 73356, requested by a specialist or consultant physician, for a patient: (a) who has a biological relative with a pathogenic mutation identified in one or more of those genes; and (b) who has not previously received a service to which any of items 73354, 73355 and 73356 apply$400.00
75% benefit $300.00
85% benefit $340.00
73358New 85% benefit and new wording on 1 November 2026Characterisation, via whole exome or genome sequencing and analysis, of germline variants known to cause monogenic disorders, if:(a) the characterisation is: (i) requested by a consultant physician practising as a clinical geneticist; or (ii) requested by a consultant physician practising as a specialist paediatrician; and (b) the patient is aged 10 years or younger and is strongly suspected of having a monogenic condition, based on the presence of: (i) dysmorphic facial appearance and one or more major structural congenital anomalies; or (ii) intellectual disability or global developmental delay of at least moderate severity, as determined by a specialist paediatrician; and (c) the characterisation is performed following the performance for the patient of a service to which item 73292 applies for which the results were non-informative; and (d) the characterisation is not performed in conjunction with a service to which item 73359 applies Applicable only once per lifetime$2,100.00
75% benefit $1,575.00
85% benefit $1,991.50 was $1,995.50
73359New 85% benefit and new wording on 1 November 2026Characterisation, via whole exome or genome sequencing and analysis, of germline variants known to cause monogenic disorders, if:(a) the characterisation is: (i) requested by a consultant physician practising as a clinical geneticist; or (ii) requested by a consultant physician practising as a specialist paediatrician; and (b) the request for the characterisation states that singleton testing is inappropriate; and (c) the patient is aged 10 years or younger and is strongly suspected of having a monogenic condition, based on the presence of: (i) dysmorphic facial appearance and one or more major structural congenital anomalies; or (ii) intellectual disability or global developmental delay of at least moderate severity, as determined by a specialist paediatrician; and (d) the characterisation is performed following the performance for the patient of a service to which item 73292 applies for which the results were non-informative; and (e) the characterisation is performed using a sample from the patient and a sample from each of the patient’s biological parents; and (f) the characterisation is not performed in conjunction with a service to which item 73358 applies Applicable only once per lifetime$2,900.00
75% benefit $2,175.00
85% benefit $2,791.50 was $2,795.50
73360New wording on 1 November 2026Re-analysis of whole exome or genome data obtained in performing a service to which item 73358 or 73359 applies, for characterisation of previously unreported germline gene variants related to the clinical phenotype, if:(a) the re-analysis is: (i) requested by a consultant physician practising as a clinical geneticist; or (ii) requested by a consultant physician practising as a specialist paediatrician; and (b) the patient is aged 15 years or younger and is strongly suspected of having a monogenic condition; and (c) the re-analysis is performed at least 18 months after: (i) a service to which item 73358 or 73359 applies; or (ii) a service to which this item applies Applicable only twice per lifetime$500.00
75% benefit $375.00
85% benefit $425.00
73361Testing of a person (the person tested) for the detection of a single gene variant for diagnostic purposes, if: the person tested has a biological sibling (the sibling) with a known monogenic condition; and a service described in item 73358, 73359 or 73360 has identified the causative variant for the sibling’s condition; and the results of the testing performed for the sibling are made available for the purpose of providing the detection for the person tested; and the detection is: requested by a consultant physician practising as a clinical geneticist; or requested by a consultant physician practising as a specialist paediatrician, following consultation with a clinical geneticist; and the detection is not performed in conjunction with a service to which item 73362 or 73363 applies Applicable only once per variant per lifetime$400.00
75% benefit $300.00
85% benefit $340.00
73362Testing of a person (the person tested) for the detection of a single gene variant for the purpose of reproductive decision making, if: the person tested has a first‑degree relative (the relative) with a known monogenic condition; and a service described in item 73358, 73359 or 73360 has identified the causative variant for the relative’s condition; and the results of the testing performed for the relative are made available for the purpose of providing the detection for the person tested; and the detection is requested by a consultant physician or specialist; and the detection is not performed in conjunction with item 73359, 73361 or 73363 Applicable only once per variant per lifetime$400.00
75% benefit $300.00
85% benefit $340.00
73363Testing of a person (the person tested) for the detection of a single gene variant for segregation analysis in relation to another person (the patient), if: the patient has a known phenotype of a suspected monogenic condition; and a service described in item 73358 or 73360 has identified a potentially causative variant for the patient; and the person tested is a biological parent or other biological relative of the patient; and a sample from the person tested has not previously been tested in relation to the patient for a service to which item 73359 applies; and the results of the testing of the person tested for this service are made available for the purpose of providing the detection for the patient; and the detection is: requested by a consultant physician practising as a clinical geneticist; or requested by a consultant physician practising as a specialist paediatrician, following consultation with a clinical geneticist; and the detection is not performed in conjunction with item 73361 or 73362 Applicable only once per variant per lifetime$400.00
75% benefit $300.00
85% benefit $340.00
73364Analysis of tumour tissue, requested by a specialist or consultant physician, that: (a) is for: (i) the characterisation of MYC gene rearrangement; and (ii) if the results of the characterisation mentioned in subparagraph (i) are positive—the characterisation of either or both of BCL2 gene rearrangement and BCL6 gene rearrangement; and (b) is for a patient: (i) for whom MYC immunohistochemistry is non-negative; and (ii) with clinical or laboratory evidence, including morphological features, of diffuse large B-cell lymphoma or high grade B-cell lymphoma; and (c) is not performed in conjunction with item 73365 Applicable only once per lifetime$400.00
75% benefit $300.00
85% benefit $340.00
73365Analysis of tumour tissue, requested by a specialist or consultant physician, that: (a) is for the characterisation of MYC gene rearrangement; and (b) is for a patient with clinical or laboratory evidence, including morphological features, of Burkitt lymphoma; and (c) is not performed in conjunction with item 73364 Applicable only once per lifetime$340.00
75% benefit $255.00
85% benefit $289.00
73366Analysis of tumour tissue, requested by a specialist or consultant physician, that: (a) is for the characterisation of either or both of the following: (i) CCND1 gene rearrangement; (ii) CCND2 gene rearrangement; and (b) is for a patient with clinical or laboratory evidence, including morphological features, of mantle cell lymphoma Applicable only once per lifetime$400.00
75% benefit $300.00
85% benefit $340.00
73367Analysis of tumour tissue, requested by a specialist or consultant physician, that: (a) is for the presence of isochromosome 7q; and (b) is for a patient with clinical or laboratory evidence, including morphological features, of hepatosplenic T‑cell lymphoma Applicable only once per lifetime$340.00
75% benefit $255.00
85% benefit $289.00
73368Analysis of tumour tissue, requested by a specialist or consultant physician, that: (a) is for the characterisation of either or both of the following: (i) DUSP22 gene rearrangement; (ii) TP63 gene rearrangement; and (b) is for a patient with clinical or laboratory evidence, including morphological features, of ALK negative anaplastic large cell lymphoma Applicable only once per lifetime$400.00
75% benefit $300.00
85% benefit $340.00
73369Analysis of blood or bone marrow, requested by a specialist or consultant physician, that: (a) is for the characterisation of either or both of the following: (i) TCL1A gene rearrangement; (ii) MTCP1 gene rearrangement; and (b) is for a patient with clinical or laboratory evidence, including morphological features, of T‑cell prolymphocytic leukaemia Applicable only once per lifetime$400.00
75% benefit $300.00
85% benefit $340.00
73370Analysis of blood or bone marrow, requested by a specialist or consultant physician, that: (a) is for the characterisation of the following: (i) chromosome translocations t(4;14), t(14;16), t(14;20); (ii) 1q gain; (iii) 17p deletion; and (b) is for a patient with clinical or laboratory evidence, including morphological features, of plasma cell myeloma Applicable only once per lifetime$500.00
75% benefit $375.00
85% benefit $425.00
73371Analysis of tumour tissue, requested by a specialist or consultant physician, that: (a) is for the detection of chromosome 1p/19q co‑deletion; and (b) is for a patient with clinical or laboratory evidence, including morphological features, of glial neoplasm with probable oligodendroglial component Applicable only once per lifetime$340.00
75% benefit $255.00
85% benefit $289.00
73372Analysis of tumour tissue, requested by a specialist or consultant physician, that: (a) is for the identification of IDH1/2 pathological variant status; and (b) is for a patient with: (i) negative IDH1 (R132H) immunohistochemistry; and (ii) clinical or laboratory evidence, including morphological features, of glial neoplasm Applicable only once per lifetime$340.00
75% benefit $255.00
85% benefit $289.00
73373Analysis of tumour tissue, requested by a specialist or consultant physician, that: (a) is for the characterisation of MGMT promoter methylation status; and (b) is for a patient with clinical or laboratory evidence, including morphological features, of glioblastoma Applicable only once per lifetime$400.00
75% benefit $300.00
85% benefit $340.00
73374Analysis of tumour tissue, requested by a specialist or consultant physician, that: (a) is for the characterisation of copy number changes, gene rearrangements, or other molecular changes in genes associated with sarcoma; and (b) is for a patient with clinical or laboratory evidence, including morphological features, of sarcoma— analysis in relation to only one gene Applicable once per tumour diagnostic episode$340.00
75% benefit $255.00
85% benefit $289.00
73375An analysis described in item 73374—analysis in relation to only 2 or 3 genes Applicable once per tumour diagnostic episode$400.00
75% benefit $300.00
85% benefit $340.00
73376New 85% benefit on 1 November 2026An analysis described in item 73374—analysis in relation to 4 or more genes Applicable once per tumour diagnostic episode$800.00
75% benefit $600.00
85% benefit $691.50 was $695.50
73377Analysis of tumour tissue, requested by a specialist or consultant physician, that: (a) is for the detection of FOXL2.402C>G status; and (b) is for a patient with clinical or laboratory evidence, including morphological features, of granulosa cell ovarian tumour Applicable only once per lifetime$250.00
75% benefit $187.50
85% benefit $212.50
73378Analysis of tumour tissue, requested by a specialist or consultant physician, that: (a) is for the characterisation of NUTM1 gene status at 15q14; and (b) is for a patient with clinical or laboratory evidence, including morphological features, of midline NUT carcinoma Applicable only once per lifetime$340.00
75% benefit $255.00
85% benefit $289.00
73379Analysis of tumour tissue, requested by a specialist or consultant physician, that: (a) is for the characterisation of ETV6‑NTRK3 gene rearrangement; and (b) is for a patient with clinical or laboratory evidence, including morphological features, of secretory carcinoma of the breast Applicable only once per lifetime$340.00
75% benefit $255.00
85% benefit $289.00
73380Analysis of tumour tissue, requested by a specialist or consultant physician, that: (a) is for the characterisation of MAML2 gene rearrangement; and (b) is for a patient with clinical or laboratory evidence, including morphological features, of mucoepidermoid carcinoma Applicable only once per lifetime$340.00
75% benefit $255.00
85% benefit $289.00
73381Analysis of tumour tissue, requested by a specialist or consultant physician, that: (a) is for the characterisation of ETV6‑NTRK3 gene rearrangement; and (b) is for a patient with clinical or laboratory evidence, including morphological features, of mammary analogue secretory carcinoma of the salivary gland Applicable only once per lifetime$340.00
75% benefit $255.00
85% benefit $289.00
73382Analysis of tumour tissue, requested by a specialist or consultant physician, that: (a) is for the characterisation of EWSR1 gene rearrangement, with or without PLAG1 gene rearrangement; and (b) is for a patient with clinical or laboratory evidence, including morphological features, of hyalinising clear cell carcinoma of the salivary gland Applicable only once per lifetime$340.00
75% benefit $255.00
85% benefit $289.00
73383Analysis of tumour tissue, requested by a specialist or consultant physician, that: (a) is for the characterisation of either or both of the following: (i) TFE3 gene rearrangement; (ii) TFEB gene rearrangement; and (b) is for a patient with clinical or laboratory evidence, including morphological features, of renal cell carcinoma Applicable only once per lifetime$400.00
75% benefit $300.00
85% benefit $340.00
73384New 85% benefit on 1 November 2026Genetic analysis, for a patient who is eligible for this service under clause 2.7.3A of the pathology services table (see PR.7.1), of samples from the patient and (if relevant) the patient’s reproductive partner, for the purpose of providing an assay for pre‑implantation genetic testing, requested by a specialist or consultant physician Applicable not more than once per patient episode per disorder (of a kind described in clause 2.7.3A (PR.7.1)) per reproductive relationship$1,736.00
75% benefit $1,302.00
85% benefit $1,627.50 was $1,631.50
73385Genetic analysis, for a patient who is eligible for this service under clause 2.7.3A of the Pathology Services Table (see PR.7.1), of embryonic tissue from a sample from one embryo, if: (a) the analysis is: (i) requested by a specialist or consultant physician; and (ii) for the purpose of providing a pre‑implantation genetic test; and (iii) performed on an embryo that was produced in a single assisted reproductive treatment cycle; and (b) the service is not a service to which item 73386 or 73387 applies for the same assisted reproductive treatment cycle Applicable not more than once per embryo$635.00
75% benefit $476.25
85% benefit $539.75
73386New 85% benefit on 1 November 2026Genetic analysis, for a patient who is eligible for this service under clause 2.7.3A of the Pathology Services Table (see PR.7.1), of embryonic tissue from samples from 2 embryos, if: (a) the analysis is: (i) requested by a specialist or consultant physician; and (ii) for the purpose of providing a pre‑implantation genetic test; and (iii) performed on embryos that were produced in a single assisted reproductive treatment cycle; and (b) the service is not a service to which item 73385 or 73387 applies for the same assisted reproductive treatment cycle Applicable not more than once per assisted reproductive treatment cycle for the 2 embryos tested$1,270.00
75% benefit $952.50
85% benefit $1,161.50 was $1,165.50
73387New 85% benefit on 1 November 2026Genetic analysis, for a patient who is eligible for this service under clause 2.7.3A of the Pathology Services Table (see PR.7.1), of embryonic tissue from samples from 3 or more embryos, if: (a) the analysis is: (i) requested by a specialist or consultant physician; and (ii) for the purpose of providing a pre‑implantation genetic test; and (iii) performed on embryos that were produced in a single assisted reproductive treatment cycle; and (b) the service is not a service to which item 73385 or 73386 applies for the same assisted reproductive treatment cycle Applicable not more than once per assisted reproductive treatment cycle for the 3 or more embryos tested$1,905.00
75% benefit $1,428.75
85% benefit $1,796.50 was $1,800.50
73388Analysis of chromosomes by genome‑wide microarray, of a sample from amniocentesis or chorionic villus sampling, including targeted assessment of specific regions for constitutional genetic abnormalities in diagnostic studies of a fetus, if one or more major fetal structural abnormalities have been detected on ultrasound; or nuchal translucency was greater than 3.5 mm Applicable only once per fetus$589.90
75% benefit $442.45
85% benefit $501.45
73389Analysis of products of conception from a patient with suspected hydatidiform mole for the characterisation of ploidy status Applicable once per pregnancy$340.00
75% benefit $255.00
85% benefit $289.00
73391Analysis of chromosomes by genome‑wide microarray in diagnostic studies of a patient with multiple myeloma Applicable once per lifetime$589.90
75% benefit $442.45
85% benefit $501.45
73392New 85% benefit on 1 November 2026Characterisation of pathogenic or likely pathogenic germline gene variants, requested by a specialist or consultant physician: (a) in at least the following genes: (i) MYBPC3; (ii) MYH7; (iii) TNNI3; (iv) TNNT2; (v) TPM1; (vi) ACTC1; (vii) MYL2; (viii) MYL3; (ix) PRKAG2; (x) LAMP2; (xi) GLA; (xii) LMNA; (xiii) SCN5A; (xiv) TTN; (xv) RBM20; (xvi) PLN; (xvii) DSP; (xviii) DSC2; (xix) DSG2; (xx) JUP; (xxi) PKP2; (xxii) TMEM43; and (b) for a patient for whom clinical history, family history or laboratory findings suggest there is a high probability of one or more of the following heritable cardiomyopathies in the patient: (i) hypertrophic cardiomyopathy; (ii) dilated cardiomyopathy; (iii) arrhythmogenic cardiomyopathy Applicable once per lifetime$1,200.00
75% benefit $900.00
85% benefit $1,091.50 was $1,095.50
73393Characterisation of one or more pathogenic or likely pathogenic germline gene variants, requested by a specialist or consultant physician, if: (a) a service described in item 73392 has not previously been performed for the patient; and (b) the patient is a first-degree biological relative (or a second-degree biological relative if a first-degree biological relative is unavailable) of a person who has a pathogenic or likely pathogenic germline gene variant that is confirmed by laboratory findings; and (c) the service is performed for the purpose of assessing present or future risk of any of the following heritable cardiomyopathies in the patient: (i) hypertrophic cardiomyopathy; (ii) dilated cardiomyopathy; (iii) arrhythmogenic cardiomyopathy Applicable once per variant per lifetime$400.00
75% benefit $300.00
85% benefit $340.00
73394New 85% benefit on 1 November 2026Characterisation of one or more recessive pathogenic or likely pathogenic germline genes, requested by a specialist or consultant physician, for the purpose of determining the reproductive risk of heritable cardiomyopathy in a patient: (a) who is a reproductive partner of a known carrier of a pathogenic or likely pathogenic germline gene that is confirmed by laboratory findings ; and (b) for whom carrier status of a pathogenic or likely pathogenic germline gene is unknown; and (c) who has a clinical history, family history or laboratory findings suggesting there is a low probability of heritable cardiomyopathy Applicable once per gene per lifetime$1,200.00
75% benefit $900.00
85% benefit $1,091.50 was $1,095.50
73395Re‑analysis of whole exome or genome data that is obtained in performing a service to which item 73392 applies, for characterisation of previously unreported germline gene variants related to the clinical phenotype, if: (a) the re-analysis is requested by a consultant physician practising as a clinical geneticist or a cardiologist; and (b) the patient is strongly suspected of having a heritable cardiomyopathy; and (c) the re-analysis is performed at least 18 months after a service to which item 73392 or this item applies is performed for the patient Applicable twice per lifetime$500.00
75% benefit $375.00
85% benefit $425.00
73396Characterisation of variants in the JAK2 exon 12 in the diagnostic work‑up of a patient with clinical and laboratory evidence of polycythaemia vera, requested by a specialist or consultant physician$90.00
75% benefit $67.50
85% benefit $76.50
73397Characterisation of variants in both the CALR and MPL genes in the diagnostic work‑up of a patient with clinical and laboratory evidence of essential thrombocythaemia or primary myelofibrosis, requested by a specialist or consultant physician$200.00
75% benefit $150.00
85% benefit $170.00
73398Characterisation of variants in at least 8 genes, which must include all of the following genes: (a) JAK2 (including exons 12 and 14); (b) CALR; (c) MPL; in the diagnostic work‑up of a patient with clinical and laboratory evidence of polycythaemia vera or essential thrombocythaemia, requested by a specialist or consultant physician Applicable to one test per diagnostic episode$420.00
75% benefit $315.00
85% benefit $357.00
73399New 85% benefit on 1 November 2026Characterisation of variants in at least 20 genes, which must include all of the following genes: (a) JAK2 (including exons 12 and 14); (b) CALR; (c) MPL; in the diagnostic work‑up of a patient, with clinical and laboratory evidence of primary myelofibrosis, who is eligible for a stem cell transplant, requested by a specialist or consultant physician Applicable to one test per diagnostic episode$700.00
75% benefit $525.00
85% benefit $595.00 was $595.50
73400Genetic testing for at least 2 HLA variants to predict the patient’s risk of a severe drug hypersensitivity reaction to carbamazepine or oxcarbazepine, if the service is conducted before or during the initiation of treatment with carbamazepine or oxcarbazepine Applicable once per lifetime$139.00
75% benefit $104.25
85% benefit $118.15
73401New 85% benefit on 1 November 2026Characterisation, by whole exome or genome sequencing and analysis, of germline gene variants in one or more of the genes implicated in heritable cystic kidney disease, if: (a) the service is requested by a consultant physician practising as: (i) a clinical geneticist; or (ii) a specialist nephrologist; and (b) the patient has a renal abnormality and is strongly suspected of having a monogenic condition Applicable once per lifetime$2,100.00
75% benefit $1,575.00
85% benefit $1,991.50 was $1,995.50
73402New 85% benefit on 1 November 2026Characterisation, by whole exome or genome sequencing and analysis, of germline gene variants in one or more of the genes implicated in heritable kidney disease, if: (a) the service is requested by a consultant physician practising as: (i) a clinical geneticist; or (ii) a specialist nephrologist; and (b) the patient has chronic kidney disease (other than cystic disease or Alport syndrome) and is strongly suspected of having a monogenic condition Applicable once per lifetime$2,100.00
75% benefit $1,575.00
85% benefit $1,991.50 was $1,995.50
73403Re‑analysis of genetic data obtained in performing a service to which item 73401 or 73402 applies, for characterisation of previously unreported germline gene variants related to the clinical phenotype, if: (a) the re-analysis is requested by a consultant physician practising as a clinical geneticist or a specialist paediatrician; and (b) the patient has a strong clinical suspicion of a monogenic condition; and (c) a service to which item 73401, 73402 or this item applies has not been performed for the patient in the previous 18 months Applicable twice per lifetime$500.00
75% benefit $375.00
85% benefit $425.00
73404Detection of a single gene variant in a patient, if: (a) the service is requested by: (i) a clinical geneticist; or (ii) a specialist or consultant physician providing professional genetic counselling services; and (b) the patient has a first-degree relative with a known monogenic cause of kidney disease; and (c) a service described in item 73401, 73402, or 73403 has identified the causative variant for the disease for the relative Applicable once per variant per lifetime$400.00
75% benefit $300.00
85% benefit $340.00
73405New 85% benefit on 1 November 2026Detection of one or more variants of a single gene known to cause heritable kidney disease, for the purpose of reproductive decision making, if: (a) the detection is requested by a consultant physician practising as: (i) a clinical geneticist; or (ii) a specialist nephrologist; and (b) the patient is the reproductive partner of an individual known to be a carrier of a pathogenic variant that causes heritable kidney disease that has a recessive mode of inheritance; and (c) a service described in item 73401, 73402, 73403 or 73404 has identified the causative gene for the patient’s partner; and (d) the detection test methodology has sufficient diagnostic range and sensitivity to detect at least 95% of pathogenic variants likely to be present in the patient$1,200.00
75% benefit $900.00
85% benefit $1,091.50 was $1,095.50
73406Testing of a pregnant patient, for the purpose of determining whether monogenic variants are present in the fetus, if: (a) the service is requested by a consultant physician practising as: (i) a clinical geneticist; or (ii) a specialist nephrologist; and (b) the patient or the patient’s reproductive partner (or both) are known to be affected by, or are carriers of, a known pathogenic variant that causes heritable kidney disease; and (c) the fetus is at risk, of at least 25%, of inheriting a monogenic variant known to cause kidney disease$400.00
75% benefit $300.00
85% benefit $340.00
73410Deletion testing of HBA1 and HBA2 for: (a) the diagnosis of alpha thalassaemia in a patient of reproductive age: (i) who has abnormal red cell indices; and (ii) for whom thalassaemia screening was suggestive of thalassaemia; and (iii) who does not have a concurrent iron deficiency (or who, irrespective of iron status, is pregnant); and (iv) who has no historic normal cell indices; or (b) the determination of carrier status in a person: (i) who is a reproductive partner of a person with alpha thalassaemia; and (ii) who has abnormal red cell indices; and (iii) who does not have a concurrent iron deficiency; or (c) the determination of carrier status in a person: (i) who is a reproductive partner of a person with alpha thalassaemia and heterozygous 2‑gene deletion; and (ii) who has normal red cell indices$100.00
75% benefit $75.00
85% benefit $85.00
73411Sequencing of HBA1 or HBA2, if the results of deletion testing described in item 73410 were inconclusive and a less common or rare variant is suspected, either: (a) for the diagnosis of alpha thalassaemia in a patient of reproductive age; or (b) for the determination of carrier status in a reproductive partner of a person with alpha thalassaemia Applicable once per gene per lifetime$400.00
75% benefit $300.00
85% benefit $340.00
73412Deletion testing of HBA1 and HBA2, if the results of deletion testing described in item 73410 were inconclusive and a large deletion variant is suspected, either: (a) for the diagnosis of alpha thalassaemia in a patient of reproductive age; or (b) for the determination of carrier status in a reproductive partner of a person with alpha thalassaemia$250.00
75% benefit $187.50
85% benefit $212.50
73413Non‑deletion testing of HBA1 and HBA2 using techniques other than sequencing, if the results of deletion testing described in item 73410 were inconclusive, either: (a) for the diagnosis of alpha thalassaemia in a patient of reproductive age ; or (b) for the determination of carrier status in a reproductive partner of a person with alpha thalassaemia$250.00
75% benefit $187.50
85% benefit $212.50
73416New 85% benefit on 1 November 2026Detection of germline gene variants, including copy number variation, requested by a specialist or consultant physician: (a) in at least the following genes: (i) KCNQ1; (ii) KCNH2; (iii) SCN5A; (iv) KCNE1; (v) KCNE2; (vi) KCNJ2; (vii) CACNA1C; (viii) RYR2; (ix) CASQ2; (x) CAV3; (xi) SCN4B; (xii) AKAP9; (xiii) SNTA1; (xiv) KCNJ5; (xv) ALG10; (xvi) CALM1; (xvii) CALM2; (xviii) ANK2; (xix) TECRL; (xx) TRDN; and (b) for a patient for whom clinical or family history criteria is suggestive of inherited cardiac arrhythmias or channelopathies that place the patient at greater than 10% risk of having a pathogenic variant Applicable once per lifetime$1,200.00
75% benefit $900.00
85% benefit $1,091.50 was $1,095.50
73417Characterisation of one or more pathogenic or likely pathogenic germline gene variants, requested by a specialist or consultant physician, if: (a) the patient is a first-degree or second‑degree biological relative of a person with a pathogenic or likely pathogenic germline gene variant that is confirmed by laboratory findings; and (b) the service is performed for the purpose of assessing present or future risk of a cardiac arrhythmia or channelopathy; and (c) a service to which item 73416 applies has not previously been performed for the patient Applicable once per variant per lifetime$400.00
75% benefit $300.00
85% benefit $340.00
73418New 85% benefit on 1 November 2026Characterisation of one or more recessive pathogenic or likely pathogenic germline genes, requested by a specialist or consultant physician, for the purpose of determining the reproductive risk of cardiac arrhythmia or channelopathy in a patient: (a) who is a reproductive partner of a person who is a known carrier of a pathogenic or likely pathogenic germline gene variant of a gene confirmed by laboratory findings; and (b) for whom a service to which item 73416 applies has not previously been performed; and (c) for whom carrier status of a pathogenic or likely pathogenic germline gene variant is unknown; and (d) who has a clinical history, family history or laboratory findings suggesting there is a low probability of cardiac arrhythmia or channelopathy Applicable once per gene per lifetime$1,200.00
75% benefit $900.00
85% benefit $1,091.50 was $1,095.50
73419Re‑analysis of whole exome or genome data that was obtained in performing a service to which item 73416 applies, for characterisation of previously unreported germline gene variants related to the clinical phenotype, if: (a) the re-analysis is requested by a consultant physician practising as a clinical geneticist or a cardiologist; and (b) the patient is strongly suspected of having inheritable cardiac arrhythmia or channelopathies; and (c) the service is performed at least 18 months after a service to which item 73416 or this item applies was performed for the patient Applicable twice per lifetime$500.00
75% benefit $375.00
85% benefit $425.00
73420Non‑invasive prenatal testing of blood from an RhD negative pregnant patient for the detection of the RHD gene from fetal DNA circulating in maternal blood, if the patient has not been previously alloimmunised against RhD$150.40
75% benefit $112.80
85% benefit $127.85
73421Non-invasive prenatal testing of blood from an RhD negative pregnant patient for the detection of the RHD gene from fetal DNA circulating in maternal blood, if the patient has been previously alloimmunised against RhD$550.00
75% benefit $412.50
85% benefit $467.50
73422New 85% benefit on 1 November 2026Characterisation of a gene variant or gene variants using a gene panel, in a patient presenting with clinical signs and symptoms suggestive of a genetic neuromuscular disorder (other than signs and symptoms associated with variants that are not detectable by massively parallel sequencing), if the service is requested: (a) by a specialist or consultant physician; and (b) after exclusion of non‑genetic causes Applicable once per lifetime$1,200.00
75% benefit $900.00
85% benefit $1,091.50 was $1,095.50
73423Detection of a single identified gene variant, in a biological relative of a person with a germline gene variant for a neuromuscular disorder identified by a service described in item 73422, 73425 or 73426, if the service is requested by a specialist or consultant physician Applicable once per variant$500.00
75% benefit $375.00
85% benefit $425.00
73424New 85% benefit on 1 November 2026Prenatal detection of an actionable pathogenic familial gene variant or gene variants (including maternal cell contamination assessment), requested by a specialist or consultant physician, for a genetic neuromuscular disorder previously identified in an index person in the patient’s family as a result of a service described in item 73422, 73434 or 73435 Applicable once per pregnancy$1,600.00
75% benefit $1,200.00
85% benefit $1,491.50 was $1,495.50
73425New 85% benefit on 1 November 2026Prenatal detection of unknown gene variants (including maternal cell contamination assessment) using a gene panel, if: (a) the service is requested: (i) by a specialist or consultant physician, for a suspected genetic neuromuscular disorder; and (ii) after exclusion of non‑genetic causes; and (b) the service is performed using a sample from the fetus; and (c) the service is not performed in conjunction with a service to which item 73426 applies Applicable once per pregnancy$1,800.00
75% benefit $1,350.00
85% benefit $1,691.50 was $1,695.50
73426New 85% benefit on 1 November 2026Prenatal detection of unknown gene variants (including maternal cell contamination assessment) using a gene panel, if: (a) the service is requested: (i) by a specialist or consultant physician; and (ii) for a suspected genetic neuromuscular disorder; and (iii) after exclusion of non‑genetic causes; and (b) the request states that singleton testing is inappropriate; and (c) the service is performed using a sample from the fetus and a sample from each of the fetus’s biological parents; and (d) the service is not performed in conjunction with a service to which item 73425 applies Applicable once per pregnancy$2,400.00
75% benefit $1,800.00
85% benefit $2,291.50 was $2,295.50
73427New 85% benefit on 1 November 2026Single gene testing for the characterisation of a germline gene variant or germline gene variants: (a) if requested by a specialist or consultant physician; and (b) within the same gene in which the patient’s reproductive partner has a documented pathogenic germline recessive gene variant for a neuromuscular disorder identified by a service described in: (i) item 73422, 73425 or 73426; or (ii) item 73434, if the patient has been provided a service described in item 73434 and that service has not identified a relevant variant Applicable once per gene$1,200.00
75% benefit $900.00
85% benefit $1,091.50 was $1,095.50
73428Re‑analysis of whole genome or exome data obtained in performing a service described in item 73422, 73425 or 73426, for characterisation of previously unreported gene variants related to the clinical phenotype, if the re‑analysis is requested by: (a) a consultant physician practicing as a clinical geneticist; or (b) a consultant physician practising as a specialist paediatrician, following consultation with a clinical geneticist Applicable twice per lifetime$500.00
75% benefit $375.00
85% benefit $425.00
73429New 85% benefit on 1 November 2026Genetic testing (including characterisation of single nucleotide variants, structural variants, fusions and copy number alterations) in a gene panel, requested by a specialist or consultant physician, for a patient with clinical or laboratory evidence of a glioma, glioneuronal tumour or glioblastoma, to aid diagnosis and classification of the relevant tumour, including assessments of at least the following kinds: (a) IDH1, IDH2—variant testing; (b) 1p/19q—co‑deletion assessment; (c) H3F3A—variant status; (d) TERT—promoter variant status; (e) EGFR—amplification; (f) CDKN2A/B—deletion; (g) BRAF—variants Applicable to one test per diagnostic episode$887.90
75% benefit $665.95
85% benefit $779.40 was $783.40
73430Fluorescence in-situ hybridisation (FISH) test of tumour tissue from a patient with locally advanced or metastatic solid tumour, if: (a) the tumour is at risk of being caused by a neurotrophic receptor tyrosine kinase (NTRK) gene fusion as determined by either: (i) occurring in a child less than 18 years of age; or (ii) being mammary analogue secretory carcinoma of the salivary gland; or (iii) being secretory breast carcinoma; and (b) the test is requested by a specialist or consultant physician to determine if requirements relating to NTRK gene fusion status for access to a tropomyosin receptor kinase (Trk) inhibitor under the Pharmaceutical Benefits Scheme are fulfilled This item cannot be claimed if item 73433 has been claimed for the same patient during the same cancer diagnosis Applicable only once per cancer diagnosis$400.00
75% benefit $300.00
85% benefit $340.00
73431Two tests described in item 73430$533.00
75% benefit $399.75
85% benefit $453.05
73432Three or more tests described in item 73430$667.00
75% benefit $500.25
85% benefit $566.95
73433New 85% benefit and new wording on 1 November 2026Next generation sequencing test for neurotrophic receptor tyrosine kinase (NTRK1, NTRK2, NTRK3) fusions by RNA or DNA in tumour tissue from a patient with locally advanced or metastatic solid tumour, if:(a) the tumour is at risk of being caused by an NTRK gene fusion as determined by either: (i) occurring in a child less than 18 years of age; or (ii) being mammary analogue secretory carcinoma of the salivary gland; or (iii) being secretory breast carcinoma; or (iv) being glioma, glioneuronal tumour or glioblastoma; and (b) the test is requested by a specialist or consultant physician for NTRK gene fusion status to determine eligibility for a relevant treatment under the Pharmaceutical Benefits Scheme This item cannot be claimed if item 73430, 73431 or 73432 has been claimed for the same patient during the same cancer diagnosis Applicable only once per cancer diagnosis$1,000.00
75% benefit $750.00
85% benefit $891.50 was $895.50
73434Detection of pathogenic or likely pathogenic gene variants, requested by a specialist or consultant physician, for any of the following: (a) a patient with a suspected neuromuscular disorder, being a neuromuscular disorder with signs and symptoms associated with variants that are not detectable by massively parallel sequencing; (b) a relative of a patient with a pathogenic or likely pathogenic germline gene variant associated with a neuromuscular disorder (confirmed by laboratory findings); (c) the reproductive partner of a patient with a recessive pathogenic or likely pathogenic germline gene variant associated with a neuromuscular disorder (confirmed by laboratory findings) Applicable once per gene per lifetime$392.00
75% benefit $294.00
85% benefit $333.20
73435New 85% benefit on 1 November 2026Detection of pathogenic or likely pathogenic DUX4 gene variants, requested by a specialist or consultant physician, for: (a) a patient with a suspected neuromuscular disorder; or (b) a relative of a patient with a pathogenic or likely pathogenic germline gene variant associated with a neuromuscular disorder (confirmed by laboratory findings) Applicable once per gene per lifetime$1,000.00
75% benefit $750.00
85% benefit $891.50 was $895.50
73436A test of tumour tissue from a patient with a new diagnosis of non-small cell lung cancer requested by, or on behalf of, a specialist or consultant physician, if the test is: (a) for MET proto-oncogene, receptor tyrosine kinase (MET) exon 14 skipping alterations (METex14sk) status to determine eligibility for access to a relevant treatment under the Pharmaceutical Benefits Scheme; and (b) not associated with a service to which item 73437 or 73438 applies$397.35
75% benefit $298.05
85% benefit $337.75
73437New 85% benefit on 1 November 2026A nucleic acid-based multi-gene panel test of tumour tissue from a patient with a new diagnosis of non-small cell lung cancer requested by, or on behalf of, a specialist or consultant physician, if the test is: (a) to detect variants in at least EGFR, BRAF, KRAS and MET exon 14 to determine eligibility for a relevant treatment under the Pharmaceutical Benefits Scheme; and (b) to detect the fusion status of at least ALK, ROS1, RET, NTRK1, NTRK2 and NTRK3 to determine eligibility for a relevant treatment under the PBS; and (c) not associated with a service to which item 73438, 73439, 73337, 73341, 73344, 73436 or 73351 applies$1,247.00
75% benefit $935.25
85% benefit $1,138.50 was $1,142.50
73438A DNA-based multi-gene panel test of tumour tissue from a patient with a new diagnosis of non-small cell lung cancer requested by, or on behalf of, a specialist or consultant physician, if the test is: (a) to detect variants in at least EGFR, BRAF, KRAS and MET exon 14; and (b) to determine eligibility for a relevant treatment under the Pharmaceutical Benefits Scheme; and (c) not associated with a service to which item 73437, 73337, 73436 or 73351 applies$682.35
75% benefit $511.80
85% benefit $580.00
73439A nucleic acid-based multi-gene panel test of tumour tissue from a patient with a new diagnosis of non-small cell lung cancer and with documented absence of activating variants of the EGFR gene, KRAS, BRAF and MET exon14, requested by, or on behalf of, a specialist or consultant physician, if the test is: (a) for fusion status of at least ALK, ROS1, RET, NTRK1, NTRK2, and NTRK3 to determine eligibility for a relevant treatment under the Pharmaceutical Benefits Scheme; and (b) not associated with a service to which item 73437, 73341, 73344 or 73351 applies$682.35
75% benefit $511.80
85% benefit $580.00
73440New 85% benefit on 1 November 2026Genomic testing and copy number variant analysis of genes known to be causative or likely causative of childhood hearing loss in a patient, if:(a) the testing and analysis is requested by a specialist or consultant physician; and(b) the patient has congenital or childhood onset hearing loss that presented before the patient was 18 years of age and is permanent moderate, severe, or profound (>40 dB in the worst ear over 3 frequencies) and classified as sensorineural, auditory neuropathy or mixed; and(c) the patient is not eligible for a service to which item 73358 or 73359 applies; and(d) the testing and analysis is not associated with a service to which item 73441 applies Applicable once per lifetime$1,200.00
75% benefit $900.00
85% benefit $1,091.50 was $1,095.50
73441New 85% benefit on 1 November 2026Genomic testing and copy number variant analysis of relevant genes known to be causative or likely causative of childhood hearing loss in a patient, if:(a) the testing and analysis is requested by a specialist or consultant physician; and(b) the patient has congenital or childhood onset hearing loss that presented before the patient was 18 years of age and is permanent moderate, severe, or profound (>40 dB in the worst ear over 3 frequencies) and classified as sensorineural, auditory neuropathy or mixed; and(c) the testing and analysis is performed using a sample from the patient and a sample from each of the patient’s biological parents; and(d) the patient is not eligible for a service to which item 73358 or 73359 applies; and(e) the testing and analysis is not associated with a service to which item 73440 applies Applicable once per lifetime$2,100.00
75% benefit $1,575.00
85% benefit $1,991.50 was $1,995.50
73442Re-analysis of whole exome or genome data obtained under a service to which item 73440 or 73441 applies, for characterisation of previously unreported germline gene variants for childhood hearing loss in a patient, if:(a) the re-analysis is requested by a specialist or consultant physician; and(b) the re-analysis is performed at least 24 months after:(i) the service to which items 73440 or 73441 applies has been provided to the patient; or(ii) a service to which this item applies is performed for the patient Applicable twice per lifetime$500.00
75% benefit $375.00
85% benefit $425.00
73443Characterisation of one or more familial germline gene variants known to be causative or likely causative of childhood hearing loss in a person, if:(a) the person tested is a biological relative of a patient with a germline gene variant known to be causative or likely causative of hearing loss confirmed by laboratory findings; and(b) the result of a previous proband testing is made available to the laboratory undertaking the characterisation$400.00
75% benefit $300.00
85% benefit $340.00
73444New 85% benefit on 1 November 2026Characterisation of all germline variants in one or more genes known to cause hearing loss in a person, if:(a) the characterisation is requested by a specialist or consultant physician; and(b) the characterisation is for the reproductive partner of a patient with a pathogenic or likely pathogenic recessive germline gene variant known to cause hearing loss confirmed by laboratory findings; and(c) the result of the patient’s previous testing is made available to the laboratory undertaking the characterisation$1,200.00
75% benefit $900.00
85% benefit $1,091.50 was $1,095.50
73445New 85% benefit on 1 November 2026Characterisation of a variant or variants in a panel of at least 25 genes using DNA and RNA, requested by a specialist or consultant physician, to determine the diagnosis, prognosis and/or management of a patient presenting with a clinically suspected haematological malignancy of myeloid origin Applicable once per diagnostic episode, at diagnosis, disease progression or relapse$1,100.00
75% benefit $825.00
85% benefit $991.50 was $995.50
73446New 85% benefit on 1 November 2026Characterisation of a variant or variants in a panel of at least 25 genes using DNA and RNA, requested by a specialist or consultant physician, to determine the diagnosis, prognosis and/or management of a patient presenting with a clinically suspected haematological malignancy of lymphoid origin Applicable once per diagnostic episode, at diagnosis, disease progression or relapse$1,100.00
75% benefit $825.00
85% benefit $991.50 was $995.50
73447New 85% benefit on 1 November 2026Characterisation of a variant or variants in a panel of at least 25 genes using DNA, requested by a specialist or consultant physician, to determine the diagnosis, prognosis and/or management of a patient presenting with a clinically suspected haematological malignancy of myeloid origin Applicable once per diagnostic episode, at diagnosis, disease progression or relapse$927.90
75% benefit $695.95
85% benefit $819.40 was $823.40
73448New 85% benefit on 1 November 2026Characterisation of a variant or variants in a panel of at least 25 genes using DNA, requested by a specialist or consultant physician, to determine the diagnosis, prognosis and/or management of a patient presenting with a clinically suspected haematological malignancy of lymphoid origin Applicable once per diagnostic episode, at diagnosis, disease progression or relapse$927.90
75% benefit $695.95
85% benefit $819.40 was $823.40
73451Testing of a patient (who is pregnant or planning pregnancy) to identify carrier status for pathogenic or likely pathogenic variants in a gene mentioned in paragraph (a), (b) or (c), to determine: (a) for the cystic fibrosis transmembrane conductance regulator (CFTR) gene—reproductive risk of cystic fibrosis; (b) for the survival motor neuron 1 (SMN1) gene—reproductive risk of spinal muscular atrophy; (c) for the fragile X messenger ribonucleoprotein 1 (FMR1) gene—reproductive risk of fragile X syndrome; (other than a service associated with a service to which item 73300, 73305, 73345, 73346, 73347, 73348, 73349 or 73350 applies) One test per lifetime$400.00
75% benefit $300.00
85% benefit $340.00
73452Testing of the reproductive partner of a patient who has been found to be a carrier of a pathogenic or likely pathogenic variant in the CFTR or SMN1 gene identified by testing under item 73451, for the purpose of determining the couple’s reproductive risk of cystic fibrosis or spinal muscular atrophy One test per condition per lifetime$400.00
75% benefit $300.00
85% benefit $340.00
73453Characterisation of germline pathogenic or likely pathogenic gene variants: (a) in at least the following genes: (i) ASPA; (ii) BLM; (iii) CFTR; (iv) ELP1; (v) FANCA; (vi) FANCC; (vii) FANCG; (viii) FMR1; (ix) G6PC1; (x) GBA1; (xi) HEXA; (xii) MCOLN1; (xiii) SLC37A4; (xiv) SMN1; (xv) SMPD1; and (b) in a patient of reproductive age who is of Ashkenazi Jewish descent for the purpose of ascertaining the patient’s carrier status for the following: (i) Bloom syndrome (ii) Canavan disease (iii) Cystic fibrosis (iv) Familial dysautonomia (v) Fanconi anaemia type C (vi) Fragile-X syndrome (vii) Gaucher disease (viii) Glycogen storage disease type I (ix) Mucolipidosis type IV (x) Niemann-Pick disease type A 7 (xi) Spinal muscular atrophy (xii) Tay-Sachs disease Applicable once per lifetime$425.00
75% benefit $318.75
85% benefit $361.25
73454New 85% benefit on 1 November 2026Whole gene sequencing of a gene or genes described in item 73453, in a patient who is the reproductive partner of an individual who is affected by, or is a known genetic carrier of, one or more conditions described in item 73453 (other than cystic fibrosis, fragile‑X syndrome or spinal muscular atrophy), for the purpose of determining the couple’s combined reproductive risk of the conditions, if: (a) the patient is not eligible for a service to which item 73453 applies; and (b) the patient has not received a service to which item 73453 applies; and (c) the patient has not received a service to which this item applies for the purpose of determining the patient’s reproductive risk with the patient’s current reproductive partner Applicable once per couple per lifetime$1,200.00
75% benefit $900.00
85% benefit $1,091.50 was $1,095.50
73455New 85% benefit on 1 November 2026Testing of a pregnant patient, if at least one prospective parent is known to be affected by, or is a genetic carrier of, one or more conditions described in item 73453, for the purpose of determining whether a familial variant or variants are present in the fetus, if: (a) the testing is requested by a specialist or consultant physician; and (b) there is at least a 25% risk of the fetus inheriting a condition described in paragraph (b) of item 73453$1,600.00
75% benefit $1,200.00
85% benefit $1,491.50 was $1,495.50
73456New 85% benefit on 1 November 2026Characterisation by whole genome sequencing, or by either or both whole exome sequencing and mitochondrial DNA sequencing, of germline variants present in nuclear DNA and in mitochondrial DNA of a patient with a strong suspicion of a mitochondrial disease, if: (a) the characterisation is requested by a specialist or consultant physician; and (b) the characterisation is requested because of the onset of one or more clinical features indicative of mitochondrial disease, including at least one or more of the following: (i) meeting the clinical criteria of a probable indicator of mitochondrial disease on a relevant scoring system; (ii) evident mitochondrial dysfunction or decompensation; (iii) unexplained hypotonia or weakness, profound hypoglycaemia or “failure to thrive” in the presence of a metabolic acidosis; (iv) unexplained single or multi-organ dysfunction or fulminant failure (including, but not limited to, neuropathies, myopathies, hepatopathy, pancreatic and/or bone marrow failure); (v) refractory or atypical seizures, developmental delays or cognitive regression, or progressive encephalopathy or progressive encephalomyopathy; (vi) cardiomyopathy and/or cardiac arrythmias; (vii) rapid hearing or painless visual loss or ptosis; (viii) stroke-like episodes or nonvasculitic strokes; (ix) ataxia, encephalopathy, seizures, muscle fatigue or weakness; (x) external ophthalmoplegia; (xi) hearing loss, diabetes, unexplained short stature, or endocrinopathy; (xii) family history of mitochondrial disease, or any of the above; and (c) the service is not a service associated with a service to which item 73358, 73359 or 73457 applies Applicable only once per lifetime$2,100.00
75% benefit $1,575.00
85% benefit $1,991.50 was $1,995.50
73457New 85% benefit on 1 November 2026Characterisation by whole genome sequencing, or either or both whole exome sequencing and mitochondrial DNA sequencing, of germline variants present in nuclear DNA and in mitochondrial DNA, of a patient with a strong suspicion of a mitochondrial disease, if: (a) the characterisation is performed using a sample from the patient and a sample from each of the patient’s biological parents; and (b) the request for the characterisation states that singleton testing is inappropriate; and (c) the characterisation is requested by a specialist or consultant physician; and (d) the characterisation is requested because of the onset of one or more clinical features indicative of mitochondrial disease, including at least one or more of the following: (i) meeting the clinical criteria of a probable indicator of mitochondrial disease on a relevant scoring system; (ii) evident mitochondrial dysfunction or decompensation; (iii) unexplained hypotonia or weakness, profound hypoglycaemia or “failure to thrive” in the presence of a metabolic acidosis; (iv) unexplained single or multi-organ dysfunction or fulminant failure (including, but not limited to, neuropathies, myopathies, hepatopathy, pancreatic and/or bone marrow failure); (v) refractory or atypical seizures, developmental delays or cognitive regression, or progressive encephalopathy or progressive encephalomyopathy; (vi) cardiomyopathy and/or cardiac arrythmias; (vii) rapid hearing or painless visual loss or ptosis; (viii) stroke-like episodes or nonvasculitic strokes; (ix) ataxia, encephalopathy, seizures, muscle fatigue or weakness; (x) external ophthalmoplegia; (xi) hearing loss, diabetes, unexplained short stature, or endocrinopathy; (xii) family history of mitochondrial disease; and (e) the service is not a service associated with a service to which item 73358, 73359 or 73456 applies Applicable only once per lifetime$3,300.00
75% benefit $2,475.00
85% benefit $3,191.50 was $3,195.50
73458Re-analysis of whole genome or whole exome or mitochondrial DNA data obtained in performing a service to which item 73456 or 73457 applies, for characterisation of previously unreported germline variants related to the clinical phenotype, if: (a) the re-analysis is requested by a specialist or consultant physician; and (b) the patient is strongly suspected of having a monogenic mitochondrial disease; and (c) the re-analysis is performed at least 24 months after: (i) the service to which item 73456 or 73457 applies; or (ii) a service to which this item applies Applicable twice per lifetime$500.00
75% benefit $375.00
85% benefit $425.00
73459New 85% benefit on 1 November 2026Testing for diagnostic purposes of a pregnant patient, for detection in the fetus of a gene variant or variants present in the parents, if: (a) the gene variant or variants are: (i) a variant or variants in the mitochondrial genome identified in the oocyte donating parent; or (ii) autosomal recessive variants identified in both biological parents within the same gene; or (iii) an autosomal dominant or X-linked variant identified in either biological parent; or (iv) identified in a biological sibling of the fetus; and (b) the causative variant or variants for the condition of the fetus’ first-degree relative have been confirmed by laboratory findings; and (c) the detection is requested by a specialist or consultant physician; and (d) the service is not a service associated with a service to which item 73361, 73362, 73363 or 73462 applies$1,600.00
75% benefit $1,200.00
85% benefit $1,491.50 was $1,495.50
73460Characterisation of mitochondrial DNA deletion or variant for diagnostic purposes in a patient suspected to have mitochondrial disease, if: (a) the characterisation is requested by the specialist or consultant physician managing the patient’s treatment; and (b) the patient displays onset of one or more clinical features indicative of mitochondrial disease, including at least one or more of the following: (i) meeting the clinical criteria of a probable indicator of mitochondrial disease on a relevant scoring system; (ii) evident mitochondrial dysfunction or decompensation; (iii) unexplained hypotonia or weakness, profound hypoglycaemia or ‘failure to thrive’ in the presence of a metabolic acidosis; (iv) unexplained single or multi-organ dysfunction or fulminant failure (including, but not limited to, neuropathies, myopathies, hepatopathy, pancreatic and/or bone marrow failure); (v) refractory or atypical seizures, developmental delays or cognitive regression, or progressive encephalopathy or progressive encephalomyopathy; (vi) cardiomyopathy and/or cardiac arrythmias; (vii) rapid hearing or painless visual loss or ptosis; (viii) stroke-like episodes or nonvasculitic strokes; (ix) ataxia, encephalopathy, seizures, muscle fatigue or weakness; (x) external ophthalmoplegia; (xi) hearing loss, diabetes, unexplained short stature, or endocrinopathy; (xii) family history of mitochondrial disease; and (c) the service is performed following a service to which items 73292, 73358, 73359, 73456 or 73457 applies for the same patient if the results were non-informativeApplicable 3 times per lifetime$450.00
75% benefit $337.50
85% benefit $382.50
73461New 85% benefit on 1 November 2026Whole gene testing of a person for the characterisation of all germline gene variants within the same gene in which the person’s reproductive partner has a pathogenic or likely pathogenic germline recessive gene variant for mitochondrial disease, if: (a) the partner’s germline recessive gene variant is confirmed by laboratory findings; and (b) the characterisation is requested by a specialist or consultant physician$1,200.00
75% benefit $900.00
85% benefit $1,091.50 was $1,095.50
73462Testing of a person for the detection of a single gene variant, if: (a) the person tested has a biological relative with a known pathogenic or likely pathogenic mitochondrial disease variant confirmed by laboratory findings; and (b) the testing is requested by a specialist or consultant physician; and (c) the service is not a service associated with a service to which item 73361, 73362 or 73363 applies$400.00
75% benefit $300.00
85% benefit $340.00

P8 Infertility And Pregnancy Tests

5 items

ItemDescriptionFee and benefits
73521Semen examination for presence of spermatozoa or examination of cervical mucus for spermatozoa (Huhner's test)$10.20
75% benefit $7.65
85% benefit $8.70
73523Semen examination (other than post-vasectomy semen examination), including: (a) measurement of volume, sperm count and motility; and (b) examination of stained preparations; and (c) morphology; and (if performed) (d) differential count and 1 or more chemical tests; (Item is subject to rule 25)$43.85
75% benefit $32.90
85% benefit $37.30
73525Sperm antibodies - sperm-penetrating ability - 1 or more tests$29.80
75% benefit $22.35
85% benefit $25.35
73527Human chorionic gonadotrophin (HCG) - detection in serum or urine by 1 or more methods for diagnosis of pregnancy - 1 or more tests$10.50
75% benefit $7.90
85% benefit $8.95
73529Human chorionic gonadotrophin (HCG), quantitation in serum by 1 or more methods (except by latex, membrane, strip or other pregnancy test kit) for diagnosis of threatened abortion, or follow up of abortion or diagnosis of ectopic pregnancy, including any services performed in item 73527 - 1 test$30.10
75% benefit $22.60
85% benefit $25.60

P9 Simple Basic Pathology Tests

28 items

ItemDescriptionFee and benefits
73801Semen examination for presence of spermatozoa$6.90
75% benefit $5.20
85% benefit $5.90
73802Leucocyte count, erythrocyte sedimentation rate, examination of blood film (including differential leucocyte count), haemoglobin, haematocrit or erythrocyte count - 1 test$4.55
75% benefit $3.45
85% benefit $3.90
738032 tests described in item 73802$6.35
75% benefit $4.80
85% benefit $5.40
738043 or more tests described in item 73802$8.15
75% benefit $6.15
85% benefit $6.95
73805Microscopy of urine, excluding dipstick testing.$4.55
75% benefit $3.45
85% benefit $3.90
73806Pregnancy test by 1 or more immunochemical methods$10.15
75% benefit $7.65
85% benefit $8.65
73807Microscopy for wet film other than urine, including any relevant stain$6.90
75% benefit $5.20
85% benefit $5.90
73808Microscopy of Gram-stained film, including (if performed) a service described in item 73805 or 73807$8.65
75% benefit $6.50
85% benefit $7.40
73809Chemical tests for occult blood in faeces by reagent stick, strip, tablet or similar method$2.35
75% benefit $1.80
85% benefit $2.00
73810Microscopy for fungi in skin, hair or nails - 1 or more sites$6.90
75% benefit $5.20
85% benefit $5.90
73811Mantoux test$11.20
75% benefit $8.40
85% benefit $9.55
73812Quantitation of glycated haemoglobin (HbA1c) performed in the management of established diabetes, if performed: (a) as a point‑of‑care test; and (b) by or on behalf of a medical practitioner who works in a general practice that is accredited to the Royal Australian College of General Practitioners Standards for point‑of-care testing under the National General Practice Accreditation Scheme; and (c) using a method certified by the National Glycohemoglobin Standardization Program (NGSP), if the instrumentation used has a total coefficient variation less than 3.0% at 48 mmol/mol (6.5%) Applicable not more than 3 times per 12 months per patient$11.80
75% benefit $8.85
85% benefit $10.05
73813Detection performed by, or on behalf of, a medical practitioner of: (a) chlamydia trachomatis (CT) and neisseria gonorrhoeae (NG) via molecular point-of-care testing for the diagnosis of CT or NG infection; and (b) trichomonas vaginalis (TV) via molecular point-of-care testing for the diagnosis of TV infection$117.65
85% benefit $100.05
73825Detection performed by a participating nurse practitioner of: (a) chlamydia trachomatis (CT) and neisseria gonorrhoeae (NG) via molecular point-of-care testing for the diagnosis of CT or NG infection; and (b) trichomonas vaginalis (TV) via molecular point-of-care testing for the diagnosis of TV infection$117.65
85% benefit $100.05
73826Quantitation of glycated haemoglobin (HbA1c) performed by a participating nurse practitioner in the management of established diabetes when performed: (a) as a point‑of‑care test; (b) by a nurse practitioner who works in a general practice that is accredited to the Royal Australian College of General Practitioners Standards for point-of-care testing under the National General Practice Accreditation Scheme; and (c) using a method and instrument certified by the National Glycohemoglobin Standardization Program (NGSP), if the instrument has a total coefficient variation less than 3.0% at 48 mmol/mol (6.5%) Applicable not more than 3 times per 12 months per patient$11.80
75% benefit $8.85
85% benefit $10.05
73828Semen examination for presence of spermatozoa by a participating nurse practitioner$6.90
85% benefit $5.90
73829Leucocyte count, erythrocyte sedimentation rate, examination of blood film (including differential leucocyte count), haemoglobin, haematocrit or erythrocyte count by a participating nurse practitioner - 1 test$4.55
85% benefit $3.90
738302 tests described in item 73829 by a participating nurse practitioner$6.35
85% benefit $5.40
738313 or more tests described in item 73829 by a participating nurse practitioner$8.15
85% benefit $6.95
73832Microscopy of urine, excluding dipstick testing by a participating nurse practitioner.$4.55
85% benefit $3.90
73833Pregnancy test by 1 or more immunochemical methods by a participating nurse practitioner$10.15
85% benefit $8.65
73834Microscopy for wet film other than urine, including any relevant stain by a participating nurse practitioner$6.90
85% benefit $5.90
73835Microscopy of Gram-stained film, including (if performed) a service described in item 73832 or 73834 by a participating nurse practitioner$8.65
85% benefit $7.40
73836Chemical tests for occult blood in faeces by reagent stick, strip, tablet or similar method by a participating nurse practitioner$2.35
85% benefit $2.00
73837Microscopy for fungi in skin, hair or nails by a participating nurse practitioner - 1 or more sites$6.90
85% benefit $5.90
73839Quantitation of HbA1c (glycated haemoglobin) performed for the diagnosis of diabetes in asymptomatic patients at high risk - not more than once in a 12 month period.$16.80
85% benefit $14.30
73840Quantitation of glycosylated haemoglobin performed in the management of established diabetes – each test to a maximum of 4 tests in a 12 month period$17.00
85% benefit $14.45
73844Quantitation of urinary albumin/creatine ratio in urine on a random spot collection in the management of patients with established diabetes or patients at risk of microalbuminuria.$20.35
85% benefit $17.30

P10 Patient Episode Initiation

21 items

ItemDescriptionFee and benefits
73899Initiation of a patient episode that consists of a service described in item 72858 or 72859 in circumstances other than those mentioned in item 73900$5.95
75% benefit $4.50
85% benefit $5.10
73900Initiation of a patient episode that consists of a service described in item 72858 or 72859 if the service is rendered in a prescribed laboratory.$2.40
75% benefit $1.80
85% benefit $2.05
73920Initiation of a patient episode by collection of a specimen for 1 or more services (other than those services described in items 73922, 73924 or 73926) if the specimen is collected in an approved collection centre that the APA operates in the same premises as it operates a category GX or GY pathology laboratory$2.40
75% benefit $1.80
85% benefit $2.05
73922Initiation of a patient episode that consists of a service described in item 73070, 73071, 73072, 73074, 73075 or 73076 (in circumstances other than those described in item 73923)$8.20
75% benefit $6.15
85% benefit $7.00
73923Initiation of a patient episode that consists of a service described in items 73070, 73071, 73072, 73074, 73075 or 73076 if: (a) the person is a private patient in a recognised hospital; or (b) the person receives the service from a prescribed laboratory$2.40
75% benefit $1.80
85% benefit $2.05
73924Initiation of a patient episode that consists of 1 or more services described in items 72813, 72816, 72817, 72818, 72823, 72824, 72825, 72826, 72827, 72828, 72830, 72836 and 72838 (in circumstances other than those described in item 73925) from a person who is an in-patient of a hospital.$14.65
75% benefit $11.00
85% benefit $12.50
73925Initiation of a patient episode that consists of 1 or more services described in items 72813, 72816, 72817, 72818, 72823, 72824, 72825, 72826, 72827, 72828, 72830, 72836 and 72838 if the person is: (a) a private patient of a recognised hospital; or (b) a private patient of a hospital who receives the service or services from a prescribed laboratory.$2.40
75% benefit $1.80
85% benefit $2.05
73926Initiation of a patient episode that consists of 1 or more services described in items 72813, 72816, 72817, 72818, 72823, 72824, 72825, 72826, 72827, 72828, 72830, 72836 and 72838 (in circumstances other than those described in item 73927) from a person who is not a patient of a hospital.$8.20
75% benefit $6.15
85% benefit $7.00
73927Initiation of a patient episode by a prescribed laboratory that consists of 1 or more services described in items, 72813, 72816, 72817, 72818, 72823, 72824, 72825, 72826, 72827, 72828, 72830, 72836 and 72838 from a person who is not a patient of a hospital.$2.40
75% benefit $1.80
85% benefit $2.05
73928Initiation of a patient episode by collection of a specimen for 1 or more services (other than those services described in items 73922, 73924 or 73926) if the specimen is collected in an approved collection centre. Unless item 73920 or 73929 applies$5.95
75% benefit $4.50
85% benefit $5.10
73929Initiation of a patient episode by collection of a specimen for 1 or more services (other than those services described in items 73922, 73924 or 73926) if the specimen is collected by an approved pathology practitioner for a prescribed laboratory or by an employee of an approved pathology authority, who conducts a prescribed laboratory, if the specimen is collected in an approved pathology collection centre$2.40
75% benefit $1.80
85% benefit $2.05
73930Initiation of a patient episode by collection of a specimen for a service for 1 or more services (other than those services described in items 73922, 73924 or 73926) if the specimen is collected by an approved pathology practitioner or an employee of an approved pathology authority from a person who is an in-patient of a hospital other than a recognised hospital. Unless item 73931 applies$5.95
75% benefit $4.50
85% benefit $5.10
73931Initiation of a patient episode by collection of a specimen for 1 or more services (other than those services described in items 73922, 73924 or 73926) if: () the specimen is collected by an approved pathology practitioner for a prescribed laboratory or by an employee of an approved pathology authority, who conducts a prescribed laboratory, from a person who is a private patient in a hospital or () the person is a private patient in a recognised hospital and the specimen is collected by an approved pathology practitioner or an employee of an approved pathology authority$2.40
75% benefit $1.80
85% benefit $2.05
73932New wording on 1 November 2026Initiation of a patient episode by collection of a specimen for one or more services (in circumstances other than those described in item 73922, 73923, 73924, 73925, 73926, 73927 or 73933) if:(a) the specimen is collected from a person in the place where the person resides; and (b) the place where the person resides is not a care institution or a residential care home; and (c) the specimen is collected by: (i) an approved pathology practitioner of an approved pathology authority; or (ii) an employee of an approved pathology authority.$10.25
75% benefit $7.70
85% benefit $8.75
73933New wording on 1 November 2026Initiation of a patient episode by collection of a specimen for one or more services (in circumstances other than those described in item 73922, 73923, 73924, 73925, 73926 or 73927) if:(a) the specimen is collected from a person in the place where the person resides; and (b) the place where the person resides is not a care institution or a residential care home; and (c) the specimen is collected by: (i) an approved pathology practitioner of a prescribed laboratory; or (ii) an employee of an approved pathology authority that operates a prescribed laboratory$2.40
75% benefit $1.80
85% benefit $2.05
73934New wording on 1 November 2026Initiation of a patient episode by collection of a specimen for one or more services (in circumstances other than those described in item 73922, 73923, 73924, 73925, 73926, 73927 or 73935) if:(a) the specimen is collected from a person in a care institution or a residential care home; and (b) the specimen is collected by: (i) an approved pathology practitioner of an approved pathology authority; or (ii) an employee of an approved pathology authority$17.60
75% benefit $13.20
85% benefit $15.00
73935New wording on 1 November 2026Initiation of a patient episode by collection of a specimen for one or more services (in circumstances other than those described in item 73922, 73923, 73924, 73925, 73926 or 73927) if:(a) the specimen is collected from a person in a care institution or a residential care home; and (b) the specimen is collected by: (i) an approved pathology practitioner of a prescribed laboratory; or (ii) an employee of an approved pathology authority that operates a prescribed laboratory$2.40
75% benefit $1.80
85% benefit $2.05
73936Initiation of a patient episode by collection of a specimen for 1 or more services (other than those services described in items 73922, 73924 or 73926) if the specimen is collected from the person by the person.$5.95
75% benefit $4.50
85% benefit $5.10
73937Initiation of a patient episode by collection of a specimen for 1 or more services (other than those services described in items 73922, 73924 or 73926), if the specimen is collected from the person by the person and if: () the service is performed in a prescribed laboratory or () the person is a private patient in a recognised hospital$2.40
75% benefit $1.80
85% benefit $2.05
73938Initiation of a patient episode by collection of a specimen for 1 or more services (other than those services described in items 73922, 73924 or 73926) if the specimen is collected by or on behalf of the treating practitioner. Unless item 73939 applies$7.95
75% benefit $6.00
85% benefit $6.80
73939Initiation of a patient episode by collection of a specimen for 1 or more services (other than those services described in items 73922, 73924 or 73926), if the specimen is collected by or on behalf of the treating practitioner and if: () the service is performed in a prescribed laboratory or () the person is a private patient in a recognised hospital$2.40
75% benefit $1.80
85% benefit $2.05

P11 Specimen Referred

1 item

ItemDescriptionFee and benefits
73940Receipt of a specimen by an approved pathology practitioner of an approved pathology authority from another approved pathology practitioner of another approved pathology authority$10.25
75% benefit $7.70
85% benefit $8.75

P12 Management Of Bulk-Billed Services

6 items

ItemDescriptionFee and benefits
74990A pathology service to which an item in this table (other than this item or item 74991, 75861, 75862, 75863 or 75864) applies if: (a) the service is an unreferred service; and (b) the service is provided to a person who is under the age of 16 or is a Commonwealth concession card holder; and (c) the person is not an admitted patient of a hospital; and (d) the service is bulk-billed in respect of the fees for: (i) this item; and (ii) the other item in this table applying to the service$8.25
85% benefit $7.05
74991A pathology service to which an item in this table (other than this item or items 74990, 75861, 75862, 75863 or 75864) applies if: (a) the service is an unreferred service; and (b) the service is provided to a person who is under the age of 16 or is a Commonwealth concession card holder; and (c) the person is not an admitted patient of a hospital; and (d) the service is bulk-billed in respect of the fees for: (i) this item; and (ii) the other item in this table applying to the service; and (e) the service is provided at, or from, a practice location in a Modified Monash 2 area.$12.50
85% benefit $10.65
75861A pathology service to which an item in this table (other than this item or item 74990, 74991, 75862, 75863 or 75864) applies if: (a) the service is an unreferred service; and (b) the service is rendered to a person who is under the age of 16 or is a concessional beneficiary; and (c) the person is not an admitted patient of a hospital; and (d) the service is bulk-billed in respect of the fees for: (i) this item; and (ii) the other item in this Schedule applying to the service; and (e) the service is rendered at, or from, a practice location in: (i) a Modified Monash 3 area; or (ii) a Modified Monash 4 area$13.30
85% benefit $11.35
75862A pathology service to which an item in this Schedule (other than this item or item 74990, 74991, 75861, 75863, or 75864) applies if: (a) the service is an unreferred service; and (b) the service is rendered to a person who is under the age of 16 or is a concessional beneficiary; and (c) the person is not an admitted patient of a hospital; and (d) the service is bulk-billed in relation to the fees for: (i) this item; and (ii) the other item in this Schedule applying to the service; and (e) the service is rendered at, or from, a practice location in a Modified Monash 5 area$14.05
85% benefit $11.95
75863A pathology service to which an item in this Schedule (other than this item or item 74990, 74991, 75861, 75862 or 75864) applies if: (a) the service is an unreferred service; and (b) the service is rendered to a person who is under the age of 16 or is a concessional beneficiary; and (c) the person is not an admitted patient of a hospital; and (d) the service is bulk-billed in respect of the fees for: (i) this item; and (ii) the other item in this Schedule applying to the service; and (e) the service is rendered at, or from, a practice location in a Modified Monash 6 area$15.00
85% benefit $12.75
75864A pathology service to which an item in this Schedule (other than this item or item 74990, 74991, 75861, 75862 or 75863) applies if: (a) the service is an unreferred service; and (b) the service is rendered to a person who is under the age of 16 or is a concessional beneficiary; and (c) the person is not an admitted patient of a hospital; and (d) the service is bulk-billed in relation to the fees for: (i) this item; and (ii) the other item in this Schedule applying to the service; and (e) the service is rendered at, or from, a practice location in a Modified Monash 7 area$16.35
85% benefit $13.90

P13 Bulk-Billing Incentive

8 items

ItemDescriptionFee and benefits
74992A payment when the episode is bulk billed and includes item 73920.$1.60
75% benefit $1.20
85% benefit $1.40
74993A payment when the episode is bulk billed and includes item 73922 or 73926.$3.75
75% benefit $2.85
85% benefit $3.20
74994A payment when the episode is bulk billed and includes item 73924.$3.25
75% benefit $2.45
85% benefit $2.80
74995A payment when the episode is bulk billed and includes item 73899, 73900, 73928, 73930 or 73936.$4.00
75% benefit $3.00
85% benefit $3.40
74996A payment when the episode is bulk billed and includes item 73932 or 73940.$3.70
75% benefit $2.80
85% benefit $3.15
74997A payment when the episode is bulk billed and includes item 73934.$3.30
75% benefit $2.50
85% benefit $2.85
74998A payment when the episode is bulk billed and includes item 73938.$2.00
75% benefit $1.50
85% benefit $1.70
74999A payment when the episode is bulk billed and includes item 73923, 73925, 73927, 73929, 73931, 73933, 73935, 73937 or 73939.$1.60
75% benefit $1.20
85% benefit $1.40

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