MBS Category 8
Miscellaneous services: MBS items and fees.
All 301 items in Category 8, with each item’s schedule fee and Medicare benefits, from the MBS edition of 1 November 2026.
Source: the MBS XML file of 1 November 2026, published by the Department of Health, Disability and Ageing. We update these pages for each MBS edition.
M3 Allied health and Aboriginal and Torres Strait Islander health and wellbeing services
16 items
| Item | Description | Fee and benefits |
|---|---|---|
| 10950 | Aboriginal and Torres Strait Islander health and wellbeing service provided to a patient by an eligible Aboriginal and Torres Strait Islander health worker or eligible Aboriginal and Torres Strait Islander health practitioner if: (a) the patient has a chronic condition and complex care needs being managed by a medical practitioner (other than a specialist or consultant physician) under: (i) a GP chronic condition management plan that has been prepared or reviewed in the last 18 months; or (ii) until the end of 30 June 2027—a GP Management Plan and Team Care Arrangements prepared prior to 1 July 2025; or (iii) a multidisciplinary care plan; and (b) the service is recommended in the patient’s plan or arrangements as part of the management of the patient’s chronic condition and complex care needs; and (c) the service is of at least 20 minutes duration; to a maximum of 5 services (including any services to which this item or any other item in this Subgroup or item 93000 or 93013 in the Telehealth Attendance Determination applies) in a calendar year | $74.55 85% benefit $63.40 |
| 10951 | Diabetes education health service provided to a patient by an eligible diabetes educator if: (a) the patient has a chronic condition and complex care needs being managed by a medical practitioner (other than a specialist or consultant physician) under: (i) a GP chronic condition management plan that has been prepared or reviewed in the last 18 months; or (ii) until the end of 30 June 2027—a GP Management Plan and Team Care Arrangements prepared prior to 1 July 2025; or (iii) a multidisciplinary care plan; and (b) the service is recommended in the patient’s plan or arrangements as part of the management of the patient’s chronic condition and complex care needs; and (c) the service is of at least 20 minutes duration; to a maximum of 5 services (including any services to which this item or any other item in this Subgroup or item 93000 or 93013 in the Telehealth Attendance Determination applies) in a calendar year | $74.55 85% benefit $63.40 |
| 10952 | Audiology health service provided to a patient by an eligible audiologist if: (a) the patient has a chronic condition and complex care needs being managed by a medical practitioner (other than a specialist or consultant physician) under: (i) a GP chronic condition management plan that has been prepared or reviewed in the last 18 months; or (ii) until the end of 30 June 2027—a GP Management Plan and Team Care Arrangements prepared prior to 1 July 2025; or (iii) a multidisciplinary care plan; and (b) the service is recommended in the patient’s plan or arrangements as part of the management of the patient’s chronic condition and complex care needs; and (c) the service is of at least 20 minutes duration; to a maximum of 5 services (including any services to which this item or any other item in this Subgroup or item 93000 or 93013 in the Telehealth Attendance Determination applies) in a calendar year | $74.55 85% benefit $63.40 |
| 10953 | Exercise physiology health service provided to a patient by an eligible exercise physiologist if: (a) the patient has a chronic condition and complex care needs being managed by a medical practitioner (other than a specialist or consultant physician) under: (i) a GP chronic condition management plan that has been prepared or reviewed in the last 18 months; or (ii) until the end of 30 June 2027—a GP Management Plan and Team Care Arrangements prepared prior to 1 July 2025; or (iii) a multidisciplinary care plan; and (b) the service is recommended in the patient’s plan or arrangements as part of the management of the patient’s chronic condition and complex care needs; and (c) the service is of at least 20 minutes duration; to a maximum of 5 services (including any services to which this item or any other item in this Subgroup or item 93000 or 93013 in the Telehealth Attendance Determination applies) in a calendar year | $74.55 85% benefit $63.40 |
| 10954 | Dietetics health service provided to a patient by an eligible dietitian if: (a) the patient has a chronic condition and complex care needs being managed by a medical practitioner (other than a specialist or consultant physician) under: (i) a GP chronic condition management plan that has been prepared or reviewed in the last 18 months; or (ii) until the end of 30 June 2027—a GP Management Plan and Team Care Arrangements prepared prior to 1 July 2025; or (iii) a multidisciplinary care plan; and (b) the service is recommended in the patient’s plan or arrangements as part of the management of the patient’s chronic condition and complex care needs; and (c) the service is of at least 20 minutes duration; to a maximum of 5 services (including any services to which this item or any other item in this Subgroup or item 93000 or 93013 in the Telehealth Attendance Determination applies) in a calendar year | $74.55 85% benefit $63.40 |
| 10955 | New wording on 1 November 2026Attendance by an eligible allied health practitioner, or eligible Aboriginal and Torres Strait Islander primary health care professional, as a member of a multidisciplinary case conference team, to participate in:(a) a community case conference; or (b) a multidisciplinary case conference in a residential care home; if the conference lasts for at least 15 minutes, but for less than 20 minutes (other than a service associated with a service to which another item in this Group applies) | $58.50 85% benefit $49.75 |
| 10956 | Mental health service provided to a patient by an eligible mental health worker if: (a) the patient has a chronic condition and complex care needs being managed by a medical practitioner (other than a specialist or consultant physician) under: (i) a GP chronic condition management plan that has been prepared or reviewed in the last 18 months; or (ii) until the end of 30 June 2027—a GP Management Plan and Team Care Arrangements prepared prior to 1 July 2025; or (iii) a multidisciplinary care plan; and (b) the service is recommended in the patient’s plan or arrangements as part of the management of the patient’s chronic condition and complex care needs; and (c) the service is of at least 20 minutes duration; to a maximum of 5 services (including any services to which this item or any other item in this Subgroup or item 93000 or 93013 in the Telehealth Attendance Determination applies) in a calendar year | $74.55 85% benefit $63.40 |
| 10957 | New wording on 1 November 2026Attendance by an eligible allied health practitioner, or eligible Aboriginal and Torres Strait Islander primary health care professional, as a member of a multidisciplinary case conference team, to participate in:(a) a community case conference; or (b) a multidisciplinary case conference in a residential care home; if the conference lasts for at least 20 minutes, but for less than 40 minutes (other than a service associated with a service to which another item in this Group applies) | $100.30 85% benefit $85.30 |
| 10958 | Occupational therapy health service provided to a patient by an eligible occupational therapist if: (a) the patient has a chronic condition and complex care needs being managed by a medical practitioner (other than a specialist or consultant physician) under: (i) a GP chronic condition management plan that has been prepared or reviewed in the last 18 months; or (ii) until the end of 30 June 2027—a GP Management Plan and Team Care Arrangements prepared prior to 1 July 2025; or (iii) a multidisciplinary care plan; and (b) the service is recommended in the patient’s plan or arrangements as part of the management of the patient’s chronic condition and complex care needs; and (c) the service is of at least 20 minutes duration; to a maximum of 5 services (including any services to which this item or any other item in this Subgroup or item 93000 or 93013 in the Telehealth Attendance Determination applies) in a calendar year | $74.55 85% benefit $63.40 |
| 10959 | New wording on 1 November 2026Attendance by an eligible allied health practitioner or eligible Aboriginal and Torres Strait Islander primary health care professional, as a member of a multidisciplinary case conference team, to participate in:(a) a community case conference; or (b) a multidisciplinary case conference in a residential care home; if the conference lasts for at least 40 minutes (other than a service associated with a service to which another item in this Group applies) | $166.85 85% benefit $141.85 |
| 10960 | Physiotherapy health service provided to a patient by an eligible physiotherapist if: (a) the patient has a chronic condition and complex care needs being managed by a medical practitioner (other than a specialist or consultant physician) under: (i) a GP chronic condition management plan that has been prepared or reviewed in the last 18 months; or (ii) until the end of 30 June 2027—a GP Management Plan and Team Care Arrangements prepared prior to 1 July 2025; or (iii) a multidisciplinary care plan; and (b) the service is recommended in the patient’s plan or arrangements as part of the management of the patient’s chronic condition and complex care needs; and (c) the service is of at least 20 minutes duration; to a maximum of 5 services (including any services to which this item or any other item in this Subgroup or item 93000 or 93013 in the Telehealth Attendance Determination applies) in a calendar year | $74.55 85% benefit $63.40 |
| 10962 | Podiatry health service provided to a patient by an eligible podiatrist if: (a) the patient has a chronic condition and complex care needs being managed by a medical practitioner (other than a specialist or consultant physician) under: (i) a GP chronic condition management plan that has been prepared or reviewed in the last 18 months; or (ii) until the end of 30 June 2027—a GP Management Plan and Team Care Arrangements prepared prior to 1 July 2025; or (iii) a multidisciplinary care plan; and (b) the service is recommended in the patient’s plan or arrangements as part of the management of the patient’s chronic condition and complex care needs; and (c) the service is of at least 20 minutes duration; to a maximum of 5 services (including any services to which this item or any other item in this Subgroup or item 93000 or 93013 in the Telehealth Attendance Determination applies) in a calendar year | $74.55 85% benefit $63.40 |
| 10964 | Chiropractic health service provided to a patient by an eligible chiropractor if: (a) the patient has a chronic condition and complex care needs being managed by a medical practitioner (other than a specialist or consultant physician) under: (i) a GP chronic condition management plan that has been prepared or reviewed in the last 18 months; or (ii) until the end of 30 June 2027—a GP Management Plan and Team Care Arrangements prepared prior to 1 July 2025; or (iii) a multidisciplinary care plan; and (b) the service is recommended in the patient’s plan or arrangements as part of the management of the patient’s chronic condition and complex care needs; and (c) the service is of at least 20 minutes duration; to a maximum of 5 services (including any services to which this item or any other item in this Subgroup or item 93000 or 93013 in the Telehealth Attendance Determination applies) in a calendar year | $74.55 85% benefit $63.40 |
| 10966 | Osteopathy health service provided to a patient by an eligible osteopath if: (a) the patient has a chronic condition and complex care needs being managed by a medical practitioner (other than a specialist or consultant physician) under: (i) a GP chronic condition management plan that has been prepared or reviewed in the last 18 months; or (ii) until the end of 30 June 2027—a GP Management Plan and Team Care Arrangements prepared prior to 1 July 2025; or (iii) a multidisciplinary care plan; and (b) the service is recommended in the patient’s plan or arrangements as part of the management of the patient’s chronic condition and complex care needs; and (c) the service is of at least 20 minutes duration; to a maximum of 5 services (including any services to which this item or any other item in this Subgroup or item 93000 or 93013 in the Telehealth Attendance Determination applies) in a calendar year | $74.55 85% benefit $63.40 |
| 10968 | Psychology health service provided to a patient by an eligible psychologist if: (a) the patient has a chronic condition and complex care needs being managed by a medical practitioner (other than a specialist or consultant physician) under: (i) a GP chronic condition management plan that has been prepared or reviewed in the last 18 months; or (ii) until the end of 30 June 2027—a GP Management Plan and Team Care Arrangements prepared prior to 1 July 2025; or (iii) a multidisciplinary care plan; and (b) the service is recommended in the patient’s plan or arrangements as part of the management of the patient’s chronic condition and complex care needs; and (c) the service is of at least 20 minutes duration; to a maximum of 5 services (including any services to which this item or any other item in this Subgroup or item 93000 or 93013 in the Telehealth Attendance Determination applies) in a calendar year | $74.55 85% benefit $63.40 |
| 10970 | Speech pathology health service provided to a patient by an eligible speech pathologist if: (a) the patient has a chronic condition and complex care needs being managed by a medical practitioner (other than a specialist or consultant physician) under: (i) a GP chronic condition management plan that has been prepared or reviewed in the last 18 months; or (ii) until the end of 30 June 2027—a GP Management Plan and Team Care Arrangements prepared prior to 1 July 2025; or (iii) a multidisciplinary care plan; and (b) the service is recommended in the patient’s plan or arrangements as part of the management of the patient’s chronic condition and complex care needs; and (c) the service is of at least 20 minutes duration; to a maximum of 5 services (including any services to which this item or any other item in this Subgroup or item 93000 or 93013 in the Telehealth Attendance Determination applies) in a calendar year | $74.55 85% benefit $63.40 |
M12 Services Provided by a Practice Nurse, an Aboriginal and Torres Strait Islander Health Worker or an Aboriginal and Torres Strait Islander health practitioner on behalf of a Medical Practitioner
5 items
| Item | Description | Fee and benefits |
|---|---|---|
| 10983 | Attendance by a practice nurse, an Aboriginal and Torres Strait Islander health worker or an Aboriginal and Torres Strait Islander health practitioner on behalf of, and under the supervision of, a medical practitioner, to provide clinical support to a patient who: (a) is participating in a video conferencing consultation with a specialist, consultant physician or psychiatrist; and (b) is not an admitted patient | $38.85 100% benefit $38.85 |
| 10987 | Follow‑up service, to a maximum of 10 services per patient in a calendar year, provided by a practice nurse or an Aboriginal and Torres Strait Islander health practitioner, on behalf of a medical practitioner, for an Indigenous person who has received a health check if: (a) the service is provided on behalf of and under the supervision of a medical practitioner; and (b) the person is not an admitted patient of a hospital; and (c) the service is consistent with the needs identified through the health assessment. | $28.70 100% benefit $28.70 |
| 10988 | Immunisation provided to a person by an Aboriginal and Torres Strait Islander health practitioner if: (a) the immunisation is provided on behalf of, and under the supervision of, a medical practitioner; and (b) the person is not an admitted patient of a hospital. | $14.35 100% benefit $14.35 |
| 10989 | Treatment of a person's wound (other than normal aftercare) provided by an Aboriginal and Torres Strait Islander health practitioner if: (a) the treatment is provided on behalf of, and under the supervision of, a medical practitioner; and (b) the person is not an admitted patient of a hospital. | $14.35 100% benefit $14.35 |
| 10997 | New wording on 1 November 2026Service provided by a practice nurse or an Aboriginal and Torres Strait Islander health practitioner to a person with a chronic condition, if: (a) the service is provided on behalf of and under the supervision of a medical practitioner; and (b) the person is not an admitted patient of a hospital; and (c) the person has in place: (i) a GP chronic condition management plan that has been prepared or reviewed in the last 18 months; or (ii) until the end of 30 June 2027—a GP management plan, or team care arrangements, prepared before 1 July 2025; or (iii) a multidisciplinary care plan; and (d) the service is consistent with the plan or arrangements Applicable up to a total of 5 services to which this item, item 93201 or item 93203 applies in a calendar year | $14.35 100% benefit $14.35 |
M1 Management Of Bulk-Billed Services
20 items
| Item | Description | Fee and benefits |
|---|---|---|
| 10990 | A medical service to which an item in this Schedule (other than this item) applies, if: (a) the service is an unreferred service; and (b) the service is provided to a person who 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) any other item in this Schedule applying to the service; other than a service associated with a service: (e) to which another item in this Group applies; or (f) that is a general practice support service; or (g) that is a MyMedicare service | $8.80 85% benefit $7.50 |
| 10991 | A medical service to which an item in this Schedule (other than this item) applies, if: (a) the service is an unreferred service; and (b) the service is provided to a person who 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) any other item in this Schedule applying to the service; and (e) the service is provided at, or from, a practice location in a Modified Monash 2 area; other than a service associated with a service: (f) to which another item in this Group applies; or (g) that is a general practice support service; or (h) that is a MyMedicare service | $13.35 85% benefit $11.35 |
| 10992 | A medical service to which: (a) item 585, 588, 591, 594, 599, 600, 5003, 5010, 5220 or 5260 applies; or (b) item 761 or 772 applies (see the Health Insurance (Section 3C General Medical Services – Other Medical Practitioner) Determination 2018); if: (c) the service is an unreferred service; and (d) the service is provided to a person who is not an admitted patient of a hospital; and (f) the service is not provided in consulting rooms; and (g) the service is provided in any of the following areas: (i) a Modified Monash 2 area; (ii) a Modified Monash 3 area; (iii) a Modified Monash 4 area; (iv) a Modified Monash 5 area; (v) a Modified Monash 6 area; (vi) a Modified Monash 7 area; and (h) the service is provided by, or on behalf of, a medical practitioner whose practice location is not in an area mentioned in paragraph (g); and (i) the service is bulk‑billed in relation to the fees for: (i) this item; and (ii) the other item mentioned in paragraph (a) or (b) applying to the service | $13.35 85% benefit $11.35 |
| 75855 | A medical service to which an item in this Schedule (other than this item) applies, if: (a) the service is an unreferred service; and (b) the service is provided to a person who 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) any other item in this Schedule applying to the service; and (e) the service is provided at, or from, a practice location in: (i) a Modified Monash 3 area; or (ii) a Modified Monash 4 area; other than a service associated with a service: (f) to which another item in this Group applies; or (g) that is a general practice support service; or (h) that is a MyMedicare service | $14.10 85% benefit $12.00 |
| 75856 | A medical service to which an item in this Schedule (other than this item) applies, if: (a) the service is an unreferred service; and (b) the service is provided to a person who 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) any other item in this Schedule applying to the service; and (e) the service is provided at, or from, a practice location in a Modified Monash 5 area; other than a service associated with a service: (f) to which another item in this Group applies; or (g) that is a general practice support service; or (h) that is a MyMedicare service | $15.10 85% benefit $12.85 |
| 75857 | A medical service to which an item in this Schedule (other than this item) applies, if: (a) the service is an unreferred service; and (b) the service is provided to a person who 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) any other item in this Schedule applying to the service; and (e) the service is provided at, or from, a practice location in a Modified Monash 6 area; other than a service associated with a service: (f) to which another item in this Group applies; or (g) that is a general practice support service; or (h) that is a MyMedicare service | $15.85 85% benefit $13.50 |
| 75858 | A medical service to which an item in this Schedule (other than this item) applies, if: (a) the service is an unreferred service; and (b) the service is provided to a person who 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) any other item in this Schedule applying to the service; and (e) the service is provided at, or from, a practice location in a Modified Monash 7 area; other than a service associated with a service: (f) to which another item in this Group applies; or (g) that is a general practice support service; or (h) that is a MyMedicare service | $16.95 85% benefit $14.45 |
| 75870 | Professional attendance (the attendance service) by a general practitioner, a medical practitioner or a prescribed medical practitioner, at which a general practice support service is provided, if: (a) the attendance service is provided to a patient who is not an admitted patient of a hospital; and (c) the attendance service is bulk-billed in relation to the fees for: (i) this item; and (ii) the general practice support service item applying to the attendance service; other than an attendance service associated with a service to which item 10990, 10991, 10992, 75855, 75856, 75857, 75858, 75871, 75872, 75873, 75874, 75875, 75876, 75880, 75881, 75882, 75883, 75884 or 75885 applies Subgroup 2NOTE: this item can be claimed with face to face level B, C, D and E general attendance items, and level B video and phone general attendance items. | $26.35 85% benefit $22.40 |
| 75871 | Professional attendance (the attendance service) by a general practitioner, a medical practitioner or a prescribed medical practitioner, at which a general practice support service is provided, if: (a) the attendance service is provided to a patient who is not an admitted patient of a hospital; and (c) the attendance service is bulk-billed in relation to the fees for: (i) this item; and (ii) the general practice support service item applying to the attendance service; and (d) the attendance service is provided at, or from, a practice location in a Modified Monash 2 area; other than an attendance service associated with a service to which item 10990, 10991, 10992, 75855, 75856, 75857, 75858, 75870, 75872, 75873, 75874, 75875, 75876, 75880, 75881, 75882, 75883, 75884 or 75885 applies Subgroup 2NOTE: this item can be claimed with face to face level B, C, D and E general attendance items, and level B video and phone general attendance items. | $40.10 85% benefit $34.10 |
| 75872 | Professional attendance (the attendance service) if: (a) item 763, 766, 769, 776, 788, 789, 2198, 2200, 5023, 5028, 5043, 5049, 5063, 5067, 5076, 5077, 5223, 5227, 5228, 5261, 5263, 5265, 5267 or 5262 applies; and (b) the attendance service is an unreferred service; and (c) the attendance service is provided to a patient who is not an admitted patient of a hospital; and (e) the attendance service is not provided in consulting rooms; and (f) the attendance service is provided in any of the following areas: (i) a Modified Monash 2 area; (ii) a Modified Monash 3 area; (iii) a Modified Monash 4 area; (iv) a Modified Monash 5 area; (v) a Modified Monash 6 area; (vi) a Modified Monash 7 area; and (g) the attendance service is provided by, or on behalf of, a general practitioner, a medical practitioner or a prescribed medical practitioner whose practice location is not in an area mentioned in paragraph (f); and (h) the attendance service is bulk-billed in relation to the fees for: (i) this item; and (ii) an item mentioned in paragraph (a) that applies to the service | $40.10 85% benefit $34.10 |
| 75873 | Professional attendance (the attendance service) by a general practitioner, a medical practitioner or a prescribed medical practitioner, at which a general practice support service is provided, if: (a) the attendance service is provided to a patient who is not an admitted patient of a hospital; and (c) the attendance service is bulk-billed in relation to the fees for: (i) this item; and (ii) the general practice support service item applying to the attendance service; and (d) the attendance service is provided at, or from, a practice location in: (i) a Modified Monash 3 area; or (ii) a Modified Monash 4 area; other than an attendance service associated with a service to which item 10990, 10991, 10992, 75855, 75856, 75857, 75858, 75870, 75871, 75872, 75874, 75875, 75876, 75880, 75881, 75882, 75883, 75884 or 75885 applies Subgroup 2NOTE: this item can be claimed with face to face level B, C, D and E general attendance items, and level B video and phone general attendance items. | $42.60 85% benefit $36.25 |
| 75874 | Professional attendance (the attendance service) by a general practitioner, a medical practitioner or a prescribed medical practitioner, at which a general practice support service is provided, if: (a) the attendance service is provided to a patient who is not an admitted patient of a hospital; and (c) the attendance service is bulk-billed in relation to the fees for: (i) this item; and (ii) the general practice support service item applying to the attendance service; and (d) the attendance service is provided at, or from, a practice location in a Modified Monash 5 area; other than an attendance service associated with a service which item 10990, 10991, 10992, 75855, 75856, 75857, 75858, 75870, 75871, 75872, 75873, 75875, 75876, 75880, 75881, 75882, 75883, 75884 or 75885 applies Subgroup 2NOTE: this item can be claimed with face to face level B, C, D and E general attendance items, and level B video and phone general attendance items. | $45.30 85% benefit $38.55 |
| 75875 | Professional attendance (the attendance service) by a general practitioner, a medical practitioner or a prescribed medical practitioner, at which a general practice support service is provided, if: (a) the attendance service is provided to a patient who is not an admitted patient of a hospital; and (c) the attendance service is bulk-billed in relation to the fees for: (i) this item; and (ii) the general practice support service item applying to the attendance service; and (d) the attendance service is provided at, or from, a practice location in a Modified Monash 6 area; other than an attendance service associated with a service to which item 10990, 10991, 10992, 75855, 75856, 75857, 75858, 75870, 75871, 75872, 75873, 75874, 75876, 75880, 75881, 75882, 75883, 75884 or 75885 applies Subgroup 2NOTE: this item can be claimed with face to face level B, C, D and E general attendance items, and level B video and phone general attendance items. | $47.80 85% benefit $40.65 |
| 75876 | Professional attendance (the attendance service) by a general practitioner, a medical practitioner or a prescribed medical practitioner, at which a general practice support service is provided, if: (a) the attendance service is provided to a patient who is not an admitted patient of a hospital; and (c) the attendance service is bulk-billed in relation to the fees for: (i) this item; and (ii) the general practice support service item applying to the attendance service; and (d) the attendance service is provided at, or from, a practice location in a Modified Monash 7 area; other than an attendance service associated with a service to which item 10990, 10991, 10992, 75855, 75856, 75857, 75858, 75870, 75871, 75872, 75873, 75874, 75875, 75880, 75881, 75882, 75883, 75884 or 75885 applies Subgroup 2NOTE: this item can be claimed with face to face level B, C, D and E general attendance items, and level B video and phone general attendance items. | $50.75 85% benefit $43.15 |
| 75880 | Professional attendance (the attendance service) by a general practitioner, a medical practitioner or a prescribed medical practitioner, at which a MyMedicare service is provided, if: (a) the attendance service is provided to a patient who is enrolled in MyMedicare at the general practice through which the attendance service is provided; and (b) the patient is not an admitted patient of a hospital; and (c) the attendance service is bulk-billed in relation to the fees for: (i) this item; and (ii) the MyMedicare service item applying to the attendance service; other than an attendance service associated with a service to which item 10990, 10991, 10992, 75855, 75856, 75857, 75858, 75870, 75871, 75872, 75873, 75874, 75875, 75876, 75881, 75882, 75883, 75884 or 75885 applies Subgroup 3NOTE: this item can be claimed with level C, D, and E video general attendance items, and level C and D phone general attendance items, where the patient is registered with MyMedicare. | $26.35 85% benefit $22.40 |
| 75881 | Professional attendance (the attendance service) by a general practitioner, a medical practitioner or a prescribed medical practitioner, at which a MyMedicare service is provided, if: (a) the attendance service is provided to a patient who is enrolled in MyMedicare at the general practice through which the attendance service is provided; and (b) the patient is not an admitted patient of a hospital; and (c) the attendance service is bulk-billed in relation to the fees for: (i) this item; and (ii) the MyMedicare service item applying to the attendance service; and (d) the attendance service is provided at, or from, a practice location in a Modified Monash 2 area; other than an attendance service associated with a service to which item 10990, 10991, 10992, 75855, 75856, 75857, 75858, 75870, 75871, 75872, 75873, 75874, 75875, 75876, 75880, 75882, 75883, 75884 or 75885 applies Subgroup 3NOTE: this item can be claimed with level C, D, and E video general attendance items, and level C and D phone general attendance items, where the patient is registered with MyMedicare. | $40.10 85% benefit $34.10 |
| 75882 | Professional attendance (the attendance service) by a general practitioner, a medical practitioner or a prescribed medical practitioner, at which a MyMedicare service is provided, if: (a) the attendance service is provided to a patient who is enrolled in MyMedicare at the general practice through which the attendance service is provided; and (b) the patient is not an admitted patient of a hospital; and (c) the attendance service is bulk-billed in relation to the fees for: (i) this item; and (ii) the MyMedicare service item applying to the attendance service; and (d) the attendance service is provided at, or from, a practice location in: (i) a Modified Monash 3 area; or (ii) a Modified Monash 4 area; other than an attendance service associated with a service to which item 10990, 10991, 10992, 75855, 75856, 75857, 75858, 75870, 75871, 75872, 75873, 75874, 75875, 75876, 75880, 75881, 75883, 75884 or 75885 applies Subgroup 3NOTE: this item can be claimed with level C, D, and E video general attendance items, and level C and D phone general attendance items, where the patient is registered with MyMedicare. | $42.60 85% benefit $36.25 |
| 75883 | Professional attendance (the attendance service) by a general practitioner, a medical practitioner or a prescribed medical practitioner, at which a MyMedicare service is provided, if: (a) the attendance service is provided to a patient who is enrolled in MyMedicare at the general practice through which the attendance service is provided; and (b) the patient is not an admitted patient of a hospital; and (c) the attendance service is bulk-billed in relation to the fees for: (i) this item; and (ii) the MyMedicare service item applying to the attendance service; and (d) the attendance service is provided at, or from, a practice location in a Modified Monash 5 area; other than an attendance service associated with a service to which item 10990, 10991, 10992, 75855, 75856, 75857, 75858, 75870, 75871, 75872, 75873, 75874, 75875, 75876, 75880, 75881, 75882, 75884 or 75885 applies Subgroup 3NOTE: this item can be claimed with level C, D, and E video general attendance items, and level C and D phone general attendance items, where the patient is registered with MyMedicare. | $45.30 85% benefit $38.55 |
| 75884 | Professional attendance (the attendance service) by a general practitioner, a medical practitioner or a prescribed medical practitioner, at which a MyMedicare service is provided, if: (a) the attendance service is provided to a patient who is enrolled in MyMedicare at the general practice through which the attendance service is provided; and (b) the patient is not an admitted patient of a hospital; and (c) the attendance service is bulk-billed in relation to the fees for: (i) this item; and (ii) the MyMedicare service item applying to the attendance service; and (d) the attendance service is provided at, or from, a practice location in a Modified Monash 6 area; other than an attendance service associated with a service to which item 10990, 10991, 10992, 75855, 75856, 75857, 75858, 75870, 75871, 75872, 75873, 75874, 75875, 75876, 75880, 75881, 75882, 75883 or 75885 applies Subgroup 3NOTE: this item can be claimed with level C, D, and E video general attendance items, and level C and D phone general attendance items, where the patient is registered with MyMedicare. | $47.80 85% benefit $40.65 |
| 75885 | Professional attendance (the attendance service) by a general practitioner, a medical practitioner or a prescribed medical practitioner, at which a MyMedicare service is provided, if: (a) the attendance service is provided to a patient who is enrolled in MyMedicare at the general practice through which the attendance service is provided; and (b) the patient is not an admitted patient of a hospital; and (c) the attendance service is bulk-billed in relation to the fees for: (i) this item; and (ii) the MyMedicare service item applying to the attendance service; and (d) the attendance service is provided at, or from, a practice location in a Modified Monash 7 area; other than an attendance service associated with a service to which item 10990, 10991, 10992, 75855, 75856, 75857, 75858, 75870, 75871, 75872, 75873, 75874, 75875, 75876, 75880, 75881, 75882, 75883 or 75884 applies Subgroup 3NOTE: this item can be claimed with level C, D, and E video general attendance items, and level C and D phone general attendance items, where the patient is registered with MyMedicare. | $50.75 85% benefit $43.15 |
M6 Psychological Therapy Services
14 items
| Item | Description | Fee and benefits |
|---|---|---|
| 80000 | Psychological therapy health service provided to a patient in consulting rooms by an eligible clinical psychologist if: (a) the patient is referred by a referring practitioner; and (b) the service is provided to the patient individually and in person; and (c) at the completion of a course of treatment, the referring practitioner reviews the need for a further course of treatment; and (d) on the completion of the course of treatment, the eligible clinical psychologist gives a written report to the referring practitioner on assessments carried out, treatment provided and recommendations on future management of the patient’s condition; and (e) the service is at least 30 minutes but less than 50 minutes duration | $119.45 85% benefit $101.55 |
| 80002 | Psychological therapy health service provided in consulting rooms by an eligible clinical psychologist to a person other than the patient, if: (a) the service is part of the patient’s treatment; (b) the patient has been referred to the eligible clinical psychologist by a referring practitioner; and (c) the service lasts at least 30 minutes but less than 50 minutes | $119.45 85% benefit $101.55 |
| 80005 | Psychological therapy health service provided to a patient at a place other than consulting rooms by an eligible clinical psychologist if: (a) the patient is referred by a referring practitioner; and (b) the service is provided to the patient individually and in person; and (c) at the completion of a course of treatment, the referring practitioner reviews the need for a further course of treatment; and (d) on the completion of the course of treatment, the eligible clinical psychologist gives a written report to the referring practitioner on assessments carried out, treatment provided and recommendations on future management of the patient’s condition; and (e) the service is at least 30 minutes but less than 50 minutes duration | $149.25 85% benefit $126.90 |
| 80006 | Psychological therapy health service provided at a place other than consulting rooms by an eligible clinical psychologist to a person other than the patient, if: (a) the service is part of the patient’s treatment; (b) the patient has been referred to the eligible clinical psychologist by a referring practitioner; and (c) the service lasts at least 30 minutes but less than 50 minutes | $149.25 85% benefit $126.90 |
| 80010 | Psychological therapy health service provided to a patient in consulting rooms by an eligible clinical psychologist if: (a) the patient is referred by a referring practitioner; and (b) the service is provided to the patient individually and in person; and (c) at the completion of a course of treatment, the referring practitioner reviews the need for a further course of treatment; and (d) on the completion of the course of treatment, the eligible clinical psychologist gives a written report to the referring practitioner on assessments carried out, treatment provided and recommendations on future management of the patient’s condition; and (e) the service is at least 50 minutes duration | $175.30 85% benefit $149.05 |
| 80012 | Psychological therapy health service provided in consulting rooms by an eligible clinical psychologist to a person other than the patient, if: (a) the service is part of the patient’s treatment; (b) the patient has been referred to the eligible clinical psychologist by a referring practitioner; and (c) the service lasts at least 50 minutes | $175.30 85% benefit $149.05 |
| 80015 | Psychological therapy health service provided to a patient at a place other than consulting rooms by an eligible clinical psychologist if: (a) the patient is referred by a referring practitioner; and (b) the service is provided to the patient individually and in person; and (c) at the completion of a course of treatment, the referring practitioner reviews the need for a further course of treatment; and (d) on the completion of the course of treatment, the eligible clinical psychologist gives a written report to the referring practitioner on assessments carried out, treatment provided and recommendations on future management of the patient’s condition; and (e) the service is at least 50 minutes duration | $205.10 85% benefit $174.35 |
| 80016 | Psychological therapy health service provided at a place other than consulting rooms by an eligible clinical psychologist to a person other than the patient, if: (a) the service is part of the patient’s treatment; (b) the patient has been referred to the eligible clinical psychologist by a referring practitioner; and (c) the service lasts at least 50 minutes | $205.10 85% benefit $174.35 |
| 80020 | Psychological therapy health service provided to a patient as part of a group of 4 to 10 patients by an eligible clinical psychologist if: (a) the patient is referred by a referring practitioner; and (b) the service is provided in person; and (c) the service is at least 60 minutes duration | $44.50 85% benefit $37.85 |
| 80021 | Psychological therapy health service provided to a patient as part of a group of 4 to 10 patients by an eligible clinical psychologist if: (a) the patient is referred by a referring practitioner; and (b) the attendance is by video conference; and (c) the patient is located within a telehealth eligible area; and (d) the patient is, at the time of the attendance, at least 15 kilometres by road from the clinical psychologist; and (e) the service is at least 60 minutes duration | $44.50 85% benefit $37.85 |
| 80022 | Psychological therapy health service provided to a patient as part of a group of 4 to 10 patients by an eligible clinical psychologist if: (a) the patient is referred for a course of treatment by a referring practitioner; and (b) the service is provided in person; and (c) the service is at least 90 minutes duration | $60.65 85% benefit $51.60 |
| 80023 | Psychological therapy health service provided to a patient as part of a group of 4 to 10 patients by an eligible clinical psychologist if: (a) the patient is referred by a referring practitioner; and (b) the attendance is by video conference; and (c) the patient is located within a telehealth eligible area; and (d) the patient is, at the time of the attendance, at least 15 kilometres by road from the clinical psychologist; and (e) the service is at least 90 minutes duration | $60.65 85% benefit $51.60 |
| 80024 | Psychological therapy health service provided to a patient as part of a group of 4 to 10 patients by an eligible clinical psychologist if: (a) the patient is referred for a course of treatment by a referring practitioner; and (b) the service is provided in person; and (c) the service is at least 120 minutes duration | $82.40 85% benefit $70.05 |
| 80025 | Psychological therapy health service provided to a patient as part of a group of 4 to 10 patients by an eligible clinical psychologist if: (a) the patient is referred by a referring practitioner; and (b) the attendance is by video conference; and (c) the patient is located within a telehealth eligible area; and (d) the patient is, at the time of the attendance, at least 15 kilometres by road from the clinical psychologist; and (e) the service is at least 120 minutes duration | $82.40 85% benefit $70.05 |
M7 Focussed Psychological Strategies (Allied Mental Health)
45 items
| Item | Description | Fee and benefits |
|---|---|---|
| 80100 | Focussed psychological strategies health service provided to a patient in consulting rooms by an eligible psychologist if: (a) the patient is referred by a referring practitioner; and (b) the service is provided to the patient individually and in person; and (c) at the completion of a course of treatment, the referring practitioner reviews the need for a further course of treatment; and (d) on the completion of the course of treatment, the eligible psychologist gives a written report to the referring practitioner on assessments carried out, treatment provided and recommendations on future management of the patient’s condition; and (e) the service is at least 20 minutes but less than 50 minutes duration | $84.65 85% benefit $72.00 |
| 80102 | Focussed psychological strategies health service provided in consulting rooms by an eligible psychologist to a person other than the patient, if: (a) the service is part of the patient’s treatment; (b) the patient has been referred to the eligible psychologist by a referring practitioner; and (c) the service lasts at least 20 minutes but less than 50 minutes | $84.65 85% benefit $72.00 |
| 80105 | Focussed psychological strategies health service provided to a patient at a place other than consulting rooms by an eligible psychologist if: (a) the patient is referred by a referring practitioner; and (b) the service is provided to the patient individually and in person; and (c) at the completion of a course of treatment, the referring practitioner reviews the need for a further course of treatment; and (d) on the completion of the course of treatment, the eligible psychologist gives a written report to the referring practitioner on assessments carried out, treatment provided and recommendations on future management of the patient’s condition; and (e) the service is at least 20 minutes but less than 50 minutes duration | $115.10 85% benefit $97.85 |
| 80106 | Focussed psychological strategies health service provided at a place other than consulting rooms by an eligible psychologist to a person other than the patient, if: (a) the service is part of the patient’s treatment; (b) the patient has been referred to the eligible psychologist by a referring practitioner; and (c) the service lasts at least 20 minutes but less than 50 minutes | $115.10 85% benefit $97.85 |
| 80110 | Focussed psychological strategies health service provided to a patient in consulting rooms by an eligible psychologist if: (a) the patient is referred by a referring practitioner; and (b) the service is provided to the patient individually and in person; and (c) at the completion of a course of treatment, the referring practitioner reviews the need for a further course of treatment; and (d) on the completion of the course of treatment, the eligible psychologist gives a written report to the referring practitioner on assessments carried out, treatment provided and recommendations on future management of the patient’s condition; and (e) the service is at least 50 minutes duration | $119.45 85% benefit $101.55 |
| 80112 | Focussed psychological strategies health service provided in consulting rooms by an eligible psychologist to a person other than the patient, if: (a) the service is part of the patient’s treatment; (b) the patient has been referred to the eligible psychologist by a referring practitioner; and (c) the service lasts at least 50 minutes | $119.45 85% benefit $101.55 |
| 80115 | Focussed psychological strategies health service provided to a patient at a place other than consulting rooms by an eligible psychologist if: (a) the patient is referred by a referring practitioner; and (b) the service is provided to the patient individually and in person; and (c) at the completion of a course of treatment, the referring practitioner reviews the need for a further course of treatment; and (d) on the completion of the course of treatment, the eligible psychologist gives a written report to the referring practitioner on assessments carried out, treatment provided and recommendations on future management of the patient’s condition; and (e) the service is at least 50 minutes duration | $150.00 85% benefit $127.50 |
| 80116 | Focussed psychological strategies health service provided at a place other than consulting rooms by an eligible psychologist to a person other than the patient, if: (a) the service is part of the patient’s treatment; (b) the patient has been referred to the eligible psychologist by a referring practitioner; and (c) the service lasts at least 50 minutes | $150.00 85% benefit $127.50 |
| 80120 | Focussed psychological strategies health service provided to a patient as part of a group of 4 to 10 patients by an eligible psychologist if: (a) the patient is referred by a referring practitioner; and (b) the service is provided in person; and (c) the service is at least 60 minutes duration | $30.45 85% benefit $25.90 |
| 80121 | Focussed psychological strategies health service provided to a patient as part of a group of 4 to 10 patients by an eligible psychologist if: (a) the patient is referred by a referring practitioner; and (b) the attendance is by video conference; and (c) the patient is located within a telehealth eligible area; and (d) the patient is, at the time of the attendance, at least 15 kilometres by road from the psychologist; and (e) the service is at least 60 minutes duration | $30.45 85% benefit $25.90 |
| 80122 | Focussed psychological strategies health service provided to a patient as part of a group of 4 to 10 patients by an eligible psychologist if: (a) the patient is referred by a referring practitioner; and (b) the service is provided in person; and (c) the service is at least 90 minutes duration | $41.50 85% benefit $35.30 |
| 80123 | Focussed psychological strategies health service provided to a patient as part of a group of 4 to 10 by an eligible psychologist if: (a) the patient is referred by a referring practitioner; and (b) the attendance is by video conference; and (c) the patient is located within a telehealth eligible area; and (d) the patient is, at the time of the attendance, at least 15 kilometres by road from the psychologist; and (e) the service is at least 90 minutes duration | $41.50 85% benefit $35.30 |
| 80125 | Focussed psychological strategies health service provided to a patient in consulting rooms by an eligible occupational therapist if: (a) the patient is referred by a referring practitioner; and (b) the service is provided to the patient individually and in person; and (c) at the completion of a course of treatment, the referring practitioner reviews the need for a further course of treatment; and (d) on the completion of the course of treatment, the eligible occupational therapist gives a written report to the referring practitioner on assessments carried out, treatment provided and recommendations on future management of the patient’s condition; and (e) the service is at least 20 minutes but less than 50 minutes duration | $74.55 85% benefit $63.40 |
| 80127 | Focussed psychological strategies health service provided to a patient as part of a group of 4 to 10 patients by an eligible psychologist if: (a) the patient is referred by a referring practitioner; and (b) the service is provided in person; and (c) the service is at least 120 minutes duration | $56.40 85% benefit $47.95 |
| 80128 | Focussed psychological strategies health service provided to a patient as part of a group of 4 to 10 patients by an eligible psychologist if: (a) the patient is referred by a referring practitioner; and (b) the attendance is by video conference; and (c) the patient is located within a telehealth eligible area; and (d) the patient is, at the time of the attendance, at least 15 kilometres by road from the psychologist; and (e) the service is at least 120 minutes duration | $56.40 85% benefit $47.95 |
| 80129 | Focussed psychological strategies health service provided in consulting rooms by an eligible occupational therapist to a person other than the patient, if: (a) the service is part of the patient’s treatment; (b) the patient has been referred to the eligible occupational therapist by a referring practitioner; and (c) the service lasts at least 20 minutes but less than 50 minutes | $74.55 85% benefit $63.40 |
| 80130 | Focussed psychological strategies health service provided to a patient at a place other than consulting rooms by an eligible occupational therapist if: (a) the patient is referred by a referring practitioner; and (b) the service is provided to the patient individually and in person; and (c) at the completion of a course of treatment, the referring practitioner reviews the need for a further course of treatment; and (d) on the completion of the course of treatment, the eligible occupational therapist gives a written report to the referring practitioner on assessments carried out, treatment provided and recommendations on future management of the patient’s condition; and (e) the service is at least 20 minutes but less than 50 minutes duration | $105.00 85% benefit $89.25 |
| 80131 | Focussed psychological strategies health service provided at a place other than consulting rooms by an eligible occupational therapist to a person other than the patient, if: (a) the service is part of the patient’s treatment; (b) the patient has been referred to the eligible occupational therapist by a referring practitioner; and (c) the service lasts at least 20 minutes but less than 50 minutes | $105.00 85% benefit $89.25 |
| 80135 | Focussed psychological strategies health service provided to a patient in consulting rooms by an eligible occupational therapist if: (a) the patient is referred by a referring practitioner; and (b) the service is provided to the patient individually and in person; and (c) at the completion of a course of treatment, the referring practitioner reviews the need for a further course of treatment; and (d) on the completion of the course of treatment, the eligible occupational therapist gives a written report to the referring practitioner on assessments carried out, treatment provided and recommendations on future management of the patient’s condition; and (e) the service is at least 50 minutes duration | $105.25 85% benefit $89.50 |
| 80137 | Focussed psychological strategies health service provided in consulting rooms by an eligible occupational therapist to a person other than the patient, if: (a) the service is part of the patient’s treatment; (b) the patient has been referred to the eligible occupational therapist by a referring practitioner; and (c) the service lasts at least 50 minutes | $105.25 85% benefit $89.50 |
| 80140 | Focussed psychological strategies health service provided to a patient at a place other than consulting rooms by an eligible occupational therapist if: (a) the patient is referred by a referring practitioner; and (b) the service is provided to the patient individually and in person; and (c) at the completion of a course of treatment, the referring practitioner reviews the need for a further course of treatment; and (d) on the completion of the course of treatment, the eligible occupational therapist gives a written report to the referring practitioner on assessments carried out, treatment provided and recommendations on future management of the patient’s condition; and (e) the service is at least 50 minutes duration | $135.65 85% benefit $115.35 |
| 80141 | Focussed psychological strategies health service provided at a place other than consulting rooms by an eligible occupational therapist to a person other than the patient, if: (a) the service is part of the patient’s treatment; (b) the patient has been referred to the eligible occupational therapist by a referring practitioner; and (c) the service lasts at least 50 minutes | $135.65 85% benefit $115.35 |
| 80145 | Focussed psychological strategies health service provided to a patient as part of a group of 4 to 10 patients by an eligible occupational therapist if: (a) the patient is referred by a referring practitioner; and (b) the service is provided in person; and (c) the service is at least 60 minutes duration | $26.70 85% benefit $22.70 |
| 80146 | Focussed psychological strategies health service provided to a patient as part of a group of 4 to 10 patients by an eligible occupational therapist if: (a) the patient is referred by a referring practitioner; and (b) the attendance is by video conference; and (c) the patient is located within a telehealth eligible area; and (d) the patient is, at the time of the attendance, at least 15 kilometres by road from the occupational therapist; and (e) the service is at least 60 minutes duration | $26.70 85% benefit $22.70 |
| 80147 | Focussed psychological strategies health service provided to a patient as part of a group of 4 to 10 patients by an eligible occupational therapist if: (a) the patient is referred by a referring practitioner; and (b) the service is provided in person; and (c) the service is at least 90 minutes duration | $36.30 85% benefit $30.90 |
| 80148 | Focussed psychological strategies health service provided to a patient as part of a group of 4 to 10 patients by an eligible occupational therapist if: (a) the patient is referred by a referring practitioner; and (b) the attendance is by video conference; and (c) the patient is located within a telehealth eligible area; and (d) the patient is, at the time of the attendance, at least 15 kilometres by road from the occupational therapist; and (e) the service is at least 90 minutes duration | $36.30 85% benefit $30.90 |
| 80150 | Focussed psychological strategies health service provided to a patient in consulting rooms by an eligible social worker if: (a) the patient is referred by a referring practitioner; and (b) the service is provided to the patient individually and in person; and (c) at the completion of a course of treatment, the referring practitioner reviews the need for a further course of treatment; and (d) on the completion of the course of treatment, the eligible social worker gives a written report to the referring practitioner on assessments carried out, treatment provided and recommendations on future management of the patient’s condition; and (e) the service is at least 20 minutes but less than 50 minutes duration | $74.55 85% benefit $63.40 |
| 80152 | Focussed psychological strategies health service provided to a patient as part of a group of 4 to 10 patients by an eligible occupational therapist if: (a) the patient is referred by a referring practitioner; and (b) the service is provided in person; and (c) the service is at least 120 minutes duration | $49.50 85% benefit $42.10 |
| 80153 | Focussed psychological strategies health service provided to a patient as part of a group of 4 to 10 patients by an eligible occupational therapist if: (a) the patient is referred by a referring practitioner; and (b) the attendance is by video conference; and (c) the patient is located within a telehealth eligible area; and (d) the patient is, at the time of the attendance, at least 15 kilometres by road from the occupational therapist; and (e) the service is at least 120 minutes duration | $49.50 85% benefit $42.10 |
| 80154 | Focussed psychological strategies health service provided in consulting rooms by an eligible social worker to a person other than the patient, if: (a) the service is part of the patient’s treatment; (b) the patient has been referred to the eligible social worker by a referring practitioner; and (c) the service lasts at least 20 minutes but less than 50 minutes | $74.55 85% benefit $63.40 |
| 80155 | Focussed psychological strategies health service provided to a patient at a place other than consulting rooms by an eligible social worker if: (a) the patient is referred by a referring practitioner; and (b) the service is provided to the patient individually and in person; and (c) at the completion of a course of treatment, the referring practitioner reviews the need for a further course of treatment; and (d) on the completion of the course of treatment, the eligible social worker gives a written report to the referring practitioner on assessments carried out, treatment provided and recommendations on future management of the patient’s condition; and (e) the service is at least 20 minutes but less than 50 minutes duration | $105.00 85% benefit $89.25 |
| 80156 | Focussed psychological strategies health service provided at a place other than consulting rooms by an eligible social worker to a person other than the patient, if: (a) the service is part of the patient’s treatment; (b) the patient has been referred to the eligible social worker by a referring practitioner; and (c) the service lasts at least 20 minutes but less than 50 minutes | $105.00 85% benefit $89.25 |
| 80160 | Focussed psychological strategies health service provided to a patient in consulting rooms by an eligible social worker if: (a) the patient is referred by a referring practitioner; and (b) the service is provided to the patient individually and in person; and (c) at the completion of a course of treatment, the referring practitioner reviews the need for a further course of treatment; and (d) on the completion of the course of treatment, the eligible social worker gives a written report to the referring practitioner on assessments carried out, treatment provided and recommendations on future management of the patient’s condition; and (e) the service is at least 50 minutes duration | $105.25 85% benefit $89.50 |
| 80162 | Focussed psychological strategies health service provided in consulting rooms by an eligible social worker to a person other than the patient, if: (a) the service is part of the patient’s treatment; (b) the patient has been referred to the eligible social worker by a referring practitioner; and (c) the service lasts at least 50 minutes | $105.25 85% benefit $89.50 |
| 80165 | Focussed psychological strategies health service provided to a patient at a place other than consulting rooms by an eligible social worker if: (a) the patient is referred by a referring practitioner; and (b) the service is provided to the patient individually and in person; and (c) at the completion of a course of treatment, the referring practitioner reviews the need for a further course of treatment; and (d) on the completion of the course of treatment, the eligible social worker gives a written report to the referring practitioner on assessments carried out, treatment provided and recommendations on future management of the patient’s condition; and (e) the service is at least 50 minutes duration | $135.65 85% benefit $115.35 |
| 80166 | Focussed psychological strategies health service provided at a place other than consulting rooms by an eligible social worker to a person other than the patient, if: (a) the service is part of the patient’s treatment; (b) the patient has been referred to the eligible social worker by a referring practitioner; and (c) the service lasts at least 50 minutes | $135.65 85% benefit $115.35 |
| 80170 | Focussed psychological strategies health service provided to a patient as part of a group of 4 to 10 patients by an eligible social worker if: (a) the patient is referred by referring practitioner; and (b) the service is provided in person; and (c) the service is at least 60 minutes duration | $26.70 85% benefit $22.70 |
| 80171 | Focussed psychological strategies health service provided to a patient as part of a group of 4 to 10 patients by an eligible social worker if: (a) the patient is referred by a referring practitioner; and (b) the attendance is by video conference; and (c) the patient is located within a telehealth eligible area; and (d) the patient is, at the time of the attendance, at least 15 kilometres by road from the social worker; and (e) the service is at least 60 minutes duration | $26.70 85% benefit $22.70 |
| 80172 | Focussed psychological strategies health service provided to a patient as part of a group of 4 to 10 patients by an eligible social worker if: (a) the patient is referred by a referring practitioner; and (b) the service is provided in person; and (c) the service is at least 90 minutes duration | $36.30 85% benefit $30.90 |
| 80173 | Focussed psychological strategies health service provided to a patient as part of a group of 4 to 10 patients by an eligible social worker if: (a) the patient is referred by a referring practitioner; and (b) the attendance is by video conference; and (c) the patient is located within a telehealth eligible area; and (d) the patient is, at the time of the attendance, at least 15 kilometres by road from the social worker; and (e) the service is at least 90 minutes duration | $36.30 85% benefit $30.90 |
| 80174 | Focussed psychological strategies health service provided to a patient as part of a group of 4 to 10 patients by an eligible social worker if: (a) the patient is referred by a referring practitioner; and (b) the service is provided in person; and (c) the service is at least 120 minutes duration | $49.50 85% benefit $42.10 |
| 80175 | Focussed psychological strategies health service provided to a patient as part of a group of 4 to 10 patients by an eligible social worker if: (a) the patient is referred by a referring practitioner; and (b) the attendance is by video conference; and (c) the patient is located within a telehealth eligible area; and (d) the patient is, at the time of the attendance, at least 15 kilometres by road from the social worker; and (e) the service is at least 120 minutes duration | $49.50 85% benefit $42.10 |
| 80176 | Attendance by an eligible allied health practitioner, as a member of a multidisciplinary case conference team, to participate in a mental health case conference if the conference lasts for at least 15 minutes, but for less than 20 minutes | $58.50 85% benefit $49.75 |
| 80177 | Attendance by an eligible allied health practitioner, as a member of a multidisciplinary case conference team, to participate in a mental health case conference if the conference lasts for at least 20 minutes, but for less than 40 minutes | $100.30 85% benefit $85.30 |
| 80178 | Attendance by an eligible allied health practitioner, as a member of a multidisciplinary case conference team, to participate in a mental health case conference if the conference lasts for at least 40 minutes | $166.85 85% benefit $141.85 |
M8 Pregnancy Support Counselling
3 items
| Item | Description | Fee and benefits |
|---|---|---|
| 81000 | Non‑directive pregnancy support counselling health service provided to a patient who is currently pregnant or who has been pregnant in the preceding 12 months, by an eligible psychologist if: (a) the patient is concerned about a current pregnancy or a pregnancy that occurred in the 12 months preceding the provision of the first service; and (b) the patient is referred by a medical practitioner who is not a specialist or consultant physician; and (c) the eligible psychologist does not have a direct pecuniary interest in a health service that has as its primary purpose the provision of services for pregnancy termination; and (d) the service is at least 30 minutes duration; to a maximum of 3 services (including services to which items 81000, 81005 or 81010, items 792 or 4001 in the general medical services table, or items 92136, 92138, 93026, 93029, 92137 or 92139 in the Telehealth Attendance Determination apply) for each pregnancy | $87.50 85% benefit $74.40 |
| 81005 | Non‑directive pregnancy support counselling health service provided to a patient, who is currently pregnant or who has been pregnant in the preceding 12 months, by an eligible social worker if: (a) the patient is concerned about a current pregnancy or a pregnancy that occurred in the 12 months preceding the provision of the first service; and (b) the patient is referred by a medical practitioner who is not a specialist or consultant physician; and (c) the eligible social worker does not have a direct pecuniary interest in a health service that has as its primary purpose the provision of services for pregnancy termination; and (d) the service is at least 30 minutes duration; to a maximum of 3 services (including services to which items 81000, 81005 or 81010, items 792 or 4001 in the general medical services table, or items 92136, 92138, 93026, 93029, 92137 or 92139 in the Telehealth Attendance Determination apply) for each pregnancy | $87.50 85% benefit $74.40 |
| 81010 | Non‑directive pregnancy support counselling health service provided to a patient, who is currently pregnant or who has been pregnant in the preceding 12 months, by an eligible mental health nurse if: (a) the patient is concerned about a current pregnancy or a pregnancy that occurred in the 12 months preceding the provision of the first service; and (b) the patient is referred by a medical practitioner who is not a specialist or consultant physician; and (c) the eligible mental health nurse does not have a direct pecuniary interest in a health service that has as its primary purpose the provision of services for pregnancy termination; and (d) the service is at least 30 minutes duration; to a maximum of 3 services (including services to which items 81000, 81005 or 81010, items 792 or 4001 in the general medical services table, or items 92136, 92138, 93026, 93029, 92137 or 92139 in the Telehealth Attendance Determination apply) for each pregnancy | $87.50 85% benefit $74.40 |
M9 Allied Health Group Services
6 items
| Item | Description | Fee and benefits |
|---|---|---|
| 81100 | Diabetes education health service provided to a patient by an eligible diabetes educator for assessing the patient’s suitability for group services for the management of type 2 diabetes, including taking a comprehensive patient history, identifying an appropriate group services program based on the patient’s needs and preparing the patient for the group services if: (a) the patient has type 2 diabetes; and (b) the patient is being managed by a medical practitioner (other than a specialist or consultant physician) under: (i) a GP chronic condition management plan that has been prepared or reviewed in the last 18 months; or (ii) until the end of 30 June 2027—a GP Management Plan prepared prior to 1 July 2025; or (iii) a multidisciplinary care plan; and (c) the patient is referred to an eligible diabetes educator by the medical practitioner; and (d) the service is provided to the patient individually and in person; and (e) the service is of at least 45 minutes duration; and (f) after the service, the eligible diabetes educator gives a written report to the referring medical practitioner mentioned in paragraph (c); payable once in a calendar year for this or any other assessment for group services item (including services in items 81100, 81110 and 81120 or items 93284 or 93286 of the Telehealth Attendance Determination) | $95.65 85% benefit $81.35 |
| 81105 | Diabetes education health service provided to a patient by an eligible diabetes educator, as a group service for the management of type 2 diabetes if: (a) the patient has been assessed as suitable for a type 2 diabetes group service under assessment item 81100, 81110 or 81120 or items 93284 or 93286 of the Telehealth Attendance Determination; and (b) the service is provided to a patient who is part of a group of between 2 and 12 patients; and (c) the service is provided in person; and (d) the service is of at least 60 minutes duration; and (e) after the last service in the group services program provided to the patient under item 81105, 81115 or 81125 or item 93285 of the Telehealth Attendance Determination, the eligible diabetes educator prepares, or contributes to, a written report to be provided to the referring medical practitioner; and (f) an attendance record for the group is maintained by the eligible diabetes educator; to a maximum of 8 group services in a calendar year (including services in items 81105, 81115 and 81125 or item 93285 of the Telehealth Attendance Determination) | $23.80 85% benefit $20.25 |
| 81110 | Exercise physiology health service provided to a person by an eligible exercise physiologist for assessing the person’s suitability for group services for the management of type 2 diabetes, including taking a comprehensive patient history, identifying an appropriate group services program based on the patient’s needs and preparing the person for the group services if: (a) the person has type 2 diabetes; and (b) the patient is being managed by a medical practitioner (other than a specialist or consultant physician) under: (i) a GP chronic condition management plan that has been prepared or reviewed in the last 18 months; or (ii) until the end of 30 June 2027—a GP Management Plan prepared prior to 1 July 2025; or (iii) a multidisciplinary care plan; and (c) the patient is referred to an eligible exercise physiologist by the medical practitioner; and (d) the service is provided to the person individually and in person; and (e) the service is of at least 45 minutes duration; and (f) after the service, the eligible exercise physiologist gives a written report to the referring medical practitioner mentioned in paragraph (c); payable once in a calendar year for this or any other assessment for group services item (including services in items 81100, 81110 and 81120 or items 93284 or 93286 of the Telehealth Attendance Determination) | $95.65 85% benefit $81.35 |
| 81115 | Exercise physiology health service provided to a person by an eligible exercise physiologist, as a group service for the management of type 2 diabetes if: (a) the person has been assessed as suitable for a type 2 diabetes group service under assessment item 81100, 81110 or 81120 or items 93284 or 93286 of the Telehealth Attendance Determination; and (b) the service is provided to a person who is part of a group of between 2 and 12 patients; and (c) the service is provided in person; and (d) the service is of at least 60 minutes duration; and (e) after the last service in the group services program provided to the person under item 81105, 81115 or 81125 or item 93285 of the Telehealth Attendance Determination, the eligible exercise physiologist prepares, or contributes to, a written report to be provided to the referring medical practitioner; and (f) an attendance record for the group is maintained by the eligible exercise physiologist; to a maximum of 8 group services in a calendar year (including services in items 81105, 81115 and 81125 or item 93285 of the Telehealth Attendance Determination) | $23.80 85% benefit $20.25 |
| 81120 | Dietetics health service provided to a person by an eligible dietitian for assessing the person’s suitability for group services for the management of type 2 diabetes, including taking a comprehensive patient history, identifying an appropriate group services program based on the patient’s needs and preparing the person for the group services if: (a) the person has type 2 diabetes; and (b) the patient is being managed by a medical practitioner (other than a specialist or consultant physician) under: (i) a GP chronic condition management plan that has been prepared or reviewed in the last 18 months; or (ii) until the end of 30 June 2027—a GP Management Plan prepared prior to 1 July 2025; or (iii) a multidisciplinary care plan; and (c) the patient is referred to an eligible dietitian by the medical practitioner; and (d) the service is provided to the person individually and in person; and (e) the service is of at least 45 minutes duration; and (f) after the service, the eligible dietitian gives a written report to the referring medical practitioner mentioned in paragraph (c); payable once in a calendar year for this or any other assessment for group services item (including services in items 81100, 81110 and 81120 or items 93284 or 93286 of the Telehealth Attendance Determination) | $95.65 85% benefit $81.35 |
| 81125 | Dietetics health service provided to a person by an eligible dietitian, as a group service for the management of type 2 diabetes if: (a) the person has been assessed as suitable for a type 2 diabetes group service under assessment item 81100, 81110 or 81120 or items 93284 or 93286 of the Telehealth Attendance Determination; and (b) the service is provided to a person who is part of a group of between 2 and 12 patients; and (c) the service is provided in person; and (d) the service is of at least 60 minutes duration; and (e) after the last service in the group services program provided to the person under item 81105, 81115 or 81125 or item 93285 of the Telehealth Determination, the eligible dietitian prepares, or contributes to, a written report to be provided to the referring medical practitioner; and (f) an attendance record for the group is maintained by the eligible dietitian; to a maximum of 8 group services in a calendar year (including services to which items 81105, 81115 and 81125 or item 93285 of the Telehealth Attendance Determination apply) | $23.80 85% benefit $20.25 |
M11 Health services for Aboriginal and Torres Strait Islander people
13 items
| Item | Description | Fee and benefits |
|---|---|---|
| 81300 | Aboriginal and Torres Strait Islander health and wellbeing service provided to a patient of Aboriginal or Torres Strait Islander descent by an eligible Aboriginal and Torres Strait Islander health worker or eligible Aboriginal and Torres Strait Islander health practitioner if the service is of at least 20 minutes duration and: (a) a medical practitioner has undertaken a health assessment and identified a need for follow-up Aboriginal and Torres Strait Islander health and wellbeing services; or (b) the patient has a chronic condition and complex care needs being managed by a medical practitioner (other than a specialist or consultant physician) under: (i) a GP chronic condition management plan that has been prepared or reviewed in the last 18 months; or (ii) until the end of 30 June 2027—a GP Management Plan and Team Care Arrangements prepared prior to 1 July 2025; or (iii) a multidisciplinary care plan; and the service is recommended in the patient’s plan or arrangements as part of the management of the patient’s chronic condition and complex care needs; to a maximum of 10 services (including any services to which this item or any other item in this Group or Subgroup 1 of Group M3 or item 93000, 93013, 93048 or 93061 of the Telehealth Attendance Determination applies) in a calendar year | $74.55 85% benefit $63.40 |
| 81305 | Diabetes education health service provided to a patient who is of Aboriginal or Torres Strait Islander descent by an eligible diabetes educator if the service is of at least 20 minutes duration and: (a) a medical practitioner has undertaken a health assessment and identified a need for follow-up allied health services; or (b) the patient has a chronic condition and complex care needs being managed by a medical practitioner (other than a specialist or consultant physician) under: (i) a GP chronic condition management plan that has been prepared or reviewed in the last 18 months; or (ii) until the end of 30 June 2027—a GP Management Plan and Team Care Arrangements prepared prior to 1 July 2025; or (iii) a multidisciplinary care plan; and the service is recommended in the patient’s plan or arrangements as part of the management of the patient’s chronic condition and complex care needs; to a maximum of 10 services (including any services to which this item or any other item in this Group or Subgroup 1 of Group M3 or item 93000, 93013, 93048 or 93061 of the Telehealth Attendance Determination applies) in a calendar year | $74.55 85% benefit $63.40 |
| 81310 | Audiology health service provided to a patient who is of Aboriginal or Torres Strait Islander descent by an eligible audiologist if the service is of at least 20 minutes duration and: (a) a medical practitioner has undertaken a health assessment and identified a need for follow-up allied health services; or (b) the patient has a chronic condition and complex care needs being managed by a medical practitioner (other than a specialist or consultant physician) under: (i) a GP chronic condition management plan that has been prepared or reviewed in the last 18 months; or (ii) until the end of 30 June 2027—a GP Management Plan and Team Care Arrangements prepared prior to 1 July 2025; or (iii) a multidisciplinary care plan; and the service is recommended in the patient’s plan or arrangements as part of the management of the patient’s chronic condition and complex care needs; to a maximum of 10 services (including any services to which this item or any other item in this Group or Subgroup 1 of Group M3 or item 93000, 93013, 93048 or 93061 of the Telehealth Attendance Determination applies) in a calendar year | $74.55 85% benefit $63.40 |
| 81315 | Exercise physiology health service provided to a patient who is of Aboriginal or Torres Strait Islander descent by an eligible exercise physiologist if the service is of at least 20 minutes duration and: (a) a medical practitioner has undertaken a health assessment and identified a need for follow-up allied health services; or (b) the patient has a chronic condition and complex care needs being managed by a medical practitioner (other than a specialist or consultant physician) under: (i) a GP chronic condition management plan that has been prepared or reviewed in the last 18 months; or (ii) until the end of 30 June 2027—a GP Management Plan and Team Care Arrangements prepared prior to 1 July 2025; or (iii) a multidisciplinary care plan; and the service is recommended in the patient’s plan or arrangements as part of the management of the patient’s chronic condition and complex care needs; to a maximum of 10 services (including any services to which this item or any other item in this Group or Subgroup 1 of Group M3 or item 93000, 93013, 93048 or 93061 of the Telehealth Attendance Determination applies) in a calendar year | $74.55 85% benefit $63.40 |
| 81320 | Dietetics health service provided to a patient who is of Aboriginal or Torres Strait Islander descent by an eligible dietitian if the service is of at least 20 minutes duration and: (a) a medical practitioner has undertaken a health assessment and identified a need for follow-up allied health services; or (b) the patient has a chronic condition and complex care needs being managed by a medical practitioner (other than a specialist or consultant physician) under: (i) a GP chronic condition management plan that has been prepared or reviewed in the last 18 months; or (ii) until the end of 30 June 2027—a GP Management Plan and Team Care Arrangements prepared prior to 1 July 2025; or (iii) a multidisciplinary care plan; and the service is recommended in the patient’s plan or arrangements as part of the management of the patient’s chronic condition and complex care needs; to a maximum of 10 services (including any services to which this item or any other item in this Group or Subgroup 1 of Group M3 or item 93000, 93013, 93048 or 93061 of the Telehealth Attendance Determination applies) in a calendar year | $74.55 85% benefit $63.40 |
| 81325 | Mental health service provided to a patient who is of Aboriginal or Torres Strait Islander descent by an eligible mental health worker if the service is of at least 20 minutes duration and: (a) a medical practitioner has undertaken a health assessment and identified a need for follow-up allied health services; or (b) the patient has a chronic condition and complex care needs being managed by a medical practitioner (other than a specialist or consultant physician) under: (i) a GP chronic condition management plan that has been prepared or reviewed in the last 18 months; or (ii) until the end of 30 June 2027—a GP Management Plan and Team Care Arrangements prepared prior to 1 July 2025; or (iii) a multidisciplinary care plan; and the service is recommended in the patient’s plan or arrangements as part of the management of the patient’s chronic condition and complex care needs; to a maximum of 10 services (including any services to which this item or any other item in this Group or Subgroup 1 of Group M3 or item 93000, 93013, 93048 or 93061 of the Telehealth Attendance Determination applies) in a calendar year | $74.55 85% benefit $63.40 |
| 81330 | Occupational therapy health service provided to a patient who is of Aboriginal or Torres Strait Islander descent by an eligible occupational therapist if the service is of at least 20 minutes duration and: (a) a medical practitioner has undertaken a health assessment and identified a need for follow-up allied health services; or (b) the patient has a chronic condition and complex care needs being managed by a medical practitioner (other than a specialist or consultant physician) under: (i) a GP chronic condition management plan that has been prepared or reviewed in the last 18 months; or (ii) until the end of 30 June 2027—a GP Management Plan and Team Care Arrangements prepared prior to 1 July 2025; or (iii) a multidisciplinary care plan; and the service is recommended in the patient’s plan or arrangements as part of the management of the patient’s chronic condition and complex care needs; to a maximum of 10 services (including any services to which this item or any other item in this Group or Subgroup 1 of Group M3 or item 93000, 93013, 93048 or 93061 of the Telehealth Attendance Determination applies) in a calendar year | $74.55 85% benefit $63.40 |
| 81335 | Physiotherapy health service provided to a patient who is of Aboriginal or Torres Strait Islander descent by an eligible physiotherapist if the service is of at least 20 minutes duration and: (a) a medical practitioner has undertaken a health assessment and identified a need for follow-up allied health services; or (b) the patient has a chronic condition and complex care needs being managed by a medical practitioner (other than a specialist or consultant physician) under: (i) a GP chronic condition management plan that has been prepared or reviewed in the last 18 months; or (ii) until the end of 30 June 2027—a GP Management Plan and Team Care Arrangements prepared prior to 1 July 2025; or (iii) a multidisciplinary care plan; and the service is recommended in the patient’s plan or arrangements as part of the management of the patient’s chronic condition and complex care needs; to a maximum of 10 services (including any services to which this item or any other item in this Group or Subgroup 1 of Group M3 or item 93000, 93013, 93048 or 93061 of the Telehealth Attendance Determination applies) in a calendar year | $74.55 85% benefit $63.40 |
| 81340 | Podiatry health service provided to a patient who is of Aboriginal or Torres Strait Islander descent by an eligible podiatrist if the service is of at least 20 minutes duration and: (a) a medical practitioner has undertaken a health assessment and identified a need for follow-up allied health services; or (b) the patient has a chronic condition and complex care needs being managed by a medical practitioner (other than a specialist or consultant physician) under: (i) a GP chronic condition management plan that has been prepared or reviewed in the last 18 months; or (ii) until the end of 30 June 2027—a GP Management Plan and Team Care Arrangements prepared prior to 1 July 2025; or (iii) a multidisciplinary care plan; and the service is recommended in the patient’s plan or arrangements as part of the management of the patient’s chronic condition and complex care needs; to a maximum of 10 services (including any services to which this item or any other item in this Group or Subgroup 1 of Group M3 or item 93000, 93013, 93048 or 93061 of the Telehealth Attendance Determination applies) in a calendar year | $74.55 85% benefit $63.40 |
| 81345 | Chiropractic health service provided to a patient who is of Aboriginal or Torres Strait Islander descent by an eligible chiropractor if the service is of at least 20 minutes duration and: (a) a medical practitioner has undertaken a health assessment and identified a need for follow-up allied health services; or (b) the patient has a chronic condition and complex care needs being managed by a medical practitioner (other than a specialist or consultant physician) under: (i) a GP chronic condition management plan that has been prepared or reviewed in the last 18 months; or (ii) until the end of 30 June 2027—a GP Management Plan and Team Care Arrangements prepared prior to 1 July 2025; or (iii) a multidisciplinary care plan; and the service is recommended in the patient’s plan or arrangements as part of the management of the patient’s chronic condition and complex care needs; to a maximum of 10 services (including any services to which this item or any other item in this Group or Subgroup 1 of Group M3 or item 93000, 93013, 93048 or 93061 of the Telehealth Attendance Determination applies) in a calendar year | $74.55 85% benefit $63.40 |
| 81350 | Osteopathy health service provided to a patient who is of Aboriginal or Torres Strait Islander descent by an eligible osteopath if the service is of at least 20 minutes duration and: (a) a medical practitioner has undertaken a health assessment and identified a need for follow‑up allied health services; or (b) the patient has a chronic condition and complex care needs being managed by a medical practitioner (other than a specialist or consultant physician) under: (i) a GP chronic condition management plan that has been prepared or reviewed in the last 18 months; or (ii) until the end of 30 June 2027—a GP Management Plan and Team Care Arrangements prepared prior to 1 July 2025; or (iii) a multidisciplinary care plan; and the service is recommended in the patient’s plan or arrangements as part of the management of the patient’s chronic condition and complex care needs; to a maximum of 10 services (including any services to which this item or any other item in this Group or Subgroup 1 of Group M3 or item 93000, 93013, 93048 or 93061 of the Telehealth Attendance Determination applies) in a calendar year | $74.55 85% benefit $63.40 |
| 81355 | Psychology health service provided to a patient who is of Aboriginal or Torres Strait Islander descent by an eligible psychologist if the service is of at least 20 minutes duration and: (a) a medical practitioner has undertaken a health assessment and identified a need for follow‑up allied health services; or (b) the patient has a chronic condition and complex care needs being managed by a medical practitioner (other than a specialist or consultant physician) under: (i) a GP chronic condition management plan that has been prepared or reviewed in the last 18 months; or (ii) until the end of 30 June 2027—a GP Management Plan and Team Care Arrangements prepared prior to 1 July 2025; or (iii) a multidisciplinary care plan; and the service is recommended in the patient’s plan or arrangements as part of the management of the patient’s chronic condition and complex care needs; to a maximum of 10 services (including any services to which this item or any other item in this Group or Subgroup 1 of Group M3 or item 93000, 93013, 93048 or 93061 of the Telehealth Attendance Determination applies) in a calendar year | $74.55 85% benefit $63.40 |
| 81360 | Speech pathology health service provided to a patient who is of Aboriginal or Torres Strait Islander descent by an eligible speech pathologist if the service is of at least 20 minutes duration and: (a) a medical practitioner has undertaken a health assessment and identified a need for follow‑up allied health services; or (b) the patient has a chronic condition and complex care needs being managed by a medical practitioner (other than a specialist or consultant physician) under: (i) a GP chronic condition management plan that has been prepared or reviewed in the last 18 months; or (ii) until the end of 30 June 2027—a GP Management Plan and Team Care Arrangements prepared prior to 1 July 2025; or (iii) a multidisciplinary care plan; and the service is recommended in the patient’s plan or arrangements as part of the management of the patient’s chronic condition and complex care needs; to a maximum of 10 services (including any services to which this item or any other item in this Group or Subgroup 1 of Group M3 or item 93000, 93013, 93048 or 93061 of the Telehealth Attendance Determination applies) in a calendar year | $74.55 85% benefit $63.40 |
M10 Complex neurodevelopmental disorder and disability services
11 items
| Item | Description | Fee and benefits |
|---|---|---|
| 82000 | Psychology health service provided to a patient aged under 25 years by an eligible psychologist if: (a) the patient was referred by an eligible medical practitioner, or by an eligible allied health practitioner following referral by an eligible medical practitioner, to: (i) assist the eligible medical practitioner with diagnostic formulation where the patient has a suspected complex neurodevelopmental disorder or eligible disability; or (ii) contribute to the patient’s treatment and management plan developed by the referring eligible medical practitioner where a complex neurodevelopmental disorder (such as autism spectrum disorder) or eligible disability is confirmed; and (b) the service is provided to the patient individually and in person; and (c) the service is at least 50 minutes duration Up to 4 services to which this item or any of items 82005, 82010, 82030, 93032, 93033, 93040 or 93041 apply may be provided to the same patient on the same day | $119.45 85% benefit $101.55 |
| 82001 | Attendance by an eligible allied health practitioner or eligible Aboriginal and Torres Strait Islander primary health care professional, as a member of a multidisciplinary case conference team, to participate in a community case conference if the conference lasts for at least 15 minutes, but for less than 20 minutes (other than a service associated with a service to which another item in this Group applies) | $58.50 85% benefit $49.75 |
| 82002 | Attendance by an eligible allied health practitioner or eligible Aboriginal and Torres Strait Islander primary health care professional, as a member of a multidisciplinary case conference team, to participate in a community case conference if the conference lasts for at least 20 minutes, but for less than 40 minutes (other than a service associated with a service to which another item in this Group applies) | $100.30 85% benefit $85.30 |
| 82003 | Attendance by an eligible allied health practitioner or eligible Aboriginal and Torres Strait Islander primary health care professional, as a member of a multidisciplinary case conference team, to participate in a community case conference if the conference lasts for at least 40 minutes (other than a service associated with a service to which another item in this Group applies) | $166.85 85% benefit $141.85 |
| 82005 | Speech pathology health service provided to a patient aged under 25 years by an eligible speech pathologist if: (a) the patient was referred by an eligible medical practitioner, or by an eligible allied health practitioner following referral by an eligible medical practitioner, to: (i) assist the eligible medical practitioner with diagnostic formulation where the patient has a suspected complex neurodevelopmental disorder or eligible disability; or (ii) contribute to the patient’s treatment and management plan developed by the referring eligible medical practitioner where a complex neurodevelopmental disorder (such as autism spectrum disorder) or eligible disability is confirmed; and (b) the service is provided to the patient individually and in person; and (c) the service is at least 50 minutes duration Up to 4 services to which this item or any of items 82000, 82010, 82030, 93032, 93033, 93040 or 93041 apply may be provided to the same patient on the same day | $105.25 85% benefit $89.50 |
| 82010 | Occupational therapy health service provided to a patient aged under 25 years by an eligible occupational therapist if: (a) the patient was referred by an eligible medical practitioner, or by an eligible allied health practitioner following referral by an eligible medical practitioner, to: (i) assist the eligible medical practitioner with diagnostic formulation where the patient has a suspected complex neurodevelopmental disorder or eligible disability; or (ii) contribute to the patient’s treatment and management plan developed by the referring eligible medical practitioner where a complex neurodevelopmental disorder (such as autism spectrum disorder) or eligible disability is confirmed; and (b) the service is provided to the patient individually and in person; and (c) the service is at least 50 minutes duration Up to 4 services to which this item or any of items 82000, 82005, 82030, 93032, 93033, 93040 or 93041 apply may be provided to the same patient on the same day | $105.25 85% benefit $89.50 |
| 82015 | Psychology health service provided to a patient aged under 25 years for the treatment of a diagnosed complex neurodevelopmental disorder (such as autism spectrum disorder) or eligible disability by an eligible psychologist, if: (a) the patient has a treatment and management plan in place and has been referred by an eligible medical practitioner for a course of treatment consistent with that treatment and management plan; and (b) the service is provided to the patient individually and in person; and (c) the service is at least 30 minutes duration; and (d) on the completion of the course of treatment, the eligible psychologist gives a written report to the referring eligible medical practitioner on assessments (if performed), treatment provided and recommendations on future management of the patient’s condition Up to 4 services to which this item or any of items 82020, 82025, 82035, 93035, 93036, 93043 or 93044 apply may be provided to the same patient on the same day | $119.45 85% benefit $101.55 |
| 82020 | Speech pathology health service provided to a patient aged under 25 years for the treatment of a diagnosed complex neurodevelopmental disorder (such as autism spectrum disorder) or eligible disability by an eligible speech pathologist, if: (a) the patient has a treatment and management plan in place and has been referred by an eligible medical practitioner for a course of treatment consistent with that treatment and management plan; and (b) the service is provided to the patient individually and in person; and (c) the service is at least 30 minutes duration; and (d) on the completion of the course of treatment, the eligible speech pathologist gives a written report to the referring eligible medical practitioner on assessments (if performed), treatment provided and recommendations on future management of the patient’s condition Up to 4 services to which this item or any of items 82015, 82025, 82035, 93035, 93036, 93043 or 93044 apply may be provided to the same patient on the same day | $105.25 85% benefit $89.50 |
| 82025 | Occupational therapy health service provided to a patient aged under 25 years for the treatment of a diagnosed complex neurodevelopmental disorder (such as autism spectrum disorder) or eligible disability by an eligible occupational therapist, if: (a) the patient has a treatment and management plan in place and has been referred by an eligible medical practitioner for a course of treatment consistent with that treatment and management plan; and (b) the service is provided to the patient individually and in person; and (c) the service is at least 30 minutes duration; and (d) on the completion of the course of treatment, the eligible occupational therapist gives a written report to the referring eligible medical practitioner on assessments (if performed), treatment provided and recommendations on future management of the patient’s condition Up to 4 services to which this item or any of items 82015, 82020, 82035, 93035, 93036, 93043 or 93044 apply may be provided to the same patient on the same day | $105.25 85% benefit $89.50 |
| 82030 | Audiology, dietetic, exercise physiology, optometry, orthoptic or physiotherapy health service provided to a patient aged under 25 years by an eligible audiologist, dietitian, exercise physiologist, optometrist, orthoptist or physiotherapist if: (a) the patient was referred by an eligible medical practitioner, or by an eligible allied health practitioner following referral by an eligible medical practitioner, to: (i) assist the eligible medical practitioner with diagnostic formulation where the patient has a suspected complex neurodevelopmental disorder or eligible disability; or (ii) contribute to the patient’s treatment and management plan developed by the referring eligible medical practitioner where a complex neurodevelopmental disorder (such as autism spectrum disorder) or eligible disability is confirmed; and (b) the service is provided to the patient individually and in person; and (c) the service is at least 50 minutes duration Up to 4 services to which this item or any of items 82000, 82005, 82010, 93032, 93033, 93040 or 93041 apply may be provided to the same patient on the same day | $105.25 85% benefit $89.50 |
| 82035 | Audiology, dietetic, exercise physiology, optometry, orthoptic or physiotherapy health service provided to a patient aged under 25 years for the treatment of a diagnosed complex neurodevelopmental disorder (such as autism spectrum disorder) or eligible disability by an eligible audiologist, dietitian, exercise physiologist, optometrist, orthoptist or physiotherapist, if: (a) the patient has a treatment and management plan in place and has been referred by an eligible medical practitioner for a course of treatment consistent with that treatment and management plan; and (b) the service is provided to the patient individually and in person; and (c) the service is at least 30 minutes duration; and (d) on the completion of the course of treatment, the eligible audiologist, dietitian, exercise physiologist, optometrist, orthoptist or physiotherapist gives a written report to the referring eligible medical practitioner on assessments (if performed), treatment provided and recommendations on future management of the patient’s condition Up to 4 services to which this item or any of items 82015, 82020, 82025, 93035, 93036, 93043 or 93044 apply may be provided to the same patient on the same day | $105.25 85% benefit $89.50 |
M13 Midwifery Services
16 items
| Item | Description | Fee and benefits |
|---|---|---|
| 82100 | Initial antenatal professional attendance by a participating midwife, lasting at least 60 minutes, including all of the following: (a) taking a detailed patient history; (b) performing a comprehensive examination; (c) performing a risk assessment; (d) based on the risk assessment — arranging referral or transfer of the patient’s care to an obstetrician; (e) requesting pathology and diagnostic imaging services, when necessary Payable only once per pregnancy | $89.00 85% benefit $75.65 |
| 82102 | Long antenatal professional attendance by a participating midwife, lasting at least 90 minutes | $133.45 75% benefit $100.10 85% benefit $113.45 |
| 82103 | Complex antenatal professional attendance by a participating midwife leading to a hospital admission and lasting at least 3 hours. A maximum of 3 services per pregnancy. Not being a service associated with a service to which intrapartum items 82116, 82118, 82120, 82123, 82125 or 82127 applies (H) | $246.05 75% benefit $184.55 |
| 82104 | Long postnatal professional attendance by a participating midwife, lasting at least 90 minutes, within 6 weeks after birth | $196.20 75% benefit $147.15 85% benefit $166.80 |
| 82105 | Short antenatal professional attendance by a participating midwife, lasting at least 10 minutes | $38.75 75% benefit $29.10 85% benefit $32.95 |
| 82110 | Routine antenatal professional attendance by a participating midwife, lasting at least 40 minutes | $89.00 75% benefit $66.75 85% benefit $75.65 |
| 82115 | Professional attendance by a participating midwife, lasting at least 90 minutes, for assessment and preparation of a maternity care plan for a patient whose pregnancy has progressed beyond 28 weeks, where the participating midwife has had at least 2 antenatal attendances with the patient in the preceding 6 months, if: (a) the patient is not an admitted patient of a hospital; and (b) the participating midwife undertakes a comprehensive assessment of the patient; and (c) the participating midwife develops a written maternity care plan that contains: (i) outcomes of the assessment; and (ii) details of agreed expectations for care during pregnancy, labour and birth; and (iii) details of any health problems or care needs; and (iv) details of any medication taken by the patient during the pregnancy, and any additional medication that may be required by the patient; and (v) details of any referrals or requests for pathology services or diagnostic imaging services for the patient during the pregnancy, and any additional referrals or requests that may be required for the patient; and (d) the maternity care plan is explained and agreed with the patient; and (e) the fee does not include any amount for the management of labour and birth; (Includes any antenatal attendance provided on the same occasion) Payable only once for any pregnancy; This item cannot be claimed if items 16590 or 16591 have previously been claimed during a single pregnancy, except in exceptional circumstances | $381.75 85% benefit $324.50 |
| 82116 | New 85% benefit on 1 November 2026Management of labour for up to 6 hours, not including birth, at a place other than a hospital if: (a) the attendance is by the participating midwife who: (i) provided the patient's antenatal care or (ii) is a member of a practice that has provided the patient's antenatal care; and (b) the total attendance time is documented in the patient notes; This item does not apply if birth is performed during the attendance; Only claimable once per pregnancy | $901.65 85% benefit $793.15 was $797.15 |
| 82118 | Management of labour for up to 6 hours total attendance, including birth where performed if: (a) the patient is an admitted patient of a hospital; and (b) the attendance is by the first participating midwife who: (i) assisted or provided the patient's antenatal care; or (ii) is a member of a practice that has provided the patient's antenatal care; and (c) the total attendance time is documented in the patient notes. (Includes all hospital attendances related to the labour by the first participating midwife) Only claimable once per pregnancy; Not being a service associated with a service to which item 82120 applies (H) | $901.65 75% benefit $676.25 |
| 82120 | Management of labour between 6 and 12 hours total attendance, including birth where performed, if: (a) the patient is an admitted patient of a hospital; and (b) the attendance is by the first participating midwife who: (i) assisted or provided the patient’s antenatal care; or (ii) is a member of a practice that provided the patient’s antenatal care; and (c) the total attendance time is documented in the patient notes; (Includes all hospital attendances related to the labour by the first participating midwife) Only claimable once per pregnancy; Not being a service associated with a service to which item 82118 applies (H) | $1,803.35 75% benefit $1,352.55 |
| 82123 | Management of labour for up to 6 hours total attendance, including birth where performed if: (a) the patient is an admitted patient of a hospital; and (b) the attendance is by the second participating midwife who either: (i) assisted or provided the patient's antenatal care; or (ii) is a member of a practice that has provided the patient's antenatal care; and (c) the total attendance time is documented in the patient notes; (Includes all hospital attendances related to the labour by the second participating midwife) Only claimable once per pregnancy; Not being a service associated with a service to which item 82125 applies (H) | $901.65 75% benefit $676.25 |
| 82125 | Management of labour between 6 and 12 hours total attendance, including birth where performed, if: (a) the patient is an admitted patient of a hospital; and (b) the attendance is by the second participating midwife who either: (i) assisted or provided the patient’s antenatal care; or (ii) is a member of a practice that provided the patient’s antenatal care; and (c) the total attendance time is documented in the patient notes; (Includes all hospital attendances related to the labour by the second participating midwife) Only claimable once per pregnancy; Not being a service associated with a service to which item 82123 or 82127 applies (H) | $1,803.35 75% benefit $1,352.55 |
| 82127 | Management of labour for up to 6 hours total attendance, including birth where performed if: (a) the patient is an admitted patient of a hospital; and (b) the attendance is by a third participating midwife who either: (i) assisted or provided the patient's antenatal care; or (ii) is a member of a practice that has provided the patient's antenatal care; and (c) an attendance to which item 82123 applies has been provided by a second participating midwife who is a member of a practice that has provided the patient's antenatal care; and (d) the total attendance time is documented in the patient notes; (Includes all hospital attendances related to the labour by the third participating midwife) Only claimable once per pregnancy; Not being a service associated with a service to which item 82125 applies (H) | $901.65 75% benefit $676.25 |
| 82130 | Short postnatal professional attendance by a participating midwife, lasting at least 20 minutes, within 6 weeks after birth | $63.90 75% benefit $47.95 85% benefit $54.35 |
| 82135 | Routine postnatal professional attendance by a participating midwife, lasting at least 40 minutes, within 6 weeks after birth | $130.80 75% benefit $98.10 85% benefit $111.20 |
| 82140 | Postnatal professional attendance by a participating midwife on a patient, not less than 4 weeks but not more than 8 weeks after birth of a baby, lasting at least 60 minutes, including all of the following: (a) a comprehensive examination of the patient and baby to ensure normal postnatal recovery; (b) a labour and birth debrief; (c) a mental health assessment or where the patient declines a mental health assessment, the participating midwife records the patient’s decision in the clinical notes; (d) referral of the patient to a primary carer for the ongoing care of the patient and baby or where the patient declines a referral to a primary carer, the participating midwife records the patient’s decision in the clinical notes Payable only once per pregnancy | $63.90 85% benefit $54.35 |
M14 Nurse Practitioners
21 items
| Item | Description | Fee and benefits |
|---|---|---|
| 82200 | Professional attendance by a participating nurse practitioner for an obvious problem characterised by the straightforward nature of the task that requires a short patient history and, if required, limited examination and management | $14.95 85% benefit $12.75 |
| 82201 | Introduction of an intra-uterine device for abnormal uterine bleeding or contraception or for endometrial protection during oestrogen replacement therapy (Anaes.) | $221.55 75% benefit $166.20 85% benefit $188.35 |
| 82202 | Removal of etonogestrel subcutaneous implant (Anaes.) | $107.90 75% benefit $80.95 85% benefit $91.75 |
| 82203 | Hormone or living tissue implantation by cannula | $103.00 75% benefit $77.25 85% benefit $87.55 |
| 82204 | A service rendered by a participating nurse practitioner to which item 82201, 82202 or 82203 applies, if the service is bulk‑billed in relation to the fees for: (a) that item; and (b) any other item in Subgroup 1 of Group M14 or item 73832 and 73833 applying to the service Derived fee: 40% of the fee for items 82201, 82202, or 82203. | Derived |
| 82205 | Professional attendance by a participating nurse practitioner lasting at least 6 minutes and less than 20 minutes and including any of the following: a) taking a history; b) undertaking clinical examination; c) arranging any necessary investigation; d) implementing a management plan; e) providing appropriate preventive health care; for 1 or more health related issues, with appropriate documentation | $32.65 85% benefit $27.80 |
| 82206 | A procedure, being a service to which an item in Subgroup 4 of Group M14 would have applied had the procedure not been discontinued on clinical grounds, other than a service to which 82203 applies Derived fee: 50% of the fee which would have applied had the procedure not been discontinued | Derived |
| 82210 | Professional attendance by a participating nurse practitioner lasting at least 20 minutes and including any of the following: a) taking a detailed history; b) undertaking clinical examination; c) arranging any necessary investigation; d) implementing a management plan; e) providing appropriate preventive health care; for 1 or more health related issues, with appropriate documentation | $61.80 85% benefit $52.55 |
| 82215 | Professional attendance by a participating nurse practitioner lasting at least 40 minutes and including any of the following: a) taking an extensive history; b) undertaking clinical examination; c) arranging any necessary investigation; d) implementing a management plan; e) providing appropriate preventive health care; for 1 or more health related issues, with appropriate documentation | $91.20 85% benefit $77.55 |
| 82216 | Professional attendance by a participating nurse practitioner lasting at least 60 minutes and including any of the following: (a) taking an extensive patient history; (b) performing a clinical examination; (c) arranging any necessary investigation; (d) implementing a management plan; (e) providing appropriate preventive health care; for one or more health related issues, with appropriate documentation | $137.85 85% benefit $117.20 |
| 82226 | Burns, involving 1% or more but less than 3% of total body surface, dressing of (including redressing of any related donor site, if required), without anaesthesia, by a participating nurse practitioner—each attendance at which the procedure is performed Not applicable for skin reactions secondary to radiotherapy | $43.50 75% benefit $32.65 85% benefit $37.00 |
| 82227 | Burns, involving 3% or more but less than 10% of total body surface, dressing of (including redressing of any related donor site, if required), without anaesthesia, by a participating nurse practitioner—each attendance at which the procedure is performed Not applicable for skin reactions secondary to radiotherapy | $55.60 75% benefit $41.70 85% benefit $47.30 |
| 82228 | Nipple or areola or both, intradermal colouration of, by a participating nurse practitioner, following breast reconstruction after mastectomy or for congenital absence of nipple | $236.80 75% benefit $177.60 85% benefit $201.30 |
| 82250 | Professional attendance by a participating nurse practitioner, at consulting rooms, lasting at least 6 minutes but less than 20 minutes, if:(a) the attendance is to provide clinical support to a patient to whom a specialist or consultant physician is providing a service, to which another item applies, by way of a video conferencing consultation; and(b) the patient is not an admitted patient; and(c) the participating nurse practitioner is located in the same room as the patient for the whole of the attendance | $53.15 85% benefit $45.20 |
| 82251 | Professional attendance by a participating nurse practitioner, at a place other than consulting rooms, lasting at least 6 minutes but less than 20 minutes, if: (a) the attendance is to provide clinical support to a patient to whom a specialist or consultant physician is providing a service, to which another item applies, by way of a video conferencing consultation; and(b) the patient is not an admitted patient; and(c) the participating nurse practitioner is located in the same room as the patient for the whole of the attendance | $53.15 85% benefit $45.20 |
| 82252 | Professional attendance by a participating nurse practitioner, at consulting rooms, lasting at least 20 minutes but less than 40 minutes, if:(a) the attendance is to provide clinical support to a patient to whom a specialist or consultant physician is providing a service, to which another item applies, by way of a video conferencing consultation; and(b) the patient is not an admitted patient; and(c) the participating nurse practitioner is located in the same room as the patient for the whole of the attendance | $82.35 85% benefit $70.00 |
| 82253 | Professional attendance by a participating nurse practitioner, at a place other than consulting rooms, lasting at least 20 minutes but less than 40 minutes, if:(a) the attendance is to provide clinical support to a patient to whom a specialist or consultant physician is providing a service, to which another item applies, by way of a video conferencing consultation; and(b) the patient is not an admitted patient; and(c) the participating nurse practitioner is located in the same room as the patient for the whole of the attendance | $82.35 85% benefit $70.00 |
| 82254 | Professional attendance by a participating nurse practitioner, at consulting rooms, lasting at least 40 minutes but less than 60 minutes, if:(a) the attendance is to provide clinical support to a patient to whom a specialist or consultant physician is providing a service, to which another item applies, by way of a video conferencing consultation; and(b) the patient is not an admitted patient; and(c) the participating nurse practitioner is located in the same room as the patient for the whole of the attendance | $111.75 85% benefit $95.00 |
| 82255 | Professional attendance by a participating nurse practitioner, at a place other than consulting rooms, lasting at least 40 minutes but less than 60 minutes, if:(a) the attendance is to provide clinical support to a patient to whom a specialist or consultant physician is providing a service, to which another item applies, by way of a video conferencing consultation; and(b) the patient is not an admitted patient; and(c) the participating nurse practitioner is located in the same room as the patient for the whole of the attendance | $111.75 85% benefit $95.00 |
| 82256 | Professional attendance by a participating nurse practitioner, at consulting rooms, lasting at least 60 minutes, if: (a) the attendance is to provide clinical support to a patient to whom a specialist or consultant physician is providing a service, to which another item applies, by way of a video conferencing consultation; and(b) the patient is not an admitted patient; and(c) the participating nurse practitioner is located in the same room as the patient for the whole of the attendance | $158.35 85% benefit $134.60 |
| 82257 | Professional attendance by a participating nurse practitioner, at a place other than consulting rooms, lasting at least 60 minutes, if: (a) the attendance is to provide clinical support to a patient to whom a specialist or consultant physician is providing a service, to which another item applies, by way of a video conferencing consultation; and(b) the patient is not an admitted patient; and(c) the participating nurse practitioner is located in the same room as the patient for the whole of the attendance | $158.35 85% benefit $134.60 |
M15 Diagnostic Audiology Services
11 items
| Item | Description | Fee and benefits |
|---|---|---|
| 82300 | Audiology health service, consisting of brain stem evoked response audiometry, performed on a patient by an eligible audiologist if: (a) the service is not for the purposes of programming either an auditory implant or the sound processors of an auditory implant; and (b) the service is performed pursuant to a written request made by a medical practitioner to assist in the diagnosis, treatment or management of ear disease or a related disorder in the patient; and (c) the service is not performed for the purpose of a hearing screening; and (d) the service is performed on the patient individually and in person; and (e) after the service, the eligible audiologist provides a copy of the results of the service performed, together with relevant comments in writing that the eligible audiologist has on those results, to the medical practitioner who requested the service; and (f) a service to which item 11300 applies has not been performed on the patient on the same day | $184.25 85% benefit $156.65 |
| 82301 | Audiology health service, consisting of programming an auditory implant or the sound processor of an auditory implant, unilateral, performed on a patient by an eligible audiologist if: (a) the service is performed on the patient individually and in person; and (b) a service to which item 11302, 11342 or 11345 applies has not been performed on the patient on the same day Applicable up to a total of 4 services to which this item, item 82302 or item 82304 applies on the same day | $184.25 85% benefit $156.65 |
| 82302 | Audiology health service by video attendance for programming of an auditory implant, or the sound processor of an auditory implant, unilateral, performed on a patient by an eligible audiologist if: (a) the service is not performed for the purpose of a hearing screening; and (b) a service to which item 11302, 11342 or 11345 applies not been performed on the patient on the same day Applicable up to a total of 4 services to which this item, item 82301 or item 82304 applies on the same day | $184.25 85% benefit $156.65 |
| 82304 | Audiology health service by phone attendance for programming of an auditory implant, or the sound processor of an auditory implant, unilateral, performed on a patient by an eligible audiologist if: (a) the service is not performed for the purpose of a hearing screening; and (b) a service to which item 11302, 11342 or 11345 applies not been performed on the patient on the same day Applicable up to a total of 4 services to which this item, item 82301 or item 82302 applies on the same day | $184.25 85% benefit $156.65 |
| 82306 | Audiology health service, consisting of non-determinate audiometry performed on a patient by an eligible audiologist if: (a) the service is performed pursuant to a written request made by a medical practitioner to assist in the diagnosis, treatment or management of ear disease or a related disorder in the patient; and (b) the service is not performed for the purpose of a hearing screening; and (c) the service is performed on the patient individually and in person; and (d) after the service, the eligible audiologist provides a copy of the results of the service performed, together with relevant comments in writing that the eligible audiologist has on those results, to the medical practitioner who requested the service; and (e) a service to which item 11306 applies has not been performed on the patient on the same day | $20.95 85% benefit $17.85 |
| 82309 | Audiology health service, consisting of an air conduction audiogram performed on a patient by an eligible audiologist if: (a) the service is performed pursuant to a written request made by a medical practitioner to assist in the diagnosis, treatment or management of ear disease or a related disorder in the patient; and (b) the service is not performed for the purpose of a hearing screening; and (c) the service is performed on the patient individually and in person; and (d) after the service, the eligible audiologist provides a copy of the results of the service performed, together with relevant comments in writing that the eligible audiologist has on those results, to the medical practitioner who requested the service; and (e) a service to which item 11309 applies has not been performed on the patient on the same day | $25.15 85% benefit $21.40 |
| 82312 | Audiology health service, consisting of an air and bone conduction audiogram or air conduction and speech discrimination audiogram performed on a patient by an eligible audiologist if: (a) the service is performed pursuant to a written request made by a medical practitioner to assist in the diagnosis, treatment or management of ear disease or a related disorder in the patient; and (b) the service is not performed for the purpose of a hearing screening; and (c) the service is performed on the patient individually and in person; and (d) after the service, the eligible audiologist provides a copy of the results of the service performed, together with relevant comments in writing that the eligible audiologist has on those results, to the medical practitioner who requested the service; and (e) a service to which item 11312 applies has not been performed on the patient on the same day | $35.60 85% benefit $30.30 |
| 82315 | Audiology health service, consisting of an air and bone conduction and speech discrimination audiogram performed on a patient by an eligible audiologist if: (a) the service is performed pursuant to a written request made by a medical practitioner to assist in the diagnosis, treatment or management of ear disease or a related disorder in the patient; and (b) the service is not performed for the purpose of a hearing screening; and (c) the service is performed on the patient individually and in person; and (d) after the service, the eligible audiologist provides a copy of the results of the service performed, together with relevant comments in writing that the eligible audiologist has on those results, to the medical practitioner who requested the service; and (e) a service to which item 11315 applies has not been performed on the patient on the same day | $47.10 85% benefit $40.05 |
| 82318 | Audiology health service, consisting of an air and bone conduction and speech discrimination audiogram with other cochlear tests performed on a patient by an eligible audiologist if: (a) the service is performed pursuant to a written request made by a medical practitioner to assist in the diagnosis, treatment or management of ear disease or a related disorder in the patient; and (b) the service is not performed for the purpose of a hearing screening; and (c) the service is performed on the patient individually and in person; and (d) after the service, the eligible audiologist provides a copy of the results of the service performed, together with relevant comments in writing that the eligible audiologist has on those results, to the medical practitioner who requested the service; and (e) a service to which item 11318 applies has not been performed on the patient on the same day | $58.15 85% benefit $49.45 |
| 82324 | Audiology health service, consisting of an impedance audiogram involving tympanometry and measurement of static compliance and acoustic reflex performed on a patient by an eligible audiologist if: (a) the service is performed pursuant to a written request made by a medical practitioner to assist in the diagnosis, treatment or management of ear disease or a related disorder in the patient; and (b) the service is not performed for the purpose of a hearing screening; and (c) the service is performed on the patient individually and in person; and (d) after the service, the eligible audiologist provides a copy of the results of the service performed, together with relevant comments in writing that the eligible audiologist has on those results, to the medical practitioner who requested the service; and (e) a service to which item 11324 applies has not been performed on the patient on the same day | $19.15 85% benefit $16.30 |
| 82332 | Audiology health service, consisting of an oto-acoustic emission audiometry for the detection of outer hair cell functioning in the cochlea, performed by an eligible audiologist, when middle ear pathology has been excluded, if: (a) the service is performed pursuant to a written request made by a medical practitioner to assist in the diagnosis, treatment or management of ear disease or a related disorder in the patient; and (b) the service is performed: (i) on an infant or child who is at risk of permanent hearing impairment; or (ii) on a patient who is at risk of oto-toxicity due to medications or medical intervention; or (iii) on a patient at risk of noise induced hearing loss; or (iv) to assist in the diagnosis of auditory neuropathy; and (c) the service is performed on the patient individually and in person; and (d) after the service, the eligible audiologist provides a copy of the results of the service performed, together with relevant comments in writing that the eligible audiologist has on those results, to the medical practitioner who requested the service; and (e) a service to which item 11332 applies has not been performed on the patient on the same day | $56.10 85% benefit $47.70 |
M16 Eating Disorders Services
25 items
| Item | Description | Fee and benefits |
|---|---|---|
| 82350 | Dietetics health service provided to an eligible patient by an eligible dietitian if: (a) the service is recommended in the patient’s eating disorder treatment and management plan; and (b) the service is provided to the patient individually and in person; and (c) the service is of at least 20 minutes in duration | $74.55 85% benefit $63.40 |
| 82352 | Eating disorder psychological treatment service provided to an eligible patient in consulting rooms by an eligible clinical psychologist if: (a) the service is recommended in the patient’s eating disorder treatment and management plan; and (b) the service is provided to the patient individually and in person; and (c) the service is at least 30 minutes but less than 50 minutes in duration | $119.45 85% benefit $101.55 |
| 82354 | Eating disorder psychological treatment service provided to an eligible patient at a place other than consulting rooms by an eligible clinical psychologist if: (a) the service is recommended in the patient’s eating disorder treatment and management plan; and (b) the service is provided to the patient individually and in person; and (c) the service is at least 30 minutes but less than 50 minutes in duration | $149.25 85% benefit $126.90 |
| 82355 | Eating disorder psychological treatment service provided to an eligible patient in consulting rooms by an eligible clinical psychologist if: (a) the service is recommended in the patient’s eating disorder treatment and management plan; and (b) the service is provided to the patient individually and in person; and (c) the service is at least 50 minutes in duration | $175.30 85% benefit $149.05 |
| 82357 | Eating disorder psychological treatment service provided to an eligible patient at a place other than consulting rooms by an eligible clinical psychologist if: (a) the service is recommended in the patient’s eating disorder treatment and management plan; and (b) the service is provided to the patient individually and in person; and (c) the service is at least 50 minutes in duration | $205.10 85% benefit $174.35 |
| 82358 | Eating disorder psychological treatment service provided to an eligible patient as part of a group of 6 to 10 patients by an eligible clinical psychologist if: (a) the service is recommended in the patient’s eating disorder treatment and management plan; and (b) the service is provided in person; and (c) the service is at least 60 minutes in duration | $44.50 85% benefit $37.85 |
| 82359 | Eating disorder psychological treatment service provided to an eligible patient as part of a group of 6 to 10 patients by an eligible clinical psychologist if: (a) the service is recommended in the patient’s eating disorder treatment and management plan; and (b) the attendance is by video conference; and (c) the patient is located within a telehealth eligible area; and (d) the patient is, at the time of the attendance, at least 15 kilometres by road from the clinical psychologist; and (e) the service is at least 60 minutes in duration | $44.50 85% benefit $37.85 |
| 82360 | Eating disorder psychological treatment service provided to an eligible patient in consulting rooms by an eligible psychologist if: (a) the service is recommended in the patient’s eating disorder treatment and management plan; and (b) the service is provided to the patient individually and in person; and (c) the service is at least 20 minutes but less than 50 minutes in duration | $84.65 85% benefit $72.00 |
| 82362 | Eating disorder psychological treatment service provided to an eligible patient at a place other than consulting rooms by an eligible psychologist if: (a) the service is recommended in the patient’s eating disorder treatment and management plan; and (b) the service is provided to the patient individually and in person; and (c) the service is at least 20 minutes but less than 50 minutes in duration | $115.10 85% benefit $97.85 |
| 82363 | Eating disorder psychological treatment service provided to an eligible patient in consulting rooms by an eligible psychologist if: (a) the service is recommended in the patient’s eating disorder treatment and management plan; and (b) the service is provided to the patient individually and in person; and (c) the service is at least 50 minutes in duration | $119.45 85% benefit $101.55 |
| 82365 | Eating disorder psychological treatment service provided to an eligible patient at a place other than consulting rooms by an eligible psychologist if: (a) the service is recommended in the patient’s eating disorder treatment and management plan; and (b) the service is provided to the patient individually and in person; and (c) the service is at least 50 minutes in duration | $150.00 85% benefit $127.50 |
| 82366 | Eating disorder psychological treatment service provided to an eligible patient as part of a group of 6 to 10 patients by an eligible psychologist if: (a) the service is recommended in the patient’s eating disorder treatment and management plan; and (b) the service is provided in person; and (c) the service is at least 60 minutes in duration | $30.45 85% benefit $25.90 |
| 82367 | Eating disorder psychological treatment service provided to an eligible patient as part of a group of 6 to 10 patients by an eligible psychologist if: (a) the service is recommended in the patient’s eating disorder treatment and management plan; and (b) the attendance is by video conference; and (c) the patient is located within a telehealth eligible area; and (d) the patient is, at the time of the attendance, at least 15 kilometres by road from the clinical psychologist; and (e) the service is at least 60 minutes in duration | $30.45 85% benefit $25.90 |
| 82368 | Eating disorder psychological treatment service provided to an eligible patient in consulting rooms by an eligible occupational therapist if: (a) the service is recommended in the patient’s eating disorder treatment and management plan; and (b) the service is provided to the patient individually and in person; and (c) the service is at least 20 minutes but less than 50 minutes in duration | $74.55 85% benefit $63.40 |
| 82370 | Eating disorder psychological treatment service provided to an eligible patient at a place other than consulting rooms by an eligible occupational therapist if: (a) the service is recommended in the patient’s eating disorder treatment and management plan; and (b) the service is provided to the patient individually and in person; and (c) the service is at least 20 minutes but less than 50 minutes in duration | $105.00 85% benefit $89.25 |
| 82371 | Eating disorder psychological treatment service provided to an eligible patient in consulting rooms by an eligible occupational therapist if: (a) the service is recommended in the patient’s eating disorder treatment and management plan; and (b) the service is provided to the patient individually and in person; and (c) the service is at least 50 minutes in duration | $105.25 85% benefit $89.50 |
| 82373 | Eating disorder psychological treatment service provided to an eligible patient at a place other than consulting rooms by an eligible occupational therapist if: (a) the service is recommended in the patient’s eating disorder treatment and management plan; and (b) the service is provided to the patient individually and in person; and (c) the service is at least 50 minutes in duration | $135.65 85% benefit $115.35 |
| 82374 | Eating disorder psychological treatment service provided to an eligible patient as part of a group of 6 to 10 patients by an eligible occupational therapist if: (a) the service is recommended in the patient’s eating disorder treatment and management plan; and (b) the service is provided in person; and (c) the service is at least 60 minutes in duration | $26.70 85% benefit $22.70 |
| 82375 | Eating disorder psychological treatment service provided to an eligible patient as part of a group of 6 to 10 patients by an eligible occupational therapist if: (a) the service is recommended in the patient’s eating disorder treatment and management plan; and (b) the attendance is by video conference; and (c) the patient is located within a telehealth eligible area; and (d) the patient is, at the time of the attendance, at least 15 kilometres by road from the clinical psychologist; and (e) the service is at least 60 minutes in duration | $26.70 85% benefit $22.70 |
| 82376 | Eating disorder psychological treatment service provided to an eligible patient in consulting rooms by an eligible social worker if: (a) the service is recommended in the patient’s eating disorder treatment and management plan; and (b) the service is provided to the patient individually and in person; and (c) the service is at least 20 minutes but less than 50 minutes in duration | $74.55 85% benefit $63.40 |
| 82378 | Eating disorder psychological treatment service provided to an eligible patient at a place other than consulting rooms by an eligible social worker if: (a) the service is recommended in the patient’s eating disorder treatment and management plan; and (b) the service is provided to the patient individually and in person; and (c) the service is at least 20 minutes but less than 50 minutes in duration | $105.00 85% benefit $89.25 |
| 82379 | Eating disorder psychological treatment service provided to an eligible patient in consulting rooms by an eligible social worker if: (a) the service is recommended in the patient’s eating disorder treatment and management plan; and (b) the service is provided to the patient individually and in person; and (c) the service is at least 50 minutes in duration | $105.25 85% benefit $89.50 |
| 82381 | Eating disorder psychological treatment service provided to an eligible patient at a place other than consulting rooms by an eligible social worker if: (a) the service is recommended in the patient’s eating disorder treatment and management plan; and (b) the service is provided to the patient individually and in person; and (c) the service is at least 50 minutes in duration | $135.65 85% benefit $115.35 |
| 82382 | Eating disorder psychological treatment service provided to an eligible patient as part of a group of 6 to 10 patients by an eligible social worker if: (a) the service is recommended in the patient’s eating disorder treatment and management plan; and (b) the service is provided in person; and (c) the service is at least 60 minutes in duration | $26.70 85% benefit $22.70 |
| 82383 | Eating disorder psychological treatment service provided to an eligible patient as part of a group of 6 to 10 patients by an eligible social worker if: (a) the service is recommended in the patient’s eating disorder treatment and management plan; and (b) the attendance is by video conference; and (c) the patient is located within a telehealth eligible area; and (d) the patient is, at the time of the attendance, at least 15 kilometres by road from the clinical psychologist; and (e) the service is at least 60 minutes in duration | $26.70 85% benefit $22.70 |
M18 Allied Health and other primary health care telehealth services
80 items
| Item | Description | Fee and benefits |
|---|---|---|
| 91166 | Psychological therapy health service provided by video attendance by an eligible clinical psychologist if: (a) the patient is referred by a referring practitioner; and (b) the service is provided to the patient individually; and (c) at the completion of a course of treatment, the referring practitioner reviews the need for a further course of treatment; and (d) on the completion of the course of treatment, the eligible clinical psychologist gives a written report to the referring practitioner on assessments carried out, treatment provided and recommendations on future management of the patient’s condition; and (e) the service is at least 30 minutes but less than 50 minutes duration | $119.45 85% benefit $101.55 |
| 91167 | Psychological therapy health service provided by video attendance by an eligible clinical psychologist if: (a) the patient is referred by a referring practitioner; and (b) the service is provided to the patient individually; and (c) at the completion of a course of treatment, the referring practitioner reviews the need for a further course of treatment; and (d) on the completion of the course of treatment, the eligible clinical psychologist gives a written report to the referring practitioner on assessments carried out, treatment provided and recommendations on future management of the patient’s condition; and (e) the service is at least 50 minutes duration | $175.30 85% benefit $149.05 |
| 91168 | Video attendance for a psychological therapy health service provided by an eligible clinical psychologist to a person other than the patient, if: (a) the service is part of the patient’s treatment; (b) the patient has been referred to the eligible clinical psychologist by a referring practitioner; and (c) the service lasts at least 30 minutes but less than 50 minutes | $119.45 85% benefit $101.55 |
| 91169 | Focussed psychological strategies health service provided by video attendance by an eligible psychologist if: (a) the patient is referred by a referring practitioner; and (b) the service is provided to the patient individually; and (c) at the completion of a course of treatment, the referring practitioner reviews the need for a further course of treatment; and (d) on the completion of the course of treatment, the eligible psychologist gives a written report to the referring practitioner on assessments carried out, treatment provided and recommendations on future management of the patient’s condition; and (e) the service is at least 20 minutes but less than 50 minutes duration | $84.65 85% benefit $72.00 |
| 91170 | Focussed psychological strategies health service provided by video attendance by an eligible psychologist if: (a) the patient is referred by a referring practitioner; and (b) the service is provided to the patient individually; and (c) at the completion of a course of treatment, the referring practitioner reviews the need for a further course of treatment; and (d) on the completion of the course of treatment, the eligible psychologist gives a written report to the referring practitioner on assessments carried out, treatment provided and recommendations on future management of the patient’s condition; and (e) the service is at least 50 minutes duration | $119.45 85% benefit $101.55 |
| 91171 | Video attendance for a psychological therapy health service provided by an eligible clinical psychologist to a person other than the patient, if: (a) the service is part of the patient’s treatment; (b) the patient has been referred to the eligible clinical psychologist by a referring practitioner; and (c) the service lasts at least 50 minutes | $175.30 85% benefit $149.05 |
| 91172 | Focussed psychological strategies health service provided by video attendance by an eligible occupational therapist if: (a) the patient is referred by a referring practitioner; and (b) the service is provided to the patient individually; and (c) at the completion of a course of treatment, the referring practitioner reviews the need for a further course of treatment; and (d) on the completion of the course of treatment, the eligible occupational therapist gives a written report to the referring practitioner on assessments carried out, treatment provided and recommendations on future management of the patient’s condition; and (e) the service is at least 20 minutes but less than 50 minutes duration | $74.55 85% benefit $63.40 |
| 91173 | Focussed psychological strategies health service provided by video attendance by an eligible occupational therapist if: (a) the patient is referred by a referring practitioner; and (b) the service is provided to the patient individually; and (c) at the completion of a course of treatment, the referring practitioner reviews the need for a further course of treatment; and (d) on the completion of the course of treatment, the eligible occupational therapist gives a written report to the referring practitioner on assessments carried out, treatment provided and recommendations on future management of the patient’s condition; and (e) the service is at least 50 minutes in duration | $105.25 85% benefit $89.50 |
| 91174 | Video attendance for a focussed psychological strategies health service provided by an eligible psychologist to a person other than the patient, if: (a) the service is part of the patient’s treatment; (b) the patient has been referred to the eligible psychologist by a referring practitioner; and (c) the service lasts at least 20 minutes but less than 50 minutes | $84.65 85% benefit $72.00 |
| 91175 | Focussed psychological strategies health service provided by video attendance by an eligible social worker if: (a) the patient is referred by a referring practitioner; and (b) the service is provided to the patient individually; and (c) at the completion of a course of treatment, the referring practitioner reviews the need for a further course of treatment; and (d) on the completion of the course of treatment, the eligible social worker gives a written report to the referring practitioner on assessments carried out, treatment provided and recommendations on future management of the patient’s condition; and (e) the service is at least 20 minutes but less than 50 minutes duration | $74.55 85% benefit $63.40 |
| 91176 | Focussed psychological strategies health service provided by video attendance by an eligible social worker if: (a) the patient is referred by a referring practitioner; and (b) the service is provided to the patient individually; and (c) at the completion of a course of treatment, the referring practitioner reviews the need for a further course of treatment; and (d) on the completion of the course of treatment, the eligible social worker gives a written report to the referring practitioner on assessments carried out, treatment provided and recommendations on future management of the patient’s condition; and (e) the service is at least 50 minutes duration | $105.25 85% benefit $89.50 |
| 91177 | Video attendance for a focussed psychological strategies health service provided by an eligible psychologist to a person other than the patient, if: (a) the service is part of the patient’s treatment; (b) the patient has been referred to the eligible psychologist by a referring practitioner; and (c) the service lasts at least 50 minutes | $119.45 85% benefit $101.55 |
| 91178 | Video attendance by a participating nurse practitioner lasting at least 6 minutes and less than 20 minutes if the attendance includes any of the following that are clinically relevant: (a) taking a short history; (b) arranging any necessary investigation; (c) implementing a management plan; (d) providing appropriate preventive health care | $32.65 85% benefit $27.80 |
| 91179 | Video attendance by a participating nurse practitioner lasting at least 20 minutes if the attendance includes any of the following that are clinically relevant: (a) taking a detailed history; (b) arranging any necessary investigation; (c) implementing a management plan; (d) providing appropriate preventive health care | $61.80 85% benefit $52.55 |
| 91180 | Video attendance by a participating nurse practitioner lasting at least 40 minutes if the attendance includes any of the following that are clinically relevant: (a) taking an extensive history; (b) arranging any necessary investigation; (c) implementing a management plan; (d) providing appropriate preventive health care | $91.20 85% benefit $77.55 |
| 91181 | Psychological therapy health service provided by phone attendance by an eligible clinical psychologist if: (a) the patient is referred by a referring practitioner; and (b) the service is provided to the patient individually; and (c) at the completion of a course of treatment, the referring practitioner reviews the need for a further course of treatment; and (d) on the completion of the course of treatment, the eligible clinical psychologist gives a written report to the referring practitioner on assessments carried out, treatment provided and recommendations on future management of the patient’s condition; and (e) the service is at least 30 minutes but less than 50 minutes duration | $119.45 85% benefit $101.55 |
| 91182 | Psychological therapy health service provided by phone attendance by an eligible clinical psychologist if: (a) the patient is referred by a referring practitioner; and (b) the service is provided to the patient individually; and (c) at the completion of a course of treatment, the referring practitioner reviews the need for a further course of treatment; and (d) on the completion of the course of treatment, the eligible clinical psychologist gives a written report to the referring practitioner on assessments carried out, treatment provided and recommendations on future management of the patient’s condition; and (e) the service is at least 50 minutes duration | $175.30 85% benefit $149.05 |
| 91183 | Focussed psychological strategies health service provided by phone attendance by an eligible psychologist if: (a) the patient is referred by a referring practitioner; and (b) the service is provided to the patient individually; and (c) at the completion of a course of treatment, the referring practitioner reviews the need for a further course of treatment; and (d) on the completion of the course of treatment, the eligible psychologist gives a written report to the referring practitioner on assessments carried out, treatment provided and recommendations on future management of the patient’s condition; and (e) the service is at least 20 minutes but less than 50 minutes duration | $84.65 85% benefit $72.00 |
| 91184 | Focussed psychological strategies health service provided by phone attendance by an eligible psychologist if: (a) the patient is referred by a referring practitioner; and (b) the service is provided to the patient individually; and (c) at the completion of a course of treatment, the referring practitioner reviews the need for a further course of treatment; and (d) on the completion of the course of treatment, the eligible psychologist gives a written report to the referring practitioner on assessments carried out, treatment provided and recommendations on future management of the patient’s condition; and (e) the service is at least 50 minutes duration | $119.45 85% benefit $101.55 |
| 91185 | Focussed psychological strategies health service provided by phone attendance by an eligible occupational therapist if: (a) the patient is referred by a referring practitioner; and (b) the service is provided to the patient individually; and (c) at the completion of a course of treatment, the referring practitioner reviews the need for a further course of treatment; and (d) on the completion of the course of treatment, the eligible occupational therapist gives a written report to the referring practitioner on assessments carried out, treatment provided and recommendations on future management of the patient’s condition; and (e) the service is at least 20 minutes but less than 50 minutes duration | $74.55 85% benefit $63.40 |
| 91186 | Focussed psychological strategies health service provided by phone attendance by an eligible occupational therapist if: (a) the patient is referred by a referring practitioner; and (b) the service is provided to the patient individually; and (c) at the completion of a course of treatment, the referring practitioner reviews the need for a further course of treatment; and (d) on the completion of the course of treatment, the eligible occupational therapist gives a written report to the referring practitioner on assessments carried out, treatment provided and recommendations on future management of the patient’s condition; and (e) the service is at least 50 minutes in duration | $105.25 85% benefit $89.50 |
| 91187 | Focussed psychological strategies health service provided by phone attendance by an eligible social worker if: (a) the patient is referred by a referring practitioner; and (b) the service is provided to the patient individually; and (c) at the completion of a course of treatment, the referring practitioner reviews the need for a further course of treatment; and (d) on the completion of the course of treatment, the eligible social worker gives a written report to the referring practitioner on assessments carried out, treatment provided and recommendations on future management of the patient’s condition; and (e) the service is at least 20 minutes but less than 50 minutes duration | $74.55 85% benefit $63.40 |
| 91188 | Focussed psychological strategies health service provided by phone attendance by an eligible social worker if: (a) the patient is referred by a referring practitioner; and (b) the service is provided to the patient individually; and (c) at the completion of a course of treatment, the referring practitioner reviews the need for a further course of treatment; and (d) on the completion of the course of treatment, the eligible social worker gives a written report to the referring practitioner on assessments carried out, treatment provided and recommendations on future management of the patient’s condition; and (e) the service is at least 50 minutes duration | $105.25 85% benefit $89.50 |
| 91189 | Phone attendance by a participating nurse practitioner lasting at least 6 minutes and less than 20 minutes if the attendance includes any of the following that are clinically relevant: (a) taking a short history; (b) arranging any necessary investigation; (c) implementing a management plan; (d) providing appropriate preventive health care | $32.65 85% benefit $27.80 |
| 91190 | Phone attendance by a participating nurse practitioner lasting at least 20 minutes if the attendance includes any of the following that are clinically relevant: (a) taking a detailed history; (b) arranging any necessary investigation; (c) implementing a management plan; (d) providing appropriate preventive health care. | $61.80 85% benefit $52.55 |
| 91191 | Phone attendance by a participating nurse practitioner lasting at least 40 minutes if the attendance includes any of the following that are clinically relevant: (a) taking an extensive history; (b) arranging any necessary investigation; (c) implementing a management plan; (d) providing appropriate preventive health care. | $91.20 85% benefit $77.55 |
| 91192 | Video attendance by a participating nurse practitioner for an obvious problem characterised by the straightforward nature of the task that requires a short patient history and, if required, limited management | $14.95 85% benefit $12.75 |
| 91193 | Phone attendance by a participating nurse practitioner for an obvious problem characterised by the straightforward nature of the task that requires a short patient history and, if required, limited management. | $14.95 85% benefit $12.75 |
| 91194 | Video attendance for a focussed psychological strategies health service provided by an eligible occupational therapist to a person other than the patient, if: (a) the service is part of the patient’s treatment; (b) the patient has been referred to the eligible occupational therapist by a referring practitioner; and (c) the service lasts at least 20 minutes but less than 50 minutes | $74.55 85% benefit $63.40 |
| 91195 | Video attendance for a focussed psychological strategies health service provided by an eligible occupational therapist to a person other than the patient, if: (a) the service is part of the patient’s treatment; (b) the patient has been referred to the eligible occupational therapist by a referring practitioner; and (c) the service lasts at least 50 minutes | $105.25 85% benefit $89.50 |
| 91196 | Video attendance for a focussed psychological strategies health service provided by an eligible social worker to a person other than the patient, if: (a) the service is part of the patient’s treatment; (b) the patient has been referred to the eligible social worker by a referring practitioner and (c) the service lasts at least 20 minutes but less than 50 minutes | $74.55 85% benefit $63.40 |
| 91197 | Video attendance for a focussed psychological strategies health service provided by an eligible social worker to a person other than the patient, if: (a) the service is part of the patient’s treatment; (b) the patient has been referred to the eligible social worker by a referring practitioner; and (c) the service lasts at least 50 minutes | $105.25 85% benefit $89.50 |
| 91198 | Phone attendance for a psychological therapy health service provided by an eligible clinical psychologist to a person other than the patient, if: (a) the service is part of the patient’s treatment; (b) the patient has been referred to the eligible clinical psychologist by a referring practitioner; and (c) the service lasts at least 30 minutes but less than 50 minutes | $119.45 85% benefit $101.55 |
| 91199 | Phone attendance for a psychological therapy health service provided by an eligible clinical psychologist to a person other than the patient, if: (a) the service is part of the patient’s treatment; (b) the patient has been referred to the eligible clinical psychologist by a referring practitioner; and (c) the service lasts at least 50 minutes | $175.30 85% benefit $149.05 |
| 91200 | Phone attendance for a focussed psychological strategies health service provided by an eligible psychologist to a person other than the patient, if: (a) the service is part of the patient’s treatment; (b) the patient has been referred to the eligible psychologist by a referring practitioner; and (c) the service lasts at least 20 minutes but less than 50 minutes | $84.65 85% benefit $72.00 |
| 91201 | Phone attendance for a focussed psychological strategies health service provided by an eligible psychologist to a person other than the patient, if: (a) the service is part of the patient’s treatment; (b) the patient has been referred to the eligible psychologist by a referring practitioner; and (c) the service lasts at least 50 minutes | $119.45 85% benefit $101.55 |
| 91202 | Phone attendance for a focussed psychological strategies health service provided by an eligible occupational therapist to a person other than the patient, if: (a) the service is part of the patient’s treatment; (b) the patient has been referred to the eligible occupational therapist by a referring practitioner; and (c) the service lasts at least 20 minutes but less than 50 minutes | $74.55 85% benefit $63.40 |
| 91203 | Phone attendance for a focussed psychological strategies health service provided by an eligible occupational therapist to a person other than the patient, if: (a) the service is part of the patient’s treatment; (b) the patient has been referred to the eligible occupational therapist by a referring practitioner; and (c) the service lasts at least 50 minutes | $105.25 85% benefit $89.50 |
| 91204 | Phone attendance for a focussed psychological strategies health service provided by an eligible social worker to a person other than the patient, if: (a) the service is part of the patient’s treatment; (b) the patient has been referred to the eligible social worker by a referring practitioner; and (c) the service lasts at least 20 minutes but less than 50 minutes | $74.55 85% benefit $63.40 |
| 91205 | Phone attendance for a focussed psychological strategies health service provided by an eligible social worker to a person other than the patient, if: (a) the service is part of the patient’s treatment; (b) the patient has been referred to the eligible social worker by a referring practitioner; and (c) the service lasts at least 50 minutes | $105.25 85% benefit $89.50 |
| 91206 | Video attendance by a participating nurse practitioner lasting at least 60 minutes and including any of the following that are clinically relevant: (a) taking an extensive patient history; (b) performing a clinical examination; (c) arranging any necessary investigation; (d) implementing a management plan; (e) providing appropriate preventive health care; for one or more health related issues, with appropriate documentation | $137.85 85% benefit $117.20 |
| 93000 | Video attendance by an eligible allied health practitioner or Aboriginal and Torres Strait Islander primary health care professional if: (a) the patient has a chronic condition and complex care needs being managed by a medical practitioner (other than a specialist or consultant physician) under: (i) a GP chronic condition management plan that has been prepared or reviewed in the last 18 months; or (ii) until the end of 30 June 2027—a GP Management Plan and Team Care Arrangements prepared prior to 1 July 2025; or (iii) a multidisciplinary care plan; and (b) the service is recommended in the patient’s plan or arrangements as part of the management of the patient’s chronic condition and complex care needs; and (c) the person is referred to the eligible health practitioner by the medical practitioner; and (d) the service is provided to the person individually; and (e) the service is of at least 20 minutes duration; and (f) after the service, the eligible health practitioner gives a written report to the referring medical practitioner mentioned in paragraph (c): (i) if the service is the only service under the referral—in relation to that service; or (ii) if the service is the first or last service under the referral—in relation to that service; or (iii) if neither subparagraph (i) nor (ii) applies but the service involves matters that the referring medical practitioner would reasonably expect to be informed of —in relation to those matters; to a maximum of 5 services (including any services to which this item, item 93013 or any item in Subgroup 1 of Group M3 of the Allied Health and other Primary Health Care Services Determination applies) in a calendar year | $74.55 85% benefit $63.40 |
| 93013 | Phone attendance by an eligible allied health practitioner or Aboriginal and Torres Strait Islander primary health care professional if: (a) the patient has a chronic condition and complex care needs being managed by a medical practitioner (other than a specialist or consultant physician) under: (i) a GP chronic condition management plan that has been prepared or reviewed in the last 18 months; or (ii) until the end of 30 June 2027—a GP Management Plan and Team Care Arrangements prepared prior to 1 July 2025; or (iii) a multidisciplinary care plan; and (b) the service is recommended in the patient’s plan or arrangements as part of the management of the patient’s chronic condition and complex care needs; and (c) the person is referred to the eligible health practitioner by the medical practitioner; and (d) the service is provided to the person individually; and (e) the service is of at least 20 minutes duration; and (f) after the service, the eligible health practitioner gives a written report to the referring medical practitioner mentioned in paragraph (c): (i) if the service is the only service under the referral—in relation to that service; or (ii) if the service is the first or last service under the referral—in relation to that service; or (iii) if neither subparagraph (i) nor (ii) applies but the service involves matters that the referring medical practitioner would reasonably expect to be informed of —in relation to those matters; to a maximum of 5 services (including any services to which this item, item 93000 or any item in Subgroup 1 of Group M3 of the Allied Health and other Primary Health Care Services Determination applies) in a calendar year | $74.55 85% benefit $63.40 |
| 93026 | Non directive pregnancy support counselling health service provided to a person who is currently pregnant or who has been pregnant in the preceding 12 months by an eligible psychologist, eligible social worker or eligible mental health nurse as a video attendance if: (a) the person is concerned about a current pregnancy or a pregnancy that occurred in the 12 months preceding the provision of the first service; and (b) the person is referred by a medical practitioner who is not a specialist or consultant physician; and (c) the service is provided to the person individually; and (d) the eligible psychologist, eligible social worker or eligible mental health nurse does not have a direct pecuniary interest in a health service that has as its primary purpose the provision of services for pregnancy termination; and (e) the service is at least 30 minutes duration; to a maximum of 3 services (including services to which items 81000, 81005, 81010, 4001 and item 93029, 92136 and 92138 apply) for each pregnancy. The service may be used to address any pregnancy related issues for which non directive counselling is appropriate | $87.50 85% benefit $74.40 |
| 93029 | Non directive pregnancy support counselling health service provided to a person, who is currently pregnant or who has been pregnant in the preceding 12 months by an eligible psychologist, eligible social worker or eligible mental health nurse as a phone attendance if: (a) the person is concerned about a current pregnancy or a pregnancy that occurred in the 12 months preceding the provision of the first service; and (b) the person is referred by a medical practitioner who is not a specialist or consultant physician; and (c) the service is provided to the person individually; and (d) the eligible psychologist, eligible social worker or eligible mental health nurse does not have a direct pecuniary interest in a health service that has as its primary purpose the provision of services for pregnancy termination; and (e) the service is at least 30 minutes duration; to a maximum of 3 services (including services to which items 81000, 81005, 81010, 4001 and item 93026, 92136 and 92138 apply) for each pregnancy. The service may be used to address any pregnancy related issues for which non directive counselling is appropriate | $87.50 85% benefit $74.40 |
| 93032 | Psychology health service provided by video attendance to a patient aged under 25 years by an eligible psychologist if: (a) the patient was referred by an eligible medical practitioner, or by an eligible allied health practitioner following referral by an eligible medical practitioner, to: (i) assist the eligible medical practitioner with diagnostic formulation where the patient has a suspected complex neurodevelopmental disorder or eligible disability; or (ii) contribute to the patient’s treatment and management plan developed by the referring eligible medical practitioner where a complex neurodevelopmental disorder (such as autism spectrum disorder) or eligible disability is confirmed; and (b) the service is provided to the patient individually; and (c) the service is at least 50 minutes duration Up to 4 services to which this item or any of items 82000, 82005, 82010, 82030, 93033, 93040 or 93041 apply may be provided to the same patient on the same day | $119.45 85% benefit $101.55 |
| 93033 | Audiology, dietetic, exercise physiology, occupational therapy, optometry, orthoptic, physiotherapy or speech pathology health service provided by video attendance to a patient aged under 25 years by an eligible audiologist, dietitian, exercise physiologist, occupational therapist, optometrist, orthoptist, physiotherapist or speech pathologist if:(a) the patient was referred by an eligible medical practitioner, or by an eligible allied health practitioner following referral by an eligible medical practitioner, to: (i) assist the eligible medical practitioner with diagnostic formulation where the patient has a suspected complex neurodevelopmental disorder or eligible disability; or (ii) contribute to the patient’s treatment and management plan developed by the referring eligible medical practitioner where a complex neurodevelopmental disorder (such as autism spectrum disorder) or eligible disability is confirmed; and (b) the service is provided to the patient individually; and (c) the service is at least 50 minutes duration Up to 4 services to which this item or any of items 82000, 82005, 82010, 82030, 93032, 93040 or 93041 apply may be provided to the same patient on the same day | $105.25 85% benefit $89.50 |
| 93035 | Psychology health service provided by video attendance to a patient aged under 25 years for the treatment of a diagnosed complex neurodevelopmental disorder (such as autism spectrum disorder) or eligible disability by an eligible psychologist, if: (a) the patient has a treatment and management plan in place and has been referred by an eligible medical practitioner for a course of treatment consistent with that treatment and management plan; and (b) the service is provided to the patient individually; and (c) the service is at least 30 minutes duration; and (d) on the completion of the course of treatment, the eligible psychologist gives a written report to the referring eligible medical practitioner on assessments (if performed), treatment provided and recommendations on future management of the patient’s condition Up to 4 services to which this item or any of items 82015, 82020, 82025, 82035, 93036, 93043 or 93044 apply may be provided to the same patient on the same day | $119.45 85% benefit $101.55 |
| 93036 | Audiology, dietetic, exercise physiology, occupational therapy, optometry, orthoptic, physiotherapy or speech pathology health service provided by video attendance to a patient aged under 25 years for the treatment of a diagnosed complex neurodevelopmental disorder (such as autism spectrum disorder) or eligible disability by an eligible audiologist, dietitian, exercise physiologist, occupational therapist, optometrist, orthoptist, physiotherapist or speech pathologist, if:(a) the patient has a treatment and management plan in place and has been referred by an eligible medical practitioner for a course of treatment consistent with that treatment and management plan; and (b) the service is provided to the patient individually; and (c) the service is at least 30 minutes duration; and (d) on the completion of the course of treatment, the eligible audiologist, dietitian, exercise physiologist, occupational therapist, optometrist, orthoptist, physiotherapist or speech pathologist gives a written report to the referring eligible medical practitioner on assessments (if performed), treatment provided and recommendations on future management of the patient’s condition Up to 4 services to which this item or any of items 82015, 82020, 82025, 82035, 93035, 93043 or 93044 apply may be provided to the same patient on the same day | $105.25 85% benefit $89.50 |
| 93040 | Psychology health service provided by phone attendance to a patient aged under 25 years by an eligible psychologist if: (a) the patient was referred by an eligible medical practitioner, or by an eligible allied health practitioner following referral by an eligible medical practitioner, to: (i) assist the eligible medical practitioner with diagnostic formulation where the patient has a suspected complex neurodevelopmental disorder or eligible disability; or (ii) contribute to the patient’s treatment and management plan developed by the referring eligible medical practitioner where a complex neurodevelopmental disorder (such as autism spectrum disorder) or eligible disability is confirmed; and (b) the service is provided to the patient individually; and (c) the service is at least 50 minutes duration Up to 4 services to which this item or any of items 82000, 82005, 82010, 82030, 93032, 93033 or 93041 apply may be provided to the same patient on the same day Further information on the requirements for this item are available in the explanatory notes to this Category | $119.45 85% benefit $101.55 |
| 93041 | Audiology, dietetic, exercise physiology, occupational therapy, optometry, orthoptic, physiotherapy or speech pathology health service provided by phone attendance to a patient aged under 25 years by an eligible audiologist, dietitian, exercise physiologist, occupational therapist, optometrist, orthoptist, physiotherapist or speech pathologist if: (a) the patient was referred by an eligible medical practitioner, or by an eligible allied health practitioner following referral by an eligible medical practitioner, to: (i) assist the eligible medical practitioner with diagnostic formulation where the patient has a suspected complex neurodevelopmental disorder or eligible disability; or (ii) contribute to the patient’s treatment and management plan developed by the referring eligible medical practitioner where a complex neurodevelopmental disorder (such as autism spectrum disorder) or eligible disability is confirmed; and (b) the service is provided to the patient individually; and (c) the service is at least 50 minutes duration Up to 4 services to which this item or any of items 82000, 82005, 82010, 82030, 93032, 93033 or 93040 apply may be provided to the same patient on the same day Further information on the requirements for this item are available in the explanatory notes to this Category | $105.25 85% benefit $89.50 |
| 93043 | Psychology health service provided by phone attendance to a patient aged under 25 years for the treatment of a diagnosed complex neurodevelopmental disorder (such as autism spectrum disorder) or eligible disability by an eligible psychologist, if: (a) the patient has a treatment and management plan in place and has been referred by an eligible medical practitioner for a course of treatment consistent with that treatment and management plan; and (b) the service is provided to the patient individually; and (c) the service is at least 30 minutes duration; and (d) on the completion of the course of treatment, the eligible psychologist gives a written report to the referring eligible medical practitioner on assessments (if performed), treatment provided and recommendations on future management of the patient’s condition Up to 4 services to which this item or any of items 82015, 82020, 82025, 82035, 93035, 93036 or 93044 apply may be provided to the same patient on the same day Further information on the requirements for this item are available in the explanatory notes to this Category | $119.45 85% benefit $101.55 |
| 93044 | Audiology, dietetic, exercise physiology, occupational therapy, optometry, orthoptic, physiotherapy or speech pathology health service provided by phone attendance to a patient aged under 25 years for the treatment of a diagnosed complex neurodevelopmental disorder (such as autism spectrum disorder) or eligible disability by an eligible audiologist, dietitian, exercise physiologist, occupational therapist, optometrist, orthoptist, physiotherapist or speech pathologist, if:(a) the patient has a treatment and management plan in place and has been referred by an eligible medical practitioner for a course of treatment consistent with that treatment and management plan; and (b) the service is provided to the patient individually; and (c) the service is at least 30 minutes duration; and (d) on the completion of the course of treatment, the eligible audiologist, dietitian, exercise physiologist, occupational therapist, optometrist, orthoptist, physiotherapist, or speech pathologist gives a written report to the referring eligible medical practitioner on assessments (if performed), treatment provided and recommendations on future management of the patient’s condition Up to 4 services to which this item or any of items 82015, 82020, 82025, 82035, 93035, 93036 or 93043 apply may be provided to the same patient on the same day Further information on the requirements for this item are available in the explanatory notes to this Category | $105.25 85% benefit $89.50 |
| 93048 | Video attendance provided to a person who is of Aboriginal or Torres Strait Islander descent by an eligible allied health practitioner or Aboriginal and Torres Strait Islander primary health care professional if: (a) a medical practitioner has undertaken a health assessment and identified a need for follow‑up health services; or (b) the patient has a chronic condition and complex care needs being managed by a medical practitioner (other than a specialist or consultant physician) under: (i) a GP chronic condition management plan that has been prepared or reviewed in the last 18 months; or (ii) until the end of 30 June 2027—a GP Management Plan and Team Care Arrangements prepared prior to 1 July 2025; or (iii) a multidisciplinary care plan; and the service is recommended in the patient’s plan or arrangements as part of the management of the patient’s chronic condition and complex care needs; (c) the person is referred to the eligible health practitioner by a medical practitioner; and (d) the service is provided to the person individually; and (e) the service is of at least 20 minutes duration; and (f) after the service, the eligible health practitioner gives a written report to the referring medical practitioner mentioned in paragraph (b): (i) if the service is the only service under the referral—in relation to that service; or (ii) if the service is the first or the last service under the referral—in relation to that service; or (iii) if neither subparagraph (i) nor (ii) applies but the service involves matters that the referring medical practitioner would reasonably expect to be informed of—in relation to those matters; to a maximum of 10 services (including any services to which this item or 93000, 93013 or 93061 or any item in Subgroup 1 of Group M3 or any item in Group M11 of the Allied Health and other Primary Health Care Services Determination applies) in a calendar year | $74.55 85% benefit $63.40 |
| 93061 | Phone attendance provided to a person who is of Aboriginal or Torres Strait Islander descent by an eligible allied health or Aboriginal and Torres Strait Islander primary health care professional if: (a) a medical practitioner has undertaken a health assessment and identified a need for follow‑up health services; or (b) the patient has a chronic condition and complex care needs being managed by a medical practitioner (other than a specialist or consultant physician) under: (i) a GP chronic condition management plan that has been prepared or reviewed in the last 18 months; or (ii) until the end of 30 June 2027—a GP Management Plan and Team Care Arrangements prepared prior to 1 July 2025; or (iii) a multidisciplinary care plan; and the service is recommended in the patient’s plan or arrangements as part of the management of the patient’s chronic condition and complex care needs; (c) the person is referred to the eligible health practitioner by a medical practitioner; and (d) the service is provided to the person individually; and (e) the service is of at least 20 minutes duration; and (f) after the service, the eligible health practitioner gives a written report to the referring medical practitioner mentioned in paragraph (b): (i) if the service is the only service under the referral—in relation to that service; or (ii) if the service is the first or the last service under the referral—in relation to that service; or (iii) if neither subparagraph (i) nor (ii) applies but the service involves matters that the referring medical practitioner would reasonably expect to be informed of—in relation to those matters; to a maximum of 10 services (including any services to which this item or item 93000, 93013, 93048 or any item in Subgroup 1 of Group M3 or any item in Group M11 of the Allied Health and other Primary Health Care Services Determination applies) in a calendar year | $74.55 85% benefit $63.40 |
| 93074 | Dietetics health service provided by video attendance to an eligible patient by an eligible dietitian: (a) the service is recommended in the patient’s eating disorder treatment and management plan; and (b) the service is provided to the patient individually; and (c) the service is of at least 20 minutes in duration | $74.55 85% benefit $63.40 |
| 93076 | Eating disorder psychological treatment service provided by video attendance to an eligible patient by an eligible clinical psychologist if: (a) the service is recommended in the patient’s eating disorder treatment and management plan; and (b) the service is provided to the patient individually; and (c) the service is at least 30 minutes but less than 50 minutes in duration | $119.45 85% benefit $101.55 |
| 93079 | Eating disorder psychological treatment service provided by video attendance to an eligible patient by an eligible clinical psychologist if: (a) the service is recommended in the patient’s eating disorder treatment and management plan; and (b) the service is provided to the patient individually; and (c) the service is at least 50 minutes in duration | $175.30 85% benefit $149.05 |
| 93084 | Eating disorder psychological treatment service provided by video attendance to an eligible patient by an eligible psychologist if: (a) the service is recommended in the patient’s eating disorder treatment and management plan; and (b) the service is provided to the patient individually; and (c) the service is at least 20 minutes but less than 50 minutes in duration | $84.65 85% benefit $72.00 |
| 93087 | Eating disorder psychological treatment service provided by video attendance to an eligible patient by an eligible psychologist if: (a) the service is recommended in the patient’s eating disorder treatment and management plan; and (b) the service is provided to the patient individually; and (c) the service is at least 50 minutes in duration | $119.45 85% benefit $101.55 |
| 93092 | Eating disorder psychological treatment service provided by video attendance to an eligible patient by an eligible occupational therapist if: (a) the service is recommended in the patient’s eating disorder treatment and management plan; and (b) the service is provided to the patient individually; and (c) the service is at least 20 minutes but less than 50 minutes in duration | $74.55 85% benefit $63.40 |
| 93095 | Eating disorder psychological treatment service provided by video attendance to an eligible patient by an eligible occupational therapist if: (a) the service is recommended in the patient’s eating disorder treatment and management plan; and (b) the service is provided to the patient individually; and (c) the service is at least 50 minutes in duration | $105.25 85% benefit $89.50 |
| 93100 | Eating disorder psychological treatment service provided by video attendance to an eligible patient by an eligible social worker if: (a) the service is recommended in the patient’s eating disorder treatment and management plan; and (b) the service is provided to the patient individually; and (c) the service is at least 20 minutes but less than 50 minutes in duration | $74.55 85% benefit $63.40 |
| 93103 | Eating disorder psychological treatment service provided by video attendance to an eligible patient by an eligible social worker if: (a) the service is recommended in the patient’s eating disorder treatment and management plan; and (b) the service is provided to the patient individually; and (c) the service is at least 50 minutes in duration | $105.25 85% benefit $89.50 |
| 93108 | Dietetics health service provided by phone attendance to an eligible patient by an eligible dietitian: (a) the service is recommended in the patient’s eating disorder treatment and management plan; and (b) the service is provided to the patient individually; and (c) the service is of at least 20 minutes in duration. | $74.55 85% benefit $63.40 |
| 93110 | Eating disorder psychological treatment service provided by phone attendance to an eligible patient by an eligible clinical psychologist if: (a) the service is recommended in the patient’s eating disorder treatment and management plan; and (b) the service is provided to the patient individually; and (c) the service is at least 30 minutes but less than 50 minutes in duration. | $119.45 85% benefit $101.55 |
| 93113 | Eating disorder psychological treatment service provided by phone attendance to an eligible patient by an eligible clinical psychologist if: (a) the service is recommended in the patient’s eating disorder treatment and management plan; and (b) the service is provided to the patient individually; and (c) the service is at least 50 minutes in duration. | $175.30 85% benefit $149.05 |
| 93118 | Eating disorder psychological treatment service provided by phone attendance to an eligible patient by an eligible psychologist if: (a) the service is recommended in the patient’s eating disorder treatment and management plan; and (b) the service is provided to the patient individually; and (c) the service is at least 20 minutes but less than 50 minutes in duration. | $84.65 85% benefit $72.00 |
| 93121 | Eating disorder psychological treatment service provided by phone attendance to an eligible patient by an eligible psychologist if: (a) the service is recommended in the patient’s eating disorder treatment and management plan; and (b) the service is provided to the patient individually; and (c) the service is at least 50 minutes in duration. | $119.45 85% benefit $101.55 |
| 93126 | Eating disorder psychological treatment service provided by phone attendance to an eligible patient by an eligible occupational therapist if: (a) the service is recommended in the patient’s eating disorder treatment and management plan; and (b) the service is provided to the patient individually; and (c) the service is at least 20 minutes but less than 50 minutes in duration | $74.55 85% benefit $63.40 |
| 93129 | Eating disorder psychological treatment service provided by phone attendance to an eligible patient by an eligible occupational therapist if: (a) the service is recommended in the patient’s eating disorder treatment and management plan; and (b) the service is provided to the patient individually; and (c) the service is at least 50 minutes in duration. | $105.25 85% benefit $89.50 |
| 93134 | Eating disorder psychological treatment service provided by phone attendance to an eligible patient by an eligible social worker if: (a) the service is recommended in the patient’s eating disorder treatment and management plan; and (b) the service is provided to the patient individually; and (c) the service is at least 20 minutes but less than 50 minutes in duration. | $74.55 85% benefit $63.40 |
| 93137 | Eating disorder psychological treatment service provided by phone attendance to an eligible patient by an eligible social worker if: (a) the service is recommended in the patient’s eating disorder treatment and management plan; and (b) the service is provided to the patient individually; and (c) the service is at least 50 minutes in duration. | $105.25 85% benefit $89.50 |
| 93200 | Follow‑up video attendance provided by a practice nurse or an Aboriginal and Torres Strait Islander health practitioner, on behalf of a medical practitioner, for an Indigenous person who has received a health check if: (a) the service is provided on behalf of and under the supervision of a medical practitioner; and (b) the service is consistent with the needs identified through the health assessment | $33.70 85% benefit $28.65 |
| 93201 | Video attendance provided by a practice nurse or an Aboriginal and Torres Strait Islander health practitioner to a person with a chronic condition, if: (a) the service is provided on behalf of and under the supervision of a medical practitioner; and (b) the person has in place: (i) a GP chronic condition management plan that has been prepared or reviewed in the last 18 months; or (ii) until the end of 30 June 2027—a GP Management Plan and Team Care Arrangements, prepared before 1 July 2025; or (iii) a multidisciplinary care plan; and (c) the service is consistent with the plan or arrangements | $17.00 85% benefit $14.45 |
| 93202 | Follow‑up phone attendance provided by a practice nurse or an Aboriginal and Torres Strait Islander health practitioner, on behalf of a medical practitioner, for an Indigenous person who has received a health check if: (a) the service is provided on behalf of and under the supervision of a medical practitioner; and (b) the service is consistent with the needs identified through the health assessment. | $33.70 85% benefit $28.65 |
| 93203 | Phone attendance provided by a practice nurse or an Aboriginal and Torres Strait Islander health practitioner to a person with a chronic condition, if: (a) the service is provided on behalf of and under the supervision of a medical practitioner; and (b) the person has in place: (i) a GP chronic condition management plan that has been prepared or reviewed in the last 18 months; or (ii) until the end of 30 June 2027—a GP Management Plan and Team Care Arrangements, prepared before 1 July 2025; or (iii) a multidisciplinary care plan; and (c) the service is consistent with the plan or arrangements | $17.00 85% benefit $14.45 |
| 93284 | Video attendance by an eligible dietitian to provide a dietetics health service to a person for assessing the person’s suitability for group services for the management of type 2 diabetes, including taking a comprehensive patient history, identifying an appropriate group services program based on the patient’s needs and preparing the person for the group services if: (a) the person has type 2 diabetes; and (b) the patient is being managed by a medical practitioner (other than a specialist or consultant physician) under: (i) a GP chronic condition management plan that has been prepared or reviewed in the last 18 months; or (ii) until the end of 30 June 2027—a GP Management Plan prepared prior to 1 July 2025; or (iii) a multidisciplinary care plan; and (c) the patient is referred to an eligible diabetes educator by the medical practitioner; and (d) the service is provided to the person individually; and (e) the service is of at least 45 minutes duration; and (f) after the service, the eligible dietitian gives a written report to the referring medical practitioner mentioned in paragraph (c); payable once in a calendar year for this or any other assessment for group services item (including services to which this item, item 92386, or items 81100, 81110 and 81120 apply) | $95.65 85% benefit $81.35 |
| 93285 | Video attendance by an eligible dietitian to provide a dietetics health service, as a group service for the management of type 2 diabetes if: (a) the person has been assessed as suitable for a type 2 diabetes group service under assessment items 81100, 81110, 81120, 93284 or 93286; and (b) the service is provided to a person who is part of a group of between 2 and 12 patients; and (c) the service is of at least 60 minutes duration; and (d) after the last service in the group services program provided to the person under this item or items 81105, 81115 or 81125, the eligible dietitian prepares, or contributes to, a written report to be provided to the referring medical practitioner; and (e) an attendance record for the group is maintained by the eligible dietitian; to a maximum of 8 group services in a calendar year (including services to which this item or items 81105, 81115 and 81125 apply) | $23.80 85% benefit $20.25 |
| 93286 | Phone attendance by an eligible dietitian to provide a dietetics health service to a person for assessing the person’s suitability for group services for the management of type 2 diabetes, including taking a comprehensive patient history, identifying an appropriate group services program based on the patient’s needs and preparing the person for the group services if: (a) the person has type 2 diabetes; and (b) the patient is being managed by a medical practitioner (other than a specialist or consultant physician) under: (i) a GP chronic condition management plan that has been prepared or reviewed in the last 18 months; or (ii) until the end of 30 June 2027—a GP Management Plan prepared prior to 1 July 2025; or (iii) a multidisciplinary care plan; and (c) the patient is referred to an eligible diabetes educator by the medical practitioner; and (d) the service is provided to the person individually; and (e) the service is of at least 45 minutes duration; and (f) after the service, the eligible dietitian gives a written report to the referring medical practitioner mentioned in paragraph (c); payable once in a calendar year for this or any other assessment for group services item (including services to which this item, item 92384, or in items 81100, 81110 and 81120 apply) | $95.65 85% benefit $81.35 |
M19 Midwifery telehealth services
8 items
| Item | Description | Fee and benefits |
|---|---|---|
| 91211 | Short antenatal video attendance by a participating midwife, lasting at least 10 minutes | $38.75 85% benefit $32.95 |
| 91212 | Routine antenatal video attendance by a participating midwife, lasting at least 40 minutes | $89.00 85% benefit $75.65 |
| 91214 | Short postnatal video attendance by a participating midwife, lasting at least 20 minutes | $63.90 85% benefit $54.35 |
| 91215 | Routine postnatal video attendance by a participating midwife, lasting at least 40 minutes | $130.80 85% benefit $111.20 |
| 91218 | Short antenatal phone attendance by a participating midwife, lasting at least 10 minutes | $38.75 85% benefit $32.95 |
| 91219 | Routine antenatal phone attendance by a participating midwife, lasting at least 40 minutes | $89.00 85% benefit $75.65 |
| 91221 | Short postnatal phone attendance by a participating midwife, lasting at least 20 minutes | $63.90 85% benefit $54.35 |
| 91222 | Routine postnatal phone attendance by a participating midwife, lasting at least 40 minutes | $130.80 85% benefit $111.20 |
M33 Non-Medical Assistance at Operations
7 items
| Item | Description | Fee and benefits |
|---|---|---|
| 93718 | Assistance by a participating nurse practitioner at any operation mentioned in an item in Group T8 that includes "(Assist.)" for which the fee does not exceed $668.25 or at a series or combination of operations mentioned in an item in Group T8 that include "(Assist. )" for which the aggregate fee does not exceed $668.25 | $103.25 75% benefit $77.45 85% benefit $87.80 |
| 93719 | Assistance by a participating nurse practitioner at any operation mentioned in an item in Group T8 that includes "(Assist.)" for which the fee exceeds $668.25 or at a series or combination of operations mentioned in an item in Group T8 that include "(Assist.)" for which the aggregate fee exceeds $668.25 Derived fee: For assistance at an operation or series or combination of operations, means 20% of the sum of the fees payable under the Act for the services provided at that operation, or series of operations, by the practitioner to whom the assistance was given. | Derived |
| 93720 | Assistance by a participating nurse practitioner at a birth involving Caesarean section (H) | $149.25 75% benefit $111.95 |
| 93721 | Assistance by a participating nurse practitioner at a series or combination of operations that include "(Assist.)" and assistance by a participating nurse practitioner at a birth involving Caesarean section (H) Derived fee: (a) 20% of the sum of the fees payable under the Act for the services provided at those operations by the practitioner to whom the assistance was given; or (b) for the caesarean section component of the operations—the fee mentioned in item 16520. | Derived |
| 93722 | Assistance by a participating nurse practitioner at any interventional obstetric procedure covered by items 16606, 16609, 16612, 16615 and 16627 (H) Derived fee: 20% of the sum of the fees payable under the Act for the services provided at that procedure or combination of procedures by the practitioner to whom the assistance was given. | Derived |
| 93723 | Assistance by a participating nurse practitioner at cataract and intraocular lens surgery covered by item 42698, 42701, 42702, 42704, 42705 or 42707, when performed in association with services covered by item 42551 to 42569, 42653, 42656, 42725, 42746, 42749, 42752, 42776 or 42779 (H) | $326.05 75% benefit $244.55 |
| 93724 | Assistance at cataract and intraocular lens surgery by a participating nurse practitioner, if patient has:(a) total loss of vision, including no potential for central vision, in the fellow eye; or (b) one of the following in the fellow eye: (i) vitreous loss;(ii) rupture of posterior capsule;(iii) loss of nuclear material into the vitreous;(iv) intraocular haemorrhage;(v) intraocular infection (endophthalmitis);(vi) cystoid macular oedema;(vii) corneal decompensation;(viii) retinal detachment; or (c) pseudo exfoliation, subluxed lens, iridodonesis, phacodonesis, retinal detachment, corneal scarring, pre-existing uveitis, bound down miosed pupil, nanophthalmos, spherophakia, Marfan's syndrome, homocysteinuria or previous blunt trauma causing intraocular damage (H) | $215.20 75% benefit $161.40 |
Check the item before you claim.
An eligibility check tests the patient and each MBS item against Medicare’s rules, so a ‘no’ comes back with the reason before the claim goes in.