Medicare Benefits Schedule - Item 16404

Search Results for Item 16404

View Associated Notes

Category 3 - THERAPEUTIC PROCEDURES

16404

16404 - Additional Information

Item Start Date:
01-Jan-2010
Description Start Date:
01-Jan-2010
Schedule Fee Start Date:
01-Nov-2012

Group
T4 - Obstetrics

Professional attendance at consulting rooms or a hospital by a specialist in the practice of his or her specialty of obstetrics after referral of the patient to him or her - each attendance SUBSEQUENT to the first attendance in a single course of treatment.

Fee: $43.00 Benefit: 75% = $32.25 85% = $36.55

(See para AN.0.70, TN.4.2 of explanatory notes to this Category)

Extended Medicare Safety Net Cap: $32.95


Associated Notes

Category 1 - PROFESSIONAL ATTENDANCES

AN.0.70

Limitation of items—certain attendances by specialists and consultant physicians

Medicare benefits are not payable for items 105, 116, 119, 386, 2806, 2814, 3010, 3014, 6019, 6052 and 16404 when claimed in association with an item in group T8 with a schedule fee of $300 or more.

The restriction applies when the procedure is performed by the same practitioner, on the same patient, on the same day.

Related Items: 105 116 119 386 2806 2814 3010 3014 6019 6052 16404

Category 3 - THERAPEUTIC PROCEDURES

TN.4.2

Items for Initial and Subsequent Obstetric Attendances (Items 16401 and 16404)

16401 and 16404 replace items 104 and 105 for any specialist obstetric attendance relating to pregnancy.  This includes any initial and subsequent attendance with a specialist obstetrician for discussion of pregnancy or pregnancy related conditions or complications, or any postnatal care provided to the patient subsequent to the expiration of normal aftercare period.  Item 16500 is still claimed for routine antenatal attendances.  These items are subject to Extended Medicare Safety Net caps.

Related Items: 16401 16404


Legend

  • Assist - Addition/Deletion of (Assist.)
  • Amend - Amended Description
  • Anaes - Anaesthetic Values Amended
  • Emsn - EMSN Change
  • Fee - Fee Amended
  • Renum - Item Number Change (renumbered)
  • New - New Item
  • NewMin - New Item (previous Ministerial Determination)
  • Qfe - QFE Change