Medicare Benefits Schedule - Item 5228

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View Associated Notes

Consultation At A Place Other Than Consulting Rooms, Hospital Or A Residential Aged Care Facility

Professional attendance by a medical practitioner (other than a general practitioner) on 1 or more patients on 1 occasion at a place other than consulting rooms, a hospital or residential aged care facility.

Category 1 - PROFESSIONAL ATTENDANCES

5228

5228 - Additional Information

Item Start Date:
01-Jan-2005
Description Start Date:
01-Jan-2013
Schedule Fee Start Date:
01-Jan-2005

Group
A23 - Other Non-Referred After-Hours Attendances To Which No Other Item Applies
Subheading
2 - Consultation At A Place Other Than Consulting Rooms, Hospital Or A Residential Aged Care Facility

Professional attendance by a medical practitioner who is not a general practitioner (other than attendance at consulting rooms, a hospital or a residential aged care facility or a service to which another item in the table applies), lasting more than 45 minutes-an attendance on one or more patients on one occasion-each patient

An amount equal to $67.50, plus $15.50 divided by the number of patients seen, up to a maximum of six patients. For seven or more patients - an amount equal to $67.50 plus $.70 per patient
Ready Reckoner

(See para AN.0.11 of explanatory notes to this Category)

Extended Medicare Safety Net Cap: 300% of the Derived fee for this item, or $500, whichever is the lesser amount


Associated Notes

Category 1 - PROFESSIONAL ATTENDANCES

AN.0.11

Professional Attendances at an Institution (Items 4, 24, 37, 47, 58, 59, 60, 65, 5003, 5023, 5043, 5063, 5220, 5223, 5227 and 5228)

For the purposes of these items an "institution" means a place (not being a hospital or residential aged care facility) at which residential accommodation or day care or both such accommodation and such care is made available to:‑

(a)              disadvantaged children;

(b)              juvenile offenders;

(c)              aged persons;

(d)              chronically ill psychiatric patients;

(e)              homeless persons;

(f)               unemployed persons;

(g)              persons suffering from alcoholism;

(h)              persons addicted to drugs; or

(i)               physically or intellectually disabled persons.

To facilitate assessment of the correct Medicare rebate in respect of a number of patients attended on the one occasion at one of the above locations, it is important that the total number of patients seen be recorded on each individual account, receipt or assignment form. For example, where ten patients were visited (for a brief consultation) in the one facility on the one occasion, each account, receipt or assignment form would show "Item 4 - 1 of 10 patients" for a general practitioner. 

The number of patients seen should not include attendances which do not attract a Medicare rebate (e.g. public in-patients, attendances for normal after-care), or where a Medicare rebate is payable under an item other than these derived fee items (e.g. health assessments, care planning, emergency after-hours attendance - first patient).
 

Related Items: 4 24 37 47 5003 5023 5043 5063 5220 5223 5227 5228


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