Medicare Benefits Schedule - Item 64994

A diagnostic imaging service to which an item in this table (other than this item or item 64990, 64991, 64992, 64993 or 64995) applies if:

(a) the service is an unreferred service; and

(b) the service is provided to a person who is under the age of 16 or is a Commonwealth concession card holder; and

(c) the person is not an admitted patient of a hospital; and

(d) the service is bulk-billed in respect of the fees for:

     (i)    this item; and

     (ii)  the other item in this Schedule applying to the service; and

(e) the service is provided at, or from, a practice location in a Modified Monash 6 area

Fee: $13.75 Benefit: 85% = $11.70

(See para IN.0.20 of explanatory notes to this Category)

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Additional bulk billing payment for diagnostic imaging services (items 64990 to 64995)

The items cannot be claimed where the associated diagnostic imaging service:

• has been requested by another practitioner;
• has been self determined by a specialist or consultant physician in the course of practicing as a specialist or consultant physician;
• is an additional service rendered because the providing practitioner formed the opinion that the results obtained following a requested diagnostic imaging service necessitated an additional service; or
• is a service that has been substituted for the originally requested service.
   

For more information about the provision of self determined, additional or substituted services see note IN.0.6 under the heading ‘Exemptions from the written request requirements for R-type diagnostic imaging services’.

Related Items: 64990 64991 64992 64993 64994 64995