Medicare Benefits Schedule - Item 74991

Search Results for Item 74991

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74991 - Additional Information

Item Start Date:
Description Updated:
Schedule Fee Updated:

P12 - Management Of Bulk-Billed Services

A pathology service to which an item in this table (other than this item or item 74990) applies if:

(a)    the service is an unreferred service; and

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

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

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

    (i)    this item; and

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

(e)    the service is provided at, or from, a practice location within Modified Monash areas 2 to 7.

Fee: $10.90 Benefit: 85% = $9.30

(See para PN.0.24 of explanatory notes to this Category)

Associated Notes



Additional Bulk Billing Payment for Pathology Services - (Item 74990 and 74991)

Item 74990 operates in the same way as item 10990 and item 74991 operates in the same way as item 10991, apart from the following differences:

· Item 74990 and 74991 can only be used in conjunction with items in the Pathology Services Table of the MBS;

· Item 74990 and 74991 applies to unreferred pathology services performed by a medical practitioner which are included in Group P9 of the Pathology Services Table, and unreferred pathology services provided by category M laboratories;

· Item 74990 and item 74991 applies to pathology services self determined by general practitioners and specialists with dual qualifications acting in their capacity as general practitioners;

· Specialists and consultant physicians who provide pathology services are not able to claim item 74990 or item 74991 unless, for the purposes of the Health Insurance Act, the medical practitioner is also a general practitioner and the service provided by the medical practitioner has not been referred to that practitioner by another medical practitioner or person with referring rights. 

Rules 3 and 18 of the Health Insurance (Pathology Services Table) Regulations 2003 have been amended to exclude item 74990 and 74991 from the Multiple Services Rule and the Coning Rule. 

Item 74991 can only be used where the service is provided at, or from, a practice location in an eligible area that is regional, rural or remote area (Monash Modified Model (MMM) 2 to 7 under the MMM geographical classification system).

Related Items: 74990 74991


  • 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