Medicare Benefits Schedule - Item 90001

Search Results for Item 90001

View Associated Notes

Category 1 - PROFESSIONAL ATTENDANCES

90001

90001 - Additional Information

Item Start Date:
01-Mar-2019
Description Updated:
01-Nov-2023
Schedule Fee Updated:
01-Nov-2023

Group
A35 - Services For Patients in Residential Aged Care Facilities
Subgroup
1 - Flag Fall Amount For Residential Aged Care Facilities

For the first patient attended during one attendance by a general practitioner at one residential aged care facility on one occasion, the fee for the medical service described in whichever of items 90020, 90035, 90043, 90051 or 90054 applies is the amount listed in the item plus $60.55.

Fee: $60.55 Benefit: 100% = $60.55

(See para AN.35.1 of explanatory notes to this Category)

Extended Medicare Safety Net Cap: $181.65


Associated Notes

Category 1 - PROFESSIONAL ATTENDANCES

AN.35.1

Flag fall amount for residential aged care facility attendance by a general practitioner

Last reviewed: 1 November 2023

Medicare item 90001 provides a flag fall fee for the initial attendance by a general practitioner at one RACF, on one occasion, applicable only to the first patient seen on the RACF visit. 

The Medicare benefit for the single flag fall fee and the associated general consultation (Levels A to E) applies only for patients within a RACF who have a general consultation with a doctor in person.

If doctors do not bill the single flag fall fee, the benefit will not be paid.

If a doctor has to return to the RACF facility twice or more on the same day and the attendances are not a continuation of an earlier episode of treatment, another flag fall fee would apply per subsequent RACF visit.

When claiming the new attendance items there is no longer a requirement to transmit the number of patients seen. A doctor would claim each attendance item like any other consultation service.

MBS items 90001 is not to be used with existing derived fee services such as for afterhours, urgent afterhours, or telehealth services.  The bulk billing incentive only applies to the attendance item, not to the single flag fall fee.

Related Items: 90001 90020 90035 90043 90051 90054


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