Medicare Benefits Schedule - Item 93043

Psychology health service provided by phone attendance to a child aged under 15 years for treatment of a pervasive developmental disorder (PDD) or eligible disability by an eligible psychologist, if:

(a) the child has been diagnosed with a PDD or an eligible disability; and

(b) the child, while aged under 13 years, received a PDD or disability treatment and management plan as prepared by the eligible practitioner; and

(c) the child was referred by an eligible practitioner for services consistent with the child’s PDD or disability treatment and management plan; and

(d) the eligible practitioner is:

(i) for a child with PDD, a consultant physician specialising in the practice of his or her field of psychiatry or paediatrics;

(ii) for a child with disability, a specialist or consultant physician practising in his or her field of specialty, or a general practitioner; and

(e) the eligible psychologist attending the child is registered with the Department of Human Services as meeting the credentialing requirements for the provision of those services; and

(f) on the completion of the course of treatment, the eligible psychologist gives a written report to the referring eligible practitioner on assessments carried out, treatment provided and recommendations on future management of the child’s condition; and

(g) the eligible practitioner is:

(i) for a child with PDD, a consultant physician specialising in the practice of his or her field of psychiatry or paediatrics;

(ii) for a child with disability, a specialist or consultant physician practising in his or her specialty, or a general practitioner; and

(h) the service is provided to the child individually; and

(i) the service is at least 30 minutes duration;

to a maximum of 20 services (including services to which this item, items 93032, 93035, 93036 and 93044 or items 82020, 82025 and 82035 in the Allied Health Determination apply)

Fee: $105.45 Benefit: 85% = $89.65

Extended Medicare Safety Net Cap: $316.35

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