Medicare Benefits Schedule - Item 93519

Search Results for Item 93519

Category 8 - MISCELLANEOUS SERVICES

93519

93519 - Additional Information

Item Start Date:
15-Sep-2021
Description Updated:
15-Sep-2021
Schedule Fee Updated:
01-Jul-2021

Group
M29 - Initial services 1 per provider per patient in a 12 month period (is included in the additional tally of 5)
Subgroup
2 - Physical therapy items (included in the tally of 5)

Additional occupational therapy health service provided to a care recipient in a residential aged care facility, at a residential aged care facility, by an eligible occupational therapist if all of the following apply:

(a)    the person’s chronic or complex care needs are assessed as requiring additional occupational therapy services in a calendar year;

(b)    the service is provided to a person whose chronic or complex care needs are being managed under:

(i)            a multidisciplinary care plan for a residential aged care recipient to which items 232, 731, 92027, 92058, 92071, 92102, 93469 or 93475 applies; or

(ii)          a shared care plan; or

(iii)        a GP Management Plan and Team Care Arrangements, where the chronic or complex condition was being treated prior to the person receiving residential care;

(c)    the person is referred to the eligible occupational therapist by the medical practitioner using a referral form that has been issued by the Department or a referral form that contains all the components of the form issued by the Department;

(d)    the service is provided to the person individually and in person;

(e)    the service is at least 20 minutes in duration;

(f)     after the service, the eligible occupational therapist gives a written report to the referring medical practitioner:

(i)                 if the service is the only service under the referral – in relation to that service; or

(ii)               if the service is the first or last service under the referral – in relation to that service; or

(iii)              if neither subparagraph (i) nor (ii) applies but the service involves matters that the referring medical practitioner would reasonably expect to be informed of – in relation to those matters

Fee: $64.80 Benefit: 85% = $55.10


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