Medicare Benefits Schedule - Item 221

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View Associated Notes

Category 1 - PROFESSIONAL ATTENDANCES

221

221 - Additional Information

Item Start Date:
01-Jul-2018
Description Start Date:
01-Jul-2018
Schedule Fee Start Date:
01-Jul-2019

Group
A7 - Acupuncture and Non-Specialist Practitioner Items
Subgroup
4 - Non-Specialist Practitioner group therapy

Professional attendance for the purpose of group therapy of not less than 1 hour in duration given under the direct continuous supervision of a medical practitioner involving members of a family and persons with close personal relationships with that family—each Group of 2 patients

Fee: $95.55 Benefit: 75% = $71.70 100% = $95.55

(See para AN.7.1, AN.7.4 of explanatory notes to this Category)

Extended Medicare Safety Net Cap: $286.65


Associated Notes

Category 1 - PROFESSIONAL ATTENDANCES

AN.7.1

Attendances by Medical Practitioners

Items 179-181, 185-187, 189-197, 203-206, 215-287, 371, 372, 733-789, 792, 812-892, 90092-93, 90095-96, 90183, 90188, 90202, and 90212 relate to attendances rendered by a medical practitioner who is not a general practitioner, specialist or consultant physician, and who:


(a) is registered under section 3GA of the Act, to the extent that the person is practising during the period in respect of which, and in the location in respect of which, he or she is registered, and insofar as the circumstances specified for paragraph 19AA(3)(b) of the Act apply; or


(b) is covered by an exemption under subsection 19AB(3) of the Act; or


(c) first became a medical practitioner before 1 November 1996. 

Related Items: 179 181 185 187 189 191 203 206 214 215 218 219 220 221 222 223 224 225 226 227 228 229 230 231 232 233 235 236 237 238 239 240 243 244 245 249 251 252 253 254 255 256 257 259 260 261 262 263 264 265 266 268 269 270 271 272 276 277 279 281 282 283 285 286 287 371 372 733 737 741 745 761 763 766 769 772 776 788 789 792 812 827 829 867 868 869 873 876 881 885 891 892 90092 90093 90095 90096 90183 90188 90202 90212

Category 1 - PROFESSIONAL ATTENDANCES

AN.7.4

Medical Practitioner Family Group Therapy (Items 221, 222 and 223)

These items refer to family group therapy supervised by medical practitioners other than consultant psychiatrists. To be used, these items require that a formal intervention with a specific therapeutic outcome, such as improved family function and/or communication, is undertaken. Other types of group attendances do not attract benefits. It should be noted that only one fee applies in respect of each group of patients.

Telephone consultations, letters of advice by medical practitioners, the issue of repeat prescriptions when the patient is not in attendance, post mortem examinations, the issue of death certificates, cremation certificates, counselling of relatives (note ‑ items 348, 350 and 352 are not counselling services), group attendances (other than group attendances covered by items 170, 171, 172, 221, 222, 223, 342, 344 and 346) such as group counselling, health education, weight reduction or fitness classes do not qualify for benefit.

Although Medicare benefits are not payable for the issue of a death certificate, an attendance on a patient at which it is determined that life is extinct can be claimed under the appropriate attendance item. The outcome of the attendance may be that a death certificate is issued, however, Medicare benefits are only payable for the attendance component of the service.

Related Items: 221 222 223


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