Medicare Benefits Schedule - Item 24

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View Associated Notes

Level B

Professional attendance by a general practitioner (not being a service to which any other item in this table applies) lasting less than 20 minutes, including any of the following that are clinically relevant:

a)     taking a patient history;

b)     performing a clinical examination;

c)     arranging any necessary investigation;

d)     implementing a management plan;

e)     providing appropriate preventive health care;

in relation to 1 or more health-related issues, with appropriate documentation.

Category 1 - PROFESSIONAL ATTENDANCES

24

24 - Additional Information

Item Start Date:
01-Nov-1997
Description Start Date:
01-Jan-2013
Schedule Fee Start Date:
01-Jul-2018

Group
A1 - General Practitioner Attendances To Which No Other Item Applies
Subheading
2 - Level B


Professional attendance by a general practitioner (other than attendance at consulting rooms or a residential aged care facility or a service to which another item in the table applies), lasting less than 20 minutes and including any of the following that are clinically relevant:

(a) taking a patient history;

(b) performing a clinical examination;

(c) arranging any necessary investigation;

(d) implementing a management plan;

(e) providing appropriate preventive health care;

for one or more health-related issues, with appropriate documentation-an attendance on one or more patients at one place on one occasion-each patient

The fee for item 23, plus $26.35 divided by the number of patients seen, up to a maximum of six patients. For seven or more patients - the fee for item 23 plus $2.05 per patient.
Ready Reckoner

(See para AN.0.9, AN.0.11, AN.0.13 of explanatory notes to this Category)

Extended Medicare Safety Net Cap: 300% of the Derived fee for this item, or $500, whichever is the lesser amount


Associated Notes

Category 1 - PROFESSIONAL ATTENDANCES

AN.0.9

Attendances by General Practitioners (Items 3 to 51, 193, 195, 197, 199, 585, 594, 599, 2497-2559 and 5000-5067)

Attendances by General Practitioners (Items 3 to 51, 193, 195, 197, 199, 585, 594, 599, 2497-2559 and 5000-5067)

Items 3 to 51 and 193, 195, 197, 199, 585, 594, 599, 2497-2559 and 5000-5067 relate to attendances rendered by medical practitioners who are:

-          listed on the Vocational Register of General Practitioners maintained by the Department of Human Services; or

-          holders of the Fellowship of the Royal Australian College of General Practitioners (FRACGP) who participate in, and meet the requirements of the RACGP for continuing medical education and quality assurance as defined in the RACGP Quality Assurance and Continuing Medical Education program; or

-          holders of the Fellowship of the Australian College of Rural and Remote Medicine (FACRRM) who participate in, and meet the requirements of the Australian College of Rural and Remote Medicine (ACRRM) for continuing medical education and quality assurance as defined in ACRRM's Professional Development Program; or

-          undertaking an approved placement in general practice as part of a training program for general practice leading to the award of the FRACGP or training recognised by the RACGP as being of an equivalent standard; or

-          undertaking an approved placement in general practice as part of a training program for general practice leading to the award of the FACRRM or training recognised by ACRRM as being of an equivalent standard. 

To assist general practitioners in selecting the appropriate item number for Medicare benefit purposes the following notes in respect of the various levels are given. 

LEVEL A

A Level A item will be used for obvious and straightforward cases and this should be reflected in the practitioner's records.  In this context, the practitioner should undertake the necessary examination of the affected part if required, and note the action taken. 

LEVEL B

A Level B item will be used for a consultation lasting less than 20 minutes for cases that are not obvious or straightforward in relation to one or more health related issues.  The medical practitioner may undertake all or some of the tasks set out in the item descriptor as clinically relevant, and this should be reflected in the practitioner's record.  In the item descriptor singular also means plural and vice versa. 

LEVEL C

A Level C item will be used for a consultation lasting at least 20 minutes for cases in relation to one or more health related issues.  The medical practitioner may undertake all or some of the tasks set out in the item descriptor as clinically relevant, and this should be reflected in the practitioner's record.  In the item descriptor singular also means plural and vice versa. 

LEVEL D

A Level D item will be used for a consultation lasting at least 40 minutes for cases in relation to one or more health related issues.  The medical practitioner may undertake all or some of the tasks set out in the item descriptor as clinically relevant, and this should be reflected in the practitioner's record. In the item descriptor singular also means plural and vice versa. 

Creating and Updating a Personally Controlled Electronic Health Record (PCEHR)

The time spent by a medical practitioner on the following activities may be counted towards the total consultation time:

· Reviewing a patient's clinical history, in the patient's file and/or the PCEHR, and preparing or updating a Shared Health Summary where it involves the exercise of clinical judgement about what aspects of the clinical history are relevant to inform ongoing management of the patient's care by other providers; or

· Preparing an Event Summary for the episode of care.

Preparing or updating a Shared Health Summary and preparing an Event Summary are clinically relevant activities.  When either of these activities are undertaken with any form of patient history taking and/or the other clinically relevant activities that can form part of a consultation, the item that can be billed is the one with the time period that matches the total consultation time. 

MBS rebates are not available for creating or updating a Shared Health Summary as a stand alone service. 

Counselling or Advice to Patients or Relatives

For items 23 to 51 and 5020 to 5067 'implementation of a management plan' includes counselling services. 

Items 3 to 51 and 5000 to 5067 include advice to patients and/or relatives during the course of an attendance. The advising of relatives at a later time does not extend the time of attendance. 

Recording Clinical Notes

In relation to the time taken in recording appropriate details of the service, only clinical details recorded at the time of the attendance count towards the time of consultation.  It does not include information added at a later time, such as reports of investigations. 

Other Services at the Time of Attendance

Where, during the course of a single attendance by a general practitioner, both a consultation and another medical service are rendered, Medicare benefits are generally payable for both the consultation and the other service. Exceptions are in respect of medical services which form part of the normal consultative process, or services which include a component for the associated consultation (see the General Explanatory Notes for further information on the interpretation of the Schedule). 

The Department of Human Services (DHS) has developed an Health Practitioner Guideline for responding to a request to substantiate that a patient attended a service which is located on the DHS website.

Related Items: 3 4 20 23 24 35 36 37 43 44 47 51 193 195 197 199 585 594 599 2497 2501 2503 2504 2506 2507 2509 2517 2518 2521 2522 2525 2546 2547 2552 2558 2559 5000 5003 5010 5020 5023 5028 5040 5043 5049 5060 5063 5067

Category 1 - PROFESSIONAL ATTENDANCES

AN.0.11

Professional Attendances at an Institution (Items 4, 24, 37, 47, 58, 59, 60, 65, 5003, 5023, 5043, 5063, 5220, 5223, 5227 and 5228)

For the purposes of these items an "institution" means a place (not being a hospital or residential aged care facility) at which residential accommodation or day care or both such accommodation and such care is made available to:‑

(a)              disadvantaged children;

(b)              juvenile offenders;

(c)              aged persons;

(d)              chronically ill psychiatric patients;

(e)              homeless persons;

(f)               unemployed persons;

(g)              persons suffering from alcoholism;

(h)              persons addicted to drugs; or

(i)               physically or intellectually disabled persons.

Related Items: 4 24 37 47 5003 5023 5043 5063 5220 5223 5227 5228

Category 1 - PROFESSIONAL ATTENDANCES

AN.0.13

Attendances at a Hospital (Items 4, 24, 37, 47, 58, 59, 60, 65)

These items refer to attendances on patients admitted to a hospital. Where medical practitioners have made arrangements with a local hospital to routinely use out-patient facilities to see their private patients, items for services provided in consulting rooms would apply.

Related Items: 4 24 37 47


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