Medicare Benefits Schedule - Item 255

Search Results for Item 255

View Associated Notes

Category 1 - PROFESSIONAL ATTENDANCES

255

255 - 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
8 - Non-Specialist Practitioner attendances associated with Practice Incentive Program payments

Professional attendance at a place other than consulting rooms of more than 25 minutes, but not more than 45 minutes in duration by a medical practitioner in an eligible area, at which a specimen for a cervical screening service is collected from the patient, if the patient is at least 24 years and 9 months of age but is less than 75 years of age and has not been provided with a cervical screening service or a cervical smear service in the last 4 years

The fee for item 254, plus $21.10 divided by the number of patients seen, up to a maximum of six patients. For seven or more patients - the fee for item 254 plus $1.65 per patient.
Ready Reckoner

(See para AN.7.1, AN.7.19 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.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.7.19

Medical Practitioner Cervical Screen from a Person Who is Unscreened or Significantly Under-Screened (Items 251 to 257)

Eligibility

Items 251 to 257 are available to medical practitioners providing services in eligible areas.

Eligible area means an area that is a Modified Monash 2 area, Modified Monash 3 area, Modified Monash 4 area, Modified Monash 5 area, Modified Monash 6 area or Modified Monash 7 area.

Medical practitioners providing services in a Modified Monash 1 area should use the items in Group A19, Subgroup 1.

A locator map to identify a medical practice's Modified Monash Model Area location is available at the DoctorConnect website at http://www.doctorconnect.gov.au/internet/otd/publishing.nsf/Content/locator

Guidance Notes

Item numbers 251, 252, 253, 254, 255, 256 and 257 should be used in place of the usual attendance item where as part of a consultation, a sample for cervical screening is collected from a person between the ages of 24 years and 9 months and 74 years inclusive who has not had a cervical smear in the last four years. Cervical Screening in accordance with the National Cervical Screening Policy at P.16.11.

Self-collection of a sample for screening is only available for women between the ages of 30 and 74 years of age who are overdue for screening by two or more years (i.e. being 4 years since their last Pap test).  Self-collection should only be offered to an eligible person who refuses to have a sample collected by their requesting practitioner.

When providing this service, the medical practitioner must satisfy themselves that the person has not had a cervical screening test in the last four years by:

(a)   asking the person if they can remember having a cervical screening test in the last four years;

(b)   checking their own practice's medical records; and

(c)   checking the National Cancer Screening Register.

A person from the following groups are more likely than the general population to be unscreened or significantly under screened - low socio-economic status, culturally and linguistically diverse backgrounds, Indigenous communities, rural and remote areas and older people.

Vault smears are not eligible for items 251 to 257.

 In addition to attracting a Medicare rebate, the use of these items will initiate a Cervical Screening SIP through the PIP.

A PIP Cervical Screening SIP is available for taking a cervical screen from a person who has not been screened in the last for four years.  The SIP will be paid to the medical practitioner who provided the service if the service was provided in a medical practice participating in the PIP Cervical Screening Incentive. A further PIP Cervical Screening Incentive payment is paid to medical practices which reach target levels of cervical screening for their patients aged 24 years and 9 months of age to 74 years inclusive. More detailed information on the PIP Cervical Screening Incentive is available from the Department of Human Services PIP enquiry line on 1800 222 032 or from the Department of Human Services website.

Related Items: 251 252 253 254 255 256 257


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