Medicare Benefits Schedule - Item 343

An interview, lasting more than 15 minutes but not more than 30 minutes, of a person other than the patient when the patient is not in attendance, by a consultant physician in the practice of the consultant physician’s specialty of psychiatry following referral of the patient to the consultant physician by a referring practitioner, for the purposes of:

(a) initial diagnostic evaluation; or

(b) continuing management of the patient;

if that service and another service to which this item or any of items 341, 345, 347, 349, 91874 to 91878 and 91882 to 91884 applies have not exceeded 15 services in a calendar year in relation to the patient

Fee: $96.60 Benefit: 75% = $72.45 85% = $82.15

(See para AN.0.32 of explanatory notes to this Category)

Extended Medicare Safety Net Cap: $289.80

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Intention of these items:

Items 341, 343, 345, 347 and 349 and telehealth equivalent items 91874 to 91878 and 91882 to 91884 are for the purpose of interviews with patient relatives or close associates to investigate the particular problem with which the patient presented or the interaction between the patient and the person interviewed. The items also provide for interviews concerned with the continuing management of the patient, focusing on clinically relevant problems rising in the management of the patient.

These items do not cover counselling of family or friends of the patient.

Referral requirements:

The patient who is the subject of the interview needs a referral to attend the psychiatrist in the first place, however the non-patient contacts who are interviewed do not require their own referral.

Claiming of Medicare benefits:

The payment of Medicare benefits under these items is limited to a total of 15 services in a calendar year. 

For Medicare benefit purposes, claims relating to services covered by items 341, 343, 345, 347, 349 and telehealth equivalent items 91874 to 91878 and 91882 to 91884 should be raised against the patient rather than against the person interviewed.

Same day attendance items:

Medicare benefits are payable on the same day for an interview under any of items 341, 343, 345, 347 and 349 or telehealth equivalent items 91874 to 91878 and 91882 to 91884 and for a consultation with a patient (under item 291, 293, 296, 297, 299, 300, 302, 304, 306, 308, 310, 312, 314, 316, 318, 319, 320, 322, 324, 326 or 328) provided that separate attendances are involved. This item can only be claimed if the interviewee attends without the patient. 

Related Items: 291 293 296 297 299 300 302 304 306 308 310 312 314 316 318 319 320 322 324 326 328 341 343 345 347 349 91874 91875 91876 91877 91878 91882 91883 91884