Medicare Benefits Schedule - Item 52

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View Associated Notes

Consultation At Consulting Rooms

Professional attendance at consulting rooms

Category 1 - PROFESSIONAL ATTENDANCES

52

52 - Additional Information

Item Start Date:
01-Dec-1989
Description Updated:
01-Nov-2019
Schedule Fee Updated:
01-Dec-1991

Group
A2 - Other Non-Referred Attendances To Which No Other Item Applies
Subgroup
1 - Other Medical Practitioner Attendances
Subheading
1 - Consultation At Consulting Rooms

 

Professional attendance at consulting rooms of not more than 5 minutes in duration (other than a service to which any other item applies)-each attendance, by:

(a) a medical practitioner (who is not a general practitioner); or

(b) a Group A1 disqualified general practitioner, as defined in the dictionary of the General Medical Services Table (GMST).

Fee: $11.00 Benefit: 100% = $11.00

(See para AN.2.1 of explanatory notes to this Category)

Extended Medicare Safety Net Cap: $33.00


Associated Notes

Category 1 - PROFESSIONAL ATTENDANCES

AN.2.1

Limitation of items - certain attendances by diagnostic imaging providers

 

Consultations rendered by specialist radiologists

Medicare benefits are not payable for items 52, 53, 54, 57, 104 and 105 when claimed by a specialist radiologist in association with any of the following diagnostic imaging items:

(a) an item in Subgroup 6 of Group I1;
(b) an item in any of Subgroups 1 to 7 of Group I3;
(c) items 58900 and 58903 in Subgroup 8 of Group I3; and
(d) item 59103 in Subgroup 9 of Group I3.

Consultations rendered in association with magnetic resonance imaging (MRI) services - Group I5

Medicare benefits are not payable for items 52, 53, 54, 57, 104 and 105 in association with MRI services unless the providing practitioner determines that the consultation is necessary for the treatment or management of the patient's condition. 

The restrictions above apply when these services are performed by the same practitioner, on the same patient, on the same day.

 

Related Items: 52 53 54 57 104 105


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