Medicare Benefits Schedule - Item 5260

Search Results for Item 5260

View Associated Notes

Consultation At A Residential Aged Care Facility

Professional attendance on 1 or more patients on 1 residential aged care facility ( but excluding a professional attendance at a self-contained unit) or attendance at consulting rooms situated within such a complex where the patient is accommodated in the residential aged care facility (excluding accommodation in a self-contained unit) on 1 occasion – each patient

Category 1 - PROFESSIONAL ATTENDANCES

5260

5260 - Additional Information

Item Start Date:
01-Jan-2005
Description Start Date:
01-Jan-2013
Schedule Fee Start Date:
01-Nov-2007

Group
A23 - Other Non-Referred After-Hours Attendances To Which No Other Item Applies
Subheading
3 - Consultation At A Residential Aged Care Facility

Professional attendance (other than a service to which another item applies) at a residential aged care facility (other than a professional attendance at a self-contained unit) or professional attendance at consulting rooms situated within such a complex if the patient is accommodated in the residential aged care facility (other than accommodation in a self-contained unit) of not more than 5 minutes in duration by a medical practitioner (other than a general practitioner)-an attendance on one or more patients at one residential aged care facility on one occasion-each patient

An amount equal to $18.50, plus $27.95 divided by the number of patients seen, up to a maximum of six patients. For seven or more patients - an amount equal to $18.50 plus $1.25 per patient
Ready Reckoner

(See para AN.0.15 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.0.15

Residential Aged Care Facility Attendances (Items 5010, 5028, 5049, 5067, 5260, 5263, 5265, 5267)

These items refer to attendances on patients in residential aged care facilities. 

Where a medical practitioner attends a patient in a self-contained unit, within a residential aged care facility complex, the attendance attracts benefits under the appropriate home visit item. 

Where a patient living in a self‑contained unit attends a medical practitioner at consulting rooms situated within the precincts of the residential aged care facility, or at free standing consulting rooms within the residential aged care facility complex, the appropriate surgery consultation item applies. 

If a patient who is accommodated in the residential aged care facility visits a medical practitioner at consulting rooms situated within the residential aged care facility complex, whether free standing or situated within the residential aged care facility precincts, benefits would be attracted under the appropriate residential aged care facility attendance item.

To facilitate assessment of the correct Medicare rebate in respect of a number of patients attended on the one occasion at one of the above locations, it is important that the total number of patients seen be recorded on each individual account, receipt or assignment form. For example, where two patients were visited (for a brief consultation) in the one facility on the one occasion, each account, receipt or assignment form would show "Item 5010 - 1 of 2 patients" for a general practitioner. 

The number of patients seen should not include attendances which do not attract a Medicare rebate (e.g. public in-patients, attendances for normal after-care), or where a Medicare rebate is payable under an item other than these derived fee items (e.g. health assessments, care planning, emergency after-hours attendance - first patient).

Related Items: 5010 5028 5049 5067 5260 5263 5265 5267


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