Medicare Benefits Schedule - Item 90001

A flag fall service to which item 2733, 2735, 90020, 90035, 90043, 90051, 93287, 93288, 93400, 93401, 93402, 93403, 93421, 93469 or 93470 applies. For the initial attendance at one residential aged care facility on one occasion, applicable to a maximum of one patient attended on.

Fee: $57.25 Benefit: 100% = $57.25

(See para AN.35.1 of explanatory notes to this Category)

Extended Medicare Safety Net Cap: $171.75

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Medicare item 90001 provides a call-out fee for the initial attendance by a general practitioner at one RACF, on one occasion, applicable only to the first patient seen on the RACF visit. 

The Medicare benefit for the single call-out fee and the associated general consultation (either Level A to D) applies only for patients within a RACF who have a general consultation with a doctor in person.

If doctors do not bill the single call-out fee, the benefit will not be paid.

If a doctor has to return to the RACF facility twice or more on the same day and the attendances are not a continuation of an earlier episode of treatment, another call-out fee would apply per subsequent RACF visit.

When claiming the new attendance items there is no longer a requirement to transmit the number of patients seen. A doctor would claim each attendance item like any other consultation service.

MBS items 90001 is not to be used with existing derived fee services such as for afterhours, urgent afterhours, or telehealth services.  The bulk billing incentive only applies to the attendance item, not to the single call-out fee.

Related Items: 90001 90020 90035 90043 90051