Medicare Benefits Schedule - Item 90002

Search Results for Item 90002

View Associated Notes

Category 1 - PROFESSIONAL ATTENDANCES

90002

90002 - Additional Information

Item Start Date:
01-Mar-2019
Description Updated:
01-Nov-2023
Schedule Fee Updated:
01-Nov-2023

Group
A35 - Services For Patients in Residential Aged Care Facilities
Subgroup
1 - Flag Fall Amount For Residential Aged Care Facilities

For the first patient attended during one attendance by a medical practitioner at one residential aged care facility on one occasion, the fee for the medical service described in whichever of items 90092, 90093, 90095, 90096, 90098, 90183, 90188, 90202, 90212 or 90215 applies is the amount listed in the item plus $43.95.

Fee: $43.95 Benefit: 100% = $43.95

(See para AN.35.2 of explanatory notes to this Category)

Extended Medicare Safety Net Cap: $131.85


Associated Notes

Category 1 - PROFESSIONAL ATTENDANCES

AN.35.2

Flag fall amount for residential aged care facility attendance by a medical practitioner or prescribed medical practitioner

Last reviewed: 1 November 2023

Medicare item 90002 provides a flag fall fee for the initial attendance by a medical practitioner or prescribed medical practitioner at one RACF, on one occasion, applicable only to the first patient seen on the RACF visit. 

The Medicare benefit for the single flag fall fee and the associated general consultation (Levels A to E) applies only for patients within a RACF who have a general consultation with a doctor in person.

If doctors do not bill the single flag fall 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 flag fall 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 90002 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 flag fall fee.

Related Items: 90002 90092 90093 90095 90096 90098 90183 90188 90202 90212 90215


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