Medicare Benefits Schedule - Item 90188

Search Results for Item 90188

View Associated Notes

Category 1 - PROFESSIONAL ATTENDANCES

90188

90188 - Additional Information

Item Start Date:
01-Mar-2019
Description Start Date:
01-Mar-2019
Schedule Fee Start Date:
01-Jul-2019

Group
A35 - Services For Patients in Residential Aged Care Facilities
Subgroup
4 - Non-Specialist Practitioner Non-Referred Attendance At A Residential Aged Care Facility

Professional attendance (other than a service to which any other 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 where the patient is accommodated in the residential aged care facility (that is not accommodation in a self‑contained unit) of more than 5 minutes in duration but not more than 25 minutes—an attendance on one or more patients at one residential aged care facility on one occasion—each patient, by a medical practitioner in an eligible area.

Fee: $30.55 Benefit: 100% = $30.55

(See para AN.7.1, AN.35.2 of explanatory notes to this Category)


Associated Notes

Category 1 - PROFESSIONAL ATTENDANCES

AN.7.1

Attendances by Medical Practitioners

Items 179-181, 185-187, 189-197, 203-206, 215-287, 371, 372, 733-789, 792, 812-892, 90092-93, 90095-96, 90183, 90188, 90202, and 90212 relate to attendances rendered by a medical practitioner who is not a general practitioner, specialist or consultant physician, and who:


(a) is registered under section 3GA of the Act, to the extent that the person is practising during the period in respect of which, and in the location in respect of which, he or she is registered, and insofar as the circumstances specified for paragraph 19AA(3)(b) of the Act apply; or


(b) is covered by an exemption under subsection 19AB(3) of the Act; or


(c) first became a medical practitioner before 1 November 1996. 

Related Items: 179 181 185 187 189 191 203 206 214 215 218 219 220 221 222 223 224 225 226 227 228 229 230 231 232 233 235 236 237 238 239 240 243 244 245 249 251 252 253 254 255 256 257 259 260 261 262 263 264 265 266 268 269 270 271 272 276 277 279 281 282 283 285 286 287 371 372 733 737 741 745 761 763 766 769 772 776 788 789 792 812 827 829 867 868 869 873 876 881 885 891 892 90092 90093 90095 90096 90183 90188 90202 90212

Category 1 - PROFESSIONAL ATTENDANCES

AN.35.2

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

Medicare item 90002 provides a call-out fee for the initial attendance by a 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 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 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 call-out fee.

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


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