Medicare Benefits Schedule - Item 92474

Phone attendance of at least 45 minutes in duration , by a consultant physician in the practice of the consultant physician’s specialty of psychiatry, following referral of the patient to the consultant physician by a referring practitioner, for assessment, diagnosis and preparation of a treatment and management plan for a patient under 13 years with autism or another pervasive developmental disorder, if the consultant physician does all of the following:

(a) undertakes a comprehensive assessment and makes a diagnosis (if appropriate, using information provided by an eligible allied health provider);

(b) develops a treatment and management plan which must include the following:

     (i) an assessment and diagnosis of the patient’s condition;

     (ii) a risk assessment;

     (iii) treatment options and decisions;

     (iv) if necessary—medication recommendations;

(c) provides a copy of the treatment and management plan to the referring practitioner;

(d) provides a copy of the treatment and management plan to one or more allied health providers, if appropriate, for the treatment of the patient;

(other than attendance on a patient for whom payment has previously been made under this item or item 135, 137, 139, 289, 92140, 92143, 92141, 92144, 92142, 92145 or 92434).

Fee: $278.75 Benefit: 85% = $236.95

Extended Medicare Safety Net Cap: $500.00

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