Medicare Benefits Schedule - Item 96

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 45 minutes in duration-an attendance on one or more patients at one residential aged care facility on one occasion-each patient, by:

(a) a medical practitioner (who is not a general practitioner); or

(b) a general practitioner to whom clause 2.3.1 applies

An amount equal to $57.50, 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 $57.50 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

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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.

Related Items: 20 35 43 51 92 93 95 96 5010 5028 5049 5067 5260 5263 5265 5267