Medicare Benefits Schedule - Note AN.0.70

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Category 1 - PROFESSIONAL ATTENDANCES

AN.0.70

Limitation of items—certain attendances by specialists and consultant physicians

Medicare benefits are not payable for items 105, 116, 119, 386, 2806, 2814, 3010, 3014, 6019, 6052 and 16404 when claimed in association with an item in group T8 with a schedule fee of $300 or more.

The restriction applies when the procedure is performed by the same practitioner, on the same patient, on the same day.

Related Items: 105 116 119 386 2806 2814 3010 3014 6019 6052 16404


Related Items

Category 1 - PROFESSIONAL ATTENDANCES

2806

2806 - Additional Information

Item Start Date:
01-May-2006
Description Start Date:
01-May-2006
Schedule Fee Start Date:
01-Jul-2018

Professional attendance at consulting rooms or hospital by a specialist, or consultant physician, in the practice of his or her specialty of pain medicine following referral of the patient to him or her by a referring practitioner-each attendance (other than a service to which item 2814 applies) after the first in a single course of treatment

Fee: $76.65 Benefit: 75% = $57.50 85% = $65.20

(See para AN.0.58, AN.0.70 of explanatory notes to this Category)

Category 1 - PROFESSIONAL ATTENDANCES

2814

2814 - Additional Information

Item Start Date:
01-May-2006
Description Start Date:
01-May-2006
Schedule Fee Start Date:
01-Jul-2018

Professional attendance at consulting rooms or hospital by a specialist, or consultant physician, in the practice of his or her specialty of pain medicine following referral of the patient to him or her by a referring practitioner-each minor attendance after the first attendance in a single course of treatment

Fee: $43.65 Benefit: 75% = $32.75 85% = $37.15

(See para AN.0.58, AN.0.70 of explanatory notes to this Category)

Category 1 - PROFESSIONAL ATTENDANCES

6052

6052 - Additional Information

Item Start Date:
01-Nov-2016
Description Start Date:
01-Nov-2016
Schedule Fee Start Date:
01-Jul-2018

Professional attendance by a sexual health medicine specialist in the practice of his or her specialty following referral of the patient to him or her by a referring practitioner, if the attendance is a patient assessment:

(a) before or after a comprehensive assessment under item 6051 in a single course of treatment; or

(b) that follows an initial assessment under item 6057 in a single course of treatment; or

(c) that follows a review under item 6058 in a single course of treatment

Fee: $76.65 Benefit: 75% = $57.50 85% = $65.20

(See para AN.0.70 of explanatory notes to this Category)

Category 1 - PROFESSIONAL ATTENDANCES

105

105 - Additional Information

Item Start Date:
01-Nov-1990
Description Start Date:
01-Nov-2017
Schedule Fee Start Date:
01-Jul-2018

Professional attendance by a specialist in the practice of his or her specialty following referral of the patient to him or her-an attendance after the first in a single course of treatment, if that attendance is at consulting rooms or hospital, other than a service to which item 16404 applies

Fee: $43.65 Benefit: 75% = $32.75 85% = $37.15

(See para AN.0.70, TN.1.4 of explanatory notes to this Category)

Category 1 - PROFESSIONAL ATTENDANCES

116

116 - Additional Information

Item Start Date:
01-Mar-1987
Description Start Date:
22-Dec-1987
Schedule Fee Start Date:
01-Jul-2018

Professional attendance at consulting rooms or hospital, by a consultant physician in the practice of his or her specialty (other than psychiatry) following referral of the patient to him or her by a referring practitioner-each attendance (other than a service to which item 119 applies) after the first in a single course of treatment

Fee: $76.65 Benefit: 75% = $57.50 85% = $65.20

(See para AN.0.70 of explanatory notes to this Category)

Category 1 - PROFESSIONAL ATTENDANCES

119

119 - Additional Information

Item Start Date:
22-Dec-1987
Description Start Date:
22-Dec-1987
Schedule Fee Start Date:
01-Jul-2018

Professional attendance at consulting rooms or hospital, by a consultant physician in the practice of his or her specialty (other than psychiatry) following referral of the patient to him or her by a referring practitioner-each minor attendance after the first in a single course of treatment

Fee: $43.65 Benefit: 75% = $32.75 85% = $37.15

(See para AN.0.21, AN.0.70 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

16404

16404 - Additional Information

Item Start Date:
01-Jan-2010
Description Start Date:
01-Jan-2010
Schedule Fee Start Date:
01-Nov-2012

Professional attendance at consulting rooms or a hospital by a specialist in the practice of his or her specialty of obstetrics after referral of the patient to him or her - each attendance SUBSEQUENT to the first attendance in a single course of treatment.

Fee: $43.00 Benefit: 75% = $32.25 85% = $36.55

(See para AN.0.70, TN.4.2 of explanatory notes to this Category)

Category 1 - PROFESSIONAL ATTENDANCES

6019

6019 - Additional Information

Item Start Date:
01-Nov-2016
Description Start Date:
01-Nov-2016
Schedule Fee Start Date:
01-Jul-2018

Professional attendance by an addiction medicine specialist in the practice of his or her specialty following referral of the patient to him or her by a referring practitioner, if the attendance is a patient assessment:

(a) before or after a comprehensive assessment under item 6018 in a single course of treatment; or

(b) that follows an initial assessment under item 6023 in a single course of treatment; or

(c) that follows a review under item 6024 in a single course of treatment

Fee: $76.65 Benefit: 75% = $57.50 85% = $65.20

(See para AN.0.70 of explanatory notes to this Category)

Category 1 - PROFESSIONAL ATTENDANCES

386

386 - Additional Information

Item Start Date:
01-Jul-1998
Description Start Date:
01-Jul-1998
Schedule Fee Start Date:
01-Jul-2018

Professional attendance at consulting rooms or hospital by a consultant occupational physician in the practice of his or her specialty of occupational medicine following referral of the patient to him or her by a referring practitioner-each attendance after the first in a single course of treatment

Fee: $43.65 Benefit: 75% = $32.75 85% = $37.15

(See para AN.0.33, AN.0.70 of explanatory notes to this Category)

Category 1 - PROFESSIONAL ATTENDANCES

3010

3010 - Additional Information

Item Start Date:
01-May-2006
Description Start Date:
01-May-2006
Schedule Fee Start Date:
01-Jul-2018

Professional attendance at consulting rooms or hospital by a specialist, or consultant physician, in the practice of his or her specialty of palliative medicine following referral of the patient to him or her by a referring practitioner-each attendance (other than a service to which item 3014 applies) after the first in a single course of treatment

Fee: $76.65 Benefit: 75% = $57.50 85% = $65.20

(See para AN.0.58, AN.0.70 of explanatory notes to this Category)

Category 1 - PROFESSIONAL ATTENDANCES

3014

3014 - Additional Information

Item Start Date:
01-May-2006
Description Start Date:
01-May-2006
Schedule Fee Start Date:
01-Jul-2018

Professional attendance at consulting rooms or hospital by a specialist, or consultant physician, in the practice of his or her specialty of palliative medicine following referral of the patient to him or her by a referring practitioner-each minor attendance after the first attendance in a single course of treatment

Fee: $43.65 Benefit: 75% = $32.75 85% = $37.15

(See para AN.0.58, AN.0.70 of explanatory notes to this Category)


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