Medicare Benefits Schedule - Note AN.35.2

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

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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 not more than 5 minutes in duration—an attendance on one or more patients at one residential aged care facility on one occasion—each patient, by a medical practitioner who is not a general practitioner.

Fee: $8.50 Benefit: 100% = $8.50

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

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 who is not a general practitioner.

Fee: $16.00 Benefit: 100% = $16.00

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

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 25 minutes in duration but not more than 45 minutes—an attendance on one or more patients at one residential aged care facility on one occasion—each patient, by a medical practitioner who is not a general practitioner.

Fee: $35.50 Benefit: 100% = $35.50

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

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 medical practitioner who is not a general practitioner.

Fee: $57.50 Benefit: 100% = $57.50

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

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 not more than 5 minutes in duration—an attendance on one or more patients at one residential aged care facility on one occasion—each patient, by medical practitioner in an eligible area.

Fee: $14.55 Benefit: 100% = $14.55

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

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: $31.80 Benefit: 100% = $31.80

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

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 25 minutes in duration but not more than 45 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: $61.55 Benefit: 100% = $61.55

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

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 medical practitioner in an eligible area.

Fee: $90.65 Benefit: 100% = $90.65

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

A flag fall service to which item 941, 942, 90092, 90093, 90095, 90096, 90183, 90188, 90202, 90212, 93291, 93292, 93431, 93432, 93433, 93434, 93451, 93475 and 93479 applies. For the initial attendance at one residential aged care facility on one occasion, applicable to a maximum of one patient attended on.

Fee: $42.25 Benefit: 100% = $42.25

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