Medicare Benefits Schedule - Note IN.1.8

Providers

It is expected that on average, a limited percentage of a provider’s services would be claimed under this item. However it is acknowledged that some providers in specific areas of clinical practice may have higher rates that are clinically appropriate, and substantiation of this appropriateness (such as compliance with guidelines or best practice) may be requested by the Department of Health's compliance area and will be considered during any clinical audit activities.

Providers of this item number should meet the Level 1 requirements described in the Cardiac Society of Australia & New Zealand Guidelines for Training and Performance in Adult Echocardiography or equivalent at 

https://www.csanz.edu.au/wp-content/uploads/2015/04/Adult-Echo_2015-February.pdf

Results

Discussions of the results, findings or interpretation of a study are reasonably expected to be part of a formal report. Discussion of these findings with a patient does not constitute a consult. Similarly, discussion(s) during the course of a study or to determine the safety or appropriateness of the study is part of the service and should not be claimed as a consult

Related Items: 55134

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Bulk bill incentive

Note: the service only applies if the patient meets one or more of the following and the requirements of Note: IR.1.2

Repeat real time transthoracic echocardiographic examination of the heart with real time colour flow mapping from at least 3 acoustic windows, with recordings on digital media, for the investigation of rare cardiac pathologies, if the service:

(a) is requested by a specialist or consultant physician; and

(b) is not associated with a service to which:

(i) another item in this Subgroup applies (except items 55137, 55141, 55143, 55145 and 55146); or

(ii) an item in Subgroup 2 applies (except items 55118 and 55130); or

(iii) an item in Subgroup 3 applies (R)

Fee: $249.95 Benefit: 75% = $187.50 85% = $212.50

(See para IN.0.19, IN.1.8, IN.7.1, IR.1.2, IR.1.3 of explanatory notes to this Category)