Medicare Benefits Schedule - Note IR.4.2

1. For any particular patient, a service associated with an attendance item listed in Part 2 of the general medical services table does not apply if a service to which item 61321 or 61325 or 61644 applies is provided in the same day; unless:

1. the attendance service is provided after the service where clinical management decisions are made; or
2. the decision to perform the service on the same day was made during the attendance service subject to clinical assessment.

2. Limitations of items 61321 and 61325

1. Item 61321 is applicable not more than once in any 24 month period if the patient is 17 years old or older.
2. Item 61325 is applicable not more than twice in any 24 month period if the patient is 17 years old or older.

Item 61644 has been introduced as a direct substitute for MBS item 61325. See IN.4.4 of explanatory notes to this Category for further information.

Related Items: 61321 61325 61644

• Previous - Note IR.4.1

Bulk bill incentive

Single rest myocardial perfusion study for the assessment of the extent and severity of viable and non‑viable myocardium, with single photon emission tomography, with or without planar imaging, if:

(a) the patient has left ventricular systolic dysfunction and probable or confirmed coronary artery disease; and

(b) the service uses a single rest technetium‑99m (Tc‑99m) protocol; and

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

(d) the service is not associated with a service to which item 11704, 11705, 11707, 11714, 11729, 11730, 61325, 61329, 61345, 61398 or 61406 applies; and

(e) if the patient is 17 years or older—a service to which this item, or item 61325, 61329, 61345, 61398 or 61406 applies has not been provided to the patient in the previous 24 months (R)

Fee: $329.00 Benefit: 75% = $246.75 85% = $279.65

(See para IN.0.19, IN.4.1, IR.4.1, IR.4.2 of explanatory notes to this Category)

Bulk bill incentive

Single rest myocardial perfusion study for the assessment of the extent and severity of viable and non‑viable myocardium, with single photon emission tomography, with or without planar imaging, if:

(a) the patient has left ventricular systolic dysfunction and probable or confirmed coronary artery disease; and

(b) the service uses:

(i) an initial rest study followed by a redistribution study on the same day; and

(ii) a thallous chloride‑201 (Tl‑201) protocol; and

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

(d) the service is not associated with a service to which item 11704, 11705, 11707, 11714, 11729, 11730, 61321, 61329, 61345, 61398 or 61406 applies; and

(e) if the patient is 17 years or older:

(i) a service to which item 61321, 61329, 61345, 61398 or 61406 applies has not been provided to the patient in the previous 24 months; and

(ii) the service is applicable only twice each 24 months (R)

Fee: $329.00 Benefit: 75% = $246.75 85% = $279.65

(See para IN.0.19, IN.4.2, IR.4.2 of explanatory notes to this Category)

Bulk bill incentive

Single rest myocardial perfusion study for the assessment of the extent and severity of non‑viable myocardium, with PET, if:

(a) the service is performed because the service to which item 61325 applies cannot be performed due to unavailability of thallous chloride 201 (Tl-201); and

(b) the patient has left ventricular systolic dysfunction and probable or confirmed coronary artery disease; and

(c) the service is performed in conjunction with a rest myocardial perfusion study using technetium-99m; and

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

(e) the service is not associated with a service to which item 11704, 11705, 11707, 11714, 11729 or 11730 applies; and

(f) this service and item 61325 are applicable only twice each 24 months (R)

Fee: $329.00 Benefit: 75% = $246.75 85% = $279.65

(See para IR.4.2 of explanatory notes to this Category)