Category 8 - MISCELLANEOUS SERVICES
MN.13.8
Safety Nets
Where practitioners charge more than the Medicare benefit, the resultant out-of-pocket costs are the responsibility of the patient.
Assistance is provided to families and singles for out-of-pocket costs for out-of-hospital services through the "original" and "extended" Medicare safety nets:
- the original safety net provides that once the threshold is met, the Medicare benefit increases to 100 per cent of the Schedule fee; and
- under the Extended Medicare Safety Net (EMSN), once certain thresholds are met, Medicare reimburses 80 per cent of the out-of-pocket costs. However, where the item has an EMSN benefit cap, there is a maximum limit on the EMSN benefit that will be paid for that item.
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