Medicare Benefits Schedule - Note ON.3.2

The Schedule fees for two or more operations performed on a patient on the one occasion are calculated by the following rule:‑

100% for the item with the greatest Schedule fee, plus 50% for the item with the next greatest Schedule fee, plus 25% for each other item. 

NOTE:

1.                Fees so calculated which result in a sum which is not a multiple of 5 cents are to be taken to the next higher multiple of 5 cents

2.                Where two or more operations performed on the one occasion have fees which are equal, one of these amounts shall be treated as being greater than the other or others of those amounts.

3.                The Schedule fee for benefits purposes is the aggregate of the fees calculated in accordance with the above formula. 

The above rule does not apply to an operation which is one of two or more operations performed under the one anaesthetic on the same patient by different dental practitioners unless either practitioner assists the other.  In this case, the fees and benefits specified in the Schedule apply.  For these purposes the term "operation" includes all services in Groups O3 to O9. 

If the operation comprises a combination of procedures which are commonly performed together and for which a specific combined item is provided in the Schedule, it is regarded as the one item and service in applying the multiple operation rule.

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