Medicare Benefits Schedule - Note TN.7.4

Items 18226 and 18227 apply where intrathecal or epidural analgesia is required for obstetric patients in the after hours period. For these items, the after hours period is defined as the period from 8pm to 8am on any weekday, or any time on a Saturday, Sunday or a public holiday. 

Medicare benefits are only payable under item 18227 where more than 50% of the service is provided in the after hours period, otherwise benefits would be payable under item 18219.

Related Items: 18226 18227

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Intrathecal, combined spinal-epidural or epidural infusion  of a therapeutic substance, initial injection or commencement of, including up to 1 hour of continuous attendance by the medical practitioner, for a patient in labour, where the service is provided in the after hours period, being the period from 8pm to 8am on any weekday, or any time on a Saturday, a Sunday or a public holiday.

Applicable once per presentation, per medical practitioner, per complete new procedure

Fee: $313.50 Benefit: 75% = $235.15 85% = $266.50

(See para TN.7.4, TN.10.7 of explanatory notes to this Category)

Intrathecal, combined spinal-epidural  or epidural infusion of a therapeutic substance, initial injection or commencement of, where continuous attendance by a medical practitioner extends beyond the first hour, for a patient in labour, where the service is provided in the after hours period, being the period from 8pm to 8am on any weekday, or any time on a Saturday, a Sunday or a public holiday.

The fee for item 18226 plus $31.50 for each additional 15 minutes or part there of beyond the first hour of attendance by the medical practitioner.

(See para TN.7.4, TN.10.7 of explanatory notes to this Category)