Medicare Benefits Schedule - Note AN.0.11

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Category 1 - PROFESSIONAL ATTENDANCES

AN.0.11

Professional Attendances at an Institution (Items 4, 24, 37, 47, 58, 59, 60, 65, 5003, 5023, 5043, 5063, 5220, 5223, 5227 and 5228)

For the purposes of these items an "institution" means a place (not being a hospital or residential aged care facility) at which residential accommodation or day care or both such accommodation and such care is made available to:‑

(a)              disadvantaged children;

(b)              juvenile offenders;

(c)              aged persons;

(d)              chronically ill psychiatric patients;

(e)              homeless persons;

(f)               unemployed persons;

(g)              persons suffering from alcoholism;

(h)              persons addicted to drugs; or

(i)               physically or intellectually disabled persons.

Related Items: 4 24 37 47 5003 5023 5043 5063 5220 5223 5227 5228


Related Items


Level D

Professional attendance by a general practitioner (not being a service to which any other item in this table applies) lasting at least 40 minutes, including any of the following that are clinically relevant:

a)     taking an extensive patient history;

b)     performing a clinical examination;

c)     arranging any necessary investigation;

d)     implementing a management plan;

e)     providing appropriate preventive health care;

in relation to 1 or more health-related issues, with appropriate documentation.

Category 1 - PROFESSIONAL ATTENDANCES

5063

5063 - Additional Information

Item Start Date:
01-Jan-2005
Description Start Date:
01-Jan-2013
Schedule Fee Start Date:
01-Jul-2014

Professional attendance by a general practitioner (other than attendance at consulting rooms, a hospital or a residential aged care facility or a service to which another item in the table applies), lasting at least 40 minutes and including any of the following that are clinically relevant:

(a) taking an extensive patient history;

(b) performing a clinical examination;

(c) arranging any necessary investigation;

(d) implementing a management plan;

(e) providing appropriate preventive health care;

for one or more health-related issues, with appropriate documentation-an attendance on one or more patients on one occasion-each patient

The fee for item 5060, plus $25.95 divided by the number of patients seen, up to a maximum of six patients. For seven or more patients - the fee for item 5060 plus $2.00 per patient.
Ready Reckoner

(See para AN.0.9, AN.0.11, AN.0.19 of explanatory notes to this Category)


Level D

Professional attendance by a general practitioner (not being a service to which any other item in this table applies) lasting at least 40 minutes, including any of the following that are clinically relevant:

a)     taking an extensive patient history;

b)     performing a clinical examination;

c)     arranging any necessary investigation;

d)     implementing a management plan;

e)     providing appropriate preventive health care;

in relation to 1 or more health-related issues, with appropriate documentation.

Category 1 - PROFESSIONAL ATTENDANCES

47

47 - Additional Information

Item Start Date:
01-Nov-1997
Description Start Date:
01-Jan-2013
Schedule Fee Start Date:
01-Jul-2014

Professional attendance by a general practitioner (other than attendance at consulting rooms or a residential aged care facility or a service to which another item in the table applies), lasting at least 40 minutes and including any of the following that are clinically relevant:

(a) taking an extensive patient history;

(b) performing a clinical examination;

(c) arranging any necessary investigation;

(d) implementing a management plan;

(e) providing appropriate preventive health care;

for one or more health-related issues, with appropriate documentation-an attendance on one or more patients at one place on one occasion-each patient

The fee for item 44, plus $25.95 divided by the number of patients seen, up to a maximum of six patients. For seven or more patients - the fee for item 44 plus $2.00 per patient.
Ready Reckoner

(See para AN.0.9, AN.0.11, AN.0.13 of explanatory notes to this Category)


Level A

Professional attendance for an obvious problem characterised by the straightforward nature of the task that requires a short patient history and, if required, limited examination and management.

Category 1 - PROFESSIONAL ATTENDANCES

4

4 - Additional Information

Item Start Date:
01-Nov-1997
Description Start Date:
01-Jan-2013
Schedule Fee Start Date:
01-Jul-2014

Professional attendance by a general practitioner (other than attendance at consulting rooms or a residential aged care facility or a service to which another item in the table applies) that requires a short patient history and, if necessary, limited examination and management-an attendance on one or more patients at one place on one occasion-each patient

The fee for item 3, plus $25.95 divided by the number of patients seen, up to a maximum of six patients. For seven or more patients - the fee for item 3 plus $2.00 per patient.
Ready Reckoner

(See para AN.0.9, AN.0.11, AN.0.13 of explanatory notes to this Category)


Consultation At A Place Other Than Consulting Rooms, Hospital Or A Residential Aged Care Facility

Professional attendance by a medical practitioner (other than a general practitioner) on 1 or more patients on 1 occasion at a place other than consulting rooms, a hospital or residential aged care facility.

Category 1 - PROFESSIONAL ATTENDANCES

5220

5220 - Additional Information

Item Start Date:
01-Jan-2005
Description Start Date:
01-Jan-2013
Schedule Fee Start Date:
01-Jan-2005

Professional attendance by a medical practitioner who is not a general practitioner (other than attendance at consulting rooms, a hospital or a residential aged care facility or a service to which another item in the table applies), lasting not more than 5 minutes-an attendance on one or more patients on one occasion-each patient

An amount equal to $18.50, plus $15.50 divided by the number of patients seen, up to a maximum of six patients. For seven or more patients - an amount equal to $18.50 plus $.70 per patient
Ready Reckoner

(See para AN.0.11 of explanatory notes to this Category)

Category 1 - PROFESSIONAL ATTENDANCES

5223

5223 - Additional Information

Item Start Date:
01-Jan-2005
Description Start Date:
01-Jan-2013
Schedule Fee Start Date:
01-Jan-2005

Professional attendance by a medical practitioner who is not a general practitioner (other than attendance at consulting rooms, a hospital or a residential aged care facility or a service to which another item in the table applies), lasting more than 5 minutes, but not more than 25 minutes-an attendance on one or more patients on one occasion-each patient

An amount equal to $26.00, plus $17.50 divided by the number of patients seen, up to a maximum of six patients. For seven or more patients - an amount equal to $26.00 plus $.70 per patient
Ready Reckoner

(See para AN.0.11 of explanatory notes to this Category)

Category 1 - PROFESSIONAL ATTENDANCES

5227

5227 - Additional Information

Item Start Date:
01-Jan-2005
Description Start Date:
01-Jan-2013
Schedule Fee Start Date:
01-Jan-2005

Professional attendance by a medical practitioner who is not a general practitioner (other than attendance at consulting rooms, a hospital or a residential aged care facility or a service to which another item in the table applies), lasting more than 25 minutes, but not more than 45 minutes-an attendance on one or more patients on one occasion-each patient

An amount equal to $45.50, plus $15.50 divided by the number of patients seen, up to a maximum of six patients. For seven or more patients - an amount equal to $45.50 plus $.70 per patient
Ready Reckoner

(See para AN.0.11 of explanatory notes to this Category)

Category 1 - PROFESSIONAL ATTENDANCES

5228

5228 - Additional Information

Item Start Date:
01-Jan-2005
Description Start Date:
01-Jan-2013
Schedule Fee Start Date:
01-Jan-2005

Professional attendance by a medical practitioner who is not a general practitioner (other than attendance at consulting rooms, a hospital or a residential aged care facility or a service to which another item in the table applies), lasting more than 45 minutes-an attendance on one or more patients on one occasion-each patient

An amount equal to $67.50, plus $15.50 divided by the number of patients seen, up to a maximum of six patients. For seven or more patients - an amount equal to $67.50 plus $.70 per patient
Ready Reckoner

(See para AN.0.11 of explanatory notes to this Category)


Level A

Professional attendance by a general practitioner for an obvious problem characterised by the straightforward nature of the task that requires a short patient history and, if required, limited examination and management.

Category 1 - PROFESSIONAL ATTENDANCES

5003

5003 - Additional Information

Item Start Date:
01-Jan-2005
Description Start Date:
01-Jan-2013
Schedule Fee Start Date:
01-Jul-2014

Professional attendance by a general practitioner (other than attendance at consulting rooms, a hospital or a residential aged care facility or a service to which another item in the table applies) that requires a short patient history and, if necessary, limited examination and management-an attendance on one or more patients on one occasion-each patient

The fee for item 5000, plus $25.95 divided by the number of patients seen, up to a maximum of six patients. For seven or more patients - the fee for item 5000 plus $2.00 per patient.
Ready Reckoner

(See para AN.0.9, AN.0.11, AN.0.19 of explanatory notes to this Category)


Level C

Professional attendance by a general practitioner (not being a service to which any other item in this table applies) lasting at least 20 minutes, including any of the following that are clinically relevant:

a)     taking a detailed patient history;

b)     performing a clinical examination;

c)     arranging any necessary investigation;

d)     implementing a management plan;

e)     providing appropriate preventive health care;

in relation to 1 or more health-related issues, with appropriate documentation.

Category 1 - PROFESSIONAL ATTENDANCES

37

37 - Additional Information

Item Start Date:
01-Nov-1997
Description Start Date:
01-Jan-2013
Schedule Fee Start Date:
01-Jul-2014

Professional attendance by a general practitioner (other than attendance at consulting rooms or a residential aged care facility or a service to which another item in the table applies), lasting at least 20 minutes and including any of the following that are clinically relevant:

(a) taking a detailed patient history;

(b) performing a clinical examination;

(c) arranging any necessary investigation;

(d) implementing a management plan;

(e) providing appropriate preventive health care;

for one or more health-related issues, with appropriate documentation-an attendance on one or more patients at one place on one occasion-each patient

The fee for item 36, plus $25.95 divided by the number of patients seen, up to a maximum of six patients. For seven or more patients - the fee for item 36 plus $2.00 per patient.
Ready Reckoner

(See para AN.0.9, AN.0.11, AN.0.13 of explanatory notes to this Category)


Level B

Professional attendance by a general practitioner (not being a service to which any other item in this table applies) lasting less than 20 minutes, including any of the following that are clinically relevant:

a)     taking a patient history;

b)     performing a clinical examination;

c)     arranging any necessary investigation;

d)     implementing a management plan;

e)     providing appropriate preventive health care;

in relation to 1 or more health-related issues, with appropriate documentation.

Category 1 - PROFESSIONAL ATTENDANCES

5023

5023 - Additional Information

Item Start Date:
01-Jan-2005
Description Start Date:
01-Jan-2013
Schedule Fee Start Date:
01-Jul-2014

Professional attendance by a general practitioner (other than attendance at consulting rooms, a hospital or a residential aged care facility or a service to which another item in the table applies), lasting less than 20 minutes and including any of the following that are clinically relevant:

(a) taking a patient history;

(b) performing a clinical examination;

(c) arranging any necessary investigation;

(d) implementing a management plan;

(e) providing appropriate preventive health care;

for one or more health-related issues, with appropriate documentation-an attendance on one or more patients on one occasion-each patient

The fee for item 5020, plus $25.95 divided by the number of patients seen, up to a maximum of six patients. For seven or more patients - the fee for item 5020 plus $2.00 per patient.
Ready Reckoner

(See para AN.0.9, AN.0.11, AN.0.19 of explanatory notes to this Category)


Level C

Professional attendance by a general practitioner (not being a service to which any other item in this table applies) lasting at least 20 minutes, including any of the following that are clinically relevant:

a)     taking a detailed patient history;

b)     performing a clinical examination;

c)     arranging any necessary investigation;

d)     implementing a management plan;

e)     providing appropriate preventive health care;

in relation to 1 or more health-related issues, with appropriate documentation.

Category 1 - PROFESSIONAL ATTENDANCES

5043

5043 - Additional Information

Item Start Date:
01-Jan-2005
Description Start Date:
01-Jan-2013
Schedule Fee Start Date:
01-Jul-2014

Professional attendance by a general practitioner (other than attendance at consulting rooms, a hospital or a residential aged care facility or a service to which another item in the table applies), lasting at least 20 minutes and including any of the following that are clinically relevant:

(a) taking a detailed patient history;

(b) performing a clinical examination;

(c) arranging any necessary investigation;

(d) implementing a management plan;

(e) providing appropriate preventive health care;

for one or more health-related issues, with appropriate documentation-an attendance on one or more patients on one occasion-each patient

The fee for item 5040, plus $25.95 divided by the number of patients seen, up to a maximum of six patients. For seven or more patients - the fee for item 5040 plus $2.00 per patient.
Ready Reckoner

(See para AN.0.9, AN.0.11, AN.0.19 of explanatory notes to this Category)


Level B

Professional attendance by a general practitioner (not being a service to which any other item in this table applies) lasting less than 20 minutes, including any of the following that are clinically relevant:

a)     taking a patient history;

b)     performing a clinical examination;

c)     arranging any necessary investigation;

d)     implementing a management plan;

e)     providing appropriate preventive health care;

in relation to 1 or more health-related issues, with appropriate documentation.

Category 1 - PROFESSIONAL ATTENDANCES

24

24 - Additional Information

Item Start Date:
01-Nov-1997
Description Start Date:
01-Jan-2013
Schedule Fee Start Date:
01-Jul-2014


Professional attendance by a general practitioner (other than attendance at consulting rooms or a residential aged care facility or a service to which another item in the table applies), lasting less than 20 minutes and including any of the following that are clinically relevant:

(a) taking a patient history;

(b) performing a clinical examination;

(c) arranging any necessary investigation;

(d) implementing a management plan;

(e) providing appropriate preventive health care;

for one or more health-related issues, with appropriate documentation-an attendance on one or more patients at one place on one occasion-each patient

The fee for item 23, plus $25.95 divided by the number of patients seen, up to a maximum of six patients. For seven or more patients - the fee for item 23 plus $2.00 per patient.
Ready Reckoner

(See para AN.0.9, AN.0.11, AN.0.13 of explanatory notes to this Category)


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