Medicare Benefits Schedule - Note AN.0.15

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Category 1 - PROFESSIONAL ATTENDANCES

AN.0.15

Residential Aged Care Facility Attendances (Items 20, 35, 43, 51, 92, 93, 95, 96, 5010, 5028, 5049, 5067, 5260, 5263, 5265, 5267)

These items refer to attendances on patients in residential aged care facilities.

Where a medical practitioner attends a patient in a self-contained unit, within a residential aged care facility complex, the attendance attracts benefits under the appropriate home visit item.

Where a patient living in a self‑contained unit attends a medical practitioner at consulting rooms situated within the precincts of the residential aged care facility, or at free standing consulting rooms within the residential aged care facility complex, the appropriate surgery consultation item applies.

If a patient who is accommodated in the residential aged care facility visits a medical practitioner at consulting rooms situated within the residential aged care facility complex, whether free standing or situated within the residential aged care facility precincts, benefits would be attracted under the appropriate residential aged care facility attendance item.

Related Items: 20 35 43 51 92 93 95 96 5010 5028 5049 5067 5260 5263 5265 5267


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

5067

5067 - 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 at a residential aged care facility to residents of the facility (other than 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 residential aged care facility on one occasion-each patient

The fee for item 5060, plus $46.70 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 $3.30 per patient.
Ready Reckoner

(See para AN.0.9, AN.0.15, 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

51

51 - Additional Information

Item Start Date:
01-Nov-1990
Description Start Date:
01-Jan-2013
Schedule Fee Start Date:
01-Jul-2014

Professional attendance by a general practitioner at a residential aged care facility to residents of the facility (other than 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 residential aged care facility on one occasion-each patient

The fee for item 44, plus $46.70 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 $3.30 per patient.
Ready Reckoner

(See para AN.0.9, AN.0.15 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

20

20 - Additional Information

Item Start Date:
01-Nov-1990
Description Start Date:
01-Jan-2013
Schedule Fee Start Date:
01-Jul-2014

Professional attendance (other than a service to which another item applies) at a residential aged care facility (other than a professional attendance at a self-contained unit) or professional attendance at consulting rooms situated within such a complex if the patient is accommodated in a residential aged care facility (other than accommodation in a self-contained unit) 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-an attendance on one or more patients at one residential aged care facility on one occasion-each patient

The fee for item 3, plus $46.70 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 $3.30 per patient.
Ready Reckoner

(See para AN.0.9, AN.0.15, AN.0.17 of explanatory notes to this Category)


Consultation At A Residential Aged Care Facility

Professional attendance on 1 or more patients in 1 residential aged care facility (but excluding a professional attendance at a self-contained unit) or attendance at consulting rooms situated within such a complex where the patient is accommodated in the residential aged care facility (excluding accommodation in a self-contained unit) on 1 occasion - each patient

Category 1 - PROFESSIONAL ATTENDANCES

92

92 - Additional Information

Item Start Date:
01-Nov-1990
Description Start Date:
01-Jan-2013
Schedule Fee Start Date:
01-Nov-2007

Professional attendance (other than a service to which any other item applies) at a residential aged care facility (other than a professional attendance at a self-contained unit) or professional attendance at consulting rooms situated within such a complex where the patient is accommodated in the residential aged care facility (that is not accommodation in a self-contained unit) of not more than 5 minutes in duration-an attendance on one or more patients at one residential aged care facility on one occasion-each patient, by:

(a) a medical practitioner (who is not a general practitioner); or

(b) a general practitioner to whom clause 2.3.1 applies

An amount equal to $8.50, plus $27.95 divided by the number of patients seen, up to a maximum of six patients. For seven or more patients - an amount equal to $8.50 plus $1.25 per patient
Ready Reckoner

(See para AN.0.15, AN.0.17 of explanatory notes to this Category)

Category 1 - PROFESSIONAL ATTENDANCES

93

93 - Additional Information

Item Start Date:
01-Nov-1990
Description Start Date:
01-Jan-2013
Schedule Fee Start Date:
01-Nov-2007

Professional attendance (other than a service to which any other item applies) at a residential aged care facility (other than a professional attendance at a self-contained unit) or professional attendance at consulting rooms situated within such a complex where the patient is accommodated in the residential aged care facility (that is not accommodation in a self-contained unit) of more than 5 minutes in duration but not more than 25 minutes-an attendance on one or more patients at one residential aged care facility on one occasion-each patient, by:

(a) a medical practitioner (who is not a general practitioner); or

(b) a general practitioner to whom clause 2.3.1 applies

An amount equal to $16.00, plus $31.55 divided by the number of patients seen, up to a maximum of six patients. For seven or more patients - an amount equal to $16.00 plus $1.25 per patient
Ready Reckoner

(See para AN.0.15 of explanatory notes to this Category)

Category 1 - PROFESSIONAL ATTENDANCES

95

95 - Additional Information

Item Start Date:
01-Nov-1990
Description Start Date:
01-Jan-2013
Schedule Fee Start Date:
01-Nov-2007

Professional attendance (other than a service to which any other item applies) at a residential aged care facility (other than a professional attendance at a self-contained unit) or professional attendance at consulting rooms situated within such a complex where the patient is accommodated in the residential aged care facility (that is not accommodation in a self-contained unit) of more than 25 minutes in duration but not more than 45 minutes-an attendance on one or more patients at one residential aged care facility on one occasion-each patient, by:

(a) a medical practitioner (who is not a general practitioner); or

(b) a general practitioner to whom clause 2.3.1 applies

An amount equal to $35.50, plus $27.95 divided by the number of patients seen, up to a maximum of six patients. For seven or more patients - an amount equal to $35.50 plus $1.25 per patient
Ready Reckoner

(See para AN.0.15 of explanatory notes to this Category)

Category 1 - PROFESSIONAL ATTENDANCES

96

96 - Additional Information

Item Start Date:
01-Nov-1990
Description Start Date:
01-Jan-2013
Schedule Fee Start Date:
01-Nov-2007

Professional attendance (other than a service to which any other item applies) at a residential aged care facility (other than a professional attendance at a self-contained unit) or professional attendance at consulting rooms situated within such a complex where the patient is accommodated in the residential aged care facility (that is not accommodation in a self-contained unit) of more than 45 minutes in duration-an attendance on one or more patients at one residential aged care facility on one occasion-each patient, by:

(a) a medical practitioner (who is not a general practitioner); or

(b) a general practitioner to whom clause 2.3.1 applies

An amount equal to $57.50, plus $27.95 divided by the number of patients seen, up to a maximum of six patients. For seven or more patients - an amount equal to $57.50 plus $1.25 per patient
Ready Reckoner

(See para AN.0.15 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

5010

5010 - Additional Information

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

Professional attendance (other than a service to which another item applies) at a residential aged care facility (other than a professional attendance at a self-contained unit) or professional attendance at consulting rooms situated within such a complex, if the patient is accommodated in a residential aged care facility (other than accommodation in a self-contained unit) 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-an attendance on one or more patients at one residential aged care facility on one occasion-each patient

The fee for item 5000, plus $46.70 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 $3.30 per patient.
Ready Reckoner

(See para AN.0.9, AN.0.15, 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

43

43 - Additional Information

Item Start Date:
01-Nov-1990
Description Start Date:
01-Jan-2013
Schedule Fee Start Date:
01-Jul-2014

Professional attendance by a general practitioner at a residential aged care facility to residents of the facility (other than 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 residential aged care facility on one occasion-each patient

The fee for item 36, plus $46.70 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 $3.30 per patient.
Ready Reckoner

(See para AN.0.9, AN.0.15 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

5028

5028 - 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 a service to which another item in the table applies), at a residential aged care facility to residents of the facility, 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 residential aged care facility on one occasion-each patient

The fee for item 5020, plus $46.70 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 $3.30 per patient.
Ready Reckoner

(See para AN.0.9, AN.0.15, 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

5049

5049 - 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 at a residential aged care facility to residents of the facility (other than 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 residential aged care facility on one occasion-each patient

The fee for item 5040, plus $46.70 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 $3.30 per patient.
Ready Reckoner

(See para AN.0.9, AN.0.15, AN.0.19 of explanatory notes to this Category)


Consultation At A Residential Aged Care Facility

Professional attendance on 1 or more patients on 1 residential aged care facility ( but excluding a professional attendance at a self-contained unit) or attendance at consulting rooms situated within such a complex where the patient is accommodated in the residential aged care facility (excluding accommodation in a self-contained unit) on 1 occasion – each patient

Category 1 - PROFESSIONAL ATTENDANCES

5260

5260 - Additional Information

Item Start Date:
01-Jan-2005
Description Start Date:
01-Jan-2013
Schedule Fee Start Date:
01-Nov-2007

Professional attendance (other than a service to which another item applies) at a residential aged care facility (other than a professional attendance at a self-contained unit) or professional attendance at consulting rooms situated within such a complex if the patient is accommodated in the residential aged care facility (other than accommodation in a self-contained unit) of not more than 5 minutes in duration by a medical practitioner (other than a general practitioner)-an attendance on one or more patients at one residential aged care facility on one occasion-each patient

An amount equal to $18.50, plus $27.95 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 $1.25 per patient
Ready Reckoner

(See para AN.0.15 of explanatory notes to this Category)

Category 1 - PROFESSIONAL ATTENDANCES

5263

5263 - Additional Information

Item Start Date:
01-Jan-2005
Description Start Date:
01-Jan-2013
Schedule Fee Start Date:
01-Nov-2007

Professional attendance (other than a service to which another item applies) at a residential aged care facility (other than a professional attendance at a self-contained unit) or professional attendance at consulting rooms situated within such a complex if the patient is accommodated in the residential aged care facility (other than accommodation in a self-contained unit) of more than 5 minutes in duration but not more than 25 minutes in duration by a medical practitioner (other than a general practitioner)-an attendance on one or more patients at one residential aged care facility on one occasion-each patient

An amount equal to $26.00, plus $31.55 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 $1.25 per patient
Ready Reckoner

(See para AN.0.15 of explanatory notes to this Category)

Category 1 - PROFESSIONAL ATTENDANCES

5265

5265 - Additional Information

Item Start Date:
01-Jan-2005
Description Start Date:
01-Jan-2013
Schedule Fee Start Date:
01-Nov-2007

Professional attendance (other than a service to which another item applies) at a residential aged care facility (other than a professional attendance at a self-contained unit) or professional attendance at consulting rooms situated within such a complex if the patient is accommodated in the residential aged care facility (other than accommodation in a self-contained unit) of more than 25 minutes in duration but not more than 45 minutes by a medical practitioner (other than a general practitioner)-an attendance on one or more patients at one residential aged care facility on one occasion-each patient

An amount equal to $45.50, plus $27.95 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 $1.25 per patient
Ready Reckoner

(See para AN.0.15 of explanatory notes to this Category)

Category 1 - PROFESSIONAL ATTENDANCES

5267

5267 - Additional Information

Item Start Date:
01-Jan-2005
Description Start Date:
01-Jan-2013
Schedule Fee Start Date:
01-Nov-2007

Professional attendance (other than a service to which another item applies) at a residential aged care facility (other than a professional attendance at a self-contained unit) or professional attendance at consulting rooms situated within such a complex if the patient is accommodated in the residential aged care facility (other than accommodation in a self-contained unit) of more than 45 minutes in duration by a medical practitioner (other than a general practitioner)-an attendance on one or more patients at one residential aged care facility on one occasion-each patient

An amount equal to $67.50, plus $27.95 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 $1.25 per patient
Ready Reckoner

(See para AN.0.15 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

35

35 - Additional Information

Item Start Date:
01-Nov-1990
Description Start Date:
01-Jan-2013
Schedule Fee Start Date:
01-Jul-2014

Professional attendance by a general practitioner at a residential aged care facility to residents of the facility (other than 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 residential aged care facility on one occasion-each patient

The fee for item 23, plus $46.70 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 $3.30 per patient.
Ready Reckoner

(See para AN.0.9, AN.0.15 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