Medicare Benefits Schedule - Note AN.0.34

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Category 1 - PROFESSIONAL ATTENDANCES

AN.0.34

Contact Lenses (Items 10801-10809)

Benefits are paid for consultations concerned with the prescription and fitting of contact lenses only if patients fall into specified categories (ie patients with certain conditions). The classes of patients eligible for benefits for contact lens consultations are described in items 10801 to 10809. 

Benefits are not payable for item 10809 in circumstances where patients want contact lenses only for:

(a)              reasons of appearance (because they do not want to wear spectacles);

(b)              sporting purposes;

(c)              work purposes; or

(d)              psychological reasons (because they cannot cope with spectacles). 

Benefits are payable for an initial referred consultation rendered in association with the fitting and prescribing of the lenses.  Subsequent follow-up attendances attract benefits on a consultation basis.

Related Items: 10801 10802 10803 10804 10805 10806 10807 10808 10809


Related Items

Category 1 - PROFESSIONAL ATTENDANCES

10801

10801 - Additional Information

Item Start Date:
01-Dec-1991
Description Updated:
01-Nov-1997
Schedule Fee Updated:
01-Nov-2023

Attendance for the investigation and evaluation of a patient for the fitting of contact lenses, with keratometry and testing with trial lenses and the issue of a prescription-one service in any period of 36 months-patient with myopia of 5.0 dioptres or greater (spherical equivalent) in one eye

Fee: $135.95 Benefit: 75% = $102.00 85% = $115.60

(See para AN.0.34 of explanatory notes to this Category)

Category 1 - PROFESSIONAL ATTENDANCES

10802

10802 - Additional Information

Item Start Date:
01-Dec-1991
Description Updated:
01-Dec-1991
Schedule Fee Updated:
01-Nov-2023

Attendance for the investigation and evaluation of a patient for the fitting of contact lenses, with keratometry and testing with trial lenses and the issue of a prescription-one service in any period of 36 months-patient with manifest hyperopia of 5.0 dioptres or greater (spherical equivalent) in one eye

Fee: $135.95 Benefit: 75% = $102.00 85% = $115.60

(See para AN.0.34 of explanatory notes to this Category)

Category 1 - PROFESSIONAL ATTENDANCES

10803

10803 - Additional Information

Item Start Date:
01-Dec-1991
Description Updated:
01-Dec-1991
Schedule Fee Updated:
01-Nov-2023

Attendance for the investigation and evaluation of a patient for the fitting of contact lenses, with keratometry and testing with trial lenses and the issue of a prescription-one service in any period of 36 months-patient with astigmatism of 3.0 dioptres or greater in one eye

Fee: $135.95 Benefit: 75% = $102.00 85% = $115.60

(See para AN.0.34 of explanatory notes to this Category)

Category 1 - PROFESSIONAL ATTENDANCES

10804

10804 - Additional Information

Item Start Date:
01-Dec-1991
Description Updated:
01-Nov-1997
Schedule Fee Updated:
01-Nov-2023

Attendance for the investigation and evaluation of a patient for the fitting of contact lenses, with keratometry and testing with trial lenses and the issue of a prescription-one service in any period of 36 months-patient with irregular astigmatism in either eye, being a condition the existence of which has been confirmed by keratometric observation, if the maximum visual acuity obtainable with spectacle correction is worse than 0.3 logMAR (6/12) and if that corrected acuity would be improved by an additional 0.1 logMAR by the use of a contact lens

Fee: $135.95 Benefit: 75% = $102.00 85% = $115.60

(See para AN.0.34 of explanatory notes to this Category)

Category 1 - PROFESSIONAL ATTENDANCES

10805

10805 - Additional Information

Item Start Date:
01-Dec-1991
Description Updated:
01-Dec-1991
Schedule Fee Updated:
01-Nov-2023

Attendance for the investigation and evaluation of a patient for the fitting of contact lenses, with keratometry and testing with trial lenses and the issue of a prescription-one service in any period of 36 months-patient with anisometropia of 3.0 dioptres or greater (difference between spherical equivalents)

Fee: $135.95 Benefit: 75% = $102.00 85% = $115.60

(See para AN.0.34 of explanatory notes to this Category)

Category 1 - PROFESSIONAL ATTENDANCES

10806

10806 - Additional Information

Item Start Date:
01-Dec-1991
Description Updated:
01-Nov-1997
Schedule Fee Updated:
01-Nov-2023

Attendance for the investigation and evaluation of a patient for the fitting of contact lenses, with keratometry and testing with trial lenses and the issue of a prescription-one service in any period of 36 months-patient with corrected visual acuity of 0.7 logMAR (6/30) or worse in both eyes and for whom a contact lens is prescribed as part of a telescopic system

Fee: $135.95 Benefit: 75% = $102.00 85% = $115.60

(See para AN.0.34 of explanatory notes to this Category)

Category 1 - PROFESSIONAL ATTENDANCES

10807

10807 - Additional Information

Item Start Date:
01-Dec-1991
Description Updated:
01-Dec-1991
Schedule Fee Updated:
01-Nov-2023

Attendance for the investigation and evaluation of a patient for the fitting of contact lenses, with keratometry and testing with trial lenses and the issue of a prescription-one service in any period of 36 months-patient for whom a wholly or segmentally opaque contact lens is prescribed for the alleviation of dazzle, distortion or diplopia caused by pathological mydriasis, aniridia, coloboma of the iris, pupillary malformation or distortion, significant ocular deformity or corneal opacity-whether congenital, traumatic or surgical in origin

Fee: $135.95 Benefit: 75% = $102.00 85% = $115.60

(See para AN.0.34 of explanatory notes to this Category)

Category 1 - PROFESSIONAL ATTENDANCES

10808

10808 - Additional Information

Item Start Date:
01-Dec-1991
Description Updated:
01-Dec-1991
Schedule Fee Updated:
01-Nov-2023

Attendance for the investigation and evaluation of a patient for the fitting of contact lenses, with keratometry and testing with trial lenses and the issue of a prescription-one service in any period of 36 months-patient who, because of physical deformity, are unable to wear spectacles

Fee: $135.95 Benefit: 75% = $102.00 85% = $115.60

(See para AN.0.34 of explanatory notes to this Category)

Category 1 - PROFESSIONAL ATTENDANCES

10809

10809 - Additional Information

Item Start Date:
01-Dec-1991
Description Updated:
01-Nov-1997
Schedule Fee Updated:
01-Nov-2023

Attendance for the investigation and evaluation of a patient for the fitting of contact lenses, with keratometry and testing with trial lenses and the issue of a prescription-one service in any period of 36 months-patient with a medical or optical condition (other than myopia, hyperopia, astigmatism, anisometropia or a condition to which item 10806, 10807 or 10808 applies) requiring the use of a contact lens for correction, if the condition is specified on the patient's account

Fee: $135.95 Benefit: 75% = $102.00 85% = $115.60

(See para AN.0.34 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