Medicare Benefits Schedule - Note AN.0.5

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Category 1 - PROFESSIONAL ATTENDANCES

AN.0.5

Services not Attracting Medicare Benefits

Telephone consultations, letters of advice by medical practitioners, the issue of repeat prescriptions when the patient is not in attendance, post mortem examinations, the issue of death certificates, cremation certificates, counselling of relatives (Note ‑ items 348, 350 and 352 are not counselling services), group attendances (other than group attendances covered by items 170, 171, 172, 342, 344 and 346) such as group counselling, health education, weight reduction or fitness classes do not qualify for benefit. 

Although Medicare benefits are not payable for the issue of a death certificate, an attendance on a patient at which it is determined that life is extinct can be claimed under the appropriate attendance item. The outcome of the attendance may be that a death certificate is issued, however, Medicare benefits are only payable for the attendance component of the service.

Related Items: 170 171 172 342 344 346 348 350 352


Related Items

Category 1 - PROFESSIONAL ATTENDANCES

170

170 - Additional Information

Item Start Date:
01-Aug-1987
Description Updated:
01-Nov-2019
Schedule Fee Updated:
01-Jul-2019

Professional attendance for the purpose of group therapy of not less than 1 hour in duration given under the direct continuous supervision of a general practitioner, specialist or consultant physician (other than a consultant physician in the practice of the consultant physician's specialty of psychiatry) involving members of a family and persons with close personal relationships with that family-each group of 2 patients

Fee: $119.45 Benefit: 75% = $89.60 100% = $119.45

(See para AN.0.5, AN.0.28 of explanatory notes to this Category)

Category 1 - PROFESSIONAL ATTENDANCES

171

171 - Additional Information

Item Start Date:
01-Aug-1987
Description Updated:
01-Nov-2019
Schedule Fee Updated:
01-Jul-2019

Professional attendance for the purpose of group therapy of not less than 1 hour in duration given under the direct continuous supervision of a general practitioner, specialist or consultant physician (other than a consultant physician in the practice of the consultant physician's specialty of psychiatry) involving members of a family and persons with close personal relationships with that family-each group of 3 patients

Fee: $125.85 Benefit: 75% = $94.40 100% = $125.85

(See para AN.0.5, AN.0.28 of explanatory notes to this Category)

Category 1 - PROFESSIONAL ATTENDANCES

172

172 - Additional Information

Item Start Date:
01-Aug-1987
Description Updated:
01-Nov-2019
Schedule Fee Updated:
01-Jul-2019

Professional attendance for the purpose of group therapy of not less than 1 hour in duration given under the direct continuous supervision of a general practitioner, specialist or consultant physician (other than a consultant physician in the practice of the consultant physician's specialty of psychiatry) involving members of a family and persons with close personal relationships with that family-each group of 4 or more patients

Fee: $153.10 Benefit: 75% = $114.85 100% = $153.10

(See para AN.0.5, AN.0.28 of explanatory notes to this Category)

Category 1 - PROFESSIONAL ATTENDANCES

342 Amend

342 - Additional Information

Item Start Date:
01-Nov-1996
Description Updated:
01-Nov-2019
Schedule Fee Updated:
01-Jul-2019

Group psychotherapy (including any associated consultations with a patient taking place on the same occasion and relating to the condition for which group therapy is conducted) of not less than 1 hour in duration given under the continuous direct supervision of a consultant physician in the practice of the consultant physician's specialty of psychiatry, involving a group of 2 to 9 unrelated patients or a family group of more than 3 patients, each of whom is referred to the consultant physician by a referring practitioner-each patient

Fee: $50.85 Benefit: 75% = $38.15 85% = $43.25

(See para AN.0.5 of explanatory notes to this Category)

Category 1 - PROFESSIONAL ATTENDANCES

344 Amend

344 - Additional Information

Item Start Date:
01-Nov-1996
Description Updated:
01-Nov-2019
Schedule Fee Updated:
01-Jul-2019

Group psychotherapy (including any associated consultations with a patient taking place on the same occasion and relating to the condition for which group therapy is conducted) of not less than 1 hour in duration given under the continuous direct supervision of a consultant physician in the practice of the consultant physician's specialty of psychiatry, involving a family group of 3 patients, each of whom is referred to the consultant physician by a referring practitioner-each patient

Fee: $67.50 Benefit: 75% = $50.65 85% = $57.40

(See para AN.0.5 of explanatory notes to this Category)

Category 1 - PROFESSIONAL ATTENDANCES

346 Amend

346 - Additional Information

Item Start Date:
01-Nov-1996
Description Updated:
01-Nov-2019
Schedule Fee Updated:
01-Jul-2019

Group psychotherapy (including any associated consultations with a patient taking place on the same occasion and relating to the condition for which group therapy is conducted) of not less than 1 hour in duration given under the continuous direct supervision of a consultant physician in the practice of the consultant physician's specialty of psychiatry, involving a family group of 2 patients, each of whom is referred to the consultant physician by a referring practitioner-each patient

Fee: $99.80 Benefit: 75% = $74.85 85% = $84.85

(See para AN.0.5 of explanatory notes to this Category)

Category 1 - PROFESSIONAL ATTENDANCES

348 Amend

348 - Additional Information

Item Start Date:
01-Nov-1996
Description Updated:
01-Nov-2019
Schedule Fee Updated:
01-Jul-2019

Professional attendance by a consultant physician in the practice of the consultant physician's specialty of psychiatry, following referral of the patient to the consultant physician by a referring practitioner, involving an interview of a person other than the patient of not less than 20 minutes, but less than 45 minutes, in duration, in the course of initial diagnostic evaluation of a patient

Fee: $130.70 Benefit: 75% = $98.05 85% = $111.10

(See para AN.0.5, AN.0.32 of explanatory notes to this Category)

Category 1 - PROFESSIONAL ATTENDANCES

350 Amend

350 - Additional Information

Item Start Date:
01-Nov-1996
Description Updated:
01-Nov-2019
Schedule Fee Updated:
01-Jul-2019

Professional attendance by a consultant physician in the practice of the consultant physician's specialty of psychiatry, following referral of the patient to the consultant physician by a referring practitioner, involving an interview of a person other than the patient of not less than 45 minutes in duration, in the course of initial diagnostic evaluation of a patient

Fee: $180.45 Benefit: 75% = $135.35 85% = $153.40

(See para AN.0.5, AN.0.32 of explanatory notes to this Category)

Category 1 - PROFESSIONAL ATTENDANCES

352 Amend

352 - Additional Information

Item Start Date:
01-Nov-1996
Description Updated:
01-Nov-2019
Schedule Fee Updated:
01-Jul-2019

Professional attendance by a consultant physician in the practice of the consultant physician's specialty of psychiatry, following referral of the patient to the consultant physician by a referring practitioner, involving an interview of a person other than the patient of not less than 20 minutes in duration, in the course of continuing management of a patient-if that attendance and another attendance to which this item applies have not exceeded 4 in a calendar year for the patient

Fee: $130.70 Benefit: 75% = $98.05 85% = $111.10

(See para AN.0.5, AN.0.32 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