Medicare Benefits Schedule - Note AN.0.7

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Category 1 - PROFESSIONAL ATTENDANCES

AN.0.7

Multiple Attendances on the Same Day

Payment of benefit may be made for each of several attendances on a patient on the same day by the same medical practitioner provided the subsequent attendances are not a continuation of the initial or earlier attendances. However, there should be a reasonable lapse of time between such attendances before they can be regarded as separate attendances. 

Where two or more attendances are made on the one day by the same medical practitioner the time of each attendance should be stated on the account (eg 10.30 am and 3.15 pm) in order to assist in the assessment of benefits. 

In some circumstances a subsequent attendance on the same day constitutes a continuation of an earlier attendance. For example, a preliminary eye examination may be concluded with the instillation of a mydriatic and then some time later an eye refraction is undertaken. These sessions are regarded as being one attendance for benefit purposes. Further examples of single attendances are skin sensitivity testing, and when a patient is issued a prescription for a vaccine and subsequently returns to the surgery for the injection.

Related Items: 104 105 110 116 119 132 133 91822 91823 91824 91825 91826 91832 91833 91834 91835 91836 92422 92423 92431 92432


Related Items

Category 1 - PROFESSIONAL ATTENDANCES

104

104 - Additional Information

Item Start Date:
01-Nov-1990
Description Updated:
01-Nov-2019
Schedule Fee Updated:
01-Jul-2020

Professional attendance at consulting rooms or hospital by a specialist in the practice of the specialist's specialty after referral of the patient to the specialist-each attendance, other than a second or subsequent attendance, in a single course of treatment, other than a service to which item 106, 109 or 16401 applies

Fee: $89.55 Benefit: 75% = $67.20 85% = $76.15

(See para AN.0.7, AN.2.1, AN.40.1, TN.1.4 of explanatory notes to this Category)

Category 1 - PROFESSIONAL ATTENDANCES

105

105 - Additional Information

Item Start Date:
01-Nov-1990
Description Updated:
01-Nov-2019
Schedule Fee Updated:
01-Jul-2020

Professional attendance by a specialist in the practice of the specialist's specialty following referral of the patient to the specialist-an attendance after the first in a single course of treatment, if that attendance is at consulting rooms or hospital, other than a service to which item 16404 applies

Fee: $45.00 Benefit: 75% = $33.75 85% = $38.25

(See para AN.0.7, AN.0.70, AN.2.1, AN.40.1, TN.1.4 of explanatory notes to this Category)

Category 1 - PROFESSIONAL ATTENDANCES

110

110 - Additional Information

Item Start Date:
01-Mar-1987
Description Updated:
01-Nov-2019
Schedule Fee Updated:
01-Jul-2020

Professional attendance at consulting rooms or hospital, by a consultant physician in the practice of the consultant physician's specialty (other than psychiatry) following referral of the patient to the consultant physician by a referring practitioner-initial attendance in a single course of treatment

Fee: $157.95 Benefit: 75% = $118.50 85% = $134.30

(See para AN.0.7, AN.40.1 of explanatory notes to this Category)

Category 1 - PROFESSIONAL ATTENDANCES

116

116 - Additional Information

Item Start Date:
01-Mar-1987
Description Updated:
01-Nov-2019
Schedule Fee Updated:
01-Jul-2020

Professional attendance at consulting rooms or hospital, by a consultant physician in the practice of the consultant physician's specialty (other than psychiatry) following referral of the patient to the consultant physician by a referring practitioner-each attendance (other than a service to which item 119 applies) after the first in a single course of treatment

Fee: $79.05 Benefit: 75% = $59.30 85% = $67.20

(See para AN.0.7, AN.0.70, AN.40.1 of explanatory notes to this Category)

Category 1 - PROFESSIONAL ATTENDANCES

119

119 - Additional Information

Item Start Date:
22-Dec-1987
Description Updated:
01-Nov-2019
Schedule Fee Updated:
01-Jul-2020

Professional attendance at consulting rooms or hospital, by a consultant physician in the practice of the consultant physician's specialty (other than psychiatry) following referral of the patient to the consultant physician by a referring practitioner-each minor attendance after the first in a single course of treatment

Fee: $45.00 Benefit: 75% = $33.75 85% = $38.25

(See para AN.0.7, AN.0.21, AN.0.70, AN.40.1 of explanatory notes to this Category)

Category 1 - PROFESSIONAL ATTENDANCES

132

132 - Additional Information

Item Start Date:
01-Nov-2007
Description Updated:
01-Nov-2019
Schedule Fee Updated:
01-Jul-2020

Professional attendance by a consultant physician in the practice of the consultant physician's specialty (other than psychiatry) of at least 45 minutes in duration for an initial assessment of a patient with at least 2 morbidities (which may include complex congenital, developmental and behavioural disorders) following referral of the patient to the consultant physician by a referring practitioner, if:

(a) an assessment is undertaken that covers:

      (i) a comprehensive history, including psychosocial history and medication review; and

      (ii) comprehensive multi or detailed single organ system assessment; and

      (iii) the formulation of differential diagnoses; and

(b) a consultant physician treatment and management plan of significant complexity is prepared and provided to the referring practitioner, which involves:

      (i) an opinion on diagnosis and risk assessment; and

      (ii) treatment options and decisions; and

      (iii) medication recommendations; and

(c) an attendance on the patient to which item 110, 116 or 119 applies did not take place on the same day by the same consultant physician; and

(d) this item has not applied to an attendance on the patient in the preceding 12 months by the same consultant physician

Fee: $276.25 Benefit: 75% = $207.20 85% = $234.85

(See para AN.0.7, AN.0.23, AN.40.1 of explanatory notes to this Category)

Category 1 - PROFESSIONAL ATTENDANCES

133

133 - Additional Information

Item Start Date:
01-Nov-2007
Description Updated:
01-Nov-2019
Schedule Fee Updated:
01-Jul-2020

Professional attendance by a consultant physician in the practice of the consultant physician's specialty (other than psychiatry) of at least 20 minutes in duration after the first attendance in a single course of treatment for a review of a patient with at least 2 morbidities (which may include complex congenital, developmental and behavioural disorders) if:

(a) a review is undertaken that covers:

      (i) review of initial presenting problems and results of diagnostic investigations; and

      (ii) review of responses to treatment and medication plans initiated at time of initial consultation; and

      (iii) comprehensive multi or detailed single organ system assessment; and

      (iv) review of original and differential diagnoses; and

(b) the modified consultant physician treatment and management plan is provided to the referring practitioner, which involves, if appropriate:

     (i) a revised opinion on the diagnosis and risk assessment; and

     (ii) treatment options and decisions; and

     (iii) revised medication recommendations; and

(c) an attendance on the patient to which item 110, 116 or 119 applies did not take place on the same day by the same consultant physician; and

(d) item 132 applied to an attendance claimed in the preceding 12 months; and

(e) the attendance under this item is claimed by the same consultant physician who claimed item 132 or a locum tenens; and

(f) this item has not applied more than twice in any 12 month period

Fee: $138.30 Benefit: 75% = $103.75 85% = $117.60

(See para AN.0.7, AN.0.23, AN.40.1 of explanatory notes to this Category)

Category 1 - PROFESSIONAL ATTENDANCES

91822

91822 - Additional Information

Item Start Date:
13-Mar-2020
Description Updated:
20-Apr-2020
Schedule Fee Updated:
01-Jul-2020

Telehealth attendance for a person by a specialist in the practice of the specialist’s specialty if:

(a)           the attendance follows referral of the patient to the specialist; and

(b)           the attendance was of more than 5 minutes in duration.

 Where the attendance was other than a second or subsequent attendance as part of a single course of treatment.

 

 


 

Fee: $89.55 Benefit: 85% = $76.15

(See para AN.0.7, AN.40.1 of explanatory notes to this Category)

Category 1 - PROFESSIONAL ATTENDANCES

91823

91823 - Additional Information

Item Start Date:
13-Mar-2020
Description Updated:
20-Apr-2020
Schedule Fee Updated:
01-Jul-2020

Telehealth attendance for a person by a specialist in the practice of the specialist’s specialty if:

(a)           the attendance follows referral of the patient to the specialist; and

(b)           the attendance was of more than 5 minutes in duration.

 Where the attendance is after the first attendance as part of a single course of treatment.

 

 

Fee: $45.00 Benefit: 85% = $38.25

(See para AN.0.7, AN.40.1 of explanatory notes to this Category)

Category 1 - PROFESSIONAL ATTENDANCES

91824

91824 - Additional Information

Item Start Date:
13-Mar-2020
Description Updated:
20-Apr-2020
Schedule Fee Updated:
01-Jul-2020

Telehealth attendance for a person by a consultant physician in the practice of the consultant physician’s specialty (other than psychiatry) if:

(a)           the attendance follows referral of the patient to the specialist; and

(b)           the attendance was of more than 5 minutes in duration. 

Where the attendance was other than a second or subsequent attendance as part of a single course of treatment.

 

 

Fee: $157.95 Benefit: 85% = $134.30

(See para AN.0.7, AN.40.1 of explanatory notes to this Category)

Category 1 - PROFESSIONAL ATTENDANCES

91825

91825 - Additional Information

Item Start Date:
13-Mar-2020
Description Updated:
20-Apr-2020
Schedule Fee Updated:
01-Jul-2020

Telehealth attendance for a person by a consultant physician in the practice of the consultant physician’s specialty (other than psychiatry) if:

(a)           the attendance follows referral of the patient to the specialist; and

(b)           the attendance was of more than 5 minutes in duration.

 Where the attendance is not a minor attendance after the first as part of a single course of treatment.

 

 

Fee: $79.05 Benefit: 85% = $67.20

(See para AN.0.7, AN.40.1 of explanatory notes to this Category)

Category 1 - PROFESSIONAL ATTENDANCES

91826

91826 - Additional Information

Item Start Date:
13-Mar-2020
Description Updated:
20-Apr-2020
Schedule Fee Updated:
01-Jul-2020

Telehealth attendance for a person by a consultant physician in the practice of the consultant physician’s specialty (other than psychiatry) if:

(a)           the attendance follows referral of the patient to the specialist; and

(b)           the attendance was of more than 5 minutes in duration. 

Where the attendance is a minor attendance after the first as part of a single course of treatment.

 

 

Fee: $45.00 Benefit: 85% = $38.25

(See para AN.0.7, AN.40.1 of explanatory notes to this Category)

Category 1 - PROFESSIONAL ATTENDANCES

92422

92422 - Additional Information

Item Start Date:
06-Apr-2020
Description Updated:
20-Apr-2020
Schedule Fee Updated:
01-Jul-2020

Telehealth attendance by a consultant physician in the practice of the consultant physician’s specialty (other than psychiatry) of at least 45 minutes in duration for an initial assessment of a patient with at least 2 morbidities (which may include complex congenital, developmental and behavioural disorders) following referral of the patient to the consultant physician by a referring practitioner, if:

(a) an assessment is undertaken that covers:

     (i) a comprehensive history, including psychosocial history and medication review; and

     (ii) comprehensive multi or detailed single organ system assessment; and

     (iii) the formulation of differential diagnoses; and

(b) a consultant physician treatment and management plan of significant complexity is prepared and provided to the referring practitioner, which involves:

    (i) an opinion on diagnosis and risk assessment; and

    (ii) treatment options and decisions; and

    (iii) medication recommendations; and

(c) an attendance on the patient to which item 110, 116, 119, 91824, 91834, 91825, 91835, 91826 or 91836 applies did not take place on the same day by the same consultant physician; and

(d) this item or item 132 or 92431 has not applied to an attendance on the patient in the preceding 12 months by the same consultant physician.

 

 

 

Fee: $276.25 Benefit: 85% = $234.85

(See para AN.0.7, AN.40.1 of explanatory notes to this Category)

Category 1 - PROFESSIONAL ATTENDANCES

92423

92423 - Additional Information

Item Start Date:
06-Apr-2020
Description Updated:
20-Apr-2020
Schedule Fee Updated:
01-Jul-2020

Telehealth attendance by a consultant physician in the practice of the consultant physician’s specialty (other than psychiatry) of at least 20 minutes in duration after the first attendance in a single course of treatment for a review of a patient with at least 2 morbidities (which may include complex congenital, developmental and behavioural disorders) if:

(a) a review is undertaken that covers:

    (i) review of initial presenting problems and results of diagnostic investigations; and

    (ii) review of responses to treatment and medication plans initiated at time of initial consultation; and

    (iii) comprehensive multi or detailed single organ system assessment; and

    (iv) review of original and differential diagnoses; and

(b) the modified consultant physician treatment and management plan is provided to the referring practitioner, which involves, if appropriate:

     (i) a revised opinion on the diagnosis and risk assessment; and

     (ii) treatment options and decisions; and

     (iii) revised medication recommendations; and

(c) an attendance on the patient to which item 110, 116, 119, 91824, 91834, 91825, 91835, 91826 or 91836 applies did not take place on the same day by the same consultant physician; and

(d) item 132, 92422 or 92431 applied to an attendance claimed in the preceding 12 months; and

(e) the attendance under this item is claimed by the same consultant physician who claimed item 132, 92422 or 92431; and

(f) this item or item 133 or 92432 has not applied more than twice in any 12 month period.

 

 

 

Fee: $138.30 Benefit: 85% = $117.60

(See para AN.0.7, AN.40.1 of explanatory notes to this Category)

Category 1 - PROFESSIONAL ATTENDANCES

91832

91832 - Additional Information

Item Start Date:
13-Mar-2020
Description Updated:
20-Apr-2020
Schedule Fee Updated:
01-Jul-2020

Phone attendance for a person by a specialist in the practice of the specialist’s specialty if:

(a)           the attendance follows referral of the patient to the specialist; and

(b)           the attendance was of more than 5 minutes in duration. 

Where the attendance was other than a second or subsequent attendance as part of a single course of treatment.

 

 

Fee: $89.55 Benefit: 85% = $76.15

(See para AN.0.7, AN.40.1 of explanatory notes to this Category)

Category 1 - PROFESSIONAL ATTENDANCES

91833

91833 - Additional Information

Item Start Date:
13-Mar-2020
Description Updated:
20-Apr-2020
Schedule Fee Updated:
01-Jul-2020

Phone attendance for a person by a specialist in the practice of the specialist’s specialty if:

(a)           the attendance follows referral of the patient to the specialist; and

(b)           the attendance was of more than 5 minutes in duration. 

Where the attendance is after the first attendance as part of a single course of treatment.

 

 

Fee: $45.00 Benefit: 85% = $38.25

(See para AN.0.7, AN.40.1 of explanatory notes to this Category)

Category 1 - PROFESSIONAL ATTENDANCES

91834

91834 - Additional Information

Item Start Date:
13-Mar-2020
Description Updated:
20-Apr-2020
Schedule Fee Updated:
01-Jul-2020

Phone attendance for a person by a consultant physician in the practice of the consultant physician’s specialty (other than psychiatry) if:

(a)           the attendance follows referral of the patient to the specialist; and

(b)           the attendance was of more than 5 minutes in duration. 

Where the attendance was other than a second or subsequent attendance as part of a single course of treatment.

 

 

Fee: $157.95 Benefit: 85% = $134.30

(See para AN.0.7, AN.40.1 of explanatory notes to this Category)

Category 1 - PROFESSIONAL ATTENDANCES

91835

91835 - Additional Information

Item Start Date:
13-Mar-2020
Description Updated:
20-Apr-2020
Schedule Fee Updated:
01-Jul-2020

Phone attendance for a person by a consultant physician in the practice of the consultant physician’s specialty (other than psychiatry) if:

(a)           the attendance follows referral of the patient to the specialist; and

(b)           the attendance was of more than 5 minutes in duration.

Where the attendance is not a minor attendance after the first as part of a single course of treatment.

 

 

Fee: $79.05 Benefit: 85% = $67.20

(See para AN.0.7, AN.40.1 of explanatory notes to this Category)

Category 1 - PROFESSIONAL ATTENDANCES

91836

91836 - Additional Information

Item Start Date:
13-Mar-2020
Description Updated:
20-Apr-2020
Schedule Fee Updated:
01-Jul-2020

Phone attendance for a person by a consultant physician in the practice of the consultant physician’s specialty (other than psychiatry) if:

(a)           the attendance follows referral of the patient to the specialist; and

(b)           the attendance was of more than 5 minutes in duration.

Where the attendance is a minor attendance after the first as part of a single course of treatment.

 

 

Fee: $45.00 Benefit: 85% = $38.25

(See para AN.0.7, AN.40.1 of explanatory notes to this Category)

Category 1 - PROFESSIONAL ATTENDANCES

92431

92431 - Additional Information

Item Start Date:
06-Apr-2020
Description Updated:
20-Apr-2020
Schedule Fee Updated:
01-Jul-2020

Phone attendance by a consultant physician in the practice of the consultant physician’s specialty (other than psychiatry) of at least 45 minutes in duration for an initial assessment of a patient with at least 2 morbidities (which may include complex congenital, developmental and behavioural disorders) following referral of the patient to the consultant physician by a referring practitioner, if:

(a) an assessment is undertaken that covers:

    (i) a comprehensive history, including psychosocial history and medication review; and

    (ii) comprehensive multi or detailed single organ system assessment; and

    (iii) the formulation of differential diagnoses; and

(b) a consultant physician treatment and management plan of significant complexity is prepared and provided to the referring practitioner, which involves:

    (i) an opinion on diagnosis and risk assessment; and

    (ii) treatment options and decisions; and

    (iii) medication recommendations; and

(c) an attendance on the patient to which item 110, 116, 119, 91824, 91834, 91825, 91835, 91826 or 91836 applies did not take place on the same day by the same consultant physician; and

(d) this item or item 132 or 92422 has not applied to an attendance on the patient in the preceding 12 months by the same consultant physician.

 

 

 

Fee: $276.25 Benefit: 85% = $234.85

(See para AN.0.7, AN.40.1 of explanatory notes to this Category)

Category 1 - PROFESSIONAL ATTENDANCES

92432

92432 - Additional Information

Item Start Date:
06-Apr-2020
Description Updated:
20-Apr-2020
Schedule Fee Updated:
01-Jul-2020

Phone attendance by a consultant physician in the practice of the consultant physician’s specialty (other than psychiatry) of at least 20 minutes in duration after the first attendance in a single course of treatment for a review of a patient with at least 2 morbidities (which may include complex congenital, developmental and behavioural disorders) if:

(a) a review is undertaken that covers:

    (i) review of initial presenting problems and results of diagnostic investigations; and

    (ii) review of responses to treatment and medication plans initiated at time of initial consultation; and

    (iii) comprehensive multi or detailed single organ system assessment; and

    (iv) review of original and differential diagnoses; and

(b) the modified consultant physician treatment and management plan is provided to the referring practitioner, which involves, if appropriate:

     (i) a revised opinion on the diagnosis and risk assessment; and

     (ii) treatment options and decisions; and

     (iii) revised medication recommendations; and

(c) an attendance on the patient to which item 110, 116, 119, 91824, 91834, 91825, 91835, 91826 or 91836 applies did not take place on the same day by the same consultant physician; and

(d) item 132, 92422 or 92431 applied to an attendance claimed in the preceding 12 months; and

(e) the attendance under this item is claimed by the same consultant physician who claimed item 132, 92422 or 92431; and

(f) this item or item 133 or 92423 has not applied more than twice in any 12 month period.

 

 

 

Fee: $138.30 Benefit: 85% = $117.60

(See para AN.0.7, AN.40.1 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