Medicare Benefits Schedule - Note MN.9.3

Items 81100, 81105, 81110, 81115, 81120, 81125, 93284, 93285 and 93286 only apply to services provided by eligible diabetes educators, exercise physiologists and dietitians who are registered with Services Australia. If providers are already registered with Services Australia to use items 10951, 10953, 10954, they do not need to register separately for these items. Eligibility criteria are as follows: 

Diabetes educator: must be a 'credentialed diabetes educator' as credentialed by the Australian Diabetes Educators Association. 

Exercise physiologist: must be an 'accredited exercise physiologist' as accredited by Exercise and Sports Science Australia. 

Dietitian: must be an 'accredited practising dietitian' as recognised by the Dietitians Association of Australia. 

Services Australia registration forms may be obtained from Services Australia on 132 150 or on the Services Australia website.

Related Items: 81100 81105 81110 81115 81120 81125 93284 93285 93286

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Diabetes education health service provided to a patient by an eligible diabetes educator for assessing the patient’s suitability for group services for the management of type 2 diabetes, including taking a comprehensive patient history, identifying an appropriate group services program based on the patient’s needs and preparing the patient for the group services if:

(a)   the patient has type 2 diabetes; and

(b)  the patient is being managed by a medical practitioner (including a general practitioner, but not a specialist or consultant physician) under a GP Management Plan or, if the patient is a resident of an aged care facility, the patient’s medical practitioner has contributed to a multidisciplinary care plan; and

(c)   the patient is referred to an eligible diabetes educator by the medical practitioner using a referral form that has been issued by the Department, or a referral form that contains all the components of the form issued by the Department; and

(d)  the service is provided to the patient individually and in person; and

(e)   the service is of at least 45 minutes duration; and

(f)   after the service, the eligible diabetes educator gives a written report to the referring medical practitioner mentioned in paragraph (c);

payable once in a calendar year for this or any other assessment for group services item (including services in items 81100, 81110 and 81120 or items 93284 or 93286 of the Telehealth and Telephone Determination)

Fee: $87.95 Benefit: 85% = $74.80

(See para MN.9.1, MN.9.2, MN.9.3, MN.9.4, MN.9.6 of explanatory notes to this Category)

Diabetes education health service provided to a patient by an eligible diabetes educator, as a group service for the management of type 2 diabetes if:

(a)   the patient has been assessed as suitable for a type 2 diabetes group service under assessment item 81100, 81110 or 81120 or items 93284 or 93286 of the Telehealth and Telephone Determination; and

(b)  the service is provided to a patient who is part of a group of between 2 and 12 patients; and

(c)   the service is provided in person; and

(d)  the service is of at least 60 minutes duration; and

(e)   after the last service in the group services program provided to the patient under item 81105, 81115 or 81125 or item 93285 of the Telehealth and Telephone Determination, the eligible diabetes educator prepares, or contributes to, a written report to be provided to the referring medical practitioner; and

(f)   an attendance record for the group is maintained by the eligible diabetes educator;

to a maximum of 8 group services in a calendar year (including services in items 81105, 81115 and 81125 or item 93285 of the Telehealth and Telephone Determination)

Fee: $21.90 Benefit: 85% = $18.65

(See para MN.9.1, MN.9.3, MN.9.5, MN.9.6 of explanatory notes to this Category)

Telehealth attendance by an eligible dietitian to provide a dietetics health service to a person for assessing the person’s suitability for group services for the management of type 2 diabetes, including taking a comprehensive patient history, identifying an appropriate group services program based on the patient’s needs and preparing the person for the group services if:

(a) the person has type 2 diabetes; and

(b) the person is being managed by a medical practitioner (including a general practitioner, but not a specialist or consultant physician) under a GP management plan or, if the person is a resident of an aged care facility, the person’s medical practitioner has contributed to a multidisciplinary care plan; and

(c) the person is referred to an eligible dietitian by the medical practitioner using a referral form that has been issued by the Department, or a referral form that contains all the components of the form issued by the Department; and

(d) the service is provided to the person individually; and

(e) the service is of at least 45 minutes duration; and

(f) after the service, the eligible dietitian gives a written report to the referring medical practitioner mentioned in paragraph (c);

payable once in a calendar year for this or any other assessment for group services item (including services to which this item, item 92386, or items 81100, 81110 and 81120 of the Allied Health  Determination apply)

Fee: $87.95 Benefit: 85% = $74.80

(See para MN.9.2, MN.9.3, MN.9.4, MN.9.6 of explanatory notes to this Category)

Telehealth attendance by an eligible dietitian to provide a dietetics health service, as a group service for the management of type 2 diabetes if:

(a)    the person has been assessed as suitable for a type 2 diabetes group service under assessment items 81100, 81110 or 81120 of the Allied Health Determination or items 93284 or 93286; and

(b)    the service is provided to a person who is part of a group of between 2 and 12 patients; and

(c)    the service is of at least 60 minutes duration; and

(d)    after the last service in the group services program provided to the person under this item or items 81105, 81115 or 81125 of the Allied Health Determination, the eligible dietitian prepares, or contributes to, a written report to be provided to the referring medical practitioner; and

(e)    an attendance record for the group is maintained by the eligible dietitian;

to a maximum of 8 group services in a calendar year (including services to which this item or items 81105, 81115 and 81125 of the Allied Health Determination apply)

Fee: $21.90 Benefit: 85% = $18.65

(See para MN.9.3, MN.9.5, MN.9.6 of explanatory notes to this Category)

Exercise physiology health service provided to a person by an eligible exercise physiologist for assessing the person’s suitability for group services for the management of type 2 diabetes, including taking a comprehensive patient history, identifying an appropriate group services program based on the patient’s needs and preparing the person for the group services if:

(a)   the person has type 2 diabetes; and

(b)  the person is being managed by a medical practitioner (including a general practitioner, but not a specialist or consultant physician) under a GP Management Plan or, if the person is a resident of an aged care facility, the person’s medical practitioner has contributed to a multidisciplinary care plan; and

(c)   the person is referred to an eligible exercise physiologist by the medical practitioner using a referral form that has been issued by the Department, or a referral form that contains all the components of the form issued by the Department; and

(d)  the service is provided to the person individually and in person; and

(e)   the service is of at least 45 minutes duration; and

(f)   after the service, the eligible exercise physiologist gives a written report to the referring medical practitioner mentioned in paragraph (c);

payable once in a calendar year for this or any other assessment for group services item (including services in items 81100, 81110 and 81120 or items 93284 or 93286 of the Telehealth and Telephone Determination)

Fee: $87.95 Benefit: 85% = $74.80

(See para MN.9.1, MN.9.2, MN.9.3, MN.9.4, MN.9.6 of explanatory notes to this Category)

Exercise physiology health service provided to a person by an eligible exercise physiologist, as a group service for the management of type 2 diabetes if:

(a)   the person has been assessed as suitable for a type 2 diabetes group service under assessment item 81100, 81110 or 81120 or items 93284 or 93286 of the Telehealth and Telephone Determination; and

(b)  the service is provided to a person who is part of a group of between 2 and 12 patients; and

(c)   the service is provided in person; and

(d)  the service is of at least 60 minutes duration; and

(e)   after the last service in the group services program provided to the person under item 81105, 81115 or 81125 or item 93285 of the Telehealth and Telephone Determination, the eligible exercise physiologist prepares, or contributes to, a written report to be provided to the referring medical practitioner; and

(f)   an attendance record for the group is maintained by the eligible exercise physiologist;

to a maximum of 8 group services in a calendar year (including services in items 81105, 81115 and 81125 or item 93285 of the Telehealth and Telephone Determination)

Fee: $21.90 Benefit: 85% = $18.65

(See para MN.9.1, MN.9.3, MN.9.5, MN.9.6 of explanatory notes to this Category)

Phone attendance by an eligible dietitian to provide a dietetics health service to a person for assessing the person’s suitability for group services for the management of type 2 diabetes, including taking a comprehensive patient history, identifying an appropriate group services program based on the patient’s needs and preparing the person for the group services if:

(a) the person has type 2 diabetes; and

(b) the person is being managed by a medical practitioner (including a general practitioner, but not a specialist or consultant physician) under a GP management plan or, if the person is a resident of an aged care facility, the person’s medical practitioner has contributed to a multidisciplinary care plan; and

(c) the person is referred to an eligible dietitian by the medical practitioner using a referral form that has been issued by the Department, or a referral form that contains all the components of the form issued by the Department; and

(d) the service is provided to the person individually; and

(e) the service is of at least 45 minutes duration; and

(f) after the service, the eligible dietitian gives a written report to the referring medical practitioner mentioned in paragraph (c);

payable once in a calendar year for this or any other assessment for group services item (including services to which this item, item 92384, or in items 81100, 81110 and 81120 of the Allied Health Determination apply)

Fee: $87.95 Benefit: 85% = $74.80

(See para MN.9.2, MN.9.3, MN.9.4, MN.9.6 of explanatory notes to this Category)

Dietetics health service provided to a person by an eligible dietitian for assessing the person’s suitability for group services for the management of type 2 diabetes, including taking a comprehensive patient history, identifying an appropriate group services program based on the patient’s needs and preparing the person for the group services if:

(a)   the person has type 2 diabetes; and

(b)  the person is being managed by a medical practitioner (including a general practitioner, but not a specialist or consultant physician) under a GP Management Plan or, if the person is a resident of an aged care facility, the person’s medical practitioner has contributed to a multidisciplinary care plan; and

(c)   the person is referred to an eligible dietitian by the medical practitioner using a referral form that has been issued by the Department, or a referral form that contains all the components of the form issued by the Department; and

(d)  the service is provided to the person individually and in person; and

(e)   the service is of at least 45 minutes duration; and

(f)   after the service, the eligible dietitian gives a written report to the referring medical practitioner mentioned in paragraph (c);

payable once in a calendar year for this or any other assessment for group services item (including services in items 81100, 81110 and 81120 or items 93284 or 93286 of the Telehealth and Telephone Determination)

Fee: $87.95 Benefit: 85% = $74.80

(See para MN.9.1, MN.9.2, MN.9.3, MN.9.4, MN.9.6 of explanatory notes to this Category)

Dietetics health service provided to a person by an eligible dietitian, as a group service for the management of type 2 diabetes if:

(a)   the person has been assessed as suitable for a type 2 diabetes group service under assessment item 81100, 81110 or 81120 or items 93284 or 93286 of the Telehealth and Telephone Determination; and

(b)  the service is provided to a person who is part of a group of between 2 and 12 patients; and

(c)   the service is provided in person; and

(d)  the service is of at least 60 minutes duration; and

(e)   after the last service in the group services program provided to the person under item 81105, 81115 or 81125 or item 93285 of the Telehealth and Telephone Determination, the eligible dietitian prepares, or contributes to, a written report to be provided to the referring medical practitioner; and

(f)   an attendance record for the group is maintained by the eligible dietitian;

to a maximum of 8 group services in a calendar year (including services to which items 81105, 81115 and 81125 or item 93285 of the Telehealth and Telephone Determination apply)

Fee: $21.90 Benefit: 85% = $18.65

(See para MN.9.1, MN.9.3, MN.9.5, MN.9.6 of explanatory notes to this Category)