Medicare Benefits Schedule - Note TN.4.3

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Category 3 - THERAPEUTIC PROCEDURES

TN.4.3

Antenatal Care - (Item 16500)

In addition to routine antenatal attendances covered by Item 16500 the following services, where rendered during the antenatal period, attract benefits:‑

(a) Items 16501, 16502, 16505, 16508, 16509 (but not normally before the 24th week of pregnancy), 16511, 16512, 16514, 16533, 16534 and 16600 to 16627.

(b) The initial consultation at which pregnancy is diagnosed.

(c) The first referred consultation by a specialist obstetrician when called in to advise on the pregnancy.

(d) All other services, excluding those in Category 1 and Group T4 of Category 3 not mentioned above.

(e) Treatment of an intercurrent condition not directly related to the pregnancy.

Item 16514 relates to antenatal cardiotocography in the management of high risk pregnancy.  Benefits for this service are not attracted when performed during the course of the labour and birth.

 

Related Items: 16500 16501 16502 16505 16508 16509 16511 16512 16514 16533 16534 16600 16603 16606 16609 16612 16615 16618 16621 16624 16627


Related Items

Category 3 - THERAPEUTIC PROCEDURES

16500

16500 - Additional Information

Item Start Date:
01-Dec-1991
Description Updated:
01-Nov-1995
Schedule Fee Updated:
01-Jul-2021

ANTENATAL ATTENDANCE

Fee: $49.05 Benefit: 75% = $36.80 85% = $41.70

(See para TN.4.3, TN.4.15 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

16501

16501 - Additional Information

Item Start Date:
01-Nov-2000
Description Updated:
01-Nov-2000
Schedule Fee Updated:
01-Jul-2021

EXTERNAL CEPHALIC VERSION for breech presentation, after 36 weeks where no contraindication exists, in a Unit with facilities for Caesarean Section, including pre- and post version CTG, with or without tocolysis, not being a service to which items 55718 to 55728 and 55768 to 55774 apply - chargeable whether or not the version is successful and limited to a maximum of 2 ECV's per pregnancy

Fee: $146.25 Benefit: 75% = $109.70 85% = $124.35

(See para TN.4.3, TN.4.4 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

16502

16502 - Additional Information

Item Start Date:
01-Nov-1995
Description Updated:
01-Nov-1995
Schedule Fee Updated:
01-Jul-2021

POLYHYDRAMNIOS, UNSTABLE LIE, MULTIPLE PREGNANCY, PREGNANCY COMPLICATED BY DIABETES OR ANAEMIA, THREATENED PREMATURE LABOUR treated by bed rest only or oral medication, requiring admission to hospital  each attendance that is not a routine antenatal attendance, to a maximum of 1 visit per day

Fee: $49.05 Benefit: 75% = $36.80 85% = $41.70

(See para TN.4.3 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

16505

16505 - Additional Information

Item Start Date:
01-Nov-1995
Description Updated:
01-Nov-1995
Schedule Fee Updated:
01-Jul-2021

THREATENED ABORTION, THREATENED MISCARRIAGE OR HYPEREMESIS GRAVIDARUM, requiring admission to hospital, treatment of  each attendance that is not a routine antenatal attendance

Fee: $49.05 Benefit: 75% = $36.80 85% = $41.70

(See para TN.4.3 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

16508

16508 - Additional Information

Item Start Date:
01-Nov-1995
Description Updated:
01-Nov-2017
Schedule Fee Updated:
01-Jul-2021

Pregnancy complicated by acute intercurrent infection, fetal growth restriction, threatened premature labour with ruptured membranes or threatened premature labour treated by intravenous therapy, requiring admission to hospital - each professional attendance (other than a service to which item 16533 applies) that is not a routine antenatal attendance, to a maximum of one visit per day

Fee: $49.05 Benefit: 75% = $36.80 85% = $41.70

(See para TN.4.3 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

16509

16509 - Additional Information

Item Start Date:
01-Nov-1995
Description Updated:
01-Nov-2017
Schedule Fee Updated:
01-Jul-2021

Pre-eclampsia, eclampsia or antepartum haemorrhage, treatment of - each professional attendance (other than a service to which item 16534 applies) that is not a routine antenatal attendance

Fee: $49.05 Benefit: 75% = $36.80 85% = $41.70

(See para TN.4.3 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

16511

16511 - Additional Information

Item Start Date:
01-Nov-1995
Description Updated:
01-Nov-1995
Schedule Fee Updated:
01-Jul-2021

CERVIX, purse string ligation of

(Anaes.)

Fee: $228.85 Benefit: 75% = $171.65 85% = $194.55

(See para TN.4.3 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

16512

16512 - Additional Information

Item Start Date:
01-Nov-1995
Description Updated:
01-Nov-1995
Schedule Fee Updated:
01-Jul-2021

CERVIX, removal of purse string ligature of

(Anaes.)

Fee: $66.05 Benefit: 75% = $49.55 85% = $56.15

(See para TN.4.3 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

16514

16514 - Additional Information

Item Start Date:
01-Nov-1995
Description Updated:
01-Nov-1995
Schedule Fee Updated:
01-Jul-2021

ANTENATAL CARDIOTOCOGRAPHY in the management of high risk pregnancy (not during the course of the confinement)

Fee: $38.15 Benefit: 75% = $28.65 85% = $32.45

(See para TN.4.3 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

16533

16533 - Additional Information

Item Start Date:
01-Nov-2017
Description Updated:
01-Nov-2017
Schedule Fee Updated:
01-Jul-2021

Pregnancy complicated by acute intercurrent infection, fetal growth restriction, threatened premature labour with ruptured membranes or threatened premature labour treated by intravenous therapy, requiring admission to hospital—each professional attendance lasting at least 40 minutes that is not a routine antenatal attendance, to a maximum of 3 services per pregnancy

Fee: $109.85 Benefit: 75% = $82.40

(See para TN.4.3, TN.4.14 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

16534

16534 - Additional Information

Item Start Date:
01-Nov-2017
Description Updated:
01-Nov-2017
Schedule Fee Updated:
01-Jul-2021

Pre-eclampsia, eclampsia or antepartum haemorrhage, treatment of—each professional attendance lasting at least 40 minutes that is not a routine antenatal attendance, to a maximum of 3 services per pregnancy

Fee: $109.85 Benefit: 75% = $82.40

(See para TN.4.3, TN.4.14 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

16600

16600 - Additional Information

Item Start Date:
01-Jul-1995
Description Updated:
01-Jul-1995
Schedule Fee Updated:
01-Jul-2021

INTERVENTIONAL TECHNIQUES


AMNIOCENTESIS, diagnostic

Fee: $66.05 Benefit: 75% = $49.55 85% = $56.15

(See para TN.4.3, TN.4.11 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

16603

16603 - Additional Information

Item Start Date:
01-Jul-1995
Description Updated:
01-Jul-1995
Schedule Fee Updated:
01-Jul-2021

CHORIONIC VILLUS SAMPLING, by any route

Fee: $126.80 Benefit: 75% = $95.10 85% = $107.80

(See para TN.4.3, TN.4.11 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

16606

16606 - Additional Information

Item Start Date:
01-Jul-1995
Description Updated:
01-Nov-2017
Schedule Fee Updated:
01-Jul-2021

Fetal blood sampling, using interventional techniques from umbilical cord or fetus, including fetal neuromuscular blockade and amniocentesis

(Anaes.)

Fee: $253.10 Benefit: 75% = $189.85 85% = $215.15

(See para TN.4.3, TN.4.11 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

16609

16609 - Additional Information

Item Start Date:
01-Jul-1995
Description Updated:
01-Jul-1995
Schedule Fee Updated:
01-Jul-2021

FOETAL INTRAVASCULAR BLOOD TRANSFUSION, using blood already collected, including neuromuscular blockade, amniocentesis and foetal blood sampling

(Anaes.)

Fee: $516.10 Benefit: 75% = $387.10 85% = $438.70

(See para TN.4.3, TN.4.11 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

16612

16612 - Additional Information

Item Start Date:
01-Jul-1995
Description Updated:
01-Jul-1995
Schedule Fee Updated:
01-Jul-2021

FOETAL INTRAPERITONEAL BLOOD TRANSFUSION, using blood already collected, including neuromuscular blockade, amniocentesis and foetal blood sampling - not performed in conjunction with a service described in item 16609

(Anaes.)

Fee: $406.05 Benefit: 75% = $304.55 85% = $345.15

(See para TN.4.3, TN.4.11 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

16615

16615 - Additional Information

Item Start Date:
01-Jul-1995
Description Updated:
01-Jul-1995
Schedule Fee Updated:
01-Jul-2021

FOETAL INTRAPERITONEAL BLOOD TRANSFUSION, using blood already collected, including neuromuscular blockade, amniocentesis and foetal blood sampling - performed in conjunction with a service described in item 16609

(Anaes.)

Fee: $216.30 Benefit: 75% = $162.25 85% = $183.90

(See para TN.4.3, TN.4.11 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

16618

16618 - Additional Information

Item Start Date:
01-Jul-1995
Description Updated:
01-Jul-1995
Schedule Fee Updated:
01-Jul-2021

AMNIOCENTESIS, THERAPEUTIC, when indicated because of polyhydramnios with at least 500ml being aspirated

Fee: $216.30 Benefit: 75% = $162.25 85% = $183.90

(See para TN.4.3, TN.4.11 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

16621

16621 - Additional Information

Item Start Date:
01-Jul-1995
Description Updated:
01-Jul-1995
Schedule Fee Updated:
01-Jul-2021

AMNIOINFUSION, for diagnostic or therapeutic purposes in the presence of severe oligohydramnios

Fee: $216.30 Benefit: 75% = $162.25 85% = $183.90

(See para TN.4.3, TN.4.11 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

16624

16624 - Additional Information

Item Start Date:
01-Jul-1995
Description Updated:
01-Jul-1995
Schedule Fee Updated:
01-Jul-2021

FOETAL FLUID FILLED CAVITY, drainage of

Fee: $311.25 Benefit: 75% = $233.45 85% = $264.60

(See para TN.4.3, TN.4.11 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

16627

16627 - Additional Information

Item Start Date:
01-Jul-1995
Description Updated:
01-Jul-1995
Schedule Fee Updated:
01-Jul-2021

FETO-AMNIOTIC SHUNT, insertion of, into fetal fluid filled cavity, including neuromuscular blockade and amniocentesis

Fee: $633.65 Benefit: 75% = $475.25 85% = $545.75

(See para TN.4.3, TN.4.11 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