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A medical service to which an item in this Schedule (other than this item) applies, if:

(a) the service is an unreferred service; and

(b) the service is provided to a person who is not an admitted patient of a hospital; and

(d) the service is bulk-billed in relation to the fees for:

(i) this item; and

(ii) any other item in this Schedule applying to the service;

other than a service associated with a service:

(e) to which another item in this Group applies; or

(f) that is a general practice support service; or

(g) that is a MyMedicare service

Fee: $8.60 Benefit: 85% = $7.35

(See para MN.1.1, MN.1.3 of explanatory notes to this Category)

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A medical service to which an item in this Schedule (other than this item) applies, if:

(a) the service is an unreferred service; and

(b) the service is provided to a person who is not an admitted patient of a hospital; and

(d) the service is bulk-billed in relation to the fees for:

(i) this item; and

(ii) any other item in this Schedule applying to the service; and

(e) the service is provided at, or from, a practice location in a Modified Monash 2 area;

other than a service associated with a service:

(f) to which another item in this Group applies; or

(g) that is a general practice support service; or

(h) that is a MyMedicare service

Fee: $13.00 Benefit: 85% = $11.05

(See para MN.1.1, MN.1.4 of explanatory notes to this Category)

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A medical service to which:

(a) item 585, 588, 591, 594, 599, 600, 5003, 5010, 5220 or 5260 applies; or

(b) item 761 or 772 applies (see the Health Insurance (Section 3C General Medical Services – Other Medical Practitioner) Determination 2018);

if:

(c) the service is an unreferred service; and

(d) the service is provided to a person who is not an admitted patient of a hospital; and

(f) the service is not provided in consulting rooms; and

(g) the service is provided in any of the following areas:

(i) a Modified Monash 2 area;

(ii) a Modified Monash 3 area;

(iii) a Modified Monash 4 area;

(iv) a Modified Monash 5 area;

(v) a Modified Monash 6 area;

(vi) a Modified Monash 7 area; and

(h) the service is provided by, or on behalf of, a medical practitioner whose practice location is not in an area mentioned in paragraph (g); and

(i) the service is bulk‑billed in relation to the fees for:

(i) this item; and

(ii) the other item mentioned in paragraph (a) or (b) applying to the service

Fee: $13.00 Benefit: 85% = $11.05

(See para MN.1.1, MN.1.3, MN.1.4 of explanatory notes to this Category)

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Service provided by a practice nurse or an Aboriginal and Torres Strait Islander health practitioner to a person with a chronic condition, if:

(a) the service is provided on behalf of and under the supervision of a medical practitioner; and

(b) the person is not an admitted patient of a hospital; and

(c) the person has in place:

(i) a GP chronic condition management plan that has been prepared or reviewed in the last 18 months; or

(ii) until the end of 30 June 2027—a GP management plan, or team care arrangements, prepared before 1 July 2025; or

(iii) a multidisciplinary care plan; and

(d) the service is consistent with the plan or arrangements

Applicable up to a total of 5 services to which this item, item 92301 or item 93203 applies in a calendar year

Fee: $14.00 Benefit: 100% = $14.00

(See para AN.14.3, AN.15.3, AN.15.5, MN.12.4 of explanatory notes to this Category)

Extended Medicare Safety Net Cap: $42.00

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