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Related Items: 17640 17645 17650 17655

• Previous - Note TN.6.1
• Next - Note TN.6.3

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: $48.05 Benefit: 75% = $36.05 85% = $40.85

(See para AN.0.7, AN.0.25, AN.0.70, AN.2.1, AN.3.1, AN.40.1, TN.1.4 of explanatory notes to this Category)

Extended Medicare Safety Net Cap: $144.15

• Previous - Item 104
• Next - Item 106

Professional attendance of more than 60 minutes in duration at consulting rooms or hospital by a consultant physician or specialist in the practice of the consultant physician's or specialist's specialty of geriatric medicine, if:

(a) the patient is at least 65 years old and referred by a medical practitioner practising in general practice (including a general practitioner, but not including a specialist or consultant physician) or a participating nurse practitioner; and

(b) the attendance is initiated by the referring practitioner for the provision of a comprehensive assessment and management plan; and

(c) during the attendance:

     (i) the medical, physical, psychological and social aspects of the patient's health are evaluated in detail using appropriately validated assessment tools if indicated (the assessment); and

     (ii) the patient's various health problems and care needs are identified and prioritised (the formulation); and

     (iii) a detailed management plan is prepared (the management plan) setting out:

          (A) the prioritised list of health problems and care needs; and

          (B) short and longer term management goals; and

          (C) recommended actions or intervention strategies to be undertaken by the patient's general practitioner or another relevant health care provider that are likely to improve or maintain health status and are readily available and acceptable to the patient and the patient's family and carers; and

    (iv) the management plan is explained and discussed with the patient and, if appropriate, the patient's family and any carers; and

    (v) the management plan is communicated in writing to the referring practitioner; and

(d) an attendance to which item 104, 105, 107, 108, 110, 116 or 119 applies has not been provided to the patient on the same day by the same practitioner; and

(e) an attendance to which this item or item 145 applies has not been provided to the patient by the same practitioner in the preceding 12 months

Fee: $505.70 Benefit: 75% = $379.30 85% = $429.85

(See para AN.0.26, AN.40.1 of explanatory notes to this Category)

Extended Medicare Safety Net Cap: $500.00

• Previous - Item 139
• Next - Item 143

Professional attendance of more than 30 minutes in duration at consulting rooms or hospital by a consultant physician or specialist in the practice of the consultant physician's or specialist's specialty of geriatric medicine to review a management plan previously prepared by that consultant physician or specialist under item 141 or 145, if:

(a) the review is initiated by the referring medical practitioner practising in general practice or a participating nurse practitioner; and

(b) during the attendance:

     (i) the patient's health status is reassessed; and

     (ii) a management plan prepared under item 141 or 145 is reviewed and revised; and

     (iii) the revised management plan is explained to the patient and (if appropriate) the patient's family and any carers and communicated in writing to the referring practitioner; and

(c) an attendance to which item 104, 105, 107, 108, 110, 116 or 119 applies was not provided to the patient on the same day by the same practitioner; and

(d) an attendance to which item 141 or 145 applies has been provided to the patient by the same practitioner in the preceding 12 months; and

(e) an attendance to which this item or item 147 applies has not been provided to the patient in the preceding 12 months, unless there has been a significant change in the patient's clinical condition or care circumstances that requires a further review

Fee: $316.15 Benefit: 75% = $237.15 85% = $268.75

(See para AN.0.26, AN.40.1 of explanatory notes to this Category)

Extended Medicare Safety Net Cap: $500.00

• Previous - Item 141
• Next - Item 145

Professional attendance of more than 60 minutes in duration at a place other than consulting rooms or hospital by a consultant physician or specialist in the practice of the consultant physician's or specialist's specialty of geriatric medicine, if:

(a) the patient is at least 65 years old and referred by a medical practitioner practising in general practice (including a general practitioner, but not including a specialist or consultant physician) or a participating nurse practitioner; and

(b) the attendance is initiated by the referring practitioner for the provision of a comprehensive assessment and management plan; and

(c) during the attendance:

    (i) the medical, physical, psychological and social aspects of the patient's health are evaluated in detail utilising appropriately validated              assessment tools if indicated (the assessment); and

    (ii) the patient's various health problems and care needs are identified and prioritised (the formulation); and

    (iii) a detailed management plan is prepared (the management plan) setting out:

          (A) the prioritised list of health problems and care needs; and

          (B) short and longer term management goals; and

          (C) recommended actions or intervention strategies, to be undertaken by the patient's general practitioner or another relevant health                   care provider that are likely to improve or maintain health status and are readily available and acceptable to the patient, the                         patient's family and any carers; and

    (iv) the management plan is explained and discussed with the patient and, if appropriate, the patient's family and any carers; and

    (v) the management plan is communicated in writing to the referring practitioner; and

(d) an attendance to which item 104, 105, 107, 108, 110, 116 or 119 applies has not been provided to the patient on the same day by the same practitioner; and

(e) an attendance to which this item or item 141 applies has not been provided to the patient by the same practitioner in the preceding 12 months

Fee: $613.15 Benefit: 85% = $521.20

(See para AN.0.26 of explanatory notes to this Category)

Extended Medicare Safety Net Cap: $500.00

• Previous - Item 143
• Next - Item 147

Professional attendance of more than 30 minutes in duration at a place other than consulting rooms or hospital by a consultant physician or specialist in the practice of the consultant physician's or specialist's specialty of geriatric medicine to review a management plan previously prepared by that consultant physician or specialist under items 141 or 145, if:

(a) the review is initiated by the referring medical practitioner practising in general practice or a participating nurse practitioner; and

(b) during the attendance:

     (i) the patient's health status is reassessed; and

     (ii) a management plan that was prepared under item 141 or 145 is reviewed and revised; and

     (iii) the revised management plan is explained to the patient and (if appropriate) the patient's family and any carers and communicated in writing to the referring practitioner; and

(c) an attendance to which item 104, 105, 107, 108, 110, 116 or 119 applies has not been provided to the patient on the same day by the same practitioner; and

(d) an attendance to which item 141 or 145 applies has been provided to the patient by the same practitioner in the preceding 12 months; and

(e) an attendance to which this item or 143 applies has not been provided by the same practitioner in the preceding 12 months, unless there has been a significant change in the patient's clinical condition or care circumstances that requires a further review

Fee: $383.30 Benefit: 85% = $325.85

(See para AN.0.26 of explanatory notes to this Category)

Extended Medicare Safety Net Cap: $500.00

• Previous - Item 145
• Next - Item 151

Professional attendance by an addiction medicine specialist in the practice of the addiction medicine specialist's specialty of at least 45 minutes for an initial assessment of a patient with at least 2 morbidities, following referral of the patient to the addiction medicine specialist by a referring practitioner, if:

(a) an assessment is undertaken that covers:

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

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

     (iii) the formulation of differential diagnoses; and

(b) an addiction medicine specialist treatment and management plan of significant complexity that includes the following is prepared and provided to the referring practitioner:

     (i) an opinion on diagnosis and risk assessment;

     (ii) treatment options and decisions;

     (iii) medication recommendations; and

(c) an attendance on the patient to which item 104, 105, 110, 116, 119, 132, 133, 6018 or 6019 applies did not take place on the same day by the same addiction medicine specialist; and

(d) neither this item nor item 132 has applied to an attendance on the patient in the preceding 12 months by the same addiction medicine specialist

Fee: $294.85 Benefit: 75% = $221.15 85% = $250.65

Extended Medicare Safety Net Cap: $500.00

• Previous - Item 6019
• Next - Item 6024

Professional attendance by an addiction medicine specialist in the practice of the addiction medicine specialist's specialty of at least 20 minutes, after the first attendance in a single course of treatment for a review of a patient with at least 2 morbidities 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 addiction medicine specialist treatment and management plan is provided to the referring practitioner, which involves, if appropriate:

     (i) a revised opinion on 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 104, 105, 110, 116, 119, 132, 133, 6018 or 6019 applies did not take place on the same day by the same addiction medicine specialist; and

(d) item 6023 applied to an attendance claimed in the preceding 12 months; and

(e) the attendance under this item is claimed by the same addiction medicine specialist who claimed item 6023 or by a locum tenens; and

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

Fee: $147.65 Benefit: 75% = $110.75 85% = $125.55

Extended Medicare Safety Net Cap: $442.95

• Previous - Item 6023
• Next - Item 6028

Professional attendance by a sexual health medicine specialist in the practice of the sexual health medicine specialist's specialty of at least 45 minutes for an initial assessment of a patient with at least 2 morbidities, following referral of the patient to the sexual health medicine specialist by a referring practitioner, if:

(a) an assessment is undertaken that covers:

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

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

     (iii) the formulation of differential diagnoses; and

(b) a sexual health medicine specialist treatment and management plan of significant complexity that includes the following is prepared and provided to the referring practitioner:

     (i) an opinion on diagnosis and risk assessment;

     (ii) treatment options and decisions;

     (iii) medication recommendations; and

(c) an attendance on the patient to which item 104, 105, 110, 116, 119, 132, 133, 6051 or 6052 applies did not take place on the same day by the same sexual health medicine specialist; and

(d) neither this item nor item 132 has applied to an attendance on the patient in the preceding 12 months by the same sexual health medicine specialist

Fee: $294.85 Benefit: 75% = $221.15 85% = $250.65

Extended Medicare Safety Net Cap: $500.00

• Previous - Item 6052
• Next - Item 6058

Professional attendance by a sexual health medicine specialist in the practice of the sexual health medicine specialist's specialty of at least 20 minutes, after the first attendance in a single course of treatment for a review of a patient with at least 2 morbidities 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 sexual health medicine specialist treatment and management plan is provided to the referring practitioner, which involves, if appropriate:

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

      (ii) treatment options and decisions; and

      (iii) revised medication recommendations; and

(c) an attendance on the patient, being an attendance to which item 104, 105, 110, 116, 119, 132, 133, 6051 or 6052 applies did not take place on the same day by the same sexual health medicine specialist; and

(d) item 6057 applied to an attendance claimed in the preceding 12 months; and

(e) the attendance under this item is claimed by the same sexual health medicine specialist who claimed item 6057 or by a locum tenens; and

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

Fee: $147.65 Benefit: 75% = $110.75 85% = $125.55

Extended Medicare Safety Net Cap: $442.95

• Previous - Item 6057
• Next - Item 6062