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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 under the age of 16 or is a concessional beneficiary; and

(e) the person 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: $12.25 Benefit: 85% = $10.45

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

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