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Professional attendance on a patient by a consultant physician practising in the consultant physician’s specialty of psychiatry if:

(a) the attendance is by video conference; and

(b) except for the requirement for the attendance to be at consulting rooms—item 291, 293, 296, 300, 302, 304, 306, 308, 310, 312, 314, 316, 318 or 319 would otherwise apply to the attendance; and

(c) the patient is not an admitted patient; and

(d) the patient is bulk‑billed; and

(e) the patient:

(i) is located:

(A) within a Modified Monash 2, 3, 4, 5, 6 or 7 area; and

(B) at the time of the attendance—at least 15 km by road from the physician; or

(ii) is a care recipient in a residential aged care facility; or

(iii) is a patient of:

(A) an Aboriginal medical service; or

(B) an Aboriginal community controlled health service;

                for which a direction made under subsection 19(2) of the Act applies

 

50% of the fee for item 291, 293, 296, 300, 302, 304, 306, 308, 310, 312, 314, 316, 318, 319, 341, 343, 345, 347 or 349
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Management of labour and birth, or birth alone, (including caesarean section), on or after 23 weeks gestation, if in the course of antenatal supervision or intrapartum management one or more of the following conditions is present, including postnatal care for 7 days:

(a) fetal loss;

(b) multiple pregnancy;

(c) antepartum haemorrhage that is:

(i) of greater than 200 ml; or

(ii) associated with disseminated intravascular coagulation;

(d) placenta praevia on ultrasound in the third trimester with the placenta within 2 cm of the internal cervical os;

(e) baby with a birth weight less than or equal to 2,500 g;

(f) trial of vaginal birth in a patient with uterine scar where there has been a planned vaginal birth after caesarean section;

(g) trial of vaginal breech birth where there has been a planned vaginal breech birth;

(h) prolonged labour greater than 12 hours with partogram evidence of abnormal cervimetric progress as evidenced by cervical dilatation at less than 1 cm/hr in the active phase of labour (after 3 cm cervical dilatation and effacement until full dilatation of the cervix);

(i) acute fetal compromise evidenced by:

(i) scalp pH less than 7.15; or

(ii) scalp lactate greater than 4.0;

(j) acute fetal compromise evidenced by at least one of the following significant cardiotocograph abnormalities:

(i) prolonged bradycardia (less than 100 bpm for more than 2 minutes);

(ii) absent baseline variability (less than 3 bpm);

(iii) sinusoidal pattern;

(iv) complicated variable decelerations with reduced (3 to 5 bpm) or absent baseline variability;

(v) late decelerations;

(k) pregnancy induced hypertension of at least 140/90 mm Hg associated with:

(i) at least 2+ proteinuria on urinalysis; or

(ii) protein-creatinine ratio greater than 30 mg/mmol; or

(iii) platelet count less than 150 x 10⁹/L; or

(iv) uric acid greater than 0.36 mmol/L;

(l) gestational diabetes mellitus requiring at least daily blood glucose monitoring;

(m) mental health disorder (whether arising prior to pregnancy, during pregnancy or postpartum) that is demonstrated by:

(i) the patient requiring hospitalisation; or

(ii) the patient receiving ongoing care by a psychologist or psychiatrist to treat the symptoms of a mental health disorder; or

(iii) the patient having a GP mental health treatment plan; or

(iv) the patient having a management plan prepared in accordance with item 291;

(n) disclosure or evidence of domestic violence;

(o) any of the following conditions either diagnosed pre-pregnancy or evident at the first antenatal visit before 20 weeks gestation:

(i) pre-existing hypertension requiring antihypertensive medication prior to pregnancy;

(ii) cardiac disease (co-managed with a specialist physician and with echocardiographic evidence of myocardial dysfunction);

(iii) previous renal or liver transplant;

(iv) renal dialysis;

(v) chronic liver disease with documented oesophageal varices;

(vi) renal insufficiency in early pregnancy (serum creatinine greater than 110 mmol/L);

(vii) neurological disorder that confines the patient to a wheelchair throughout pregnancy;

(viii) maternal height of less than 148 cm;

(ix) a body mass index greater than or equal to 40;

(x) pre-existing diabetes mellitus on medication prior to pregnancy;

(xi) thyrotoxicosis requiring medication;

(xii) previous thrombosis or thromboembolism requiring anticoagulant therapy through pregnancy and the early puerperium;

(xiii) thrombocytopenia with platelet count of less than 100,000 prior to 20 weeks gestation;

(xiv) HIV, hepatitis B or hepatitis C carrier status positive;

(xv) red cell or platelet iso-immunisation;

(xvi) cancer with metastatic disease;

(xvii) illicit drug misuse during pregnancy

(Anaes.)

Fee: $1,793.40 Benefit: 75% = $1,345.05

(See para TN.4.7 of explanatory notes to this Category)

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Telehealth attendance lasting more than 45 minutes by a consultant physician in the practice of the consultant physician’s specialty of psychiatry, if:

(a)    the attendance follows referral of the patient to the consultant, by a medical practitioner in general practice (including a general practitioner, but not a specialist or consultant physician) or a participating nurse practitioner for an assessment or management; and

(b)    during the attendance, the consultant:

(i)     if it is clinically appropriate to do so—uses an appropriate outcome tool; and

(ii)   carries out a mental state examination; and

(iii)  undertakes a comprehensive diagnostic assessment; and

(c)    the consultant decides that it is clinically appropriate for the patient to be managed by the referring practitioner without ongoing management by the consultant and

(d)    within 2 weeks after the attendance, the consultant prepares and gives the referring practitioner a written report, which includes:

(i)     a comprehensive diagnostic assessment of the patient; and

(ii)   a management plan for the patient for the next 12 months for the patient that comprehensively evaluates the patient’s biopsychosocial factors and makes recommendations to the referring practitioner to manage the patient’s ongoing care in a biopsychosocial model; and

(e)    if clinically appropriate, the consultant explains the diagnostic assessment and management plan, and a gives a copy, to:

(i)     the patient; and

(ii)   the patient’s carer (if any), if the patient agrees; and

(f)     in the preceding 12 months, a service to which this item or item 291 of the general medical services table applies has not been provided

Fee: $505.70 Benefit: 85% = $429.85

(See para AN.0.30, AN.0.75, AN.0.76 of explanatory notes to this Category)

Extended Medicare Safety Net Cap: $500.00

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Telehealth attendance lasting more than 30 minutes, but not more than 45 minutes, by a consultant physician in the practice of the consultant physician’s specialty of psychiatry, if:

(a)    the patient is being managed by a medical practitioner or a participating nurse practitioner in accordance with a management plan prepared by the consultant in accordance with item 291 or 92435; and

(b)    the attendance follows referral of the patient to the consultant, by the medical practitioner or participating nurse practitioner managing the patient, for review of the management plan and the associated comprehensive diagnostic assessment; and

(c)    during the attendance, the consultant:

(i)     if it is clinically appropriate to do so—uses an appropriate outcome tool; and

(ii)   carries out a mental state examination; and

(iii)  reviews the comprehensive diagnostic assessment and undertakes additional assessment as required; and

(iv)  reviews the management plan; and

(d)    within 2 weeks after the attendance, the consultant prepares and gives to the referring practitioner a written report, which includes:

(i)     a revised comprehensive diagnostic assessment of the patient; and

(ii)   a revised management plan including updated recommendations to the referring practitioner to manage the patient’s ongoing care in a biopsychosocial model; and

(e)    if clinically appropriate, the consultant explains the diagnostic assessment and the management plan, and gives a copy, to:

(i)     the patient; and

(ii)   the patient’s carer (if any), if the patient agrees; and

(f)    in the preceding 12 months, a service to which item 291 of the general medical services table or item 92435 applies has been provided; and

(g)    in the preceding 12 months, a service to which this item or item 293 of the general medical services table applies has not been provided

Fee: $316.15 Benefit: 85% = $268.75

(See para AN.0.30 of explanatory notes to this Category)

Extended Medicare Safety Net Cap: $500.00

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