Search the MBS

Postnatal telehealth attendance (other than a service to which any other item applies) if:

(a)   the attendance is rendered by:

(i)    a practice midwife (on behalf of and under the supervision of the medical practitioner who attended the birth); or

(ii)   an obstetrician; or

(iii)  a general practitioner; and

(b)   is between 1 week and 4 weeks after the birth; and

(c)   lasts at least 20 minutes; and

(d)   is for a patient who was privately admitted for the birth; and

(e)   is for a pregnancy in relation to which a service to which item 82130, 82135 or 82140 of the Health Insurance (Midwife and Nurse Practitioner) Determination 2015 or item 91214, 91215, 91221 or 91222 is not provided.

Applicable once for a pregnancy

Fee: $58.80 Benefit: 85% = $50.00

Extended Medicare Safety Net Cap: $38.25

• Previous - Item 91851
• Next - Item 91853

Antenatal phone service provided by a practice midwife, nurse or an Aboriginal and Torres Strait Islander health practitioner, to a maximum of 10 services per pregnancy, if:

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

(b)     the service is not performed in conjunction with another antenatal attendance item in Group T4 for the same patient on the same day by the same practitioner.

Fee: $30.00 Benefit: 85% = $25.50

Extended Medicare Safety Net Cap: $13.10

• Previous - Item 91853
• Next - Item 91856

Postnatal phone attendance (other than a service to which any other item applies) if:

(a)   the attendance is rendered by:

(i)    a practice midwife (on behalf of and under the supervision of the medical practitioner who attended the birth); or

(ii)   an obstetrician; or

(iii)  a general practitioner; and

(b)   is between 1 week and 4 weeks after the birth; and

(c)   lasts at least 20 minutes; and

(d)   is for a patient who was privately admitted for the birth; and

(e)   is for a pregnancy in relation to which a service to which item 82130, 82135 or 82140 of the Health Insurance (Midwife and Nurse Practitioner) Determination 2015 or item 91214, 91215, 91221 or 91222 is not provided.

Applicable once for a pregnancy

Fee: $58.80 Benefit: 85% = $50.00

Extended Medicare Safety Net Cap: $38.25

• Previous - Item 91856
• Next - Item 91858

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

• Previous - Item 92434
• Next - Item 92436

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

• Previous - Item 92435
• Next - Item 92437

Telehealth attendance of more than 60 minutes in duration 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 (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) all relevant 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, 119 of the general medical services table or item, 91822, 91823, 91833, 91824, 91825, 91826 or 91836 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 of the general medical services table applies has not been provided to the patient by the same practitioner in the preceding 12 months

Fee: $505.70 Benefit: 85% = $429.85

Extended Medicare Safety Net Cap: $500.00

• Previous - Item 92618
• Next - Item 92624

Telehealth attendance of more than 30 minutes in duration 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, 92623 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, 92623 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, 119 of the general medical services table or item 91822, 91823, 91833, 91824, 91825, 91826 or 91836 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 of the general medical services table or item 92623 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 of the general medical services table 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: 85% = $268.75

Extended Medicare Safety Net Cap: $500.00

• Previous - Item 92623
• Next - Item 92701

Telehealth attendance provided to a person who is of Aboriginal or Torres Strait Islander descent by an eligible allied health practitioner if:

(a) a medical practitioner has undertaken a health assessment and identified a need for follow‑up allied health services; or

(b) the patient has:

(i) a chronic condition; and

(ii) complex care needs being managed by a medical practitioner (other than a specialist or consultant physician) under both a GP Management Plan and Team Care Arrangements or, if the patient is a resident of an aged care facility, the patient’s medical practitioner has contributed to a multidisciplinary care plan; and

(iii) the service is recommended in the patient’s Team Care Arrangements or multidisciplinary care plan as part of the management of the patient’s chronic condition and complex care needs; and

(c) the person is referred to the eligible allied health practitioner by a medical practitioner using a referral form issued by the Department or a referral form that contains all the components of the form issued by the Department; and

(d) the service is provided to the person individually; and

(e) the service is of at least 20 minutes duration; and

(f) after the service, the eligible allied health practitioner gives a written report to the referring medical practitioner mentioned in paragraph (b):

(i) if the service is the only service under the referral—in relation to that service; or

(ii) if the service is the first or the last service under the referral—in relation to that service; or

(iii) if neither subparagraph (i) nor (ii) applies but the service involves matters that the referring medical practitioner would reasonably expect to be informed of—in relation to those matters;

to a maximum of 10 services (including any services to which this item or 93000, 93013 or 93061 or any item in Subgroup 1 of Group M3 or any item in Group M11 of the Allied Health Determination applies) in a calendar year

Fee: $68.55 Benefit: 75% = $51.45 85% = $58.30

(See para MN.11.1 of explanatory notes to this Category)

Extended Medicare Safety Net Cap: $205.65

• Previous - Item 93044
• Next - Item 93061

Phone attendance provided to a person who is of Aboriginal or Torres Strait Islander descent by an eligible allied health practitioner if:

(a) a medical practitioner has undertaken a health assessment and identified a need for follow‑up allied health services; or

(b) the patient has

(i) a chronic condition; and

(ii) complex care needs being managed by a medical practitioner (other than a specialist or consultant physician) under both a GP Management Plan and Team Care Arrangements or, if the patient is a resident of an aged care facility, the patient’s medical practitioner has contributed to a multidisciplinary care plan; and

(iii) the service is recommended in the patient’s Team Care Arrangements or multidisciplinary care plan as part of the management of the patient’s chronic condition and complex care needs; and

(c) the person is referred to the eligible allied health practitioner by a medical practitioner using a referral form issued by the Department or a referral form that contains all the components of the form issued by the Department; and

(d) the service is provided to the person individually; and

(e) the service is of at least 20 minutes duration; and

(f) after the service, the eligible allied health practitioner gives a written report to the referring medical practitioner mentioned in paragraph (b):

(i) if the service is the only service under the referral—in relation to that service; or

(ii) if the service is the first or the last service under the referral—in relation to that service; or

(iii)  if neither subparagraph (i) nor (ii) applies but the service involves matters that the referring medical practitioner would reasonably expect to be informed of—in relation to those matters;

to a maximum of 10 services (including any services to which this item or item 93000, 93013, 93048 or any item in Subgroup 1 of Group M3 or any item in Group M11 of the Allied Health Determination applies) in a calendar year

Fee: $68.55 Benefit: 85% = $58.30

(See para MN.11.1 of explanatory notes to this Category)

Extended Medicare Safety Net Cap: $205.65

• Previous - Item 93048
• Next - Item 93074

Follow‑up telehealth attendance provided by a practice nurse or an Aboriginal and Torres Strait Islander health practitioner, on behalf of a medical practitioner, for an Indigenous person who has received a health check if:

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

(b) the service is consistent with the needs identified through the health assessment.

Fee: $31.00 Benefit: 85% = $26.35

Extended Medicare Safety Net Cap: $93.00

• Previous - Item 93137
• Next - Item 93201