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Professional attendance by a general practitioner, specialist or consultant physician for a period of not less than 4 hours but less than 5 hours (other than a service to which another item applies) on a patient in imminent danger of death

Fee: $731.50 Benefit: 75% = $548.65 100% = $731.50

(See para AN.0.27 of explanatory notes to this Category)

Extended Medicare Safety Net Cap: $500.00

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Professional attendance by a general practitioner, specialist or consultant physician for a period of 5 hours or more (other than a service to which another item applies) on a patient in imminent danger of death

Fee: $812.75 Benefit: 75% = $609.60 100% = $812.75

(See para AN.0.27 of explanatory notes to this Category)

Extended Medicare Safety Net Cap: $500.00

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Professional attendance for the purpose of group therapy of not less than 1 hour in duration given under the direct continuous supervision of a general practitioner, specialist or consultant physician (other than a consultant physician in the practice of the consultant physician's specialty of psychiatry) involving members of a family and persons with close personal relationships with that family-each group of 2 patients

Fee: $129.40 Benefit: 75% = $97.05 100% = $129.40

(See para AN.0.5, AN.0.28 of explanatory notes to this Category)

Extended Medicare Safety Net Cap: $388.20

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Professional attendance for the purpose of group therapy of not less than 1 hour in duration given under the direct continuous supervision of a general practitioner, specialist or consultant physician (other than a consultant physician in the practice of the consultant physician's specialty of psychiatry) involving members of a family and persons with close personal relationships with that family-each group of 3 patients

Fee: $136.35 Benefit: 75% = $102.30 100% = $136.35

(See para AN.0.5, AN.0.28 of explanatory notes to this Category)

Extended Medicare Safety Net Cap: $409.05

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Professional attendance for the purpose of group therapy of not less than 1 hour in duration given under the direct continuous supervision of a general practitioner, specialist or consultant physician (other than a consultant physician in the practice of the consultant physician's specialty of psychiatry) involving members of a family and persons with close personal relationships with that family-each group of 4 or more patients

Fee: $165.90 Benefit: 75% = $124.45 100% = $165.90

(See para AN.0.5, AN.0.28 of explanatory notes to this Category)

Extended Medicare Safety Net Cap: $497.70

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Professional attendance on a patient who is 30 years of age or over for a heart health assessment by a medical practitioner at consulting rooms (other than a specialist or consultant physician) lasting at least 20 minutes and including:

(a) collection of relevant information, including taking a patient history; and

(b) a basic physical examination, which must include recording blood pressure and cholesterol; and

(c) initiating interventions and referrals as indicated; and

(d) implementing a management plan; and

(e) providing the patient with preventative health care advice and information.

Fee: $64.10 Benefit: 100% = $64.10

(See para AN.14.2 of explanatory notes to this Category)

Extended Medicare Safety Net Cap: $192.30

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Professional attendance by a prescribed medical practitioner at consulting rooms or in a place other than a hospital or a residential aged care facility, for a health assessment of a patient who is of Aboriginal or Torres Strait Islander descent—applicable not more than once in a 9 month period and only if the following items are not applicable within the same 9 month period:
(a) item 715;
(b) item 92004 or 92011 of the Telehealth and Telephone Determination

Fee: $186.90 Benefit: 100% = $186.90

(See para AN.7.1, AN.7.13, AN.7.14, AN.7.15, AN.7.16 of explanatory notes to this Category)

Extended Medicare Safety Net Cap: $500.00

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Professional attendance lasting more than 45 minutes at consulting rooms 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 to the referring practitioner a written report, which includes:

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

(ii) a management plan for the patient for the next 12 months 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 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 92435 applies has not been provided to the patient

Fee: $505.70 Benefit: 85% = $429.85

(See para AN.0.30, AN.0.32, AN.0.75, AN.0.76, AN.40.1 of explanatory notes to this Category)

Extended Medicare Safety Net Cap: $500.00

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Attendance by a general practitioner, specialist or consultant physician as a member of a case conference team, to lead and coordinate a multidisciplinary case conference on a patient with cancer to develop a multidisciplinary treatment plan, if the case conference is of at least 10 minutes, with a multidisciplinary team of at least 3 other medical practitioners from different areas of medical practice (which may include general practice), and, in addition, allied health providers

Fee: $89.70 Benefit: 75% = $67.30 85% = $76.25

(See para AN.0.65 of explanatory notes to this Category)

Extended Medicare Safety Net Cap: $269.10

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Attendance by a general practitioner, specialist or consultant physician as a member of a case conference team, to participate in a multidisciplinary case conference on a patient with cancer to develop a multidisciplinary treatment plan, if the case conference is of at least 10 minutes, with a multidisciplinary team of at least 4 medical practitioners from different areas of medical practice (which may include general practice), and, in addition, allied health providers

Fee: $41.80 Benefit: 75% = $31.35 85% = $35.55

(See para AN.0.65 of explanatory notes to this Category)

Extended Medicare Safety Net Cap: $125.40

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