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Telehealth attendance by a medical practitioner (not including a general practitioner, specialist or consultant physician), for providing eating disorder psychological treatment services by a medical practitioner registered with the Chief Executive Medicare as meeting the credentialling requirements for provision of this service, and lasting at least 40 minutes in duration, for an eligible patient if treatment is clinically indicated under an eating disorder treatment and management plan

Fee: $116.90 Benefit: 100% = $116.90

Extended Medicare Safety Net Cap: $350.70

• Previous - Item 92186
• Next - Item 92194

Telehealth attendance by a general practitioner on not more than one patient on one occasion—each attendance in unsociable hours if:

(a) the attendance is requested by the patient or a responsible person in the same unbroken after‑hours period; and

(b) the patient’s medical condition requires urgent assessment.

Fee: $168.40 Benefit: 100% = $168.40

(See para AN.1.1 of explanatory notes to this Category)

Extended Medicare Safety Net Cap: $500.00

• Previous - Item 92200
• Next - Item 92211

Telehealth attendance by a medical practitioner (other than a general practitioner) on not more than one patient on one occasion—each attendance in unsociable hours if:

(a) the attendance is requested by the patient or a responsible person in the same unbroken after‑hours period; and

(b) the patient’s medical condition requires urgent assessment.

Fee: $134.60 Benefit: 100% = $134.60

Extended Medicare Safety Net Cap: $403.80

• Previous - Item 92210
• Next - Item 92422

Telehealth attendance by a consultant physician in the practice of the consultant physician’s specialty (other than psychiatry) of at least 45 minutes in duration for an initial assessment of a patient with at least 2 morbidities (which may include complex congenital, developmental and behavioural disorders) following referral of the patient to the consultant physician by a referring practitioner, if:

(a) an assessment is undertaken that covers:

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

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

     (iii) the formulation of differential diagnoses; and

(b) a consultant physician treatment and management plan of significant complexity is prepared and provided to the referring practitioner, which involves:

    (i) an opinion on diagnosis and risk assessment; and

    (ii) treatment options and decisions; and

    (iii) medication recommendations; and

(c) an attendance on the patient to which item 110, 116, 119 of the general medical services table or item 91824, 91825, 91826 or 91836 applies did not take place on the same day by the same consultant physician; and

(d) this item, or item 132 of the general medical services table, has not applied to an attendance on the patient in the preceding 12 months by the same consultant physician

Fee: $294.85 Benefit: 85% = $250.65

(See para AN.0.7, AN.40.1 of explanatory notes to this Category)

Extended Medicare Safety Net Cap: $500.00

• Previous - Item 92211
• Next - Item 92423

Telehealth attendance by a consultant physician in the practice of the consultant physician’s specialty (other than psychiatry) of at least 20 minutes in duration after the first attendance in a single course of treatment for a review of a patient with at least 2 morbidities (which may include complex congenital, developmental and behavioural disorders) 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 consultant physician treatment and management plan is provided to the referring practitioner, which involves, if appropriate:

     (i) a revised opinion on the 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 110, 116, 119 of the general medical services table or 91824, 91825, 91826 or 91836 applies did not take place on the same day by the same consultant physician; and

(d) item 132 of the general medical services table or item 92422 applied to an attendance claimed in the preceding 12 months; and

(e) the attendance under this item is claimed by the same consultant physician who claimed item 132 of the general medical services table or 92422; and

(f) this item, or item 133 of the general medical services table has not applied more than twice in any 12 month period

Fee: $147.65 Benefit: 85% = $125.55

(See para AN.0.7, AN.40.1 of explanatory notes to this Category)

Extended Medicare Safety Net Cap: $442.95

• Previous - Item 92422
• Next - Item 92434

Telehealth attendance lasting at least 45 minutes by a consultant physician in the practice of the consultant physician’s specialty of psychiatry, following referral of the patient to the consultant psychiatrist by a referring practitioner, for a patient aged under 25, if the consultant psychiatrist:

(a) undertakes, or has previously undertaken in prior attendances, a comprehensive assessment in relation to which a diagnosis of a complex neurodevelopmental disorder (such as autism spectrum disorder) is made (if appropriate, using information provided by an eligible allied health provider); and

(b) develops a treatment and management plan, which must include:

(i) documentation of the confirmed diagnosis; and

(ii) findings of any assessments performed for the purposes of formulation of the diagnosis or contribution to the treatment and management plan; and

(iii) a risk assessment; and

(iv) treatment options (which may include biopsychosocial recommendations); and

(c) provides a copy of the treatment and management plan to:

(i) the referring practitioner; and

(ii) one or more allied health providers, if appropriate, for the treatment of the patient;

(other than attendance on a patient for whom payment has previously been made under this item or item 135, 137, 139, 289, 92140, 92141 or 92142)

Applicable only once per lifetime

Fee: $294.85 Benefit: 85% = $250.65

(See para AN.0.72 of explanatory notes to this Category)

Extended Medicare Safety Net Cap: $500.00

• Previous - Item 92423
• Next - Item 92435

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 45 minutes in duration by a consultant physician in the practice of the consultant physician’s speciality of psychiatry following referral of the patient to the consultant physician by a referring practitioner:

(a) if the patient:

    (i) is a new patient for this consultant physician; or

    (ii) has not received an attendance from this consultant physician in the preceding 24 months; and

(b)  the patient has not received an attendance under this item, or item 91827 to 91831, 91837 to 91839, 92455 to 92457, 91868 to 91873, 91879 to 91881 or item 296, 297, 299, 300, 302, 304, 306 to 308, 310, 312, 314, 316, 318, 319, 320, 322, 324, 326, 328, 330, 332, 334, 336, 338, 342, 344 or 346 of the general medical services table, in the preceding 24 months

Fee: $290.85 Benefit: 85% = $247.25

(See para AN.0.25, AN.0.30, AN.0.31, AN.0.75, AN.0.76 of explanatory notes to this Category)

Extended Medicare Safety Net Cap: $500.00

• Previous - Item 92436
• Next - Item 92455

Telehealth attendance for group psychotherapy (including any associated consultations with a patient taking place on the same occasion and relating to the condition for which group therapy is conducted):

(a) of not less than 1 hour in duration; and

(b) given under the continuous direct supervision of a consultant physician in the practice of the consultant physician’s specialty of psychiatry; and

(c) involving a group of 2 to 9 unrelated patients or a family group of more than 3 patients, each of whom is referred to the consultant physician by a referring practitioner;

—each patient

Fee: $55.05 Benefit: 85% = $46.80

(See para AN.0.25 of explanatory notes to this Category)

Extended Medicare Safety Net Cap: $165.15

• Previous - Item 92437
• Next - Item 92456