Medicare Benefits Schedule - Item 15950

Kilovoltage planning

Simple complexity single‑field radiation therapy simulation and dosimetry for treatment planning without imaging for field setting, if:

(a) both of the following apply in relation to the simulation:

(i) localisation is based on clinical mark‑up and image‑based simulation is not required;

(ii) patient set‑up and immobilisation techniques are suitable for two‑dimensional radiation therapy treatment, with wide margins and allowance for movement; and

(b) all of the following apply in relation to the dosimetry:

(i) the planning process is required to deliver a prescribed dose to a point, either at depth or on the surface of the patient;

(ii) based on review and assessment by a radiation oncologist, the planning process does not require the differential of dose between target, organs at risk and normal tissue dose;

(iii) delineation of structures is not possible or required, and field borders will delineate the treatment volume;

(iv) doses are calculated in reference to a point, either at depth or on the surface of the patient, from tables, charts or data from a treatment planning system

Applicable once per course of treatment

Fee: $203.70 Benefit: 75% = $152.80 85% = $173.15

(See para TN.2.4 of explanatory notes to this Category)

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Multiple treatment sites at one attendance (15950)

Where patients are having more than one anatomical site treated, there must be a separate prescription for each site being planned for this to be payable for each site.

Planning validation

The final treatment plan is validated by a radiation therapist or medical physicist, using robust quality assurance processes, with the plan approved by the radiation oncologist prior to delivery.

Related Items: 15950