Medicare Benefits Schedule - Item 15990

Proton beam dosimetry, and proton-photon comparative plan reporting, to assess eligibility for proton beam therapy via the Medical Treatment Overseas Program if:

(a) proton planning is required to calculate dose to single or multiple-target structures and requires a dose-volume histogram to complete the planning process; and

(b) the proton planning process optimises the differential between target dose, organs at risk, and normal tissue dose, based on review and assessment by a radiation oncologist; and

(c) all relevant gross tumour volumes, clinical target volumes and organs at risk are rendered as volumes and nominated with planning dose objectives; and

(d) organs at risk are nominated as planning dose constraints; and

(e) dose calculations and dose-volume histograms are generated in an inverse planned process, using a specialised calculation algorithm, with prescription and plan details approved and recorded with the plan; and

(f) a three-dimensional or four-dimensional image volume dataset is used for the relevant region to be planned and verified; and

(g) the final proton dosimetry plan is:

(i) validated by a radiation therapist and a medical physicist, using quality assurance processes; and

(ii) approved by the radiation oncologist; and

(h) a proton-photon comparative plan report is generated; and

(i) the service is bulk-billed

Fee: $7,532.80 Benefit: 75% = $5,649.60 85% = $7,428.30

• Previous - Item 15984
• Next - Item 16003