Medicare Benefits Schedule - Note AN.0.19

Last reviewed: 1 November 2023

Guidelines for the After Hours Other Medical Practitioners (AHOMPS) Program are available on the Department of Health and Aged Care website at AHOMPS Program Guidelines.

After-hours attendance items may be claimed as follows:

Items 585, 588, 591, 594, 599, 600 apply only to a professional attendance that is provided: 

-          on a public holiday;

-          on a Sunday;

-          before 8am, or after 12 noon on a Saturday;

-          before 8am, or after 6pm on any day other than a Saturday, Sunday or public holiday.

Items 5000, 5020, 5040, 5060, 5071, 5200, 5203, 5207, 5208 and 5209 apply only to a professional attendance that is provided:

-          on a public holiday;

-          on a Sunday;

-          before 8am, or after 1 pm on a Saturday;

-          before 8am, or after 8pm on any day other than a Saturday, Sunday or public holiday.

Items 5003, 5010, 5023, 5028, 5043, 5049, 5063, 5067, 5076, 5077, 5220, 5223, 5227, 5228, 5260, 5261, 5262, 5263, 5265 and 5267 apply to a professional attendance that is provided:

-          on a public holiday;

-          on a Sunday;

-          before 8am, or after 12 noon on a Saturday;

-          before 8am, or after 6pm on any day other than a Saturday, Sunday or public holiday. 

Urgent After-Hours Attendances (Items 585 - 600)

Items 585, 588, 591, 594, 599 and 600 can be used for urgent after-hours services. 

Urgent After-Hours Attendances (Items 585, 588, 591, and 594) allow for urgent attendances (other than an attendance between 11pm and 7am) in an after-hours period. 

Urgent After-Hours Attendances during Unsociable Hours (Items 599 and 600) allow for urgent attendances between 11pm and 7am in an after-hours period. 

The attendance for all these items must be requested by the patient or a responsible person during the same unbroken urgent after-hours period in which the medical service is provided.  The medical practitioner must first determine that the patient requires urgent medical assessment.

In considering the need for an urgent assessment of a patient’s condition, the practitioner may rely on information conveyed by the patient or patient’s carer, other health professionals or emergency services personnel. A record of the assessment must be completed and included in the patient’s medical record.

The MBS urgent after-hours items may be used when, on the information available to the medical practitioner, the patient’s condition requires urgent medical assessment during the after-hours period to prevent deterioration or potential deterioration in their health. Specifically, the patient’s assessment:

·         cannot be delayed until the next in-hours period; and

·         the medical practitioner must attend the patient at the patient’s location or reopen the practice rooms.

Appendix B of the Approved Medical Deputising Service (AMDS) Program Guidelines offers a useful protocol to determine whether prospective after-hours patients should be seen by a deputising medical practitioner or see their regular medical practitioner.  The Guidelines are available on the Department of Health and Aged Care website at AMDS Program Guidelines.

If the attendance is undertaken at consulting rooms, it is necessary for the practitioner to return to and specially open the consulting rooms for the attendance.

MBS Item 585 is available to medical practitioners who are:

-          listed on the Vocational Register of General Practitioners maintained by Services Australia; or

-          holders of the Fellowship of the Royal Australian College of General Practitioners (FRACGP) who participate in, and meet the requirements of the RACGP for continuing medical education and quality assurance as defined in the RACGP Continuing Professional Development Program; or

-          holders of the Fellowship of the Australian College of Rural and Remote Medicine (FACRRM) who participate in, and meet the requirements of the Australian College of Rural and Remote Medicine (ACRRM) for continuing medical education and quality assurance as defined in ACRRM's Professional Development Program; or

-          undertaking an approved placement in general practice as part of a training program for general practice leading to the award of the FRACGP or training recognised by the RACGP as being of an equivalent standard; or

-          undertaking an approved placement in general practice as part of a training program for general practice leading to the award of the FACRRM or training recognised by ACRRM as being of an equivalent standard.

NOTE: MBS incentives continue to be available through the After-Hours Other Medical Practitioners (AHOMPs) Program to non-vocationally recognised medical practitioners who perform after-hours attendances. MBS item 585 will be available to AHOMPs Program participants if they perform an urgent after-hours attendance as part of their employment with a full-time general practice.  

AHOMPs will not extend access to item 585 to non-vocationally recognised medical practitioners who work with an after-hours only practice or a medical deputising service (including an AMDS).

MBS Item 588 is available to non-vocationally recognised medical practitioners who are providing services (as a contractor, employee, member or otherwise) for a general practice or clinic or as part of medical deputising arrangements in Modified Monash Model Areas 2 to 7.

A locator map to identify a medical practice's Modified Monash Model Area location is on the Health Workforce Locator.

MBS item 591 is available to non-vocationally recognised medical practitioners who perform attendances for after-hours clinics or as part of deputising arrangements in Modified Monash Model Area 1. 

If more than one patient is seen on the same occasion (that is, the second and any further services are consequential to the first service) using either MBS items 585, 588 or 591. 

MBS item 594 must be used in respect of the second and subsequent services to patients attended on the same occasion.

Medical practitioners who routinely provide services to patients in the after-hours periods at consulting rooms, or who provide the services (as a contractor, employee, member or otherwise) for a general practice or clinic that routinely provides services to patients in after-hours periods at consulting rooms, will not be able to bill urgent after-hours items 585, 588, 591, 594, 599 and 600.

A routine service means a regular or habitual provision of services to patients.  This does not include ad hoc services provided after-hours in consulting rooms by a medical practitioner (excluding consultant physicians and specialists) working in a general practice or a clinic while participating in an on-call roster.

There is no change to the types of providers who can render services under the Urgent After-Hours Attendances during Unsociable Hours items (MBS items 599 and 600).  Attendances using these items must be booked during the same unbroken urgent after-hours period.

MBS item 599 continues to be available to medical practitioners who are:

-          listed on the Vocational Register of General Practitioners maintained by Services Australia; or

-          holders of the Fellowship of the Royal Australian College of General Practitioners (FRACGP) who participate in, and meet the requirements of the RACGP for continuing medical education and quality assurance as defined in the RACGP Continuing Professional Development Program; or

-          holders of the Fellowship of the Australian College of Rural and Remote Medicine (FACRRM) who participate in, and meet the requirements of the Australian College of Rural and Remote Medicine (ACRRM) for continuing medical education and quality assurance as defined in ACRRM's Professional Development Program; or

-          undertaking an approved placement in general practice as part of a training program for general practice leading to the award of the FRACGP or training recognised by the RACGP as being of an equivalent standard; or

-          undertaking an approved placement in general practice as part of a training program for general practice leading to the award of the FACRRM or training recognised by ACRRM as being of an equivalent standard non-vocationally recognised medical practitioners through the AHOMPs Program; or

-          non-vocationally recognised medical practitioners participating in the AHOMPs Program.

MBS item 600 continues to be available to non-vocationally recognised medical practitioners. 

Non-Urgent After-Hours Attendances (5000 - 5077 and 5200 - 5267)

Non-Urgent After-Hours Attendances in Consulting Rooms (Items 5000, 5020, 5040, 5060, 5071, 5200, 5203, 5207, 5208 and 5209) are to be used for non-urgent consultations at consulting rooms initiated either on a public holiday, on a Sunday, or before 8am and after 1pm on a Saturday, or before 8am and after 8pm on any other day. 

Non-Urgent After-Hours Attendances at a Place Other than Consulting Rooms (Other than a Hospital or Residential Aged Care Facility) (items 5003, 5023, 5043, 5063, 5076, 5220, 5223, 5227, 5228 and 5261) and Non-Urgent After-Hours Attendances in a Residential Aged Care Facility (Items 5010, 5028, 5049, 5067, 5077, 5260, 5262, 5263, 5265 and 5267) are to be used for non-urgent attendances on 1 or more patients on 1 occasion on a public holiday, on a Sunday, or before 8am and after 12 noon on a Saturday, or before 8am and after 6pm on any other day.

*with the exception of public holidays which fall on a Saturday

Related Items: 585 588 591 594 599 600 5000 5003 5010 5020 5023 5028 5040 5043 5049 5060 5063 5067 5071 5076 5077

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Professional attendance by a general practitioner at consulting rooms (other than a service to which another item in this Schedule applies), lasting at least 60 minutes and including any of the following that are clinically relevant:
(a) taking an extensive patient history;
(b) performing a clinical examination;
(c) arranging any necessary investigation;
(d) implementing a management plan;
(e) providing appropriate preventive health care;
for one or more health-related issues, with appropriate documentation

Fee: $227.95 Benefit: 100% = $227.95

(See para AN.0.9, AN.0.19, AN.0.74, MN.1.3, MN.1.4, MN.1.5, MN.1.6, MN.1.7, MN.1.8 of explanatory notes to this Category)

Professional attendance by a general practitioner (other than attendance at consulting rooms, a hospital or a residential aged care facility or a service to which another item in this Schedule applies), lasting at least 60 minutes and including any of the following that are clinically relevant:
(a) taking an extensive patient history;
(b) performing a clinical examination;
(c) arranging any necessary investigation;
(d) implementing a management plan;
(e) providing appropriate preventive health care;
for one or more health-related issues, with appropriate documentation—an attendance on one or more patients on one occasion—each patient

The fee for item 5071, plus $29.60 divided by the number of patients seen, up to a maximum of six patients. For seven or more patients - the fee for item 5071 plus $2.35 per patient.
Ready Reckoner

(See para AN.0.9, AN.0.11, AN.0.19, AN.0.74, MN.1.3, MN.1.4, MN.1.5, MN.1.6, MN.1.7, MN.1.8 of explanatory notes to this Category)

Professional attendance by a general practitioner, on care recipients in a residential aged care facility, other than a service to which another item in this Schedule applies, lasting at least 60 minutes and including any of the following that are clinically relevant:
(a) taking an extensive patient history;
(b) performing a clinical examination;
(c) arranging any necessary investigation;
(d) implementing a management plan;
(e) providing appropriate preventive health care;
for one or more health-related issues, with appropriate documentation—an attendance on one or more patients at one residential aged care facility on one occasion—each patient

The fee for item 5071, plus $53.25 divided by the number of patients seen, up to a maximum of six patients. For seven or more patients - the fee for item 5071 plus $3.80 per patient.
Ready Reckoner

(See para AN.0.9, AN.0.11, AN.0.15, AN.0.19, AN.0.74, MN.1.3, MN.1.4, MN.1.5, MN.1.6, MN.1.7, MN.1.8 of explanatory notes to this Category)

Professional attendance by a general practitioner at consulting rooms (other than a service to which another item in the table applies), lasting at least 20 minutes and including any of the following that are clinically relevant:

(a) taking a detailed patient history;

(b) performing a clinical examination;

(c) arranging any necessary investigation;

(d) implementing a management plan;

(e) providing appropriate preventive health care;

for one or more health-related issues, with appropriate documentation-each attendance

Fee: $95.70 Benefit: 100% = $95.70

(See para AN.0.9, AN.0.19, AN.0.74, MN.1.3, MN.1.4, MN.1.5, MN.1.6, MN.1.7, MN.1.8 of explanatory notes to this Category)

Professional attendance by a general practitioner (other than attendance at consulting rooms, a hospital or a residential aged care facility or a service to which another item in the table applies), lasting at least 20 minutes and including any of the following that are clinically relevant:

(a) taking a detailed patient history;

(b) performing a clinical examination;

(c) arranging any necessary investigation;

(d) implementing a management plan;

(e) providing appropriate preventive health care;

for one or more health-related issues, with appropriate documentation-an attendance on one or more patients on one occasion-each patient

The fee for item 5040, plus $29.60 divided by the number of patients seen, up to a maximum of six patients. For seven or more patients - the fee for item 5040 plus $2.35 per patient.
Ready Reckoner

(See para AN.0.9, AN.0.11, AN.0.19, AN.0.74, MN.1.3, MN.1.4, MN.1.5, MN.1.6, MN.1.7, MN.1.8 of explanatory notes to this Category)

Professional attendance by a general practitioner at a residential aged care facility to residents of the facility (other than a service to which another item in the table applies), lasting at least 20 minutes and including any of the following that are clinically relevant:

(a) taking a detailed patient history;

(b) performing a clinical examination;

(c) arranging any necessary investigation;

(d) implementing a management plan;

(e) providing appropriate preventive health care;

for one or more health-related issues, with appropriate documentation-an attendance on one or more patients at one residential aged care facility on one occasion-each patient

The fee for item 5040, plus $53.25 divided by the number of patients seen, up to a maximum of six patients. For seven or more patients - the fee for item 5040 plus $3.80 per patient.
Ready Reckoner

(See para AN.0.9, AN.0.11, AN.0.15, AN.0.19, AN.0.74, MN.1.3, MN.1.4, MN.1.5, MN.1.6, MN.1.7, MN.1.8 of explanatory notes to this Category)

Professional attendance by a general practitioner at consulting rooms (other than a service to which another item in the table applies), lasting at least 40 minutes and including any of the following that are clinically relevant:

(a) taking an extensive patient history;

(b) performing a clinical examination;

(c) arranging any necessary investigation;

(d) implementing a management plan;

(e) providing appropriate preventive health care;

for one or more health-related issues, with appropriate documentation-each attendance

Fee: $134.20 Benefit: 100% = $134.20

(See para AN.0.9, AN.0.19, AN.0.74, MN.1.3, MN.1.4, MN.1.5, MN.1.6, MN.1.7, MN.1.8 of explanatory notes to this Category)

Professional attendance by a general practitioner (other than attendance at consulting rooms, a hospital or a residential aged care facility or a service to which another item in the table applies), lasting at least 40 minutes and including any of the following that are clinically relevant:

(a) taking an extensive patient history;

(b) performing a clinical examination;

(c) arranging any necessary investigation;

(d) implementing a management plan;

(e) providing appropriate preventive health care;

for one or more health-related issues, with appropriate documentation-an attendance on one or more patients on one occasion-each patient

The fee for item 5060, plus $29.60 divided by the number of patients seen, up to a maximum of six patients. For seven or more patients - the fee for item 5060 plus $2.35 per patient.
Ready Reckoner

(See para AN.0.9, AN.0.11, AN.0.19, AN.0.74, MN.1.3, MN.1.4, MN.1.5, MN.1.6, MN.1.7, MN.1.8 of explanatory notes to this Category)

Professional attendance by a general practitioner at a residential aged care facility to residents of the facility (other than a service to which another item in the table applies), lasting at least 40 minutes and including any of the following that are clinically relevant:

(a) taking an extensive patient history;

(b) performing a clinical examination;

(c) arranging any necessary investigation;

(d) implementing a management plan;

(e) providing appropriate preventive health care;

for one or more health-related issues, with appropriate documentation-an attendance on one or more patients at one residential aged care facility on one occasion-each patient

The fee for item 5060, plus $53.25 divided by the number of patients seen, up to a maximum of six patients. For seven or more patients - the fee for item 5060 plus $3.80 per patient.
Ready Reckoner

(See para AN.0.9, AN.0.11, AN.0.15, AN.0.19, AN.0.74, MN.1.3, MN.1.4, MN.1.5, MN.1.6, MN.1.7, MN.1.8 of explanatory notes to this Category)

Professional 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; and

(c) if the attendance is at consulting rooms—it is necessary for the practitioner to return to, and specially open, the consulting rooms for the attendance

Fee: $174.30 Benefit: 75% = $130.75 100% = $174.30

(See para AN.0.19 of explanatory notes to this Category)

Professional 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; and

(c) if the attendance is at consulting rooms—it is necessary for the practitioner to return to, and specially open, the consulting rooms for the attendance

Fee: $139.30 Benefit: 75% = $104.50 100% = $139.30

(See para AN.0.19 of explanatory notes to this Category)

Professional attendance by a general practitioner at consulting rooms (other than a service to which another item in this Schedule applies), lasting at least 6 minutes and less than 20 minutes and including any of the following that are clinically relevant:
(a) taking a patient history;
(b) performing a clinical examination;
(c) arranging any necessary investigation;
(d) implementing a management plan;
(e) providing appropriate preventive health care;
for one or more health-related issues, with appropriate documentation

Fee: $55.80 Benefit: 100% = $55.80

(See para AN.0.9, AN.0.19, AN.0.74, MN.1.3, MN.1.4, MN.1.5, MN.1.6, MN.1.7, MN.1.8 of explanatory notes to this Category)

Professional attendance by a general practitioner (other than attendance at consulting rooms, a hospital or a residential aged care facility or a service to which another item in this Schedule applies), lasting at least 6 minutes and less than 20 minutes and including any of the following that are clinically relevant:
(a) taking a patient history;
(b) performing a clinical examination;
(c) arranging any necessary investigation;
(d) implementing a management plan;
(e) providing appropriate preventive health care;
for one or more health-related issues, with appropriate documentation—an attendance on one or more patients on one occasion—each patient

The fee for item 5020, plus $29.60 divided by the number of patients seen, up to a maximum of six patients. For seven or more patients - the fee for item 5020 plus $2.35 per patient.
Ready Reckoner

(See para AN.0.9, AN.0.11, AN.0.19, AN.0.74, MN.1.3, MN.1.4, MN.1.5, MN.1.6, MN.1.7, MN.1.8 of explanatory notes to this Category)

Professional attendance by a general practitioner (other than a service to which another item in this Schedule applies), on care recipients in a residential aged care facility, lasting at least 6 minutes and less than 20 minutes and including any of the following that are clinically relevant:
(a) taking a patient history;
(b) performing a clinical examination;
(c) arranging any necessary investigation;
(d) implementing a management plan;
(e) providing appropriate preventive health care;
for one or more health-related issues, with appropriate documentation—an attendance on one or more patients at one residential aged care facility on one occasion—each patient

The fee for item 5020, plus $53.25 divided by the number of patients seen, up to a maximum of six patients. For seven or more patients - the fee for item 5020 plus $3.80 per patient.
Ready Reckoner

(See para AN.0.9, AN.0.11, AN.0.15, AN.0.19, AN.0.74, MN.1.3, MN.1.4, MN.1.5, MN.1.6, MN.1.7, MN.1.8 of explanatory notes to this Category)

Professional attendance by a general practitioner on one patient on one occasion—each attendance (other than an attendance in unsociable hours) in an after-hours period 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; and

(c) if the attendance is at consulting rooms—it is necessary for the practitioner to return to, and specially open, the consulting rooms for the attendance

Fee: $147.90 Benefit: 75% = $110.95 100% = $147.90

(See para AN.0.19 of explanatory notes to this Category)

Professional attendance by a medical practitioner (other than a general practitioner) on one patient on one occasion—each attendance (other than an attendance in unsociable hours) in an after-hours period 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; and

(c) the attendance is in an after-hours rural area; and

(d) if the attendance is at consulting rooms—it is necessary for the practitioner to return to, and specially open, the consulting rooms for the attendance

Fee: $147.90 Benefit: 75% = $110.95 100% = $147.90

(See para AN.0.19 of explanatory notes to this Category)

Professional attendance by a medical practitioner (other than a general practitioner) on one patient on one occasion—each attendance (other than an attendance in unsociable hours) in an after-hours period 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; and

(c) the attendance is not in an after-hours rural area; and

(d) if the attendance is at consulting rooms—it is necessary for the practitioner to return to, and specially open, the consulting rooms for the attendance

Fee: $102.55 Benefit: 75% = $76.95 100% = $102.55

(See para AN.0.19 of explanatory notes to this Category)

Professional attendance by a medical practitioner—each additional patient at an attendance that qualifies for item 585, 588 or 591 in relation to the first patient

Fee: $47.80 Benefit: 75% = $35.85 100% = $47.80

(See para AN.0.19 of explanatory notes to this Category)

Professional attendance at consulting rooms (other than a service to which another item applies) by a general practitioner for an obvious problem characterised by the straightforward nature of the task that requires a short patient history and, if required, limited examination and management-each attendance

Fee: $33.00 Benefit: 100% = $33.00

(See para AN.0.9, AN.0.19, AN.0.74, MN.1.3, MN.1.4, MN.1.5, MN.1.6, MN.1.7, MN.1.8 of explanatory notes to this Category)

Professional attendance by a general practitioner (other than attendance at consulting rooms, a hospital or a residential aged care facility or a service to which another item in the table applies) that requires a short patient history and, if necessary, limited examination and management-an attendance on one or more patients on one occasion-each patient

The fee for item 5000, plus $29.60 divided by the number of patients seen, up to a maximum of six patients. For seven or more patients - the fee for item 5000 plus $2.35 per patient.
Ready Reckoner

(See para AN.0.9, AN.0.11, AN.0.19, AN.0.74, MN.1.3, MN.1.4, MN.1.5, MN.1.6, MN.1.7, MN.1.8 of explanatory notes to this Category)

Professional attendance (other than a service to which another item applies) at a residential aged care facility (other than a professional attendance at a self-contained unit) or professional attendance at consulting rooms situated within such a complex, if the patient is accommodated in a residential aged care facility (other than accommodation in a self-contained unit) by a general practitioner for an obvious problem characterised by the straightforward nature of the task that requires a short patient history and, if required, limited examination and management-an attendance on one or more patients at one residential aged care facility on one occasion-each patient

The fee for item 5000, plus $53.25 divided by the number of patients seen, up to a maximum of six patients. For seven or more patients - the fee for item 5000 plus $3.80 per patient.
Ready Reckoner

(See para AN.0.9, AN.0.11, AN.0.15, AN.0.19, AN.0.74, MN.1.3, MN.1.4, MN.1.5, MN.1.6, MN.1.7, MN.1.8 of explanatory notes to this Category)