Medicare Benefits Schedule - Note MN.14.19

The multiple operation rule applies where two or more operations are performed on a patient on the one occasion. It will apply if you bill MBS items 82201 and 82202 for procedures you performed on a patient on one occasion.

The fees for co-claimed items 82201 and 82202, performed on a patient on the one occasion are calculated by the following rule:

• 100% for the item with the greatest Schedule fee; plus
• 50% for the item with the next greatest Schedule fee.

Note:

(a) Fees so calculated that result in a sum which is not a multiple of 5 cents are to be taken to the next higher multiple of 5 cents.

(b) The Schedule fee for benefit purposes is the aggregate of the fees calculated in accordance with the above formula.

(c) For these purposes the term "procedure" only refers to item 82201 and 82202.

(d) 82203 is not subject to the multiple operation rule.

If MBS items 82201 and 82202 are billed for procedures performed on the same patient on the one occasion by different practitioners who do not assist each other, the rule will not apply.

Related Items: 82201 82202

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Introduction of an intra-uterine device for abnormal uterine bleeding or contraception or for endometrial protection during oestrogen replacement therapy

(Anaes.)

Fee: $215.95 Benefit: 75% = $162.00 85% = $183.60

(See para MN.14.17, MN.14.18, MN.14.19 of explanatory notes to this Category)

Removal of etonogestrel subcutaneous implant

(Anaes.)

Fee: $105.15 Benefit: 75% = $78.90 85% = $89.40

(See para MN.14.17, MN.14.18, MN.14.19 of explanatory notes to this Category)