Medicare Benefits Schedule - Item 120

Professional attendance at consulting rooms or in hospital by a consultant physician in the practice of the consultant physician’s specialty (other than psychiatry) following referral of the patient to the consultant physician by a referring practitioner—minor attendance, if:

(a) during the attendance, the consultant physician determines the need to perform an operation on the patient that had not otherwise been scheduled; and

(b) the consultant physician subsequently performs the operation on the patient, on the same day; and

(c) the operation is a service to which an item in Group T8 applies; and

(d) the amount specified in the item in Group T8 as the fee for a service to which that item applies is $341.75 or more

For any particular patient, once only on the same day

Fee: $49.75 Benefit: 75% = $37.35 85% = $42.30

(See para AN.0.21 of explanatory notes to this Category)

Extended Medicare Safety Net Cap: $149.25

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A minor consultation is regarded as being a consultation in which the assessment of the patient does not require the physical examination of the patient and does not involve a substantial alteration to the patient's treatment. Examples of consultations which could be regarded as being 'minor consultations' are listed below (this is by no means an exhaustive list) :‑

-                  hospital visits where a physical examination does not result, or where only a limited examination is performed;

-                  hospital visits where a significant alteration to the therapy or overall management plan does not ensue;

-                  brief consultations or hospital visits not involving subsequent discussions regarding patient's progress with a specialist colleague or the referring practitioner.

Related Items: 119 120 131