Medicare Benefits Schedule - Item 13762

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13762 - Additional Information

Item Start Date:
Description Updated:
Schedule Fee Updated:

T1 - Miscellaneous Therapeutic Procedures
8 - Haematology

Extracorporeal photopheresis for the treatment of chronic graft‑versus‑host disease, if:

(a)   the person is:

(i)      has received allogeneic haematopoietic stem cell transplantation; and

(ii)     has been diagnosed with chronic graft versus host disease following the transplantation; and

(iii)    steroid treatment is clinically unsuitable as the disease is steroid refractory or the person is steroid‑dependent or steroid‑intolerant; and

(b)   the person has previously received an extracorporeal photopheresis treatment cycle and had a partial or complete response in at least one organ in response to treatment; and

(c)   the person requires further extracorporeal photopheresis; and

(d)   the service is delivered using an integrated, closed extracorporeal photopheresis system; and

(e)   the service is provided in combination with the use of methoxsalen that is listed on the Pharmaceutical Benefits Scheme; and

(f)    the service is provided by, or on behalf of, a specialist or consultant physician who:

(i)     is practising in the speciality of haematology or oncology; and

(ii)    has experience with allogeneic bone marrow transplantation.

Applicable once per treatment session

Fee: $2,089.40 Benefit: 75% = $1,567.05 85% = $1,990.70

(See para TN.1.29 of explanatory notes to this Category)

Associated Notes



Extracorporeal Photopheresis (ECP) for Chronic Graft Versus Host Disease (cGVHD)

For the purpose of administering MBS item 13761 the phrase ‘treatment cycle’ usually refers to a 12-week time period and item 13762 usually refers to a 6-week time period. A ‘treatment session’ is an attendance for ECP, which occurs two or three times per week.  

A cycle of treatment funded under item 13762 can be preceded by a cycle funded by either item 13761 or by item 13762, provided at least a partial organ response occurs. A response, for the purposes of administering MBS item 13762, is defined as attaining a complete or partial response in at least one organ according to National Institutes of Health (NIH) criteria. A response only needs to be demonstrated after the first 12 weeks of treatment.


Patient Requirements

For the purpose of administering MBS item 13761 and item 13762, steroid-refractory or steroid-dependent disease is defined as one of the following:

  1. A lack of response or disease progression after a minimum of prednisone 1 mg/kg/day or equivalent for at least 1 week, OR
  2. Disease persistence without improvement despite continued treatment with prednisone at > 0.5 mg/kg/day or 1 mg/kg every day or equivalent other day for at least 4 weeks, OR
  3. Increase to prednisolone dose to > 0.25 mg/kg/day or equivalent after 2 unsuccessful attempts to taper the dose.

Related Items: 13761 13762


  • Assist - Addition/Deletion of (Assist.)
  • Amend - Amended Description
  • Anaes - Anaesthetic Values Amended
  • Emsn - EMSN Change
  • Fee - Fee Amended
  • Renum - Item Number Change (renumbered)
  • New - New Item
  • NewMin - New Item (previous Ministerial Determination)
  • Qfe - QFE Change