Medicare Benefits Schedule - Item 14249

Extracorporeal photopheresis for the continuing treatment of erythrodermic stage III‑IVa T4 M0 cutaneous T‑cell lymphoma; if

(a) in the preceding 6 months:

(i) a service to which item 14247 applies has been provided; and

(ii) the patient has demonstrated a response to this service; and

(iii) the patient requires further treatment; and

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

(c) the patient is 18 years old or over; and

(d) the service is provided in combination with the use of Pharmaceutical Benefits Scheme‑subsidised methoxsalen; and

(e) the service is supervised by a specialist or consultant physician in the speciality of haematology.

Applicable once per treatment cycle (H)

Fee: $2,215.00 Benefit: 75% = $1,661.25

(See para TN.1.25 of explanatory notes to this Category)

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A response, for the purposes of administering MBS item 14249, is defined as attaining a reduction of at least 50% in the overall skin lesion score from baseline, for at least 4 consecutive weeks. Refer to the Product Information for methoxsalen for directions on calculating an overall skin lesion score. The definition of a clinically significant reduction in the Product Information differs to the 50% requirement for MBS-subsidy. Response only needs to be demonstrated after the first six months of treatment.

Related Items: 14249