Medicare Benefits Schedule - Item 219

Professional attendance by a prescribed medical practitioner for a period of not less than 4 hours but less than 5 hours (other than a service to which another item applies) on a patient in imminent danger of death

Fee: $585.20 Benefit: 75% = $438.90 100% = $585.20

(See para AN.7.1, AN.7.3 of explanatory notes to this Category)

Extended Medicare Safety Net Cap: $500.00

• Previous - Item 218
• Next - Item 220

Last reviewed: 1 November 2023

A prescribed medical practitioner is a medical practitioner:

(a) who is not a general practitioner (see GN.4.13), specialist or consultant physician, and

(b) who:

a. is registered under section 3GA of the Act and is practising during the period, and in the location in respect of which the medical practitioner is registered, and insofar as the circumstances specified for paragraph 19AA(3)(b) of the Act apply; or

b. is covered by an exemption under subsection 19AB(3) of the Act; or

c. first became a medical practitioner before 1 November 1996.

Related Items: 179 181 185 187 189 191 203 206 214 215 218 219 220 221 222 223 224 225 226 227 228 229 230 231 232 233 235 236 237 238 239 240 243 244 245 249 272 276 277 279 281 282 283 285 286 287 301 303 733 737 741 745 761 763 766 769 772 776 788 789 792 2197 2198 2200 90092 90093 90095 90096 90098 90183 90188 90202 90212 90215

Last reviewed: 1 November 2023

The conditions to be met before services covered by items 214-220 attract benefits are:‑

(i)     the patient must be in imminent danger of death;

(ii)    if the personal attendance is not continuous, the occasion on which the service is provided is taken to be the total time of the attendance; and

(iii)   if personal attendance on a single patient is provided by 1 or more prescribed medical practitioners (see note AN.7.1) concurrently, each practitioner may claim an attendance fee.

Note: Medicare benefits are not payable for the issue of a death certificate, although an attendance on a patient at which it is determined that life is extinct can be claimed under the appropriate attendance item. The outcome of the attendance may be that a death certificate is issued, however, Medicare benefits are only payable for the attendance component of the service.

Related Items: 214 215 218 219 220