Medicare Benefits Schedule - Item 61336

Cerebral study, with PET, if the service is performed because the service to which item 61402 applies cannot be performed due to unavailability of technetium-99m (R)

Bulk bill incentive

Fee: $605.05 Benefit: 75% = $453.80 85% = $514.30

(See para IN.4.4 of explanatory notes to this Category)

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Substitute PET items are available for use in radiopharmaceutical supply disruptions. The following items are available:

Technetium-99m: items 61333, 61336 and 61341 can be used following a valid request for a service to which items 61348, 61402, 61421 or 61425 would apply.

Gallium-67: item 61527 can be used following a valid request for a service to which items 61429, 61430, 61442, 61450 or 61453 would apply.

Thallium-201: Item 61644 can be used following a valid request for a service to which item 61325 would apply.

For substitute PET items listed above, the following conditions must also be met:

1. the requested service is not available due to a supply disruption of the relevant radioisotope; and
2. the patient’s clinical condition requires the service to be performed before the resumption of normal radioisotope supply is anticipated by the practitioner who provides the service; and
3. the report of the service performed includes a justification for the substitute service and the unavailability of the original item.

Related Items: 61333 61336 61341 61527