Medicare Benefits Schedule - Item 82301

Search Results for Item 82301

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Category 8 - MISCELLANEOUS SERVICES

82301

82301 - Additional Information

Item Start Date:
01-Mar-2023
Description Updated:
01-Mar-2024
Schedule Fee Updated:
01-Nov-2023

Group
M15 - Diagnostic Audiology Services

Audiology health service, consisting of programming an auditory implant or the sound processor of an auditory implant, unilateral, performed on a patient by an eligible audiologist if:

(a) the service is performed on the patient individually and in person; and

(b) a service to which item 11302, 11342 or 11345 applies has not been performed on the patient on the same day

Applicable up to a total of 4 services to which this item, item 82302 or item 82304 applies on the same day

Fee: $169.45 Benefit: 75% = $127.10 85% = $144.05

(See para MN.15.5 of explanatory notes to this Category)

Extended Medicare Safety Net Cap: $500.00


Associated Notes

Category 8 - MISCELLANEOUS SERVICES

MN.15.5

Provision of Diagnostic Audiology Services by Audiologists - (Items 82300 to 82332)

OVERVIEW

The diagnostic audiology services available through MBS items 82300 to 82332 (excepting 82301, 82302 and 82304) enable an eligible audiologist to perform diagnostic tests upon written request from a medical practitioner. MBS items 82301, 82302 and 82304, for the programming of an auditory implant or the sound processor of an auditory implant, do not require a request from a medical practitioner.

These diagnostic audiology services assist medical practitioners, including ENT specialists and neurologists, in their medical diagnosis and/or treatment and/or management of ear disease or related disorders. The diagnostic audiology items supplement Otolaryngology items for services delivered by, or on behalf of medical practitioners (MBS items 11300 to 11345, excluding 11304).  

Requesting arrangements

The written request must be in writing and must contain:

(a) the date of the request; and

(b) the name of the medical practitioner who requested the service and either the address of his or her place of practice or the provider number in respect of his or her place of practice; and

(c) a description of the service which provides sufficient information to identify the service as relating to a particular item (but need not specify the item number).

Written requests should, where possible, note the clinical indication/s for the requested service/s. 

A request may be for the performance of more than one diagnostic audiology service making up a single audiological assessment but cannot be for more than one audiological assessment. This means that for Medicare benefits to be payable, any re-evaluation of the patient should be made at the discretion of the medical practitioner through a separate request.

Audiologists do not have the discretion to self-determine diagnostic tests under items 82300 to 82332 (excepting items 82301, 82302 and 82304). If a written request is incomplete or requires clarification, the audiologist should contact the requesting medical practitioner for further information. If an audiologist considers that additional tests may be necessary, the audiologist should contact the requesting medical practitioner to discuss the need and if the requesting practitioner determines that additional tests are necessary, an amended or separate written request must be arranged.

It is recommended that audiologists retain the written request for 24 months from the date the service was rendered (for Medicare auditing purposes). A copy of the written request is not required to accompany Medicare claims or be attached to patients' itemised accounts/receipts or assignment of benefit forms.

Eligibility requirements for audiologists

The diagnostic audiology items (82300 to 82332) can only be claimed by audiologists who are registered with Services Australia. To be eligible to register with the Services Australia to provide these services, audiologists must meet the following requirements:

Audiologists must be either:

· a 'Full Member' of Audiology Australia who is an Audiology Australia Accredited Audiologist; or

· an 'Ordinary Member - Audiologist' or 'Fellow Audiologist' of the Australian College of Audiology (ACAud).

Registering with Services Australia

Provider registration forms may be obtained from Medicare on 132 150 or at www.servicesaustralia.gov.au. 

Changes to provider details

Audiologists must notify Services Australia in writing of all changes to mailing details to ensure that they continue to receive information about Medicare services.

Reporting requirements

Where an audiologist provides diagnostic audiology service/s to the patient under a written request, they must provide a copy of the results of the service/s performed together with relevant written comments on those results to the requesting medical practitioner. It is recommended that these be provided within 7 days of the date the service was performed.

Out-of-pocket expenses and Medicare Safety Net

Audiologists can determine their own fees for the professional service. Charges in excess of the Medicare benefit are the responsibility of the patient. However, out-of-pocket costs will count toward the Medicare Safety Net for that patient.

Publicly funded services

Items 82300 to 82332 do not apply for services that are provided by any Commonwealth or state funded services or provided to an admitted patient of a hospital. However, where an exemption under subsection 19(2) of the Health Insurance Act 1973 has been granted to an Aboriginal Community Controlled Health Service or state/territory government health clinic, items 82300 to 82332 can be claimed for services provided by audiologists salaried by, or contracted to, the service or health clinic. All requirements of the relevant item must be met, including registration of the audiologist with Services Australia. Medicare services provided under a subsection 19(2) exemption must be bulk billed (i.e., the Medicare rebate is accepted as full payment for services).

Private health insurance

Patients need to decide if they will use Medicare or their private health insurance ancillary cover to pay for these services. Patients cannot use their private health insurance ancillary cover to 'top up' the Medicare rebate paid for the services.

Related Items: 82300 82301 82302 82304 82306 82309 82312 82315 82318 82324 82332


Legend

  • 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