Medicare Benefits Schedule - Note AN.0.15

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Category 1 - PROFESSIONAL ATTENDANCES

AN.0.15

After hours Residential Aged Care Facility Attendances (Items 772, 776, 788, 789, 2200, 5010, 5028, 5049, 5067, 5077, 5260, 5262, 5263, 5265, 5267)

Last reviewed: 1 November 2023

These items refer to attendances on patients in residential aged care facilities. 

Where a medical practitioner attends a patient in a self-contained unit, within a residential aged care facility complex, the attendance attracts benefits under the appropriate home visit item. 

Where a patient living in a self‑contained unit attends a medical practitioner at consulting rooms situated within the precincts of the residential aged care facility, or at free standing consulting rooms within the residential aged care facility complex, the appropriate surgery consultation item applies. 

If a patient who is accommodated in the residential aged care facility visits a medical practitioner at consulting rooms situated within the residential aged care facility complex, whether free standing or situated within the residential aged care facility precincts, benefits would be attracted under the appropriate residential aged care facility attendance item.

To facilitate assessment of the correct Medicare rebate in respect of a number of patients attended on the one occasion at one of the above locations, it is important that the total number of patients seen be recorded on each individual account, receipt or assignment form. For example, where two patients were visited (for a brief consultation) in the one facility on the one occasion, each account, receipt or assignment form would show "Item 5010 - 1 of 2 patients" for a general practitioner. 

The number of patients seen should not include attendances which do not attract a Medicare rebate (e.g. public in-patients, attendances for normal after-care), or where a Medicare rebate is payable under an item other than these derived fee items (e.g. items that attract a flag fall, health assessments, care planning, emergency after-hours attendance - first patient).

Related Items: 772 776 788 789 2200 5010 5028 5049 5067 5077 5260 5262 5263 5265 5267


Related Items

Category 1 - PROFESSIONAL ATTENDANCES

5262

5262 - Additional Information

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

Professional attendance (other than a service to which another item applies) at a residential aged care facility (other than a professional attendance at a self-contained unit) or professional attendance at consulting rooms situated within such a complex, if the patient is a care recipient at the facility and is not a resident of a self-contained unit, lasting more than 60 minutes by a medical practitioner (other than a general practitioner)—an attendance on one or more patients at one residential aged care facility on one occasion—each patient

An amount equal to $112.20, plus $27.95 divided by the number of patients seen, up to a maximum of six patients. For seven or more patients - an amount equal to $112.20 plus $1.25 per patient
Ready Reckoner

(See para AN.0.9, AN.0.15, AN.7.2, MN.1.3, MN.1.4, MN.1.5, MN.1.6, MN.1.7, MN.1.8 of explanatory notes to this Category)

Category 1 - PROFESSIONAL ATTENDANCES

5077

5077 - Additional Information

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

Professional attendance by a general practitioner, on care recipients in a residential aged care facility, other than a service to which another item in this Schedule applies, lasting at least 60 minutes and including any of the following that are clinically relevant:
(a) taking an extensive patient history;
(b) performing a clinical examination;
(c) arranging any necessary investigation;
(d) implementing a management plan;
(e) providing appropriate preventive health care;
for one or more health-related issues, with appropriate documentation—an attendance on one or more patients at one residential aged care facility on one occasion—each patient

The fee for item 5071, plus $51.45 divided by the number of patients seen, up to a maximum of six patients. For seven or more patients - the fee for item 5071 plus $3.65 per patient.
Ready Reckoner

(See para AN.0.9, AN.0.11, AN.0.15, AN.0.19, AN.0.74, MN.1.3, MN.1.4, MN.1.5, MN.1.6, MN.1.7, MN.1.8 of explanatory notes to this Category)


Level C

Professional attendance by a general practitioner (not being a service to which any other item in this table applies) lasting at least 20 minutes, including any of the following that are clinically relevant:

a)     taking a detailed patient history;

b)     performing a clinical examination;

c)     arranging any necessary investigation;

d)     implementing a management plan;

e)     providing appropriate preventive health care;

in relation to 1 or more health-related issues, with appropriate documentation.

Category 1 - PROFESSIONAL ATTENDANCES

5049

5049 - Additional Information

Item Start Date:
01-Jan-2005
Description Updated:
01-Jan-2013
Schedule Fee Updated:
01-Nov-2023

Professional attendance by a general practitioner at a residential aged care facility to residents of the facility (other than a service to which another item in the table applies), lasting at least 20 minutes and including any of the following that are clinically relevant:

(a) taking a detailed patient history;

(b) performing a clinical examination;

(c) arranging any necessary investigation;

(d) implementing a management plan;

(e) providing appropriate preventive health care;

for one or more health-related issues, with appropriate documentation-an attendance on one or more patients at one residential aged care facility on one occasion-each patient

The fee for item 5040, plus $51.45 divided by the number of patients seen, up to a maximum of six patients. For seven or more patients - the fee for item 5040 plus $3.65 per patient.
Ready Reckoner

(See para AN.0.9, AN.0.11, AN.0.15, AN.0.19, AN.0.74, MN.1.3, MN.1.4, MN.1.5, MN.1.6, MN.1.7, MN.1.8 of explanatory notes to this Category)


Level D

Professional attendance by a general practitioner (not being a service to which any other item in this table applies) lasting at least 40 minutes, including any of the following that are clinically relevant:

a)     taking an extensive patient history;

b)     performing a clinical examination;

c)     arranging any necessary investigation;

d)     implementing a management plan;

e)     providing appropriate preventive health care;

in relation to 1 or more health-related issues, with appropriate documentation.

Category 1 - PROFESSIONAL ATTENDANCES

5067

5067 - Additional Information

Item Start Date:
01-Jan-2005
Description Updated:
01-Jan-2013
Schedule Fee Updated:
01-Nov-2023

Professional attendance by a general practitioner at a residential aged care facility to residents of the facility (other than a service to which another item in the table applies), lasting at least 40 minutes and including any of the following that are clinically relevant:

(a) taking an extensive patient history;

(b) performing a clinical examination;

(c) arranging any necessary investigation;

(d) implementing a management plan;

(e) providing appropriate preventive health care;

for one or more health-related issues, with appropriate documentation-an attendance on one or more patients at one residential aged care facility on one occasion-each patient

The fee for item 5060, plus $51.45 divided by the number of patients seen, up to a maximum of six patients. For seven or more patients - the fee for item 5060 plus $3.65 per patient.
Ready Reckoner

(See para AN.0.9, AN.0.11, AN.0.15, AN.0.19, AN.0.74, MN.1.3, MN.1.4, MN.1.5, MN.1.6, MN.1.7, MN.1.8 of explanatory notes to this Category)


Consultation At A Residential Aged Care Facility

Professional attendance on 1 or more patients on 1 residential aged care facility ( but excluding a professional attendance at a self-contained unit) or attendance at consulting rooms situated within such a complex where the patient is accommodated in the residential aged care facility (excluding accommodation in a self-contained unit) on 1 occasion – each patient

Category 1 - PROFESSIONAL ATTENDANCES

5260

5260 - Additional Information

Item Start Date:
01-Jan-2005
Description Updated:
01-Jan-2013
Schedule Fee Updated:
01-Nov-2007

Professional attendance (other than a service to which another item applies) at a residential aged care facility (other than a professional attendance at a self-contained unit) or professional attendance at consulting rooms situated within such a complex if the patient is accommodated in the residential aged care facility (other than accommodation in a self-contained unit) of not more than 5 minutes in duration by a medical practitioner (other than a general practitioner)-an attendance on one or more patients at one residential aged care facility on one occasion-each patient

An amount equal to $18.50, plus $27.95 divided by the number of patients seen, up to a maximum of six patients. For seven or more patients - an amount equal to $18.50 plus $1.25 per patient
Ready Reckoner

(See para AN.0.9, AN.0.15, AN.7.2, MN.1.3, MN.1.4, MN.1.5, MN.1.6, MN.1.7, MN.1.8 of explanatory notes to this Category)

Category 1 - PROFESSIONAL ATTENDANCES

5263

5263 - Additional Information

Item Start Date:
01-Jan-2005
Description Updated:
01-Jan-2013
Schedule Fee Updated:
01-Nov-2007

Professional attendance (other than a service to which another item applies) at a residential aged care facility (other than a professional attendance at a self-contained unit) or professional attendance at consulting rooms situated within such a complex if the patient is accommodated in the residential aged care facility (other than accommodation in a self-contained unit) of more than 5 minutes in duration but not more than 25 minutes in duration by a medical practitioner (other than a general practitioner)-an attendance on one or more patients at one residential aged care facility on one occasion-each patient

An amount equal to $26.00, plus $31.55 divided by the number of patients seen, up to a maximum of six patients. For seven or more patients - an amount equal to $26.00 plus $1.25 per patient
Ready Reckoner

(See para AN.0.9, AN.0.15, AN.7.2, MN.1.3, MN.1.4, MN.1.5, MN.1.6, MN.1.7, MN.1.8 of explanatory notes to this Category)

Category 1 - PROFESSIONAL ATTENDANCES

5265

5265 - Additional Information

Item Start Date:
01-Jan-2005
Description Updated:
01-Jan-2013
Schedule Fee Updated:
01-Nov-2007

Professional attendance (other than a service to which another item applies) at a residential aged care facility (other than a professional attendance at a self-contained unit) or professional attendance at consulting rooms situated within such a complex if the patient is accommodated in the residential aged care facility (other than accommodation in a self-contained unit) of more than 25 minutes in duration but not more than 45 minutes by a medical practitioner (other than a general practitioner)-an attendance on one or more patients at one residential aged care facility on one occasion-each patient

An amount equal to $45.50, plus $27.95 divided by the number of patients seen, up to a maximum of six patients. For seven or more patients - an amount equal to $45.50 plus $1.25 per patient
Ready Reckoner

(See para AN.0.9, AN.0.15, AN.7.2, MN.1.3, MN.1.4, MN.1.5, MN.1.6, MN.1.7, MN.1.8 of explanatory notes to this Category)

Category 1 - PROFESSIONAL ATTENDANCES

5267

5267 - Additional Information

Item Start Date:
01-Jan-2005
Description Updated:
01-Nov-2023
Schedule Fee Updated:
01-Nov-2007

Professional attendance (other than a service to which another item applies) at a residential aged care facility (other than a professional attendance at a self-contained unit) or professional attendance at consulting rooms situated within such a complex, if the patient is a care recipient in the facility who is not a resident of a self-contained unit, lasting more than 45 minutes, but not more than 60 minutes, by a medical practitioner (other than a general practitioner)—an attendance on one or more patients at one residential aged care facility on one occasion—each patient

An amount equal to $67.50, plus $27.95 divided by the number of patients seen, up to a maximum of six patients. For seven or more patients - an amount equal to $67.50 plus $1.25 per patient
Ready Reckoner

(See para AN.0.9, AN.0.15, AN.7.2, MN.1.3, MN.1.4, MN.1.5, MN.1.6, MN.1.7, MN.1.8 of explanatory notes to this Category)


Level B

Professional attendance by a general practitioner (not being a service to which any other item in this table applies) lasting less than 20 minutes, including any of the following that are clinically relevant:

a)     taking a patient history;

b)     performing a clinical examination;

c)     arranging any necessary investigation;

d)     implementing a management plan;

e)     providing appropriate preventive health care;

in relation to 1 or more health-related issues, with appropriate documentation.

Category 1 - PROFESSIONAL ATTENDANCES

5028

5028 - Additional Information

Item Start Date:
01-Jan-2005
Description Updated:
01-Nov-2023
Schedule Fee Updated:
01-Nov-2023

Professional attendance by a general practitioner (other than a service to which another item in this Schedule applies), on care recipients in a residential aged care facility, lasting at least 6 minutes and less than 20 minutes and including any of the following that are clinically relevant:
(a) taking a patient history;
(b) performing a clinical examination;
(c) arranging any necessary investigation;
(d) implementing a management plan;
(e) providing appropriate preventive health care;
for one or more health-related issues, with appropriate documentation—an attendance on one or more patients at one residential aged care facility on one occasion—each patient

The fee for item 5020, plus $51.45 divided by the number of patients seen, up to a maximum of six patients. For seven or more patients - the fee for item 5020 plus $3.65 per patient.
Ready Reckoner

(See para AN.0.9, AN.0.11, AN.0.15, AN.0.19, AN.0.74, MN.1.3, MN.1.4, MN.1.5, MN.1.6, MN.1.7, MN.1.8 of explanatory notes to this Category)

Category 1 - PROFESSIONAL ATTENDANCES

772

772 - Additional Information

Item Start Date:
01-Jul-2018
Description Updated:
01-Nov-2023
Schedule Fee Updated:
01-Nov-2023

Professional attendance (other than a service to which another item applies) at a residential aged care facility (other than a professional attendance at a self-contained unit) or professional attendance at consulting rooms situated within such a complex if the patient is accommodated in the residential aged care facility (other than accommodation in a self-contained unit) of not more than 5 minutes in duration by a prescribed medical practitioner—an attendance on one or more patients at one residential aged care facility on one occasion—each patient

The fee for item 733, plus $41.15 divided by the number of patients seen, up to a maximum of six patients. For seven or more patients - the fee for item 733 plus $2.90 per patient.
Ready Reckoner

(See para AN.0.9, AN.0.11, AN.0.15, AN.7.1, AN.7.2, AN.7.24, MN.1.3, MN.1.4, MN.1.5, MN.1.6, MN.1.7, MN.1.8 of explanatory notes to this Category)

Category 1 - PROFESSIONAL ATTENDANCES

776

776 - Additional Information

Item Start Date:
01-Jul-2018
Description Updated:
01-Nov-2023
Schedule Fee Updated:
01-Nov-2023

Professional attendance (other than a service to which another item applies) at a residential aged care facility (other than a professional attendance at a self-contained unit) or professional attendance at consulting rooms situated within such a complex if the patient is accommodated in the residential aged care facility (other than accommodation in a self-contained unit) of more than 5 minutes in duration but not more than 25 minutes in duration by a prescribed medical practitioner—an attendance on one or more patients at one residential aged care facility on one occasion—each patient

The fee for item 737, plus $41.15 divided by the number of patients seen, up to a maximum of six patients. For seven or more patients - the fee for item 737 plus $2.90 per patient.
Ready Reckoner

(See para AN.0.9, AN.0.11, AN.0.15, AN.7.1, AN.7.2, AN.7.24, MN.1.3, MN.1.4, MN.1.5, MN.1.6, MN.1.7, MN.1.8 of explanatory notes to this Category)

Category 1 - PROFESSIONAL ATTENDANCES

788

788 - Additional Information

Item Start Date:
01-Jul-2018
Description Updated:
01-Nov-2023
Schedule Fee Updated:
01-Nov-2023

Professional attendance (other than a service to which another item applies) at a residential aged care facility (other than a professional attendance at a self-contained unit) or professional attendance at consulting rooms situated within such a complex if the patient is accommodated in the residential aged care facility (other than accommodation in a self-contained unit) of more than 25 minutes in duration but not more than 45 minutes by a prescribed medical practitioner—an attendance on one or more patients at one residential aged care facility on one occasion—each patient

The fee for item 741, plus $41.15 divided by the number of patients seen, up to a maximum of six patients. For seven or more patients - the fee for item 741 plus $2.90 per patient.
Ready Reckoner

(See para AN.0.9, AN.0.11, AN.0.15, AN.7.1, AN.7.2, AN.7.24, MN.1.3, MN.1.4, MN.1.5, MN.1.6, MN.1.7, MN.1.8 of explanatory notes to this Category)

Category 1 - PROFESSIONAL ATTENDANCES

789

789 - Additional Information

Item Start Date:
01-Jul-2018
Description Updated:
01-Nov-2023
Schedule Fee Updated:
01-Nov-2023

Professional attendance (other than a service to which another item applies) at a residential aged care facility (other than a professional attendance at a self-contained unit) or professional attendance at consulting rooms situated within such a complex if the patient is accommodated in the residential aged care facility (other than accommodation in a self-contained unit) of more than 45 minutes but not more than 60 minutes in duration by a prescribed medical practitioner—an attendance on one or more patients at one residential aged care facility on one occasion—each patient

The fee for item 745, plus $41.15 divided by the number of patients seen, up to a maximum of six patients. For seven or more patients - the fee for item 745 plus $2.90 per patient.
Ready Reckoner

(See para AN.0.9, AN.0.11, AN.0.15, AN.7.1, AN.7.2, AN.7.24, MN.1.3, MN.1.4, MN.1.5, MN.1.6, MN.1.7, MN.1.8 of explanatory notes to this Category)

Category 1 - PROFESSIONAL ATTENDANCES

2200

2200 - Additional Information

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

Professional attendance (other than a service to which another item applies) at a residential aged care facility (other than a professional attendance at a self-contained unit) or professional attendance at consulting rooms situated within such a complex if the patient is accommodated in the residential aged care facility (other than accommodation in a self-contained unit) of more than 60 minutes in duration by a prescribed medical practitioner—an attendance on one or more patients at one residential aged care facility on one occasion—each patient.

The fee for item 2197, plus $41.15 divided by the number of patients seen, up to a maximum of six patients. For seven or more patients - the fee for item 2197 plus $2.90 per patient.
Ready Reckoner

(See para AN.0.9, AN.0.11, AN.0.15, AN.7.1, AN.7.2, AN.7.24, MN.1.3, MN.1.4, MN.1.5, MN.1.6, MN.1.7, MN.1.8 of explanatory notes to this Category)


Level A

Professional attendance by a general practitioner for an obvious problem characterised by the straightforward nature of the task that requires a short patient history and, if required, limited examination and management.

Category 1 - PROFESSIONAL ATTENDANCES

5010

5010 - Additional Information

Item Start Date:
01-Jan-2005
Description Updated:
01-Jan-2013
Schedule Fee Updated:
01-Nov-2023

Professional attendance (other than a service to which another item applies) at a residential aged care facility (other than a professional attendance at a self-contained unit) or professional attendance at consulting rooms situated within such a complex, if the patient is accommodated in a residential aged care facility (other than accommodation in a self-contained unit) by a general practitioner for an obvious problem characterised by the straightforward nature of the task that requires a short patient history and, if required, limited examination and management-an attendance on one or more patients at one residential aged care facility on one occasion-each patient

The fee for item 5000, plus $51.45 divided by the number of patients seen, up to a maximum of six patients. For seven or more patients - the fee for item 5000 plus $3.65 per patient.
Ready Reckoner

(See para AN.0.9, AN.0.11, AN.0.15, AN.0.19, AN.0.74, MN.1.3, MN.1.4, MN.1.5, MN.1.6, MN.1.7, MN.1.8 of explanatory notes to this Category)


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