Medicare Benefits Schedule - Note AN.40.1

From 1 January 2022, a number of telehealth items were permanently added to the MBS.

The intent of these ongoing telehealth items is to allow practitioners to provide MBS attendances remotely (by videoconference or telephone) where it is safe and clinically appropriate to do so in accordance with relevant professional standards.  

Providing telehealth services by videoconference is the preferred substitution for a face-to-face consultation. However, providers can provide a consultation via telephone where it is clinically relevant (and the service is covered by a relevant telephone item).

A list of the ongoing telehealth items and the equivalent face‑to‑face items can be found at Table 1.

Table 1 – Ongoing telehealth items and equivalent face to face services (out of hospital patients)

Further information on the telehealth changes can be found at www.mbsonline.gov.au by searching under the Facts Sheets tab – July 2022.

Eligible providers

All MBS items for referred attendances require a valid referral. However, if the specialist, consultant physician, consultant psychiatrist, paediatrician or geriatrician has previously seen the patient under a referral that is still valid, there is no need to obtain a specific referral for the purposes of claiming the video and telephone items.

Restrictions

All MBS telehealth and telephone attendance items are stand-alone items and are to be billed instead of a face‑to-face MBS item.

Billing Requirements

Bulk billing of specialist (and Allied Health) telehealth services is at the discretion of the provider, so long as informed financial consent is obtained prior to the provision of the service.

Further information on the assignment of benefit for bulk billed MBS telehealth services can be found in the ‘Provider Frequently Asked Questions’ at www.mbsonline.gov.au.

Relevant definitions and requirements

Specialist telehealth services (91822, 91823 and 91833) can be billed by all specialities that can currently bill items 104 and 105 or equivalent MBS items. This also includes sports and exercise medicine and occupational and environmental health medicine specialists.

Consultant physician telehealth services (91824, 91825, 91826 and 91836) can be billed by all specialities that can currently bill items 110, 116 and 119 or equivalent MBS items. This also includes pain and palliative medicine, sexual health medicine and addiction medicine.

Consultant physician telehealth services to prepare and review a management plan (92422 and 92423) can be billed by all physicians that can currently bill items 132 and 133 or equivalent MBS items. This also includes sexual health medicine, addiction medicine and paediatricians.

The specialist and consultant physician service for diagnosis and treatment for patients with an eligible disability (92141) can be billed by specialists and consultant physicians that are able to item 137.

Single course of treatment

The same conditions for a single course of treatment apply across all modalities (i.e. face‑to-face, video or telephone). Once an initial consultation is billed, all subsequent services related to the same condition are considered to be part of a single course of treatment. For example, if a patient has seen a specialist in a face‑to‑face consultation (where item 104 has been billed), item 91823 (video) or 91833 (telephone) should be billed if the patient sees the specialist remotely for the same condition.

Anaesthetist services

The Anaesthetist telehealth service (92701) can be billed by practitioners that can currently bill item 17615.

Service limits

At present, the service limits that apply to standard psychiatry services do not currently apply to the video and telephone attendance items for psychiatry (except for item 92460). Patients who have received more than 50 attendances under existing items are eligible to receive services under the video and telephone psychiatry items as long as they meet the item descriptor requirements.

In addition, patients who have received more than 50 attendances under item 319 are eligible to receive services under the video and telephone psychiatry items as long as they meet the item descriptor requirements.

The Department of Health and Aged Care will work with the Royal Australian and New Zealand College of Psychiatrists (RANZCP) and the Medicare Review Advisory Committee (MRAC) to review the current service limits, and ensure a consistent approach across all of the psychiatry attendance items, including services provided by face‑to‑face, video and telephone.

Interview item (92460)

Item 92460 provides for an interview with a person other than the patient. A maximum of 4 services in a calendar year can be billed under item 92460, or the equivalent face‑to‑face item (item 352), in the continuing management of a patient. That is, a consultant psychiatrist can bill for a service under item 92460 once more in the calendar year if a patient has received three MBS services under items 352 or 92460 in the same calendar year.

Management Plan items (92435 and 92436)

The MBS remote attendance preparation and review of GP management plan items have the same diagnosis, assessment and record-keeping requirements as the existing face-to-face items (291 and 293). Refer to MBS Explanatory Note AN.0.30 for further information.

Group psychotherapy items (92455, 92456 and 92457)

The MBS remote attendance group psychotherapy items have the same requirements as the existing face-to-face  items (342, 344 and 346). It is the responsibility of the practitioner rendering the service to maintain privacy and confidentiality for all participants throughout the service. Practitioners should refer to the relevant professional practice standards and guidelines for technology-based consultations.

Technical Requirements

The services can be provided by telehealth and by phone. It is the responsibility of the practitioner rendering the service to maintain privacy and confidentiality for all participants throughout the service. 

Telehealth attendance means a professional attendance by video conference where the medical practitioner:

1. has the capacity to provide the full service through this means safely and in accordance with relevant professional standards; and
2. is satisfied that it is clinically appropriate to provide the service to the patient; and
3. maintains a visual and audio link with the patient; and
4. is satisfied that the software and hardware used to deliver the service meets the applicable laws for security and privacy.

Note – only the time where a visual and audio link is maintained between the patient and the provider can be counted in meeting the relevant item descriptor.

No specific equipment is required to provide Medicare-compliant telehealth services. Practitioners must ensure that their chosen telecommunications solution meets their clinical requirements and satisfies privacy laws. Information on how to select a web conferencing solution is available at: www.cyber.gov.au

Phone attendance means a professional attendance by telephone where the health practitioner:

1. has the capacity to provide the full service through this means safely and in accordance with professional standards; and
2. is satisfied that it is clinically appropriate to provide the service to the patient; and
3. maintains an audio link with the patient.

There are no longer geographic restrictions on the MBS video or telephone services provided by specialists, consultant physicians, consultant psychiatrists, paediatricians, geriatricians and anaesthetists.

Recording Clinical Notes (for specialist, consultant physician, consultant psychiatrist, neurosurgery, public health medicine, geriatrician, paediatrician and anaesthetist)

In relation to the time taken in recording appropriate details of the service, only clinical details recorded at the time of the attendance count towards the time of consultation.  It does not include information added later, such as reports of investigations, or when either the visual or audio link between the patient and the practitioner is lost. 

Clinicians should record the date, time and duration of the consultation, and retain these records.

Related Items: 104 105 110 116 119 132 133 135 137 141 143 289 291 293 296 300 302 304 306 308 342 344 346 410 411 412 413 6007 6009 6011 6013 6015 90260 90261 90266 90267 91822 91823 91824 91825 91826 91833 91836 92422 92423

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Professional attendance at consulting rooms or hospital by a specialist in the practice of the specialist's specialty after referral of the patient to the specialist-each attendance, other than a second or subsequent attendance, in a single course of treatment, other than a service to which item 106, 109 or 16401 applies

Fee: $98.95 Benefit: 75% = $74.25 85% = $84.15

(See para AN.0.7, AN.0.25, AN.0.76, AN.2.1, AN.40.1, TN.1.4 of explanatory notes to this Category)

Professional attendance by a specialist in the practice of the specialist's specialty following referral of the patient to the specialist-an attendance after the first in a single course of treatment, if that attendance is at consulting rooms or hospital, other than a service to which item 16404 applies

Fee: $49.75 Benefit: 75% = $37.35 85% = $42.30

(See para AN.0.7, AN.0.25, AN.0.70, AN.2.1, AN.3.1, AN.40.1, TN.1.4 of explanatory notes to this Category)

Professional attendance lasting at least 45 minutes by a consultant physician in the practice of the consultant physician’s specialty of paediatrics, following referral of the patient to the consultant paediatrician by a referring practitioner, for a patient aged under 25, if the consultant paediatrician:

(a) undertakes, or has previously undertaken in prior attendances, a comprehensive assessment in relation to which a diagnosis of a complex neurodevelopmental disorder (such as autism spectrum disorder) is made (if appropriate, using information provided by an eligible allied health provider); and

(b) develops a treatment and management plan, which must include:

(i) documentation of the confirmed diagnosis; and

(ii) findings of any assessments performed for the purposes of formulation of the diagnosis or contribution to the treatment and management plan; and

(iii) a risk assessment; and

(iv) treatment options (which may include biopsychosocial recommendations); and

(c) provides a copy of the treatment and management plan to:

(i) the referring practitioner; and

(ii) one or more allied health providers, if appropriate, for the treatment of the patient;

(other than attendance on a patient for whom payment has previously been made under this item or item 137, 139, 289, 92140, 92141, 92142 or 92434)

Applicable only once per lifetime

Fee: $305.15 Benefit: 75% = $228.90 85% = $259.40

(See para AN.0.24, AN.40.1 of explanatory notes to this Category)

Professional attendance lasting at least 45 minutes by a specialist or consultant physician (not including a general practitioner), following referral of the patient to the specialist or consultant physician by a referring practitioner, for a patient aged under 25, if the specialist or consultant physician:

(a) undertakes, or has previously undertaken in prior attendances, a comprehensive assessment in relation to which a diagnosis of an eligible disability is made (if appropriate, using information provided by an eligible allied health provider); and

(b) develops a treatment and management plan, which must include:

(i) documentation of the confirmed diagnosis; and

(ii) findings of any assessments performed for the purposes of formulation of the diagnosis or contribution to the treatment and management plan; and

(iii) a risk assessment; and

(iv) treatment options (which may include biopsychosocial recommendations); and

(c) provides a copy of the treatment and management plan to:

(i) the referring practitioner; and

(ii) one or more allied health providers, if appropriate, for the treatment of the patient;

(other than attendance on a patient for whom payment has previously been made under this item or item 135, 139, 289, 92140, 92141, 92142 or 92434)

Applicable only once per lifetime

Fee: $305.15 Benefit: 75% = $228.90 85% = $259.40

(See para AN.0.25, AN.40.1, AR.29.1 of explanatory notes to this Category)

Phone attendance for a person by a specialist in the practice of the specialist’s specialty if:

(a)           the attendance follows referral of the patient to the specialist; and

(b)           the attendance was of more than 5 minutes in duration. 

Where the attendance is after the first attendance as part of a single course of treatment.

Fee: $49.75 Benefit: 85% = $42.30

(See para AN.0.7, AN.0.25, AN.0.70, AN.3.1, AN.40.1 of explanatory notes to this Category)

Professional attendance lasting at least 45 minutes, by a consultant physician in the practice of the consultant physician’s specialty of psychiatry, following referral of the patient to the consultant psychiatrist by a referring practitioner, for a patient aged under 25, if the consultant psychiatrist:

(a) undertakes, or has previously undertaken in prior attendances, a comprehensive assessment in relation to which a diagnosis of a complex neurodevelopmental disorder (such as autism spectrum disorder) is made (if appropriate, using information provided by an eligible allied health provider); and

(b) develops a treatment and management plan, which must include:

(i) documentation of the confirmed diagnosis; and

(ii) findings of any assessments performed for the purposes of formulation of the diagnosis or contribution to the treatment and management plan; and

(iii) a risk assessment; and

(iv) treatment options (which may include biopsychosocial recommendations); and

(c) provides a copy of the treatment and management plan to:

(i) the referring practitioner; and

(ii) one or more allied health providers, if appropriate, for the treatment of the patient;

(other than attendance on a patient for whom payment has previously been made under this item or item 135, 137, 139, 92140, 92141, 92142 or 92434)

Applicable only once per lifetime

Fee: $305.15 Benefit: 75% = $228.90 85% = $259.40

(See para AN.0.72, AN.40.1 of explanatory notes to this Category)

Professional attendance lasting more than 45 minutes at consulting rooms by a consultant physician in the practice of the consultant physician’s specialty of psychiatry, if:

(a) the attendance follows referral of the patient to the consultant, by a medical practitioner in general practice (including a general practitioner, but not a specialist or consultant physician) or a participating nurse practitioner, for an assessment or management; and

(b) during the attendance, the consultant:

(i) if it is clinically appropriate to do so—uses an appropriate outcome tool; and

(ii) carries out a mental state examination; and

(iii) undertakes a comprehensive diagnostic assessment; and

(c) the consultant decides that it is clinically appropriate for the patient to be managed by the referring practitioner without ongoing management by the consultant; and

(d) within 2 weeks after the attendance, the consultant prepares and gives to the referring practitioner a written report, which includes:

(i) the comprehensive diagnostic assessment of the patient; and

(ii) a management plan for the patient for the next 12 months that comprehensively evaluates the patient’s biopsychosocial factors and makes recommendations to the referring practitioner to manage the patient’s ongoing care in a biopsychosocial model; and

(e) if clinically appropriate, the consultant explains the diagnostic assessment and management plan, and gives a copy, to:

(i) the patient; and

(ii) the patient’s carer (if any), if the patient agrees; and

(f) in the preceding 12 months, a service to which this item or item 92435 applies has not been provided to the patient

Fee: $523.40 Benefit: 85% = $444.90

(See para AN.0.30, AN.0.32, AN.0.75, AN.0.76, AN.40.1 of explanatory notes to this Category)

Professional attendance lasting more than 30 minutes, but not more than 45 minutes, at consulting rooms by a consultant physician in the practice of the consultant physician’s specialty of psychiatry, if:

(a) the patient is being managed by a medical practitioner or a participating nurse practitioner in accordance with a management plan prepared by the consultant in accordance with item 291 or item 92435; and

(b) the attendance follows referral of the patient to the consultant, by the medical practitioner or participating nurse practitioner managing the patient, for review of the management plan and the associated comprehensive diagnostic assessment; and

(c) during the attendance, the consultant:

(i) if it is clinically appropriate to do so—uses an appropriate outcome tool; and

(ii) carries out a mental state examination; and

(iii) reviews the comprehensive diagnostic assessment and undertakes additional assessment as required; and

(iv) reviews the management plan; and

(d) within 2 weeks after the attendance, the consultant prepares and gives to the referring practitioner a written report, which includes:

(i) the revised comprehensive diagnostic assessment of the patient; and

(ii) a revised management plan including updated recommendations to the referring practitioner to manage the patient’s ongoing care in a biopsychosocial model; and

(e) if clinically appropriate, the consultant explains the diagnostic assessment and management plan, and gives a copy, to:

(i) the patient; and

(ii) the patient’s carer (if any), if the patient agrees; and

(f) in the preceding 12 months, a service to which item 291 or item 92435 applies has been provided to the patient; and

(g) in the preceding 12 months, a service to which this item or item 92436 applies has not been provided to the patient

Fee: $327.20 Benefit: 85% = $278.15

(See para AN.0.30, AN.0.32, AN.0.76, AN.40.1 of explanatory notes to this Category)

Professional attendance of more than 45 minutes in duration by a consultant physician in the practice of the consultant physician's speciality of psychiatry following referral of the patient to him or her by a referring practitioner-an attendance at consulting rooms if the patient:

(a) is a new patient for this consultant psychiatrist; or

(b) has not received a professional attendance from this consultant psychiatrist in the preceding 24 months;

other than attendance on a patient in relation to whom this item, or any of items 297, 299, 300, 302, 304, 306, 308, 91827 to 91831, 91837 to 91839 and 92437 has applied in the preceding 24 months

Fee: $301.05 Benefit: 75% = $225.80 85% = $255.90

(See para AN.0.25, AN.0.30, AN.0.31, AN.0.32, AN.0.75, AN.0.76, AN.40.1 of explanatory notes to this Category)

Professional attendance by a consultant physician in the practice of the consultant physician's specialty of psychiatry following referral of the patient to him or her by a referring practitioner-an attendance of not more than 15 minutes in duration at consulting rooms, if that attendance and another attendance to which any of items 296, 297, 299, 300, 302, 304, 306, 308, 91827 to 91831, 91837 to 91839 and 92437 applies have not exceeded 50 attendances in a calendar year for the patient

Fee: $50.10 Benefit: 75% = $37.60 85% = $42.60

(See para AN.0.25, AN.0.30, AN.0.31, AN.0.32, AN.0.75, AN.0.76, AN.40.1 of explanatory notes to this Category)

Professional attendance by a consultant physician in the practice of the consultant physician's specialty of psychiatry following referral of the patient to him or her by a referring practitioner-an attendance of more than 15 minutes, but not more than 30 minutes, in duration at consulting rooms, if that attendance and another attendance to which any of items 296, 297, 299, 300, 302, 304, 306, 308, 91827 to 91831, 91837 to 91839 and 92437 applies have not exceeded 50 attendances in a calendar year for the patient

Fee: $100.00 Benefit: 75% = $75.00 85% = $85.00

(See para AN.0.25, AN.0.30, AN.0.31, AN.0.32, AN.0.75, AN.0.76, AN.40.1 of explanatory notes to this Category)

Professional attendance by a consultant physician in the practice of the consultant physician's specialty of psychiatry following referral of the patient to him or her by a referring practitioner-an attendance of more than 30 minutes, but not more than 45 minutes, in duration at consulting rooms), if that attendance and another attendance to which any of items 296, 297, 299, 300, 302, 304, 306, 308, 91827 to 91831, 91837 to 91839 and 92437 applies have not exceeded 50 attendances in a calendar year for the patient

Fee: $153.90 Benefit: 75% = $115.45 85% = $130.85

(See para AN.0.25, AN.0.30, AN.0.31, AN.0.32, AN.0.75, AN.0.76, AN.40.1 of explanatory notes to this Category)

Professional attendance by a consultant physician in the practice of the consultant physician's specialty of psychiatry following referral of the patient to him or her by a referring practitioner-an attendance of more than 45 minutes, but not more than 75 minutes, in duration at consulting rooms, if that attendance and another attendance to which any of items 296, 297, 299, 300, 302, 304, 306, 308, 91827 to 91831, 91837 to 91839 and 92437 applies have not exceeded 50 attendances in a calendar year for the patient

Fee: $212.40 Benefit: 75% = $159.30 85% = $180.55

(See para AN.0.25, AN.0.30, AN.0.31, AN.0.32, AN.0.75, AN.0.76, AN.40.1 of explanatory notes to this Category)

Professional attendance by a consultant physician in the practice of the consultant physician's specialty of psychiatry following referral of the patient to him or her by a referring practitioner-an attendance of more than 75 minutes in duration at consulting rooms), if that attendance and another attendance to which any of items 296, 297, 299, 300, 302, 304, 306, 308, 91827 to 91831, 91837 to 91839 and 92437 applies have not exceeded 50 attendances in a calendar year for the patient

Fee: $246.50 Benefit: 75% = $184.90 85% = $209.55

(See para AN.0.25, AN.0.30, AN.0.31, AN.0.32, AN.0.75, AN.0.76, AN.40.1 of explanatory notes to this Category)

Group psychotherapy (including any associated consultations with a patient taking place on the same occasion and relating to the condition for which group therapy is conducted) of not less than 1 hour in duration given under the continuous direct supervision of a consultant physician in the practice of the consultant physician's specialty of psychiatry, involving a group of 2 to 9 unrelated patients or a family group of more than 3 patients, each of whom is referred to the consultant physician by a referring practitioner-each patient

Fee: $57.00 Benefit: 75% = $42.75 85% = $48.45

(See para AN.0.5, AN.0.25, AN.0.76, AN.40.1 of explanatory notes to this Category)

Group psychotherapy (including any associated consultations with a patient taking place on the same occasion and relating to the condition for which group therapy is conducted) of not less than 1 hour in duration given under the continuous direct supervision of a consultant physician in the practice of the consultant physician's specialty of psychiatry, involving a family group of 3 patients, each of whom is referred to the consultant physician by a referring practitioner-each patient

Fee: $75.65 Benefit: 75% = $56.75 85% = $64.35

(See para AN.0.5, AN.0.25, AN.0.76, AN.40.1 of explanatory notes to this Category)

Group psychotherapy (including any associated consultations with a patient taking place on the same occasion and relating to the condition for which group therapy is conducted) of not less than 1 hour in duration given under the continuous direct supervision of a consultant physician in the practice of the consultant physician's specialty of psychiatry, involving a family group of 2 patients, each of whom is referred to the consultant physician by a referring practitioner-each patient

Fee: $111.95 Benefit: 75% = $84.00 85% = $95.20

(See para AN.0.5, AN.0.25, AN.0.76, AN.0.77, AN.40.1 of explanatory notes to this Category)

Professional attendance by a specialist in the practice of neurosurgery following referral of the patient to the specialist-an attendance (other than a second or subsequent attendance in a single course of treatment) at consulting rooms or hospital

Fee: $149.80 Benefit: 75% = $112.35 85% = $127.35

(See para AN.0.64, AN.40.1 of explanatory notes to this Category)

Professional attendance by a specialist in the practice of neurosurgery following referral of the patient to the specialist-a minor attendance after the first in a single course of treatment at consulting rooms or hospital

Fee: $49.75 Benefit: 75% = $37.35 85% = $42.30

(See para AN.0.64, AN.0.70, AN.3.1, AN.40.1 of explanatory notes to this Category)

Professional attendance by a specialist in the practice of neurosurgery following referral of the patient to the specialist-an attendance after the first in a single course of treatment, involving an extensive and comprehensive examination, arranging any necessary investigations in relation to one or more complex problems and of more than 15 minutes in duration but not more than 30 minutes in duration at consulting rooms or hospital

Fee: $98.95 Benefit: 75% = $74.25 85% = $84.15

(See para AN.0.64, AN.0.70, AN.3.1, AN.40.1 of explanatory notes to this Category)

Professional attendance by a specialist in the practice of neurosurgery following referral of the patient to the specialist-an attendance after the first in a single course of treatment, involving a detailed and comprehensive examination, arranging any necessary investigations in relation to one or more complex problems and of more than 30 minutes in duration but not more than 45 minutes in duration at consulting rooms or hospital

Fee: $137.05 Benefit: 75% = $102.80 85% = $116.50

(See para AN.0.64, AN.0.70, AN.3.1, AN.40.1 of explanatory notes to this Category)

Professional attendance by a specialist in the practice of neurosurgery following referral of the patient to the specialist-an attendance after the first in a single course of treatment, involving an exhaustive and comprehensive examination, arranging any necessary investigations in relation to one or more complex problems and of more than 45 minutes in duration at consulting rooms or hospital

Fee: $174.50 Benefit: 75% = $130.90 85% = $148.35

(See para AN.0.64, AN.0.70, AN.3.1, AN.40.1 of explanatory notes to this Category)

Professional attendance of more than 60 minutes in duration at consulting rooms or hospital by a consultant physician or specialist in the practice of the consultant physician's or specialist's specialty of geriatric medicine, if:

(a) the patient is at least 65 years old and referred by a medical practitioner practising in general practice (including a general practitioner, but not including a specialist or consultant physician) or a participating nurse practitioner; and

(b) the attendance is initiated by the referring practitioner for the provision of a comprehensive assessment and management plan; and

(c) during the attendance:

     (i) the medical, physical, psychological and social aspects of the patient's health are evaluated in detail using appropriately validated assessment tools if indicated (the assessment); and

     (ii) the patient's various health problems and care needs are identified and prioritised (the formulation); and

     (iii) a detailed management plan is prepared (the management plan) setting out:

          (A) the prioritised list of health problems and care needs; and

          (B) short and longer term management goals; and

          (C) recommended actions or intervention strategies to be undertaken by the patient's general practitioner or another relevant health care provider that are likely to improve or maintain health status and are readily available and acceptable to the patient and the patient's family and carers; and

    (iv) the management plan is explained and discussed with the patient and, if appropriate, the patient's family and any carers; and

    (v) the management plan is communicated in writing to the referring practitioner; and

(d) an attendance to which item 104, 105, 107, 108, 110, 116 or 119 applies has not been provided to the patient on the same day by the same practitioner; and

(e) an attendance to which this item or item 145 applies has not been provided to the patient by the same practitioner in the preceding 12 months

Fee: $523.40 Benefit: 75% = $392.55 85% = $444.90

(See para AN.0.26, AN.40.1 of explanatory notes to this Category)

Professional attendance of more than 30 minutes in duration at consulting rooms or hospital by a consultant physician or specialist in the practice of the consultant physician's or specialist's specialty of geriatric medicine to review a management plan previously prepared by that consultant physician or specialist under item 141 or 145, if:

(a) the review is initiated by the referring medical practitioner practising in general practice or a participating nurse practitioner; and

(b) during the attendance:

     (i) the patient's health status is reassessed; and

     (ii) a management plan prepared under item 141 or 145 is reviewed and revised; and

     (iii) the revised management plan is explained to the patient and (if appropriate) the patient's family and any carers and communicated in writing to the referring practitioner; and

(c) an attendance to which item 104, 105, 107, 108, 110, 116 or 119 applies was not provided to the patient on the same day by the same practitioner; and

(d) an attendance to which item 141 or 145 applies has been provided to the patient by the same practitioner in the preceding 12 months; and

(e) an attendance to which this item or item 147 applies has not been provided to the patient in the preceding 12 months, unless there has been a significant change in the patient's clinical condition or care circumstances that requires a further review

Fee: $327.20 Benefit: 75% = $245.40 85% = $278.15

(See para AN.0.26, AN.40.1 of explanatory notes to this Category)

Professional attendance at consulting rooms by a consultant physician in the practice of the physician’s specialty of psychiatry to prepare an eating disorder treatment and management plan, if:

(a) the patient is referred; and

(b) the attendance lasts at least 45 minutes

Fee: $523.40 Benefit: 85% = $444.90

(See para AN.36.1, AN.36.2, AN.40.1 of explanatory notes to this Category)

Professional attendance at consulting rooms by a consultant physician in the practice of the physician’s specialty of paediatrics to prepare an eating disorder treatment and management plan, if:

(a) the patient is referred; and

(b) the attendance lasts at least 45 minutes

Fee: $305.15 Benefit: 85% = $259.40

(See para AN.36.1, AN.36.2, AN.40.1 of explanatory notes to this Category)

Telehealth attendance for a person by a consultant physician in the practice of the consultant physician’s specialty (other than psychiatry) if:

(a)           the attendance follows referral of the patient to the specialist; and

(b)           the attendance was of more than 5 minutes in duration. 

Where the attendance was other than a second or subsequent attendance as part of a single course of treatment.

Fee: $174.50 Benefit: 85% = $148.35

(See para AN.0.7, AN.40.1 of explanatory notes to this Category)

Telehealth attendance for a person by a consultant physician in the practice of the consultant physician’s specialty (other than psychiatry) if:

(a)           the attendance follows referral of the patient to the specialist; and

(b)           the attendance was of more than 5 minutes in duration.

 Where the attendance is not a minor attendance after the first as part of a single course of treatment.

Fee: $87.30 Benefit: 85% = $74.25

(See para AN.0.7, AN.0.70, AN.3.1, AN.40.1 of explanatory notes to this Category)

Telehealth attendance for a person by a consultant physician in the practice of the consultant physician’s specialty (other than psychiatry) if:

(a)           the attendance follows referral of the patient to the specialist; and

(b)           the attendance was of more than 5 minutes in duration. 

Where the attendance is a minor attendance after the first as part of a single course of treatment.

Fee: $49.75 Benefit: 85% = $42.30

(See para AN.0.7, AN.0.70, AN.3.1, AN.40.1 of explanatory notes to this Category)

Telehealth attendance by a consultant physician in the practice of the consultant physician’s specialty (other than psychiatry) of at least 45 minutes in duration for an initial assessment of a patient with at least 2 morbidities (which may include complex congenital, developmental and behavioural disorders) following referral of the patient to the consultant physician by a referring practitioner, if:

(a) an assessment is undertaken that covers:

     (i) a comprehensive history, including psychosocial history and medication review; and

     (ii) comprehensive multi or detailed single organ system assessment; and

     (iii) the formulation of differential diagnoses; and

(b) a consultant physician treatment and management plan of significant complexity is prepared and provided to the referring practitioner, which involves:

    (i) an opinion on diagnosis and risk assessment; and

    (ii) treatment options and decisions; and

    (iii) medication recommendations; and

(c) an attendance on the patient to which item 110, 116, 119 of the general medical services table or item 91824, 91825, 91826 or 91836 applies did not take place on the same day by the same consultant physician; and

(d) this item, or item 132 of the general medical services table, has not applied to an attendance on the patient in the preceding 12 months by the same consultant physician

Fee: $305.15 Benefit: 85% = $259.40

(See para AN.0.7, AN.40.1 of explanatory notes to this Category)

Telehealth attendance by a consultant physician in the practice of the consultant physician’s specialty (other than psychiatry) of at least 20 minutes in duration after the first attendance in a single course of treatment for a review of a patient with at least 2 morbidities (which may include complex congenital, developmental and behavioural disorders) if:

(a) a review is undertaken that covers:

    (i) review of initial presenting problems and results of diagnostic investigations; and

    (ii) review of responses to treatment and medication plans initiated at time of initial consultation; and

    (iii) comprehensive multi or detailed single organ system assessment; and

    (iv) review of original and differential diagnoses; and

(b) the modified consultant physician treatment and management plan is provided to the referring practitioner, which involves, if appropriate:

     (i) a revised opinion on the diagnosis and risk assessment; and

     (ii) treatment options and decisions; and

     (iii) revised medication recommendations; and

(c) an attendance on the patient to which item 110, 116, 119 of the general medical services table or 91824, 91825, 91826 or 91836 applies did not take place on the same day by the same consultant physician; and

(d) item 132 of the general medical services table or item 92422 applied to an attendance claimed in the preceding 12 months; and

(e) the attendance under this item is claimed by the same consultant physician who claimed item 132 of the general medical services table or 92422; and

(f) this item, or item 133 of the general medical services table has not applied more than twice in any 12 month period

Fee: $152.80 Benefit: 85% = $129.90

(See para AN.0.7, AN.40.1 of explanatory notes to this Category)

Phone attendance for a person by a consultant physician in the practice of the consultant physician’s specialty (other than psychiatry) if:

(a)           the attendance follows referral of the patient to the specialist; and

(b)           the attendance was of more than 5 minutes in duration.

Where the attendance is a minor attendance after the first as part of a single course of treatment.

Fee: $49.75 Benefit: 85% = $42.30

(See para AN.0.7, AN.0.25, AN.0.70, AN.3.1, AN.40.1 of explanatory notes to this Category)

Professional attendance at consulting rooms by a consultant physician in the practice of the physician’s specialty of psychiatry to review an eating disorder treatment and management plan, if:

(a) the patient is referred; and

(b) the attendance lasts at least 30 minutes

Fee: $327.20 Benefit: 85% = $278.15

(See para AN.36.1, AN.36.3, AN.40.1 of explanatory notes to this Category)

Professional attendance at consulting rooms by a consultant physician in the practice of the physician’s specialty of paediatrics to review an eating disorder treatment and management plan, if:

(a) the patient is referred; and

(b) the attendance lasts at least 20 minutes

Fee: $152.80 Benefit: 85% = $129.90

(See para AN.36.1, AN.36.3, AN.40.1 of explanatory notes to this Category)

Professional attendance at consulting rooms or hospital, by a consultant physician in the practice of the consultant physician's specialty (other than psychiatry) following referral of the patient to the consultant physician by a referring practitioner-initial attendance in a single course of treatment

Fee: $174.50 Benefit: 75% = $130.90 85% = $148.35

(See para AN.0.7, AN.0.25, AN.40.1 of explanatory notes to this Category)

Professional attendance at consulting rooms or hospital, by a consultant physician in the practice of the consultant physician's specialty (other than psychiatry) following referral of the patient to the consultant physician by a referring practitioner-each attendance (other than a service to which item 119 applies) after the first in a single course of treatment

Fee: $87.30 Benefit: 75% = $65.50 85% = $74.25

(See para AN.0.7, AN.0.25, AN.0.70, AN.3.1, AN.40.1 of explanatory notes to this Category)

Professional attendance at consulting rooms or hospital, by a consultant physician in the practice of the consultant physician's specialty (other than psychiatry) following referral of the patient to the consultant physician by a referring practitioner-each minor attendance after the first in a single course of treatment

Fee: $49.75 Benefit: 75% = $37.35 85% = $42.30

(See para AN.0.7, AN.0.21, AN.0.25, AN.0.70, AN.3.1, AN.40.1 of explanatory notes to this Category)

Professional attendance by a consultant physician in the practice of the consultant physician's specialty (other than psychiatry) of at least 45 minutes in duration for an initial assessment of a patient with at least 2 morbidities (which may include complex congenital, developmental and behavioural disorders) following referral of the patient to the consultant physician by a referring practitioner, if:

(a) an assessment is undertaken that covers:

      (i) a comprehensive history, including psychosocial history and medication review; and

      (ii) comprehensive multi or detailed single organ system assessment; and

      (iii) the formulation of differential diagnoses; and

(b) a consultant physician treatment and management plan of significant complexity is prepared and provided to the referring practitioner, which involves:

      (i) an opinion on diagnosis and risk assessment; and

      (ii) treatment options and decisions; and

      (iii) medication recommendations; and

(c) an attendance on the patient to which item 110, 116 or 119 applies did not take place on the same day by the same consultant physician; and

(d) this item has not applied to an attendance on the patient in the preceding 12 months by the same consultant physician

Fee: $305.15 Benefit: 75% = $228.90 85% = $259.40

(See para AN.0.7, AN.0.23, AN.40.1 of explanatory notes to this Category)

Professional attendance by a consultant physician in the practice of the consultant physician's specialty (other than psychiatry) of at least 20 minutes in duration after the first attendance in a single course of treatment for a review of a patient with at least 2 morbidities (which may include complex congenital, developmental and behavioural disorders) if:

(a) a review is undertaken that covers:

      (i) review of initial presenting problems and results of diagnostic investigations; and

      (ii) review of responses to treatment and medication plans initiated at time of initial consultation; and

      (iii) comprehensive multi or detailed single organ system assessment; and

      (iv) review of original and differential diagnoses; and

(b) the modified consultant physician treatment and management plan is provided to the referring practitioner, which involves, if appropriate:

     (i) a revised opinion on the diagnosis and risk assessment; and

     (ii) treatment options and decisions; and

     (iii) revised medication recommendations; and

(c) an attendance on the patient to which item 110, 116 or 119 applies did not take place on the same day by the same consultant physician; and

(d) item 132 applied to an attendance claimed in the preceding 12 months; and

(e) the attendance under this item is claimed by the same consultant physician who claimed item 132 or a locum tenens; and

(f) this item has not applied more than twice in any 12 month period

Fee: $152.80 Benefit: 75% = $114.60 85% = $129.90

(See para AN.0.7, AN.0.23, AN.40.1 of explanatory notes to this Category)

LEVEL A

Professional attendance at consulting rooms by a public health physician in the practice of his or her specialty of public health medicine 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.

Fee: $22.60 Benefit: 75% = $16.95 85% = $19.25

(See para AN.0.50, AN.40.1 of explanatory notes to this Category)

LEVEL B

Professional attendance by a public health physician in the practice of his or her specialty of public health medicine at consulting rooms 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.

Fee: $49.40 Benefit: 75% = $37.05 85% = $42.00

(See para AN.0.50, AN.40.1 of explanatory notes to this Category)

LEVEL C

Professional attendance by a public health physician in the practice of his or her specialty of public health medicine at consulting rooms 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.

Fee: $95.65 Benefit: 75% = $71.75 85% = $81.35

(See para AN.0.50, AN.40.1 of explanatory notes to this Category)

LEVEL D

Professional attendance by a public health physician in the practice of his or her specialty of public health medicine at consulting rooms 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.

Fee: $140.80 Benefit: 75% = $105.60 85% = $119.70

(See para AN.0.50, AN.40.1 of explanatory notes to this Category)

Telehealth attendance for a person by a specialist in the practice of the specialist’s specialty if:

(a)           the attendance follows referral of the patient to the specialist; and

(b)           the attendance was of more than 5 minutes in duration.

 Where the attendance was other than a second or subsequent attendance as part of a single course of treatment.

Fee: $98.95 Benefit: 85% = $84.15

(See para AN.0.7, AN.0.25, AN.40.1 of explanatory notes to this Category)

Telehealth attendance for a person by a specialist in the practice of the specialist’s specialty if:

(a)           the attendance follows referral of the patient to the specialist; and

(b)           the attendance was of more than 5 minutes in duration.

 Where the attendance is after the first attendance as part of a single course of treatment.

Fee: $49.75 Benefit: 85% = $42.30

(See para AN.0.7, AN.0.70, AN.3.1, AN.40.1 of explanatory notes to this Category)