Medicare Benefits Schedule - Note AN.7.4

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Category 1 - PROFESSIONAL ATTENDANCES

AN.7.4

Prescribed Medical Practitioner Family Group Therapy (Items 221, 222 and 223)

Last reviewed: 1 November 2023

These items refer to family group therapy supervised by prescribed medical practitioners (see note AN.7.1). To be used, these items require that a formal intervention with a specific therapeutic outcome, such as improved family function and/or communication, is undertaken. Other types of group attendances do not attract benefits. It should be noted that only one fee applies in respect of each group of patients.

Telephone consultations, letters of advice by prescribed medical practitioners, the issue of repeat prescriptions when the patient is not in attendance, post mortem examinations, the issue of death certificates, cremation certificates, counselling of relatives (note ‑ items 348, 350 and 352 are not counselling services), group attendances (other than group attendances covered by items 170, 171, 172, 221, 222, 223, 342, 344 and 346) such as group counselling, health education, weight reduction or fitness classes do not qualify for benefit.

Although Medicare benefits are not payable for the issue of a death certificate, 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: 221 222 223


Related Items

Category 1 - PROFESSIONAL ATTENDANCES

221

221 - Additional Information

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

Professional attendance for the purpose of Group therapy lasting at least one hour given under the direct continuous supervision of a prescribed medical practitioner, involving members of a family and persons with close personal relationships with that family—each Group of 2 patients

Fee: $103.50 Benefit: 75% = $77.65 100% = $103.50

(See para AN.7.1, AN.7.4 of explanatory notes to this Category)

Category 1 - PROFESSIONAL ATTENDANCES

222

222 - Additional Information

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

Professional attendance for the purpose of Group therapy lasting at least one hour given under the direct continuous supervision of a prescribed medical practitioner, involving members of a family and persons with close personal relationships with that family—each Group of 3 patients

Fee: $109.10 Benefit: 75% = $81.85 100% = $109.10

(See para AN.7.1, AN.7.4 of explanatory notes to this Category)

Category 1 - PROFESSIONAL ATTENDANCES

223

223 - Additional Information

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

Professional attendance for the purpose of Group therapy lasting at least one hour given under the direct continuous supervision of a prescribed medical practitioner, involving members of a family and persons with close personal relationships with that family—each Group of 4 or more patients

Fee: $132.70 Benefit: 75% = $99.55 100% = $132.70

(See para AN.7.1, AN.7.4 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