Medicare Benefits Schedule - Note CN.0.11

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Category 7 - CLEFT AND CRANIOFACIAL SERVICES

CN.0.11

Referral of Oral and Maxillofacial Surgical Services

Benefits are payable for items 75002 to 75621 only where the service has been rendered to a patient who has been referred by letter of referral by a medical practitioner or referring dentist. 

Item 75621 may be claimed in association with items 46150 to 46161 where the service is performed by a practitioner holding a FRACDS (OMS) qualification.

Related Items: 46150 46151 46152 46153 46154 46155 46156 46157 46158 46159 46160 46161 75621


Related Items

Category 7 - CLEFT AND CRANIOFACIAL SERVICES

75621

75621 - Additional Information

Item Start Date:
01-Jul-1995
Description Updated:
01-Mar-2024
Schedule Fee Updated:
01-Nov-2023

The fabrication and fitting of surgical splint or guide in conjunction with orthognathic surgical procedures and implant treatment, if provided in association with a service to which:

(a) any item in the following series applies:

(i) any of items 46150 to 46161 apply; or
(ii) any of items 52342 to 52375 apply; or

(b) item 52380 or 52382 applies; 

(c) item 75610 applies

 

Fee: $254.90 Benefit: 75% = $191.20 85% = $216.70

(See para CN.0.11, CN.2.1 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

46150

46150 - Additional Information

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

Mandible or maxilla, procedure for advancement, retrusion or alteration of tilt, by osteotomy in standard planes, including fixation by any means (including application of distractors if used)—one service per patient on the same occasion (H)

(Anaes.) (Assist.)

Fee: $1,463.70 Benefit: 75% = $1,097.80

(See para CN.0.11, TN.8.107, TN.8.269 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

46151

46151 - Additional Information

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

Mandible and maxilla (bimaxillary), procedure for advancement, retrusion or alteration of tilt, or combination of these, by osteotomies in standard planes, including fixation by any means (including application of distractors if used)—conjoint surgery, principal specialist surgeon, one service per patient on the same occasion (H)

(Anaes.) (Assist.)

Fee: $1,595.95 Benefit: 75% = $1,197.00

(See para CN.0.11, TN.8.107, TN.8.269 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

46152

46152 - Additional Information

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

Mandible and maxilla (bimaxillary), procedure for advancement, retrusion or alteration of tilt, or combination of these, by osteotomies in standard planes, including fixation by any means (including application of distractors if used)—conjoint surgery, conjoint specialist surgeon, one service per patient on the same occasion (H)

(Anaes.) (Assist.)

Fee: $1,196.95 Benefit: 75% = $897.75

(See para CN.0.11, TN.8.107, TN.8.269 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

46153

46153 - Additional Information

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

Mandible and maxilla (bimaxillary), procedure for advancement, retrusion or alteration of tilt, or combination of these, by osteotomies in standard planes, including fixation by any means (including application of distractors if used)—single surgeon, one service per patient on the same occasion (H)

(Anaes.) (Assist.)

Fee: $1,994.80 Benefit: 75% = $1,496.10

(See para CN.0.11, TN.8.107, TN.8.269 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

46154

46154 - Additional Information

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

Maxilla, procedure for reshaping arch of, by complex segmental osteotomies, including fixation by any means (including application of distractors if used), one service per patient on the same occasion (H)

(Anaes.) (Assist.)

Fee: $1,670.50 Benefit: 75% = $1,252.90

(See para CN.0.11, TN.8.107 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

46155

46155 - Additional Information

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

Mandible, procedure for reshaping arch of, by complex segmental osteotomies, including genioplasty (if performed) and fixation by any means (including application of distractors if used), one service per patient on the same occasion (H)

(Anaes.) (Assist.)

Fee: $1,670.50 Benefit: 75% = $1,252.90

(See para CN.0.11, TN.8.107 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

46156

46156 - Additional Information

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

Mandible and maxilla (bimaxillary), procedure for any combination of arch reshaping, advancement, retrusion or tilting of, involving complex segmental osteotomies, with or without standard osteotomies, including genioplasty (if performed) and fixation by any means (including application of distractors if used)—conjoint surgery, principal specialist surgeon, one service per patient on the same occasion (H)

(Anaes.) (Assist.)

Fee: $1,907.10 Benefit: 75% = $1,430.35

(See para CN.0.11, TN.8.107 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

46157

46157 - Additional Information

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

Mandible and maxilla (bimaxillary), procedure for any combination of arch reshaping, advancement, retrusion or tilting of, involving complex segmental osteotomies, with or without standard osteotomies, including genioplasty (if performed) and fixation by any means (including application of distractors if used)—conjoint surgery, conjoint specialist surgeon, one service per patient on the same occasion (H)

(Anaes.) (Assist.)

Fee: $1,430.30 Benefit: 75% = $1,072.75

(See para CN.0.11, TN.8.107 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

46158

46158 - Additional Information

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

Mandible and maxilla (bimaxillary), procedure for any combination of arch reshaping, advancement, retrusion or tilting of, involving complex segmental osteotomies, with or without standard osteotomies, including genioplasty (if performed) and fixation by any means (including application of distractors if used)—single surgeon, one service per patient on the same occasion (H)

(Anaes.) (Assist.)

Fee: $2,383.80 Benefit: 75% = $1,787.85

(See para CN.0.11, TN.8.107 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

46159

46159 - Additional Information

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

Midfacial osteotomies, Le Fort II or Le Fort III—conjoint surgery, principal specialist surgeon (H)

(Anaes.) (Assist.)

Fee: $2,109.05 Benefit: 75% = $1,581.80

(See para CN.0.11 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

46160

46160 - Additional Information

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

Midfacial osteotomies, Le Fort II or Le Fort III—conjoint surgery, conjoint specialist surgeon (H)

(Anaes.) (Assist.)

Fee: $1,581.75 Benefit: 75% = $1,186.35

(See para CN.0.11 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

46161

46161 - Additional Information

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

Midfacial osteotomies, Le Fort II or Le Fort III—single surgeon (H)

(Anaes.) (Assist.)

Fee: $2,636.25 Benefit: 75% = $1,977.20

(See para CN.0.11 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