Medicare Benefits Schedule - Note MN.10.1

These allied health items provide a benefit for:

• the assessment of patients for the purpose of assisting the referring eligible medical practitioner with the diagnosis (including a differential diagnosis) of a complex Neurodevelopmental Disorder (such as Autism Spectrum Disorder) or an eligible disability; or
• to contribute to a treatment and management plan that is being developed by the referring eligible medical practitioner.

The list of eligible disabilities can be found at MN.10.3.

Number of services

• A maximum of 8 services can be claimed per patient per lifetime, including services consisting of any combination of 82000, 82005, 82010, 82030, 93032, 93033, 93040 or 93041.
• A course of assessment means up to 4 services.
• Up to 4 of these services may be provided to the same patient on the same day.
• Where a patient requires more than 4 services from the same eligible allied health provider, review and agreement is required by the referring medical practitioner before further Medicare eligible services can be claimed. 

Provision of assessment services and need for review and agreement by the referring eligible medical practitioner

• An eligible allied health practitioner can provide up to 4 assessment services without the need for review and agreement by the referring eligible medical practitioner.
• If an eligible allied health professional has provided 4 assessment services to a patient and proposes to provide more assessment services to that patient, review and agreement from the referring eligible medical practitioner must be obtained prior.
• The referring eligible medical practitioner may specify the type of review that should be undertaken as part of the original referral. If it is not specified, an acceptable means of review includes: a case conference, phone call, written correspondence, secure online messaging exchange, or attendance with the referring eligible medical practitioner. 
• The review and agreement by the referring eligible medical practitioner should be recorded by the eligible allied health practitioner in the patient notes.

Referral requirements

For an MBS benefit to be claimed for these services, a valid referral from an eligible medical practitioner (or subsequent interdisciplinary referral) is required. The general requirements for referrals under group M10 (subgroup 1) are detailed in Note AN.15.6 ‘Referral requirements for allied health services’. 

The eligible medical practitioner referral is only valid if the referring eligible medical practitioner used any of the following MBS items* for the suspected diagnosis of:

• complex Neurodevelopmental Disorders referred by a:

- consultant psychiatrist using items 296 to 308, 310, 312, 314, 316, 318 or 319 to 349 of the general medical services table or items 91827, 91828, 91829, 91830, 91831, 91837, 91838, 91839, 92437, 92455, 92456 or 92457 of the Telehealth Attendance Determination.

- consultant paediatrician using items 110 to 131 of the general medical services table or items 91824, 91825, 91826 or 91836 of the Telehealth Attendance Determination.

• eligible disability referred by a:

- specialist or consultant physician using items 104 to 131, 296 to 308, 310, 312, 314, 316, 318 or 319 to 349 of the general medical services table or items 91822 to 91839, 92437, 92455, 92456 or 92457 of the Telehealth Attendance Determination.

- GP using items 3 to 47 of the general medical services table or item 91790, 91800, 91801, 91802, 91890 or 91891 of the Telehealth Attendance Determination.

* Note that more information on the telehealth (video and phone) items that can be claimed for these services can be found in Note AN.40.1.

A separate referral from the eligible medical practitioner is required for each eligible allied health practitioner providing the service. A Medicare claim must be submitted for the referring MBS service before a benefit for the subsequent referred allied health service can be paid.

Allied health practitioners should retain referrals for 24 months from the date the service was rendered for Medicare auditing purposes.

Interdisciplinary referrals

If an eligible allied health practitioner seeks to make an interdisciplinary referral of the patient to another eligible allied health professional, this must be undertaken in consultation and agreement with, but without the need for a physical attendance by, the original referring eligible medical practitioner (such as but not limited to, a phone call, written correspondence or secure online messaging exchange). This consultation and agreement should be documented in the patient notes by the eligible allied health practitioner and included in the interdisciplinary referral. The referral may be a letter or note to an eligible allied health practitioner, signed and dated by the referring eligible allied health practitioner. There is no specific form to refer patients for these services. The referral should include a copy of the original referral by the eligible medical practitioner.

Interdisciplinary referrals will only be valid where the referring eligible medical practitioner’s referral (whose original referral initiated the assessment and assisting with a diagnosis service/contribution to a treatment and management plan) remains valid.

Reporting requirements for assessment services

After completion of the final assessment service by an eligible allied health practitioner, a written report must be provided to the referring eligible medical practitioner that outlines the assessment findings. Preparation of the report is not counted towards the service time under the item.

The written report must include information on:

• the assessment/s provided;
• the results of the assessment/s that may assist with diagnostic formulation or development of a treatment and management plan by the referring eligible medical practitioner; and
• if applicable, advice on further assessments that could be undertaken by other eligible allied health practitioners to assist with the referring medical practitioners’ diagnostic formulation or development of a treatment and management plan by the referring eligible medical practitioner.

Related Items: 3 4 23 24 36 37 44 47 104 105 106 107 108 109 110 111 115 116 117 119 120 122 123 124 125 126 127 128 129 131 296 297 299 300 301 302 303 304 306 308 310 312 314 316 318 319 320 322 324 326 328 330 332 334 336 338 341 342 343 344 345 346 347 349 82000 82005 82010 82030 91790 91800 91801 91802 91822 91823 91824 91825 91826 91827 91828 91829 91830 91831 91833 91836 91837 91838 91839 91890 91891 92437 92455 92456 92457 93032 93033 93040 93041 93044

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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—initial attendance in a single course of treatment, other than a service to which item 106, 109, 125 or 16401 applies

Fee: $101.30 Benefit: 75% = $76.00 85% = $86.15

(See para AN.0.7, AN.0.25, AN.2.1, AN.40.1, MN.10.1, 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 initial attendance in a single course of treatment, if that attendance is at consulting rooms or hospital, other than a service to which item 126 or 16404 applies

Fee: $50.95 Benefit: 75% = $38.25 85% = $43.35

(See para AN.0.7, AN.0.25, AN.0.70, AN.2.1, AN.3.1, AN.40.1, MN.10.1, TN.1.4 of explanatory notes to this Category)

Professional attendance by a specialist in the practice of the specialist's specialty of ophthalmology and following referral of the patient to the specialist-an attendance (other than a second or subsequent attendance in a single course of treatment) at which the only service provided is refraction testing for the issue of a prescription for spectacles or contact lenses, if that attendance is at consulting rooms or hospital (other than a service to which any of items 104, 109 and 10801 to 10816 applies)

Fee: $84.05 Benefit: 75% = $63.05 85% = $71.45

(See para MN.10.1 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 (other than a second or subsequent attendance in a single course of treatment), if that attendance is at a place other than consulting rooms or hospital

Fee: $148.65 Benefit: 75% = $111.50 85% = $126.40

(See para AN.0.25, MN.10.1 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-each attendance after the first in a single course of treatment, if that attendance is at a place other than consulting rooms or hospital

Fee: $94.10 Benefit: 75% = $70.60 85% = $80.00

(See para AN.0.25, MN.10.1 of explanatory notes to this Category)

Professional attendance by a specialist in the practice of the specialist's specialty of ophthalmology following referral of the patient to the specialist-an attendance (other than a second or subsequent attendance in a single course of treatment) at which a comprehensive eye examination, including pupil dilation, is performed on:

(a) a patient aged 9 years or younger; or

(b) a patient aged 14 years or younger with developmental delay;

(other than a service to which any of items 104, 106 and 10801 to 10816 applies)

Fee: $228.30 Benefit: 75% = $171.25 85% = $194.10

(See para MN.10.1 of explanatory notes to this Category)

Professional attendance at consulting rooms or in hospital by a specialist in the practice of the specialist's specialty following referral of the patient to the specialist by a referring practitioner-an attendance after the first attendance in a single course of treatment, if:

(a) during the attendance, the specialist determines the need to perform an operation on the patient that had not otherwise been scheduled; and

(b) the specialist subsequently performs the operation on the patient, on the same day; and

(c) the operation is a service to which an item in Group T8 applies; and

(d) the amount specified in the item in Group T8 as the fee for a service to which that item applies is $349.95 or more

For any particular patient, once only on the same day

Fee: $50.95 Benefit: 75% = $38.25 85% = $43.35

(See para AN.0.24, MN.10.1 of explanatory notes to this Category)

Professional attendance at consulting rooms or in hospital on a day by a medical practitioner (the attending practitioner) who is a specialist or consultant physician in the practice of the attending practitioner’s specialty after referral of the patient to the attending practitioner by a referring practitioner—an attendance after the initial attendance in a single course of treatment, if:

(a) the attending practitioner performs a scheduled operation on the patient on the same day; and

(b) the operation is a service to which an item in Group T8 applies; and

(c) the amount specified in the item in Group T8 as the fee for a service to which that item applies is $349.95 or more; and

(d) the attendance is unrelated to the scheduled operation; and

(e) it is considered a clinical risk to defer the attendance to a later day

For any particular patient, once only on the same day

Fee: $50.95 Benefit: 75% = $38.25 85% = $43.35

(See para AN.0.24, AN.3.1, MN.10.1 of explanatory notes to this Category)

Professional attendance lasting at least 45 minutes at consulting rooms or hospital, by a specialist in the practice of the specialist’s specialty of gynaecology, following referral of the patient to the specialist by a referring practitioner—initial attendance in a single course of treatment, if:

(a) the specialist takes a comprehensive history, including psychosocial history and medication review; and

(b) the specialist undertakes any of the following that are clinically relevant:

(i) a comprehensive multi-system physical examination;

(ii) consideration of multiple complex diagnoses;

(iii) discussion of all treatment options available;

(iv) assessment of pros and cons of each treatment option given patient characteristics and medical history;

(v) consideration, discussion and provision of necessary referrals for clinically appropriate investigations or treatment;

(vi) communication of a patient-centred management plan; and

(c) the specialist makes available to the patient or carer written documentation that outlines treatment options and information on associated risks and benefits; and

(d) another attendance on the patient did not take place on the same day by the specialist in the same single course of treatment

Fee: $178.70 Benefit: 75% = $134.05 85% = $151.90

(See para AN.0.1, AN.0.7, AN.3.2, AN.40.1, MN.10.1 of explanatory notes to this Category)

Professional attendance lasting at least 45 minutes at consulting rooms or hospital, by a specialist in the practice of the specialist’s specialty of gynaecology, following referral of the patient to the specialist by a referring practitioner—an attendance after the initial attendance in a single course of treatment, if:

(a) the specialist takes a comprehensive history, including psychosocial history and medication review; and

(b) the specialist reviews implemented management strategies; and

(c) the specialist undertakes any of the following that are clinically relevant:

(i) update of management plan;

(ii) performance of a physical examination;

(iii) discussion of treatment options;

(iv) consideration, discussion and provision of necessary referrals;

(v) provision of appropriate education; and

(d) the specialist makes available to the patient or carer written documentation that outlines treatment options and information on associated risks and benefits; and

(e) another attendance on the patient did not take place on the same day by the specialist in the same single course of treatment

Fee: $89.40 Benefit: 75% = $67.05 85% = $76.00

(See para AN.0.1, AN.0.7, AN.3.1, AN.3.2, AN.40.1, MN.10.1 of explanatory notes to this Category)

Video attendance lasting at least 45 minutes by a specialist in the practice of the specialist’s specialty of gynaecology, following referral of the patient to the specialist by a referring practitioner—initial attendance in a single course of treatment, if: 

(a) the specialist takes a comprehensive history, including psycho-social history and medication review; and 

(b) the specialist undertakes any of the following that are clinically relevant: 
 (i) arranging for necessary investigations which may include a detailed physical examination; 
 (ii) consideration of multiple complex diagnoses; 
 (iii) discussion of all treatment options available; 
 (iv) assessment of pros and cons of each treatment option given patient characteristics and medical history; 
 (v) consideration, discussion and provision of necessary referrals for clinically appropriate investigations or treatment; 
 (vi) communication of a patient-centred management plan; and 

(c) the specialist makes available to the patient or carer written documentation that outlines treatment options and information on associated risks and benefits; and 

(d) an attendance on the patient did not take place on the same day by the same specialist gynaecologist in the same single course of treatment. 

Fee: $178.70 Benefit: 85% = $151.90

(See para AN.3.2, AN.40.1, MN.10.1 of explanatory notes to this Category)

Video attendance lasting at least 45 minutes by a specialist in the practice of the specialist’s speciality of gynaecology, following referral of the patient to the specialist by a referring practitioner - an attendance after the initial attendance in a single course of treatment if: 

(a) the specialist updates the patient’s comprehensive history, including psycho-social history and medication review; and 

(b) the specialist reviews implemented management strategies; and 

(c) the specialist undertakes any of the following that are clinically relevant: 
 (i) update of management plan; 
 (ii) arranging for necessary investigations which may include a detailed physical examination; 
 (iii) discussion of treatment options; 
 (iv) consideration, discussion and provision of necessary referrals; 
 (v) provision of appropriate education; and 

(d) the specialist makes available to the patient or carer written documentation that outlines treatment options and information on associated risks and benefits; and 

(e) an attendance on the patient did not take place on the same day by the specialist for the same single course of treatment. 

Fee: $89.40 Benefit: 85% = $76.00

(See para AN.3.2, AN.40.1, MN.10.1 of explanatory notes to this Category)

Video 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 management

NOTE: It is a legislative requirement that this service must be performed by the patient’s eligible telehealth practitioner (please see Note AN.1.1 for the definitions as some exemptions do apply)

Fee: $20.05 Benefit: 100% = $20.05

(See para AN.0.9, AN.0.73, AN.0.74, MN.1.3, MN.1.4, MN.1.5, MN.1.6, MN.1.7, MN.1.8, MN.10.1 of explanatory notes to this Category)

Video attendance by a general practitioner lasting at least 6 minutes but less than 20 minutes if the attendance includes any of the following that are clinically relevant:

(a) taking a short patient history;

(b) arranging any necessary investigation;

(c) implementing a management plan;

(d) providing appropriate preventative health care

NOTE: It is a legislative requirement that this service must be performed by the patient’s eligible telehealth practitioner (please see Note AN.1.1 for the definitions as some exemptions do apply)

Fee: $43.90 Benefit: 100% = $43.90

(See para AN.0.9, AN.0.73, AN.0.74, MN.1.3, MN.1.4, MN.1.5, MN.1.6, MN.1.7, MN.1.8, MN.10.1 of explanatory notes to this Category)

Video attendance by a general practitioner lasting at least 20 minutes if the attendance includes any of the following that are clinically relevant:

(a) taking a detailed patient history;

(b) arranging any necessary investigation;

(c) implementing a management plan;

(d) providing appropriate preventative health care

NOTE: It is a legislative requirement that this service must be performed by the patient’s eligible telehealth practitioner (please see Note AN.1.1 for the definitions as some exemptions do apply)

Fee: $84.90 Benefit: 100% = $84.90

(See para AN.0.9, AN.0.73, AN.0.74, MN.1.3, MN.1.4, MN.1.5, MN.1.6, MN.1.7, MN.1.8, MN.10.1 of explanatory notes to this Category)

Video attendance by a general practitioner lasting at least 40 minutes if the attendance includes any of the following that are clinically relevant:

(a) taking an extensive patient history;

(b) arranging any necessary investigation;

(c) implementing a management plan;

(d) providing appropriate preventative health care

NOTE: It is a legislative requirement that this service must be performed by the patient’s eligible telehealth practitioner (please see Note AN.1.1 for the definitions as some exemptions do apply)

Fee: $125.10 Benefit: 100% = $125.10

(See para AN.0.9, AN.0.73, AN.0.74, MN.1.3, MN.1.4, MN.1.5, MN.1.6, MN.1.7, MN.1.8, MN.10.1 of explanatory notes to this Category)

Video 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: $101.30 Benefit: 85% = $86.15

(See para AN.0.7, AN.0.25, AN.40.1, MN.10.1 of explanatory notes to this Category)

Video 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: $50.95 Benefit: 85% = $43.35

(See para AN.0.7, AN.0.25, AN.0.70, AN.3.1, AN.40.1, MN.10.1 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: $50.95 Benefit: 85% = $43.35

(See para AN.0.7, AN.0.25, AN.0.70, AN.3.1, AN.40.1, MN.10.1 of explanatory notes to this Category)

Psychology health service provided to a patient aged under 25 years by an eligible psychologist if:

(a)    the patient was referred by an eligible medical practitioner, or by an eligible allied health practitioner following referral by an eligible medical practitioner, to:

(i)   assist the eligible medical practitioner with diagnostic formulation where the patient has a suspected complex neurodevelopmental disorder or eligible disability; or

(ii)  contribute to the patient’s treatment and management plan developed by the referring eligible medical practitioner where a complex neurodevelopmental disorder (such as autism spectrum disorder) or eligible disability is confirmed; and

(b)    the service is provided to the patient individually and in person; and

(c)    the service is at least 50 minutes duration

Up to 4 services to which this item or any of items 82005, 82010, 82030, 93032, 93033, 93040 or 93041 apply may be provided to the same patient on the same day

Fee: $116.40 Benefit: 85% = $98.95

(See para AN.0.24, AN.0.25, AN.0.72, AN.0.73, AN.15.6, MN.10.1, MN.10.3 of explanatory notes to this Category)

Speech pathology health service provided to a patient aged under 25 years by an eligible speech pathologist if:

(a)    the patient was referred by an eligible medical practitioner, or by an eligible allied health practitioner following referral by an eligible medical practitioner, to:

(i)   assist the eligible medical practitioner with diagnostic formulation where the patient has a suspected complex neurodevelopmental disorder or eligible disability; or

(ii)  contribute to the patient’s treatment and management plan developed by the referring eligible medical practitioner where a complex neurodevelopmental disorder (such as autism spectrum disorder) or eligible disability is confirmed; and

(b)    the service is provided to the patient individually and in person; and

(c)    the service is at least 50 minutes duration

Up to 4 services to which this item or any of items 82000, 82010, 82030, 93032, 93033, 93040 or 93041 apply may be provided to the same patient on the same day

Fee: $102.60 Benefit: 85% = $87.25

(See para AN.0.24, AN.0.25, AN.0.72, AN.0.73, AN.15.6, MN.10.1, MN.10.3 of explanatory notes to this Category)

Occupational therapy health service provided to a patient aged under 25 years by an eligible occupational therapist if:

(a)    the patient was referred by an eligible medical practitioner, or by an eligible allied health practitioner following referral by an eligible medical practitioner, to:

(i)   assist the eligible medical practitioner with diagnostic formulation where the patient has a suspected complex neurodevelopmental disorder or eligible disability; or

(ii)  contribute to the patient’s treatment and management plan developed by the referring eligible medical practitioner where a complex neurodevelopmental disorder (such as autism spectrum disorder) or eligible disability is confirmed; and

(b)    the service is provided to the patient individually and in person; and

(c)    the service is at least 50 minutes duration

Up to 4 services to which this item or any of items 82000, 82005, 82030, 93032, 93033, 93040 or 93041 apply may be provided to the same patient on the same day

Fee: $102.60 Benefit: 85% = $87.25

(See para AN.0.24, AN.0.25, AN.0.72, AN.0.73, AN.15.6, MN.10.1, MN.10.3 of explanatory notes to this Category)

Audiology, dietetic, exercise physiology, optometry, orthoptic or physiotherapy health service provided to a patient aged under 25 years by an eligible audiologist, dietitian, exercise physiologist, optometrist, orthoptist or physiotherapist if:

(a)    the patient was referred by an eligible medical practitioner, or by an eligible allied health practitioner following referral by an eligible medical practitioner, to:

(i)   assist the eligible medical practitioner with diagnostic formulation where the patient has a suspected complex neurodevelopmental disorder or eligible disability; or

(ii)  contribute to the patient’s treatment and management plan developed by the referring eligible medical practitioner where a complex neurodevelopmental disorder (such as autism spectrum disorder) or eligible disability is confirmed; and

(b)    the service is provided to the patient individually and in person; and

(c)    the service is at least 50 minutes duration

Up to 4 services to which this item or any of items 82000, 82005, 82010, 93032, 93033, 93040 or 93041 apply may be provided to the same patient on the same day

Fee: $102.60 Benefit: 85% = $87.25

(See para AN.0.24, AN.0.25, AN.0.72, AN.0.73, AN.15.6, MN.10.1, MN.10.3 of explanatory notes to this Category)

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

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

(b) has not received a professional attendance from this consultant physician 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, 92437 and 92478 to 92483 has applied in the preceding 24 months

Fee: $308.30 Benefit: 75% = $231.25 85% = $262.10

(See para AN.0.25, AN.0.30, AN.0.31, AN.0.32, AN.0.72, AN.0.75, AN.40.1, AR.8.1, MN.10.1 of explanatory notes to this Category)

Professional attendance lasting more than 45 minutes by a consultant physician in the practice of the consultant physician's speciality of psychiatry following referral of the patient to the consultant physician by a referring practitioner—an attendance at hospital if the patient:

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

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

other than attendance on a patient in relation to whom this item, or any of items 296, 299, 300, 302, 304, 306, 308, 91827 to 91831, 91837 to 91839, 92437 and 92478 to 92483 has applied in the preceding 24 months (H)

Fee: $308.30 Benefit: 75% = $231.25

(See para AN.0.25, AN.0.30, AN.0.31, AN.0.32, AN.0.72, AN.0.75, MN.10.1 of explanatory notes to this Category)

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

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

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

other than attendance on a patient in relation to whom this item, or any of items 296, 297, 300, 302, 304, 306, 308, 91827 to 91831, 91837 to 91839, 92437 and 92478 to 92483 has applied in the preceding 24 months

Fee: $368.55 Benefit: 85% = $313.30

(See para AN.0.25, AN.0.30, AN.0.31, AN.0.32, AN.0.72, AN.0.75, MN.10.1 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: $51.30 Benefit: 75% = $38.50 85% = $43.65

(See para AN.0.25, AN.0.30, AN.0.31, AN.0.32, AN.0.72, AN.0.75, AN.40.1, AR.8.1, MN.10.1 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: $102.40 Benefit: 75% = $76.80 85% = $87.05

(See para AN.0.25, AN.0.30, AN.0.31, AN.0.32, AN.0.72, AN.0.75, AN.40.1, AR.8.1, MN.10.1 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: $157.60 Benefit: 75% = $118.20 85% = $134.00

(See para AN.0.25, AN.0.30, AN.0.31, AN.0.32, AN.0.72, AN.0.75, AN.40.1, AR.8.1, MN.10.1 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: $217.50 Benefit: 75% = $163.15 85% = $184.90

(See para AN.0.25, AN.0.30, AN.0.31, AN.0.32, AN.0.72, AN.0.75, AN.40.1, AR.8.1, MN.10.1 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: $252.40 Benefit: 75% = $189.30 85% = $214.55

(See para AN.0.25, AN.0.30, AN.0.31, AN.0.32, AN.0.72, AN.0.75, AN.40.1, AR.8.1, MN.10.1 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 the consultant physician 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 exceed 50 attendances in a calendar year for the patient

Fee: $25.55 Benefit: 75% = $19.20 85% = $21.75

(See para AN.0.25, AN.0.31, AN.0.32, AN.0.72, AR.8.1, MN.10.1 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 the consultant physician 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 exceed 50 attendances in a calendar year for the patient

Fee: $51.30 Benefit: 75% = $38.50 85% = $43.65

(See para AN.0.25, AN.0.31, AN.0.32, AN.0.72, AR.8.1, MN.10.1 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 the consultant physician 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 exceed 50 attendances in a calendar year for the patient

Fee: $79.00 Benefit: 75% = $59.25 85% = $67.15

(See para AN.0.25, AN.0.31, AN.0.32, AN.0.72, AR.8.1, MN.10.1 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 the consultant physician 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 exceed 50 attendances in a calendar year for the patient

Fee: $108.85 Benefit: 75% = $81.65 85% = $92.55

(See para AN.0.25, AN.0.31, AN.0.32, AN.0.72, AR.8.1, MN.10.1 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 the consultant physician 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 exceed 50 attendances in a calendar year for the patient

Fee: $126.20 Benefit: 75% = $94.65 85% = $107.30

(See para AN.0.25, AN.0.31, AN.0.32, AN.0.72, AR.8.1, MN.10.1 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 the consultant physician by a referring practitioner—an attendance lasting more than 45 minutes at consulting rooms, if:

(a) the formulation of the patient’s clinical presentation indicates intensive psychotherapy is a clinically appropriate and indicated treatment; and

(b) that attendance and another attendance to which any of items 296, 297, 299, 300, 302, 304, 306, 308, 91827 to 91831, 91837 to 91839, 91873 and 92437 applies have not exceeded 160 attendances in a calendar year for the patient

Fee: $217.50 Benefit: 75% = $163.15 85% = $184.90

(See para AN.0.25, AN.0.31, AN.0.32, AN.0.72, AR.8.1, MN.10.1 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 the consultant physician by a referring practitioner-an attendance of not more than 15 minutes in duration at hospital

Fee: $51.30 Benefit: 75% = $38.50 85% = $43.65

(See para AN.0.25, AN.0.32, AN.0.72, MN.10.1 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 the consultant physician by a referring practitioner-an attendance of more than 15 minutes, but not more than 30 minutes, in duration at hospital

Fee: $102.40 Benefit: 75% = $76.80 85% = $87.05

(See para AN.0.32, AN.0.72, MN.10.1 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 the consultant physician by a referring practitioner-an attendance of more than 30 minutes, but not more than 45 minutes, in duration at hospital

Fee: $157.60 Benefit: 75% = $118.20 85% = $134.00

(See para AN.0.25, AN.0.32, AN.0.72, MN.10.1 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 the consultant physician by a referring practitioner-an attendance of more than 45 minutes, but not more than 75 minutes, in duration at hospital

Fee: $217.50 Benefit: 75% = $163.15 85% = $184.90

(See para AN.0.25, AN.0.32, AN.0.72, MN.10.1 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 the consultant physician by a referring practitioner-an attendance of more than 75 minutes in duration at hospital

Fee: $252.40 Benefit: 75% = $189.30 85% = $214.55

(See para AN.0.25, AN.0.32, AN.0.72, MN.10.1 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 the consultant physician by a referring practitioner-an attendance of not more than 15 minutes in duration if that attendance is at a place other than consulting rooms or hospital

Fee: $94.20 Benefit: 75% = $70.65 85% = $80.10

(See para AN.0.25, AN.0.72, MN.10.1 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 the consultant physician by a referring practitioner-an attendance of more than 15 minutes, but not more than 30 minutes, in duration if that attendance is at a place other than consulting rooms or hospital

Fee: $147.50 Benefit: 75% = $110.65 85% = $125.40

(See para AN.0.25, AN.0.72, MN.10.1 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 the consultant physician by a referring practitioner-an attendance of more than 30 minutes, but not more than 45 minutes, in duration if that attendance is at a place other than consulting rooms or hospital

Fee: $215.00 Benefit: 75% = $161.25 85% = $182.75

(See para AN.0.25, AN.0.72, MN.10.1 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 the consultant physician by a referring practitioner-an attendance of more than 45 minutes, but not more than 75 minutes, in duration if that attendance is at a place other than consulting rooms or hospital

Fee: $260.15 Benefit: 75% = $195.15 85% = $221.15

(See para AN.0.25, AN.0.72, MN.10.1 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 the consultant physician by a referring practitioner-an attendance of more than 75 minutes in duration if that attendance is at a place other than consulting rooms or hospital

Fee: $295.50 Benefit: 75% = $221.65 85% = $251.20

(See para AN.0.25, AN.0.72, MN.10.1 of explanatory notes to this Category)

An interview, lasting not more than 15 minutes, of a person other than the patient when the patient is not in attendance, by a consultant physician in the practice of the consultant physician’s specialty of psychiatry following referral of the patient to the consultant physician by a referring practitioner, for the purposes of:

(a) initial diagnostic evaluation; or

(b) continuing management of the patient;

if that service and another service to which this item or any of items 343, 345, 347, 349, 91874 to 91878 and 91882 to 91884 applies have not exceeded 15 services in a calendar year in relation to the patient

Fee: $51.30 Benefit: 75% = $38.50 85% = $43.65

(See para AN.0.25, AN.0.32, AN.0.72, MN.10.1 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: $58.35 Benefit: 75% = $43.80 85% = $49.60

(See para AN.0.5, AN.0.25, AN.0.72, AN.40.1, MN.10.1 of explanatory notes to this Category)

An interview, lasting more than 15 minutes but not more than 30 minutes, of a person other than the patient when the patient is not in attendance, by a consultant physician in the practice of the consultant physician’s specialty of psychiatry following referral of the patient to the consultant physician by a referring practitioner, for the purposes of:

(a) initial diagnostic evaluation; or

(b) continuing management of the patient;

if that service and another service to which this item or any of items 341, 345, 347, 349, 91874 to 91878 and 91882 to 91884 applies have not exceeded 15 services in a calendar year in relation to the patient

Fee: $102.40 Benefit: 75% = $76.80 85% = $87.05

(See para AN.0.25, AN.0.32, AN.0.72, MN.10.1 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: $77.45 Benefit: 75% = $58.10 85% = $65.85

(See para AN.0.5, AN.0.25, AN.0.72, AN.40.1, MN.10.1 of explanatory notes to this Category)

An interview, lasting more than 30 minutes but not more than 45 minutes, of a person other than the patient when the patient is not in attendance, by a consultant physician in the practice of the consultant physician’s specialty of psychiatry following referral of the patient to the consultant physician by a referring practitioner, for the purposes of:

(a) initial diagnostic evaluation; or

(b) continuing management of the patient;

if that service and another service to which this item or any of items 341, 343, 347, 349, 91874 to 91878 and 91882 to 91884 applies have not exceeded 15 services in a calendar year in relation to the patient

Fee: $157.60 Benefit: 75% = $118.20 85% = $134.00

(See para AN.0.25, AN.0.32, AN.0.72, MN.10.1 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: $114.65 Benefit: 75% = $86.00 85% = $97.50

(See para AN.0.5, AN.0.25, AN.0.72, AN.0.77, AN.40.1, MN.10.1 of explanatory notes to this Category)

An interview, lasting more than 45 minutes but not more than 75 minutes, of a person other than the patient when the patient is not in attendance, by a consultant physician in the practice of the consultant physician’s specialty of psychiatry following referral of the patient to the consultant physician by a referring practitioner, for the purposes of:

(a) initial diagnostic evaluation; or

(b) continuing management of the patient;

if that service and another service to which this item or any of items 341, 343, 345, 349, 91874 to 91878 and 91882 to 91884 applies have not exceeded 15 services in a calendar year in relation to the patient

Fee: $217.50 Benefit: 75% = $163.15 85% = $184.90

(See para AN.0.25, AN.0.32, AN.0.72, MN.10.1 of explanatory notes to this Category)

An interview, lasting more than 75 minutes, of a person other than the patient when the patient is not in attendance, by a consultant physician in the practice of the consultant physician’s specialty of psychiatry following referral of the patient to the consultant physician by a referring practitioner, for the purposes of:

(a) initial diagnostic evaluation; or

(b) continuing management of the patient;

if that service and another service to which this item or any of items 341, 343, 345, 347, 91874 to 91878 and 91882 to 91884 applies have not exceeded 15 services in a calendar year in relation to the patient

Fee: $252.40 Benefit: 75% = $189.30 85% = $214.55

(See para AN.0.25, AN.0.32, AN.0.72, MN.10.1 of explanatory notes to this Category)

Professional attendance at consulting rooms (other than a service to which another item applies) 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-each attendance

Fee: $20.05 Benefit: 100% = $20.05

(See para AN.0.9, AN.0.73, AN.0.74, MN.1.3, MN.1.4, MN.1.5, MN.1.6, MN.1.7, MN.1.8, MN.10.1 of explanatory notes to this Category)

Professional attendance by a general practitioner (other than attendance at consulting rooms or a residential aged care facility or a service to which another item in the table applies) that requires a short patient history and, if necessary, limited examination and management-an attendance on one or more patients at one place on one occasion-each patient

The fee for item 3, plus $30.70 divided by the number of patients seen, up to a maximum of six patients. For seven or more patients - the fee for item 3 plus $2.45 per patient.
Ready Reckoner

(See para AN.0.9, AN.0.11, AN.0.13, AN.0.73, AN.0.74, MN.1.3, MN.1.4, MN.1.5, MN.1.6, MN.1.7, MN.1.8, MN.10.1 of explanatory notes to this Category)

Video attendance for a person by a consultant psychiatrist; if:

(a) the attendance follows a referral of the patient to the consultant psychiatrist by a referring practitioner; and

(b) the attendance was not more than 15 minutes in duration;

if that attendance and another attendance to which item 296, 297, 299 or any of items 300, 302, 304, 306, 308, 91828 to 91831, 91837 to 91839 and 92437 applies have not exceeded 50 attendances in a calendar year

Fee: $51.30 Benefit: 85% = $43.65

(See para AN.0.25, AN.0.30, AN.0.31, AN.0.72, AN.0.75, MN.10.1 of explanatory notes to this Category)

Video attendance for a person by a consultant psychiatrist; if:

(a) the attendance follows a referral of the patient to the consultant psychiatrist by a referring practitioner; and

(b) the attendance was at least 15 minutes, but not more than 30 minutes in duration;

if that attendance and another attendance to which item 296, 297, 299, or any of items 300, 302, 304, 306 to 308, 91827, 91829 to 91831, 91837 to 91839 and 92437 applies have not exceeded 50 attendances in a calendar year

Fee: $102.40 Benefit: 85% = $87.05

(See para AN.0.25, AN.0.72, MN.10.1 of explanatory notes to this Category)

Video attendance for a person by a consultant psychiatrist; if:

(a) the attendance follows a referral of the patient to the consultant psychiatrist by a referring practitioner; and

(b) the attendance was at least 30 minutes, but not more than 45 minutes in duration;

if that attendance and another attendance to which item 296, 297, 299 or any of items 300, 302, 304, 306 to 308, 91827, 91828, 91830, 91831, 91837 to 91839 and 92437 applies have not exceeded 50 attendances in a calendar year

Fee: $157.60 Benefit: 85% = $134.00

(See para AN.0.25, AN.0.72, MN.10.1 of explanatory notes to this Category)

Video attendance for a person by a consultant psychiatrist; if:

(a) the attendance follows a referral of the patient to the consultant psychiatrist by a referring practitioner; and

(b) the attendance was at least 45 minutes, but not more than 75 minutes in duration;

if that attendance and another attendance to which item 296, 297, 299 or any of items 300, 302, 304, 306 to 308, 91827 to 91829, 91831, 91837 to 91839 and 92437 applies have not exceeded 50 attendances in a calendar year

Fee: $217.50 Benefit: 85% = $184.90

(See para AN.0.25, AN.0.72, MN.10.1 of explanatory notes to this Category)

Video attendance for a person by a consultant psychiatrist; if:

(a) the attendance follows a referral of the patient to the consultant psychiatrist by a referring practitioner; and

(b) the attendance was at least 75 minutes in duration;

if that attendance and another attendance to which item 296, 297, 299 or any of items 300, 302, 304, 306 to 308, 91827 to 91830, 91837 to 91839 and 92437 applies have not exceeded 50 attendances in a calendar year

Fee: $252.40 Benefit: 85% = $214.55

(See para AN.0.25, AN.0.30, AN.0.31, AN.0.72, AN.0.75, MN.10.1 of explanatory notes to this Category)

Video 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 the consultant physician by a referring practitioner:

(a) if the patient:

    (i) is a new patient for this consultant physician; or

    (ii) has not received an attendance from this consultant physician in the preceding 24 months; and

(b)  the patient has not received an attendance under this item, or item 91827 to 91831, 91837 to 91839, 92455 to 92457, 91868 to 91873, 91879 to 91881 or item 296, 297, 299, 300, 302, 304, 306 to 308, 310, 312, 314, 316, 318, 319, 320, 322, 324, 326, 328, 330, 332, 334, 336, 338, 342, 344 or 346 of the general medical services table, in the preceding 24 months

Fee: $308.30 Benefit: 85% = $262.10

(See para AN.0.25, AN.0.30, AN.0.31, AN.0.72, AN.0.75, MN.10.1 of explanatory notes to this Category)

Video attendance for 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):

(a) of not less than 1 hour in duration; and

(b) given under the continuous direct supervision of a consultant physician in the practice of the consultant physician’s specialty of psychiatry; and

(c) 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: $58.35 Benefit: 85% = $49.60

(See para AN.0.25, AN.0.72, MN.10.1 of explanatory notes to this Category)

Video attendance for 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):

(a) of not less than 1 hour in duration; and

(b) given under the continuous direct supervision of a consultant physician in the practice of the consultant physician’s specialty of psychiatry; and

(c) involving a family group of 3 patients, each of whom is referred to the consultant physician by a referring practitioner;

—each patient

Fee: $77.45 Benefit: 85% = $65.85

(See para AN.0.25, AN.0.72, MN.10.1 of explanatory notes to this Category)

Video attendance for 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):

(a) of not less than 1 hour in duration; and

(b) given under the continuous direct supervision of a consultant physician in the practice of the consultant physician’s specialty of psychiatry; and

(c) involving a family group of 2 patients, each of whom is referred to the consultant physician by a referring practitioner;

—each patient

Fee: $114.65 Benefit: 85% = $97.50

(See para AN.0.25, AN.0.72, MN.10.1 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 consultant physician; 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: $50.95 Benefit: 85% = $43.35

(See para AN.0.7, AN.0.25, AN.0.70, AN.3.1, AN.40.1, MN.10.1 of explanatory notes to this Category)

Psychology health service provided by phone attendance to a patient aged under 25 years by an eligible psychologist if:

(a) the patient was referred by an eligible medical practitioner, or by an eligible allied health practitioner following referral by an eligible medical practitioner, to:

(i) assist the eligible medical practitioner with diagnostic formulation where the patient has a suspected complex neurodevelopmental disorder or eligible disability; or

(ii) contribute to the patient’s treatment and management plan developed by the referring eligible medical practitioner where a complex neurodevelopmental disorder (such as autism spectrum disorder) or eligible disability is confirmed; and

(b) the service is provided to the patient individually; and

(c) the service is at least 50 minutes duration

Up to 4 services to which this item or any of items 82000, 82005, 82010, 82030, 93032, 93033 or 93041 apply may be provided to the same patient on the same day

Further information on the requirements for this item are available in the explanatory notes to this Category

Fee: $116.40 Benefit: 85% = $98.95

(See para AN.0.24, AN.0.25, AN.0.72, AN.0.73, MN.10.1, MN.10.3 of explanatory notes to this Category)

Audiology, dietetic, exercise physiology, occupational therapy, optometry, orthoptic, physiotherapy or speech pathology health service provided by phone attendance to a patient aged under 25 years by an eligible audiologist, dietitian, exercise physiologist, occupational therapist, optometrist, orthoptist, physiotherapist or speech pathologist if:

(a) the patient was referred by an eligible medical practitioner, or by an eligible allied health practitioner following referral by an eligible medical practitioner, to:

(i) assist the eligible medical practitioner with diagnostic formulation where the patient has a suspected complex neurodevelopmental disorder or eligible disability; or

(ii) contribute to the patient’s treatment and management plan developed by the referring eligible medical practitioner where a complex neurodevelopmental disorder (such as autism spectrum disorder) or eligible disability is confirmed; and

(b) the service is provided to the patient individually; and

(c) the service is at least 50 minutes duration

Up to 4 services to which this item or any of items 82000, 82005, 82010, 82030, 93032, 93033 or 93040 apply may be provided to the same patient on the same day

Further information on the requirements for this item are available in the explanatory notes to this Category

Fee: $102.60 Benefit: 85% = $87.25

(See para AN.0.24, AN.0.25, AN.0.72, AN.0.73, MN.10.1, MN.10.3 of explanatory notes to this Category)

Audiology, dietetic, exercise physiology, occupational therapy, optometry, orthoptic, physiotherapy or speech pathology health service provided by phone attendance to a patient aged under 25 years for the treatment of a diagnosed complex neurodevelopmental disorder (such as autism spectrum disorder) or eligible disability by an eligible audiologist, dietitian, exercise physiologist, occupational therapist, optometrist, orthoptist, physiotherapist or speech pathologist, if:

(a) the patient has a treatment and management plan in place and has been referred by an eligible medical practitioner for a course of treatment consistent with that treatment and management plan; and

(b) the service is provided to the patient individually; and

(c) the service is at least 30 minutes duration; and

(d) on the completion of the course of treatment, the eligible audiologist, dietitian, exercise physiologist, occupational therapist, optometrist, orthoptist, physiotherapist, or speech pathologist gives a written report to the referring eligible medical practitioner on assessments (if performed), treatment provided and recommendations on future management of the patient’s condition

Up to 4 services to which this item or any of items 82015, 82020, 82025, 82035, 93035, 93036 or 93043 apply may be provided to the same patient on the same day

Further information on the requirements for this item are available in the explanatory notes to this Category

Fee: $102.60 Benefit: 85% = $87.25

(See para AN.0.24, AN.0.25, AN.0.72, AN.0.73, MN.10.1, MN.10.2, MN.10.3 of explanatory notes to this Category)

Phone attendance by a general practitioner lasting less than 6 minutes for an obvious problem characterised by the straightforward nature of the task that requires a short patient history and, if required, limited management

NOTE: It is a legislative requirement that this service must be performed by the patient’s eligible telehealth practitioner (please see Note AN.1.1 for the definitions as some exemptions do apply)

Fee: $20.05 Benefit: 100% = $20.05

(See para AN.0.9, AN.0.73, AN.0.74, MN.1.3, MN.1.4, MN.1.5, MN.1.6, MN.1.7, MN.1.8, MN.10.1 of explanatory notes to this Category)

Phone attendance by a general practitioner lasting at least 6 minutes if the attendance includes any of the following that are clinically relevant:

(a) taking a short patient history;

(b) arranging any necessary investigation;

(c) implementing a management plan;

(d) providing appropriate preventative health care

NOTE: It is a legislative requirement that this service must be performed by the patient’s eligible telehealth practitioner (please see Note AN.1.1 for the definitions as some exemptions do apply)

Fee: $43.90 Benefit: 100% = $43.90

(See para AN.0.9, AN.0.73, AN.0.74, MN.1.3, MN.1.4, MN.1.5, MN.1.6, MN.1.7, MN.1.8, MN.10.1 of explanatory notes to this Category)

Video 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 consultant physician; 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: $178.70 Benefit: 85% = $151.90

(See para AN.0.7, AN.0.24, AN.40.1, MN.10.1 of explanatory notes to this Category)

Video 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 consultant physician; 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: $89.40 Benefit: 85% = $76.00

(See para AN.0.7, AN.0.24, AN.0.25, AN.0.70, AN.3.1, AN.40.1, MN.10.1 of explanatory notes to this Category)

Video 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 consultant physician; 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: $50.95 Benefit: 85% = $43.35

(See para AN.0.7, AN.0.24, AN.0.25, AN.0.70, AN.3.1, AN.40.1, MN.10.1 of explanatory notes to this Category)

Professional attendance by a general practitioner at consulting rooms (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

Fee: $202.65 Benefit: 100% = $202.65

(See para AN.0.9, AN.0.24, AN.0.74, MN.1.3, MN.1.4, MN.1.5, MN.1.6, MN.1.7, MN.1.8, MN.10.1 of explanatory notes to this Category)

Professional attendance by a general practitioner (other than attendance at consulting rooms or a residential aged care facility or 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 place on one occasion—each patient

The fee for item 123, plus $30.70 divided by the number of patients seen, up to a maximum of six patients. For seven or more patients - the fee for item 123 plus $2.45 per patient.
Ready Reckoner

(See para AN.0.9, AN.0.11, AN.0.13, AN.0.24, AN.0.74, MN.1.3, MN.1.4, MN.1.5, MN.1.6, MN.1.7, MN.1.8, MN.10.1 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: $178.70 Benefit: 75% = $134.05 85% = $151.90

(See para AN.0.7, AN.0.24, AN.0.25, AN.36.2, AN.40.1, MN.10.1 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: $89.40 Benefit: 75% = $67.05 85% = $76.00

(See para AN.0.7, AN.0.24, AN.0.25, AN.0.70, AN.3.1, AN.36.2, AN.40.1, MN.10.1 of explanatory notes to this Category)

Professional attendance at consulting rooms or in 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-an attendance after the first attendance in a single course of treatment, if:

(a) the attendance is not a minor attendance; and

(b) during the attendance, the consultant physician determines the need to perform an operation on the patient that had not otherwise been scheduled; and

(c) the consultant physician subsequently performs the operation on the patient, on the same day; and

(d) the operation is a service to which an item in Group T8 applies; and

(e) the amount specified in the item in Group T8 as the fee for a service to which that item applies is $349.95 or more

For any particular patient, once only on the same day

Fee: $89.40 Benefit: 75% = $67.05 85% = $76.00

(See para AN.0.24, MN.10.1 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: $50.95 Benefit: 75% = $38.25 85% = $43.35

(See para AN.0.7, AN.0.21, AN.0.24, AN.0.25, AN.0.70, AN.3.1, AN.36.2, AN.40.1, MN.10.1 of explanatory notes to this Category)

Professional attendance at consulting rooms or in 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—minor attendance, if:

(a) during the attendance, the consultant physician determines the need to perform an operation on the patient that had not otherwise been scheduled; and

(b) the consultant physician subsequently performs the operation on the patient, on the same day; and

(c) the operation is a service to which an item in Group T8 applies; and

(d) the amount specified in the item in Group T8 as the fee for a service to which that item applies is $349.95 or more

For any particular patient, once only on the same day

Fee: $50.95 Benefit: 75% = $38.25 85% = $43.35

(See para AN.0.21, AN.0.24, MN.10.1 of explanatory notes to this Category)

Professional attendance at a place other than 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: $216.75 Benefit: 75% = $162.60 85% = $184.25

(See para AN.0.24, AN.0.25, MN.10.1 of explanatory notes to this Category)

Professional attendance at a place other than 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 131 applies) after the first in a single course of treatment

Fee: $131.10 Benefit: 75% = $98.35 85% = $111.45

(See para AN.0.24, AN.0.25, MN.10.1 of explanatory notes to this Category)

Professional attendance at a place other than 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: $94.45 Benefit: 75% = $70.85 85% = $80.30

(See para AN.0.21, AN.0.24, AN.0.25, MN.10.1 of explanatory notes to this Category)

Professional attendance at consulting rooms lasting more than 60 minutes (other than a service to which any other item in this Schedule applies) by a prescribed medical practitioner in an eligible area—each attendance

Fee: $162.10 Benefit: 100% = $162.10

(See para AN.0.9, AN.0.72, AN.7.1, AN.7.2, MN.1.4, MN.1.5, MN.1.6, MN.1.7, MN.1.8, MN.10.1 of explanatory notes to this Category)

Professional attendance (other than an attendance at consulting rooms or a residential aged care facility or a service to which any other item applies) lasting more than 60 minutes—an attendance on one or more patients at one place on one occasion by a prescribed medical practitioner in an eligible area—each patient

The fee for item 301, plus $24.60 divided by the number of patients seen, up to a maximum of six patients. For seven or more patients - the fee for item 301 plus $1.95 per patient.
Ready Reckoner

(See para AN.0.9, AN.0.11, AN.0.72, AN.7.1, AN.7.2, MN.1.4, MN.1.5, MN.1.6, MN.1.7, MN.1.8, MN.10.1 of explanatory notes to this Category)

Professional attendance by a general practitioner at consulting rooms (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-each attendance

Fee: $125.10 Benefit: 100% = $125.10

(See para AN.0.9, AN.0.73, AN.0.74, MN.1.3, MN.1.4, MN.1.5, MN.1.6, MN.1.7, MN.1.8, MN.10.1 of explanatory notes to this Category)

Professional attendance by a general practitioner (other than attendance at consulting rooms or a residential aged care facility or 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 place on one occasion-each patient

The fee for item 44, plus $30.70 divided by the number of patients seen, up to a maximum of six patients. For seven or more patients - the fee for item 44 plus $2.45 per patient.
Ready Reckoner

(See para AN.0.9, AN.0.11, AN.0.13, AN.0.73, AN.0.74, MN.1.3, MN.1.4, MN.1.5, MN.1.6, MN.1.7, MN.1.8, MN.10.1 of explanatory notes to this Category)

Phone attendance for a person by a consultant psychiatrist; if:

(a)   the attendance follows a referral of the patient to the consultant psychiatrist by a referring practitioner; and

(b)   the attendance was not more than 15 minutes duration;

Where the attendance is after the first attendance as part of a single course of treatment, if that attendance and another attendance to which item 296, 297, 299 or any of items 300, 302, 304, 306 to 308, 91827 to 91831, 91838, 91839 and 92437 applies have not exceeded 50 attendances in a calendar year

Fee: $51.30 Benefit: 85% = $43.65

(See para AN.0.25, AN.0.30, AN.0.31, AN.0.72, AN.0.75, MN.10.1 of explanatory notes to this Category)

 Phone attendance for a person by a consultant psychiatrist; if:

(a)   the attendance follows a referral of the patient to the consultant psychiatrist by a referring practitioner and

(b)   the attendance was at least 15 minutes, but not more than 30 minutes in duration;

Where the attendance is after the first attendance as part of a single course of treatment, if that attendance and another attendance to which item 296, 297, 299 or any of items 300, 302, 304, 306 to 308, 91827 to 91831, 91837, 91839 and 92437 applies have not exceeded 50 attendances in a calendar year

Fee: $102.40 Benefit: 85% = $87.05

(See para AN.0.25, AN.0.72, MN.10.1 of explanatory notes to this Category)

 Phone attendance for a person by a consultant psychiatrist; if:

(a)   the attendance follows a referral of the patient to the consultant psychiatrist by a referring practitioner; and

(b)   the attendance was at least 30 minutes, but not more than 45 minutes in duration

Where the attendance is after the first attendance as part of a single course of treatment, if that attendance and another attendance to which item 296, 297, 299 or any of items 300, 302, 304, 306 to 308, 91827 to 91831, 91837, 91838 and 92437 applies have not exceeded 50 attendances in a calendar year

Fee: $157.60 Benefit: 85% = $134.00

(See para AN.0.25, AN.0.30, AN.0.31, AN.0.72, AN.0.75, MN.10.1 of explanatory notes to this Category)

Psychology health service provided by video attendance to a patient aged under 25 years by an eligible psychologist if:

(a) the patient was referred by an eligible medical practitioner, or by an eligible allied health practitioner following referral by an eligible medical practitioner, to:

(i) assist the eligible medical practitioner with diagnostic formulation where the patient has a suspected complex neurodevelopmental disorder or eligible disability; or

(ii) contribute to the patient’s treatment and management plan developed by the referring eligible medical practitioner where a complex neurodevelopmental disorder (such as autism spectrum disorder) or eligible disability is confirmed; and

(b) the service is provided to the patient individually; and

(c) the service is at least 50 minutes duration

Up to 4 services to which this item or any of items 82000, 82005, 82010, 82030, 93033, 93040 or 93041 apply may be provided to the same patient on the same day

Fee: $116.40 Benefit: 85% = $98.95

(See para AN.0.24, AN.0.25, AN.0.72, AN.0.73, MN.10.1, MN.10.3 of explanatory notes to this Category)

Audiology, dietetic, exercise physiology, occupational therapy, optometry, orthoptic, physiotherapy or speech pathology health service provided by video attendance to a patient aged under 25 years by an eligible audiologist, dietitian, exercise physiologist, occupational therapist, optometrist, orthoptist, physiotherapist or speech pathologist if:

(a) the patient was referred by an eligible medical practitioner, or by an eligible allied health practitioner following referral by an eligible medical practitioner, to:

(i) assist the eligible medical practitioner with diagnostic formulation where the patient has a suspected complex neurodevelopmental disorder or eligible disability; or

(ii) contribute to the patient’s treatment and management plan developed by the referring eligible medical practitioner where a complex neurodevelopmental disorder (such as autism spectrum disorder) or eligible disability is confirmed; and

(b) the service is provided to the patient individually; and

(c) the service is at least 50 minutes duration

Up to 4 services to which this item or any of items 82000, 82005, 82010, 82030, 93032, 93040 or 93041 apply may be provided to the same patient on the same day

Fee: $102.60 Benefit: 85% = $87.25

(See para AN.0.24, AN.0.25, AN.0.72, AN.0.73, MN.10.1, MN.10.3 of explanatory notes to this Category)

Professional attendance by a general practitioner at consulting rooms (other than a service to which another item in this Schedule applies), 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

Fee: $43.90 Benefit: 100% = $43.90

(See para AN.0.9, AN.0.73, AN.0.74, MN.1.3, MN.1.4, MN.1.5, MN.1.6, MN.1.7, MN.1.8, MN.10.1 of explanatory notes to this Category)

Professional attendance by a general practitioner (other than attendance at consulting rooms or a residential aged care facility or a service to which another item in this Schedule applies), 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 place on one occasion—each patient

The fee for item 23, plus $30.70 divided by the number of patients seen, up to a maximum of six patients. For seven or more patients - the fee for item 23 plus $2.45 per patient.
Ready Reckoner

(See para AN.0.9, AN.0.11, AN.0.13, AN.0.73, AN.0.74, MN.1.3, MN.1.4, MN.1.5, MN.1.6, MN.1.7, MN.1.8, MN.10.1 of explanatory notes to this Category)

Professional attendance by a general practitioner at consulting rooms (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-each attendance

Fee: $84.90 Benefit: 100% = $84.90

(See para AN.0.9, AN.0.73, AN.0.74, MN.1.3, MN.1.4, MN.1.5, MN.1.6, MN.1.7, MN.1.8, MN.10.1 of explanatory notes to this Category)

Professional attendance by a general practitioner (other than attendance at consulting rooms or a residential aged care facility or 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 place on one occasion-each patient

The fee for item 36, plus $30.70 divided by the number of patients seen, up to a maximum of six patients. For seven or more patients - the fee for item 36 plus $2.45 per patient.
Ready Reckoner

(See para AN.0.9, AN.0.11, AN.0.13, AN.0.73, AN.0.74, MN.1.3, MN.1.4, MN.1.5, MN.1.6, MN.1.7, MN.1.8, MN.10.1 of explanatory notes to this Category)