Medicare Benefits Schedule - Note AN.0.50

Attendances by public health physicians will attract Medicare benefits under the new items only where the attendance relates to one or more of the following: - 

(i)    management of a patient's vaccination requirements for accepted immunisation programs; or

(ii)   prevention or management of sexually transmitted disease; or

(iii)  prevention or management of disease due to environmental hazards or poisons; or

(iv)  prevention or management of exotic diseases; or

(v)   prevention or management of infection during outbreaks of infectious disease. 

For more information on the content-based item structure used in this Group, see A.5 in the explanatory notes.

Related Items: 410 411 412 413 414 415 416 417

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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)

LEVEL A

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

The fee for item 410, plus $29.50 divided by the number of patients seen, up to a maximum of six patients. For seven or more patients - the fee for item 410 plus $2.35 per patient.
Ready Reckoner

(See para AN.0.50 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 other than 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.

The fee for item 411, plus $29.50 divided by the number of patients seen, up to a maximum of six patients. For seven or more patients - the fee for item 411 plus $2.35 per patient.
Ready Reckoner

(See para AN.0.50 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 other than 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.

The fee for item 412, plus $29.50 divided by the number of patients seen, up to a maximum of six patients. For seven or more patients - the fee for item 412 plus $2.35 per patient.
Ready Reckoner

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

LEVEL D

Professional attendance by a public health physician in the practice of the public health physician’s specialty of public health medicine at other than consulting rooms, 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

The fee for item 413, plus $29.50 divided by the number of patients seen, up to a maximum of six patients. For seven or more patients - the fee for item 413 plus $2.35 per patient.
Ready Reckoner

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