Medicare Benefits Schedule - Note AN.0.58

Attendance by a recognised specialist or consultant physician in the specialty of pain medicine (2801, 2806, 2814, 2824, 2832, 2840, 92751, 92752, 92753, 92754) and Case conference by a recognised specialist or consultant physician in the specialty of pain medicine (2946, 2949, 2954, 2958, 2972, 2974, 2978, 2984, 2988, 2992, 2996, 3000). 

Items 2801, 2806, 2814, 2824, 2832, 2840, 2946, 2949, 2954, 2958, 2972, 2974, 2978, 2984, 2988, 2992, 2996, 3000, 92751, 92752, 92753, 92754, apply only to a service provided by a recognised specialist or consultant physician in the specialty of pain medicine, in relation to a pain patient referred from another practitioner (see Paragraph 6 of the General Explanatory notes). 

The conditions that apply to the Case Conferences items (2946, 2949, 2954, 2958, 2972, 2974, 2978, 2984, 2988, 2992, 2996, 3000) are the same as those for the Case Conferences by consultant physicians (Items 820 to 838).  See explanatory note AN.0.51 for details of these conditions. 

Where the service provided to a referred patient is by a medical practitioner who is a recognised specialist or consultant physician in the specialty of pain medicine and that service is pain medicine, then the relevant items from the pain specialist group (2801, 2806, 2814, 2824, 2832, 2840, 2946, 2949, 2954, 2958, 2972, 2974, 2978, 2984, 2988, 2992, 2996, 3000, 92751, 92752, 92753, 92754) must be claimed. Services to patients who are not receiving pain medicine services should be claimed using the relevant attendance or case conferencing items. 

Attendance by a recognised specialist or consultant physician in the specialty of palliative medicine (3005, 3010, 3014, 3018, 3023, 3028, 92755, 92756, 92757, 92758) and Case conference by a recognised specialist or consultant physician in the specialty of palliative medicine (3032, 3040, 3044, 3051, 3055, 3062, 3069, 3074, 3078, 3083, 3088, 3093). 

Items 3005, 3010, 3014, 3018, 3023, 3028, 3032, 3040, 3044, 3051, 3055, 3062, 3069, 3074, 3078, 3083, 3088, 3093, 92755, 92756, 92757, 92758, apply only to a service provided by a recognised specialist or consultant physician in the specialty of palliative medicine, in relation to a palliative patient referred from another practitioner (see Paragraph 6 of the General Explanatory notes). 

General Practitioners who are recognised specialists in the specialty of palliative medicine and are treating a referred palliative patient and claiming items 3005, 3010, 3014, 3018, 3023, 3028, 3032, 3040, 3044, 3051, 3055, 3062, 3069, 3074, 3078, 3083, 3088, 3093 cannot access the GP Chronic Condition Management Plan items (765 767, 92029 and 92030) for that patient. The referring practitioner is able to provide these services. 

The conditions that apply to the Case Conferences items (3032, 3040, 3044, 3051, 3055, 3062, 3069, 3074, 3078, 3083, 3088, 3093) are the same as those for the Case Conferences by consultant physicians (Items 820 to 838).  See explanatory note AN.0.51 for details of these conditions. 

Where the service provided to a referred patient is by a medical practitioner who is a recognised specialist or consultant physician in the specialty of palliative medicine and that service is a palliative medicine service, then the relevant items from the palliative specialist group 3005, 3010, 3014, 3018, 3023, 3028, 3032, 3040, 3044, 3051, 3055, 3062, 3069, 3074, 3078, 3083, 3088, 3093, 92755, 92756, 92757, 9275, must be claimed. Services to patients who are not receiving palliative care services should be claimed using the relevant attendance or case conferencing items.

Related Items: 2801 2806 2814 2824 2832 2840 2946 2949 2954 2958 2972 2974 2978 2984 2988 2992 2996 3000 3005 3010 3014 3018 3023 3028 3032 3040 3044 3051 3055 3062 3069 3074 3078 3083 3088 3093 92751 92752 92753 92754 92755 92756 92757 92758

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Professional attendance at consulting rooms or hospital by a specialist, or consultant physician, in the practice of the specialist's or consultant physician's specialty of palliative medicine following referral of the patient to the specialist or 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.0.58, AN.40.1 of explanatory notes to this Category)

Professional attendance at consulting rooms or hospital by a specialist, or consultant physician, in the practice of the specialist's or consultant physician's specialty of palliative medicine following referral of the patient to the specialist or consultant physician by a referring practitioner-each attendance (other than a service to which item 3014 applies) after the first in a single course of treatment

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

(See para AN.0.58, AN.0.70, AN.3.1, AN.40.1 of explanatory notes to this Category)

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

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

(See para AN.0.58, AN.0.70, AN.3.1, AN.40.1 of explanatory notes to this Category)

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

Fee: $216.75 Benefit: 85% = $184.25

(See para AN.0.58 of explanatory notes to this Category)

Professional attendance at a place other than consulting rooms or hospital by a specialist, or consultant physician, in the practice of the specialist's or consultant physician's specialty of palliative medicine following referral of the patient to the specialist or consultant physician by a referring practitioner-each attendance (other than a service to which item 3028 applies) after the first in a single course of treatment

Fee: $131.10 Benefit: 85% = $111.45

(See para AN.0.58 of explanatory notes to this Category)

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

Fee: $94.45 Benefit: 85% = $80.30

(See para AN.0.58 of explanatory notes to this Category)

Attendance by a specialist, or consultant physician, in the practice of the specialist's or consultant physician's specialty of pain medicine, as a member of a multidisciplinary case conference team, to organise and coordinate a community case conference of at least 15 minutes but less than 30 minutes

Fee: $164.65 Benefit: 75% = $123.50 85% = $140.00

(See para AN.0.58 of explanatory notes to this Category)

Attendance by a specialist, or consultant physician, in the practice of the specialist's or consultant physician's specialty of pain medicine, as a member of a multidisciplinary case conference team, to organise and coordinate a community case conference of at least 30 minutes but less than 45 minutes

Fee: $247.15 Benefit: 75% = $185.40 85% = $210.10

(See para AN.0.58 of explanatory notes to this Category)

Attendance by a specialist, or consultant physician, in the practice of the specialist's or consultant physician's specialty of pain medicine, as a member of a multidisciplinary case conference team, to organise and coordinate a community case conference of at least 45 minutes

Fee: $329.25 Benefit: 75% = $246.95 85% = $279.90

(See para AN.0.58 of explanatory notes to this Category)

Attendance by a specialist, or consultant physician, in the practice of the specialist's or consultant physician's specialty of pain medicine, as a member of a multidisciplinary case conference team, to participate in a community case conference (other than to organise and coordinate the conference) of at least 15 minutes but less than 30 minutes

Fee: $118.25 Benefit: 75% = $88.70 85% = $100.55

(See para AN.0.58 of explanatory notes to this Category)

Attendance by a specialist, or consultant physician, in the practice of the specialist's or consultant physician's specialty of pain medicine, as a member of a multidisciplinary case conference team, to participate in a community case conference (other than to organise and coordinate the conference) of at least 30 minutes but less than 45 minutes

Fee: $188.65 Benefit: 75% = $141.50 85% = $160.40

(See para AN.0.58 of explanatory notes to this Category)

Attendance by a specialist, or consultant physician, in the practice of the specialist's or consultant physician's specialty of pain medicine, as a member of a multidisciplinary case conference team, to participate in a community case conference (other than to organise and coordinate the conference) of at least 45 minutes

Fee: $259.00 Benefit: 75% = $194.25 85% = $220.15

(See para AN.0.58 of explanatory notes to this Category)

Attendance by a specialist, or consultant physician, in the practice of the specialist's or consultant physician's specialty of pain medicine, as a member of a multidisciplinary case conference team, to organise and coordinate a discharge case conference of at least 15 minutes but less than 30 minutes, before the patient is discharged from a hospital (H)

Fee: $164.65 Benefit: 75% = $123.50 85% = $140.00

(See para AN.0.58 of explanatory notes to this Category)

Attendance by a specialist, or consultant physician, in the practice of the specialist's or consultant physician's specialty of pain medicine, as a member of a multidisciplinary case conference team, to organise and coordinate a discharge case conference of at least 30 minutes but less than 45 minutes, before the patient is discharged from a hospital (H)

Fee: $247.15 Benefit: 75% = $185.40 85% = $210.10

(See para AN.0.58 of explanatory notes to this Category)

Attendance by a specialist, or consultant physician, in the practice of the specialist's or consultant physician's specialty of pain medicine, as a member of a multidisciplinary case conference team, to organise and coordinate a discharge case conference of at least 45 minutes, before the patient is discharged from a hospital (H)

Fee: $329.25 Benefit: 75% = $246.95 85% = $279.90

(See para AN.0.58 of explanatory notes to this Category)

Attendance by a specialist, or consultant physician, in the practice of the specialist's or consultant physician's specialty of pain medicine, as a member of a multidisciplinary case conference team, to participate in a discharge case conference (other than to organise and coordinate the conference) of at least 15 minutes but less than 30 minutes, before the patient is discharged from a hospital (H)

Fee: $118.25 Benefit: 75% = $88.70 85% = $100.55

(See para AN.0.58 of explanatory notes to this Category)

Attendance by a specialist, or consultant physician, in the practice of the specialist's or consultant physician's specialty of pain medicine, as a member of a multidisciplinary case conference team, to participate in a discharge case conference (other than to organise and coordinate the conference) of at least 30 minutes but less than 45 minutes, before the patient is discharged from a hospital (H)

Fee: $188.65 Benefit: 75% = $141.50 85% = $160.40

(See para AN.0.58 of explanatory notes to this Category)

Attendance by a specialist, or consultant physician, in the practice of the specialist's or consultant physician's specialty of pain medicine, as a member of a multidisciplinary case conference team, to participate in a discharge case conference (other than to organise and coordinate the conference) of at least 45 minutes, before the patient is discharged from a hospital (H)

Fee: $259.00 Benefit: 75% = $194.25 85% = $220.15

(See para AN.0.58 of explanatory notes to this Category)

Video attendance for a person by a specialist, or consultant physician, in the practice of the specialist's or consultant physician's specialty of pain medicine if:

(a)  the attendance follows referral of the patient to the specialist or consultant physician;

(b)  the attendance is of more than 5 minutes in duration; 

(c)  the attendance is an initial attendance in a single course of treatment; and

(d)  the attendance on the patient, being an attendance to which item 2801, 91824 or 110 applies did not take place on the same day by the same pain medicine specialist or consultant physician.

Fee: $178.70 Benefit: 85% = $151.90

(See para AN.0.58, AN.40.1 of explanatory notes to this Category)

Video attendance for a person by a specialist, or consultant physician, in the practice of the specialist's or consultant physician's specialty of pain medicine if:

(a)  the attendance follows referral of the patient to the specialist or consultant physician;

(b)  the attendance is of more than 5 minutes in duration; and

(c)  the attendance is not a minor attendance after the first in a single course of treatment.

Fee: $89.40 Benefit: 85% = $76.00

(See para AN.0.58, AN.0.70, AN.3.1, AN.40.1 of explanatory notes to this Category)

Video attendance for a person by a specialist, or consultant physician, in the practice of the specialist’s or consultant physician’s specialty of pain medicine if:

(a)  the attendance follows referral of the patient to the specialist or consultant physician;

(b)  the attendance is of more than 5 minutes in duration; and

(c)  the attendance is a minor attendance after the first in a single course of treatment.

Fee: $50.95 Benefit: 85% = $43.35

(See para AN.0.58, AN.0.70, AN.3.1, AN.40.1 of explanatory notes to this Category)

Phone attendance for a person by a specialist, or consultant physician, in the practice of the specialist's or consultant physician's specialty of pain medicine if:

(a)  the attendance follows referral of the patient to the specialist or consultant physician;

(b)  the attendance is of more than 5 minutes in duration; and

(c)  the attendance is a minor attendance after the first of a single course of treatment.

Fee: $50.95 Benefit: 85% = $43.35

(See para AN.0.58, AN.0.70, AN.3.1, AN.40.1 of explanatory notes to this Category)

Video attendance for a person by a specialist, or consultant physician, in the practice of the specialists’ or consultant physician’s specialty of palliative medicine if:

(a)  the attendance follows referral of the patient to the specialist or consultant physician;

(b)  the attendance is of more than 5 minutes in duration; 

(c)  the attendance is an initial attendance in a single course of treatment; and

(d)  the attendance on the patient, being an attendance to which item 3005, 91824 or 110 applies did not take place on the same day by the same palliative medicine specialist or consultant physician.

Fee: $178.70 Benefit: 85% = $151.90

(See para AN.0.58, AN.40.1 of explanatory notes to this Category)

Video attendance for a person by a specialist, or consultant physician, in the practice of the specialist's, or consultant physician's, specialty of palliative medicine if:   
(a) the attendance follows referral of the patient to the specialist or consultant physician; 
(b) the attendance is of more than 5 minutes in duration; and 
(c) the attendance is not a minor attendance after the first in a single course of treatment.

Fee: $89.40 Benefit: 85% = $76.00

(See para AN.0.58, AN.0.70, AN.3.1, AN.40.1 of explanatory notes to this Category)

Video attendance for a person by a specialist, or consultant physician, in the practice of the specialist's or consultant physician's specialty of palliative medicine, if: 
(a) the attendance follows referral of the patient to the specialist or consultant physician;  
(b) the attendance is of more than 5 minutes in duration; and 
(c) the attendance is a minor attendance after the first in a single course of treatment. 

Fee: $50.95 Benefit: 85% = $43.35

(See para AN.0.58, AN.0.70, AN.3.1, AN.40.1 of explanatory notes to this Category)

Phone attendance for a person by a specialist, or consultant physician, in the practice of the specialists’ or consultant physician’s specialty of palliative medicine if:  
(a) the attendance follows referral of the patient to the specialist or consultant physician; 
(b) the attendance is of more than 5 minutes in duration; and 
(c) the attendance is a minor attendance after the first in a single course of treatment. 

Fee: $50.95 Benefit: 85% = $43.35

(See para AN.0.58, AN.0.70, AN.3.1, AN.40.1 of explanatory notes to this Category)

Professional attendance at consulting rooms or hospital by a specialist, or consultant physician, in the practice of the specialist's or consultant physician's specialty of pain medicine following referral of the patient to the specialist or 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.0.58, AN.40.1 of explanatory notes to this Category)

Professional attendance at consulting rooms or hospital by a specialist, or consultant physician, in the practice of the specialist's or consultant physician's specialty of pain medicine following referral of the patient to the specialist or consultant physician by a referring practitioner-each attendance (other than a service to which item 2814 applies) after the first in a single course of treatment

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

(See para AN.0.58, AN.0.70, AN.3.1, AN.40.1 of explanatory notes to this Category)

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

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

(See para AN.0.58, AN.0.70, AN.3.1, AN.40.1 of explanatory notes to this Category)

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

Fee: $216.75 Benefit: 85% = $184.25

(See para AN.0.58 of explanatory notes to this Category)

Professional attendance at a place other than consulting rooms or hospital by a specialist, or consultant physician, in the practice of the specialist's or consultant physician's specialty of pain medicine following referral of the patient to the specialist or consultant physician by a referring practitioner-each attendance (other than a service to which item 2840 applies) after the first in a single course of treatment

Fee: $131.10 Benefit: 85% = $111.45

(See para AN.0.58 of explanatory notes to this Category)

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

Fee: $94.45 Benefit: 85% = $80.30

(See para AN.0.58 of explanatory notes to this Category)

Attendance by a specialist, or consultant physician, in the practice of the specialist's or consultant physician's specialty of palliative medicine, as a member of a multidisciplinary case conference team, to organise and coordinate a community case conference of at least 15 minutes but less than 30 minutes

Fee: $164.65 Benefit: 75% = $123.50 85% = $140.00

(See para AN.0.58 of explanatory notes to this Category)

Attendance by a specialist, or consultant physician, in the practice of the specialist's or consultant physician's specialty of palliative medicine, as a member of a multidisciplinary case conference team, to organise and coordinate a community case conference of at least 30 minutes but less than 45 minutes

Fee: $247.15 Benefit: 75% = $185.40 85% = $210.10

(See para AN.0.58 of explanatory notes to this Category)

Attendance by a specialist, or consultant physician, in the practice of the specialist's or consultant physician's specialty of palliative medicine, as a member of a multidisciplinary case conference team, to organise and coordinate a community case conference of at least 45 minutes

Fee: $329.25 Benefit: 75% = $246.95 85% = $279.90

(See para AN.0.58 of explanatory notes to this Category)

Attendance by a specialist, or consultant physician, in the practice of the specialist's or consultant physician's specialty of palliative medicine, as a member of a multidisciplinary case conference team, to participate in a community case conference (other than to organise and coordinate the conference) of at least 15 minutes but less than 30 minutes

Fee: $118.25 Benefit: 75% = $88.70 85% = $100.55

(See para AN.0.58 of explanatory notes to this Category)

Attendance by a specialist, or consultant physician, in the practice of the specialist's or consultant physician's specialty of palliative medicine, as a member of a multidisciplinary case conference team, to participate in a community case conference (other than to organise and coordinate the conference) of at least 30 minutes but less than 45 minutes, with a multidisciplinary team of at least 2 other formal care providers of different disciplines

Fee: $188.65 Benefit: 75% = $141.50 85% = $160.40

(See para AN.0.58 of explanatory notes to this Category)

Attendance by a specialist, or consultant physician, in the practice of the specialist's or consultant physician's specialty of palliative medicine, as a member of a multidisciplinary case conference team, to participate in a community case conference (other than to organise and coordinate the conference) of at least 45 minutes

Fee: $259.00 Benefit: 75% = $194.25 85% = $220.15

(See para AN.0.58 of explanatory notes to this Category)

Attendance by a specialist, or consultant physician, in the practice of the specialist's or consultant physician's specialty of palliative medicine, as a member of a multidisciplinary case conference team, to organise and coordinate a discharge case conference of at least 15 minutes but less than 30 minutes, before the patient is discharged from a hospital (H)

Fee: $164.65 Benefit: 75% = $123.50 85% = $140.00

(See para AN.0.58 of explanatory notes to this Category)

Attendance by a specialist, or consultant physician, in the practice of the specialist's or consultant physician's specialty of palliative medicine, as a member of a case conference team, to organise and coordinate a discharge case conference of at least 30 minutes but less than 45 minutes, before the patient is discharged from a hospital (H)

Fee: $247.15 Benefit: 75% = $185.40 85% = $210.10

(See para AN.0.58 of explanatory notes to this Category)

Attendance by a specialist, or consultant physician, in the practice of the specialist's or consultant physician's specialty of palliative medicine, as a member of a multidisciplinary case conference team, to organise and coordinate a discharge case conference of at least 45 minutes, before the patient is discharged from a hospital (H)

Fee: $329.25 Benefit: 75% = $246.95 85% = $279.90

(See para AN.0.58 of explanatory notes to this Category)

Attendance by a specialist, or consultant physician, in the practice of the specialist's or consultant physician's specialty of palliative medicine, as a member of a case conference team, to participate in a discharge case conference (other than to organise and coordinate the conference) of at least 15 minutes but less than 30 minutes, before the patient is discharged from a hospital (H)

Fee: $118.25 Benefit: 75% = $88.70 85% = $100.55

(See para AN.0.58 of explanatory notes to this Category)

Attendance by a specialist, or consultant physician, in the practice of the specialist's or consultant physician's specialty of palliative medicine, as a member of a multidisciplinary case conference team, to participate in a discharge case conference (other than to organise and coordinate the conference) of at least 30 minutes but less than 45 minutes, before the patient is discharged from a hospital (H)

Fee: $188.65 Benefit: 75% = $141.50 85% = $160.40

(See para AN.0.58 of explanatory notes to this Category)

Attendance by a specialist, or consultant physician, in the practice of the specialist's or consultant physician's specialty of palliative medicine, as a member of a multidisciplinary case conference team, to participate in a discharge case conference (other than to organise and coordinate the conference) of at least 45 minutes, before the patient is discharged from a hospital (H)

Fee: $259.00 Benefit: 75% = $194.25 85% = $220.15

(See para AN.0.58 of explanatory notes to this Category)