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Category 1 - PROFESSIONAL ATTENDANCES
AN.0.70
Limitation of items—certain attendances by specialists and consultant physicians
Medicare benefits are not payable for items 105, 116, 119, 386, 2806, 2814, 3010, 3014, 6009, 6011, 6013, 6015, 6019, 6052, 16404, 91823, 91825, 91826, 91833, 91836, 92611, 92612, 92613, 92614, 92618, 92749, 92750, 92752, 92753, 92754, 92756, 92757, 92758, 92760, 92761, 92765 and 92766 when claimed in association with an item in group T8 with a schedule fee of $349.95 or more.
The restriction applies when the procedure is performed by the same practitioner, on the same patient, on the same day.
Related Items: 105 116 119 386 2806 2814 3010 3014 6009 6011 6013 6015 6019 6052 16404 91823 91825 91826 91833 91836 92611 92612 92613 92614 92618 92749 92750 92752 92753 92754 92756 92757 92758 92760 92761 92765 92766
Related Items
Category 1 - PROFESSIONAL ATTENDANCES
105 - Additional Information
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)
Category 1 - PROFESSIONAL ATTENDANCES
3010 - Additional Information
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)
Category 1 - PROFESSIONAL ATTENDANCES
3014 - Additional Information
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)
Category 1 - PROFESSIONAL ATTENDANCES
6019 - Additional Information
Professional attendance by an addiction medicine specialist in the practice of the addiction medicine specialist's specialty following referral of the patient to the addiction medicine specialist by a referring practitioner, if the attendance is a patient assessment:
(a) before or after a comprehensive assessment under item 6018 in a single course of treatment; or
(b) that follows an initial assessment under item 6023 in a single course of treatment; or
(c) that follows a review under item 6024 in a single course of treatment
Fee: $89.40 Benefit: 75% = $67.05 85% = $76.00
(See para AN.0.70, AN.3.1, AN.40.1 of explanatory notes to this Category)
Category 1 - PROFESSIONAL ATTENDANCES
91823 - Additional Information
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)
Category 1 - PROFESSIONAL ATTENDANCES
91833 - Additional Information
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)
Category 1 - PROFESSIONAL ATTENDANCES
6009 - Additional Information
Professional attendance by a specialist in the practice of neurosurgery following referral of the patient to the specialist-a minor attendance after the first in a single course of treatment at consulting rooms or hospital
Fee: $50.95 Benefit: 75% = $38.25 85% = $43.35
(See para AN.0.64, AN.0.70, AN.3.1, AN.40.1 of explanatory notes to this Category)
Category 1 - PROFESSIONAL ATTENDANCES
6011 - Additional Information
Professional attendance by a specialist in the practice of neurosurgery following referral of the patient to the specialist-an attendance after the first in a single course of treatment, involving an extensive and comprehensive examination, arranging any necessary investigations in relation to one or more complex problems and of more than 15 minutes in duration but not more than 30 minutes in duration at consulting rooms or hospital
Fee: $101.30 Benefit: 75% = $76.00 85% = $86.15
(See para AN.0.64, AN.0.70, AN.3.1, AN.40.1 of explanatory notes to this Category)
Category 1 - PROFESSIONAL ATTENDANCES
6013 - Additional Information
Professional attendance by a specialist in the practice of neurosurgery following referral of the patient to the specialist-an attendance after the first in a single course of treatment, involving a detailed and comprehensive examination, arranging any necessary investigations in relation to one or more complex problems and of more than 30 minutes in duration but not more than 45 minutes in duration at consulting rooms or hospital
Fee: $140.35 Benefit: 75% = $105.30 85% = $119.30
(See para AN.0.64, AN.0.70, AN.3.1, AN.40.1 of explanatory notes to this Category)
Category 1 - PROFESSIONAL ATTENDANCES
6015 - Additional Information
Professional attendance by a specialist in the practice of neurosurgery following referral of the patient to the specialist-an attendance after the first in a single course of treatment, involving an exhaustive and comprehensive examination, arranging any necessary investigations in relation to one or more complex problems and of more than 45 minutes in duration at consulting rooms or hospital
Fee: $178.70 Benefit: 75% = $134.05 85% = $151.90
(See para AN.0.64, AN.0.70, AN.3.1, AN.40.1 of explanatory notes to this Category)
Category 1 - PROFESSIONAL ATTENDANCES
92618 - Additional Information
Category 1 - PROFESSIONAL ATTENDANCES
386 - Additional Information
Professional attendance at consulting rooms or hospital by a consultant occupational physician in the practice of the consultant occupational physician's specialty of occupational medicine following referral of the patient to the consultant occupational physician by a referring practitioner-each attendance after the first in a single course of treatment
Fee: $50.95 Benefit: 75% = $38.25 85% = $43.35
(See para AN.0.33, AN.0.70, AN.3.1, AN.40.1 of explanatory notes to this Category)
Category 1 - PROFESSIONAL ATTENDANCES
91836 - Additional Information
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)
Category 1 - PROFESSIONAL ATTENDANCES
6052 - Additional Information
Professional attendance by a sexual health medicine specialist in the practice of the sexual health medicine specialist's specialty following referral of the patient to the sexual health medicine specialist by a referring practitioner, if the attendance is a patient assessment:
(a) before or after a comprehensive assessment under item 6051 in a single course of treatment; or
(b) that follows an initial assessment under item 6057 in a single course of treatment; or
(c) that follows a review under item 6058 in a single course of treatment
Fee: $89.40 Benefit: 75% = $67.05 85% = $76.00
(See para AN.0.70, AN.3.1, AN.40.1 of explanatory notes to this Category)
Category 1 - PROFESSIONAL ATTENDANCES
91825 - Additional Information
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)
Category 1 - PROFESSIONAL ATTENDANCES
91826 - Additional Information
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)
Category 1 - PROFESSIONAL ATTENDANCES
116 - Additional Information
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)
Category 1 - PROFESSIONAL ATTENDANCES
119 - Additional Information
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)
Category 3 - THERAPEUTIC PROCEDURES
16404 - Additional Information
Professional attendance at consulting rooms or a hospital by a specialist in the practice of the specialist’s specialty of obstetrics after referral of the patient to the specialist—an attendance after the initial attendance in a single course of treatment
Fee: $50.20 Benefit: 75% = $37.65 85% = $42.70
(See para AN.0.70, AN.3.1, TN.4.2 of explanatory notes to this Category)
Category 1 - PROFESSIONAL ATTENDANCES
92611 - Additional Information
Category 1 - PROFESSIONAL ATTENDANCES
92612 - Additional Information
Video attendance by a specialist in the practice of neurosurgery following referral of the patient to the specialist—an attendance after the first in a single course of treatment, involving arranging any necessary investigations in relation to one or more complex problems and of more than 15 minutes in duration but not more than 30 minutes in duration
Fee: $101.30 Benefit: 85% = $86.15
(See para AN.0.70, AN.3.1 of explanatory notes to this Category)
Category 1 - PROFESSIONAL ATTENDANCES
92613 - Additional Information
Video attendance by a specialist in the practice of neurosurgery following referral of the patient to the specialist—an attendance after the first in a single course of treatment, involving arranging any necessary investigations in relation to one or more complex problems and of more than 30 minutes in duration but not more than 45 minutes in duration
Fee: $140.35 Benefit: 85% = $119.30
(See para AN.0.70, AN.3.1 of explanatory notes to this Category)
Category 1 - PROFESSIONAL ATTENDANCES
92614 - Additional Information
Video attendance by a specialist in the practice of neurosurgery following referral of the patient to the specialist—an attendance after the first in a single course of treatment, involving arranging any necessary investigations in relation to one or more complex problems and of more than 45 minutes in duration
Fee: $178.70 Benefit: 85% = $151.90
(See para AN.0.70, AN.3.1 of explanatory notes to this Category)
Category 1 - PROFESSIONAL ATTENDANCES
2806 - Additional Information
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)
Category 1 - PROFESSIONAL ATTENDANCES
2814 - Additional Information
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)
Category 1 - PROFESSIONAL ATTENDANCES
92749 - Additional Information
Video attendance for a person by a consultant occupational physician in the practice of the consultant occupational physician's specialty of occupational medicine if:
(a) the attendance follows referral of the patient to the consultant occupational physician;
(b) the attendance is of more than 5 minutes in duration; and
(c) the attendance is after the first in a single course of treatment.
Fee: $50.95 Benefit: 85% = $43.35
(See para AN.0.33, AN.0.70, AN.3.1, AN.40.1 of explanatory notes to this Category)
Category 1 - PROFESSIONAL ATTENDANCES
92750 - Additional Information
Phone attendance for a person by a consultant occupational physician in the practice of the consultant occupational physician's specialty of occupational medicine if:
(a) the attendance follows referral of the patient to the consultant occupational physician;
(b) the attendance is of more than 5 minutes in duration; and
(c) the attendance is after the first attendance in a single course of treatment.
Fee: $50.95 Benefit: 85% = $43.35
(See para AN.0.33, AN.0.70, AN.3.1, AN.40.1 of explanatory notes to this Category)
Category 1 - PROFESSIONAL ATTENDANCES
92752 - Additional Information
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)
Category 1 - PROFESSIONAL ATTENDANCES
92753 - Additional Information
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)
Category 1 - PROFESSIONAL ATTENDANCES
92754 - Additional Information
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)
Category 1 - PROFESSIONAL ATTENDANCES
92756 - Additional Information
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)
Category 1 - PROFESSIONAL ATTENDANCES
92757 - Additional Information
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)
Category 1 - PROFESSIONAL ATTENDANCES
92758 - Additional Information
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)
Category 1 - PROFESSIONAL ATTENDANCES
92760 - Additional Information
Video attendance for a person by an addiction medicine specialist in the practice of the addiction medicine specialist's specialty if:
(a) the attendance follows referral of the patient to the specialist;
(b) the attendance is of more than 5 minutes in duration; and
(c) the attendance is a patient assessment:
(i) before or after a comprehensive assessment under item 110, 6018, 91824 or 92759 in a single course of treatment; or
(ii) that follows an initial assessment under item 132, 6023, 92422 or 92762 in a single course of treatment; or
(iii) that follows a review under item 133, 6024, 92423 or 92763 in a single course of treatment.
Fee: $89.40 Benefit: 85% = $76.00
(See para AN.0.70, AN.3.1, AN.40.1 of explanatory notes to this Category)
Category 1 - PROFESSIONAL ATTENDANCES
92761 - Additional Information
Phone attendance for a person by an addiction medicine specialist in the practice of the addiction medicine specialist's specialty if:
(a) the attendance follows referral of the patient to the specialist;
(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.0.70, AN.3.1, AN.40.1 of explanatory notes to this Category)
Category 1 - PROFESSIONAL ATTENDANCES
92765 - Additional Information
Video attendance by a sexual health medicine specialist in the practice of the sexual health medicine specialist's specialty if:
(a) the attendance follows referral of the patient to the specialist;
(b) the attendance is a patient assessment:
(i) before or after a comprehensive assessment under item 6051, 91824 or 92764 in a single course of treatment; or
(ii) that follows an initial assessment under item 6057 or 92767 in a single course of treatment; or
(iii) that follows a review under item 6058 or 92768 in a single course of treatment.
Fee: $89.40 Benefit: 85% = $76.00
(See para AN.0.70, AN.3.1, AN.40.1 of explanatory notes to this Category)
Category 1 - PROFESSIONAL ATTENDANCES
92766 - Additional Information
Phone attendance for a person by a sexual health medicine specialist in the practice of the sexual health medicine specialist's specialty if:
(a) the attendance follows referral of the patient to the sexual health medicine specialist; and
(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.0.70, AN.3.1, AN.40.1 of explanatory notes to this Category)
Legend
- Assist - Addition/Deletion of (Assist.)
- Amend - Amended Description
- Anaes - Anaesthetic Values Amended
- Emsn - EMSN Change
- Fee - Fee Amended
- Renum - Item Number Change (renumbered)
- New - New Item
- NewMin - New Item (previous Ministerial Determination)
- Qfe - QFE Change