Medicare Benefits Schedule - Note AN.0.72

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Category 1 - PROFESSIONAL ATTENDANCES

AN.0.72

Attendance services for complex neurodevelopmental disorders (such as autism)

Intention of this service under item 289 and video equivalent item 92434

Items 289 or video equivalent item 92434 are intended for complex conditions, characterised by multi-domain cognitive and functional impairment. Patient eligibility is for neurodevelopmental disorders (NDD), which are assessed to be complex and mean that individuals require support across multiple domains.

The intention of this service is to provide access to treatment, through the development of a treatment and management plan by a psychiatrist, for individuals under 25 years of age, diagnosed with a complex NDD. The development of the treatment and management plan, follows a comprehensive medical assessment, and provides the opportunity to refer to eligible allied health practitioners for up to a total of 20 MBS treatment services per patient’s lifetime (items 82015, 82020, 82025, 82035, 93035, 93036, 93043 or 93044). This item is claimable once in a patient’s lifetime.

Eligibility:

In the context of item 289 (or 92434), the diagnosis of a complex NDD requires evidence of requiring support and showing impairment across two or more neurodevelopmental domains. Complexity is characterised by multi-domain cognitive and functional disabilities, delay or clinically significant impairment.

Neurodevelopmental domains include:

  • Cognition
  • Language
  • Social-emotional development
  • Motor skills
  • Adaptive behaviour:  conceptual skills, practical skills, social skills or social communication skills

Referral pathways:

Early identification of, and intervention for, individuals with complex NDD is important in promoting positive longer-term outcomes. Symptoms can cause clinically significant impairment in social, occupational or other important areas of functioning.

Where neurodevelopmental concerns have been identified and brought to the attention of the patient’s GP to initially assess these concerns and the GP considers there are persisting indications that require more specialised assessment, they are encouraged to refer to either a consultant paediatrician or psychiatrist for a comprehensive assessment.

Diagnostic assessment:

The assessment and diagnosis of a complex NDD should be evaluated in the context of both a physical and developmental assessment. The psychiatrist may require a number of separate attendances (through usual time-tiered or subsequent attendance items 296 to 308, 310, 312, 314, 316, 318, 319 to 349, 91827 to 91831 or 91837 to 91839, 92437, 92455 to 92457) to complete a comprehensive accurate assessment and formulate a diagnosis, exclude other disorders or assess for co-occurring conditions.

Multi-disciplinary assistance with assessment and/or contribution to the treatment and management plan:

Depending on a range of factors, not limited to the patient’s age and nature of suspected disabilities, the consultant physician may require a multi-disciplinary approach to complete a comprehensive accurate assessment and formulate a diagnosis. 

Where the psychiatrist determines the patient requires additional assessments to formulate a diagnosis, through the assistance of an allied health practitioner, they are able to refer the patient to an eligible allied health provider from standard attendance items (296 to 308, 310, 312, 314, 316, 318, 319 to 349 or telehealth (video and phone) items 91827 to 91831, 91837 to 91839, 92437, 92455 to 92457).

Whilst Medicare benefits provide for a total of 8 allied health assessment services per patient per lifetime, an eligible allied health practitioner can only provide up to 4 services before the need for a review (the type of review can be specified in the referral to the eligible allied health professional) by the referring psychiatrist, who must agree to the need for any additional allied health services prior to the delivery of the remaining 4 allied health assessment services.

Eligible allied health assessment practitioners include:

  • Psychologist (MBS item 82000, 93032, 93040)
  • Speech pathologist (MBS item 82005, 93033, 93041)
  • Occupational therapist (82010, 93033, 93041)
  • Audiologist, dietitian, exercise physiologist, optometrist, orthoptist, physiotherapist (MBS item 82030, 93033, 93041)

Requirements of the referral to allied health practitioners

The psychiatrist can refer to multiple eligible allied health practitioners concurrently, but a separate referral letter must be provided to each allied health practitioner. The referral should specify the intent of the assessment and if appropriate, specify the number of services to be provided. Where the number of sessions is not specified, each allied health practitioner can provide up to 4 assessment services without the need for review or agreement to provide further assessment services.

Review requirements following delivery of four (4) allied health assessment services

Whilst an eligible allied health practitioner has provided 4 assessment services (through items 82000, 82005, 82010, 82030, 93032, 93040, 93033 or 93041) and considers additional assessment services are required, they must ensure the referring psychiatrist undertakes a review. If the type of review is not specified by the referring psychiatrist an acceptable means of review includes: a case conference, phone call, written correspondence, secure online messaging exchange or attendance of the patient with the referring psychiatrist.

Inter-disciplinary allied health referral

Eligible allied health practitioners are also able to make inter-disciplinary referrals to other eligible allied health practitioners as clinically necessary to assist with the formulation of the diagnosis or contribute to the treatment and management plan. Inter-disciplinary referrals must be undertaken in consultation and agreement with the referring psychiatrist.  Whilst they do not require the need for an attendance with the patient (face-to-face/video/phone) by the referring psychiatrist, they do require an agreement from the referring psychiatrist.  This can be undertaken (but is not limited to) an exchange by phone, written communication or secure online messaging.

Contribution to the Treatment and Management Plan through allied health referral

In addition to referring to allied health practitioners for assistance with formulating a diagnosis, once a psychiatrist makes a complex NDD diagnosis, the psychiatrist may require the contribution of an eligible allied health practitioner to assist with the development of the Treatment and Management plan (before billing item 289 or 92434).

MBS items 82000, 82005, 82010, 82030, 93032, 93033, 93040 or 93041 provide a dual function for this purpose. It is important to note that the service limit of a total of 8 services per patient per lifetime apply regardless of whether the items are used for assistance with diagnosis or contribution to the treatment and management plan, and the referring psychiatrist should be mindful of this when referring to eligible allied health practitioners.

Development of the Treatment and Management Plan

Once the psychiatrist has made a diagnosis of a complex NDD, to complete the item requirements of item 289 or 92434 they must develop a treatment and management plan which includes:

  • Written documentation of the patient’s confirmed diagnosis of a complex NDD, including any findings of assessments performed (which assisted with the formulation of the diagnosis or contributed to the treatment and management plan)
  • A risk assessment which means assessment of:
    • the risk to the patient of a contributing co‑morbidity and
    • environmental, physical, social and emotional risk factors that may apply to the patient or to another individual.
  • Treatment options which include:
    • Recommendations using a biopsychosocial model
    • Identifying major treatment goals and important milestones and objectives
    • Recommendation/s and referral for treatment services provided by eligible allied health practitioners (where relevant) and who should provide this, specifying number of treatments recommended (to a maximum of 20 treatment services)
    • Indications for review or episodes requiring escalation of treatment strategies
  • Documenting the Treatment and Management plan and providing a copy to the referring medical practitioner and relevant allied health practitioner/s.

Referral for allied health treatment services

Once a treatment and management plan is in place (after item 289 or 92434 has been claimed) the psychiatrist can refer the individual to eligible allied health practitioners for the provision of treatment services. Treatment services address the functional impairments identified through the comprehensive medical assessment which are outlined in the treatment and management plan. Treatment services focus on interventions to address developmental delays/disabilities or impairments.

Eligible allied health treatment practitioners include:

  • Psychologist (MBS items 82015, 93035, 93043)
  • Speech pathologist (MBS items 82020, 93036, 93044)
  • Occupational therapist (MBS items 82025, 93036, 93044)
  • Audiologist, dietitian, exercise physiologist, optometrist, orthoptist, physiotherapist (MBS items 82035, 93036, 93044)

A total of 20 allied health treatment services per patient per lifetime are available through the MBS, which may consist of any combination of items 82015, 82020, 82025 or 82035 or equivalent video items. Whilst the psychiatrist can refer to multiple eligible allied health practitioners concurrently, a separate referral letter must be provided to each allied health practitioner.

The referral should specify the goals of the treatment and if appropriate, specify the number of services to be provided. It is the responsibility of the referring psychiatrist to allocate the number of treatment services (up to a maximum of 10 services per course of treatment) in keeping with the individual’s treatment and management plan.

It is important to note, that a benefit will not be paid for the MBS allied health treatment services unless the pre-requisite items (289 or 92434) have been processed through the Medicare claiming system.

On the completion of a “course of treatment” (specified by the referring psychiatrist, up to maximum of 10 services), the eligible allied health practitioner must provide a written report to the referring psychiatrist, which should include information on the treatment provided, recommendations for future management of the individual’s disorder and any advice to caregivers (such as parents, carers, school teachers). This written report will inform the referring psychiatrist’s decision to refer for further treatment services. Where subsequent courses of treatment after the initial 10 services are required (up to a maximum of 20 services per patient per lifetime) a new referral is required.

Inconclusive assessment:

Where a patient does not meet the diagnostic threshold of a complex NDD and where ongoing medical management is required, patients can be managed through psychiatry attendance items 300-308, 310, 312, 314, 316, 318 or telehealth equivalent items 91827-91831 (video) or 91837-91839 (phone).

Examples include where:

  • Neurodevelopment assessment is incomplete or inconclusive
  • Neurodevelopmental impairment is present in fewer than two domains
  • Neurodevelopmental impairment is present in two or more domains, but individuals do not require sufficient support to meet criteria
  • Comprehensive, age-appropriate neurodevelopmental assessment is impossible or unavailable (e.g. in infants or young children- particularly those under 6 years of age)

These individuals may be considered “at risk of a complex NDD” and require follow-up and reassessment in the future.

Related Items: 289 296 297 299 300 301 302 303 304 306 308 310 312 314 316 318 319 320 322 324 326 328 330 332 334 336 338 341 342 343 344 345 346 347 349 82000 82005 82010 82015 82020 82025 82030 82035 91827 91828 91829 91830 91831 91837 91838 91839 92434 92437 92455 92456 92457 93032 93033 93035 93036 93040 93041 93043 93044


Related Items

Category 8 - MISCELLANEOUS SERVICES

82000

82000 - Additional Information

Item Start Date:
01-Jul-2008
Description Updated:
01-Mar-2024
Schedule Fee Updated:
01-Jul-2025

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)

Category 8 - MISCELLANEOUS SERVICES

82005

82005 - Additional Information

Item Start Date:
01-Jul-2008
Description Updated:
01-Mar-2024
Schedule Fee Updated:
01-Jul-2025

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)

Category 8 - MISCELLANEOUS SERVICES

82010

82010 - Additional Information

Item Start Date:
01-Jul-2008
Description Updated:
01-Mar-2024
Schedule Fee Updated:
01-Jul-2025

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)

Category 8 - MISCELLANEOUS SERVICES

82015

82015 - Additional Information

Item Start Date:
01-Jul-2008
Description Updated:
01-Mar-2024
Schedule Fee Updated:
01-Jul-2025

Psychology health service provided 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 psychologist, 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 in person; and

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

(d)    on the completion of the course of treatment, the eligible psychologist 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 82020, 82025, 82035, 93035, 93036, 93043 or 93044 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.10.2, MN.10.3 of explanatory notes to this Category)

Category 8 - MISCELLANEOUS SERVICES

82020

82020 - Additional Information

Item Start Date:
01-Jul-2008
Description Updated:
01-Mar-2024
Schedule Fee Updated:
01-Jul-2025

Speech pathology health service provided 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 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 in person; and

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

(d)    on the completion of the course of treatment, the eligible 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, 82025, 82035, 93035, 93036, 93043 or 93044 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.10.2, MN.10.3 of explanatory notes to this Category)

Category 8 - MISCELLANEOUS SERVICES

82025

82025 - Additional Information

Item Start Date:
01-Jul-2008
Description Updated:
01-Mar-2024
Schedule Fee Updated:
01-Jul-2025

Occupational therapy health service provided 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 occupational therapist, 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 in person; and

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

(d)    on the completion of the course of treatment, the eligible occupational therapist 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, 82035, 93035, 93036, 93043 or 93044 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.10.2, MN.10.3 of explanatory notes to this Category)

Category 8 - MISCELLANEOUS SERVICES

82030

82030 - Additional Information

Item Start Date:
01-Jul-2011
Description Updated:
01-Jul-2025
Schedule Fee Updated:
01-Jul-2025

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)

Category 8 - MISCELLANEOUS SERVICES

82035

82035 - Additional Information

Item Start Date:
01-Jul-2011
Description Updated:
01-Jul-2025
Schedule Fee Updated:
01-Jul-2025

Audiology, dietetic, exercise physiology, optometry, orthoptic or physiotherapy health service provided 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, optometrist, orthoptist or physiotherapist, 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 in person; 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, optometrist, orthoptist or physiotherapist 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, 93035, 93036, 93043 or 93044 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.10.2, MN.10.3 of explanatory notes to this Category)

Category 1 - PROFESSIONAL ATTENDANCES

289

289 - Additional Information

Item Start Date:
01-Jul-2008
Description Updated:
01-Mar-2023
Schedule Fee Updated:
01-Jul-2025

Professional attendance lasting at least 45 minutes, by a consultant physician in the practice of the consultant physician’s specialty of psychiatry, following referral of the patient to the consultant psychiatrist by a referring practitioner, for a patient aged under 25, if the consultant psychiatrist:

(a) undertakes, or has previously undertaken in prior attendances, a comprehensive assessment in relation to which a diagnosis of a complex neurodevelopmental disorder (such as autism spectrum disorder) is made (if appropriate, using information provided by an eligible allied health provider); and

(b) develops a treatment and management plan, which must include:

(i) documentation of the confirmed diagnosis; and

(ii) findings of any assessments performed for the purposes of formulation of the diagnosis or contribution to the treatment and management plan; and

(iii) a risk assessment; and

(iv) treatment options (which may include biopsychosocial recommendations); and

(c) provides a copy of the treatment and management plan to:

(i) the referring practitioner; and

(ii) one or more allied health providers, if appropriate, for the treatment of the patient;

(other than attendance on a patient for whom payment has previously been made under this item or item 135, 137, 139, 92140, 92141, 92142 or 92434)

Applicable only once per lifetime

Fee: $312.45 Benefit: 75% = $234.35 85% = $265.60

(See para AN.0.72, AN.40.1 of explanatory notes to this Category)

Category 1 - PROFESSIONAL ATTENDANCES

296

296 - Additional Information

Item Start Date:
01-Nov-2006
Description Updated:
01-Nov-2024
Schedule Fee Updated:
01-Jul-2025

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)

Category 1 - PROFESSIONAL ATTENDANCES

297 Amend Emsn

297 - Additional Information

Item Start Date:
01-Nov-2006
Description Updated:
01-Jan-2026
Schedule Fee Updated:
01-Jul-2025

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)

Category 1 - PROFESSIONAL ATTENDANCES

299

299 - Additional Information

Item Start Date:
01-Nov-2006
Description Updated:
01-Nov-2024
Schedule Fee Updated:
01-Jul-2025

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)

Category 1 - PROFESSIONAL ATTENDANCES

300

300 - Additional Information

Item Start Date:
01-Nov-1996
Description Updated:
01-Mar-2024
Schedule Fee Updated:
01-Jul-2025

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)

Category 1 - PROFESSIONAL ATTENDANCES

302

302 - Additional Information

Item Start Date:
01-Nov-1996
Description Updated:
01-Mar-2024
Schedule Fee Updated:
01-Jul-2025

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)

Category 1 - PROFESSIONAL ATTENDANCES

304

304 - Additional Information

Item Start Date:
01-Nov-1996
Description Updated:
01-Mar-2024
Schedule Fee Updated:
01-Jul-2025

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)

Category 1 - PROFESSIONAL ATTENDANCES

306

306 - Additional Information

Item Start Date:
01-Nov-1996
Description Updated:
01-Mar-2024
Schedule Fee Updated:
01-Jul-2025

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)

Category 1 - PROFESSIONAL ATTENDANCES

308

308 - Additional Information

Item Start Date:
01-Nov-1996
Description Updated:
01-Mar-2024
Schedule Fee Updated:
01-Jul-2025

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)

Category 1 - PROFESSIONAL ATTENDANCES

310

310 - Additional Information

Item Start Date:
01-Nov-1996
Description Updated:
01-Mar-2024
Schedule Fee Updated:
01-Jul-2025

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)

Category 1 - PROFESSIONAL ATTENDANCES

312

312 - Additional Information

Item Start Date:
01-Nov-1996
Description Updated:
01-Mar-2024
Schedule Fee Updated:
01-Jul-2025

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)

Category 1 - PROFESSIONAL ATTENDANCES

314

314 - Additional Information

Item Start Date:
01-Nov-1996
Description Updated:
01-Mar-2024
Schedule Fee Updated:
01-Jul-2025

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)

Category 1 - PROFESSIONAL ATTENDANCES

316

316 - Additional Information

Item Start Date:
01-Nov-1996
Description Updated:
01-Mar-2024
Schedule Fee Updated:
01-Jul-2025

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)

Category 1 - PROFESSIONAL ATTENDANCES

318

318 - Additional Information

Item Start Date:
01-Nov-1996
Description Updated:
01-Mar-2024
Schedule Fee Updated:
01-Jul-2025

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)

Category 1 - PROFESSIONAL ATTENDANCES

319

319 - Additional Information

Item Start Date:
01-Jan-1997
Description Updated:
01-Mar-2024
Schedule Fee Updated:
01-Jul-2025

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)

Category 1 - PROFESSIONAL ATTENDANCES

320

320 - Additional Information

Item Start Date:
01-Nov-1996
Description Updated:
01-Nov-2019
Schedule Fee Updated:
01-Jul-2025

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)

Category 1 - PROFESSIONAL ATTENDANCES

322

322 - Additional Information

Item Start Date:
01-Nov-1996
Description Updated:
01-Nov-2019
Schedule Fee Updated:
01-Jul-2025

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)

Category 1 - PROFESSIONAL ATTENDANCES

324

324 - Additional Information

Item Start Date:
01-Nov-1996
Description Updated:
01-Nov-2019
Schedule Fee Updated:
01-Jul-2025

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)

Category 1 - PROFESSIONAL ATTENDANCES

326

326 - Additional Information

Item Start Date:
01-Nov-1996
Description Updated:
01-Nov-2019
Schedule Fee Updated:
01-Jul-2025

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)

Category 1 - PROFESSIONAL ATTENDANCES

328

328 - Additional Information

Item Start Date:
01-Nov-1996
Description Updated:
01-Nov-2019
Schedule Fee Updated:
01-Jul-2025

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)

Category 1 - PROFESSIONAL ATTENDANCES

330

330 - Additional Information

Item Start Date:
01-Nov-1996
Description Updated:
01-Nov-2019
Schedule Fee Updated:
01-Jul-2025

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)

Category 1 - PROFESSIONAL ATTENDANCES

332

332 - Additional Information

Item Start Date:
01-Nov-1996
Description Updated:
01-Nov-2019
Schedule Fee Updated:
01-Jul-2025

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)

Category 1 - PROFESSIONAL ATTENDANCES

334

334 - Additional Information

Item Start Date:
01-Nov-1996
Description Updated:
01-Nov-2019
Schedule Fee Updated:
01-Jul-2025

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)

Category 1 - PROFESSIONAL ATTENDANCES

336

336 - Additional Information

Item Start Date:
01-Nov-1996
Description Updated:
01-Nov-2019
Schedule Fee Updated:
01-Jul-2025

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)

Category 1 - PROFESSIONAL ATTENDANCES

338

338 - Additional Information

Item Start Date:
01-Nov-1996
Description Updated:
01-Nov-2019
Schedule Fee Updated:
01-Jul-2025

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)

Category 1 - PROFESSIONAL ATTENDANCES

341

341 - Additional Information

Item Start Date:
01-Mar-2024
Description Updated:
01-Mar-2024
Schedule Fee Updated:
01-Jul-2025

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)

Category 1 - PROFESSIONAL ATTENDANCES

342

342 - Additional Information

Item Start Date:
01-Nov-1996
Description Updated:
01-Nov-2019
Schedule Fee Updated:
01-Jul-2025

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)

Category 1 - PROFESSIONAL ATTENDANCES

343

343 - Additional Information

Item Start Date:
01-Mar-2024
Description Updated:
01-Mar-2024
Schedule Fee Updated:
01-Jul-2025

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)

Category 1 - PROFESSIONAL ATTENDANCES

344

344 - Additional Information

Item Start Date:
01-Nov-1996
Description Updated:
01-Nov-2019
Schedule Fee Updated:
01-Jul-2025

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)

Category 1 - PROFESSIONAL ATTENDANCES

345

345 - Additional Information

Item Start Date:
01-Mar-2024
Description Updated:
01-Mar-2024
Schedule Fee Updated:
01-Jul-2025

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)

Category 1 - PROFESSIONAL ATTENDANCES

346

346 - Additional Information

Item Start Date:
01-Nov-1996
Description Updated:
01-Nov-2019
Schedule Fee Updated:
01-Jul-2025

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)

Category 1 - PROFESSIONAL ATTENDANCES

347

347 - Additional Information

Item Start Date:
01-Mar-2024
Description Updated:
01-Mar-2024
Schedule Fee Updated:
01-Jul-2025

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)

Category 1 - PROFESSIONAL ATTENDANCES

349

349 - Additional Information

Item Start Date:
01-Mar-2024
Description Updated:
01-Mar-2024
Schedule Fee Updated:
01-Jul-2025

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)

Category 1 - PROFESSIONAL ATTENDANCES

91827

91827 - Additional Information

Item Start Date:
13-Mar-2020
Description Updated:
01-Mar-2025
Schedule Fee Updated:
01-Jul-2025

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)

Category 1 - PROFESSIONAL ATTENDANCES

91828

91828 - Additional Information

Item Start Date:
13-Mar-2020
Description Updated:
01-Mar-2025
Schedule Fee Updated:
01-Jul-2025

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)

Category 1 - PROFESSIONAL ATTENDANCES

91829

91829 - Additional Information

Item Start Date:
13-Mar-2020
Description Updated:
01-Mar-2025
Schedule Fee Updated:
01-Jul-2025

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)

Category 1 - PROFESSIONAL ATTENDANCES

91830

91830 - Additional Information

Item Start Date:
13-Mar-2020
Description Updated:
01-Mar-2025
Schedule Fee Updated:
01-Jul-2025

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)

Category 1 - PROFESSIONAL ATTENDANCES

91831

91831 - Additional Information

Item Start Date:
13-Mar-2020
Description Updated:
01-Mar-2025
Schedule Fee Updated:
01-Jul-2025

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)

Category 1 - PROFESSIONAL ATTENDANCES

92434

92434 - Additional Information

Item Start Date:
06-Apr-2020
Description Updated:
01-Mar-2025
Schedule Fee Updated:
01-Jul-2025

Video attendance lasting at least 45 minutes by a consultant physician in the practice of the consultant physician’s specialty of psychiatry, following referral of the patient to the consultant psychiatrist by a referring practitioner, for a patient aged under 25, if the consultant psychiatrist:

(a) undertakes, or has previously undertaken in prior attendances, a comprehensive assessment in relation to which a diagnosis of a complex neurodevelopmental disorder (such as autism spectrum disorder) is made (if appropriate, using information provided by an eligible allied health provider); and

(b) develops a treatment and management plan, which must include:

(i) documentation of the confirmed diagnosis; and

(ii) findings of any assessments performed for the purposes of formulation of the diagnosis or contribution to the treatment and management plan; and

(iii) a risk assessment; and

(iv) treatment options (which may include biopsychosocial recommendations); and

(c) provides a copy of the treatment and management plan to:

(i) the referring practitioner; and

(ii) one or more allied health providers, if appropriate, for the treatment of the patient;

(other than attendance on a patient for whom payment has previously been made under this item or item 135, 137, 139, 289, 92140, 92141 or 92142)

Applicable only once per lifetime

Fee: $312.45 Benefit: 85% = $265.60

(See para AN.0.72 of explanatory notes to this Category)

Category 1 - PROFESSIONAL ATTENDANCES

92437

92437 - Additional Information

Item Start Date:
06-Apr-2020
Description Updated:
01-Mar-2025
Schedule Fee Updated:
01-Jul-2025

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)

Category 1 - PROFESSIONAL ATTENDANCES

92455

92455 - Additional Information

Item Start Date:
20-Apr-2020
Description Updated:
01-Mar-2025
Schedule Fee Updated:
01-Jul-2025

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)

Category 1 - PROFESSIONAL ATTENDANCES

92456

92456 - Additional Information

Item Start Date:
20-Apr-2020
Description Updated:
01-Mar-2025
Schedule Fee Updated:
01-Jul-2025

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)

Category 1 - PROFESSIONAL ATTENDANCES

92457

92457 - Additional Information

Item Start Date:
20-Apr-2020
Description Updated:
01-Mar-2025
Schedule Fee Updated:
01-Jul-2025

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)

Category 8 - MISCELLANEOUS SERVICES

93040

93040 - Additional Information

Item Start Date:
30-Mar-2020
Description Updated:
01-Mar-2023
Schedule Fee Updated:
01-Jul-2025

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)

Category 8 - MISCELLANEOUS SERVICES

93041

93041 - Additional Information

Item Start Date:
30-Mar-2020
Description Updated:
01-Jul-2025
Schedule Fee Updated:
01-Jul-2025

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)

Category 8 - MISCELLANEOUS SERVICES

93043

93043 - Additional Information

Item Start Date:
30-Mar-2020
Description Updated:
01-Mar-2023
Schedule Fee Updated:
01-Jul-2025

Psychology 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 psychologist, 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 psychologist 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 93044 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.10.2, MN.10.3 of explanatory notes to this Category)

Category 8 - MISCELLANEOUS SERVICES

93044

93044 - Additional Information

Item Start Date:
30-Mar-2020
Description Updated:
01-Jul-2025
Schedule Fee Updated:
01-Jul-2025

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)

Category 1 - PROFESSIONAL ATTENDANCES

301

301 - Additional Information

Item Start Date:
01-Nov-2023
Description Updated:
01-Nov-2023
Schedule Fee Updated:
01-Jul-2025

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)

Category 1 - PROFESSIONAL ATTENDANCES

303

303 - Additional Information

Item Start Date:
01-Nov-2023
Description Updated:
01-Nov-2023
Schedule Fee Updated:
01-Jul-2025

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)

Category 1 - PROFESSIONAL ATTENDANCES

91837

91837 - Additional Information

Item Start Date:
13-Mar-2020
Description Updated:
01-Mar-2024
Schedule Fee Updated:
01-Jul-2025

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)

Category 1 - PROFESSIONAL ATTENDANCES

91838

91838 - Additional Information

Item Start Date:
13-Mar-2020
Description Updated:
01-Mar-2024
Schedule Fee Updated:
01-Jul-2025

 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)

Category 1 - PROFESSIONAL ATTENDANCES

91839

91839 - Additional Information

Item Start Date:
13-Mar-2020
Description Updated:
01-Mar-2024
Schedule Fee Updated:
01-Jul-2025

 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)

Category 8 - MISCELLANEOUS SERVICES

93032

93032 - Additional Information

Item Start Date:
30-Mar-2020
Description Updated:
01-Mar-2025
Schedule Fee Updated:
01-Jul-2025

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)

Category 8 - MISCELLANEOUS SERVICES

93033

93033 - Additional Information

Item Start Date:
30-Mar-2020
Description Updated:
01-Jul-2025
Schedule Fee Updated:
01-Jul-2025

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)

Category 8 - MISCELLANEOUS SERVICES

93035

93035 - Additional Information

Item Start Date:
30-Mar-2020
Description Updated:
01-Mar-2025
Schedule Fee Updated:
01-Jul-2025

Psychology health service provided by video 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 psychologist, 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 psychologist 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, 93036, 93043 or 93044 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.10.2, MN.10.3 of explanatory notes to this Category)

Category 8 - MISCELLANEOUS SERVICES

93036

93036 - Additional Information

Item Start Date:
30-Mar-2020
Description Updated:
01-Jul-2025
Schedule Fee Updated:
01-Jul-2025

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 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, 93043 or 93044 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.10.2, MN.10.3 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