Medicare Benefits Schedule - Note AN.0.73

Intention and eligibility of this service under item 139 and video equivalent item 92142

Items 139 or video equivalent item 92142 are intended for diagnosis and treatment for patients under 25 years of age with an eligible disability by a general practitioner.

Definition of Eligible Disabilities is found AR.29.1

The intention of this service is to provide access to treatment, through the development of a treatment and management plan by a general practitioner, for individuals under 25 years of age, diagnosed an eligible disability. 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.

Diagnostic assessment:

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

The assessment and diagnosis of an eligible disability should be evaluated in the context of both a physical and developmental assessment. The GP may require a number of separate attendances (through usual time-tiered or subsequent attendance items 3 to 47 or telehealth items 91790, 91800 to 91802 (video), 91890 and 91891 (phone) 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 GP may require a multi-disciplinary approach to complete a comprehensive accurate assessment and formulate a diagnosis. 

Where the GP 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 3 to 47 or telehealth items 91790, 91800 to 91802 (video), 91890 and 91891(phone).

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 GP, 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 (MBS item 82010, 93033, 93041)
• Audiologist, dietitian, exercise physiologist, optometrist, orthoptist, physiotherapist (MBS item 82030, 93033, 93041)

Requirements of the referral to allied health practitioners

The GP 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

Where an eligible allied health practitioner has provided 4 assessment services (through items 82000, 82005, 82010, 82030, 93032, 93033, 93040, or 93041) and considers additional assessment services are required, they must ensure the referring GP undertakes a review.  If the type of review is not specified by the GP, 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 GP. Whilst they do not require the need for an attendance with the patient (face-to-face/video/phone) by the referring GP, they do require an agreement from the referring GP.  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 the GP makes a diagnosis, the GP may require the contribution of an eligible allied health practitioner to assist with the development of the Treatment and Management plan (before billing item 139 or 92142).

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 GP should be mindful of this when referring to eligible allied health practitioners.

Development of the Treatment and Management Plan

Once the GP has made a diagnosis of an eligible disability, to complete the item requirements of item 139 or 92142 they must develop a treatment and management plan which includes:

• Written documentation of the patient’s confirmed diagnosis of an eligible disability, 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 relevant allied health practitioner/s.

Referral for allied health treatment services

Once a treatment and management plan is in place (after item 139 or 92142 has been claimed) the GP 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 GP 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, the 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 (139 or 92142) have been processed through the Medicare claiming system.

On the completion of a “course of treatment” (specified by the referring GP, up to maximum of 10 services), the eligible allied health practitioner must provide a written report to the referring GP, which should include information on the treatment provided, recommendations on future management of the individual’s disorder and any advice to caregivers (such as parents, carers, schoolteachers). This written report will inform the referring GPs 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.

Related Items: 3 4 23 24 36 37 44 47 139 82000 82005 82010 82015 82020 82025 82030 82035 91790 91800 91801 91802 91890 91891 92142 93032 93033 93035 93036 93040 93041 93043 93044

• Previous - Note AN.0.72
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Professional attendance lasting at least 45 minutes, at a place other than a hospital, by a general practitioner (not including a specialist or consultant physician), for a patient aged under 25, if the general practitioner:

(a) undertakes, or has previously undertaken in prior attendances, a comprehensive assessment in relation to which a diagnosis of an eligible disability 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 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, 289, 92140, 92141, 92142 or 92434)

Applicable only once per lifetime

Fee: $156.95 Benefit: 100% = $156.95

(See para AN.0.73, AR.29.1 of explanatory notes to this Category)

Video attendance by a general practitioner for an obvious problem characterised by the straightforward nature of the task that requires a short patient history and, if required, limited management

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

Fee: $20.05 Benefit: 100% = $20.05

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

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

(a) taking a short patient history;

(b) arranging any necessary investigation;

(c) implementing a management plan;

(d) providing appropriate preventative health care

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

Fee: $43.90 Benefit: 100% = $43.90

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

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

(a) taking a detailed patient history;

(b) arranging any necessary investigation;

(c) implementing a management plan;

(d) providing appropriate preventative health care

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

Fee: $84.90 Benefit: 100% = $84.90

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

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

(a) taking an extensive patient history;

(b) arranging any necessary investigation;

(c) implementing a management plan;

(d) providing appropriate preventative health care

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

Fee: $125.10 Benefit: 100% = $125.10

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

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

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

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

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

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

(c)    the service is at least 50 minutes duration

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

Fee: $116.40 Benefit: 85% = $98.95

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

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

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

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

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

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

(c)    the service is at least 50 minutes duration

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

Fee: $102.60 Benefit: 85% = $87.25

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

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

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

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

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

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

(c)    the service is at least 50 minutes duration

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

Fee: $102.60 Benefit: 85% = $87.25

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

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)

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)

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)

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)

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)

Professional attendance at consulting rooms (other than a service to which another item applies) by a general practitioner for an obvious problem characterised by the straightforward nature of the task that requires a short patient history and, if required, limited examination and management-each attendance

Fee: $20.05 Benefit: 100% = $20.05

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

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

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

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

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

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

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

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

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

(c) the service is at least 50 minutes duration

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

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

Fee: $116.40 Benefit: 85% = $98.95

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

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

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

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

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

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

(c) the service is at least 50 minutes duration

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

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

Fee: $102.60 Benefit: 85% = $87.25

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

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)

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

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

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

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

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

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

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

Fee: $102.60 Benefit: 85% = $87.25

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

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

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

Fee: $20.05 Benefit: 100% = $20.05

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

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

(a) taking a short patient history;

(b) arranging any necessary investigation;

(c) implementing a management plan;

(d) providing appropriate preventative health care

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

Fee: $43.90 Benefit: 100% = $43.90

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

Video attendance lasting at least 45 minutes by a general practitioner (not including a specialist or consultant physician), for a patient aged under 25, if the general practitioner:

(a) undertakes, or has previously undertaken in prior attendances, a comprehensive assessment in relation to which a diagnosis of an eligible disability 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 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 92434)

Applicable only once per lifetime

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

Fee: $156.95 Benefit: 100% = $156.95

(See para AN.0.73, AR.29.1 of explanatory notes to this Category)

Professional attendance by a general practitioner at consulting rooms (other than a service to which another item in the table applies), lasting at least 40 minutes and including any of the following that are clinically relevant:

(a) taking an extensive patient history;

(b) performing a clinical examination;

(c) arranging any necessary investigation;

(d) implementing a management plan;

(e) providing appropriate preventive health care;

for one or more health-related issues, with appropriate documentation-each attendance

Fee: $125.10 Benefit: 100% = $125.10

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

Professional attendance by a general practitioner (other than attendance at consulting rooms or a residential aged care facility or a service to which another item in the table applies), lasting at least 40 minutes and including any of the following that are clinically relevant:

(a) taking an extensive patient history;

(b) performing a clinical examination;

(c) arranging any necessary investigation;

(d) implementing a management plan;

(e) providing appropriate preventive health care;

for one or more health-related issues, with appropriate documentation-an attendance on one or more patients at one place on one occasion-each patient

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

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

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

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

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

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

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

(c) the service is at least 50 minutes duration

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

Fee: $116.40 Benefit: 85% = $98.95

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

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

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

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

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

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

(c) the service is at least 50 minutes duration

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

Fee: $102.60 Benefit: 85% = $87.25

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

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)

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)

Professional attendance by a general practitioner at consulting rooms (other than a service to which another item in this Schedule applies), lasting at least 6 minutes and less than 20 minutes and including any of the following that are clinically relevant:
(a) taking a patient history;
(b) performing a clinical examination;
(c) arranging any necessary investigation;
(d) implementing a management plan;
(e) providing appropriate preventive health care;
for one or more health-related issues, with appropriate documentation

Fee: $43.90 Benefit: 100% = $43.90

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

Professional attendance by a general practitioner (other than attendance at consulting rooms or a residential aged care facility or a service to which another item in this Schedule applies), lasting at least 6 minutes and less than 20 minutes and including any of the following that are clinically relevant:
(a) taking a patient history;
(b) performing a clinical examination;
(c) arranging any necessary investigation;
(d) implementing a management plan;
(e) providing appropriate preventive health care;
for one or more health-related issues, with appropriate documentation—an attendance on one or more patients at one place on one occasion—each patient

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

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

Professional attendance by a general practitioner at consulting rooms (other than a service to which another item in the table applies), lasting at least 20 minutes and including any of the following that are clinically relevant:

(a) taking a detailed patient history;

(b) performing a clinical examination;

(c) arranging any necessary investigation;

(d) implementing a management plan;

(e) providing appropriate preventive health care;

for one or more health-related issues, with appropriate documentation-each attendance

Fee: $84.90 Benefit: 100% = $84.90

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

Professional attendance by a general practitioner (other than attendance at consulting rooms or a residential aged care facility or a service to which another item in the table applies), lasting at least 20 minutes and including any of the following that are clinically relevant:

(a) taking a detailed patient history;

(b) performing a clinical examination;

(c) arranging any necessary investigation;

(d) implementing a management plan;

(e) providing appropriate preventive health care;

for one or more health-related issues, with appropriate documentation-an attendance on one or more patients at one place on one occasion-each patient

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

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