Medicare Benefits Schedule - Note AN.1.1

It is a legislative requirement that medical practitioners working in general practice must only perform a telehealth or telephone service where they have an established clinical relationship with the patient.

An established clinical relationship is defined as:

• the medical practitioner who performs the service has provided a face-to-face service to the patient in the last 12 months; or
• the medical practitioner who performs the service is located at a medical practice, and the patient has a face-to-face service arranged by that practice in the last 12 months. This can be a service performed by another doctor located at the practice, or a service performed by another health professional located at the practice (such as a practice nurse or Aboriginal and Torres Strait Islander health worker); or
• the medical practitioner who performs the service is a participant in the Approved Medical Deputising Service (AMDS) program, and the Approved Medical Deputising Service provider (AMDS provider) that employs the medical practitioner has a formal agreement with a medical practice that has provided at least one face-to-face service to the patient in the last 12 months.

This requirement does not apply to a person who is under the age of 12 months, a person who is experiencing homelessness, a person receiving treatment through Mental Health telehealth items, a person receiving treatment through Blood Borne Virus, Sexual or Reproductive Health telehealth items, a person living in a natural disaster affected area, a person receiving an urgent after-hours service (in unsociable hours), a person who receives the service from a medical practitioner located at an Aboriginal Medical Service or an Aboriginal Community Controlled Health Service, or a person isolating because of a COVID-related State or Territory public health order, or in COVID-19 quarantine because of a State or Territory public health order.

person who is experiencing homelessness means when a person does not have suitable accommodation alternatives, they are considered homeless if their current living arrangement:

(a)  is in a dwelling that is inadequate; or

(b)  has no tenure, or if their initial tenure is short and not extendable; or

(c)  does not allow them to have control of, and access to space for social relations.

person receiving treatment through Mental Health telehealth items means services must be claimed as specific GP or prescribed medical practitioner mental health and eating disorder telehealth items. 

person receiving treatment through Blood Borne Virus, Sexual or Reproductive Health telehealth items means services must be claimed as specific GP or prescribed medical practitioner telehealth items (see also AN.40.5) 

people living in a natural disaster affected area is defined as a State or Territory local government area which is currently declared as a natural disaster area by a State or Territory Government until that declaration is deemed to have expired.

Related Items: 92210 92211 92715 92716 92717 92718 92719 92720 92721 92722 92723 92724 92725 92726 92731 92732 92733 92734 92735 92736 92737 92738 92739 92740 92741 92742

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Telehealth attendance for the provision of services related to blood borne viruses, sexual or reproductive health by a general practitioner of not more than 5 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 preventive health care

Note: Consultations related to assisted reproductive technology and antenatal care are outside the scope of these items and cannot be rendered under these items.

Fee: $19.60 Benefit: 100% = $19.60

(See para AN.1.1, AN.40.5 of explanatory notes to this Category)

Telehealth attendance for the provision of services related to blood borne viruses, sexual or reproductive health by a medical practitioner (not including a general practitioner, specialist or consultant physician) of not more than 5 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 preventive health care

Note: Consultations related to assisted reproductive technology and antenatal care are outside the scope of these items and cannot be rendered under these items.

Fee: $11.00 Benefit: 100% = $11.00

(See para AN.1.1, AN.40.5 of explanatory notes to this Category)

Telehealth attendance for the provision of services related to blood borne viruses, sexual or reproductive health by a medical practitioner (not including a general practitioner, specialist or consultant physician), in an eligible area, of not more than 5 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 preventive health care

Note: Consultations related to assisted reproductive technology and antenatal care are outside the scope of these items and cannot be rendered under these items

Fee: $15.70 Benefit: 100% = $15.70

(See para AN.1.1, AN.40.5 of explanatory notes to this Category)

Telehealth attendance for the provision of services related to blood borne viruses, sexual or reproductive health by a general practitioner of more than 5 minutes in duration but not more than 20 minutes if the attendance includes any of the following that are clinically relevant:

(a) taking a patient history;

(b) arranging any necessary investigation;

(c) implementing a management plan;

(d) providing appropriate preventive health care

Note: Consultations related to assisted reproductive technology and antenatal care are outside the scope of these items and cannot be rendered under these items.

Fee: $42.85 Benefit: 100% = $42.85

(See para AN.1.1, AN.40.5 of explanatory notes to this Category)

Telehealth attendance for the provision of services related to blood borne viruses, sexual or reproductive health by a medical practitioner (not including a general practitioner, specialist or consultant physician) of more than 5 minutes in duration but not more than 20 minutes if the attendance includes any of the following that are clinically relevant:

(a) taking a patient history;

(b) arranging any necessary investigation;

(c) implementing a management plan;

(d) providing appropriate preventive health care

Note: Consultations related to assisted reproductive technology and antenatal care are outside the scope of these items and cannot be rendered under these items.

Fee: $21.00 Benefit: 100% = $21.00

(See para AN.1.1, AN.40.5 of explanatory notes to this Category)

Telehealth attendance for the provision of services related to blood borne viruses, sexual or reproductive health by a medical practitioner (not including a general practitioner, specialist or consultant physician), in an eligible area, of more than 5 minutes in duration but not more than 20 minutes if the attendance includes any of the following that are clinically relevant:

(a) taking a patient history;

(b) arranging any necessary investigation;

(c) implementing a management plan;

(d) providing appropriate preventive health care

Note: Consultations related to assisted reproductive technology and antenatal care are outside the scope of these items and cannot be rendered under these items

Fee: $34.25 Benefit: 100% = $34.25

(See para AN.1.1, AN.40.5 of explanatory notes to this Category)

Telehealth attendance for the provision of services related to blood borne viruses, sexual or reproductive health by a general practitioner of more than 20 minutes in duration but not more than 40 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 preventive health care

Note: Consultations related to assisted reproductive technology and antenatal care are outside the scope of these items and cannot be rendered under these items.

Fee: $82.90 Benefit: 100% = $82.90

(See para AN.1.1, AN.40.5 of explanatory notes to this Category)

Telehealth attendance for the provision of services related to blood borne viruses, sexual or reproductive health by a medical practitioner (not including a general practitioner, specialist or consultant physician) of more than 20 minutes in duration but not more than 40 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 preventive health care

Note: Consultations related to assisted reproductive technology and antenatal care are outside the scope of these items and cannot be rendered under these items.

Fee: $38.00 Benefit: 100% = $38.00

(See para AN.1.1, AN.40.5 of explanatory notes to this Category)

Telehealth attendance for the provision of services related to blood borne viruses, sexual or reproductive health by a medical practitioner (not including a general practitioner, specialist or consultant physician), in an eligible area, of more than 20 minutes in duration but not more than 40 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 preventive health care

Note: Consultations related to assisted reproductive technology and antenatal care are outside the scope of these items and cannot be rendered under these items

Fee: $66.35 Benefit: 100% = $66.35

(See para AN.1.1, AN.40.5 of explanatory notes to this Category)

Telehealth attendance for the provision of services related to blood borne viruses, sexual or reproductive health by a general practitioner lasting at least 40 minutes in duration 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 preventive health care

Note: Consultations related to assisted reproductive technology and antenatal care are outside the scope of these items and cannot be rendered under these items.

Fee: $122.15 Benefit: 100% = $122.15

(See para AN.1.1, AN.40.5 of explanatory notes to this Category)

Telehealth attendance for the provision of services related to blood borne viruses, sexual or reproductive health by a medical practitioner (not including a general practitioner, specialist or consultant physician) lasting at least 40 minutes in duration 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 preventive health care

Note: Consultations related to assisted reproductive technology and antenatal care are outside the scope of these items and cannot be rendered under these items.

Fee: $61.00 Benefit: 100% = $61.00

(See para AN.1.1, AN.40.5 of explanatory notes to this Category)

Telehealth attendance for the provision of services related to blood borne viruses, sexual or reproductive health by a medical practitioner (not including a general practitioner, specialist or consultant physician), in an eligible area, lasting at least 40 minutes in duration 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 preventive health care

Note: Consultations related to assisted reproductive technology and antenatal care are outside the scope of these items and cannot be rendered under these items

Fee: $97.70 Benefit: 100% = $97.70

(See para AN.1.1, AN.40.5 of explanatory notes to this Category)

Telehealth attendance by a general practitioner on not more than one patient on one occasion—each attendance in unsociable hours if:

(a) the attendance is requested by the patient or a responsible person in the same unbroken after‑hours period; and

(b) the patient’s medical condition requires urgent assessment.

Fee: $174.30 Benefit: 100% = $174.30

(See para AN.1.1 of explanatory notes to this Category)

Telehealth attendance by a medical practitioner (other than a general practitioner) on not more than one patient on one occasion—each attendance in unsociable hours if:

(a) the attendance is requested by the patient or a responsible person in the same unbroken after‑hours period; and

(b) the patient’s medical condition requires urgent assessment.

Fee: $139.30 Benefit: 100% = $139.30

(See para AN.1.1 of explanatory notes to this Category)

Phone attendance for the provision of services related to blood borne viruses, sexual or reproductive health by a general practitioner of not more than 5 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 preventive health care

Note: Consultations related to assisted reproductive technology and antenatal care are outside the scope of these items and cannot be rendered under these items.

Fee: $19.60 Benefit: 100% = $19.60

(See para AN.1.1, AN.40.5 of explanatory notes to this Category)

Phone attendance for the provision of services related to blood borne viruses, sexual or reproductive health by a medical practitioner (not including a general practitioner, specialist or consultant physician) of not more than 5 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 preventive health care

Note: Consultations related to assisted reproductive technology and antenatal care are outside the scope of these items and cannot be rendered under these items.

Fee: $11.00 Benefit: 100% = $11.00

(See para AN.1.1, AN.40.5 of explanatory notes to this Category)

Phone attendance for the provision of services related to blood borne viruses, sexual or reproductive health by a medical practitioner (not including a general practitioner, specialist or consultant physician), in an eligible area, of not more than 5 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 preventive health care

Note: Consultations related to assisted reproductive technology and antenatal care are outside the scope of these items and cannot be rendered under these items

Fee: $15.70 Benefit: 100% = $15.70

(See para AN.1.1, AN.40.5 of explanatory notes to this Category)

Phone attendance for the provision of services related to blood borne viruses, sexual or reproductive health by a general practitioner of more than 5 minutes in duration but not more than 20 minutes if the attendance includes any of the following that are clinically relevant:

(a) taking a patient history;

(b) arranging any necessary investigation;

(c) implementing a management plan;

(d) providing appropriate preventive health care

Note: Consultations related to assisted reproductive technology and antenatal care are outside the scope of these items and cannot be rendered under these items.

Fee: $42.85 Benefit: 100% = $42.85

(See para AN.1.1, AN.40.5 of explanatory notes to this Category)

Phone attendance for the provision of services related to blood borne viruses, sexual or reproductive health by a medical practitioner (not including a general practitioner, specialist or consultant physician) of more than 5 minutes in duration but not more than 20 minutes if the attendance includes any of the following that are clinically relevant:

(a) taking a patient history;

(b) arranging any necessary investigation;

(c) implementing a management plan;

(d) providing appropriate preventive health care

Note: Consultations related to assisted reproductive technology and antenatal care are outside the scope of these items and cannot be rendered under these items.

Fee: $21.00 Benefit: 100% = $21.00

(See para AN.1.1, AN.40.5 of explanatory notes to this Category)

Phone attendance for the provision of services related to blood borne viruses, sexual or reproductive health by a medical practitioner (not including a general practitioner, specialist or consultant physician), in an eligible area, of more than 5 minutes in duration but not more than 20 minutes if the attendance includes any of the following that are clinically relevant:

(a) taking a patient history;

(b) arranging any necessary investigation;

(c) implementing a management plan;

(d) providing appropriate preventive health care

Note: Consultations related to assisted reproductive technology and antenatal care are outside the scope of these items and cannot be rendered under these items

Fee: $34.25 Benefit: 100% = $34.25

(See para AN.1.1, AN.40.5 of explanatory notes to this Category)

Phone attendance for the provision of services related to blood borne viruses, sexual or reproductive health by a general practitioner of more than 20 minutes in duration but not more than 40 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 preventive health care

Note: Consultations related to assisted reproductive technology and antenatal care are outside the scope of these items and cannot be rendered under these items.

Fee: $82.90 Benefit: 100% = $82.90

(See para AN.1.1, AN.40.5 of explanatory notes to this Category)

Phone attendance for the provision of services related to blood borne viruses, sexual or reproductive health by a medical practitioner (not including a general practitioner, specialist or consultant physician) of more than 20 minutes in duration but not more than 40 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 preventive health care

Note: Consultations related to assisted reproductive technology and antenatal care are outside the scope of these items and cannot be rendered under these items.

Fee: $38.00 Benefit: 100% = $38.00

(See para AN.1.1, AN.40.5 of explanatory notes to this Category)

Phone attendance for the provision of services related to blood borne viruses, sexual or reproductive health by a medical practitioner (not including a general practitioner, specialist or consultant physician), in an eligible area, of more than 20 minutes in duration but not more than 40 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 preventive health care

Note: Consultations related to assisted reproductive technology and antenatal care are outside the scope of these items and cannot be rendered under these items

Fee: $66.35 Benefit: 100% = $66.35

(See para AN.1.1, AN.40.5 of explanatory notes to this Category)

Phone attendance for the provision of services related to blood borne viruses, sexual or reproductive health by a general practitioner lasting at least 40 minutes in duration 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 preventive health care

Note: Consultations related to assisted reproductive technology and antenatal care are outside the scope of these items and cannot be rendered under these items.

Fee: $122.15 Benefit: 100% = $122.15

(See para AN.1.1, AN.40.5 of explanatory notes to this Category)

Phone attendance for the provision of services related to blood borne viruses, sexual or reproductive health by a medical practitioner (not including a general practitioner, specialist or consultant physician) lasting at least 40 minutes in duration 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 preventive health care

Note: Consultations related to assisted reproductive technology and antenatal care are outside the scope of these items and cannot be rendered under these items.

Fee: $61.00 Benefit: 100% = $61.00

(See para AN.1.1, AN.40.5 of explanatory notes to this Category)

Phone attendance for the provision of services related to blood borne viruses, sexual or reproductive health by a medical practitioner (not including a general practitioner, specialist or consultant physician), in an eligible area, lasting at least 40 minutes in duration 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 preventive health care

Note: Consultations related to assisted reproductive technology and antenatal care are outside the scope of these items and cannot be rendered under these items

Fee: $97.70 Benefit: 100% = $97.70

(See para AN.1.1, AN.40.5 of explanatory notes to this Category)