Medicare Benefits Schedule - Note IN.4.5

Gallium-67

Item 61477 is a temporary item that provides additional funding for services that use gallium-67 to offset some of the recent price increases of the radiopharmaceutical.

Item 61477 can be claimed in conjunction with items 61429, 61430, 61442, 61450 or 61453 and must be bulk-billed*.

Item 61477 is available from 8 November 2022 until 30 June 2026.

Thallium-201

Item 61470 is a temporary item that provides additional funding for services that use thallium-201 to offset some of the recent price increases of the radiopharmaceutical.

Item 61470 can be claimed in conjunction with items 61438, 61461 or 61325 and must be bulk-billed*.

Item 61470 is available from 1 July 2023 until 30 June 2026.

*Note: As there will be two or more services claimed for the patient, the diagnostic multiple services rules will apply to these services. See Rule A under IN.0.11 for more information on the diagnostic imaging multiple services rules.

Related Items: 61470 61477

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Bulk bill incentive

Whole body or localised study using thallium-201, or single rest myocardial perfusion study using thallium-201, if all of the following apply:

a)      the service is bulk billed; and

b)      the service is performed in conjunction with a service described in item 61438, 61461 or 61325

Fee: $1,463.80 Benefit: 75% = $1,097.85 85% = $1,365.10

(See para IN.4.5 of explanatory notes to this Category)

Bulk bill incentive

Whole body or localised study using gallium, if all of the following apply:

(a) the service is bulk-billed; 

(b) the service is performed in conjunction with a service described in items 61429, 61430, 61442, 61450 or 61453

Fee: $962.00 Benefit: 75% = $721.50 85% = $863.30

(See para IN.4.5 of explanatory notes to this Category)