Medicare Benefits Schedule - Note MN.14.16

Pathology Services 

Determination of Necessity of Service

The participating nurse practitioner requesting a pathology service for a patient must determine that the pathology service is necessary. 

Request for Service

The service may only be provided in response to a request from the treating practitioner and the request must be in writing (or, if oral, confirmed in writing within fourteen days). 

Pathology Services approved for participating nurse practitioners

Nurse practitioners may request MBS pathology items in any Groups P1 to P8 or any of items 73826 to 73837 of the pathology services table. Requesting pathology services must be within the nurse practitioner's scope of practice. 

Further information

For further information about Medicare Benefits Schedule items, please refer to the Department of Health, Disability and Ageing's website at www.health.gov.au/mbsonline. 

Diagnostic Imaging Services 

Determination of Necessity of Service

The participating nurse practitioner requesting a diagnostic imaging service for a patient must determine that the diagnostic imaging service is necessary for the appropriate professional care of the patient.  

Request for Service

The service may only be provided in response to a request from the treating nurse practitioner, and the request must be in writing, signed and dated.  The legislation provides that a request must be in writing and contain sufficient information, in terms that are generally understood by the profession, to clearly identify the item/s of service requested.  This includes, where relevant, noting on the request the clinical indication(s) for the requested service.  The provision of additional relevant clinical information can often assist the service provider, and enhance the overall service provided to the patient. 

It is not necessary that a written request for a diagnostic imaging service be addressed to a particular provider or that, if the request is addressed to a particular provider, the service must be rendered by that provider. 

A single request may be used to order a number of diagnostic imaging services. However, all services provided under this request must be rendered within seven days after rendering the first service.

Further Information 

For further information on Medical Benefit Schedule items nurse practitioners can request for Diagnostic Imaging services please refer to note IN.0.6, which can be found here.

Related Items: 82200 82205 82210 82215 91178 91180 91189 91190 91191 91192 91193

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Phone attendance by a participating nurse practitioner lasting at least 6 minutes and less than 20 minutes if the attendance includes any of the following that are clinically relevant:

(a)     taking a short history;

(b)    arranging any necessary investigation;

(c)     implementing a management plan;

(d)    providing appropriate preventive health care

Fee: $31.80 Benefit: 85% = $27.05

(See para MN.0.1, MN.14.12, MN.14.15, MN.14.16 of explanatory notes to this Category)

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

(a)     taking a detailed history;

(b)    arranging any necessary investigation;

(c)     implementing a management plan;

(d)    providing appropriate preventive health care.

Fee: $60.25 Benefit: 85% = $51.25

(See para MN.0.1, MN.14.12, MN.14.15, MN.14.16 of explanatory notes to this Category)

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

(a)     taking an extensive history;

(b)    arranging any necessary investigation;

(c)     implementing a management plan;

(d)    providing appropriate preventive health care.

Fee: $88.90 Benefit: 85% = $75.60

(See para MN.0.1, MN.14.12, MN.14.15, MN.14.16 of explanatory notes to this Category)

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

Fee: $14.55 Benefit: 85% = $12.40

(See para MN.0.1, MN.14.12, MN.14.15, MN.14.16 of explanatory notes to this Category)

Professional attendance by a participating nurse 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

Fee: $14.55 Benefit: 85% = $12.40

(See para MN.14.12, MN.14.15, MN.14.16 of explanatory notes to this Category)

Professional attendance by a participating nurse practitioner lasting at least 6 minutes and less than 20 minutes and including any of the following:

a)    taking a history;

b)    undertaking clinical examination;

c)    arranging any necessary investigation;

d)    implementing a management plan;

e)    providing appropriate preventive health care;

for 1 or more health related issues, with appropriate documentation

Fee: $31.80 Benefit: 85% = $27.05

(See para MN.14.12, MN.14.15, MN.14.16 of explanatory notes to this Category)

Professional attendance by a participating nurse practitioner lasting at least 20 minutes and including any of the following:

a)    taking a detailed history;

b)    undertaking clinical examination;

c)    arranging any necessary investigation;

d)    implementing a management plan;

e)    providing appropriate preventive health care;

for 1 or more health related issues, with appropriate documentation

Fee: $60.25 Benefit: 85% = $51.25

(See para MN.14.12, MN.14.15, MN.14.16 of explanatory notes to this Category)

Professional attendance by a participating nurse practitioner lasting at least 40 minutes and including any of the following:

a)    taking an extensive history;

b)    undertaking clinical examination;

c)    arranging any necessary investigation;

d)    implementing a management plan;

e)    providing appropriate preventive health care;

for 1 or more health related issues, with appropriate documentation

Fee: $88.90 Benefit: 85% = $75.60

(See para MN.14.12, MN.14.15, MN.14.16 of explanatory notes to this Category)

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

(a) taking a short history;

(b) arranging any necessary investigation;

(c) implementing a management plan;

(d) providing appropriate preventive health care

Fee: $31.80 Benefit: 85% = $27.05

(See para AN.1.1, MN.0.1, MN.14.12, MN.14.15, MN.14.16 of explanatory notes to this Category)

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

(a)     taking an extensive history;

(b)    arranging any necessary investigation;

(c)     implementing a management plan;

(d)    providing appropriate preventive health care

Fee: $88.90 Benefit: 85% = $75.60

(See para AN.1.1, MN.0.1, MN.14.12, MN.14.15, MN.14.16 of explanatory notes to this Category)

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

Fee: $14.55 Benefit: 85% = $12.40

(See para MN.0.1, MN.14.12, MN.14.15, MN.14.16 of explanatory notes to this Category)