Medicare Benefits Schedule - Note TN.1.23

The purpose of item 13105 is for the management of haemodialysis to a person with end-stage renal disease. The service is provided in very remote areas (defined as Modified Monash 7) by a registered nurse, an Aboriginal and Torres Strait Islander health worker or an Aboriginal and Torres Strait Islander health practitioner on behalf of a medical practitioner. The service is supervised by a medical practitioner (either in person or remotely).

As a condition of receiving the Medicare-funded dialysis treatment, the patient’s care must be managed by a nephrologist, with the patient being treated or reviewed by the nephrologist every 3 to 6 months (either in person or remotely).

The patient is not an admitted patient of a hospital, and the service is provided in a primary care setting.

Item 13104 should not be claimed if item 13105 is claimed.

Related Items: 13104 13105

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Planning and management of home dialysis (either haemodialysis or peritoneal dialysis), by a consultant physician in the practice of his or her specialty of renal medicine, for a patient with end-stage renal disease, and supervision of that patient on self-administered dialysis, to a maximum of 12 claims per year

Fee: $172.55 Benefit: 85% = $146.70

(See para TN.1.3, TN.1.23 of explanatory notes to this Category)

Haemodialysis for a patient with end‑stage renal disease if:

(a) the service is provided by a registered nurse, an Aboriginal and Torres Strait Islander health worker or an Aboriginal and Torres Strait Islander health practitioner on behalf of a medical practitioner; and

(b) the service is supervised by the medical practitioner (either in person or remotely); and

(c) the patient’s care is managed by a nephrologist; and

(d) the patient is treated or reviewed by the nephrologist every 3 to 6 months (either in person or remotely); and

(e) the patient is not an admitted patient of a hospital; and

(f) the service is provided in a Modified Monash 7 area

Fee: $690.60 Benefit: 100% = $690.60

(See para TN.1.23 of explanatory notes to this Category)