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Related Items: 135 92140

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Related Items: 289 92434

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• Next - Note AN.0.73

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• Previous - Note MN.10.1
• Next - Note MN.10.3

Professional attendance lasting at least 45 minutes by a consultant physician in the practice of the consultant physician’s specialty of paediatrics, following referral of the patient to the consultant paediatrician by a referring practitioner, for a patient aged under 25, if the consultant paediatrician:

(a) undertakes, or has previously undertaken in prior attendances, a comprehensive assessment in relation to which a diagnosis of a complex neurodevelopmental disorder (such as autism spectrum disorder) 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:

(i) the referring practitioner; and

(ii) 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 137, 139, 289, 92140, 92141, 92142 or 92434)

Applicable only once per lifetime

Fee: $305.15 Benefit: 75% = $228.90 85% = $259.40

(See para AN.0.24, AN.40.1 of explanatory notes to this Category)

Extended Medicare Safety Net Cap: $500.00

• Previous - Item 133
• Next - Item 137

Professional attendance lasting at least 45 minutes by a specialist or consultant physician (not including a general practitioner), following referral of the patient to the specialist or consultant physician by a referring practitioner, for a patient aged under 25, if the specialist or consultant physician:

(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:

(i) the referring practitioner; and

(ii) 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, 139, 289, 92140, 92141, 92142 or 92434)

Applicable only once per lifetime

Fee: $305.15 Benefit: 75% = $228.90 85% = $259.40

(See para AN.0.25, AN.40.1, AR.29.1 of explanatory notes to this Category)

Extended Medicare Safety Net Cap: $500.00

• Previous - Item 135
• Next - Item 139

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: $153.25 Benefit: 100% = $153.25

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

Extended Medicare Safety Net Cap: $459.75

• Previous - Item 137
• Next - Item 141

Professional attendance lasting at least 45 minutes, by a consultant physician in the practice of the consultant physician’s specialty of psychiatry, following referral of the patient to the consultant psychiatrist by a referring practitioner, for a patient aged under 25, if the consultant psychiatrist:

(a) undertakes, or has previously undertaken in prior attendances, a comprehensive assessment in relation to which a diagnosis of a complex neurodevelopmental disorder (such as autism spectrum disorder) 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:

(i) the referring practitioner; and

(ii) 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, 92140, 92141, 92142 or 92434)

Applicable only once per lifetime

Fee: $305.15 Benefit: 75% = $228.90 85% = $259.40

(See para AN.0.72, AN.40.1 of explanatory notes to this Category)

Extended Medicare Safety Net Cap: $500.00

• Previous - Item 287
• Next - Item 291

Telehealth attendance lasting at least 45 minutes by a consultant physician in the practice of the consultant physician’s specialty of paediatrics, following referral of the patient to the consultant paediatrician by a referring practitioner, for a patient aged under 25, if the consultant paediatrician:

(a) undertakes, or has previously undertaken in prior attendances, a comprehensive assessment in relation to which a diagnosis of a complex neurodevelopmental disorder (such as autism spectrum disorder) 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:

(i) the referring practitioner; and

(ii) 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, 92141, 92142 or 92434)

Applicable only once per lifetime

Fee: $305.15 Benefit: 85% = $259.40

(See para AN.0.24 of explanatory notes to this Category)

Extended Medicare Safety Net Cap: $500.00

• Previous - Item 92139
• Next - Item 92141

Telehealth attendance lasting at least 45 minutes by a specialist or consultant physician (not including a general practitioner), following referral of the patient to the specialist or consultant physician by a referring practitioner, for a patient aged under 25, if the specialist or consultant physician:

(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:

(i) the referring practitioner; and

(ii) 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, 92142 or 92434)

Applicable only once per lifetime

Fee: $305.15 Benefit: 85% = $259.40

(See para AN.0.25, AR.29.1 of explanatory notes to this Category)

Extended Medicare Safety Net Cap: $500.00

• Previous - Item 92140
• Next - Item 92142