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Psychology health service provided to a patient by an eligible psychologist if:

(a) the patient has a chronic condition and complex care needs being managed by a medical practitioner (other than a specialist or consultant physician) under:

(i) a GP chronic condition management plan that has been prepared or reviewed in the last 18 months; or

(ii) until the end of 30 June 2027—a GP Management Plan and Team Care Arrangements prepared prior to 1 July 2025; or

(iii) a multidisciplinary care plan; and

(b) the service is recommended in the patient’s plan or arrangements as part of the management of the patient’s chronic condition and complex care needs; and

(c) the service is of at least 20 minutes duration;

to a maximum of 5 services (including any services to which this item or any other item in this Subgroup or item 93000 or 93013 in the Telehealth Attendance Determination applies) in a calendar year

Fee: $74.55 Benefit: 85% = $63.40

(See para AN.15.3, AN.15.5, AN.15.6, MN.3.1 of explanatory notes to this Category)

Extended Medicare Safety Net Cap: $223.65

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Speech pathology health service provided to a patient by an eligible speech pathologist if:

(a) the patient has a chronic condition and complex care needs being managed by a medical practitioner (other than a specialist or consultant physician) under:

(i) a GP chronic condition management plan that has been prepared or reviewed in the last 18 months; or

(ii) until the end of 30 June 2027—a GP Management Plan and Team Care Arrangements prepared prior to 1 July 2025; or

(iii) a multidisciplinary care plan; and

(b) the service is recommended in the patient’s plan or arrangements as part of the management of the patient’s chronic condition and complex care needs; and

(c) the service is of at least 20 minutes duration;

to a maximum of 5 services (including any services to which this item or any other item in this Subgroup or item 93000 or 93013 in the Telehealth Attendance Determination applies) in a calendar year

Fee: $74.55 Benefit: 85% = $63.40

(See para AN.15.3, AN.15.5, AN.15.6, MN.3.1 of explanatory notes to this Category)

Extended Medicare Safety Net Cap: $223.65

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• Next - Item 10983

Overnight investigation of sleep, for at least 8 hours, for a patient aged at least 3 years but less than 12 years, if:

(a) the patient is referred by a medical practitioner to a qualified paediatric sleep medicine practitioner; and

(b) following professional attendance on the patient (either face-to-face or by video conference), the qualified paediatric sleep medicine practitioner determines that:

(i) the investigation is necessary for a purpose mentioned in paragraph (c); and

(ii) an unattended sleep study is appropriate for the investigation; and

(c) the purpose of the investigation is documented and is any of the following:

(i) to confirm diagnosis of sleep apnoea;

(ii) as a repeat investigation to assess treatment effectiveness;

(iii) as a repeat investigation to determine respiratory support needs following a significant change in clinical status; and

(d) during a period of sleep, there is continuous monitoring and recording of at least the following measures:

(i) airflow;

(ii) EMG;

(iii) ECG or heart rate;

(iv) EEG;

(v) EOG;

(vi) oxygen saturation;

(vii) respiratory effort; and

(e) the investigation is provided:

(i) under the supervision of a qualified paediatric sleep medicine practitioner; and

(ii) in accordance with current professional guidelines (including in relation to interpreting polygraphic data and preparing a report); and

(f) before the investigation commences, a parent or caregiver of the patient is given:

(i) written or video instructions on how to monitor the patient overnight; and

(ii) a way of contacting a sleep technician to enable trouble shooting overnight; and

(g) the equipment is applied to the patient by:

(i) a sleep technician; or

(ii) the parent or caregiver of the patient if:

(A) before the set-up process commences, the parent or caregiver is given written or video instructions for how to apply the equipment; and

(B) there is continuous telehealth support from a sleep technician throughout the set-up process; and

(C) the use of telehealth is documented; and

(h) polygraphic records are:

(i) analysed (for assessment of sleep stage, arousals, respiratory events and cardiac abnormalities) using manual scoring, or manual correction of computerised scoring in epochs of not more than 1 minute; and

(ii) stored for interpretation and preparation of a report; and

(i) interpretation and preparation of a permanent report are provided by a qualified paediatric sleep medicine practitioner with personal direct review of raw data from the original recording of polygraphic data from the patient

Applicable in relation to the first 3 investigations to which this item or item 12210 applies in any 12 month period

Fee: $489.90 Benefit: 85% = $416.45

(See para AN.0.12, DN.1.37 of explanatory notes to this Category)

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• Next - Item 12219

Overnight investigation of sleep, for at least 8 hours, for a patient aged at least 12 years but less than 18 years, if:

(a) the patient is referred by a medical practitioner to a qualified sleep medicine practitioner; and

(b) following professional attendance on the patient (either face-to-face or by video conference), the qualified sleep medicine practitioner determines that:

(i) the investigation is necessary for a purpose mentioned in paragraph (c); and

(ii) an unattended sleep study is appropriate for the investigation; and

(c) the purpose of the investigation is documented and is any of the following:

(i) to confirm diagnosis of sleep apnoea;

(ii) as a repeat investigation to assess treatment effectiveness;

(iii) as a repeat investigation to determine respiratory support needs following a significant change in clinical status; and

(d) during a period of sleep, there is continuous monitoring and recording of at least the following measures:

(i) airflow;

(ii) EMG;

(iii) ECG or heart rate;

(iv) EEG;

(v) EOG;

(vi) oxygen saturation;

(vii) respiratory effort; and

(e) the investigation is provided:

(i) under the supervision of a qualified sleep medicine practitioner; and

(ii) in accordance with current professional guidelines (including in relation to interpreting polygraphic data and preparing a report); and

(f) before the investigation commences, a parent or caregiver of the patient is given:

(i) written or video instructions on how to monitor the patient overnight; and

(ii) a way of contacting a sleep technician to enable trouble shooting overnight; and

(g) the equipment is applied to the patient by:

(i) a sleep technician; or

(ii) the parent or caregiver of the patient if:

(A) before the set-up process commences, the parent or caregiver is given written or video instructions for how to apply the equipment; and

(B) there is continuous telehealth support from a sleep technician throughout the set-up process; and

(C) the use of telehealth is documented; and

(h) polygraphic records are:

(i) analysed (for assessment of sleep stage, arousals, respiratory events and cardiac abnormalities) using manual scoring, or manual correction of computerised scoring in epochs of not more than 1 minute; and

(ii) stored for interpretation and preparation of a report; and

(i) interpretation and preparation of a permanent report are provided by a qualified sleep medicine practitioner with personal direct review of raw data from the original recording of polygraphic data from the patient

Applicable in relation to the first 3 investigations to which this item or item 12210, 12213 or 12218 applies in any 12 month period

Fee: $455.25 Benefit: 85% = $387.00

(See para AN.0.12, DN.1.37 of explanatory notes to this Category)

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• Next - Item 12250

Psychological therapy health service provided to a patient as part of a group of 4 to 10 patients by an eligible clinical psychologist if:

(a)  the patient is referred by a referring practitioner; and

(b)  the attendance is by video conference; and

(c)  the patient is located within a telehealth eligible area; and

(d)  the patient is, at the time of the attendance, at least 15 kilometres by road from the clinical psychologist; and

(e)  the service is at least 60 minutes duration

Fee: $44.50 Benefit: 85% = $37.85

(See para AN.0.78, MN.6.2, MN.6.3 of explanatory notes to this Category)

Extended Medicare Safety Net Cap: $133.50

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• Next - Item 80022

Psychological therapy health service provided to a patient as part of a group of 4 to 10 patients by an eligible clinical psychologist if:

(a)  the patient is referred by a referring practitioner; and

(b)  the attendance is by video conference; and

(c)  the patient is located within a telehealth eligible area; and

(d)  the patient is, at the time of the attendance, at least 15 kilometres by road from the clinical psychologist; and

(e)  the service is at least 90 minutes duration

Fee: $60.65 Benefit: 85% = $51.60

(See para AN.0.78, MN.6.2, MN.6.3 of explanatory notes to this Category)

Extended Medicare Safety Net Cap: $181.95

• Previous - Item 80022
• Next - Item 80024

Psychological therapy health service provided to a patient as part of a group of 4 to 10 patients by an eligible clinical psychologist if:

(a)  the patient is referred by a referring practitioner; and

(b)  the attendance is by video conference; and

(c)  the patient is located within a telehealth eligible area; and

(d)  the patient is, at the time of the attendance, at least 15 kilometres by road from the clinical psychologist; and

(e)  the service is at least 120 minutes duration

Fee: $82.40 Benefit: 85% = $70.05

(See para AN.0.78, MN.6.2, MN.6.3 of explanatory notes to this Category)

Extended Medicare Safety Net Cap: $247.20

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• Next - Item 80100

Focussed psychological strategies health service provided to a patient as part of a group of 4 to 10 patients by an eligible psychologist if:

(a)  the patient is referred by a referring practitioner; and

(b)  the attendance is by video conference; and

(c)  the patient is located within a telehealth eligible area; and

(d)  the patient is, at the time of the attendance, at least 15 kilometres by road from the psychologist; and

(e)  the service is at least 60 minutes duration

Fee: $30.45 Benefit: 85% = $25.90

(See para AN.0.78, MN.6.3, MN.7.4 of explanatory notes to this Category)

Extended Medicare Safety Net Cap: $91.35

• Previous - Item 80120
• Next - Item 80122

Focussed psychological strategies health service provided to a patient as part of a group of 4 to 10 by an eligible psychologist if:

(a)  the patient is referred by a referring practitioner; and

(b)  the attendance is by video conference; and

(c)  the patient is located within a telehealth eligible area; and

(d)  the patient is, at the time of the attendance, at least 15 kilometres by road from the psychologist; and

(e)  the service is at least 90 minutes duration

Fee: $41.50 Benefit: 85% = $35.30

(See para AN.0.78, MN.6.3, MN.7.4 of explanatory notes to this Category)

Extended Medicare Safety Net Cap: $124.50

• Previous - Item 80122
• Next - Item 80125

Focussed psychological strategies health service provided to a patient as part of a group of 4 to 10 patients by an eligible psychologist if:

(a)  the patient is referred by a referring practitioner; and

(b)  the attendance is by video conference; and

(c)  the patient is located within a telehealth eligible area; and

(d)  the patient is, at the time of the attendance, at least 15 kilometres by road from the psychologist; and

(e)  the service is at least 120 minutes duration

Fee: $56.40 Benefit: 85% = $47.95

(See para AN.0.78, MN.6.3, MN.7.4 of explanatory notes to this Category)

Extended Medicare Safety Net Cap: $169.20

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• Next - Item 80129