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SR 2001 No. 280 Regulations as made
Principal Regulations. These regulations repeal the Health Insurance (General Medical Services Table) Regulations 2000.
Tabling HistoryDate
Tabled HR12-Feb-2002
Tabled Senate12-Feb-2002
Gazetted 05 Oct 2001
Date of repeal 01 Nov 2002
Repealed by Health Insurance (General Medical Services Table) Regulations 2002

Commonwealth Coat of Arms of Australia

Health Insurance (General Medical Services Table) Regulations 2001

Statutory Rules 2001 No. 2801

I, PETER JOHN HOLLINGWORTH, Governor-General of the Commonwealth of Australia, acting with the advice of the Federal Executive Council, make the following Regulations under the Health Insurance Act 1973.

Dated 27 September 2001

PETER HOLLINGWORTH

Governor-General

By His Excellency’s Command

MICHAEL WOOLDRIDGE


Contents

Page

                        1  Name of Regulations                                                         2

                        2  Commencement                                                                2

                        3  Health Insurance (General Medical Services Table) Regulations 2000 — repeal          2

                        4  Definitions                                                                        2

                        5  General medical services table                                           3

Schedule 1           Table of general medical services                                    4

Part 1                    Prescription of table                                                          4

Part 2                    Rules of interpretation                                                        4

Part 3                    Services and fees                                                            46

 


  

  

1              Name of Regulations

                These Regulations are the Health Insurance (General Medical Services Table) Regulations 2001.

2              Commencement

                These Regulations commence on 1 November 2001.

3              Health Insurance (General Medical Services Table) Regulations 2000 — repeal

                The following Statutory Rules are repealed:

                  ·    2000 Nos. 292 and 356

                  ·    2001 No. 79.

4              Definitions

                In these Regulations:

Act means the Health Insurance Act 1973.

this table means the table of general medical services set out in Schedule 1.

5              General medical services table

                The table of medical services (other than diagnostic imaging services and pathology services) set out in Schedule 1 is prescribed for subsection 4 (1) of the Act.


Schedule 1        Table of general medical services

(regulation 5)

Part 1          Prescription of table

1              Prescription of table

                For section 4 of the Act, these Regulations prescribe a table of general medical services that sets out:

                (a)    in Part 2 — rules for interpretation of the table; and

               (b)    in Part 3:

                          (i)    items of general medical services; and

                         (ii)    the amount of fees applicable for each item.

Part 2          Rules of interpretation

2              General

         (1)   In this table, unless the contrary intention appears:

attendance of a minor nature or minor attendance, for an attendance on a patient by a consultant physician, means an attendance that:

                (a)    is a second or subsequent attendance on the patient, in the course of a single course of treatment by the consultant physician, during which it is not necessary for the consultant physician to carry out a physical examination of the patient; and

               (b)    does not result in a substantial alteration to the treatment of the patient.

closed reduction:

                (a)    means treatment of a dislocation or fracture by non‑operative reduction; and

               (b)    includes the use of percutaneous fixation, or external splintage by cast or splints.

comprehensive hyperbaric medicine facility means a separate hospital area that, on a 24-hour basis:

                (a)    is equipped and staffed so that it is capable of providing to a patient:

                          (i)    hyperbaric oxygen therapy at a treatment pressure of at least 2.8 atmospheric pressure absolute (180 kilopascal gauge pressure); and

                         (ii)    mechanical ventilation and invasive cardiovascular monitoring within a monoplace or multiplace chamber for the duration of the hyperbaric treatment; and

               (b)    is under the direction of at least 1 practitioner who is rostered, and immediately available, to the facility during normal working hours and who:

                          (i)    is a specialist with training in diving and hyperbaric medicine; or

                         (ii)    holds a Diploma of Diving and Hyperbaric Medicine of the South Pacific Underwater Medicine Society; and

                (c)    is staffed by:

                          (i)    at least 1 medical practitioner with training in diving and hyperbaric medicine who is present in the facility and immediately available at all times when patients are being treated at the facility; and

                         (ii)    at least 1 registered nurse with specific training in hyperbaric patient care to the published standards of the Hyperbaric Technicians and Nurses Association, who is present during hyperbaric oxygen therapy; and

               (d)    has admission and discharge policies in operation.

general intensive care unit means a separate hospital area that:

                (a)    is equipped and staffed so that it is capable of providing to a patient:

                          (i)    mechanical ventilation for a period of several days; and

                         (ii)    invasive cardiovascular monitoring; and

               (b)    is supported by:

                          (i)    during normal working hours — at least 1 specialist, or consultant physician, in the specialty of intensive care, who is immediately available, and exclusively rostered, to that area; and

                         (ii)    at all times — at least 1 registered medical practitioner who is present in the hospital and immediately available to that area; and

                        (iii)    at least 18 hours each day — at least 1 registered nurse; and

                (c)    has admission and discharge policies in operation.

general practitioner means:

                (a)    a practitioner who is vocationally registered under section 3F of the Act; or

               (b)    a practitioner who:

                          (i)    is a Fellow of the RACGP; and

                         (ii)    participates in the quality assurance and continuing medical education program of the RACGP; and

                        (iii)    meets the RACGP requirements for quality assurance and continuing education; or

                (c)    a practitioner who is undertaking a placement in general practice that is approved by the RACGP:

                          (i)    as part of a training program for general practice leading to the award of Fellowship of the RACGP; or

                         (ii)    as part of another training program recognised by the RACGP as being an equivalent standard; or

                        (iii)    as part of the Rural and Remote Area Placement Program administered by the Australian College of Rural and Remote Medicine; or

               (d)    an eligible non-vocationally recognised medical practitioner.

institution means a place (other than a hospital or residential aged care facility) at which residential accommodation or day care is, or both residential accommodation and day care are, made available to:

                (a)    disadvantaged children; or

               (b)    juvenile offenders; or

                (c)    aged persons; or

               (d)    chronically ill psychiatric patients; or

                (e)    homeless persons; or

                (f)    unemployed persons; or

               (g)    persons suffering from alcoholism; or

               (h)    persons addicted to drugs; or

                (i)    physically or intellectually disabled persons.

intensive care unit means a general intensive care unit or a neo-natal intensive care unit.

item means:

                (a)    an item mentioned, by number, in column 1 of:

                          (i)    Part 3; or

                         (ii)    Part 3 of the diagnostic imaging services table; or

                        (iii)    Part 3 of the pathology services table; and

               (b)    in a reference immediately followed by a number — the item so numbered.

Example

A reference (if any) by number to item 55028 is a reference to the item so numbered in the diagnostic imaging services table.

neo-natal intensive care unit means a separate hospital area that:

                (a)    is equipped and staffed so that it is capable of providing to a patient who is a newly born child:

                          (i)    mechanical ventilation for a period of several days; and

                         (ii)    invasive cardiovascular monitoring; and

               (b)    is supported by:

                          (i)    during normal working hours — at least 1 consultant physician in paediatric medicine who is immediately available, and exclusively rostered, to that area; and

                         (ii)    at all times — at least 1 registered medical practitioner who is present in the hospital and immediately available to that area; and

                        (iii)    at least 18 hours each day — at least 1 registered nurse; and

                (c)    has admission and discharge policies in operation.

open reduction means treatment of a dislocation or fracture by either:

                (a)    operative exposure, including the use of any internal or external fixation; or

               (b)    non-operative (closed) reduction using intra-medullary fixation or external fixation.

RACGP means the Royal Australian College of General Practitioners.

referring practitioner, for the referral of a patient, means:

                (a)    in the case of all referrals — a medical practitioner; and

               (b)    for a referral made to a specialist who is an ophthalmologist — an optometrist; and

                (c)    for a referral that arises out of a dental service provided by a dental practitioner and that is made to a specialist (but not a consultant physician) — a dental practitioner; and

               (d)    for a referral that arises out of a dental service provided by a dental practitioner who is approved by the Minister for the purposes of paragraph (b) of the definition of professional service in subsection 3 (1) of the Act and that is made to a consultant physician — a dental practitioner.

residential aged care facility means a facility where residential care (within the meaning given by section 41‑3 of the Aged Care Act 1997) is provided.

         (2)   A reference to a Group in the table includes every item in the Group, and a reference to a Subgroup in the table includes every item in the Subgroup.

         (3)   A reference in the table to an eligible non-vocationally recognised medical practitioner is a reference to a medical practitioner (including an overseas trained practitioner or a temporary resident medical practitioner) who:

                (a)    is providing general medical services in a rural or remote area under the Rural, Remote and Metropolitan Areas Classification, as in force on 1 January 2001; and

               (b)    is registered as a medical practitioner under the Rural Other Medical Practitioners’ Program; and

                (c)    not being a practitioner vocationally registered under section 3F of the Act, is undertaking, or has indicated in writing an intention to undertake, additional training:

                          (i)    that could enable vocational registration within 4 years or, on written application, 5 years, of commencing that training; and

                         (ii)    of which the Health Insurance Commission has written notice.

         (4)   For subrule (3):

                (a)    the Rural, Remote and Metropolitan Areas Classification sets out certain categories of areas in Australia, that have been determined by the Department of Health and Aged Care by reference to population size and remoteness of locality on the basis of 1991 census data published by the Australian Bureau of Statistics in 1994; and

               (b)    the Rural Other Medical Practitioners’ Program is a program administered by the Health Insurance Commission that, in relation to medical services provided to patients in rural and remote areas, provides a particular level of medicare benefits.

3              Meaning of symbols (S) and (G)

         (1)   An item including the symbol (S) applies only to a service performed by a specialist (and not to a service performed by a consultant physician) in the practice of his or her specialty, being:

                (a)    a service that:

                          (i)    is provided to a patient who has been referred to the specialist; and

                         (ii)    is the first service performed by the specialist in accordance with the referral; or

               (b)    a service that:

                          (i)    is provided to a patient who has been referred to the specialist; and

                         (ii)    is part of a single course of treatment given for the condition identified in the referral or, if no condition was identified in the referral, part of a single course of treatment for the condition identified by the specialist; and

                        (iii)    is provided within the period of validity of the referral that is applicable under regulation 31 of the Health Insurance Regulations 1975; or

                (c)    a service that:

                          (i)    is provided to a patient who has declared that a written referral completed by a named referring practitioner has been lost, stolen or destroyed before the service was provided; and

                         (ii)    is the first service performed by the specialist in accordance with the referral; or

               (d)    a service that:

                          (i)    is provided to a patient who has not been referred to the specialist; and

                         (ii)    is a service that, in an emergency within the meaning of subregulation 30 (5) of the Health Insurance Regulations 1975, the specialist decides is necessary in the patient’s interests to be provided as soon as practicable without a referral.

         (2)   An item including the symbol (G) applies only to a service provided otherwise than by a specialist in accordance with subrule (1).

4              Meaning of single course of treatment in certain circumstances

         (1)   In subrules 2 (1), 3 (1) and 7 (1) and items 104, 105, 106, 107, 108, 110, 116, 119, 122, 128, 131, 385, 386, 387 and 388, single course of treatment, in relation to a patient, includes:

                (a)    the initial attendance on the patient by a specialist or consultant physician; and

               (b)    the continuing management or treatment up to and including the stage when the patient is referred back to the care of the referring practitioner; and

                (c)    any subsequent review of the patient’s condition by the specialist or consultant physician that may be necessary, whether the review is initiated by the referring practitioner or by the specialist or consultant physician.

         (2)   For subrule (1), single course of treatment does not include treatment of an unrelated illness that requires referral of the patient to the specialist’s or consultant physician’s care.

         (3)   For subrule (1), an attendance (the later attendance) on the patient by the specialist or consultant physician, after the end of the period of validity of the last referral to have application under regulation 31 of the Health Insurance Regulations 1975, initiates a new course of treatment if:

                (a)    the referring practitioner considers the later attendance necessary for the patient’s condition to be reviewed; and

               (b)    the patient was most recently attended by the specialist or consultant physician more than 9 months before the later attendance.

5              Meaning of professional attendance in certain items

         (1)   In items 1 to 172, 193 to 338, 348 to 388, 410 to 417, 601, 602, 697, 698, 2501 to 2677 and 10900 to 10929, professional attendance includes (but is not limited to) the provision, in relation to a patient, of any of the following services:

                (a)    the evaluation of the patient’s condition or conditions including, if applicable, evaluation using a health screening service mentioned in subsection 19 (5) of the Act;

               (b)    the formulation of a plan for the management and, if applicable, for the treatment of the patient’s condition or conditions;

                (c)    the provision of advice to the patient about the patient’s condition or conditions and, if applicable, about treatment;

               (d)    if authorised by the patient, the provision of advice to another person, or other persons, about the patient’s condition or conditions and, if applicable, about treatment;

                (e)    the recording of the clinical details of the service or services provided to the patient.

         (2)   If:

                (a)    in connection with a professional attendance mentioned in any of items 3 to 96, vaccine is supplied to a patient; and

               (b)    the cost of the vaccine is not subsidised by the Commonwealth or a State;

the professional attendance is taken not to include that supply.

6              Interpretation of items 104 to 131 and 300 to 388

         (1)   In items 104 to 131 and 300 to 388, a reference to an attendance on a patient by a specialist, or consultant physician, in the practice of his or her specialty following referral of the patient to him or her:

                (a)    includes such an attendance on a patient who:

                          (i)    has declared that a written referral of the patient was completed by a medical practitioner; or

                         (ii)    in an emergency (within the meaning of subregulation 30 (5) of the Health Insurance Regulations 1975) has not been referred to the specialist, or consultant physician, if the specialist or consultant physician decides that it is necessary in the patient’s interests to provide the service mentioned in the item as soon as practicable without a referral; but

               (b)    does not include such an attendance if:

                          (i)    the attendance forms part of a single course of treatment in which the first service was provided more than 12 months (or such other period, if any, set by the referring practitioner in, or in connection with, the referral) before the attendance; and

                         (ii)    a later referral has not been made.

         (2)   For this rule, referral means referral by a referring practitioner.

7              Meaning of amount under rule 7 in certain items

         (1)   In items 4, 13, 19 and 20, amount under rule 7 means an amount equal to the sum of:

                (a)    the fee for item 3; and

               (b)    either:

                          (i)    if not more than 6 patients are attended at a single attendance — $20.05 divided by the number of patients attended; or

                         (ii)    if more than 6 patients are attended at a single attendance — $1.40.

         (2)   In items 24, 25, 33 and 35, amount under rule 7 means an amount equal to the sum of:

                (a)    the fee for item 23; and

               (b)    either:

                          (i)    if not more than 6 patients are attended at a single attendance — $20.05 divided by the number of patients attended; or

                         (ii)    if more than 6 patients are attended at a single attendance — $1.40.

         (3)   In items 37, 38, 40 and 43, amount under rule 7 means an amount equal to the sum of:

                (a)    the fee for item 36; and

               (b)    either:

                          (i)    if not more than 6 patients are attended at a single attendance — $20.05 divided by the number of patients attended; or

                         (ii)    if more than 6 patients are attended at a single attendance — $1.40.

         (4)   In items 47, 48, 50 and 51, amount under rule 7 means an amount equal to the sum of:

                (a)    the fee for item 44; and

               (b)    either:

                          (i)    if not more than 6 patients are attended at a single attendance — $20.05 divided by the number of patients attended; or

                         (ii)    if more than 6 patients are attended at a single attendance — $1.40.

         (5)   In items 58, 81, 87 and 92, amount under rule 7 means an amount equal to the sum of:

                (a)    $8.50; and

               (b)    either:

                          (i)    if not more than 6 patients are attended at a single attendance — $15.50 divided by the number of patients attended; or

                         (ii)    if more than 6 patients are attended at a single attendance — 70 cents.

         (6)   In items 59, 83, 89, 93, 2610, 2631 and 2673, amount under rule 7 means an amount equal to the sum of:

                (a)    $16.00; and

               (b)    either:

                          (i)    if not more than 6 patients are attended at a single attendance — $17.50 divided by the number of patients attended; or

                         (ii)    if more than 6 patients are attended at a single attendance — 70 cents.

         (7)   In items 60, 84, 90, 95, 2613, 2633 and 2675, amount under rule 7 means an amount equal to the sum of:

                (a)    $35.50; and

               (b)    either:

                          (i)    if not more than 6 patients are attended at a single attendance — $15.50 divided by the number of patients attended; or

                         (ii)    if more than 6 patients are attended at a single attendance — 70 cents.

         (8)   In items 65, 86, 91, 96, 2616, 2635 and 2677, amount under rule 7 means an amount equal to the sum of:

                (a)    $57.50; and

               (b)    either:

                          (i)    if not more than 6 patients are attended at a single attendance — $15.50 divided by the number of patients attended; or

                         (ii)    if more than 6 patients are attended at a single attendance — 70 cents.

         (9)   In item 195, amount under rule 7 means an amount equal to the sum of:

                (a)    the fee for item 193; and

               (b)    either:

                          (i)    if not more than 6 patients are attended at a single attendance — $20.05 divided by the number of patients attended; or

                         (ii)    if more than 6 patients are attended at a single attendance — $1.40.

       (10)   In item 414, amount under rule 7 means an amount equal to the sum of:

                (a)    the fee for item 410; and

               (b)    either:

                          (i)    if not more than 6 patients are attended at a single attendance — $20.05 divided by the number of patients attended; or

                         (ii)    if more than 6 patients are attended at a single attendance — $1.40.

       (11)   In item 415, amount under rule 7 means an amount equal to the sum of:

                (a)    the fee for item 411; and

               (b)    either:

                          (i)    if not more than 6 patients are attended at a single attendance — $20.05 divided by the number of patients attended; or

                         (ii)    if more than 6 patients are attended at a single attendance — $1.40.

       (12)   In item 416, amount under rule 7 means an amount equal to the sum of:

                (a)    the fee for item 412; and

               (b)    either:

                          (i)    if not more than 6 patients are attended at a single attendance — $20.05 divided by the number of patients attended; or

                         (ii)    if more than 6 patients are attended at a single attendance — $1.40.

       (13)   In item 417, amount under rule 7 means an amount equal to the sum of:

                (a)    the fee for item 413; and

               (b)    either:

                          (i)    if not more than 6 patients are attended at a single attendance — $20.05 divided by the number of patients attended; or

                         (ii)    if more than 6 patients are attended at a single attendance — $1.40.

8              Items 10809 and 10929 not to apply in certain circumstances

                Items 10809 and 10929 do not apply if the patient’s requirement for contact lenses is only for any of the following reasons:

                (a)    because the patient does not want to wear spectacles for reasons of appearance;

               (b)    because the patient wants contact lenses for work or sporting purposes;

                (c)    because the patient has difficulty in using, or cannot use, spectacles for psychological reasons.

9              Personal attendance by medical practitioners generally

         (1)   The items mentioned in subrule (2) apply only to a service provided in the course of a personal attendance by a single medical practitioner on a single patient on a single occasion.

         (2)   The items are items 1 to 164, 173 to 338, 348 to 10816, 11012, 11015, 11018, 11021, 11212, 11304, 11500, 11600, 11601, 11627, 11701, 11712, 11724, 11921, 12000, 12003, 13030, 13100, 13103, 13106, 13109, 13110, 13112, 13209, 13290, 13292, 13300, 13303, 13306, 13309, 13312, 13318, 13319, 13400, 13500, 13503, 13506, 13700, 13815, 13818, 13830, 13839, 13842, 13845, 13848, 13851, 13854, 13857, 13870, 13873, 13876, 13879, 13882, 13885, 13888, 14100, 14103, 14106, 14109, 14112, 14115, 14118, 14120, 14122, 14124, 14126, 14128, 14130, 14132, 14200, 14203, 14206, 14209, 14212, 14215, 14224, 15600, 16003 to 16512 and 16515 to 51318.

         (3)   Items 170, 171, 172, 342, 344 and 346 apply only to a service provided in the course of a personal attendance by a single medical practitioner.

10            Personal attendance by certain medical practitioners

         (1)   The items mentioned in subrule (3) apply only to a service provided in the course of a personal attendance by:

                (a)    a medical practitioner (other than a medical practitioner employed by the proprietor of a hospital that is not a private hospital); or

               (b)    a medical practitioner who:

                          (i)    is employed by the proprietor of a hospital that is not a private hospital; and

                         (ii)    provides the service otherwise than in the course of employment by that proprietor.

         (2)   Paragraph (1) (b) applies whether or not another person provides essential assistance to the medical practitioner in accordance with accepted medical practice.

         (3)   The items are items 1 to 10816, 11012, 11015, 11018, 11021, 11212, 11304, 11500, 11600, 11601, 11627, 11701, 11712, 11724, 11921, 12000, 12003, 13030, 13100, 13103, 13106, 13109, 13110, 13112, 13209, 13290, 13292, 13300, 13303, 13306, 13309, 13312, 13318, 13319, 13400, 13500, 13503, 13506, 13700, 13815, 13818, 13830, 13839, 13842, 13845, 13848, 13851, 13854, 13857, 13870, 13873, 13876, 13879, 13882, 13885, 13888, 14100, 14103, 14106, 14109, 14112, 14115, 14118, 14120, 14122, 14124, 14126, 14128, 14130, 14132, 14200, 14203, 14206, 14209, 14212, 14215, 14224, 15600, 16003 to 16512 and 16515 to 51318.

11            Certain services may be provided by persons other than medical practitioners

         (1)   The items mentioned in subrule (2) apply whether the medical service is given by:

                (a)    a medical practitioner; or

               (b)    a person, other than a medical practitioner, who:

                          (i)    is employed by a medical practitioner; or

                         (ii)    in accordance with accepted medical practice, acts under the supervision of a medical practitioner.

         (2)   The items are items 11000, 11003, 11006, 11009, 11024, 11027, 11200, 11203, 11204, 11205, 11210, 11211, 11215, 11218, 11221, 11222, 11224, 11225, 11235, 11240, 11241, 11242, 11243, 11300, 11303, 11306, 11309, 11312, 11315, 11318, 11321, 11324, 11327, 11330, 11332, 11333, 11336, 11339, 11503, 11506, 11509, 11512, 11603, 11606, 11609, 11612, 11615, 11618, 11621, 11624, 11700, 11702, 11706, 11708, 11709, 11710, 11711, 11713, 11715, 11718, 11721, 11800, 11810, 11830, 11833, 11900, 11903, 11906, 11909, 11912, 11915, 11918, 12012, 12015, 12018, 12021, 12200, 12203, 12207, 12210, 12213, 12215, 12217, 12500 to 12533, 13020, 13025, 13200, 13203, 13206, 13212, 13215, 13218, 13221, 13703, 13706, 13709, 13750, 13755, 13757, 13760, 13915 to 13948, 14050, 14053, 14218, 14221, 15000 to 15336, 15339 to 15539 and 16514.

12            Conditions under which certain services to be provided

                Items 11309, 11312, 11315, 11318 and 11321 apply only to a service provided:

                (a)    in conditions that allow the establishment of determinate thresholds; and

               (b)    in a sound-attenuated environment with background noise conditions that comply with Australian Standard AS1269‑1983 of the Standards Association of Australia, as in force on 1 August 1987; and

                (c)    using calibrated equipment that complies with Australian Standard AS2586-1983 of the Standards Association of Australia, as in force on 1 August 1987.

13            Application of items 51700 to 53706

                Items 51700 to 53706 apply only to a service provided in the course of dental practice by a dental practitioner approved by the Minister for the purposes of the definition of professional service in subsection 3 (1) of the Act.

14            Meaning of amount under rule 14 in certain items

         (1)   In item 15003, amount under rule 14 means an amount equal to the sum of:

                (a)    the fee for item 15000; and

               (b)    $13.50 for each field separately treated in excess of 1.

         (2)   In item 15009, amount under rule 14 means an amount equal to the sum of:

                (a)    the fee for item 15006; and

               (b)    $14.70 for each field separately treated in excess of 1.

         (3)   In item 15103, amount under rule 14 means an amount equal to the sum of:

                (a)    the fee for item 15100; and

               (b)    $14.90 for each field separately treated in excess of 1.

         (4)   In item 15109, amount under rule 14 means an amount equal to the sum of:

                (a)    the fee for item 15106; and

               (b)    $17.95 for each field separately treated in excess of 1.

         (5)   In item 15115, amount under rule 14 means an amount equal to the sum of:

                (a)    the fee for item 15112; and

               (b)    $37.40 for each field separately treated in excess of 1.

         (6)   In item 15204, amount under rule 14 means an amount equal to the sum of:

                (a)    the fee for item 15203; and

               (b)    $30.00 for each field separately treated in excess of 1.

         (7)   In item 15208, amount under rule 14 means an amount equal to the sum of:

                (a)    the fee for item 15207; and

               (b)    $30.00 for each field separately treated in excess of 1.

         (8)   In item 15214, amount under rule 14 means an amount equal to the sum of:

                (a)    the fee for item 15211; and

               (b)    $25.20 for each field separately treated in excess of 1.

15            Meaning of amount under rule 15 in certain items

                In item 44376 (reamputation), amount under rule 15 means an amount equal to 75% of the fee specified for the item relating to an original amputation (any of items 44325 to 44373) of the body part for which the reamputation is performed.

16            Meaning of (AD) in Group C2 — Oral and maxillofacial surgical services and Group C3 — General and prosthodontic services

                An item in the range 75200 to 75206 and 75800 to 75854 that includes the symbol (AD) applies only to a service provided by a dental practitioner practising as a dentist.

17            Orthodontic services

         (1)   An item in the range 75001 to 75006 or 75024 to 75051 that includes the symbol (AO) applies only to a service provided by an accredited orthodontist.

         (2)   An item in the range 75009 to 75023 that includes the symbol (AO) and the symbol (AOS) applies only to a service provided by:

                (a)    an accredited orthodontist; or

               (b)    a dental practitioner who is:

                          (i)    registered or licensed as an oral and maxillofacial surgeon under a law of the State or Territory in which the service is rendered that provides for the registration or licensing of oral and maxillofacial surgeons; and

                         (ii)    a dental practitioner approved by the Minister for the purposes of the definition of professional service in subsection 3 (1) of the Act.

         (3)   In this rule:

accredited orthodontist means:

                (a)    a dental practitioner who is:

                          (i)    registered or licensed as an orthodontist under the relevant law; and

                         (ii)    accredited by the Minister for the purposes of this rule; or

               (b)    a dental practitioner:

                          (i)    who is not registered or licensed under the relevant law as an orthodontist or who practises in a State or Territory in which there is no provision for the registration or licensing of orthodontists; and

                         (ii)    whose qualifications or experience demonstrate to the Committee his or her competence in the field of orthodontics that is applicable to the giving of the services specified in items 75001 to 75051; and

                        (iii)    who is accredited by the Minister for the purposes of this rule.

Committee means the Medical Benefits (Dental Practitioners) Advisory Committee established under section 136 of the National Health Act 1953.

relevant law, in relation to a service provided to a patient, means a law of the State or Territory in which the service is provided that provides for the registration or licensing of orthodontists.

18            Oral surgery services

                An item in the range 75150 to 75621 that includes the symbol (AOS) applies only to a service provided by a dental practitioner who is:

                (a)    registered as an oral and maxillofacial surgeon under a law of the State or Territory in which the service is rendered that provides for the registration or licensing of oral and maxillofacial surgeons; and

               (b)    a dental practitioner approved by the Minister for the purposes of the definition of professional service in subsection 3 (1) of the Act.

19            Meaning of report in Group D1 — Miscellaneous diagnostic procedures and investigations

                In items 11000 to 12217, report means a report prepared by a medical practitioner.

20            Meaning of treatment cycle of a patient

                In rule 23 and items 13200 to 13221, treatment cycle of a patient means a series of treatments of the patient that:

                (a)    begins:

                          (i)    if treatment with superovulatory drugs is given — on the day on which that treatment begins; or

                         (ii)    if treatment with superovulatory drugs is not given — on the first day of a menstrual cycle of the patient; and

               (b)    ends not more than 30 days after that day.

21            Items provided as part of treatment cycle relating to assisted reproductive services not to apply

         (1)   Subrule (2) applies to a service mentioned in:

                (a)    an item in Subgroup 3 of Group T1 (assisted reproductive services); and

               (b)    any other item (the associated item) associated with an item in Subgroup 3 of Group T1.

         (2)   A service provided as part of a treatment cycle to which an item in paragraph (1) (a) applies, is not a medical service for the purposes of the associated item.

22            Items relating to assisted reproductive services not to apply in certain pregnancy-related circumstances

                Items 13200 to 13221 do not apply to a service provided in relation to a patient’s pregnancy, or intended pregnancy, that is, at the time of the service, the subject of an agreement, or arrangement, under which the patient makes provision for transfer to another person of the guardianship of, or custodial rights to, a child born as a result of the pregnancy.

23            Meaning of embryology laboratory services in items 13200 and 13206

                In items 13200 and 13206, embryology laboratory services does not include semen preparation but includes:

                (a)    egg recovery from aspirated follicular fluid; and

               (b)    insemination; and

                (c)    monitoring of fertilisation and embryo development; and

               (d)    preparation of gametes or embryos for transfer or freezing.

24            Meaning of delivery in certain items

                In items 16515, 16519 and 16522, delivery includes:

                (a)    induction of labour by surgical or intravenous infusion methods; and

               (b)    forceps or vacuum extraction; and

                (c)    breech delivery; and

               (d)    management of multiple deliveries; and

                (e)    episiotomy; and

                (f)    repair of tears; and

               (g)    evacuation of the products of conception by manual removal.

25            Certain obstetrical procedures constitute a single operation

                The fee mentioned for item 16519, 16520, 16522, 16564, 16567, 16570, 16571 or 16573 applies inclusively to:

                (a)    the procedure, or procedures, mentioned in the item; and

               (b)    the administration of anaesthetic or the giving of assistance, within the meaning of subsection 16 (2), (3) or (4) of the Act.

26            Meaning of maxilla in certain items

                In items 45720 to 45752 and 52342 to 52375, maxilla includes the zygoma.

27            Items 46300 to 46534 apply only in certain circumstances

                Items 46300 to 46534 apply only to a service provided in the course of an operation on a hand or hands.

28            Assistance at operations

         (1)   Items 51300 to 51318 apply only to assistance rendered by a medical practitioner other than:

                (a)    the practitioner performing the operation; or

               (b)    the anaesthetist administering the anaesthetic in connection with the operation, if any; or

                (c)    the assistant anaesthetist, if any.

         (2)   Items 51800 and 51803 apply only to assistance rendered by an approved dental practitioner other than:

                (a)    the practitioner performing the operation; or

               (b)    the anaesthetist administering the anaesthetic in connection with the operation, if any; or

                (c)    the assistant anaesthetist, if any.

29            Meaning of amount under rule 29 in items 51303 and 51803

                In items 51303 and 51803, amount under rule 29, in relation to assistance at an operation or series of operations, means an amount equal to 20% of the sum of the fees payable under the Act for the services provided at that operation, or series of operations, by the practitioner to whom the assistance was given.

30            Meaning of amount under rule 30 in item 51309

         (1)   In item 51309, amount under rule 30, in relation to assistance at a series or combination of operations, means an amount equal to 20% of the sum of the fees payable under the Act for the services provided at those operations by the practitioner to whom the assistance was given.

         (2)   For subrule (1), the fee for the caesarean section component of the operations is the fee applicable to item 16520.

31            Meaning of amount under rule 31 in item 18219

                In item 18219, amount under rule 31 means an amount equal to the sum of:

                (a)    the fee for item 18216; and

               (b)    for continuous attendance by the medical practitioner beyond the first hour of attendance — $15.05 for each additional period of 15 minutes and part of a period of 15 minutes.

32            Histopathological proof of malignancy in certain cases for purposes of certain items relating to surgical procedures

                For items 30196 to 30205, the requirement for histopathological proof of malignancy is satisfied in a case where multiple lesions are to be removed from a single anatomical region if a single lesion from that region is histologically tested and proven positive for malignancy.

33            Meaning of amount under rule 33 in items 16633 and 16636

         (1)   In item 16633, amount under rule 33 means, for a second or subsequent foetus, the amount that is equal to 50% of the amount of the fee specified in items 16606, 16609, 16612, 16615 and 16627 for services provided in relation to the multiple pregnancy.

         (2)   In item 16636, amount under rule 33 means, for a second or subsequent foetus, the amount that is equal to 50% of the amount of the fee specified in items 16600, 16603, 16618, 16621 and 16624 for services provided in relation to the multiple pregnancy.

34            Meaning of amount under rule 34 in item 51312

                In item 51312, amount under rule 34, in relation to assistance at a procedure, means an amount equal to 20% of the sum of the fees payable under the Act for the services provided at that procedure by the practitioner to whom the assistance was given.

35            Meaning of amount under rule 35 in item 31340

                In item 31340, amount under rule 35, in relation to the excision of muscle, bone or cartilage in association with the excision of a malignant tumour of skin under another item, means an amount equal to 75% of the fee payable under that other item.

36            Meaning of previous significant surgical complication in item 51318

                In item 51318, previous significant surgical complication means:

                (a)    vitreous loss; or

               (b)    rupture of posterior capsule; or

                (c)    loss of nuclear material into the vitreous; or

               (d)    intraocular haemorrhage; or

                (e)    intraocular infection (endophthalmitis); or

                (f)    cystoid macular oedema; or

               (g)    corneal decompensation; or

               (h)    retinal detachment.

37            Meaning of amount under rule 37 in item 30001

                In item 30001, amount under rule 37 means 50% of the specified fee that would normally apply for a surgical procedure if the surgical procedure had not been discontinued before completion.

38            Consultant occupational physicians

                A fee specified for an attendance by a consultant occupational physician only applies if the attendance relates to 1 or more of the following matters:

                (a)    evaluation and assessment of a patient’s rehabilitation requirements where, in the consultant’s opinion, the patient has an accepted medical condition that:

                          (i)    may be affected by the patient’s working environment; or

                         (ii)    affects the patient’s capacity to be employed;

               (b)    management of an accepted medical condition that, in the consultant’s opinion, may affect a patient’s capacity for continued employment, or return to employment, following a non-compensable accident, injury or ill-health;

                (c)    evaluation and forming an opinion, including management as the case requires, of a patient’s medical condition where causation may be related to acute or chronic exposure to scientifically acknowledged environmental hazards or toxins.

39            Qualified sleep medicine practitioner

         (1)   For items 12203 to 12217, qualified sleep medicine practitioner means a qualified adult sleep medicine practitioner or a qualified paediatric sleep medicine practitioner.

         (2)   A person is a qualified adult sleep medicine practitioner or a qualified paediatric sleep medicine practitioner if:

                (a)    the person has been assessed by the Credentialling Subcommittee or the Appeal Committee as having had, before 1 March 1999, sufficient training and experience in the relevant field of sleep medicine to be competent in independent clinical assessment and management of patients with respiratory sleep disorders and in reporting sleep studies; or

               (b)    the person has been assessed by the Credentialling Subcommittee or the Appeal Committee as having had, before 1 March 1999, substantial training or experience in adult sleep medicine, but requiring further specified training or experience in the relevant field of sleep medicine to be competent in independent clinical assessment and management of patients with respiratory sleep disorders and in reporting sleep studies, and either:

                          (i)    the period of 2 years immediately following that assessment has not expired; or

                         (ii)    the person has been assessed by the Credentialling Subcommittee as having satisfactorily finished the further training or gained the further experience specified for that person; or

                (c)    the person has attained Level I or Level II of the relevant Advanced Training Program of the Thoracic Society of Australia and New Zealand and the Australasian Sleep Association, after having completed at least 12 months core training, including clinical practice in the relevant field of sleep medicine and in reporting sleep studies; or

               (d)    the Advisory Committee has recognised the person, in writing, as having training equivalent to the training mentioned in paragraph (c).

         (3)   In this rule:

Advisory Committee means the Specialist Advisory Committee in Thoracic and Sleep Medicine of the Royal Australasian College of Physicians.

Appeal Committee means the Appeal Committee of the Royal Australasian College of Physicians.

Credentialling Subcommittee means the Credentialling Subcommittee of the Advisory Committee.

relevant Advanced Training Program means:

                (a)    in relation to an assessment for qualification as a qualified adult sleep medicine practitioner — the Advanced Training Program in Adult Sleep Medicine; and

               (b)    in relation to an assessment for qualification as a qualified paediatric sleep medicine practitioner — the Advanced Training Program in Paediatric Sleep Medicine.

relevant field of sleep medicine means:

                (a)    in relation to an assessment for qualification as a qualified adult sleep medicine practitioner — adult sleep medicine; and

               (b)    in relation to an assessment for qualification as a qualified paediatric sleep medicine practitioner — paediatric sleep medicine.

40            Public health physicians

                Items 410 to 417 apply to an attendance on a patient by a public health physician only if the attendance relates to 1 or more of the following matters:

                (a)    management of a patient’s vaccination requirements for immunisation programs;

               (b)    prevention or management of sexually transmitted disease;

                (c)    prevention or management of disease caused by scientifically accepted environmental hazards or toxins;

               (d)    prevention or management of infection arising from an outbreak of an infectious disease;

                (e)    prevention or management of an exotic disease.

Note   An exotic disease is medically accepted as a disease that is of foreign origin.

41            Application of items in Group A14 to certain patients only

         (1)   Items 700, 702, 704 and 706 apply only to a service in relation to a patient who:

                (a)    is either:

                          (i)    at least 75 years old; or

                         (ii)    at least 55 years old and of Aboriginal or Torres Strait Islander descent; and

               (b)    is not an in-patient of a hospital or day-hospital facility, or a care recipient in a residential aged care facility.

                                     

         (2)   For subrule (1), a person is of Aboriginal or Torres Strait Islander descent if the person identifies himself or herself as being of that descent.

42            Application of items in Group A15 to certain patients only

         (1)   Items 720, 724, 726, 740, 742, 744, 759, 762 and 765 apply only to a service in relation to a patient who:

                (a)    suffers from at least 1 medical condition that:

                          (i)    has been (or is likely to be) present for at least 6 months; or

                         (ii)    is terminal; and

               (b)    is not an in-patient of a hospital or day-hospital facility, or a care recipient in a residential aged care facility.

         (2)   Items 722, 728, 746, 749, 757, 768, 771 and 773 apply only to a service in relation to a patient who:

                (a)    suffers from at least 1 medical condition that:

                          (i)    has been (or is likely to be) present for at least 6 months; or

                         (ii)    is terminal; and

               (b)    is an in-patient of a hospital or day-hospital facility; and

                (c)    is not a care recipient in a residential aged care facility.

         (3)   Items 730, 734, 736, 738, 775, 778 and 779 apply only to a service in relation to a patient who:

                (a)    suffers from at least 1 medical condition that:

                          (i)    has been (or is likely to be) present for at least 6 months; or

                         (ii)    is terminal; and

               (b)    is a care recipient in a residential aged care facility; and

                (c)    is not an in-patient of a hospital or day-hospital facility.

43            Meaning of health assessment

         (1)   For items 700, 702, 704 and 706, health assessment means the assessment of:

                (a)    a patient’s health and physical, psychological and social function; and

               (b)    whether preventative health care and education should be offered to the patient, to improve the patient’s health and physical, psychological and social function.

         (2)   A health assessment involves all of the following:

                (a)    a personal attendance by the medical practitioner;

               (b)    measurement of the patient’s blood pressure, pulse rate and rhythm;

                (c)    an assessment of the patient’s medication;

               (d)    an assessment of the patient’s continence;

                (e)    an assessment of the patient’s immunisation status for influenza, tetanus and pneumococcus;

                (f)    an assessment of the patient’s physical functions, including the patient’s activities of daily living and whether or not the patient has had a fall in the last 3 months;

               (g)    an assessment of the patient’s psychological function, including the patient’s cognition and mood;

               (h)    an assessment of the patient’s social function, including:

                          (i)    the availability and adequacy of paid, and unpaid, help; and

                         (ii)    whether the patient is responsible for caring for another person.

         (3)   A health assessment also includes:

                (a)    keeping a record of the health assessment; and

               (b)    offering the patient a written report about the health assessment, with recommendations about matters covered by the health assessment; and

                (c)    offering the patient’s carer (if any, and if the practitioner considers it appropriate and the patient agrees) a copy of the report or extracts of the report relevant to the carer.

44            Meaning of multidisciplinary care plan

         (1)   For items 720, 722, 724, 726, 728 and 730 preparation of a multidisciplinary care plan means the preparation of a written plan describing all of the following matters:

                (a)    an assessment of the patient’s health care needs;

               (b)    an assessment of the kinds of treatment, health services and health care that the patient is likely to need;

                (c)    an assessment of any other kinds of services and care that the patient is likely to need;

               (d)    arrangements for giving the treatment, services and care referred to in paragraphs (b) and (c);

                (e)    management goals with which the patient agrees;

                (f)    arrangements to review the plan by a day specified in the plan.

Example

For paragraph (c), other kinds of services and care may include home and community care service providers.

         (2)   Preparation of a plan also includes:

                (a)    discussing the preparation of the plan with the patient and the patient’s carer (if any, and if the practitioner considers it appropriate and the patient agrees); and

               (b)    telling the patient which persons will be included in the multidisciplinary care plan team; and

                (c)    recording the plan and the patient’s agreement to the preparation of the plan; and

               (d)    giving copies of relevant parts of the plan to persons who, under the plan, will give the patient the treatment, service and care mentioned in the plan; and

                (e)    offering a copy of the plan (and evidence of the contribution made to the plan by members of the team) to the patient and the patient’s carer (if any, and if the medical practitioner considers it appropriate and the patient agrees).

45            Meaning of multidisciplinary care plan team

         (1)   A multidisciplinary care plan team includes:

                (a)    a medical practitioner; and

               (b)    at least 2 other members, each of whom provides a different kind of care or service to the patient and is not a family carer of the patient, and 1 of whom may be another medical practitioner; and

                (c)    may additionally include a family carer of the patient.

Example

Examples of persons who, for paragraph (b), may be included in a team are:

(a)   allied health professionals such as:

·       Aboriginal health care workers

·       asthma educators

·       audiologists

·       dental therapists

·       dentists

·       diabetes educators

·       dieticians

·       mental health workers

·       occupational therapists

·       optometrists

·       orthoptists

·       orthotists or prosthetists

·       pharmacists

·       physiotherapists

·       podiatrists

·       psychologists

·       registered nurses

·       social workers

·       speech pathologists; and

(b)   home and community service providers, or care organisers, such as:

·       education providers

·       ‘meals on wheels’ providers

·       personal care workers

·       probation officers.

         (2)   In subrule (1):

family carer includes a person who:

                (a)    is a relative or friend of the patient; and

               (b)    is providing care to the patient other than as a paid service.

46            Meaning of multidisciplinary discharge care plan

                For items 722 and 728, a multidisciplinary discharge care plan is a multidisciplinary care plan that is prepared for a patient before the patient is discharged from a hospital.

47            Meaning of review of a multidisciplinary care plan

         (1)   For item 724, review of a multidisciplinary care plan means a process by which the medical practitioner:

                (a)    reviews the matters mentioned in subrule 44 (1); and

               (b)    considers whether the arrangements for treatment, service and care have been carried out; and

                (c)    considers, in consultation with other members of the multidisciplinary care plan team, whether different arrangements need to be made to achieve the management goals mentioned in the plan; and

               (d)    if different arrangements need to be made, prepares a revised multidisciplinary care plan stating those arrangements.

         (2)   The review of a plan also includes:

                (a)    discussing the review of the plan with the patient and the patient’s carer (if any, and if the practitioner considers it appropriate and the patient agrees); and

               (b)    recording the patient’s agreement to reviewing the plan; and

                (c)    offering a copy of relevant parts of the revised multidisciplinary care plan (if any) to the patient and the patient’s carer (if any, and if the practitioner considers it appropriate and the patient agrees), and giving copies to persons who, under the revised plan, will give the patient the treatment, service and care mentioned in the plan.

 

48            Meaning of contribution to a plan

         (1)   For items 726, 728 and 730, a contribution to a multidisciplinary community care plan, a multidisciplinary discharge care plan or a multidisciplinary care plan in a residential aged care facility must be at the request of the person (or residential aged care facility) who prepares the plan, and may include:

                (a)    preparation of a part of the plan that relates to the treatment, service or care that the medical practitioner will give to the patient; and

               (b)    giving advice to the person who prepares the plan.

         (2)   Contribution to a plan does not necessarily include preparation of the plan or part of the plan.

49            Meaning of multidisciplinary case conference

                For the items mentioned in Subgroup 2 of Group A15, a multidisciplinary case conference is a process by which a multidisciplinary case conference team (see rule 52) carries out all of the following activities:

                (a)    discussing a patient’s history;

               (b)    identifying the patient’s multidisciplinary care needs;

                (c)    identifying outcomes to be achieved by members of the case conference team giving care and service to the patient;

               (d)    identifying tasks that need to be undertaken to achieve these outcomes, and allocating those tasks to members of the case conference team;

                (e)    assessing whether previously identified outcomes (if any) have been achieved.

 

50            Meaning of multidisciplinary discharge case conference

                For items 746, 749, 757, 768, 771 and 773, a multidisciplinary discharge case conference is a multidisciplinary case conference carried out in relation to a patient before the patient is discharged from a hospital or day-hospital facility.

51            Meaning of multidisciplinary case conference in a residential aged care facility

                For items 734, 736, 738, 775, 778 and 779, a multidisciplinary case conference in a residential aged care facility is a multidisciplinary case conference carried out in relation to a care recipient in a residential aged care facility.

52            Meaning of multidisciplinary case conference team

         (1)   For this table, a multidisciplinary case conference team:

                (a)    includes a medical practitioner; and

               (b)    includes at least 2 other members, each of whom provides a different kind of care or service to the patient and is not a family carer of the patient, and 1 of whom may be another medical practitioner; and

                (c)    may additionally include a family carer of the patient.

Example

Examples of persons who, for paragraph (b), may be included in a team are:

(a)   allied health professionals such as:

·       Aboriginal health care workers

·       asthma educators

·       audiologists

·       dental therapists

·       dentists

·       diabetes educators

·       dieticians

·       mental health workers

·       occupational therapists

·       optometrists

·       orthoptists

·       orthotists or prosthetists

·       pharmacists

·       physiotherapists

·       podiatrists

·       psychologists

·       registered nurses

·       social workers

·       speech pathologists; and

(b)   home and community service providers, or care organisers, such as:

·       education providers

·       ‘meals on wheels’ providers

·       personal care workers

·       probation officers.

         (2)   In subrule (1):

family carer includes a person who:

                (a)    is a relative or friend of the patient; and

               (b)    is providing care to the patient other than as a paid service.

53            Meaning of organise and co-ordinate a multidisciplinary case conference and participation in a multidisciplinary case conference

         (1)   For items 734, 736, 738, 740, 742, 744, 746, 749 and 757, organise and co-ordinate a multidisciplinary case conference means undertaking all of the following activities in relation to a case conference:

                (a)    explaining to the patient the nature of a multidisciplinary case conference, and asking the patient whether the patient agrees to the conference taking place;

               (b)    recording the patient’s agreement to the conference;

                (c)    recording the day on which the conference was held, and the times at which the conference started and ended;

               (d)    recording the names of the participants;

                (e)    recording the matters mentioned in rule 49, and putting a copy of that record in the patient’s medical records;

                (f)    offering the patient and the patient’s carer (if any and if the practitioner considers appropriate and the patient agrees), and giving each other member of the team, a summary of the conference;

               (g)    discussing the outcomes of the conference with the patient and the patient’s carer (if any and if the practitioner considers appropriate and the patient agrees).

         (2)   For items 759, 762, 765, 768, 771, 773, 775, 778 and 779 participation in a multidisciplinary case conference must be at the request of the person who organises and co-ordinates the conference, and involves undertaking all of the following activities in relation to a case conference:

                (a)    explaining to the patient the nature of a multidisciplinary case conference, and asking the patient whether the patient agrees to the practitioner’s participation in the conference;

               (b)    recording the patient’s agreement to the practitioner’s participation;

                (c)    recording the day on which the conference was held, and the times at which the conference started and ended;

               (d)    recording the names of the participants;

                (e)    recording the matters mentioned in rule 49, and putting a copy of that record in the patient’s medical records.

         (3)   Participation in a multidisciplinary case conference does not include organising and co-ordinating a multidisciplinary case conference.

54            Meaning of living in a community setting in item 900

                For item 900, a patient is living in a community setting if the patient:

                (a)    is not an in-patient of a hospital or day-hospital facility; and

               (b)    is not a care recipient in a residential aged care facility.

55            Meaning of amount under rule 55 in certain items

         (1)   In item 2503, amount under rule 55 means an amount equal to the sum of:

                (a)    the fee for item 2501; and

               (b)    either:

                          (i)    if not more than 6 patients are attended at a single attendance — $20.05 divided by the number of patients attended; or

                         (ii)    if more than 6 patients are attended at a single attendance — $1.40.

         (2)   In item 2506, amount under rule 55 means an amount equal to the sum of:

                (a)    the fee for item 2504; and

               (b)    either:

                          (i)    if not more than 6 patients are attended at a single attendance — $20.05 divided by the number of patients attended; or

                         (ii)    if more than 6 patients are attended at a single attendance — $1.40.

         (3)   In item 2509, amount under rule 55 means an amount equal to the sum of:

                (a)    the fee for item 2507; and

               (b)    either:

                          (i)    if not more than 6 patients are attended at a single attendance — $20.05 divided by the number of patients attended; or

                         (ii)    if more than 6 patients are attended at a single attendance — $1.40.

         (4)   In item 2518, amount under rule 55 means an amount equal to the sum of:

                (a)    the fee for item 2517; and

               (b)    either:

                          (i)    if not more than 6 patients are attended at a single attendance — $20.05 divided by the number of patients attended; or

                         (ii)    if more than 6 patients are attended at a single attendance — $1.40.

         (5)   In item 2522, amount under rule 55 means an amount equal to the sum of:

                (a)    the fee for item 2521; and

               (b)    either:

                          (i)    if not more than 6 patients are attended at a single attendance — $20.05 divided by the number of patients attended; or

                         (ii)    if more than 6 patients are attended at a single attendance — $1.40.

         (6)   In item 2526, amount under rule 55 means an amount equal to the sum of:

                (a)    the fee for item 2525; and

               (b)    either:

                          (i)    if not more than 6 patients are attended at a single attendance — $20.05 divided by the number of patients attended; or

                         (ii)    if more than 6 patients are attended at a single attendance — $1.40.

         (7)   In item 2547, amount under rule 55 means an amount equal to the sum of:

                (a)    the fee for item 2546; and

               (b)    either:

                          (i)    if not more than 6 patients are attended at a single attendance — $20.05 divided by the number of patients attended; or

                         (ii)    if more than 6 patients are attended at a single attendance — $1.40.

         (8)   In item 2553, amount under rule 55 means an amount equal to the sum of:

                (a)    the fee for item 2552; and

               (b)    either:

                          (i)    if not more than 6 patients are attended at a single attendance — $20.05 divided by the number of patients attended; or

                         (ii)    if more than 6 patients are attended at a single attendance — $1.40.

         (9)   In item 2559, amount under rule 55 means an amount equal to the sum of:

                (a)    the fee for item 2558; and

               (b)    either:

                          (i)    if not more than 6 patients are attended at a single attendance — $20.05 divided by the number of patients attended; or

                         (ii)    if more than 6 patients are attended at a single attendance — $1.40.

56            Meaning of complete the requirements of Asthma 3+ Visit Plan in certain items

                For any of items 2546 to 2559 and 2664 to 2677, complete the requirements of the Asthma 3+ Visit Plan means complete, over a period of not less than 4 weeks and not more than 4 months, the following, for a patient with moderate to severe asthma:

                (a)    at least 3 asthma related consultations, at least 2 of which are consultations that have been planned at a previous consultation;

               (b)    diagnosis and assessment of severity;

                (c)    review of asthma related medication;

               (d)    provision of:

                          (i)    a written asthma action plan; and

                         (ii)    education to the patient.

57            Meaning of approved site in items 15338 and 37220

                For items 15338 and 37220, approved site, in relation to radiation oncology, means a site at which radiation oncology may be performed lawfully under the law of the State or Territory in which the site is located.

58            Group T10 applies only in connection with certain services

         (1)   Each of items 20100 to 21990 (other than item 21965), 23010 to 24136, 22060, 25200 and 25205 applies to a service only if the service is provided in connection with a service that:

                (a)    is a professional service within the meaning of subsection 3 (1) of the Act; and

               (b)    is specified in an item that includes, in its description, ‘(Anaes.)’.

         (2)   Each of items 22900 and 22905 applies to a service only if the service is provided in connection with a dental service (other than a dental service that is a prescribed medical service under paragraph (b) of the definition of professional service in subsection 3 (1) of the Act).

59            Meaning of amount under rule 59 in item 22060

                For item 22060, amount under rule 59, means the sum of:

                (a)    $343.00; and

               (b)    the fee specified in the item in the range 23010 to 24136 that applies to the perfusion; and

                (c)    if any of items 25000 to 25020 applies to the perfusion — the fee specified in that item.

60            Services specified in Subgroups 21 to 25 of Group T10

                In Subgroups 21 to 25 of Group T10:

                (a)    a reference to anaesthesia is a reference to administration of anaesthesia performed in association with a service to which any of items 20100 to 21997, 22900 and 22905 applies; and

               (b)    a reference to perfusion is a reference to perfusion to which item 22060 applies; and

                (c)    a reference to assistance is a reference to assistance:

                          (i)    in the administration of anaesthesia; and

                         (ii)    to which item 25200 or 25205 applies.

61            Meaning of service time in Subgroups 21, 24, 25 and 26 of Group T10

                In Subgroups 21, 24, 25 and 26 of Group T10:

service time means:

                (a)    in relation to administration of anaesthesia on a patient by an anaesthetist — the period that:

                          (i)    begins when the anaesthetist commences exclusive and continuous care of the patient for anaesthesia; and

                         (ii)    ends when the anaesthetist places the patient safely under the supervision of other personnel; and

               (b)    in relation to perfusion performed on a patient under anaesthesia — the period that:

                          (i)    begins when the anaesthetic commences; and

                         (ii)    ends with the closure of the chest of the patient; and

                (c)    in relation to assistance given by an assistant anaesthetist in the administration of anaesthesia performed on a patient — the period when the assistant anaesthetist is actively attending on the patient.

62            Application of Subgroup 21 of Group T10

         (1)   An item in the range 23010 to 24136 applies to perfusion only as a component of item 22060 and for the purpose of calculating the amount of fee for that item.

         (2)   An item in the range 23010 to 24136 applies to assistance only as a component of item 25200 or 25205 and for the purpose of calculating the amount of fee for that item.

63            Application of Subgroups 22 and 23 of Group T10

         (1)   An item in the range 25000 to 25020 applies to anaesthesia in addition to any other item that applies to the anaesthesia.

         (2)   An item in the range 25000 to 25020 applies to perfusion only as a component of item 22060 and for the purpose of calculating the amount of fee for that item.

         (3)   An item in the range 25000 to 25020 applies to assistance only as a component of item 25200 or 25205 and for the purpose of calculating the amount of fee for that item.

64            Meaning of amount under rule 64 in items 25025, 25030 and 25050

         (1)   For item 25025 amount under rule 64 means the amount that is equal to 50% of the sum of:

                (a)    the fee specified in any of items 20100 to 21997 and 22905 for the initiation of management of anaesthesia in association with which the anaesthesia is performed; and

               (b)    the fee specified in the item in the range 23010 to 24136 that applies to the anaesthesia; and

                (c)    if any of items 25000 to 25015 applies to the anaesthesia — the fee specified in that item; and

               (d)    if a service specified in an item in the range 22001 to 22050 is performed in association with the anaesthesia — the fee specified in that item.

         (2)   For item 25030 amount under rule 64 means the amount that is equal to 50% of the sum of:

                (a)    $85.75; and

               (b)    the fee specified in the item in the range 23010 to 24136 that applies to the assistance; and

                (c)    if any of items 25000 to 25015 applies to the assistance — the fee specified in that item; and

               (d)    if a service specified in an item in the range 22001 to 22050 is performed in association with the assistance — the fee specified in that item.

         (3)   For item 25050 amount under rule 64 means the amount that is equal to 50% of the sum of:

                (a)    $343.00; and

               (b)    the fee specified in the item in the range 23010 to 24136 that applies to the perfusion; and

                (c)    if any of items 25000 to 25015 applies to the perfusion — the fee specified in that item; and

               (d)    if a service specified in an item in the range 22001 to 22050 is performed in association with the perfusion — the fee specified in that item.

65            Application of Subgroups 24 and 25 of Group T10

                An item in the range 25025 to 25050 applies to the anaesthesia, assistance or perfusion in addition to any other item that applies to the service.

66            Meaning of complex paediatric case in item 25205

                For item 25205, a complex paediatric case involves 1 or more of the following services:

                (a)    invasive monitoring, either intravascular or transoesophageal;

               (b)    organ transplantation;

                (c)    craniofacial surgery;

               (d)    major tumour resection;

                (e)    separation of conjoint twins.

67            Meaning of amount under rule 67 in items 25200 and 25205

                For each of items 25200 and 25205, amount under rule 67, means the sum of:

                (a)    $85.75; and

               (b)    the fee specified in the item in the range 23010 to 24136 that applies to the assistance; and

                (c)    if any of items 25000 to 25020 applies to the assistance — the fee specified in that item.

Part 3          Services and fees

 

Item

Service

Fee ($)

Attendances

Group A1 — General practitioner attendances to which no other item applies

 

1

Professional attendance being an attendance at other than consulting rooms, by a general practitioner on not more than 1 patient on the 1 occasion — each attendance, other than an attendance between 11 pm and 7 am, on a public holiday, on a Sunday, before 8 am or after 1 pm on a Saturday or at any time other than between 8 am and 8 pm on a day not being a Saturday, Sunday or public holiday, where the attendance is initiated by or on behalf of the patient in the same unbroken after-hours period and where the patient’s medical condition requires immediate treatment

91.40

 

2

Professional attendance being an attendance at consulting rooms, by a general practitioner on not more than 1 patient on the 1 occasion — each attendance, other than an attendance between 11 pm and 7 am, on a public holiday, on a Sunday, before 8 am or after 1 pm on a Saturday or at any time other than between 8 am and 8 pm on a day not being a Saturday, Sunday or public holiday, where the attendance is initiated by or on behalf of the patient in the same unbroken after-hours period and where the patient’s medical condition requires immediate treatment and where it is necessary for the doctor to return to, and specially open, consulting rooms for the attendance

91.40

 

3

Professional attendance at consulting rooms (not being a service to which any other item applies) by a general 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 — each attendance

13.10

 

4

Professional attendance, other than a service to which any other item applies, and not being an attendance at consulting rooms, an institution, a hospital or a residential aged care facility by a general 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 — an attendance on 1 or more patients on 1 occasion — each patient

Amount under rule 7

 

13

Professional attendance at an institution (not being a service to which any other item applies) by a general 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 — an attendance on 1 or more patients at 1 institution on 1 occasion — each patient

Amount under rule 7

 

19

Professional attendance at a hospital (not being a service to which any other item applies) by a general 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 — an attendance on 1 or more patients at 1 hospital on 1 occasion — each patient

Amount under rule 7

 

20

Professional attendance (not being a service to which any other item applies) at a residential aged care facility (other than a professional attendance at a self contained unit) or professional attendance at consulting rooms situated within such a complex where the patient is accommodated in a residential aged care facility (not being accommodation in a self contained unit) by a general 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 — an attendance on 1 or more patients at 1 residential aged care facility on 1 occasion — each patient

Amount under rule 7

 

23

Professional attendance at consulting rooms (not being a service to which any other item applies) by a general practitioner involving taking a selective history, examination of the patient with implementation of a management plan in relation to 1 or more problems, or a professional attendance of less than 20 minutes duration involving components of a service to which item 36 or 44 applies — each attendance

28.75

 

24

Professional attendance, other than a service to which any other item applies, and not being an attendance at consulting rooms, an institution, a hospital or a residential aged care facility by a general practitioner taking a selective history, examination of the patient with implementation of a management plan in relation to 1 or more problems, or a professional attendance of less than 20 minutes duration involving components of a service to which item 37 to 47 applies — an attendance on 1 or more patients on 1 occasion — each patient

Amount under rule 7

 

25

Professional attendance at an institution (not being a service to which any other item applies) by a general practitioner involving taking a selective history, examination of the patient with implementation of a management plan in relation to 1 or more problems, or a professional attendance of less than 20 minutes duration involving components of a service to which item 38 or 48 applies — an attendance on 1 or more patients at 1 institution on 1 occasion — each patient

Amount under rule 7

 

33

Professional attendance at a hospital (not being a service to which any other item applies) by a general practitioner involving taking a selective history, examination of the patient with implementation of a management plan in relation to 1 or more problems, or a professional attendance of less than 20 minutes duration involving components of a service to which item 40 or 50 applies — an attendance on 1 or more patients at 1 hospital on 1 occasion — each patient

Amount under rule 7

 

35

Professional attendance (not being a service to which any other item applies) at a residential aged care facility (other than a professional attendance at a self contained unit) or professional attendance at consulting rooms situated within such a complex where the patient is accommodated in the residential aged care facility (not being accommodation in a self-contained unit) by a general practitioner involving taking a selective history, examination of the patient with implementation of a management plan in relation to 1 or more problems, or a professional attendance of less than 20 minutes duration involving components of a service to which item 43 or 51 applies — an attendance on 1 or more patients at 1 residential aged care facility on 1 occasion — each patient

Amount under rule 7

 

36

Professional attendance at consulting rooms (not being a service to which any other item applies) by a general practitioner involving taking a detailed history, an examination of multiple systems, arranging any necessary investigations and implementing a management plan in relation to 1 or more problems, and lasting at least 20 minutes, or a professional attendance of less than 40 minutes duration involving components of a service to which item 44 applies — each attendance

54.60

 

37

Professional attendance, other than a service to which any other item applies, and not being an attendance at consulting rooms, an institution, a hospital or a residential aged care facility by a general practitioner taking a detailed history, an examination of multiple systems, arranging any necessary investigations and implementing a management plan in relation to 1 or more problems, or a professional attendance of less than 40 minutes duration involving components of a service to which item 47 applies — an attendance on 1 or more patients on 1 occasion — each patient

Amount under rule 7

 

38

Professional attendance at an institution (not being a service to which any other item applies) by a general practitioner involving taking a detailed history, an examination of multiple systems, arranging any necessary investigations and implementing a management plan in relation to 1 or more problems, and lasting at least 20 minutes, or a professional attendance of less than 40 minutes duration involving components of a service to which item 48 applies — an attendance on 1 or more patients at 1 institution on 1 occasion — each patient

Amount under rule 7

 

40

Professional attendance at a hospital (not being a service to which any other item applies) by a general practitioner involving taking a detailed history, an examination of multiple systems, arranging any necessary investigations and implementing a management plan in relation to 1 or more problems, and lasting at least 20 minutes, or a professional attendance of less than 40 minutes duration involving components of a service to which item 50 applies — an attendance on 1 or more patients at 1 hospital on 1 occasion — each patient

Amount under rule 7

 

43

Professional attendance (not being a service to which any other item applies) at a residential aged care facility (other than a professional attendance at a self contained unit) or professional attendance at consulting rooms situated within such a complex where the patient is accommodated in the residential aged care facility (not being accommodation in a self-contained unit) by a general practitioner involving taking a detailed history, an examination of multiple systems, arranging any necessary investigations and implementing a management plan in relation to 1 or more problems, and lasting at least 20 minutes, or a professional attendance of less than 40 minutes duration involving components of a service to which item 51 applies — an attendance on 1 or more patients at 1 residential aged care facility on 1 occasion — each patient

Amount under rule 7

 

44

Professional attendance at consulting rooms (not being a service to which any other item applies) by a general practitioner involving taking an exhaustive history, a comprehensive examination of multiple systems, arranging any necessary investigations and implementing a management plan in relation to 1 or more complex problems, and lasting at least 40 minutes, or a professional attendance of at least 40 minutes duration for implementation of a management plan — each attendance

80.40

 

47

Professional attendance, other than a service to which any other item applies, and not being an attendance at consulting rooms, an institution, a hospital or a residential aged care facility by a general practitioner taking an exhaustive history, a comprehensive examination of multiple systems, arranging any necessary investigations and implementing a management plan in relation to 1 or more complex problems and lasting at least 40 minutes, or a professional attendance of at least 40 minutes duration for implementation of a management plan — an attendance on 1 or more patients on 1 occasion — each patient

Amount under rule 7

 

48

Professional attendance at an institution (not being a service to which any other item applies) by a general practitioner involving taking an exhaustive history, a comprehensive examination of multiple systems, arranging any necessary investigations and implementing a management plan in relation to 1 or more complex problems, and lasting at least 40 minutes, or a professional attendance of at least 40 minutes duration for implementation of a management plan — an attendance on 1 or more patients at 1 institution on 1 occasion — each patient

Amount under rule 7

 

50

Professional attendance at a hospital (not being a service to which any other item applies) by a general practitioner involving taking an exhaustive history, a comprehensive examination of multiple systems, arranging any necessary investigations and implementing a management plan in relation to 1 or more complex problems, and lasting at least 40 minutes, or a professional attendance of at least 40 minutes duration for implementation of a management plan — an attendance on 1 or more patients at 1 hospital on 1 occasion — each patient

Amount under rule 7

 

51

Professional attendance (not being a service to which any other item applies) at a residential aged care facility (other than a professional attendance at a self contained unit) or professional attendance at consulting rooms situated within such a complex where the patient is accommodated in the residential aged care facility (not being accommodation in a self-contained unit) by a general practitioner involving taking an exhaustive history, a comprehensive examination of multiple systems, arranging any necessary investigations and implementing a management plan in relation to 1 or more complex problems, and lasting at least 40 minutes, or a professional attendance of at least 40 minutes duration for implementation of a management plan — an attendance on 1 or more patients at 1 residential aged care facility on 1 occasion — each patient

Amount under rule 7

 

Group A2 — Other non-referred attendances to which no other item applies

 

52

Professional attendance at consulting rooms of not more than 5 minutes duration (not being a service to which any other item applies) by a medical practitioner (not being a general practitioner) — each attendance

11.00

53

Professional attendance at consulting rooms of more than 5 minutes duration but not more than 25 minutes duration (not being a service to which any other item applies) by a medical practitioner (not being a general practitioner) — each attendance

21.00

54

Professional attendance at consulting rooms of more than 25 minutes duration but not more than 45 minutes duration (not being a service to which any other item applies) by a medical practitioner (not being a general practitioner) — each attendance

38.00

57

Professional attendance at consulting rooms of more than 45 minutes duration (not being a service to which any other item applies) by a medical practitioner (not being a general practitioner) — each attendance

61.00

58

Professional attendance (not being an attendance at consulting rooms, an institution, a hospital or a residential aged care facility) of not more than 5 minutes duration (not being a service to which any other item applies) by a medical practitioner (not being a general practitioner) — an attendance on 1 or more patients on 1 occasion — each patient

Amount under rule 7

59

Professional attendance (not being an attendance at consulting rooms, an institution, a hospital or a residential aged care facility) of more than 5 minutes duration but not more than 25 minutes duration (not being a service to which any other item applies) by a medical practitioner (not being a general practitioner) — an attendance on 1 or more patients on 1 occasion — each patient

Amount under rule 7

60

Professional attendance (not being an attendance at consulting rooms, an institution, a hospital or a residential aged care facility) of more than 25 minutes duration but not more than 45 minutes duration (not being a service to which any other item applies) by a medical practitioner (not being a general practitioner) — an attendance on 1 or more patients on 1 occasion — each patient

Amount under rule 7

65

Professional attendance (not being an attendance at consulting rooms, an institution, a hospital or a residential aged care facility) of more than 45 minutes duration (not being a service to which any other item applies) by a medical practitioner (not being a general practitioner) — an attendance on 1 or more patients on 1 occasion — each patient

Amount under rule 7

81

Professional attendance at an institution of not more than 5 minutes duration (not being a service to which any other item applies) by a medical practitioner (not being a general practitioner) — an attendance on 1 or more patients at 1 institution on 1 occasion — each patient

Amount under rule 7

83

Professional attendance at an institution of more than 5 minutes duration but not more than 25 minutes duration (not being a service to which any other item applies) by a medical practitioner (not being a general practitioner) — an attendance on 1 or more patients at 1 institution on 1 occasion — each patient

Amount under rule 7

84

Professional attendance at an institution of more than 25 minutes duration but not more than 45 minutes duration (not being a service to which any other item applies) by a medical practitioner (not being a general practitioner) — an attendance on 1 or more patients at 1 institution on 1 occasion — each patient

Amount under rule 7

86

Professional attendance at an institution of more than 45 minutes duration (not being a service to which any other item applies) by a medical practitioner (not being a general practitioner) — an attendance on 1 or more patients at 1 institution on 1 occasion — each patient

Amount under rule 7

87

Professional attendance at a hospital of not more than 5 minutes duration (not being a service to which any other item applies) by a medical practitioner (not being a general practitioner) — an attendance on 1 or more patients at 1 hospital on 1 occasion — each patient

Amount under rule 7

89

Professional attendance at a hospital of more than 5 minutes duration but not more than 25 minutes duration (not being a service to which any other item applies) by a medical practitioner (not being a general practitioner) — an attendance on 1 or more patients at 1 hospital on 1 occasion — each patient

Amount under rule 7

90

Professional attendance at a hospital of more than 25 minutes duration but not more than 45 minutes duration (not being a service to which any other item applies) by a medical practitioner (not being a general practitioner) — an attendance on 1 or more patients at 1 hospital on 1 occasion — each patient

Amount under rule 7

91

Professional attendance at a hospital of more than 45 minutes duration (not being a service to which any other item applies) by a medical practitioner (not being a general practitioner) — an attendance on 1 or more patients at 1 hospital on 1 occasion — each patient

Amount under rule 7

92

Professional attendance (not being a service to which any other item applies) at a residential aged care facility (other than a professional attendance at a self contained unit) or professional attendance at consulting rooms situated within such a complex where the patient is accommodated in the residential aged care facility (not being accommodation in a self-contained unit) of not more than 5 minutes duration by a medical practitioner (not being a general practitioner) — an attendance on 1 or more patients at 1 residential aged care facility on 1 occasion — each patient

Amount under rule 7

93

Professional attendance (not being a service to which any other item applies) at a residential aged care facility (other than a professional attendance at a self contained unit) or professional attendance at consulting rooms situated within such a complex where the patient is accommodated in the residential aged care facility (not being accommodation in a self-contained unit) of more than 5 minutes duration but not more than 25 minutes duration by a medical practitioner (not being a general practitioner) — an attendance on 1 or more patients at 1 residential aged care facility on 1 occasion — each patient

Amount under rule 7

95

Professional attendance (not being a service to which any other item applies) at a residential aged care facility (other than a professional attendance at a self contained unit) or professional attendance at consulting rooms situated within such a complex where the patient is accommodated in the residential aged care facility (not being accommodation in a self-contained unit) of more than 25 minutes duration but not more than 45 minutes by a medical practitioner (not being a general practitioner) — an attendance on 1 or more patients at 1 residential aged care facility on 1 occasion — each patient

Amount under rule 7

96

Professional attendance (not being a service to which any other item applies) at a residential aged care facility (other than a professional attendance at a self contained unit) or professional attendance at consulting rooms situated within such a complex where the patient is accommodated in the residential aged care facility (not being accommodation in a self-contained unit) of more than 45 minutes duration by a medical practitioner (not being a general practitioner) — an attendance on 1 or more patients at 1 residential aged care facility on 1 occasion — each patient

Amount under rule 7

97

Professional attendance being an attendance at other than consulting rooms, by a medical practitioner (not being a general practitioner) on not more than 1 patient on the 1 occasion — each attendance, other than an attendance between 11 pm and 7 am, on a public holiday, on a Sunday, before 8 am or after 1 pm on a Saturday or at any time other than between 8 am and 8 pm on a day not being a Saturday, Sunday or public holiday, where the attendance is initiated by or on behalf of the patient in the same unbroken after-hours period and where the patient’s medical condition requires immediate treatment

78.35

98

Professional attendance being an attendance at consulting rooms, by a medical practitioner (not being a general practitioner) on not more than 1 patient on the 1 occasion — each attendance, other than an attendance between 11 pm and 7 am, on a public holiday, on a Sunday, before 8 am or after 1 pm on a Saturday or at any time other than between 8 am and 8 pm on a day not being a Saturday, Sunday or public holiday, where the attendance is initiated by or on behalf of the patient in the same unbroken after-hours period and where the patient’s medical condition requires immediate treatment and where it is necessary for the doctor to return to, and specially open, consulting rooms for the attendance

78.35

Group A3 — Specialist attendances to which no other item applies

 

104

Professional attendance by a specialist in the practice of his or her specialty following referral of the patient to him or her — an attendance (other than a second or subsequent attendance in a single course of treatment) where that attendance is at consulting rooms or hospital, not being a service to which item 106 applies

67.65

105

Professional attendance by a specialist in the practice of his or her specialty following referral of the patient to him or her — an attendance (other than a second or subsequent attendance in a single course of treatment) where that attendance is at consulting rooms or hospital

33.95

106

Professional attendance by a specialist in the practice of his or her specialty following referral of the patient to him or her — an attendance (other than a second or subsequent attendance in a single course of treatment) at which refraction is performed by a specialist ophthalmologist, and the attendance results in the issuing of a prescription for spectacles or contact lenses, including any consultation on the same occasion and any other attendance on the same day (not being a service to which item 10801, 10802, 10803, 10804, 10805, 10806, 10807, 10808, 10809 or 10816 applies) where that attendance is at consulting rooms or hospital

55.75

107

Professional attendance by a specialist in the practice of his or her specialty following referral of the patient to him or her — an attendance (other than a second or subsequent attendance in a single course of treatment) where that attendance is at a place other than consulting rooms or hospital

99.20

108

Professional attendance by a specialist in the practice of his or her specialty following referral of the patient to him or her — each attendance subsequent to the first in a single course of treatment where that attendance is at a place other than consulting rooms or hospital

62.80

Group A4 — Consultant physician attendances to which no other item applies

 

110

Professional attendance at consulting rooms or hospital, by a consultant physician in the practice of his or her specialty (other than psychiatry) following referral of the patient to him or her by a medical practitioner — initial attendance in a single course of treatment

119.35

116

Professional attendance at consulting rooms or hospital, by a consultant physician in the practice of his or her specialty (other than psychiatry) following referral of the patient to him or her by a medical practitioner — each attendance (not being a service to which item 119 applies) subsequent to the first in a single course of treatment

59.75

119

Professional attendance at consulting rooms or hospital, by a consultant physician in the practice of his or her specialty (other than psychiatry) following referral of the patient to him or her by a medical practitioner — each minor attendance subsequent to the first in a single course of treatment

33.95

122

Professional attendance at a place other than consulting rooms or hospital, by a consultant physician in the practice of his or her specialty (other than psychiatry) following referral of the patient to him or her by a medical practitioner — initial attendance in a single course of treatment

144.90

128

Professional attendance at a place other than consulting rooms or hospital, by a consultant physician in the practice of his or her specialty (other than psychiatry) following referral of the patient to him or her by a medical practitioner — each attendance (other than a service to which item 131 applies) subsequent to the first in a single course of treatment

87.55

131

Professional attendance at a place other than consulting rooms or hospital, by a consultant physician in the practice of his or her specialty (other than psychiatry) following referral of the patient to him or her by a medical practitioner — each minor attendance subsequent to the first in a single course of treatment

63.05

Group A5 — Prolonged attendances to which no other item applies

 

160

Professional attendance for a period of not less than 1 hour but less than 2 hours (not being a service to which any other item applies) on a patient in imminent danger of death requiring continuous attendance on the patient to the exclusion of all other patients

171.75

161

Professional attendance for a period of not less than 2 hours but less than 3 hours (not being a service to which any other item applies) on a patient in imminent danger of death requiring continuous attendance on the patient to the exclusion of all other patients

286.25

162

Professional attendance for a period of not less than 3 hours but less than 4 hours (not being a service to which any other item applies) on a patient in imminent danger of death requiring continuous attendance on the patient to the exclusion of all other patients

400.70

163

Professional attendance for a period of not less than 4 hours but less than 5 hours (not being a service to which any other item applies) on a patient in imminent danger of death requiring continuous attendance on the patient to the exclusion of all other patients

515.30

164

Professional attendance for a period of 5 hours or more (not being a service to which any other item applies) on a patient in imminent danger of death requiring continuous attendance on the patient to the exclusion of all other patients

572.60

Group A6 — Group therapy

 

170

Professional attendance for the purpose of group therapy of not less than 1 hour’s duration given under the direct continuous supervision of a medical practitioner, other than a consultant physician in the practice of his or her specialty of psychiatry, involving members of a family and persons with close personal relationships with that family — each group of 2 patients

93.45

171

Professional attendance for the purpose of group therapy of not less than 1 hour’s duration given under the direct continuous supervision of a medical practitioner, other than a consultant physician in the practice of his or her specialty of psychiatry, involving members of a family and persons with close personal relationships with that family — each group of 3 patients

98.50

172

Professional attendance for the purpose of group therapy of not less than 1 hour’s duration given under the direct continuous supervision of a medical practitioner, other than a consultant physician in the practice of his or her specialty of psychiatry, involving members of a family and persons with close personal relationships with that family — each group of 4 or more patients

119.80

Group A7 — Acupuncture

 

173

Attendance at which acupuncture is performed by a medical practitioner by application of stimuli on or through the surface of the skin by any means, including any consultation on the same occasion and any other attendance on the same day related to the condition for which the acupuncture was performed

21.65

193

Professional attendance by a general practitioner at a place other than a hospital, on 1 occasion, involving either:

   (a)  taking a selective history, examination of the patient with implementation of a management plan in relation to 1 or more problems; or

  (b)  a professional attendance of less than 20 minutes duration involving components of a service to which item 36, 37, 38, 40, 43, 44, 47, 48, 50 or 51 applies and at which acupuncture is performed by the medical practitioner by the application of stimuli on or through the surface of the skin by any means, including any consultation on the same occasion and any other attendance on the same day related to the condition for which the acupuncture was performed

28.75

195

Professional attendance by a general practitioner on 1 or more patients at a hospital, on 1 occasion, involving either:

   (a)  taking a selective history, examination of the patient with implementation of a management plan in relation to 1 or more problems; or

  (b)  a professional attendance of less than 20 minutes duration involving components of a service to which item 36, 37, 38, 40, 43, 44, 47, 48, 50 or 51 applies and at which acupuncture is performed by the medical practitioner by the application of stimuli on or through the surface of the skin by any means, including any consultation on the same occasion and any other attendance on the same day related to the condition for which the acupuncture was performed

Amount under rule 7

Group A8 — Consultant psychiatrist attendances to which no other item applies

 

300

Professional attendance by a consultant physician in the practice of his or her specialty of psychiatry following referral of the patient to him or her by a medical practitioner — an attendance of not more than 15 minutes duration at consulting rooms, where that attendance and any other attendance to which item 300, 302, 304, 306 or 308 applies have not exceeded the sum of 50 attendances in a calendar year

34.25

302

Professional attendance by a consultant physician in the practice of his or her specialty of psychiatry following referral of the patient to him or her by a medical practitioner — an attendance of more than 15 minutes duration but not more than 30 minutes duration at consulting rooms, where that attendance and any other attendance to which item 300, 302, 304, 306 or 308 applies have not exceeded the sum of 50 attendances in a calendar year

68.45

304

Professional attendance by a consultant physician in the practice of his or her specialty of psychiatry following referral of the patient to him or her by a medical practitioner — an attendance of more than 30 minutes duration but not more than 45 minutes duration at consulting rooms, where that attendance and any other attendance to which item 300, 302, 304, 306 or 308 applies have not exceeded the sum of 50 attendances in a calendar year

100.30

306

Professional attendance by a consultant physician in the practice of his or her specialty of psychiatry following referral of the patient to him or her by a medical practitioner — an attendance of more than 45 minutes duration but not more than 75 minutes duration at consulting rooms, where that attendance and any other attendance to which item 300, 302, 304, 306 or 308 applies have not exceeded the sum of 50 attendances in a calendar year

138.45

308

Professional attendance by a consultant physician in the practice of his or her specialty of psychiatry following referral of the patient to him or her by a medical practitioner — an attendance of more than 75 minutes duration at consulting rooms, where that attendance and any other attendance to which item 300, 302, 304, 306 or 308 applies have not exceeded the sum of 50 attendances in a calendar year

168.65

310

Professional attendance by a consultant physician in the practice of his or her specialty of psychiatry following referral of the patient to him or her by a medical practitioner — an attendance of not more than 15 minutes duration at consulting rooms, where that attendance and any other attendance to which item 300, 302, 304, 306, 308, 310, 312, 314, 316 or 318 applies exceed 50 attendances in a calendar year

17.10

312

Professional attendance by a consultant physician in the practice of his or her specialty of psychiatry following referral of the patient to him or her by a medical practitioner — an attendance of more than 15 minutes duration but not more than 30 minutes duration at consulting rooms, where that attendance and any other attendance to which item 300, 302, 304, 306, 308, 310, 312, 314, 316 or 318 applies exceed 50 attendances in a calendar year

34.25

314

Professional attendance by a consultant physician in the practice of his or her specialty of psychiatry following referral of the patient to him or her by a medical practitioner — an attendance of more than 30 minutes duration but not more than 45 minutes duration at consulting rooms, where that attendance and any other attendance to which item 300, 302, 304, 306, 308, 310, 312, 314, 316 or 318 applies exceed 50 attendances in a calendar year

50.15

316

Professional attendance by a consultant physician in the practice of his or her specialty of psychiatry following referral of the patient to him or her by a medical practitioner — an attendance of more than 45 minutes duration but not more than 75 minutes duration at consulting rooms, where that attendance and any other attendance to which item 300, 302, 304, 306, 308, 310, 312, 314, 316 or 318 applies exceed 50 attendances in a calendar year

69.25

318

Professional attendance by a consultant physician in the practice of his or her specialty of psychiatry following referral of the patient to him or her by a medical practitioner — an attendance of more than 75 minutes duration at consulting rooms, where that attendance and any other attendance to which item 300, 302, 304, 306, 308, 310, 312, 314, 316 or 318 applies exceed 50 attendances in a calendar year

84.40

319

Professional attendance by a consultant physician in the practice of his or her specialty of psychiatry following referral of the patient to him or her by a medical practitioner — an attendance of more than 45 minutes duration at consulting rooms, where the patient has:

   (a)  been diagnosed as suffering severe personality disorder, anorexia nervosa, bulimia nervosa, dysthymic disorder, substance-related disorder, somatoform disorder or a pervasive development disorder; and

  (b)  for persons 18 years and over, been rated with a level of functional impairment within the range 1 to 50 according to the Global Assessment of Functioning Scale — where that attendance and any other attendance to which items 300 to 308 apply do not exceed 160 attendances in a calendar year

138.45

320

Professional attendance by a consultant physician in the practice of his or her specialty of psychiatry following referral of the patient to him or her by a medical practitioner — an attendance of not more than 15 minutes duration at hospital

34.25

322

Professional attendance by a consultant physician in the practice of his or her specialty of psychiatry following referral of the patient to him or her by a medical practitioner — an attendance of more than 15 minutes duration but not more than 30 minutes duration at hospital

68.45

324

Professional attendance by a consultant physician in the practice of his or her specialty of psychiatry following referral of the patient to him or her by a medical practitioner — an attendance of more than 30 minutes duration but not more than 45 minutes duration at hospital

100.30

326

Professional attendance by a consultant physician in the practice of his or her specialty of psychiatry following referral of the patient to him or her by a medical practitioner — an attendance of more than 45 minutes duration but not more than 75 minutes duration at hospital

138.45

328

Professional attendance by a consultant physician in the practice of his or her specialty of psychiatry following referral of the patient to him or her by a medical practitioner — an attendance of more than 75 minutes duration at hospital

168.65

330

Professional attendance by a consultant physician in the practice of his or her specialty of psychiatry following referral of the patient to him or her by a medical practitioner — an attendance of not more than 15 minutes duration where that attendance is at a place other than consulting rooms or hospital

62.90

332

Professional attendance by a consultant physician in the practice of his or her specialty of psychiatry following referral of the patient to him or her by a medical practitioner — an attendance of more than 15 minutes duration but not more than 30 minutes duration where that attendance is at a place other than consulting rooms or hospital

98.65

334

Professional attendance by a consultant physician in the practice of his or her specialty of psychiatry following referral of the patient to him or her by a medical practitioner — an attendance of more than 30 minutes duration but not more than 45 minutes duration where that attendance is at a place other than consulting rooms or hospital

136.85

336

Professional attendance by a consultant physician in the practice of his or her specialty of psychiatry following referral of the patient to him or her by a medical practitioner — an attendance of more than 45 minutes duration but not more than 75 minutes duration where that attendance is at a place other than consulting rooms or hospital

165.55

338

Professional attendance by a consultant physician in the practice of his or her specialty of psychiatry following referral of the patient to him or her by a medical practitioner — an attendance of more than 75 minutes duration where that attendance is at a place other than consulting rooms or hospital

197.35

342

Group psychotherapy (including any associated consultations with a patient taking place on the same occasion and relating to the condition for which group therapy is conducted) of not less than 1 hour’s duration given under the continuous direct supervision of a consultant physician in the practice of his or her specialty of psychiatry, involving a group of 2 to 9 unrelated patients or a family group of more than 3 patients, each of whom is referred to the consultant physician by a medical practitioner — each patient

39.00

344

Group psychotherapy (including any associated consultations with a patient taking place on the same occasion and relating to the condition for which group therapy is conducted) of not less than 1 hour’s duration given under the continuous direct supervision of a consultant physician in the practice of his or her specialty of psychiatry, involving a family group of 3 patients, each of whom is referred to the consultant physician by a medical practitioner — each patient

51.80

346

Group psychotherapy (including any associated consultations with a patient taking place on the same occasion and relating to the condition for which group therapy is conducted) of not less than 1 hour’s duration given under the continuous direct supervision of a consultant physician in the practice of his or her specialty of psychiatry, involving a family group of 2 patients, each of whom is referred to the consultant physician by a medical practitioner — each patient

76.60

348

Professional attendance by a consultant physician in the practice of his or her specialty of psychiatry, following referral of the patient to him or her by a medical practitioner, involving an interview of a person other than the patient of not less than 20 minutes duration but less than 45 minutes duration, in the course of initial diagnostic evaluation of a patient

41.40

350

Professional attendance by a consultant physician in the practice of his or her specialty of psychiatry, following referral of the patient to him or her by a medical practitioner, involving an interview of a person other than the patient of not less than 45 minutes duration, in the course of initial diagnostic evaluation of a patient

93.05

352

Professional attendance by a consultant physician in the practice of his or her specialty of psychiatry, following referral of the patient to him or her by a medical practitioner, involving an interview of a person other than the patient of not less than 20 minutes duration, in the course of continuing management of a patient — payable not more than 4 times in any 12 month period

41.40

Group A12 — Consultant occupational physician attendances to which no other item applies

 

385

Professional attendance at consulting rooms or hospital by a consultant occupational physician in the practice of his or her specialty of occupational medicine following referral of the patient to him or her by a medical practitioner — initial attendance in a single course of treatment

67.65

386

Professional attendance at consulting rooms or hospital by a consultant occupational physician in the practice of his or her specialty of occupational medicine following referral of the patient to him or her by a medical practitioner — each attendance subsequent to the first in a single course of treatment

33.95

387

Professional attendance at a place other than consulting rooms or hospital by a consultant occupational physician in the practice of his or her specialty of occupational medicine following referral of the patient to him or her by a medical practitioner — initial attendance in a single course of treatment

99.20

388

Professional attendance at a place other than consulting rooms or hospital by a consultant occupational physician in the practice of his or her specialty of occupational medicine following referral of the patient to him or her by a medical practitioner — each attendance subsequent to the first in a single course of treatment

62.80

Group A13 — Public health physician attendances to which no other item applies

 

410

Professional attendance at consulting rooms by a public health physician in the practice of his or her specialty of public health medicine — attendance 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

13.10

411

Professional attendance at consulting rooms by a public health physician in the practice of his or her specialty of public health medicine — attendance involving taking a selective patient history, examination of the patient with implementation of a management plan in relation to 1 or more problems, or an attendance of less than 20 minutes duration involving components of a service to which item 412 applies

28.75

412

Professional attendance at consulting rooms by a public health physician in the practice of his or her specialty of public health medicine — attendance involving taking a detailed patient history, an examination of multiple systems, arranging any necessary investigations and implementing a management plan in relation to 1 or more problems, and lasting at least 20 minutes, or an attendance of less than 40 minutes duration involving components of a service to which item 413 applies

54.60

413

Professional attendance at consulting rooms by a public health physician in the practice of his or her specialty of public health medicine — attendance involving taking an exhaustive patient history, a comprehensive examination of multiple systems, arranging any necessary investigations and implementing a management plan in relation to 1 or more complex problems, and lasting at least 40 minutes, or an attendance of at least 40 minutes duration for implementation of a management plan

80.40

414

Professional attendance at other than consulting rooms by a public health physician in the practice of his or her specialty of public health medicine — attendance 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

Amount under rule 7

415

Professional attendance at other than consulting rooms by a public health physician in the practice of his or her specialty of public health medicine — attendance involving taking a selective patient history, examination of the patient with implementation of a management plan in relation to 1 or more problems, or an attendance of less than 20 minutes duration involving components of a service to which item 416 applies

Amount under rule 7

416

Professional attendance at other than consulting rooms by a public health physician in the practice of his or her specialty of public health medicine — attendance involving taking a detailed patient history, an examination of multiple systems, arranging any necessary investigations and implementing a management plan in relation to 1 or more problems, and lasting at least 20 minutes, or an attendance of less than 40 minutes duration involving components of a service to which item 417 applies

Amount under rule 7

417

Professional attendance at other than consulting rooms by a public health physician in the practice of his or her specialty of public health medicine — attendance involving taking an exhaustive patient history, a comprehensive examination of multiple systems, arranging any necessary investigations and implementing a management plan in relation to 1 or more complex problems, and lasting at least 40 minutes, or an attendance of at least 40 minutes duration for implementation of a management plan

Amount under rule 7

Group A16 — Attendance by a medical practitioner who is a sports physician in the practice of sports medicine and to which no other item applies

 

Subgroup 1 — Surgery consultations

 

444

Professional attendance at consulting rooms 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

13.10

 

445

Professional attendance at consulting rooms involving taking a selective history, examination of the patient with implementation of a management plan in relation to 1 or more problems, or an attendance of less than 20 minutes duration involving components of a service to which item 446 applies

28.75

 

446

Professional attendance at consulting rooms involving taking a detailed history, an examination of multiple systems, arranging any necessary investigations and implementing a management plan in relation to 1 or more problems, and lasting at least 20 minutes, or an attendance of less than 40 minutes duration involving components of a service to which item 447 applies

54.60

 

447

Professional attendance at consulting rooms involving taking an exhaustive history, a comprehensive examination of multiple systems, arranging any necessary investigations and implementing a management plan in relation to 1 or more complex problems, and lasting at least 40 minutes, or an attendance of at least 40 minutes duration for implementation of a management plan

80.40

 

Subgroup 2 — Emergency attendances — after hours

 

448

Professional attendance at consulting rooms where the attendance is initiated by or on behalf of the patient in the same unbroken after hours period and where the patient’s medical condition requires immediate treatment and where it is necessary for the practitioner to return to, and specially open, consulting rooms for the attendance — each attendance other than an attendance between 11 pm and 7 am, on a public holiday, on a Sunday, before 8 am or after 1 pm on a Saturday, or at any time other than between 8 am and 8 pm on a day not being a Saturday, Sunday or public holiday

91.40

 

449

Professional attendance at consulting rooms where the attendance is initiated by or on behalf of the patient in the same unbroken after hours period and where the patient’s medical condition requires immediate treatment and where it is necessary for the practitioner to return to, and specially open, consulting rooms for the attendance — each attendance on any day of the week between 11 pm and 7 am

109.30

 

Group A11 — Unsociable hours

 

601

Professional attendance, being an attendance at other than consulting rooms, by a general practitioner on not more than 1 patient on the 1 occasion — each attendance on any day of the week between 11 pm and 7 am, where the attendance is initiated by or on behalf of the patient in the same unbroken after-hours period and where the patient’s medical condition requires immediate treatment

109.30

602

Professional attendance, being an attendance at consulting rooms, by a general practitioner on not more than 1 patient on the 1 occasion — each attendance on any day of the week between 11 pm and 7 am, where the attendance is initiated by or on behalf of the patient in the same unbroken after-hours period and where the patient’s medical condition requires immediate treatment and where it is necessary for the doctor to return to, and specially open, consulting rooms for the attendance

109.30

697

Professional attendance, being an attendance at other than consulting rooms, by a medical practitioner, (not being a general practitioner) on not more than 1 patient on the 1 occasion — each attendance on any day of the week between 11 pm and 7 am, where the attendance is initiated by or on behalf of the patient in the same unbroken after-hours period and where the patient’s medical condition requires immediate treatment

94.65

698

Professional attendance, being an attendance at consulting rooms, by a medical practitioner (not being a general practitioner) on not more than 1 patient on the 1 occasion — each attendance on any day of the week between 11 pm and 7 am, where the attendance is initiated by or on behalf of the patient in the same unbroken after-hours period and where the patient’s medical condition requires immediate treatment and where it is necessary for the doctor to return to, and specially open, consulting rooms for the attendance

94.65

Group A14 — Health assessments

 

700

Attendance by a medical practitioner (including a general practitioner, but not including a specialist or consultant physician) at consulting rooms for a health assessment of a patient who is at least 75 years old — not being a health assessment of a patient in respect of whom, in the preceding 12 months, a payment has been made under this item or item 702, 704 or 706

149.90

702

Attendance by a medical practitioner (including a general practitioner, but not including a specialist or consultant physician) not being an attendance at consulting rooms, a hospital or a residential aged care facility, for a health assessment of a patient who is at least 75 years old — not being a health assessment of a patient in respect of whom, in the preceding 12 months, a payment has been made under this item or item 700, 704 or 706

212.00

704

Attendance by a medical practitioner (including a general practitioner, but not including a specialist or consultant physician) at consulting rooms for a health assessment of a patient who is at least 55 years old and of Aboriginal or Torres Strait Islander descent — not being a health assessment of a patient in respect of whom, in the preceding 12 months, a payment has been made under this item or item 700, 702 or 706

149.90

706

Attendance by a medical practitioner (including a general practitioner, but not including a specialist or consultant physician) not being an attendance at consulting rooms, a hospital or a residential aged care facility, for a health assessment of a patient who is at least 55 years old and of Aboriginal or Torres Strait Islander descent — not being a health assessment of a patient in respect of whom, in the preceding 12 months, a payment has been made under this item or item 700, 702 or 704

212.00

Group A15 — Multidisciplinary care plans and multidisciplinary case conferences

 

Subgroup 1 — Multidisciplinary care plans

 

720

Preparation by a medical practitioner (including a general practitioner, but not including a specialist or consultant physician), in consultation with a multidisciplinary care plan team, of a multidisciplinary community care plan for a patient (not being a service associated with a service to which items 734 to 779 apply) — payable not more than once in any 6 month period

192.75

722

Preparation by a medical practitioner (including a general practitioner, but not including a specialist or consultant physician), in consultation with a multidisciplinary care plan team, of a multidisciplinary care plan for a patient (not being a service associated with a service to which items 734 to 779 apply) — payable not more than once for each hospital admission

192.75

724

Attendance by a medical practitioner (including a general practitioner, but not including a specialist or consultant physician), to review a multidisciplinary community care plan or a discharge care plan prepared by that medical practitioner for a patient and claimed for under item 720 or 722 (not being a payment for a service to which items 734 to 779 apply) — payable not more than once in any 3 month period, and not being an attendance in relation to a patient:

   (a)  for whom, in the preceding 3 months, a payment has been made under item 720; or

  (b)  for whom, in the preceding month, a payment has been made under item 722

96.40

726

Attendance by a medical practitioner (including a general practitioner, but not including a specialist or consultant physician), as a member of a multidisciplinary care plan team, to contribute to a multidisciplinary community care plan or to a review of a multidisciplinary community care plan prepared by another provider (not being a payment for a service to which items 734 to 779 apply) — not being an attendance in relation to a patient for whom, in the preceding 6 months, a payment has been made under item 720

38.85

728

Attendance by a medical practitioner (including a general practitioner, but not including a specialist or consultant physician), as a member of a multidisciplinary care plan team, to contribute to a multidisciplinary discharge care plan or to a review of a multidisciplinary discharge care plan prepared by another provider (not being a service associated with a service to which items 722 and 734 to 779 apply)

38.85

730

Attendance by a medical practitioner (including a general practitioner, but not including a specialist or consultant physician), as a member of a multidisciplinary care plan team, to make a contribution to a multidisciplinary care plan in a residential aged care facility or to a review of a multidisciplinary care plan in a residential aged care facility prepared by the residential aged care facility (not being a payment in respect of a service to which items 734 to 779 apply)

38.85

Subgroup 2 — Case conferences

734

Attendance by a medical practitioner (including a general practitioner, but not including a specialist or consultant physician), as a member of a multidisciplinary case conference team, to organise and co-ordinate a multidisciplinary case conference in a residential aged care facility, where the conference time is at least 15 minutes, but less than 30 minutes (not being a service associated with a service to which item 730 applies)

75.00

736

Attendance by a medical practitioner (including a general practitioner, but not including a specialist or consultant physician), as a member of a multidisciplinary case conference team, to organise and co-ordinate a multidisciplinary case conference in a residential aged care facility, where the conference time is at least 30 minutes, but less than 45 minutes (not being a service associated with a service to which item 730 applies)

112.45

738

Attendance by a medical practitioner (including a general practitioner, but not including a specialist or consultant physician), as a member of a multidisciplinary case conference team, to organise and co-ordinate a multidisciplinary case conference in a residential aged care facility, where the conference time is at least 45 minutes, (not being a service associated with a service to which item 730 applies)

149.90

740

Attendance by a medical practitioner (including a general practitioner, but not including a specialist or consultant physician), as a member of a multidisciplinary case conference team, to organise and co-ordinate a community case conference, where the conference time is at least 15 minutes, but less than 30 minutes (not being a service associated with a service to which items 720 to 730 apply)

75.00

742

Attendance by a medical practitioner (including a general practitioner, but not including a specialist or consultant physician), as a member of a multidisciplinary case conference team, to organise and co-ordinate a community case conference, where the conference time is at least 30 minutes, but less than 45 minutes (not being a service associated with a service to which items 720 to 730 apply)

112.45

744

Attendance by a medical practitioner (including a general practitioner, but not including a specialist or consultant physician), as a member of a multidisciplinary case conference team, to organise and co-ordinate a community case conference, where the conference time is at least 45 minutes (not being a service associated with a service to which items 720 to 730 apply)

149.90

746

Attendance by a medical practitioner (including a general practitioner, but not including a specialist or consultant physician), as a member of a multidisciplinary case conference team, to organise and co-ordinate a multidisciplinary discharge case conference, where the conference time is at least 15 minutes, but less than 30 minutes (not being a service associated with a service to which items 720 to 730 apply) — payable not more than once for each hospital admission

75.00

749

Attendance by a medical practitioner (including a general practitioner, but not including a specialist or consultant physician), as a member of a multidisciplinary case conference team, to organise and co-ordinate a multidisciplinary discharge case conference, where the conference time is at least 30 minutes, but less than 45 minutes (not being a service associated with a service to which items 720 to 730 apply) — payable not more than once for each hospital admission

112.45

757

Attendance by a medical practitioner (including a general practitioner, but not including a specialist or consultant physician), as a member of a multidisciplinary case conference team, to organise and co-ordinate a multidisciplinary discharge case conference, where the conference time is at least 45 minutes (not being a service associated with a service to which items 720 to 730 apply) — payable not more than once for each hospital admission

149.90

759

Attendance by a medical practitioner (including a general practitioner, but not including a specialist or consultant physician), as a member of a multidisciplinary case conference team, to participate in a community case conference (other than to organise and co-ordinate the conference), where the conference time is at least 15 minutes, but less than 30 minutes (not being a service associated with a service to which items 720 to 730 apply)

53.50

762

Attendance by a medical practitioner (including a general practitioner, but not including a specialist or consultant physician), as a member of a multidisciplinary case conference team, to participate in a community case conference (other than to organise and co-ordinate the conference), where the conference time is at least 30 minutes, but less than 45 minutes (not being a service associated with a service to which items 720 to 730 apply)

85.65

765

Attendance by a medical practitioner (including a general practitioner, but not including a specialist or consultant physician), as a member of a multidisciplinary case conference team, to participate in a community case conference (other than to organise and co-ordinate the conference), where the conference time is at least 45 minutes (not being a service associated with a service to which items 720 to 730 apply)

117.75

768

Attendance by a medical practitioner (including a general practitioner, but not including a specialist or consultant physician), as a member of a multidisciplinary case conference team, to participate in a multidisciplinary discharge case conference (other than to organise and

co-ordinate the conference), where the conference time is at least 15 minutes, but less than 30 minutes (not being a service associated with a service to which items 720 to 730 apply) — payable not more than once for each hospital admission

53.50

771

Attendance by a medical practitioner (including a general practitioner, but not including a specialist or consultant physician), as a member of a multidisciplinary case conference team, to participate in a multidisciplinary discharge case conference (other than to organise and

co-ordinate the conference), where the conference time is at least 30 minutes, but less than 45 minutes (not being a service associated with a service to which items 720 to 730 apply) — payable not more than once for each hospital admission

85.65

773

Attendance by a medical practitioner (including a general practitioner, but not including a specialist or consultant physician), as a member of a multidisciplinary case conference team, to participate in a multidisciplinary discharge case conference (other than to organise and

co-ordinate the conference), where the conference time is at least 45 minutes, (not being a service associated with a service to which items 720 to 730 apply) — payable not more than once for each hospital admission

117.75

775

Attendance by a medical practitioner (including a general practitioner, but not including a specialist or consultant physician), as a member of a multidisciplinary case conference team, to participate in a multidisciplinary case conference in a residential aged care facility, (other than to organise and co-ordinate the conference), where the conference time is at least 15 minutes, but less than 30 minutes (not being a service associated with a service to which item 730 applies)

53.50

778

Attendance by a medical practitioner (including a general practitioner, but not including a specialist or consultant physician), as a member of a multidisciplinary case conference team, to participate in a multidisciplinary case conference in a residential aged care facility, (other than to organise and co-ordinate the conference), where the conference time is at least 30 minutes, but less than 45 minutes (not being a service associated with a service to which item 730 applies)

85.65

779

Attendance by a medical practitioner (including a general practitioner, but not including a specialist or consultant physician), as a member of a multidisciplinary case conference team, to participate in a multidisciplinary case conference in a residential aged care facility, (other than to organise and co-ordinate the conference), where the conference time is at least 45 minutes, (not being a service associated with a service to which item 730 applies)

117.75

801

Attendance by a consultant physician in the practice of his or her specialty, as a member of a case conference team, to organise and coordinate a community case conference of at least 30 minutes but less than 60 minutes, with a multidisciplinary team of at least 3 other formal care providers of different disciplines

185.95

803

Attendance by a consultant physician in the practice of his or her specialty, as a member of a case conference team, to organise and coordinate a community case conference of more than 60 minutes, with a multidisciplinary team of at least 3 other formal care providers of different disciplines

247.90

805

Attendance by a consultant physician in the practice of his or her specialty, as a member of a case conference team, to participate in a community case conference (other than to organise and to coordinate the conference) of at least 30 minutes but less than 60 minutes, with a multidisciplinary team of at least 3 other formal care providers of different disciplines

154.45

807

Attendance by a consultant physician in the practice of his or her specialty, as a member of a case conference team, to participate in a community case conference (other than to organise and to coordinate the conference) of more than 60 minutes, with a multidisciplinary team of at least 3 other formal care providers of different disciplines

205.85

809

Attendance by a consultant physician in the practice of his or her specialty, as a member of a case conference team, to organise and coordinate a discharge case conference of at least 30 minutes but less than 60 minutes, with a multidisciplinary team of at least 3 other formal care providers of different disciplines

185.95

811

Attendance by a consultant physician in the practice of his or her specialty, as a member of a case conference team, to organise and coordinate a discharge case conference of more than 60 minutes, with a multidisciplinary team of at least 3 other formal care providers of different disciplines

247.90

813

Attendance by a consultant physician in the practice of his or her specialty, as a member of a case conference team, to participate in a discharge case conference of at least 30 minutes but less than 60 minutes, with a multidisciplinary team of at least 3 other formal care providers of different disciplines

154.45

815

Attendance by a consultant physician in the practice of his or her specialty, as a member of a case conference team, to participate in a discharge case conference of more than 60 minutes, with a multidisciplinary team of at least 3 other formal care providers of different disciplines

205.85

Group A17 — Domiciliary medication management review

 

900

Participation by a medical practitioner (including a general practitioner, but not including a specialist or consultant physician) in a Domiciliary Medication Management Review (DMMR) for patients living in a community setting, where the medical practitioner:

   (a)  assesses a patient’s medication management needs and, following that assessment, refers the patient to a community pharmacy for a DMMR and, with the patient’s consent, provides relevant clinical information required for the review; and

  (b)  discusses with the reviewing pharmacist the results of that review including suggested medication management strategies; and

   (c)  develops a written medication management plan following discussion with the patient.

For any particular patient — applicable not more than once in each 12 month period, except where there has been a significant change in the patient’s condition or medication regimen requiring a new DMMR

120.00

Group A18 — General practitioner attendance associated with Practice Incentive Payments (PIP)

 

Subgroup 1 — Taking of a cervical smear from an unscreened or significantly underscreened woman

 

2501

Professional attendance at consulting rooms by a general practitioner:

   (a)  involving taking a selective history, examination of the patient with the implementation of a management plan in relation to 1 or more problems; or

  (b)  being attendance of less than 20 minutes duration involving components of a service to which item 2504 or 2507 applies;

at which a cervical smear is taken from a woman between the ages of 20 and 69 (inclusive), who has not had a cervical smear in the last 4 years

28.75

 

2503

Professional attendance at a place other than consulting rooms by a general practitioner:

   (a)  involving taking a selective history, examination of the patient with the implementation of a management plan in relation to 1 or more problems; or

  (b)  being attendance of less than 20 minutes duration involving components of a service to which item 2504 or 2507 applies;

at which a cervical smear is taken from a woman between the ages of 20 and 69 (inclusive), who has not had a cervical smear in the last 4 years

Amount under rule 55

 

2504

Professional attendance at consulting rooms by a general practitioner:

   (a)  involving taking a detailed history, an examination of multiple systems, arranging any necessary investigations and implementing a management plan in relation to 1 or more problems and lasting at least 20 minutes; or

  (b)  being attendance of less than 40 minutes duration involving components of a service to which item 2507 applies;

at which a cervical smear is taken from a woman between the ages of 20 and 69 (inclusive), who has not had a cervical smear in the last 4 years

54.60

 

2506

Professional attendance at a place other than consulting rooms by a general practitioner:

   (a)  involving taking a detailed history, an examination of multiple systems, arranging any necessary investigations and implementing a management plan in relation to 1 or more problems and lasting at least 20 minutes; or

  (b)  being attendance of less than 40 minutes duration involving components of a service to which item 2507 applies;

at which a cervical smear is taken from a woman between the ages of 20 and 69 (inclusive), who has not had a cervical smear in the last 4 years

Amount under rule 55

 

2507

Professional attendance at consulting rooms by a general practitioner:

   (a)  involving taking an exhaustive history, a comprehensive examination of multiple systems, arranging any necessary investigations and implementing a management plan in relation to 1 or more complex problems and lasting at least 40 minutes; or

  (b)  being attendance of at least 40 minutes duration for implementation of a management plan;

at which a cervical smear is taken from a woman between the ages of 20 and 69 (inclusive), who has not had a cervical smear in the last 4 years

80.40

 

2509

Professional attendance at a place other than consulting rooms by a general practitioner involving:

   (a)  taking an exhaustive history, a comprehensive examination of multiple systems, arranging any necessary investigations and implementing a management plan in relation to 1 or more complex problems and lasting at least 40 minutes; or

  (b)  being attendance of at least 40 minutes duration for implementation of a management plan;

at which a cervical smear is taken from a woman between the ages of 20 and 69 (inclusive), who has not had a cervical smear in the last 4 years

Amount under rule 55

 

Subgroup 2 — Completion of an annual cycle of care for patients with established diabetes mellitus

 

2517

Professional attendance at consulting rooms by a general practitioner:

   (a)  involving taking a selective history, examination of the patient with the implementation of a  management plan in relation to 1 or more problems; or

  (b)  being attendance of less than 20 minutes duration involving components of a service to which item 2521 or 2525 applies;

which completes the requirements for an annual cycle of care of a patient with established diabetes mellitus

28.75

 

2518

Professional attendance at a place other than consulting rooms by a general practitioner:

   (a)  involving taking a selective history, examination of the patient with the implementation of a management plan in relation to 1 or more problems; or

  (b)  being attendance of less than 20 minutes duration involving components of a service to which item 2521 or 2525 applies;

which completes the requirements for an annual cycle of care of a patient with established diabetes mellitus

Amount under rule 55

 

2521

Professional attendance at consulting rooms by a general practitioner:

   (a)  involving taking a detailed history, an examination of multiple systems, arranging any necessary investigations and implementing a management plan in relation to 1 or more problems and lasting at least 20 minutes; or

  (b)  being attendance of less than 40 minutes duration involving components of a service to which item 2525 applies;

which completes the requirements for an annual cycle of care of a patient with established diabetes mellitus

54.60

 

2522

Professional attendance at a place other than consulting rooms by a general practitioner:

   (a)  involving taking a detailed history, an examination of multiple systems, arranging any necessary investigations and implementing a management plan in relation to 1 or more problems and lasting at least 20 minutes; or

  (b)  being attendance of less than 40 minutes duration involving components of a service to which item 2525 applies;

which completes the requirements for an annual cycle of care of a patient with established diabetes mellitus

Amount under rule 55

 

2525

Professional attendance at consulting rooms by a general practitioner:

   (a)  involving taking an exhaustive history, a comprehensive examination of multiple systems, arranging any necessary investigations and implementing a management plan in relation to 1 or more complex problems and lasting at least 40 minutes; or

  (b)  being attendance of at least 40 minutes duration for implementation of a management plan;

which completes the requirements for an annual cycle of care of a patient with established diabetes mellitus

80.40

 

2526

Professional attendance at a place other than consulting rooms by a general practitioner:

   (a)  involving taking an exhaustive history, a comprehensive examination of multiple systems, arranging any necessary investigations and implementing a management plan in relation to 1 or more complex problems and lasting at least 40 minutes; or

  (b)  being attendance of at least 40 minutes duration for implementation of a management plan;

which completes the requirements for an annual cycle of care of a patient with established diabetes mellitus

Amount under rule 55

 

Subgroup 3 — Completion Of The Asthma 3+ Visit Plan

 

2546

Professional attendance at conducting rooms by a general practitioner:

   (a)  involving taking a selective history, examination of the patient with the implementation of a management plan in relation to 1 or more problems; or

  (b)  being attendance of less than 20 minutes duration involving components of a service to which item 2552 or 2558 applies;

which completes the requirements of the Asthma 3+ Visit plan

28.75

 

2547

Professional attendance at a place other than conducting rooms by a general practitioner:

   (a)  involving taking a selective history, examination of the patient with the implementation of a management plan in relation to 1 or more problems; or

  (b)  being attendance of less than 20 minutes duration involving components of a service to which item 2552 or 2558 applies;

which completes the requirements of the Asthma 3+ Visit plan

Amount under rule 55

 

2552

Professional attendance at conducting rooms by a general practitioner:

   (a)  involving taking a detailed history, an examination of multiple systems, arranging any necessary investigations and implementing a management plan in relation to 1 or more problems and lasting at least 20 minutes; or

  (b)  being attendance of less than 40 minutes duration involving components of a service to which item 2558 applies;

which completes the requirements of the Asthma 3+ Visit Plan

54.60

 

2553

Professional attendance at a place other than conducting rooms by a general practitioner:

   (a)  involving taking a detailed history, an examination of multiple systems, arranging any necessary investigations and implementing a management plan in relation to 1 or more problems and lasting at least 20 minutes; or

  (b)  being attendance of less than 40 minutes duration involving components of a service to which item 2558 applies;

which completes the requirements of the Asthma 3+ Visit Plan

Amount under rule 55

 

2558

Professional attendance at conducting rooms by a general practitioner:

   (a)  involving taking an exhaustive history, a comprehensive examination of multiple systems, arranging any necessary investigations and implementing a management plan in relation to 1 or more complex problems and lasting at least 40 minutes; or

  (b)  being attendance of at least 40 minutes duration for implementation of a management plan;

which completes the requirements of the Asthma 3+ Visit Plan

80.40

 

2559

Professional attendance at a place other than conducting rooms by a general practitioner:

   (a)  involving taking an exhaustive history, a comprehensive examination of multiple systems, arranging any necessary investigations and implementing a management plan in relation to 1 or more complex problems and lasting at least 40 minutes; or

  (b)  being attendance of at least 40 minutes duration for implementation of a management plan;

which completes the requirements of the Asthma 3+ Visit Plan

Amount under rule 55

 

Group A19 — Other non-referred attendances associated with Practice Incentive Payments (PIP) to which no other item applies

 

Subgroup 1 — Taking of a cervical smear from an unscreened or significantly underscreened woman

 

2600

Professional attendance at consulting rooms of more than 5 minutes but not more than 25 minutes duration by a general practitioner, and at which a cervical smear is taken from a woman between the ages of 20 and 69 (inclusive) who has not had a cervical smear in the last 4 years

21.00

 

2603

Professional attendance at consulting rooms of more than 25 minutes but not more than 45 minutes duration by a general practitioner, and at which a cervical smear is taken from a woman between the ages of 20 and 69 (inclusive) who has not had a cervical smear in the last 4 years

38.00

 

2606

Professional attendance at consulting rooms of more than 45 minutes duration, and at which a cervical smear is taken from a woman between the ages of 20 and 69 (inclusive) who has not had a cervical smear in the last 4 years

61.00

 

2610

Professional attendance at a place other than consulting rooms of more than 5 minutes but not more than 25 minutes duration by a general practitioner, and at which a cervical smear is taken from a woman between the ages of 20 and 69 (inclusive) who has not had a cervical smear in the last 4 years

Amount under rule 7

 

2613

Professional attendance at a place other than consulting rooms of more than 25 minutes but not more than 45 minutes duration by a general practitioner, and at which a cervical smear is taken from a woman between the ages of 20 and 69 (inclusive) who has not had a cervical smear in the last 4 years

Amount under rule 7

 

2616

Professional attendance at a place other than consulting rooms of more than 45 minutes duration by a general practitioner, and at which a cervical smear is taken from a woman between the ages of 20 and 69 (inclusive) who has not had a cervical smear in the last 4 years

Amount under rule 7

 

Subgroup 2 — Completion of an annual cycle of care for patients with established diabetes mellitus

 

2620

Professional attendance at consulting rooms of more than 5 minutes but not more than 25 minutes duration by a general practitioner, and which completes the requirements for an annual cycle of care of a patient with established diabetes mellitus

21.00

 

2622

Professional attendance at consulting rooms of more than 25 minutes but not more than 45 minutes duration by a general practitioner, and which completes the requirements for an annual cycle of care of a patient with established diabetes mellitus

38.00

 

2624

Professional attendance at consulting rooms of more than 45 minutes duration by a general practitioner, and which completes the requirements for an annual cycle of care of a patient with established diabetes mellitus

61.00

 

2631

Professional attendance at a place other than consulting rooms of more than 5 minutes but not more than 25 minutes duration by a general practitioner, and which completes the requirements for an annual cycle of care of a patient with established diabetes mellitus

Amount under rule 7

 

2633

Professional attendance at a place other than consulting rooms of more than 25 minutes but not more than 45 minutes duration by a general practitioner, and which completes the requirements for an annual cycle of care of a patient with established diabetes mellitus

Amount under rule 7

 

2635

Professional attendance at a place other than consulting rooms of more than 45 minutes duration by a general practitioner, and which completes the requirements for an annual cycle of care of a patient with established diabetes mellitus

Amount under rule 7

 

Subgroup 3 — Completion of the Asthma 3+ Visit Plan

 

2664

Professional attendance at consulting rooms of more than 5 minutes but not more than 25 minutes duration by a general practitioner, and which completes the requirements of the Asthma 3+ Visit Plan

21.00

 

2666

Professional attendance at consulting rooms of more than 25 minutes but not more than 45 minutes duration by a general practitioner, and which completes the requirements of the Asthma 3+ Visit Plan

38.00

 

2668

Professional attendance at consulting rooms of more than 45 minutes duration by a general practitioner, and which completes the requirements of the Asthma 3+ Visit Plan

61.00

 

2673

Professional attendance at a place other than consulting rooms of more than 5 minutes but not more than 25 minutes duration by a general practitioner, and which completes the requirements of the Asthma 3+ Visit Plan

Amount under rule 7

 

2675

Professional attendance at a place other than consulting rooms of more than 25 minutes but not more than 45 minutes duration by a general practitioner, and which completes the requirements of the Asthma 3+ Visit Plan

Amount under rule 7

 

2677

Professional attendance at a place other than consulting rooms of more than 45 minutes duration by a general practitioner, and which completes the requirements of the Asthma 3+ Visit Plan

Amount under rule 7

 

Group A9 — Contact lenses

 

10801

Attendance for the investigation and evaluation of a patient for the fitting of contact lenses, with keratometry and testing with trial lenses and the issue of a prescription — 1 service in any period of 36 months — patients with myopia of 5.0 dioptres or greater (spherical equivalent) in 1 eye

96.30

10802

Attendance for the investigation and evaluation of a patient for the fitting of contact lenses, with keratometry and testing with trial lenses and the issue of a prescription — 1 service in any period of 36 months — patients with manifest hyperopia of 5.0 dioptres or greater (spherical equivalent) in 1 eye

96.30

10803

Attendance for the investigation and evaluation of a patient for the fitting of contact lenses, with keratometry and testing with trial lenses and the issue of a prescription — 1 service in any period of 36 months — patients with astigmatism of 3.0 dioptres or greater in 1 eye

96.30

10804

Attendance for the investigation and evaluation of a patient for the fitting of contact lenses, with keratometry and testing with trial lenses and the issue of a prescription — 1 service in any period of 36 months — patients with irregular astigmatism in either eye, being a condition the existence of which has been confirmed by keratometric observation, if the maximum visual acuity obtainable with spectacle correction is worse than 0.3 logMAR (6/12) and if that corrected acuity would be improved by an additional 0.1 logMAR by the use of a contact lens

96.30

10805

Attendance for the investigation and evaluation of a patient for the fitting of contact lenses, with keratometry and testing with trial lenses and the issue of a prescription — 1 service in any period of 36 months — patients with anisometropia of 3.0 dioptres or greater (difference between spherical equivalents)

96.30

10806

Attendance for the investigation and evaluation of a patient for the fitting of contact lenses, with keratometry and testing with trial lenses and the issue of a prescription — 1 service in any period of 36 months — patients with corrected visual acuity of 0.7 logMAR (6/30) or worse in both eyes, being patients for whom a contact lens is prescribed as part of a telescopic system

96.30

10807

Attendance for the investigation and evaluation of a patient for the fitting of contact lenses, with keratometry and testing with trial lenses and the issue of a prescription — 1 service in any period of 36 months — patients for whom a wholly or segmentally opaque contact lens is prescribed for the alleviation of dazzle, distortion or diplopia caused by pathological mydriasis, aniridia, coloboma of the iris, pupillary malformation or distortion, significant ocular deformity or corneal opacity — whether congenital, traumatic or surgical in origin

96.30

10808

Attendance for the investigation and evaluation of a patient for the fitting of contact lenses, with keratometry and testing with trial lenses and the issue of a prescription — 1 service in any period of 36 months — patients who, by reason of physical deformity, are unable to wear spectacles

96.30

10809

Attendance for the investigation and evaluation of a patient for the fitting of contact lenses, with keratometry and testing with trial lenses and the issue of a prescription — 1 service in any period of 36 months — patients who have a medical or optical condition (other than myopia, hyperopia, astigmatism, anisometropia or a condition to which item 10806, 10807 or 10808 applies) requiring the use of a contact lens for correction, where the condition is specified on the patient’s account

96.30

10816

Attendance for the refitting of contact lenses with keratometry and testing with trial lenses and the issue of a prescription, where the patient requires a change in contact lens material or basic lens parameters, other than simple power change, because of a structural or functional change in the eye or an allergic response within 36 months of the fitting of a contact lens to which items 10801 to 10809 apply

96.30

Group A10 — Optometric consultations

 

10900

Professional attendance of more than 15 minutes duration, being the first in a course of attention — not payable within 24 months of an attendance to which item 10900, 10905, 10907, 10912, 10913 or 10914 applied

56.15

10905

Professional attendance of more than 15 minutes duration, being the first in a course of attention, where the patient has been referred by another optometrist who is not associated with the optometrist to whom the patient is referred

56.15

10907

Professional attendance of more than 15 minutes duration being the first in a course of attention where the patient has attended another optometrist within the previous 24 months for an attendance to which item 10900, 10905, 10907, 10912, 10913 or 10914 applied. The appropriate fee for the purpose of paragraph 23A (2) (c) of the Health Insurance Act 1973 is $54.85

28.15

10912

Professional attendance of more than 15 minutes duration, being the first in a course of attention, where the patient has suffered a significant change of visual function requiring comprehensive reassessment within 24 months of initial consultation to which item 10900, 10905, 10907, 10912, 10913 or 10914 at the same practice applied

56.15

10913

Professional attendance of more than 15 minutes duration, being the first in a course of attention, where the patient has new signs or symptoms, unrelated to the earlier course of attention, requiring comprehensive reassessment within 24 months of initial consultation to which item 10900, 10905, 10907, 10912, 10913 or 10914 at the same practice applied

56.15

10914

Professional attendance of more than 15 minutes duration, being the first in a course of attention, where the patient has a progressive disorder (excluding presbyopia) requiring comprehensive reassessment within 24 months of initial consultation to which item 10900, 10905, 10907, 10912, 10913 or 10914 applied

56.15

10916

Professional attendance, being the first in a course of attention, of not more than 15 minutes duration

28.15

10918

Professional attendance being the second or subsequent in a course of attention not related to the prescription and fitting of contact lenses

28.15

10921

All professional attendances after the first, being those attendances regarded as a single service, in a single course of attention involving the prescription and fitting of contact lenses, being a course of attention in respect of which the first attendance is a service to which item 10900, 10905, 10907, 10912, 10913, 10914 or 10916 applies — payable only once in a period of 36 months — patients with myopia of 5.0 dioptres or greater (spherical equivalent) in 1 eye

139.35

10922

All professional attendances after the first, being those attendances regarded as a single service, in a single course of attention involving the prescription and fitting of contact lenses, being a course of attention in respect of which the first attendance is a service to which item 10900, 10905, 10907, 10912, 10913, 10914 or 10916 applies — payable only once in a period of 36 months — patients with manifest hyperopia of 5.0 dioptres or greater (spherical equivalent) in 1 eye

139.35

10923

All professional attendances after the first, being those attendances regarded as a single service, in a single course of attention involving the prescription and fitting of contact lenses, being a course of attention in respect of which the first attendance is a service to which item 10900, 10905, 10907, 10912, 10913, 10914 or 10916 applies — payable only once in a period of 36 months — patients with astigmatism of 3.0 dioptres or greater in 1 eye

139.35

10924

All professional attendances after the first, being those attendances regarded as a single service, in a single course of attention involving the prescription and fitting of contact lenses, being a course of attention in respect of which the first attendance is a service to which item 10900, 10905, 10907, 10912, 10913, 10914 or 10916 applies — payable only once in a period of 36 months — patients with irregular astigmatism in either eye, being a condition the existence of which has been confirmed by keratometric observation, if the maximum visual acuity obtainable with spectacle correction is worse than 0.3 logMAR (6/12) and if that corrected acuity would be improved by an additional 0.1 logMAR by the use of a contact lens

175.85

10925

All professional attendances after the first, being those attendances regarded as a single service, in a single course of attention involving the prescription and fitting of contact lenses, being a course of attention in respect of which the first attendance is a service to which item 10900, 10905, 10907, 10912, 10913, 10914 or 10916 applies — payable only once in a period of 36 months — patients with anisometropia of 3.0 dioptres or greater (difference between spherical equivalents)

139.35

10926

All professional attendances after the first, being those attendances regarded as a single service, in a single course of attention involving the prescription and fitting of contact lenses, being a course of attention in respect of which the first attendance is a service to which item 10900, 10905, 10907, 10912, 10913, 10914 or 10916 applies — payable only once in a period of 36 months — patients with corrected visual acuity of 0.7 logMAR (6/30) or worse in both eyes, being patients for whom a contact lens is prescribed as part of a telescopic system

139.35

10927

All professional attendances after the first, being those attendances regarded as a single service, in a single course of attention involving the prescription and fitting of contact lenses, being a course of attention in respect of which the first attendance is a service to which item 10900, 10905, 10907, 10912, 10913, 10914 or 10916 applies — payable only once in a period of 36 months — patients for whom a wholly or segmentally opaque contact lens is prescribed for the alleviation of dazzle, distortion or diplopia caused by pathological mydriasis, aniridia, coloboma of the iris, pupillary malformation or distortion, significant ocular deformity or corneal opacity — whether congenital, traumatic or surgical in origin

175.85

10928

All professional attendances after the first, being those attendances regarded as a single service, in a single course of attention involving the prescription and fitting of contact lenses, being a course of attention in respect of which the first attendance is a service to which item 10900, 10905, 10907, 10912, 10913, 10914 or 10916 applies — payable only once in a period of 36 months — patients who, by reason of physical deformity, are unable to wear spectacles

139.35

10929

All professional attendances after the first, being those attendances regarded as a single service, in a single course of attention involving the prescription and fitting of contact lenses, being a course of attention in respect of which the first attendance is a service to which item 10900, 10905, 10907, 10912, 10913, 10914 or 10916 applies — payable only once in a period of 36 months — patients who have a medical or optical condition (other than myopia, hyperopia, astigmatism, anisometropia or a condition to which item 10926, 10927 or 10928 applies) requiring the use of a contact lens for correction, where the condition is specified on the patient’s account

175.85

10930

All professional attendances regarded as a single service in a single course of attention involving the prescription and fitting of contact lenses where the patient meets the requirements of an item in the series 10921 to 10929 and requires a change in contact lens material or basic lens parameters, other than a simple power change, because of a structural or functional change in the eye or an allergic response within 36 months of the fitting of a contact lens covered by items 10921 to 10929

139.35

Diagnostic procedures and investigations

Group D1 — Miscellaneous diagnostic procedures and investigations

Subgroup 1 — Neurology

 

11000

Electroencephalography, not being a service:

   (a)  associated with a service to which item 11003, 11006 or 11009 applies; or

  (b)  involving quantitative topographic mapping using neurometrics or similar devices (Anaes.)

97.35

11003

Electroencephalography, prolonged recording of at least 3 hours duration, not being a service:

   (a)  associated with a service to which item 11000, 11006 or 11009 applies; or

  (b)  involving quantitative topographic mapping using neurometrics or similar devices

257.65

11006

Electroencephalography, temporosphenoidal, not being a service involving quantitative topographic mapping using neurometrics or similar devices

132.10

11009

Electrocorticography

180.15

11012

Neuromuscular electrodiagnosis — conduction studies on 1 nerve or electromyography of 1 or more muscles using concentric needle electrodes or both these examinations (not being a service associated with a service to which item 11015 or 11018 applies)

88.55

11015

Neuromuscular electrodiagnosis — conduction studies on 2 or 3 nerves with or without electromyography (not being a service associated with a service to which item 11012 or 11018 applies)

118.60

11018

Neuromuscular electrodiagnosis — conduction studies on 4 or more nerves with or without electromyography or recordings from single fibres of nerves and muscles or both of these examinations (not being a service associated with a service to which item 11012 or 11015 applies)

177.15

11021

Neuromuscular electrodiagnosis — repetitive stimulation for study of neuromuscular conduction or electromyography with quantitative computerised analysis or both of these examinations

118.60

11024

Central nervous system evoked responses, investigation of, by computerised averaging techniques, not being a service involving quantitative topographic mapping of event — related potentials — 1 or 2 studies

90.10

11027

Central nervous system evoked responses, investigation of, by computerised averaging techniques, not being a service involving quantitative topographic mapping of event — related potentials — 3 or more studies

133.60

Subgroup 2 — Ophthalmology

 

11200

Provocative test or tests for glaucoma, including water drinking

32.25

11203

Tonography — in the investigation or management of glaucoma, of one or both eyes — using an electrical tonography machine producing a directly recorded tracing

54.55

11204

Electroretinography of 1 or both eyes by computerised averaging techniques, including 3 or more studies performed according to current professional guidelines or standards

85.60

11205

Electrooculography of 1 or both eyes performed according to current professional guidelines or standards

85.60

11210

Pattern electroretinography of 1 or both eyes by computerised averaging techniques, including 3 or more studies performed according to current professional guidelines or standards

85.60

11211

Dark adaptometry of 1 or both eyes with a quantitative estimation of threshold in log lumens at 45 minutes of dark adaptations

85.60

11212

Optic fundi, examination of following intravenous dye injection

55.50

11215

Retinal photography, multiple exposures, of 1 eye with intravenous dye injection

97.25

11218

Retinal photography, multiple exposures of both eyes with intravenous dye injection

120.15

11221

Full quantitative computerised perimetry — (automated absolute static threshold) performed by or on behalf of a specialist in the practice of his or her specialty, where indicated by the presence of relevant ocular disease or suspected pathology of the visual pathways or brain with assessment and report, bilateral — to a maximum of 2 examinations (including examinations to which item 11224 applies) in any 12 month period

53.60

11222

Full quantitative computerised perimetry (automated absolute static threshold), performed by or on behalf of a specialist in the practice of his or her specialty, with assessment and report, bilateral, where it can be demonstrated that a further examination is indicated in the same 12 month period to which item 11221 applies due to presence of 1 of the following conditions:

   (a)  established glaucoma (where surgery is being considered) where there has been definite progression of damage over a 12 month period;

53.60

 

  (b)  established neurologic disease (whether or not progressive);

   (c)  for the monitoring of systemic drug toxicity, where there is also other disease such as glaucoma or neurologic disease;

each additional examination

 

11224

Full quantitative computerised perimetry — (automated absolute static threshold) performed by or on behalf of a specialist in the practice of his or her specialty, where indicated by the presence of relevant ocular disease or suspected pathology of the visual pathways or brain with assessment and report, unilateral — to a maximum of 2 examinations (including examinations to which item 11221 applies) in any 12 month period

32.30

11225

Full quantitative computerised perimetry — (automated absolute static threshold), performed by or on behalf of a specialist in the practice of his or her specialty, with assessment and report, unilateral, where it can be demonstrated that a further examination is indicated in the same 12 month period to which item 11224 applies due to presence of 1 of the following conditions:

   (a)  established glaucoma (where surgery is being considered) where there has been definite progression of damage over a 12 month period;

  (b)  established neurologic disease (whether or not progressive);

   (c)  for the monitoring of systemic drug toxicity, where there is also other disease such as glaucoma or neurologic disease;

each additional examination

32.30

11235

Examination of the eye by impression cytology of cornea for the investigation of ocular surface dysplasia, including the collection of cells, processing and all cytological examinations and preparation of report

97.00

11240

Orbital contents, ultrasonic echography of, for 1 eye, not being a service associated with a service to which items in Group I1 apply

64.40

11241

Orbital contents, ultrasonic echography of, for both eyes, not being a service associated with a service to which items in Group I1 apply

82.00

11242

Orbital contents, ultrasonic echography of, for the measurement of an eye previously measured and on which lens surgery has been performed, and where further lens surgery is contemplated in that eye, not being a service associated with a service to which items in Group I1 apply

63.40

11243

Orbital contents, ultrasonic echography of, for the measurement of a second eye if:

   (a)  surgery for the first eye has resulted in more than 1 dioptre of error; or

  (b)  more than 3 years have elapsed since the surgery for the first eye;

not being a service associated with a service to which items in Group I1 apply

63.40

Subgroup 3 — Otolaryngology

 

11300

Brain stem evoked response audiometry (Anaes.)

152.25

11303

Electrocochleography, extratympanic method, 1 or both ears

152.25

11304

Electrocochleography, transtympanic membrane insertion technique, 1 or both ears

250.70

11306

Non-determinate audiometry

17.35

11309

Audiogram, air conduction

20.80

11312

Audiogram, air and bone conduction or air conduction and speech discrimination

29.35

11315

Audiogram, air and bone conduction and speech

38.95

11318

Audiogram, air and bone conduction and speech, with other cochlear tests

48.00

11321

Glycerol induced cochlear function changes assessed by a minimum of 4 air conduction and speech discrimination tests (Klockoff’s test)

91.25

11324

Impedance audiogram involving tympanometry and measurement of static compliance and acoustic reflex performed by, or on behalf of, a specialist in the practice of his or her specialty, where the patient is referred by a medical practitioner — not being a service associated with a service to which item 11309, 11312, 11315 or 11318 applies

26.00

11327

Impedance audiogram involving tympanometry and measurement of static compliance and acoustic reflex performed by, or on behalf of, a specialist in the practice of his or her specialty, where the patient is referred by a medical practitioner — being a service associated with a service to which item 11309, 11312, 11315 or 11318 applies

15.60

11330

Impedance audiogram where the patient is not referred by a medical practitioner — 1 examination in any 4 week period

6.25

11332

Oto-acoustic emission audiometry for the detection of permanent congenital hearing impairment, performed by or on behalf of a specialist or consultant physician, on an infant or child who is at risk due to 1 or more of the following factors:

   (a)  admission to a neonatal intensive care unit;

  (b)  family history of hearing impairment;

   (c)  intra-uterine or perinatal infection (either suspected or confirmed);

  (d)  birthweight less than 1.5 kg;

   (e)  craniofacial deformity;

   (f)  birth asphyxia;

   (g)  chromosomal abnormality, including Down’s Syndrome;

  (h)  exchange transfusion;

where:

   (i)  the patient is referred by another medical practitioner; and

   (j)  middle ear pathology has been excluded by specialist opinion

46.30

11333

Caloric test of labyrinth or labyrinths

35.25

11336

Simultaneous bithermal caloric test of labyrinths

35.25

11339

Electronystagmography

35.25

Subgroup 4 — Respiratory

 

11500

Bronchospirometry, including gas analysis

132.10

11503

Measurement of the mechanical or gas exchange function of the respiratory system, or of respiratory muscle function, or of ventilatory control mechanisms, using measurements of various parameters including pressures, volumes, flow, gas concentrations in inspired or expired air, alveolar gas or blood, electrical activity of muscles (the tests being performed under the supervision of a specialist or consultant physician or in the respiratory laboratory of a hospital) — each occasion at which 1 or more such tests are performed

109.70

11506

Measurement of respiratory function involving a permanently recorded tracing performed before and after inhalation of bronchodilator — each occasion at which 1 or more such tests are performed

16.25

11509

Measurement of respiratory function involving a permanently recorded tracing and written report, performed before and after inhalation of bronchodilator, with continuous technician attendance in a laboratory equipped to perform complex respiratory function tests (the tests being performed under the supervision of a specialist or consultant physician or in the respiratory laboratory of a hospital) — each occasion at which 1 or more such tests are performed

28.25

11512

Continuous measurement of the relationship between flow and volume during expiration or inspiration involving a permanently recorded tracing and written report, performed before and after inhalation of bronchodilator, with continuous technician attendance in a laboratory equipped to perform complex lung function tests (the tests being performed under the supervision of a specialist or consultant physician or in the respiratory laboratory of a hospital) — each occasion at which 1 or more such tests are performed

48.85

Subgroup 5 — Vascular

 

11600

Blood pressure monitoring (central venous, pulmonary arterial, systemic arterial or cardiac intracavity), by indwelling catheter — each day of monitoring for each type of pressure up to a maximum of 4 pressures (not being a service to which item 13876 applies) (Anaes.)

54.80

11601

Blood pressure monitoring (central venous, pulmonary arterial, systemic arterial or cardiac intracavity), by indwelling catheter — for each type of pressure up to a maximum of 4 pressures (not being a service to which item 13876 applies) performed in association with the administration of an anaesthetic relating to another discrete operation on the same day (Anaes.)

54.80

11603

Examination of peripheral vessels at rest (unilateral or bilateral) excluding the cavernosal artery and dorsal artery of the penis, with hard copy recordings of wave forms, involving 1 of the following techniques:

   (a)  Doppler recordings (pulsed, continuous wave, or both) of blood flow velocity with or without pulse volume recordings;

  (b)  Doppler recordings involving real time fast fourier transform analysis;

   (c)  venous occlusion plethysmography;

  (d)  strain-gauge plethysmography;

   (e)  impedance plethysmography;

   (f)  photo plethysmography;

(not being a service to which item 11612 or 11615 applies) — 1 examination and report

40.90

11606

2 examinations of the kind referred to in item 11603 and report (not being a service associated with a service to which item 11612 or 11615 applies)

57.95

11609

3 or more examinations of the kind referred to in item 11603 and report (not being a service to which item 11612 or 11615 applies)

75.20

11612

Examination of peripheral vessels and report, involving any of the techniques referred to in item 11603, with hard copy recording of wave forms before measured exercise using a treadmill or bicycle ergometer, and measurement of pressure after exercise for 10 minutes or until pressure is normal (unilateral or bilateral)

75.20

11615

Measurement of digital temperature, 1 or more digits, (unilateral or bilateral) and report, with hard copy recording of temperature before and for 10 minutes or more after cold stress testing

60.00

11618

Examination of carotid or vertebral vessels, or both (unilateral or bilateral) with hard copy recordings of wave forms, involving 1 of the following techniques:

   (a)  Doppler real time fast fourier transform analysis;

  (b)  oculoplethysmography, phonoangiography or both;

   (c)  periorbital Doppler examination;

(not being a service associated with a service to which item 55274, 55288 or 55290 applies) — 1 examination and report

53.35

11621

2 examinations of the kind referred to in item 11618, and report (not being a service associated with a service to which item 55274, 55288 or 55290 applies)

80.35

11624

3 examinations of the kind referred to in item 11618, and report (not being a service associated with a service to which item 55274, 55288 or 55290 applies)

106.75

11627

Pulmonary artery pressure monitoring during open heart surgery, in a person under 12 years of age

180.85

Subgroup 6 — Cardiovascular

 

11700

Twelve-lead electrocardiography, tracing and report

24.70

11701

Twelve-lead electrocardiography, report only where the tracing has been forwarded to another medical practitioner, not in association with a consultation on the same occasion

12.35

11702

Twelve-lead electrocardiography, tracing only

12.35

11706

Phonocardiography with electrocardiograph lead with indirect arterial or venous pulse tracing, with or without apex cardiogram — interpretation and report

57.00

11708

Continuous ECG recording of ambulatory patient for 12 or more hours (including resting ECG and the recording of parameters), not in association with ambulatory blood pressure monitoring, involving microprocessor based analysis equipment, interpretation and report of recordings by a specialist physician or consultant physician, not being a service to which item 11709 applies

101.15

11709

Continuous ECG recording (Holter) of ambulatory patient for 12 or more hours (including resting ECG and the recording of parameters), not in association with ambulatory blood pressure monitoring, utilising a system capable of superimposition and full disclosure printout of at least 12 hours of recorded ECG data, microprocessor based scanning analysis, with interpretation and report by a specialist physician or consultant physician

132.50

11710

Ambulatory ECG monitoring, patient activated, single or multiple event recording, utilising a looping memory recording device which is connected continuously to the patient for 12 hours or more and is capable of recording for at least 20 seconds prior to each activation and for 15 seconds after each activation, including transmission, analysis, interpretation and report — payable once in any 4 week period

41.00

11711

Ambulatory ECG monitoring for 12 hours or more, patient activated, single or multiple event recording, utilising a memory recording device which is capable of recording for at least 30 seconds after each activation, including transmission, analysis, interpretation and report — payable once in any 4 week period

22.35

11712

Multi channel ECG monitoring and recording during exercise (motorised treadmill or cycle ergometer capable of quantifying external workload in watts) or pharmacological stress, involving the continuous attendance of a medical practitioner for not less than 20 minutes, with resting ECG, and with or without continuous blood pressure monitoring and the recording of other parameters, on premises equipped with mechanical respirator and defibrillator

120.30

11713

Signal averaged ECG recording involving not more than 300 beats, using at least 3 leads with data acquisition at not less than 1000Hz of at least 100 QRS complexes, including analysis, interpretation and report of recording by a specialist physician or consultant physician

55.15

11715

Blood dye — dilution indicator test

95.55

11718

Implanted pacemaker testing involving electrocardiography, measurement of rate, width and amplitude of stimulus, including reprogramming when required, not being a service associated with a service to which item 11700 or 11721 applies

27.45

11721

Implanted pacemaker testing of atrioventricular (AV) sequential, rate responsive, or antitachycardia pacemakers, including reprogramming when required, not being a service associated with a service to which item 11700 or 11718 applies

55.15

11724

Up-right tilt table testing for the investigation of syncope of suspected cardiothoracic origin, including blood pressure monitoring, continuous ECG monitoring and the recording of the parameters, and involving an established intravenous line and the continuous attendance of a specialist or consultant physician — on premises equipped with a mechanical respirator and defibrillator

133.60

Subgroup 7 — Gastroenterology and colorectal

 

11800

Oesophageal motility test, manometric

138.05

11810

Clinical assessment of gastro-oesophageal reflux disease involving 24-hour pH monitoring, including analysis, interpretation and report and including any associated consultation

138.05

11830

Diagnosis of abnormalities of the pelvic floor involving anal manometry or measurement of anorectal sensation or measurement of the rectosphincteric reflex

147.70

11833

Diagnosis of abnormalities of the pelvic floor and sphincter muscles involving electromyography or measurement of pudendal and spinal nerve motor latency

197.55

Subgroup 8 — Genito-urinary physiological investigations

 

11900

Urine flow study including peak urine flow measurement, not being a service associated with a service to which item 11918 applies

21.80

11903

Cystometrography, not being a service associated with a service to which items 11012 to 11027, 11912, 11915, 11918, 11921, 36800 or any item in Group I3 of the Diagnostic Imaging Services Table applies

87.90

11906

Urethral pressure profilometry, not being a service associated with a service to which items 11012 to 11027, 11909, 11918, 11921, 36800 or any item in Group I3 of the Diagnostic Imaging Services Table applies

87.90

11909

Urethral pressure profilometry with simultaneous measurement of urethral sphincter electromyography, not being a service associated with a service to which item 11906, 11915, 11918, 36800 or any item in Group I3 of the Diagnostic Imaging Services Table applies

130.55

11912

Cystometrography with simultaneous measurement of rectal pressure, not being a service associated with a service to which items 11012 to 11027, 11903, 11915, 11918, 11921, 36800 or any item in Group I3 of the Diagnostic Imaging Services Table applies (Anaes.)

130.55

11915

Cystometrography with simultaneous measurement of urethral sphincter electromyography, not being a service associated with a service to which item 11012 to 11027, 11903, 11909, 11912, 11918, 11921, 36800 or any item in Group I3 of the Diagnostic Imaging Services Table applies (Anaes.)

130.55

11918

Cystometrography in conjunction with imaging, with measurement of any 1 or more of urine flow rate, urethral pressure profile, rectal pressure, urethral sphincter electromyography; including all imaging associated with cystometrography, not being a service associated with a service to which items 11012 to 11027, 11900 to 11915, 11921 and 36800 apply (Anaes.)

338.80

11921

Bladder washout test for localisation of urinary infection — not including bacterial counts for organisms in specimens

59.35

Subgroup 9 — Allergy testing

 

12000

Skin sensitivity testing for allergens, using 1 to 20 allergens, not being a service associated with a service to which item 12012, 12015, 12018 or 12021 applies

30.80

12003

Skin sensitivity testing for allergens, using more than 20 allergens, not being a service associated with a service to which item 12012, 12015, 12018 or 12021 applies

46.55

12012

Epicutaneous patch testing in the investigation of allergic dermatitis using less than the number of allergens included in a standard patch test battery

16.45

12015

Epicutaneous patch testing in the investigation of allergic dermatitis using all of the allergens in a standard patch test battery

49.40

12018

Epicutaneous patch testing in the investigation of allergic dermatitis using all of the allergens in a standard patch test battery and additional allergens to a total of up to and including 50 allergens

63.60

12021

Epicutaneous patch testing in the investigation of allergic dermatitis, performed by or on behalf of a specialist in the practice of his or her specialty, using more than 50 allergens

93.20

Subgroup 10 — Other diagnostic procedures and investigations

 

12200

Collection of specimen of sweat by iontophoresis

29.40

12203

Overnight investigation for sleep apnoea for a period of at least 8 hours duration, for a patient aged 18 years or more where:

   (a)  continuous monitoring of oxygen saturation and breathing using a multi-channel polygraph, and recordings of EEG, EOG, submental EMG, anterior tibial EMG, respiratory movement, airflow, oxygen saturation and ECG are performed; and

  (b)  a technician is in continuous attendance under the supervision of a qualified sleep medicine practitioner; and

   (c)  the patient is referred by a medical practitioner; and

  (d)  the necessity for the investigation is determined by a qualified adult sleep medicine practitioner prior to the investigation; and

465.10

 

   (e)  polygraphic records are analysed (for assessment of sleep stage, arousals, respiratory events and assessment of clinically significant alterations in heart rate and limb movement) with manual scoring, or manual correction of computerised scoring in epochs of not more than 1 minute, and stored for interpretation and preparation of report; and

   (f)  interpretation and report are provided by a qualified adult sleep medicine practitioner based on reviewing the direct original recording of polygraphic data from the patient.

For any particular patient — applicable only in relation to each of the first 3 occasions the investigation is performed in any 12 month period

 

12207

Overnight investigation for sleep apnoea for a period of at least 8 hours duration, for a patient aged 18 years or more where:

   (a)  continuous monitoring of oxygen saturation and breathing using a multi-channel polygraph, and recordings of EEG, EOG, submental EMG, anterior tibial EMG, respiratory movement, airflow, oxygen saturation and ECG are performed; and

  (b)  a technician is in continuous attendance under the supervision of a qualified sleep medicine practitioner; and

   (c)  the patient is referred by a medical practitioner; and

  (d)  the necessity for the investigation is determined by a qualified adult sleep medicine practitioner prior to the investigation; and

   (e)  polygraphic records are analysed (for assessment of sleep stage, arousals, respiratory events and assessment of clinically significant alterations in heart rate and limb movement) with manual scoring, or manual correction of computerised scoring in epochs of not more than 1 minute, and stored for interpretation and preparation of report; and

   (f)  interpretation and report are provided by a qualified adult sleep medicine practitioner based on reviewing the direct original recording of polygraphic data from the patient;

where it can be demonstrated that a further investigation is indicated in the same 12 month period to which item 12203 applies for the adjustment or testing, or both, of the effectiveness of a positive pressure ventilatory support device (other than nasal continuous positive airway pressure) in sleep, in a patient with severe cardio-respiratory failure, and where previous studies have demonstrated failure of continuous positive airway pressure or oxygen — each additional investigation

465.10

12210

Overnight paediatric investigation for a period of at least 8 hours duration for a patient aged 12 years or less, where:

   (a)  continuous monitoring of oxygen saturation and breathing using a multi-channel polygraph, and recordings of EEG (with a minimum of 4 EEG leads or, in selected investigations, of 6 EEG leads), EOG, submental or diaphragm EMG (or both), respiratory movement of rib and abdomen (whether movement of rib is recorded separately from, or together with, movement of abdomen), airflow, measurement of carbon dioxide (either end-tidal or transcutaneous), oxygen saturation and ECG are performed; and

  (b)  a technician or registered nurse with sleep technology training is in continuous attendance under the supervision of a qualified paediatric sleep medicine practitioner; and

   (c)  the patient is referred by a medical practitioner; and

  (d)  the necessity for the investigation is determined by a qualified paediatric sleep medicine practitioner prior to the investigation; and

   (e)  polygraphic records are analysed (for assessment of sleep stage, and maturation of sleep indices, arousals, respiratory events and assessment of clinically significant alterations in heart rate and body movement) with manual scoring, or manual correction of computerised scoring in epochs of not more than 1 minute, and stored for interpretation and preparation of report; and

   (f)  interpretation and report are provided by a qualified paediatric sleep medicine practitioner based on reviewing the direct original recording of polygraphic data from the patient.

For each particular patient — applicable only in relation to each of the first 3 occasions the investigation is performed in any 12 month period

555.10

12213

Overnight paediatric investigation for a period of at least 8 hours duration for a patient aged between 12 and 18 years, where:

   (a)  recordings of EEG (with a minimum of 4 EEG leads or, in selected investigations, of 6 EEG leads), EOG, submental or diaphragm EMG (or both), respiratory movement of rib and abdomen (whether movement of rib is recorded separately from, or together with, movement of abdomen), airflow, measurement of carbon dioxide (either end-tidal or transcutaneous), oxygen saturation and ECG are performed; and

  (b)  a technician or registered nurse with sleep technology training is in continuous attendance under the supervision of a qualified sleep medicine practitioner; and

   (c)  the patient is referred by a medical practitioner; and

  (d)  the necessity for the investigation is determined by a qualified sleep medicine practitioner prior to the investigation; and

   (e)  polygraphic records are analysed (for assessment of sleep stage, and maturation of sleep indices, arousals, respiratory events and assessment of clinically significant alterations in heart rate and body movement) with manual scoring, or manual correction of computerised scoring in epochs of not more than 1 minute, and stored for interpretation and preparation of report; and

   (f)  interpretation and report are provided by a qualified sleep medicine practitioner based on reviewing the direct original recording of polygraphic data from the patient.

For each particular patient — applicable only in relation to each of the first 3 occasions the investigation is performed in any 12 month period

500.10

12215

Overnight paediatric investigation for a period of at least 8 hours duration for a patient aged 12 years or less, where:

   (a)  continuous monitoring of oxygen saturation and breathing using a multi-channel polygraph, and recordings of EEG (with a minimum of 4 EEG leads or, in selected investigations, of 6 EEG leads), EOG, submental or diaphragm EMG (or both), respiratory movement of rib and abdomen (whether movement of rib is recorded separately from, or together with, movement of abdomen), airflow, measurement of carbon dioxide (either end-tidal or transcutaneous), oxygen saturation and ECG are performed; and

  (b)  a technician or registered nurse with sleep technology training is in continuous attendance under the supervision of a qualified paediatric sleep medicine practitioner; and

   (c)  the patient is referred by a medical practitioner; and

  (d)  the necessity for the investigation is determined by a qualified paediatric sleep medicine practitioner prior to the investigation; and

   (e)  polygraphic records are analysed (for assessment of sleep stage, and maturation of sleep indices, arousals, respiratory events and assessment of clinically significant alterations in heart rate and body movement) with manual scoring, or manual correction of computerised scoring in epochs of not more than 1 minute, and stored for interpretation and preparation of report; and

   (f)  interpretation and report are provided by a qualified paediatric sleep medicine practitioner based on reviewing the direct original recording of polygraphic data from the patient;

where it can be demonstrated that a further investigation is indicated in the same 12 month period to which item 12210 applies, for the adjustment, or testing of the effectiveness, or both, of Continuous Positive Airway Pressure (CPAP) or of the bilevel pressure support or ventilation (or both), or if supplemental oxygen is required because of recurring hypoxia — each additional investigation

555.10

12217

Overnight paediatric investigation for a period of at least 8 hours duration for a patient aged between 12 and 18 years, where:

   (a)  continuous monitoring of oxygen saturation and breathing using a multi-channel polygraph, and recordings of EEG (with a minimum of 4 EEG leads or, in selected investigations, of 6 EEG leads), EOG, submental or diaphragm EMG (or both), respiratory movement of rib and abdomen (whether movement of rib is recorded separately from, or together with, movement of abdomen), airflow, measurement of carbon dioxide (either end-tidal or transcutaneous), oxygen saturation and ECG are performed; and

  (b)  a technician or registered nurse with sleep technology training is in continuous attendance under the supervision of a qualified sleep medicine practitioner; and

   (c)  the patient is referred by a medical practitioner; and

  (d)  the necessity for the investigation is determined by a qualified sleep medicine practitioner prior to the investigation; and

   (e)  polygraphic records are analysed (for assessment of sleep stage, and maturation of sleep indices, arousals, respiratory events and assessment of clinically significant alterations in heart rate and body movement) with manual scoring, or manual correction of computerised scoring in epochs of not more than 1 minute, and stored for interpretation and preparation of report; and

   (f)  interpretation and report to be provided by a qualified sleep medicine practitioner based on reviewing the direct original recording of polygraphic data from the patient;

where it can be demonstrated that a further investigation is indicated in the same 12 month period to which item 12210 applies, for the adjustment, or testing of the effectiveness, or both, of Continuous Positive Airway Pressure (CPAP) or of the bilevel pressure support or ventilation (or both), or if there is recurring hypoxia and supplemental oxygen is required — each additional investigation

500.10

Group D2 — Nuclear medicine (non-imaging)

 

12500

Blood volume estimation

171.30

12503

Erythrocyte radioactive uptake survival time test or iron kinetic test

336.05

12506

Gastrointestinal blood loss estimation involving examination of stool specimens

239.90

12509

Gastrointestinal protein loss

171.30

12512

Radioactive B12 absorption test — 1 isotope

83.00

12515

Radioactive B12 absorption test — 2 isotopes

181.85

12518

Thyroid uptake (using probe)

83.00

12521

Perchlorate discharge study

100.20

12524

Renal function test (without imaging procedure)

125.20

12527

Renal function test (with imaging and at least 2 blood samples)

67.15

12530

Whole body count — not being a service associated with a service to which another item applies

100.20

12533

Carbon-labelled urea breath test using oral C-13 or C-14 urea, performed by a specialist or consultant physician, including the measurement of exhaled 13CO2 or 14CO2 , for either:

   (a)  the confirmation of Helicobactor pylori colonisation, where:

         (i)   suitable biopsy material for diagnosis cannot be obtained at endoscopy in patients with peptic ulcer disease, or where the diagnosis of peptic ulcer has been made on barium meal; or

        (ii)   in patients with past history of duodenal ulcer, gastric ulcer or gastric neoplasia, where endoscopy is not indicated; or

66.90

 

  (b)  the monitoring of the success of eradication of Helicobactor pylori in patients with peptic ulcer disease;

where any request for the test by another medical practitioner who collects the breath sample specifically identifies in writing 1 or more of the clinical indications for the test

 

Therapeutic procedures

Group T1 — Miscellaneous therapeutic procedures

Subgroup 1 — Hyperbaric oxygen therapy

 

13020

Hyperbaric oxygen therapy, for treatment of decompression illness, gas gangrene, air or gas embolism, diabetic wounds (including diabetic gangrene and diabetic foot ulcers), necrotising tissue infections (including necrotising fasciitis, Fournier’s gangrene or osteoradino ecrosis), performed in a comprehensive hyperbaric medicine facility for a period in the hyperbaric chamber of between 1 hour 30 minutes and 3 hours (both inclusive), including any associated attendance

204.70

13025

Hyperbaric oxygen therapy, for treatment of decompression illness, air or gas embolism, performed in a comprehensive hyperbaric medicine facility, under the supervision of a medical practitioner qualified in hyperbaric medicine, for a period in the hyperbaric chamber greater than 3 hours, including any associated attendance — per hour (or part of an hour)

91.55

13030

Hyperbaric oxygen therapy performed in a comprehensive hyperbaric medicine facility where the medical practitioner is pressurised in the hyperbaric chamber for the purpose of providing continuous life saving emergency treatment, including any associated attendance — per hour (or part of an hour)

129.30

Subgroup 2 — Dialysis

 

13100

Supervision in hospital by a medical specialist of — haemodialysis, haemofiltration, haemoperfusion or peritoneal dialysis, including all professional attendances, where the total attendance time on the patient by the supervising medical specialist exceeds 45 minutes in 1 day

108.10

13103

Supervision in hospital by a medical specialist of — haemodialysis, haemofiltration, haemoperfusion or peritoneal dialysis, including all professional attendances, where the total attendance time on the patient by the supervising medical specialist does not exceed 45 minutes in 1 day

56.30

13106

Declotting of an arteriovenous shunt

96.05

13109

Indwelling peritoneal catheter (Tenckhoff or similar) for dialysis — insertion and fixation of (Anaes.)

180.15

13110

Tenckhoff peritoneal dialysis catheter, removal of (including catheter cuffs) (Anaes.)

180.70

13112

Peritoneal dialysis, establishment of, by abdominal puncture and insertion of temporary catheter (including associated consultation) (Anaes.)

108.10

Subgroup 3 — Assisted reproductive services

 

13200

Assisted reproductive services (such as in vitro fertilisation, gamete intra-fallopian transfer or similar procedures) involving the use of drugs to induce superovulation, and including quantitative estimation of hormones, ultrasound examinations, all treatment counselling and embryology laboratory services but excluding artificial insemination or transfer of frozen embryos or donated embryos or ova or a service to which item 13203, 13206 or 13218 applies — being services rendered during 1 treatment cycle, if the duration of the treatment cycle is at least 9 days

1 581.40

13203

Ovulation monitoring services, for superovulated treatment cycles of less than 9 days duration and artificial insemination — including quantitative estimation of hormones and ultrasound examinations, being services rendered during 1 treatment cycle but excluding a service to which item 13200, 13206, 13212, 13215 or 13218 applies

395.35

13206

Assisted reproductive services (such as in vitro fertilisation, gamete intra-fallopian transfer or similar procedures), using unstimulated ovulation or ovulation stimulated only by clomiphene citrate, and including quantitative estimation of hormones, ultrasound examinations, all treatment counselling and embryology laboratory services — but excluding artificial insemination, frozen embryo transfer or donated embryos or ova or treatment involving the use of drugs to induce superovulation — being services rendered during 1 treatment cycle but only if rendered in conjunction with a service to which item 13212 applies

677.70

13209

Planning and management of a referred patient by a specialist for the purpose of treatment by assisted reproductive technologies including in vitro fertilisation, gamete intra-fallopian transfer and similar procedures, or for artificial insemination — payable once only during 1 treatment cycle

67.65

13212

Oocyte retrieval by any means including laparoscopy or ultrasound-guided ova flushing, for the purposes of assisted reproductive technologies including in vitro fertilisation, gamete intra-fallopian transfer or similar procedures — only if rendered in conjunction with a service to which item 13200 or 13206 applies (Anaes.)

288.05

13215

Transfer of embryos or both ova and sperm to the female reproductive system, by any means but excluding artificial insemination or the transfer of frozen or donated embryos — only if rendered in conjunction with a service to which item 13200 or 13206 applies, being services rendered in 1 treatment cycle (Anaes.)

90.40

13218

Preparation and transfer of frozen or donated embryos or both ova and sperm, to the female reproductive system, by any means and including quantitative estimation of hormones and all treatment counselling but excluding artificial insemination services rendered in 1 treatment cycle and excluding a service to which item 13200, 13203, 13206, 13212 or 13215 applies (Anaes.)

677.70

13221

Preparation of semen for the purposes of assisted reproductive technologies or for artificial insemination

41.25

13290

Semen, collection of, from a patient with spinal injuries or medically induced impotence, for the purposes of analysis, storage or assisted reproduction, by a medical practitioner using a vibrator or electro-ejaculation device including catheterisation and drainage of bladder where required

161.60

13292

Semen, collection of, from a patient with spinal injuries or medically induced impotence, for the purposes of analysis, storage or assisted reproduction, by a medical practitioner using a vibrator or electro-ejaculation device including catheterisation and drainage of bladder where required, under general anaesthetic, in a hospital or approved day-hospital facility (Anaes.)

323.20

Subgroup 4 — Paediatric and neonatal

 

13300

Umbilical or scalp vein catheterisation in a neonate with or without infusion or cannulation of a vein

45.05

13303

Umbilical artery catheterisation with or without infusion

66.80

13306

Blood transfusion with venesection and complete replacement of blood, including collection from donor

264.25

13309

Blood transfusion with venesection and complete replacement of blood, using blood already collected

225.30

13312

Blood for pathology test, collection of, by femoral or external jugular vein puncture in infants

22.45

13318

Central vein catheterisation (via jugular or subclavian vein) — by open exposure, in a person under 12 years of age (Anaes.)

179.95

13319

Central vein catheterisation in a neonate via peripheral vein (Anaes.)

179.95

Subgroup 5 — Cardiovascular

 

13400

Restoration of cardiac rhythm by electrical stimulation (cardioversion), other than in the course of cardiac surgery (Anaes.)

76.60

Subgroup 6 — Gastroenterology

 

13500

Gastric hypothermia by closed circuit circulation of refrigerant in the absence of gastrointestinal haemorrhage

142.65

13503

Gastric hypothermia by closed circuit circulation of refrigerant for upper gastrointestinal haemorrhage

285.30

13506

Gastro-oesophageal balloon intubation, Minnesota, Sengstaken-Blakemore or similar, for control of bleeding from gastric oesophageal varices

145.90

Subgroup 8 — Haematology

 

13700

Harvesting of homologous (including allogeneic) or autologous bone marrow for the purpose of transplantation (Anaes.)

263.65

13703

Administration of blood including collection from donor

94.50

13706

Administration of blood or bone marrow already collected

66.00

13709

Collection of blood for autologous transfusion or when homologous blood is required for immediate transfusion in emergency situation

38.30

13750

Therapeutic haemapheresis for the removal of plasma or cellular (or both) elements of blood, utilising continuous or intermittent flow techniques, including morphological tests for cell counts and viability studies, if performed; continuous monitoring of vital signs, fluid balance, blood volume and other parameters with continuous registered nurse attendance under the supervision of a consultant physician, not being a service associated with a service to which item 13755 applies — each day

108.10

13755

Donor haemapheresis for the collection of blood products for transfusion, utilising continuous or intermittent flow techniques, including morphological tests for cell counts and viability studies; continuous monitoring of vital signs, fluid balance, blood volume and other parameters; with continuous registered nurse attendance under the supervision of a consultant physician — not being a service associated with a service to which item 13750 applies — each day

108.10

13757

Therapeutic venesection for the management of haemochromatosis, polycythemia vera or porphyria cutanea tarda

57.70

13760

In vitro processing (and cryopreservation) of bone marrow or peripheral blood for autologous stem cell transplantation as an adjunct to high dose chemotherapy for:

   (a)  chemosensitive intermediate or high grade

         non-Hodgkin’s lymphoma at high risk of relapse following first line chemotherapy; or

  (b)  Hodgkin’s disease which has relapsed following, or is refractory to, chemotherapy; or

   (c)  acute myelogenous leukaemia in first remission, where suitable genotypically matched sibling donor is not available for allogenic bone marrow transplant; or

  (d)  multiple myeloma in remission (complete or partial) following standard dose chemotherapy; or

   (e)  small round cell sarcomas; or

   (f)  primitive neuroectodermal tumour; or

   (g)  germ cell tumours which have relapsed following, or are refractory to, chemotherapy; or

  (h)  germ cell tumours which have had an incomplete response to first line therapy;

performed under the supervision of a consultant physician — each day

603.25

Subgroup 9 — Procedures associated with intensive care and cardiopulmonary support

 

13815

Central vein catheterisation (via jugular, subclavian or femoral vein) by percutaneous or open exposure not being a service to which item 13318 applies (Anaes.)

67.40

13818

Right heart balloon catheter, insertion of, including pulmonary wedge pressure and cardiac output measurement (Anaes.)

89.95

13830

Intracranial pressure, monitoring of, by intraventricular or subdural catheter, subarachnoid bolt or similar, by a specialist or consultant physician — each day

59.60

13839

Arterial puncture and collection of blood for diagnostic purposes

18.20

13842

Intra-arterial cannulisation for the purpose of taking multiple arterial blood samples for blood gas analysis

54.80

13845

Counterpulsation by intra-aortic balloon-management on the first day, including percutaneous insertion, initial and subsequent consultations and monitoring of parameters (Anaes.)

427.90

13848

Counterpulsation by intra-aortic balloon-management on each day subsequent to the first, including associated consultations and monitoring of parameters

103.65

13851

Circulatory support device, management of, on first day

390.50

13854

Circulatory support device, management of, on each day subsequent to the first

90.80

13857

Mechanical ventilation, initiation of (other than initiation of ventilation in the context of an anaesthetic for surgery), outside of an intensive care unit, where subsequent management of ventilatory support is undertaken in an intensive care unit

115.80

Subgroup 10 — Management and procedures undertaken in an intensive care unit

 

13870

Management of a patient in an intensive care unit by a specialist or consultant physician — including initial and subsequent attendances, electrocardiographic monitoring, arterial sampling, bladder catheterisation and blood sampling — management on the first day

241.30

13873

Management of a patient in an intensive care unit by a specialist or consultant physician — including all attendances, electrocardiographic monitoring, arterial sampling, bladder catheterisation and blood sampling — management on each day subsequent to the first day

179.70

13876

Central venous pressure, pulmonary arterial pressure, systemic arterial pressure or cardiac intracavity pressure, continuous monitoring by indwelling catheter by a specialist or consultant physician in an intensive care unit — each day of monitoring for each type of pressure up to a maximum of 4 pressures

54.80

13879

Mechanical ventilation, initiation of, by a specialist or consultant physician, in an intensive care unit, including subsequent management of ventilatory support on the first day

175.10

13882

Ventilatory support in an intensive care unit, management of, by a specialist or consultant physician — not being a service to which item 13879 applies — each day

59.60

13885

Continuous arterio venous or veno venous haemofiltration, management by a specialist or consultant physician — on the first day in an intensive care unit

107.80

13888

Continuous arterio venous or veno venous haemofiltration, management by a specialist or consultant physician — on each day subsequent to the first day in an intensive care unit

56.15

Subgroup 11 — Chemotherapeutic procedures

 

13915

Cytotoxic chemotherapy, administration of, either by intravenous push technique (directly into a vein, or a butterfly needle, or the side-arm of an infusion) or by intravenous infusion of not more than 1 hour’s duration — payable once only on the same day

51.45

13918

Cytotoxic chemotherapy, administration of, by intravenous infusion of more than 1 hour’s duration but not more than 6 hours duration — payable once only on the same day

77.40

13921

Cytotoxic chemotherapy, administration of, by intravenous infusion of more than 6 hours duration — for the first day of treatment

87.60

13924

Cytotoxic chemotherapy, administration of, by intravenous infusion of more than 6 hours duration — on each day subsequent to the first in the same continuous treatment episode

51.65

13927

Cytotoxic chemotherapy, administration of, either by intra-arterial push technique (directly into an artery, a butterfly needle or the side-arm of an infusion) or by intra-arterial infusion of not more than 1 hour’s duration — payable once only on the same day

66.80

13930

Cytotoxic chemotherapy, administration of, by

intra-arterial infusion of more than 1 hour’s duration but not more than 6 hours duration — payable once only on the same day

93.15

13933

Cytotoxic chemotherapy, administration of, by

intra-arterial infusion of more than 6 hours duration — for the first day of treatment

103.35

13936

Cytotoxic chemotherapy, administration of, by

intra-arterial infusion of more than 6 hours duration — on each day subsequent to the first in the same continuous treatment episode

67.30

13939

Implanted pump or reservoir, loading of, with a cytotoxic agent or agents, not being a service associated with a service to which item 13915, 13918, 13921, 13924, 13927, 13930, 13933, 13936 or 13945 applies

77.40

13942

Ambulatory drug delivery device, loading of, with a cytotoxic agent or agents for the infusion of the agent or agents via the intravenous, intra-arterial or spinal routes, not being a service associated with a service to which item 13915, 13918, 13921, 13924, 13927, 13930, 13933, 13936 or 13945 applies

51.65

13945

Long-term implanted drug delivery device for cytotoxic chemotherapy, accessing of

41.55

13948

Cytotoxic agent, instillation of, into a body cavity

51.65

Subgroup 12 — Dermatology

 

14050

PUVA therapy or UVB therapy administered in whole body cabinet (not being a service associated with a service to which item 14053 applies) including associated consultations other than an initial consultation

41.75

14053

PUVA therapy or UVB therapy administered to localised body areas in a hand and foot cabinet (not being a service associated with a service to which item 14050 applies) including associated consultations other than an initial consultation

41.75

14100

Laser photocoagulation using laser light within the wave length of 510-600nm in the treatment of severely disfiguring vascular lesions of the head or neck where abnormality is visible from 4 metres, including any associated consultation, up to a maximum of 6 sessions (including any sessions to which items 14100 to 14118 and 30213 apply) in any 12 month period — session of at least 30 minutes duration (Anaes.)

120.65

14103

Laser photocoagulation using laser light within the wave length of 510-600nm in the treatment of severely disfiguring vascular lesions of the head or neck where abnormality is visible from 4 metres, including any associated consultation, up to a maximum of 6 sessions (including any sessions to which items 14100 to 14118 and 30213 apply) in any 12 month period — session of at least 60 minutes duration (Anaes.)

148.15

14106

Laser photocoagulation using laser light within the wave length of 510-1064nm in the treatment of port wine stains, haemangiomas, café-au-lait macules and naevi of Ota, other than melanocytic naevi (common moles), including any associated consultation, up to a maximum of 6 sessions (including any sessions to which items 14100 to 14118 and 30213 apply) in any 12 month period — area of treatment up to 50 cm2 (Anaes.)

120.65

14109

Laser photocoagulation using laser light within the wave length of 510-1064nm in the treatment of port wine stains, haemangiomas, café-au-lait macules and naevi of Ota, other than melanocytic naevi (common moles), including any associated consultation, up to a maximum of 6 sessions (including any sessions to which items 14100 to 14118 and 30213 apply) in any 12 month period — area of treatment more than 50 cm2 and up to 100 cm2 (Anaes.)

148.15

14112

Laser photocoagulation using laser light within the wave length of 510-1064nm in the treatment of port wine stains, haemangiomas, café-au-lait macules and naevi of Ota, other than melanocytic naevi (common moles), including any associated consultation, up to a maximum of 6 sessions (including any sessions to which items 14100 to 14118 and 30213 apply) in any 12 month period — area of treatment more than 100 cm2 and up to 150 cm2 (Anaes.)

175.45

14115

Laser photocoagulation using laser light within the wave length of 510-1064nm in the treatment of port wine stains, haemangiomas, café-au-lait macules and naevi of Ota, other than melanocytic naevi (common moles), including any associated consultation, up to a maximum of 6 sessions (including any sessions to which items 14100 to 14118 and 30213 apply) in any 12 month period — area of treatment more than 150 cm2 and up to 250 cm2 (Anaes.)

202.85

14118

Laser photocoagulation using laser light within the wave length of 510-1064nm in the treatment of port wine stains, haemangiomas, café-au-lait macules and naevi of Ota, other than melanocytic naevi (common moles), including any associated consultation, up to a maximum of 6 sessions (including any sessions to which items 14100 to 14118 apply) in any 12 month period — area of treatment more than 250 cm2 (Anaes.)

257.70

14120

Laser photocoagulation using laser light within the wave length of 510-600nm in the treatment of severely disfiguring vascular lesions of the head or neck where abnormality is visible from 4 metres, including any associated consultation-session of at least 30 minutes duration — where it can be demonstrated that a 7th or subsequent session (including any sessions to which items 14100 to 14118 and 30213 apply) is indicated in a 12 month period (Anaes.)

120.65

14122

Laser photocoagulation using laser light within the wave length of 510-600nm in the treatment of severely disfiguring vascular lesions of the head or neck where abnormality is visible from 4 metres, including any associated consultation-session of at least 60 minutes duration — where it can be demonstrated that a 7th or subsequent session (including any sessions to which items 14100 to 14118 and 30213 apply) is indicated in a 12 month period (Anaes.)

148.15

14124

Laser photocoagulation using laser light within the wave length of 510-1064nm in the treatment of port wine stains, haemangiomas, café-au-lait macules and naevi of Ota, other than melanocytic naevi (common moles), including any associated consultation-area of treatment up to 50 cm2 — where it can be demonstrated that a 7th or subsequent session (including any sessions to which items 14100 to 14118 and 30213 apply) is indicated in a 12 month period (Anaes.)

120.65

14126

Laser photocoagulation using laser light within the wave length of 510-1064nm in the treatment of port wine stains, haemangiomas, café-au-lait macules and naevi of Ota, other than melanocytic naevi (common moles), including any associated consultation-area of treatment more than 50 cm2 and up to 100 cm2 — where it can be demonstrated that a 7th or subsequent session (including any sessions to which items 14100 to 14118 and 30213 apply) is indicated in a 12 month period (Anaes.)

148.15

14128

Laser photocoagulation using laser light within the wave length of 510-1064nm in the treatment of port wine stains, haemangiomas, café-au-lait macules and naevi of Ota, other than melanocytic naevi (common moles), including any associated consultation-area of treatment more than 100 cm2 and up to 150 cm2 — where it can be demonstrated that a 7th or subsequent session (including any sessions to which items 14100 to 14118 and 30213 apply) is indicated in a 12 month period (Anaes.)

175.45

14130

Laser photocoagulation using laser light within the wave length of 510-1064nm in the treatment of port wine stains, haemangiomas, café-au-lait macules and naevi of Ota, other than melanocytic naevi (common moles), including any associated consultation-area of treatment more than 150 cm2 and up to 250 cm2 — where it can be demonstrated that a 7th or subsequent session (including any sessions to which items 14100 to 14118 and 30213 apply) is indicated in a 12 month period (Anaes.)

202.85

14132

Laser photocoagulation using laser light within the wave length of 510-1064nm in the treatment of port wine stains, haemangiomas, café-au-lait macules and naevi of Ota, other than melanocytic naevi (common moles), including any associated consultation-area of treatment more than 250 cm2 — where it can be demonstrated that a 7th or subsequent session (including any sessions to which items 14100 to 14118 and 30213 apply) is indicated in a 12 month period (Anaes.)

257.70

Subgroup 13 — Other therapeutic procedures

 

14200

Gastric lavage in the treatment of ingested poison

47.35

14203

Hormone or living tissue implantation, by direct implantation involving incision and suture (Anaes.)

40.45

14206

Hormone or living tissue implantation — by cannula

28.20

14209

Intra-arterial infusion or retrograde intravenous perfusion of a sympatholytic agent

70.20

14212

Intussusception, management of fluid or gas reduction for (Anaes.)

146.60

14215

Long-term implanted reservoir associated with the adjustable gastric band, accessing of to add or remove fluid

77.40

14218

Implanted pump or reservoir, loading of, with a therapeutic agent or agents, for infusion to the subarachnoid or epidural space

77.40

14221

Long-term implanted device for delivery of therapeutic agents, accessing of, not being a service associated with a service to which item 13945 applies

41.55

14224

Electroconvulsive therapy, with or without the use of stimulus dosing techniques, including any electroencephalographic monitoring and associated consultation (Anaes.)

55.60

Group T2 — Radiation oncology

 

Subgroup 1 — Superficial

 

15000

Radiotherapy, superficial (including treatment with

x-rays, radium rays or other radioactive substances), not being a service to which another item in this group applies — each attendance at which fractionated treatment is given — 1 field

33.70

15003

Radiotherapy, superficial (including treatment with

x-rays, radium rays or other radioactive substances), not being a service to which another item in this group applies — each attendance at which fractionated treatment is given — 2 or more fields up to a maximum of 5 additional fields

Amount under rule 14

15006

Radiotherapy, superficial-attendance at which a single dose technique is applied — 1 field

74.70

15009

Radiotherapy, superficial-attendance at which a single dose technique is applied — 2 or more fields up to a maximum of 5 additional fields

Amount under rule 14

15012

Radiotherapy, superficial — each attendance at which treatment is given to an eye

42.25

Subgroup 2 — Orthovoltage

 

15100

Radiotherapy, deep or orthovoltage — each attendance at which fractionated treatment is given at 3 or more treatments per week — 1 field

37.75

15103

Radiotherapy, deep or orthovoltage — each attendance at which fractionated treatment is given at 3 or more treatments per week — 2 or more fields up to a maximum of 5 additional fields (rotational therapy being 3 fields)

Amount under rule 14

15106

Radiotherapy, deep or orthovoltage — each attendance at which fractionated treatment is given at 2 treatments per week or less frequently — 1 field

44.55

15109

Radiotherapy, deep or orthovoltage — each attendance at which fractionated treatment is given at 2 treatments per week or less frequently — 2 or more fields up to a maximum of 5 additional fields (rotational therapy being 3 fields)

Amount under rule 14

15112

Radiotherapy, deep or orthovoltage — attendance at which a single dose technique is applied — 1 field

95.05

15115

Radiotherapy, deep or orthovoltage — attendance at which a single dose technique is applied — 2 or more fields up to a maximum of 5 additional fields (rotational therapy being 3 fields)

Amount under rule 14

Subgroup 3 — Megavoltage

 

15203

Radiation oncology treatment, using a single photon energy linear accelerator, with or without electron facilities — each attendance at which treatment is given — 1 field

47.20

15204

Radiation oncology treatment, using a single photon energy linear accelerator, with or without electron facilities — each attendance at which treatment is given — 2 or more fields up to a maximum of 5 additional fields (rotational therapy being 3 fields)

Amount under rule 14

15207

Radiation oncology treatment, using a dual photon energy linear accelerator with a minimum higher energy of 10 MV photons or greater, with electron facilities — each attendance at which treatment is given — 1 attendance

47.20

15208

Radiation oncology treatment, using a dual photon energy linear accelerator with a minimum higher energy of 10 MV photons or greater, with electron facilities — each attendance at which treatment is given — 2 or more fields up to a maximum of 5 additional fields (rotational therapy being 3 fields)

Amount under rule 14

15211

Radiation oncology treatment, using cobalt unit or caesium teletherapy unit — each attendance at which treatment is given — 1 field

43.25

15214

Radiation oncology treatment, using cobalt unit or caesium teletherapy unit — each attendance at which treatment is given — 2 or more fields up to a maximum of 5 additional fields (rotational therapy being 3 fields)

Amount under rule 14

Subgroup 4 — Brachytherapy

 

15303

Intrauterine treatment alone using radioactive sealed sources having a half-life greater than 115 days using manual afterloading techniques (Anaes.)

282.40

15304

Intrauterine treatment alone using radioactive sealed sources having a half-life greater than 115 days using automatic afterloading techniques (Anaes.)

282.40

15307

Intrauterine treatment alone using radioactive sealed sources having a half-life of less than 115 days including iodine, gold, iridium or tantalum using manual afterloading techniques (Anaes.)

535.40

15308

Intrauterine treatment alone using radioactive sealed sources having a half-life of less than 115 days including iodine, gold, iridium or tantalum using automatic afterloading techniques (Anaes.)

535.40

15311

Intravaginal treatment alone using radioactive sealed sources having a half-life greater than 115 days using manual afterloading techniques (Anaes.)

263.60

15312

Intravaginal treatment alone using radioactive sealed sources having a half-life greater than 115 days using automatic afterloading techniques (Anaes.)

261.70

15315

Intravaginal treatment alone using radioactive sealed sources having a half-life of less than 115 days including iodine, gold, iridium or tantalum using manual afterloading techniques (Anaes.)

517.50

15316

Intravaginal treatment alone using radioactive sealed sources having a half-life of less than 115 days including iodine, gold, iridium or tantalum using automatic afterloading techniques (Anaes.)

517.50

15319

Combined intrauterine and intravaginal treatment using radioactive sealed sources having a half-life greater than 115 days using manual afterloading techniques (Anaes.)

321.10

15320

Combined intrauterine and intravaginal treatment using radioactive sealed sources having a half-life greater than 115 days using automatic afterloading techniques (Anaes.)

321.10

15323

Combined intrauterine and intravaginal treatment using radioactive sealed sources having a half-life of less than 115 days including iodine, gold, iridium, or tantalum using manual afterloading techniques (Anaes.)

571.05

15324

Combined intrauterine and intravaginal treatment using radioactive sealed sources having a half-life of less than 115 days including iodine, gold, iridium, or tantalum using automatic afterloading techniques (Anaes.)

571.05

15327

Implantation of a sealed radioactive source (having a

half-life of less than 115 days including iodine, gold, iridium or tantalum) to a region, under general anaesthesia, or epidural or spinal (intrathecal) nerve block, requiring surgical exposure and using manual afterloading techniques (Anaes.)

621.30

15328

Implantation of a sealed radioactive source (having a

half-life of less than 115 days including iodine, gold, iridium or tantalum) to a region, under general anaesthesia, or epidural or spinal (intrathecal) nerve block, requiring surgical exposure and using automatic afterloading techniques (Anaes.)

621.30

15331

Implantation of a sealed radioactive source (having a

half-life of less than 115 days including iodine, gold, iridium or tantalum) to a site (including the tongue, mouth, salivary gland, axilla, subcutaneous sites), where the volume treated involves multiple planes but does not require surgical exposure and using manual afterloading techniques (Anaes.)

589.95

15332

Implantation of a sealed radioactive source (having a

half-life of less than 115 days including iodine, gold, iridium or tantalum) to a site (including the tongue, mouth, salivary gland, axilla, subcutaneous sites), where the volume treated involves multiple planes but does not require surgical exposure and using automatic afterloading techniques (Anaes.)

589.95

15335

Implantation of a sealed radioactive source (having a

half-life of less than 115 days including iodine, gold, iridium or tantalum) to a site where the volume treated involves only a single plane but does not require surgical exposure and using manual afterloading techniques (Anaes.)

535.40

15336

Implantation of a sealed radioactive source (having a

half-life of less than 115 days including iodine, gold, iridium or tantalum) to a site where the volume treated involves only a single plane but does not require surgical exposure and using automatic afterloading techniques (Anaes.)

535.40

15338

Prostate, radioactive seed implantation of, radiation oncology component, using transrectal ultrasound guidance, for localised prostatic malignancy at clinical stages T1, T2A or T2B, with a Gleason score of 6 or less and a prostate specific antigen (PSA) of 10ng/ml or less at the time of diagnosis, where the procedure is performed at an approved site in association with a urologist

740.00

15339

Removal of a sealed radioactive source under general anaesthesia, or under epidural or spinal nerve block (Anaes.)

60.25

15342

Construction and application of a radioactive mould using a sealed source having a half-life of greater than 115 days, to treat intracavity, intraoral or intranasal site

150.55

15345

Construction and application of a radioactive mould using a sealed source having a half-life of less than 115 days including iodine, gold, iridium or tantalum to treat intracavity, intraoral or intranasal sites

401.70

15348

Subsequent applications of radioactive mould referred to in item 15342 or 15345 — each attendance

46.20

15351

Construction and first application of a radioactive mould not exceeding 5 cm in diameter to an external surface

92.25

15354

Construction and first application of a radioactive mould more than 5 cm in diameter to an external surface

112.00

15357

Attendance upon a patient to apply a radioactive mould constructed for application to an external surface of the patient other than an attendance which is the first attendance to apply the mould — each attendance

31.60

Subgroup 5 — Computerised planning

 

15500

Radiation field setting using a simulator or isocentric

x-ray or megavoltage machine of a single area for treatment by a single field or parallel opposed fields (not being a service associated with a service to which item 15509 applies)

192.00

15503

Radiation field setting using a simulator or isocentric

x-ray or megavoltage machine of a single area, where views in more than 1 plane are required for treatment by multiple fields, or of 2 areas (not being a service associated with a service to which item 15512 applies)

246.50

15506

Radiation field setting using a simulator or isocentric

x-ray or megavoltage machine of 3 or more areas, or of total body or half body irradiation, or of mantle therapy or inverted Y fields, or of irregularly shaped fields using multiple blocks, or of off-axis fields or several joined fields (not being a service associated with a service to which item 15515 applies)

368.05

15509

Radiation field setting using a diagnostic x-ray unit of a single area for treatment by a single field or parallel opposed fields (not being a service associated with a service to which item 15500 applies)

166.45

15512

Radiation field setting using a diagnostic x-ray unit of a single area, where views in more than 1 plane are required for treatment by multiple fields, or of 2 areas (not being a service associated with a service to which item 15503 applies)

214.45

15513

Radiation source localisation using a simulator or x-ray machine of a single area, where views in more than 1 plane are required, for brachytherapy treatment planning for Iodine 125 seed implantation of localised prostate cancer, being a service associated with a service to which item 15338 applies

242.60

15515

Radiation field setting using a diagnostic x-ray unit of 3 or more areas, or of total body or half body irradiation, or of mantle therapy or inverted Y fields, or of irregularly shaped fields using multiple blocks, or of off‑axis fields or several joined fields (not being a service associated with a service to which item 15506 applies)

310.45

15518

Radiation Dosimetry by a CT interfacing planning computer for megavoltage or teletherapy radiotherapy by a single field or parallel opposed fields to 1 area with up to 2 shielding blocks

60.90

15521

Radiation Dosimetry by a CT interfacing planning computer for megavoltage or teletherapy radiotherapy to a single area by 3 or more fields, or by a single field or parallel opposed fields to 2 areas, or where wedges are used

268.85

15524

Radiation Dosimetry by a CT interfacing planning computer for megavoltage or teletherapy radiotherapy to 3 or more areas, or by mantle fields or inverted Y fields or tangential fields or irregularly shaped fields using multiple blocks, or off-axis fields, or several joined fields

504.15

15527

Radiation Dosimetry by a non-CT interfacing planning computer for megavoltage or teletherapy radiotherapy by a single field or parallel opposed fields to 1 area with up to 2 shielding blocks

62.40

15530

Radiation Dosimetry by a non-CT interfacing planning computer for megavoltage or teletherapy radiotherapy to a single area by 3 or more fields, or by a single field or parallel opposed fields to 2 areas, or where wedges are used

278.50

15533

Radiation Dosimetry by a non-CT interfacing planning computer for megavoltage or teletherapy radiotherapy to 3 or more areas, or by mantle fields or inverted Y fields, or tangential fields or irregularly shaped fields using multiple blocks, or off-axis fields, or several joined fields

528.10

15536

Brachytherapy planning, computerised Radiation Dosimetry

211.05

15539

Brachytherapy planning, computerised radiation dosimetry for Iodine 125 seed implantation of localised prostate cancer, being a service associated with a service to which item 15338 applies

496.20

Subgroup 6 — Stereotactic radiosurgery

 

15600

Stereotactic radiosurgery, including all radiation oncology consultations, planning, simulation, dosimetry and treatment

1 346.55

Group T3 — Therapeutic nuclear medicine

 

16003

Intra-cavitary administration of a therapeutic dose of Yttrium 90 (not including preliminary paracentesis) (Anaes.)

514.60

16006

Administration of a therapeutic dose of Iodine 131 for thyroid cancer by single dose technique

395.40

16009

Administration of a therapeutic dose of Iodine 131 for thyrotoxicosis by single dose technique

269.85

16012

Intravenous administration of a therapeutic dose of Phosphorous 32

233.45

16015

Administration of Strontium 89 for painful bony metastases from carcinoma of the prostate where hormone therapy has failed and either:

   (a)  the disease is poorly controlled by conventional radiotherapy; or

3 231.80

 

  (b)  conventional radiotherapy is inappropriate, due to the wide distribution of sites of bone pain

 

16018

Administration of 153 Sm-lexidronam for the relief of bone pain due to skeletal metastases (as indicated by a positive bone scan) from:

   (a)  carcinoma of the prostate, where hormonal therapy has failed; or

  (b)  carcinoma of the breast, where both hormonal therapy and chemotherapy have failed and:

         (i)   the disease is poorly controlled by conventional radiotherapy; or

        (ii)   conventional radiotherapy is inappropriate, due to the wide distribution of sites of bone pain

1 931.95

Group T4 — Obstetrics

 

16500

Antenatal attendance

28.75

16501

External cephalic version for breech presentation, after 36 weeks where no contraindication exists, in a unit with facilities for caesarean section, including pre and post version CTG, with or without tocolysis, not being a service to which items 55718 to 55728 and 55768 to 55774 apply — chargeable whether or not the version is successful and limited to a maximum of 2 ECV’s per pregnancy

111.15

16502

Polyhydramnios, unstable lie, multiple pregnancy, pregnancy complicated by diabetes or anaemia, threatened premature labour treated by bed rest only or oral medication, requiring admission to hospital — each attendance that is not a routine antenatal attendance, to a maximum of 1 visit per day

28.75

16504

Treatment of habitual miscarriage by injection of hormones — each injection up to a maximum of 12 injections, where the injection is not administered during a routine antenatal attendance

28.75

16505

Threatened abortion, threatened miscarriage or hyperemesis gravidarum, requiring admission to hospital, treatment of — each attendance that is not a routine antenatal attendance

28.75

16508

Pregnancy complicated by acute intercurrent infection, intra-uterine growth retardation, threatened premature labour with ruptured membranes or threatened premature labour treated by intravenous therapy, requiring admission to hospital — each attendance that is not a routine antenatal attendance, to a maximum of 1 visit per day

28.75

16509

Pre-eclampsia, eclampsia or antepartum haemorrhage, treatment of — each attendance that is not a routine antenatal attendance

28.75

16511

Cervix, purse string ligation of (Anaes.)

173.95

16512

Cervix, removal of purse string ligature of (Anaes.)

50.20

16514

Antenatal cardiotocography in the management of high risk pregnancy (not during the course of the confinement)

29.00

16515

Management of vaginal delivery as an independent procedure where the patient’s care has been transferred by another medical practitioner for management of the delivery and the attending medical practitioner has not provided antenatal care to the patient, including all attendances related to the delivery

274.15

16518

Management of labour, incomplete, where the patient’s care has been transferred to another medical practitioner for completion of the delivery

269.85

16519

Management of labour and delivery by any means (including Caesarean section) including post-partum care for 5 days

422.25

16520

Caesarean section and post-operative care for 7 days where the patient’s care has been transferred by another medical practitioner for management of the confinement and the attending medical practitioner has not provided any of the antenatal care

493.40

16522

Management of labour and delivery, or delivery alone, (including Caesarean section), where in the course of antenatal supervision or intrapartum management, 1 or more, of the following conditions is present, including postnatal care for 7 days:

   (a)  multiple pregnancy;

991.40

 

  (b)  recurrent antepartum haemorrhage from 20 weeks gestation;

   (c)  grades 2, 3 or 4 placenta praevia;

  (d)  baby with a birth weight less than or equal to 2500 gm;

   (e)  pre-existing diabetes mellitus dependent on medication, or gestational diabetes requiring at least daily blood glucose monitoring;

   (f)  trial of vaginal delivery in a patient with uterine scar, or trial of vaginal breech delivery;

   (g)  pre-existing hypertension requiring antihypertensive medication, or pregnancy induced hypertension of at least 140/90mmHg associated with at least 1+ proteinuria on urinalysis;

  (h)  prolonged labour greater than 12 hours with partogram evidence of abnormal cervimetric progress;

   (i)  fetal distress defined by significant cardiotocograph or scalp pH abnormalities requiring immediate delivery;

   (j)  conditions that pose a significant risk of maternal death

 

16525

Management of second trimester labour, with or without induction, for intrauterine fetal death, gross fetal abnormality or life threatening maternal disease, not being a service to which item 35643 applies

233.90

16564

Evacuation of retained products of conception (placenta, membranes or mole) as a complication of confinement, with or without curettage of the uterus, as an independent procedure

172.45

16567

Management of postpartum haemorrhage by special measures such as packing of uterus, as an independent procedure

252.25

16570

Acute inversion of the uterus, vaginal correction of, as an independent procedure

329.05

16571

Cervix, repair of extensive laceration or lacerations

252.25

16573

Third degree tear, involving anal sphincter muscles and rectal mucosa, repair of, as an independent procedure

205.55

16600

Amniocentesis, diagnostic

50.20

16603

Chorionic villus sampling, by any route

96.45

16606

Fetal blood sampling, using interventional techniques from umbilical cord or fetus, including fetal neuromuscular blockade and amniocentesis (Anaes.)

192.35

16609

Fetal intravascular blood transfusion, using blood already collected, including neuromuscular blockade, amniocentesis and fetal blood sampling (Anaes.)

392.35

16612

Fetal intraperitoneal blood transfusion, using blood already collected, including neuromuscular blockade, amniocentesis and fetal blood sampling — not performed in conjunction with a service described in item 16609 (Anaes.)

308.70

16615

Fetal intraperitoneal blood transfusion, using blood already collected, including neuromuscular blockade, amniocentesis and fetal blood sampling — performed in conjunction with a service described in item 16609 (Anaes.)

164.35

16618

Amniocentesis, therapeutic, when indicated because of polyhydramnios with at least 500 ml being aspirated

164.35

16621

Amnioinfusion, for diagnostic or therapeutic purposes in the presence of severe oligohydramnios

164.35

16624

Fetal fluid filled cavity, drainage of

236.60

16627

Feto-amniotic shunt, insertion of, into fetal fluid filled cavity, including neuromuscular blockade and amniocentesis

481.65

16633

Procedure on multiple pregnancies relating to items 16606, 16609, 16612, 16615 and 16627

Amount under rule 33

16636

Procedure on multiple pregnancies relating to items 16600, 16603, 16618, 16621 and 16624

Amount under rule 33

Group T6 — Examination by an anaesthetist

 

17603

Examination of a patient in preparation for the administration of an anaesthetic relating to a clinically relevant service, being an examination carried out at a place other than an operating theatre or an anaesthetic induction room

33.95

Group T7 — Regional or field nerve blocks

 

18213

Intravenous regional anaesthesia of limb by retrograde perfusion

70.15

18216

Intrathecal or epidural infusion of a therapeutic substance, initial injection or commencement of, including up to 1 hour of continuous attendance by the medical practitioner

150.20

18219

Intrathecal or epidural infusion of a therapeutic substance, initial injection or commencement of, where continuous attendance by the medical practitioner extends beyond the first hour

Amount under rule 31

18222

Infusion of a therapeutic substance to maintain regional anaesthesia or analgesia, subsequent injection or revision of, where the period of continuous medical practitioner attendance is 15 minutes or less

29.75

18225

Infusion of a therapeutic substance to maintain regional anaesthesia or analgesia, subsequent injection or revision of, where the period of continuous medical practitioner attendance is more than 15 minutes

39.65

18228

Interpleural block, initial injection or commencement of infusion of a therapeutic substance

49.45

18230

Intrathecal or epidural injection of neurolytic substance

188.60

18232

Intrathecal or epidural injection of substance other than anaesthetic, contrast or neurolytic solutions, not being a service to which another item in this group applies

150.20

18233

Epidural injection of blood for blood patch

150.20

18234

Trigeminal nerve, primary division of, injection of an anaesthetic agent

98.75

18236

Trigeminal nerve, peripheral branch of, injection of an anaesthetic agent

49.45

18238

Facial nerve, injection of an anaesthetic agent, not being a service associated with a service to which item 18240 applies

29.75

18240

Retrobulbar or peribulbar injection of an anaesthetic agent

74.00

18242

Greater occipital nerve, injection of an anaesthetic agent

29.75

18244

Vagus nerve, injection of an anaesthetic agent

79.70

18246

Glossopharyngeal nerve, injection of an anaesthetic agent

79.70

18248

Phrenic nerve, injection of an anaesthetic agent

70.15

18250

Spinal accessory nerve, injection of an anaesthetic agent

49.45

18252

Cervical plexus, injection of an anaesthetic agent

79.70

18254

Brachial plexus, injection of an anaesthetic agent

79.70

18256

Suprascapular nerve, injection of an anaesthetic agent

49.45

18258

Intercostal nerve (single), injection of an anaesthetic agent

49.45

18260

Intercostal nerves (multiple), injection of an anaesthetic agent

70.15

18262

Ilio-inguinal, iliohypogastric or genitofemoral nerves, 1 or more of, injection of an anaesthetic agent

49.45

18264

Pudendal nerve, injection of an anaesthetic agent

79.70

18266

Ulnar, radial or median nerve, main trunk of, 1 or more of, injection of an anaesthetic agent, not being associated with a brachial plexus block

49.45

18268

Obturator nerve, injection of an anaesthetic agent

70.15

18270

Femoral nerve, injection of an anaesthetic agent

70.15

18272

Saphenous, sural, popliteal or posterior tibial nerve, main trunk of, 1 or more of, injection of an anaesthetic agent

49.45

18274

Paravertebral, cervical, thoracic, lumbar, sacral or coccygeal nerves, injection of an anaesthetic agent, (single vertebral level)

70.15

18276

Paravertebral nerves, injection of an anaesthetic agent, (multiple levels)

98.75

18278

Sciatic nerve, injection of an anaesthetic agent

70.15

18280

Sphenopalatine ganglion, injection of an anaesthetic agent

98.75

18282

Carotid sinus, injection of an anaesthetic agent, as an independent percutaneous procedure

79.70

18284

Stellate ganglion, injection of an anaesthetic agent, (cervical sympathetic block)

116.80

18286

Lumbar or thoracic nerves, injection of an anaesthetic agent, (paravertebral sympathetic block)

116.80

18288

Coeliac plexus or splanchnic nerves, injection of an anaesthetic agent

116.80

18290

Cranial nerve other than trigeminal, destruction by a neurolytic agent

197.55

18292

Nerve branch, destruction by a neurolytic agent, not being a service to which any other item in this group applies

98.75

18294

Coeliac plexus or splanchnic nerves, destruction by a neurolytic agent

139.20

18296

Lumbar sympathetic chain, destruction by a neurolytic agent

119.00

18298

Cervical or thoracic sympathetic chain, destruction by a neurolytic agent

139.20

Group T10 —  Anaesthesia performed in connection with certain services (Relative Value Guide)

 

Subgroup 1 — Head

 

20100

Initiation of management of anaesthesia for procedures on the skin, subcutaneous tissue, muscles, salivary glands or superficial vessels of the head, including biopsy, not being a service to which another item in this subgroup applies

85.75

20102

Initiation of management of anaesthesia for plastic repair of cleft lip

102.90

20104

Initiation of management of anaesthesia for electroconvulsive therapy

68.60

20120

Initiation of management of anaesthesia for procedures on external, middle or inner ear, including biopsy, not being a service to which another item in this subgroup applies

85.75

20124

Initiation of management of anaesthesia for otoscopy

68.60

20140

Initiation of management of anaesthesia for procedures on eye, not being a service to which another item in this subgroup applies

85.75

20142

Initiation of management of anaesthesia for lens surgery

102.90

20143

Initiation of management of anaesthesia for retinal surgery

102.90

20144

Initiation of administration of anaesthesia for corneal transplant

137.20

20145

Initiation of management of anaesthesia for vitrectomy

137.20

20146

Initiation of management of anaesthesia for biopsy of conjunctiva

85.75

20148

Initiation of management of anaesthesia for ophthalmoscopy

68.60

20160

Initiation of management of anaesthesia for procedures on nose or accessory sinuses, not being a service to which another item in this subgroup applies

85.75

20162

Initiation of management of anaesthesia for radical surgery on the nose and accessory sinuses

120.05

20164

Initiation of management of anaesthesia for biopsy of soft tissue of the nose and accessory sinuses

68.60

20170

Initiation of management of anaesthesia for intraoral procedures, including biopsy, not being a service to which another item in this subgroup applies

85.75

20172

Initiation of management of anaesthesia for repair of cleft palate

120.05

20174

Initiation of management of anaesthesia for excision of retropharyngeal tumour

154.35

20176

Initiation of management of anaesthesia for radical intraoral surgery

171.50

20190

Initiation of management of anaesthesia for procedures on facial bones, not being a service to which another item in this subgroup applies

85.75

20192

Initiation of management of anaesthesia for radical surgery on facial bones (including prognathism and extensive facial bone reconstruction)

171.50

20210

Initiation of management of anaesthesia for intracranial procedures, not being a service to which another item in this subgroup applies

257.25

20212

Initiation of management of anaesthesia for subdural taps

85.75

20214

Initiation of management of anaesthesia for burr holes of the cranium

154.35

20216

Initiation of management of anaesthesia for intracranial vascular procedures, including those for aneurysms or arterio-venous abnormalities

343.00

20220

Initiation of management of anaesthesia for spinal fluid shunt procedures

171.50

20222

Initiation of management of anaesthesia for ablation of an intracranial nerve

102.90

20225

Initiation of management of anaesthesia for all cranial bone procedures

205.80

Subgroup 2 — Neck

 

20300

Initiation of management of anaesthesia for procedures on the skin or subcutaneous tissue of the neck

85.75

 

20305

Initiation of management of anaesthesia for incision and drainage of large haematoma, large abscess, cellulitis or similar lesion or epiglottitis, causing life threatening airway obstruction

257.25

 

20320

Initiation of management of anaesthesia for procedures on oesophagus, thyroid, larynx, trachea, lymphatic system, muscles, nerves or other deep tissues of the neck, not being a service to which another item in this subgroup applies

102.90

 

20321

Initiation of management of anaesthesia for laryngectomy, hemi laryngectomy, laryngopharyngectomy or pharyngectomy

171.50

 

20330

Initiation of management of anaesthesia for laser surgery to the airway (excluding nose and mouth)

137.20

 

20350

Initiation of management of anaesthesia for procedures on major vessels of neck, not being a service to which another item in this subgroup applies

171.50

 

20352

Initiation of management of anaesthesia for simple ligation of major vessels of neck

85.75

 

Subgroup 3 — Thorax

 

20400

Initiation of management of anaesthesia for procedures on the skin or subcutaneous tissue of the anterior part of the chest, not being a service to which another item in this subgroup applies

51.45

 

20401

Initiation of management of anaesthesia for procedures on the breast, not being a service to which another item in this subgroup applies

68.60

 

20402

Initiation of management of anaesthesia for reconstructive procedures on breast

85.75

 

20403

Initiation of management of anaesthesia for removal of breast lump or for breast segmentectomy with axillary node dissection

85.75

 

20404

Initiation of management of anaesthesia for mastectomy

102.90

 

20405

Initiation of management of anaesthesia for reconstructive procedures on the breast using myocutaneous flaps

137.20

 

20406

Initiation of management of anaesthesia for radical or modified radical procedures on breast with internal mammary node dissection

222.95

 

20410

Initiation of management of anaesthesia for electrical conversion of arrhythmias

85.75

 

20420

Initiation of management of anaesthesia for procedures on the skin of the posterior part of the chest

85.75

 

20450

Initiation of management of anaesthesia for procedures on clavicle, scapula or sternum, not being a service to which another item in this subgroup applies

85.75

 

20452

Initiation of management of anaesthesia for radical surgery on clavicle, scapula or sternum

102.90

 

20470

Initiation of management of anaesthesia for partial rib resection, not being a service to which another item in this subgroup applies

102.90

 

20472

Initiation of management of anaesthesia for thoracoplasty

171.50

 

20474

Initiation of management of anaesthesia for radical procedures on chest wall

222.95

 

Subgroup 4 — Intrathoracic

 

20500

Initiation of management of anaesthesia for open procedures on the oesophagus

257.25

 

20520

Initiation of management of anaesthesia for all closed chest procedures (including rigid oesophagoscopy, bronchoscopy or transvenous pacemaker), not being a service to which another item in this subgroup applies

102.90

 

20522

Initiation of management of anaesthesia for needle biopsy of pleura

68.60

 

20524

Initiation of management of anaesthesia for pneumocentesis

68.60

 

20526

Initiation of management of anaesthesia for thoracoscopy

171.50

 

20528

Initiation of management of anaesthesia for mediastinoscopy

137.20

 

20540

Initiation of management of anaesthesia for thoracotomy procedures involving lungs, pleura, diaphragm, or mediastinum, not being a service to which another item in this subgroup applies

222.95

 

20542

Initiation of management of anaesthesia for pulmonary decortication

257.25

 

20546

Initiation of management of anaesthesia for pulmonary resection with thoracoplasty

257.25

 

20548

Initiation of management of anaesthesia for intrathoracic repair of trauma to trachea and bronchi

257.25

 

20560

Initiation of management of anaesthesia for open procedures on the heart, pericardium or great vessels of chest

343.00

 

Subgroup 5 —Spine and spinal cord

 

20600

Initiation of management of anaesthesia for procedures on cervical spine or spinal cord, or both, not being a service to which another item in this subgroup applies

171.50

 

20604

Initiation of management of anaesthesia for posterior cervical laminectomy with the patient in the sitting position

222.95

 

20620

Initiation of management of anaesthesia for procedures on thoracic spine or spinal cord, or both, not being a service to which another item in this subgroup applies

171.50

 

20622

Initiation of management of anaesthesia for thoracolumbar sympathectomy

222.95

 

20630

Initiation of management of anaesthesia for procedures in lumbar region, not being a service to which another item in this subgroup applies

137.20

 

20632

Initiation of management of anaesthesia for lumbar sympathectomy

120.05

 

20634

Initiation of management of anaesthesia for chemonucleolysis

171.50

 

20670

Initiation of management of anaesthesia for extensive spine or spinal cord procedures, or both

222.95

 

20680

Initiation of management of anaesthesia for manipulation of spine when performed in the operating theatre of a hospital or day hospital facility

51.45

 

20690

Initiation of management of anaesthesia for percutaneous spinal procedures, not being a service to which another item in this subgroup applies

85.75

 

Subgroup 6 — Upper abdomen

 

20700

Initiation of management of anaesthesia for procedures on the skin or subcutaneous tissue of the upper anterior abdominal wall, not being a service to which another item in this subgroup applies

51.45

 

20702

Initiation of management of anaesthesia for percutaneous liver biopsy

68.60

 

20705

Initiation of management of anaesthesia for diagnostic laparoscopy procedures

102.90

 

20706

Initiation of management of anaesthesia for laparoscopic procedures in the upper abdomen, not being a service to which another item in this subgroup applies

120.05

 

20730

Initiation of management of anaesthesia for procedures on the skin or subcutaneous tissue of the upper posterior abdominal wall, not being a service to which another item in this subgroup applies

85.75

 

20740

Initiation of management of anaesthesia for upper gastrointestinal endoscopic procedures

85.75

 

20745

Initiation of management of anaesthesia for upper gastrointestinal endoscopic procedures in association with acute gastrointestinal haemorrhage

102.90

 

20750

Initiation of management of anaesthesia for hernia repairs in upper abdomen, not being a service to which another item in this subgroup applies

68.60

 

20752

Initiation of management of anaesthesia for repair of incisional hernia or wound dehiscence, or both

102.90

 

20754

Initiation of management of anaesthesia for procedures on an omphalocele

120.05

 

20756

Initiation of management of anaesthesia for transabdominal repair of diaphragmatic hernia

154.35

 

20770

Initiation of management of anaesthesia for procedures on major upper abdominal blood vessels

257.25

 

20790

Initiation of management of anaesthesia for procedures within the peritoneal cavity in upper abdomen including cholecystectomy, gastrectomy, laparoscopic nephrectomy or bowel shunts

137.20

 

20791

Initiation of management of anaesthesia for gastric reduction or gastroplasty for the treatment of morbid obesity

171.50

 

20792

Initiation of management of anaesthesia for partial hepatectomy (excluding liver biopsy)

222.95

 

20793

Initiation of management of anaesthesia for extended or trisegmental hepatectomy

257.25

 

20794

Initiation of management of anaesthesia for pancreatectomy, partial or total

205.80

 

20798

Initiation of management of anaesthesia for neuro endocrine tumour removal in the upper abdomen

171.50

 

Subgroup 7 — Lower abdomen

 

20800

Initiation of management of anaesthesia for procedures on the skin or subcutaneous tissue of the lower anterior abdominal walls, not being a service to which another item in this subgroup applies

51.45

 

20802

Initiation of management of anaesthesia for lipectomy of the lower abdomen

85.75

 

20805

Initiation of management of anaesthesia for diagnostic laparoscopic procedures

102.90

 

20806

Initiation of management of anaesthesia for laparoscopic procedures in the lower abdomen

120.05

 

20810

Initiation of management of anaesthesia for lower intestinal endoscopic procedures

68.60

 

20815

Initiation of management of anaesthesia for extracorporeal shock wave lithotripsy to urinary tract

102.90

 

20820

Initiation of management of anaesthesia for procedures on the skin, its derivatives or subcutaneous tissue of the lower posterior abdominal wall

85.75

 

20830

Initiation of management of anaesthesia for hernia repairs in lower abdomen, not being a service to which another item in this subgroup applies

68.60

 

20832

Initiation of management of anaesthesia for repair of incisional herniae or wound dehiscence, or both, of the lower abdomen

102.90

 

20840

Initiation of management of anaesthesia for all procedures within the peritoneal cavity in lower abdomen, including appendicectomy, not being a service to which another item in this subgroup applies

102.90

 

20841

Initiation of management of anaesthesia for bowel resection, including laparoscopic bowel resection, not being a service to which another item in this subgroup applies

137.20

 

20842

Initiation of management of anaesthesia for amniocentesis

68.60

 

20844

Initiation of management of anaesthesia for abdominoperineal resection, including pull through procedures, ultra low anterior resection and formation of bowel reservoir

171.50

 

20845

Initiation of management of anaesthesia for radical prostatectomy

171.50

 

20846

Initiation of management of anaesthesia for radical hysterectomy

171.50

 

20848

Initiation of management of anaesthesia for pelvic exenteration

171.50

 

20850

Initiation of management of anaesthesia for caesarean section

205.80

 

20855

Initiation of management of anaesthesia for caesarean hysterectomy

257.25

 

20860

Initiation of management of anaesthesia for extraperitoneal procedures in lower abdomen, including those on the urinary tract, not being a service to which another item in this subgroup applies

102.90

 

20862

Initiation of management of anaesthesia for renal procedures, including upper one-third of ureter

120.05

 

20864

Initiation of management of anaesthesia for total cystectomy

171.50

 

20866

Initiation of management of anaesthesia for adrenalectomy

171.50

 

20867

Initiation of management of anaesthesia for neuro endocrine tumour removal in the lower abdomen

171.50

 

20868

Initiation of management of anaesthesia for renal transplantation (donor or recipient)

171.50

 

20880

Initiation of management of anaesthesia for procedures on major lower abdominal vessels, not being a service to which another item in this subgroup applies

257.25

 

20882

Initiation of management of anaesthesia for inferior vena cava ligation

171.50

 

20884

Initiation of management of anaesthesia for percutaneous umbrella insertion

85.75

 

Subgroup 8 — Perineum

 

20900

Initiation of management of anaesthesia for procedures on the skin or subcutaneous tissue of the perineum (including biopsy of male genital system), not being a service to which another item in this subgroup applies

51.45

 

20902

Initiation of management of anaesthesia for anorectal procedures (including endoscopy or biopsy, or both)

68.60

 

20904

Initiation of management of anaesthesia for radical perineal procedures, including radical perineal prostatectomy or radical vulvectomy

120.05

 

20906

Initiation of management of anaesthesia for vulvectomy

68.60

 

20910

Initiation of management of anaesthesia for transurethral procedures (including urethrocyctoscopy), not being a service to which another item in this subgroup applies

68.60

 

20912

Initiation of management of anaesthesia for transurethral resection of bladder tumour or tumours

85.75

 

20914

Initiation of management of anaesthesia for transurethral resection of prostate

120.05

 

20916

Initiation of management of anaesthesia for bleeding

post-transurethral resection

120.05

 

20920

Initiation of management of anaesthesia for procedures on male external genitalia, not being a service to which another item in this subgroup applies

51.45

 

20924

Initiation of management of anaesthesia for procedures on undescended testis, unilateral or bilateral

68.60

 

20926

Initiation of management of anaesthesia for radical orchidectomy, inguinal approach

68.60

 

20928

Initiation of management of anaesthesia for radical orchidectomy, abdominal approach

102.90

 

20930

Initiation of management of anaesthesia for orchiopexy, unilateral or bilateral

68.60

 

20932

Initiation of management of anaesthesia for complete amputation of penis

68.60

 

20934

Initiation of management of anaesthesia for complete amputation of penis with bilateral inguinal lymphadenectomy

102.90

 

20936

Initiation of management of anaesthesia for complete amputation of penis with bilateral inguinal and iliac lymphadenectomy

137.20

 

20938

Initiation of management of anaesthesia for insertion of penile prosthesis

68.60

 

20940

Initiation of management of anaesthesia for vaginal procedures (including biopsy of labia, vagina, cervix or endometrium), not being a service to which another item in this subgroup applies

51.45

 

20942

Initiation of management of anaesthesia for colpotomy, colpectomy or colporrhaphy

68.60

 

20943

Initiation of management of anaesthesia for transvaginal oocyte collection

68.60

 

20944

Initiation of management of anaesthesia for vaginal hysterectomy

102.90

 

20946

Initiation of management of anaesthesia for vaginal delivery

137.20

 

20948

Initiation of management of anaesthesia for purse string ligation of cervix, or removal of purse string ligature, or removal of purse string ligature

68.60

 

20950

Initiation of management of anaesthesia for culdoscopy

85.75

 

20952

Initiation of management of anaesthesia for hysteroscopy

68.60

 

20954

Initiation of management of anaesthesia for correction of inverted uterus

171.50

 

Subgroup 9 — Pelvis (except hip)

 

21100

Initiation of management of anaesthesia for procedures on the skin or subcutaneous tissue of the anterior pelvic region (anterior to iliac crest), except external genitalia

51.45

 

21110

Initiation of management of anaesthesia for procedures on the skin, its derivatives or subcutaneous tissue of the pelvic region (posterior to iliac crest), except perineum

85.75

 

21120

Initiation of management of anaesthesia for procedures on the bony pelvis

102.90

 

21130

Initiation of management of anaesthesia for body cast application or revision, when performed in the operating theatre of a hospital or day hospital facility

51.45

 

21140

Initiation of management of anaesthesia for interpelviabdominal (hindquarter) amputation

257.25

 

21150

Initiation of management of anaesthesia for radical procedures for tumour of the pelvis, except hindquarter amputation

171.50

 

21160

Initiation of management of anaesthesia for closed procedures involving symphysis pubis or sacroiliac joint, when performed in the operating theatre of a hospital or day hospital facility

68.60

 

21170

Initiation of management of anaesthesia for open procedures involving symphysis pubis or sacroiliac joint

68.60

 

Subgroup 10 — Upper leg (except knee)

 

21195

Initiation of management of anaesthesia for procedures on the skins or subcutaneous tissue of the upper leg

51.45

 

21199

Initiation of management of anaesthesia for procedures on nerves, muscles, tendons, fascia or bursae of the upper leg

68.60

 

21200

Initiation of management of anaesthesia for closed procedures involving hip joint, when performed in the operating theatre of a hospital or day hospital facility

68.60

 

21202

Initiation of management of anaesthesia for arthroscopic procedures of the hip joint

68.60

 

21210

Initiation of management of anaesthesia for open procedures involving hip joint, not being a service to which another item in this subgroup applies

102.90

 

21212

Initiation of management of anaesthesia for hip disarticulation

171.50

 

21214

Initiation of management of anaesthesia for total hip replacement or revision

171.50

 

21220

Initiation of management of anaesthesia for closed procedures involving upper two-third of femur, when performed in the operating theatre of a hospital or day hospital facility

68.60

 

21230

Initiation of management of anaesthesia for open procedures involving upper two-third of femur, not being a service to which another item in this subgroup applies

102.90

 

21232

Initiation of management of anaesthesia for above knee amputation

85.75

 

21234

Initiation of management of anaesthesia for radical resection of the upper two-third of femur

137.20

 

21260

Initiation of management of anaesthesia for procedures involving veins of upper leg, including exploration

68.60

 

21270

Initiation of management of anaesthesia for procedures involving arteries of upper leg, including bypass graft, not being a service to which another item in this subgroup applies

137.20

 

21272

Initiation of management of anaesthesia for femoral artery ligation

68.60

 

21274

Initiation of management of anaesthesia for femoral artery embolectomy

102.90

 

21280

Initiation of management of anaesthesia for microsurgical reimplantation of upper leg

257.25

 

Subgroup 11 — Knee and popliteal area

 

21300

Initiation of management of anaesthesia for procedures on the skin or subcutaneous tissue of the knee or popliteal area, or both

51.45

 

21321

Initiation of management of anaesthesia for procedures on nerves, muscles, tendons, fascia or bursae of knee or popliteal area, or both

68.60

 

21340

Initiation of management of anaesthesia for closed procedures on lower one-third of femur, when performed in the operating theatre of a hospital or day hospital facility

68.60

 

21360

Initiation of management of anaesthesia for open procedures on lower one-third of femur

85.75

 

21380

Initiation of management of anaesthesia for closed procedures on knee joint when performed in the operating theatre of a hospital or day hospital facility

51.45

 

21382

Initiation of management of anaesthesia for arthroscopic procedures of knee joint

68.60

 

21390

Initiation of management of anaesthesia for closed procedures on upper ends of tibia, fibula or patella, or any of them, when performed in the operating theatre of a hospital or day hospital facility

51.45

 

21392

Initiation of management of anaesthesia for open procedures on upper ends of tibia, fibula or patella, or any of them

68.60

 

21400

Initiation of management of anaesthesia for open procedures on knee joint, not being a service to which another item in this subgroup applies

68.60

 

21402

Initiation of management of anaesthesia for total knee replacement

120.05

 

21403

Initiation of management of anaesthesia for bilateral knee replacement

171.50

 

21404

Initiation of management of anaesthesia for disarticulation of knee

85.75

 

21420

Initiation of management of anaesthesia for cast application, removal or repair, involving knee joint, undertaken in a hospital or approved day hospital facility

51.45

 

21430

Initiation of management of anaesthesia for procedures on veins of knee or popliteal area, not being a service to which another item in this subgroup applies

68.60

 

21432

Initiation of management of anaesthesia for repair of arteriovenous fistula of knee or popliteal area

85.75

 

21440

Initiation of management of anaesthesia for procedures on arteries of knee or popliteal area, not being a service to which another item in this subgroup applies

137.20

 

Subgroup 12 — Lower leg (below knee)

 

21460

Initiation of management of anaesthesia for procedures on the skin or subcutaneous tissue of lower leg, ankle, or foot

51.45

 

21461

Initiation of management of anaesthesia for procedures on nerves, muscles, tendons, or fascia of lower leg, ankle, or foot, not being a service to which another item in this subgroup applies

68.60

 

21462

Initiation of management of anaesthesia for all closed procedures on lower leg, ankle, or foot

51.45

 

21464

Initiation of management of anaesthesia for arthroscopic procedure of ankle joint

68.60

 

21472

Initiation of management of anaesthesia for repair of achilles tendon

85.75

 

21474

Initiation of management of anaesthesia for gastrocnemius recession

85.75

 

21480

Initiation of management of anaesthesia for open procedures on bones of lower leg, ankle, or foot, including amputation, not being a service to which another item in this subgroup applies

68.60

 

21482

Initiation of management of anaesthesia for radical resection of bone involving lower leg, ankle or foot

85.75

 

21484

Initiation of management of anaesthesia for osteotomy or osteoplasty of tibia or fibula

85.75

 

21486

Initiation of management of anaesthesia for total ankle replacement

120.05

 

21490

Initiation of management of anaesthesia for lower leg cast application, removal or repair, undertaken in a hospital or approved day hospital facility

51.45

 

21500

Initiation of management of anaesthesia for procedures on arteries of lower leg, including bypass graft, not being a service to which another item in this subgroup applies

137.20

 

21502

Initiation of management of anaesthesia for embolectomy of the lower leg

102.90

 

21520

Initiation of management of anaesthesia for procedures on veins of lower leg, not being a service to which another item in this subgroup applies

68.60

 

21522

Initiation of management of anaesthesia for venous thrombectomy of the lower leg

85.75

 

21530

Initiation of management of anaesthesia for microsurgical reimplantation of lower leg, ankle or foot

257.25

 

21532

Initiation of management of anaesthesia for microsurgical reimplantation of toe

137.20

 

Subgroup 13 — shoulder and axilla

 

21600

Initiation of management of anaesthesia for procedures on the skin or subcutaneous tissue of the shoulder or axilla

51.45

 

21610

Initiation of management of anaesthesia for procedures on nerves, muscles, tendons, fascia or bursae of shoulder or axilla, including axillary dissection

85.75

 

21620

Initiation of management of anaesthesia for closed procedures on humeral head and neck, sternoclavicular joint, acromioclavicular joint or shoulder joint, when performed in the operating theatre of a hospital or day hospital facility

68.60

 

21622

Initiation of management of anaesthesia for arthroscopic procedures of shoulder joint

85.75

 

21630

Initiation of management of anaesthesia for open procedures on humeral head and neck, sternoclavicular joint, acromioclavicular joint or shoulder joint, not being a service to which another item in this subgroup applies

85.75

 

21632

Initiation of management of anaesthesia for radical resection involving humeral head and neck, sternoclavicular joint, acromioclavicular joint or shoulder joint

102.90

 

21634

Initiation of management of anaesthesia for shoulder disarticulation

154.35

 

21636

Initiation of management of anaesthesia for interthoracoscapular (forequarter) amputation

257.25

 

21638

Initiation of management of anaesthesia for total shoulder replacement

171.50

 

21650

Initiation of management of anaesthesia for procedures on arteries of shoulder or axilla, not being a service to which another item in this subgroup applies

137.20

 

21652

Initiation of management of anaesthesia for procedures for axillary-brachial aneurysm

171.50

 

21654

Initiation of management of anaesthesia for bypass graft of arteries of shoulder or axilla

137.20

 

21656

Initiation of management of anaesthesia for

axillary-femoral bypass graft

171.50

 

21670

Initiation of management of anaesthesia for procedures on veins of shoulder or axilla

68.60

 

21680

Initiation of management of anaesthesia for shoulder cast application, removal or repair, not being a service to which another item in this subgroup applies, when undertaken in a hospital or approved day hospital facility

51.45

 

21682

Initiation of management of anaesthesia for shoulder spica application, when undertaken in a hospital or approved day hospital facility

68.60

 

Subgroup 14 — Upper arm and elbow

 

21700

Initiation of management of anaesthesia for procedures on the skin or subcutaneous tissue of the upper arm or elbow

51.45

 

21710

Initiation of management of anaesthesia for procedures on nerves, muscles, tendons, fascia or bursae of upper arm or elbow, not being a service to which another item in this subgroup applies

68.60

 

21712

Initiation of management of anaesthesia for open tenotomy of the upper arm or elbow

85.75

 

21714

Initiation of management of anaesthesia for tenoplasty of the upper arm or elbow

85.75

 

21716

Initiation of management of anaesthesia for tenodesis for rupture of long tendon of biceps

85.75

 

21730

Initiation of management of anaesthesia for closed procedures on the upper arm or elbow, when performed in the operating theatre of a hospital or day hospital facility

51.45

 

21732

Initiation of management of anaesthesia for arthroscopic procedures of elbow joint

68.60

 

21740

Initiation of management of anaesthesia for open procedures on the upper arm or elbow, not being a service to which another item in this subgroup applies

85.75

 

21756

Initiation of management of anaesthesia for radical procedures on the upper arm or elbow

102.90

 

21760

Initiation of management of anaesthesia for total elbow replacement

120.05

 

21770

Initiation of management of anaesthesia for procedures on arteries of upper arm, not being a service to which another item in this subgroup applies

137.20

 

21772

Initiation of management of anaesthesia for embolectomy of arteries of the upper arm

102.90

 

21780

Initiation of management of anaesthesia for procedures on veins of upper arm, not being a service to which another item in this subgroup applies

68.60

 

21790

Initiation of management of anaesthesia for microsurgical reimplantation of upper arm

257.25

 

Subgroup 15 — Forearm wrist and hand

 

21800

Initiation of management of anaesthesia for procedures on the skin or subcutaneous tissue of the forearm, wrist or hand

51.45

 

21810

Initiation of management of anaesthesia for procedures on the nerves, muscles, tendons, fascia, or bursae of the forearm, wrist or hand

68.60

 

21820

Initiation of management of anaesthesia for closed procedures on the radius, ulna, wrist, or hand bones, when performed in the operating theatre of a hospital or day hospital facility

51.45

 

21830

Initiation of management of anaesthesia for open procedures on the radius, ulna, wrist, or hand bones, not being a service to which another item in this subgroup applies

68.60

 

21832

Initiation of management of anaesthesia for total wrist replacement

120.05

 

21834

Initiation of management of anaesthesia for arthroscopic procedures of the wrist joint

68.60

 

21840

Initiation of management of anaesthesia for procedures on the arteries of forearm, wrist or hand, not being a service to which another item in this subgroup applies

137.20

 

21842

Initiation of management of anaesthesia for embolectomy of artery of forearm, wrist or hand

102.90

 

21850

Initiation of management of anaesthesia for procedures on the veins of forearm, wrist or hand, not being a service to which another item in this subgroup applies

68.60

 

21860

Initiation of management of anaesthesia for forearm, wrist, or hand cast application, removal or repair, when undertaken in a hospital or approved day hospital facility

51.45

 

21870

Initiation of management of anaesthesia for microsurgical reimplantation of forearm, wrist or hand

257.25

 

21872

Initiation of management of anaesthesia for microsurgical reimplantation of a finger

137.20

 

Subgroup 16 — Anaesthesia for burns

 

21878

Initiation of management of anaesthesia for excision or debridement of burns, with or without skin grafting, where the area of burn involves not more than 3% of total body surface

51.45

 

21879

Initiation of management of anaesthesia for excision or debridement of burns, with or without skin grafting, where the area of burn involves more than 3% but less than 10% of total body surface

85.75

 

21880

Initiation of management of anaesthesia for excision or debridement of burns, with or without skin grafting, where the area of burn involves 10% or more but less than 20% of total body surface

120.05

 

21881

Initiation of management of anaesthesia for excision or debridement of burns, with or without skin grafting, where the area of burn involves 20% or more but less than 30% of total body surface

154.35

 

21882

Initiation of management of anaesthesia for excision or debridement of burns, with or without skin grafting, where the area of burn involves 30% or more but less than 40% of total body surface

188.65

 

21883

Initiation of management of anaesthesia for excision or debridement of burns, with or without skin grafting, where the area of burn involves 40% or more but less than 50% of total body surface

222.95

 

21884

Initiation of management of anaesthesia for excision or debridement of burns, with or without skin grafting, where the area of burn involves 50% or more but less than 60% of total body surface

275.25

 

21885

Initiation of management of anaesthesia for excision or debridement of burns, with or without skin grafting, where the area of burn involves 60% or more but less than 70% of total body surface

291.55

 

21886

Initiation of management of anaesthesia for excision or debridement of burns, with or without skin grafting, where the area of burn involves 70% or more but less than 80% of total body surface

325.85

 

21887

Initiation of management of anaesthesia for excision or debridement of burns, with or without skin grafting, where the area of burn involves 80% or more of total body surface

360.15

 

Subgroup 17 — Anaesthesia for radiological or other diagnostic or therapeutic procedures

 

21900

Initiation of management of anaesthesia for injection procedure for hysterosalpingography

51.45

 

21906

Initiation of management of anaesthesia for injection procedure for myelography — lumbar or thoracic

85.75

 

21908

Initiation of management of anaesthesia for injection procedure for myelography — cervical

102.90

 

21910

Initiation of management of anaesthesia for injection procedure for myelography — posterior fossa

154.35

 

21912

Initiation of management of anaesthesia for injection procedure for discography — lumbar or thoracic

85.75

 

21914

Initiation of management of anaesthesia for injection procedure for discography — cervical

102.90

 

21915

Initiation of management of anaesthesia for peripheral arteriogram

85.75

 

21916

Initiation of management of anaesthesia for arteriograms — cerebral, carotid or vertebral

85.75

 

21918

Initiation of management of anaesthesia for retrograde arteriogram: brachial or femoral

85.75

 

21922

Initiation of management of anaesthesia for computerised axial tomography scanning, magnetic resonance scanning or digital subtraction angiography scanning

120.05

 

21925

Initiation of management of anaesthesia for retrograde cystography, retrograde urethrography or retrograde cystourethrography

68.60

 

21926

Initiation of management of anaesthesia for fluoroscopy

85.75

 

21927

Initiation of management of anaesthesia for barium enema or other opaque study of the small bowel

85.75

 

21930

Initiation of management of anaesthesia for bronchography

102.90

 

21935

Initiation of management of anaesthesia for phlebography

85.75

 

21936

Initiation of management of anaesthesia for heart — 2 dimensional real time transoesophageal examination

102.90

 

21939

Initiation of management of anaesthesia for peripheral venous cannulation

51.45

 

21941

Initiation of management of anaesthesia for cardiac catheterisation (including coronary arteriography, ventriculography or cardiac mapping)

120.05

 

21943

Initiation of management of anaesthesia for central vein catheterisation or insertion of right heart balloon catheter (via jugular, subclavian or femoral vein) by percutaneous or open exposure

85.75

 

21945

Initiation of management of anaesthesia for lumbar puncture, cisternal puncture, or epidural injection

85.75

 

21949

Initiation of management of anaesthesia for harvesting of bone marrow for the purpose of transplantation

85.75

 

21952

Initiation of management of anaesthesia for muscle biopsy for malignant hyperpyrexia

171.50

 

21955

Initiation of management of anaesthesia for electroencephalography

85.75

 

21959

Initiation of management of anaesthesia for brain stem evoked response audiometry

85.75

 

21962

Initiation of management of anaesthesia for electrocochleography by extratympanic method or transtympanic membrane insertion method

85.75

 

21965

Initiation of management of anaesthesia as a therapeutic procedure where it can be demonstrated that there is a clinical need for anaesthesia

85.75

 

21969

Initiation of management of anaesthesia during hyperbaric therapy, where the medical practitioner is not confined in the chamber (including the administration of oxygen)

137.20

 

21970

Initiation of management of anaesthesia during hyperbaric therapy, where the medical practitioner is confined in the chamber (including the administration of oxygen)

257.25

 

21973

Initiation of management of anaesthesia for brachytherapy using radioactive sealed sources

85.75

 

21976

Initiation of management of anaesthesia for therapeutic nuclear medicine

85.75

 

21980

Initiation of management of anaesthesia for radiotherapy

85.75

 

Subgroup 18 — Miscellaneous

 

21990

Initiation of management of anaesthesia, being a service to which another item in this subgroup or in Subgroups 1 to 17 or 20 would have applied if the procedure in connection with which the service is provided had not been discontinued

51.45

 

21992

Initiation of management of anaesthesia performed on a person under the age of 10 years in connection with a procedure covered by an item that does not include the word ‘(Anaes.)’

68.60

 

21997

Initiation of management of anaesthesia in connection with a procedure covered by an item that does not include the word ‘(Anaes.)’, not being a service to which item 21965 or 21992 applies, where it can be demonstrated that