Health Insurance (1990-91 General Medical Services Table) Regulations (Cth)

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Statutory Rules 1990 No. 3421

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Health Insurance (1990-91 General Medical Services Table) Regulations

I, THE GOVERNOR-GENERAL of the Commonwealth of Australia, acting with the advice of the Federal Executive Council, hereby make the following Regulations under the Health Insurance Act 1973.

Dated 25 October 1990.

BILL HAYDEN

Governor-General

By His Excellency's Command,

B. HOWE

Minister of State for Community Services

and Health

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Citation

1. These Regulations may be cited as the Health Insurance (1990-91 General Medical Services Table) Regulations.

Commencement

2. These Regulations commence on 1 November 1990.

Repeal

3. Statutory Rules 1989 Nos. 230 and 329 and 1990 Nos. 83 and 250 are repealed.

General medical services table

4. The table of medical services in the Schedule is prescribed for the purposes of subsection 4 (2) of the Health Insurance Act 1973.

SCHEDULE Regulation 4

TABLE OF MEDICAL SERVICES

RULES OF INTERPRETATION

1. In this table:

"item" means an item in the list of services and fees in this table;

"Division" means a Division of a Part of that list;

"Part" means a Part of that list.

2. If an item in Part 1, in Division 3 of Part 3 or in Part 4 includes the symbol "(S)", the item is taken to relate to the service specified in the item when rendered by a specialist in the practice of his or her specialty.

3. If an item in Part 1, in Division 3 of Part 3 or in Part 4 includes the symbol "(G)", the item is taken to relate to the service specified in the item when rendered otherwise than by a specialist in the practice of his or her specialty.

4. If an item (other than an item in Part 1, in Division 3 of Part 3 or in Part 4) includes the symbol "(S)", the item is taken to relate to a service specified in the item when rendered by a specialist in the practice of his or her specialty:

(a) to a patient who has been referred to the specialist, where the service is the first service rendered to the patient by the specialist after the referral; or

(b) to a patient who has been referred to the specialist, where the service constitutes part of a single course of treatment rendered to the patient for the condition identified in the referral, or, if no condition was identified in the referral, for the condition identified by the specialist, and that service is rendered within the period of 12 months (or such lesser period, if any, specified by the medical practitioner who referred the patient) after the day on which the first service rendered pursuant to that referral was rendered; or

(c) to a patient who has declared that a written referral was completed by a specified medical practitioner and that the referral has been lost, stolen or destroyed before the rendering of the service, where that service is the first service rendered by the specialist pursuant to that referral or where that service constitutes part of a single course of treatment rendered to the patient for the condition identified by the specialist when he or she rendered the first service rendered to that patient after the making of the declaration and that service is rendered within the period of 12 months after the day on which the first service rendered pursuant to that referral was rendered; or

(d) to a patient who has not been referred to the specialist, where the specialist was, at the time that the service was rendered, of the opinion that it was necessary that that service be rendered as quickly as possible.

5. If an item (other than an item in Part 1, in Division 3 of Part 3 or in Part 4) includes the symbol "(G)", the item is taken to relate to the service specified in the item when rendered otherwise than by a specialist in accordance with rule 4.

6. A reference in rule 4 or 5 or in Part 1 to the referring of a patient to a specialist is a reference to a referring by a medical practitioner and:

(a) if the specialist concerned is an ophthalmologist—includes a reference to a referring by a registered optometrist or by a registered optician; and

SCHEDULE—continued

(b) if a referring arises out of a dental service rendered to the person who has been referred—includes a reference to a referring by a dental practitioner.

7. A reference in an item in Part 1 to an attendance by a specialist or consultant physician in the practice of his or her specialty if the patient is referred to him or her includes a reference to an attendance by a specialist or consultant physician in the practice of his or her specialty if:

(a) the patient has declared that a written referral in respect of the patient was completed by a medical practitioner named in the declaration and that the referral has been lost, stolen or destroyed before the attendance specified in the item; or

(b) the patient has not been referred to the specialist or consultant physician and the specialist or consultant physician was, at the time of the attendance specified in the item, of the opinion that it was necessary that that attendance occur as quickly as possible;

but does not include a reference to an attendance by a specialist or consultant physician in the practice of his or her specialty if the attendance forms part of a single course of treatment for which the first service was rendered on a day more than 12 months before the day on which that service was rendered, unless a later referral has been made.

8. (1) In the items in Parts 1, 2, 6 and 10 to which this rule applies, "attendance" means a physical attendance on not more than 1 person on a single occasion, other than an attendance on a person in the course of a group session.

(2) This rule applies to each of the following items:

(a) all items in Part 1 (other than items 170, 171 and 172);

(b) items 190, 192, 198, 246, 247, 248 and 273 in Part 2;

(c) items 821, 824, 890, 893 and 980 in Part 6;

(d) items 5264, 6835, 6904, 7601, 7605, 7694, 7697, 7701, 7706, 7774, 7781 and 7785 in Part 10.

9. (1) A service specified in:

(a) an item in Part 2, 3, 4, 5, 9 or 10; or

(b) an item in Part 6 to which rule 10 applies;

other than:

(c) item 290 in Part 2; or

(d) item 887, 888 or 889 in Part 6; or

(e) an item to which rule 8 applies; or

(f) an item in Part 10 that includes the symbol "D";

is a medical service only if the service is performed personally by a medical practitioner on not more than 1 patient on a single occasion.

(2) A service specified in:

(a) item 170, 171 or 172 in Part 1; or

(b) item 887, 888 or 889 in Part 6;

is a medical service only if the service is performed personally by a medical practitioner.

10. (1) A service specified in:

(a) an item in Part 1, 2, 3, 4, 5, 9 or 10; or

(b) an item in Part 6 to which this rule applies;

other than:

(c) item 180, 182, 184 or 186 in Part 1; or

(d) an item in Part 10 that includes the symbol "D";

SCHEDULE—continued

is a medical service for the purposes of the Act only if the service is rendered by a medical practitioner, being:

(e) a medical practitioner other than a medical practitioner employed by the proprietor of a hospital; or

(f) a medical practitioner who is employed by the proprietor of a hospital and renders that medical service otherwise than in the course of his or her employment by that proprietor;

whether or not essential assistance is provided, in accordance with accepted medical practice, to the medical practitioner rendering that service.

(2) This rule applies to each of the following items in Part 6, that is to say, items. 770, 774, 777, 787, 790, 810, 811, 813, 814, 819, 821, 824, 831, 833, 836, 839, 851, 852, 856, 886, 887, 888, 889, 890, 893, 895, 897, 902, 904, 907, 916, 917, 918, 922, 923, 924, 925, 931, 932, 934, 936, 938, 939, 940, 944, 947, 949, 950, 951, 953, 954, 956, 957, 960, 963, 968, 970, 974, 976, 977, 980, 987 and 989.

11. A service specified in item 290 or in an item in Part 6, 7A, 8, 8A, 9A or 11 (other than an item in Part 6 to which rule 10 applies) is a medical service for the purposes of this Act, whether the medical service is rendered by:

(a) a medical practitioner; or

(b) a person, other than a medical practitioner, who is employed by a medical practitioner or, in accordance with accepted medical practice, acts under the supervision of a medical practitioner.

12. A service to which an item in Division 5 of Part 6 relates (other than item 862, 877, 878, 879, 882, 883 or 884) is a medical service only if it is rendered:

(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 AS 1269-1983 of the Standards Association of Australia, being that Standard as in force on 1 August 1987; and

(c) using calibrated equipment that complies with Australian Standard AS 2586-1983 of the Standards Association of Australia, being that Standard as in force on 1 August 1987.

13. In Part 1, "institution" means a place (not being a hospital, nursing home, aged persons accommodation attached to a nursing home or aged persons accommodation situated within a nursing home complex) 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 mentally handicapped persons.

14. If an item in Part 9A includes the symbol "(HR)", the item relates to the service specified in the item when rendered with the use of magnetic resonance imaging equipment of a recognised hospital or a radiology unit included in a prescribed class of radiology units.

SCHEDULE—continued

15. If an item (other than an item in Part 3) includes a symbol in parentheses consisting of the letters "AU" followed by a number, that symbol refers to an item in Part 3 in respect of the administration of an anaesthetic in connection with the medical service to which the first-mentioned item relates, being:

(a) if the anaesthetic is administered by a medical practitioner other than a specialist anaesthetist—the relevant item in Division 1 of Part 3; or

(b) if the anaesthetic is administered by a specialist anaesthetist—the relevant item in Division 2 of Part 3.

16. For the purposes of rule 14, each of the following classes of radiology units is a prescribed class of radiology units:

(a) radiology units operated by the Commonwealth;

(b) radiology units operated by a State or an authority of a State;

(c) radiology units operated by the Northern Territory;

(d) radiology units operated by the Australian Capital Territory Community and Health Service;

(e) radiology units operated by Australian tertiary education institutions.

17. If an item includes the symbol "(D)", the item relates to the service specified in the item when rendered 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).

18. A reference in an item in Division 1 of Part 3 to the administration of an anaesthetic is a reference to the administration of an anaesthetic by a medical practitioner other than a specialist anaesthetist.

19. A reference in an item in Division 2 of Part 3 to the administration of an anaesthetic is a reference to the administration of an anaesthetic by a specialist anaesthetist.

20. A reference in an item in Division 3 of Part 3 to the administration of an anaesthetic is a reference to the administration of an anaesthetic in connection with a dental service other than a service that is a prescribed medical service for the purposes of paragraph (b) of the definition of "professional service" in subsection 3(1).

21. In item 793, "group of practitioners" has the same meaning as in section 16A.

22. A reference in an item referred to in a paragraph of this rule to an amount under this rule is a reference to an amount equal to the sum of the fee set out in the item that relates to a radiographic examination of the kind referred to in the first-mentioned item and:

(a) in the case of item 2732—$19.80; or

(b) in the case of item 2782—$21.00; or

(c) in the case of item 2798—$12.60.

23. A reference in an item referred to in a paragraph of this rule to an amount under this rule is a reference to an amount equal to the sum of the fee set out in the item that relates to a course of radiotherapy treatment of the kind referred to in the first-mentioned item when given to 1 field only and:

(a) in the case of item 2863—$11.40 for each field separately treated in excess of 1 up to a maximum of 5 additional fields; and

(b) in the case of item 2877—$12.60 for each field separately treated in excess of 1 up to a maximum of 5 additional fields; and

(c) in the case of item 2881—$15.00 for each field separately treated in excess of 1 up to a maximum of 5 additional fields; and

SCHEDULE—continued

(d) in the case of item 2889—$20.00 for each field separately treated in excess of 1 up to a maximum of 5 additional fields; and

(e) in the case of item 2893—$16.60 for each field separately treated in excess of 1 up to a maximum of 5 additional fields.

24. A reference in an item referred to in a paragraph of this rule to an amount under this rule is a reference to an amount equal to the sum of the fee set out in the item that relates to treatment by a single dose of radiotherapy of the kind referred to in the first-mentioned item when given to 1 field only and:

(a) in the case of item 2871—$12.40 for each field separately treated in excess of 1 up to a maximum of 5 additional fields; and

(b) in the case of item 2885—$31.50 for each field separately treated in excess of 1 up to a maximum of 5 additional fields.

25. A reference in item 2953 to an amount under this rule, being an amount payable for assistance at an operation, is a reference to an amount equal to one-fifth of the sum of the fees payable under this Act for the services at that operation of the practitioner to whom the assistance was rendered.

26. (1) A reference in item 2957 to an amount under this rule, being an amount payable for assistance at a series or combination of operations, is a reference to an amount equal to one-fifth of the sum of the fees payable under this Act for the services at those operations of the practitioner to whom the assistance was rendered.

(2) For the purposes of subrule (1), the amount payable for the Caesarean section component of the operations is the fee applicable to item 210.

27. A reference in an item referred to in a paragraph of this rule to an amount under this rule is a reference to an amount equal to the sum of the fee set out in the item that relates to a dislocation or fracture of the kind treated and:

(a) in the case of item 7483, 7809, 7812, 7817 or 7818—one-half of that fee; or

(b) in the case of item 7803, 7804, 7847 or 7849—one-third of that fee; or

(c) in the case of item 7823 or 7824—three-quarters of that fee.

28. A reference in item 482 or 553 to an amount under this rule is a reference to an amount equal to the sum of:

(a) the fee set out in the item relating to the administration of an anaesthetic that is referred to in the item relating to a dislocation of the kind treated (being an item relating to a dislocation that is referred to in items 7397 to 7472 (inclusive)); and

(b) one-half of the fee referred to in paragraph (a).

29. A reference in item 484 or 556 to an amount under this rule is a reference to an amount equal to the sum of:

(a) the fee set out in the item relating to the administration of an anaesthetic that is referred to in the item relating to a fracture of the kind treated (being an item relating to a fracture that is referred to in items 7505 to 7798 (inclusive)); and

(b) one-half of the fee referred to in paragraph (a).

30. A reference in item 483 or 554 to an amount under this rule is a reference to an amount equal to the sum of:

(a) the fee set out in the item relating to the administration of an anaesthetic that is referred to in the item relating to a fracture of the kind treated (being an item relating to a fracture that is referred to in items 7505 to 7798 (inclusive)); and

SCHEDULE—continued

(b) one-third of the fee referred to in paragraph (a).

31. A reference in item 485 or 557 to an amount under this rule is a reference to an amount equal to the sum of:

(a) the fee set out in the item relating to the administration of an anaesthetic that is referred to in the item relating to a fracture of the kind treated (being an item relating to a fracture that is referred to in items 7505 to 7798 (inclusive)); and

(b) three-quarters of the fee referred to in paragraph (a).

32. A reference in an item referred to in a paragraph of this rule to an amount under this rule is a reference to an amount equal to:

(a) in the case of item 488 or 560—85% of the fee set out in the item relating to the administration of an anaesthetic that is referred to in the item relating to an amputation of the kind performed (being an item relating to an amputation that is referred to in items 4927 to 5055 (inclusive)); or

(b) in the case of item 5057—75% of the fee set out in the item relating to an amputation of the kind performed (being an item relating to an amputation that is referred to in items 4927 to 5055 (inclusive)).

33. A reference in an item referred to in a paragraph of this rule to an amount under this rule is a reference to an amount equal to:

(a) in the case of item 7828, 7831, 7834 or 7836—one-half of the fee set out in the item that would, but for the first-mentioned item, relate to the reduction effected; or

(b) in the case of item 7839 or 7841—the fee set out in the item that would, but for that first-mentioned item, relate to the reduction effected; or

(c) in the case of item 7844—the fee set out in the item that relates to a simple and uncomplicated fracture of the part treated.

34. If an item in Part 11 includes the symbol "(C)", the item relates to a service specified in the item when rendered with the use of a radioisotope imaging scanner at a nuclear medicine unit that has computerised processing facilities capable of being used in the rendering of the service.

35. If an item in Part 11 includes the symbol "(NC)", the item relates to a service specified in the item when rendered with the use of a radioisotope imaging scanner at a nuclear medicine unit other than a nuclear medicine unit that has computerised processing facilities capable of being used in the rendering of the service.

36. If an item in Part 12 includes the symbol "(AD)", the item relates to the service specified in the item when rendered by an accredited dental practitioner.

37 (1). If an item in Part 12 includes the symbol "(AO)", the item relates to the service specified in the item when rendered by a recognised orthodontist.

(2) For the purposes of subrule (1) and Division 2 of Part 12, a person is a recognised orthodontist if the person is an accredited dental practitioner and:

(a) the person is registered or licensed as an orthodontist under a relevant law; or

(b) in the case of a person who is not so registered or licensed—the person, by means of his or her qualifications or experience, demonstrates to the Committee his or her competence in the field of orthodontics applicable to the rendering of the services specified in Division 1 of Part 12.

(3) In subrule (2):

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

SCHEDULE—continued

"relevant law" means a law of the State or Territory in which the service is rendered that provides for the registration or licensing of dental practitioners or dentists as orthodontists.

38. If an item in Part 12 includes the symbol "(AOS)", the item relates to the service specified in the item when rendered by an accredited dental practitioner who is a dental practitioner approved by the Minister for the purposes of the definition of "professional service" in subsection 3(1).

39. A reference in items 8658 to 8669 (inclusive) to maxilla includes a reference to the zygoma.

40. A reference in item 6931 to an amount under this rule is a reference to an amount equal to the sum of:

(a) the fee set out in the item relating to the squint operation performed (being an operation covered by item 6922, 6924 or 6930); and

(b) one-quarter of the fee referred to in paragraph (a).

41. A reference in item 2455 to an amount under this rule is a reference to an amount equal to the sum of:

(a) the fee set out in the item relating to the service (being a service in Part 7a) in conjunction with which the service referred to in item 2455 is performed; and

(b) $108.00.

42. A service specified in item 186 or 851 is a medical service for the purposes of this Act only if the service is performed upon a patient in any of the following classes of patients:

(a) patients with myopia of greater than 4.0 dioptres (spherical equivalent) in the dominant eye;

(b) patients with manifest hyperopia of greater than 5.0 dioptres (spherical equivalent) in the dominant eye;

(c) patients with astigmatism of greater than 4.0 dioptres in the dominant eye;

(d) patients with astigmatism of greater than 3.0 dioptres in the dominant eye, requiring, for distance correction, a lens of plus power plus 3.0 dioptres or greater in 1 meridian;

(e) 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 less than 6/12 and if that corrected acuity would be improved by more than 10% by the use of a contact lens;

(f) patients with anisometropia of greater than 4.0 dioptres (difference between spherical equivalents);

(g) patients with subnormal corrected visual acuity of not greater than 6/30 in either eye, being patients for whom a contact lens is prescribed as part of a telescopic system;

(h) patients for whom a wholly or segmentally opaque contact lens is prescribed for the alleviation of dazzle, distortion or diplopia caused by:

(i) pathological mydriasis; or

(ii) aniridia; or

(iii) coloboma of the iris; or

(iv) pupillary malformation or distortion;

whether congenital, traumatic or surgical in origin;

(i) patients who, by reason of physical deformity, are unable to wear spectacles and in respect of whom a medical practitioner has prescribed, or recommended the prescription of, contact lenses;

SCHEDULE—continued

(j) patients in respect of whom a participating optometrist (in the case of a service specified in item 186) or a medical practitioner (in the case of a service specified in item 851) has certified that an ocular or a medical condition (other than a condition referred to in paragraphs (a) to (h) (inclusive)), requiring for correction the use of contact lenses, is present.

43. In Parts 6 and 8, "report" means a report prepared by a medical practitioner.

44. In items 194, 196, 198, 201, 204 and 205 "confinement" 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) a medical service referred to in item 295 or 298 when performed at the time of delivery; and

(h) evacuation of the products of conception by manual removal;

but does not include a service referred to in an item in Division 2 of Part 2 (other than item 295 or 298).

45. In Part 1, "attendance of a minor nature" means an attendance by a consultant physician on a person, being an attendance that:

(a) is a second or subsequent attendance (in this rule called the "later attendance") in the course of a single course of treatment of that person by that consultant physician if it is not necessary for the consultant physician, in the course of the later attendance, to carry out a physical examination of the person; and

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

46. (1) In rules 4, 7 and 45 and items 104, 105, 107, 108, 110, 116, 119, 122, 128 and 131, a reference to a single course of treatment includes:

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

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

(2) For the purposes of subrule (1), occurrence in the patient of an unrelated illness, requiring referral of the patient to the specialist's or consultant physician's care, initiates a new course of treatment, in which case a new referral is required.

(3) For the purposes of subrule (1), if:

(a) the referring practitioner considers it necessary for the patient's condition to be reviewed; and

(b) the patient is seen by the specialist or consultant physician outside the currency of the last referral; and

(c) the patient was last seen by the specialist or consultant physician more than 9 months before the attendance;

the attendance initiates a new course of treatment.

(4) In subrule (3), "currency", in relation to the referral of a patient to a specialist, means the period of 12 months, or lesser period, applicable under paragraph 4 (b) or (c) to that referral.

SCHEDULE—continued

47. For the purposes of section 16, each operation referred to in item 204, 205, 210, 362, 363, 365 or 383 is a single operation.

48. A nuclear scanning service to which an item in Part 11 relates is a medical service for the purposes of this Act only if the preliminary examination of the patient, the estimation and administration of the dosage and performance of the scan are undertaken by a medical practitioner, or on behalf of a medical practitioner in the practitioner's presence, and the compilation of the final report is undertaken by the medical practioner.

49. A reference in item 8748 or 8749 to an amount under this rule is a reference to an amount equal to the sum of the fee set out in the item relating to the service (being a service in Part 11), in conjunction with which the service referred to in item 8748 or 8749 is performed and:

(a) in the case of item 8748—$84.00; and

(b) in the case of item 8749—$63.00.

50. A reference in item 8868 to an amount under this rule is a reference to an amount equal to the sum of:

(a) the fee set out in the item relating to the service (being a service in Part 11) in conjunction with which the service referred to in item 8868 is performed; and

(b) $168.00.

51. A reference in item 3, 4, 13, 19, 20, 23, 24, 25, 33, 35, 36, 37, 38, 40, 43, 44, 47, 48, 50 or 51 to a professional attendance may include (but is not limited to) the provision in relation to a patient of any 1 or more of the following services:

(a) the evaluation of the patient's medical condition or conditions including, if applicable, by use of the health screening services referred to in subsection 19(5);

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

(c) the provision:

(i) of advice to the patient as to the medical condition or conditions present in the patient and, if applicable, their treatment; or

(ii) if the patient has so authorised, of advice to a person or persons other than the patient as to the medical condition or conditions present in the patient and, where applicable, their treatment;

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

52. A reference in an item referred to in a paragraph of this rule to an amount under this rule is a reference to an amount equal to:

(a) in the case of item 13, 19 or 20—the sum of the fee set out in item 3 and:

(i) for each patient attended at a single attendance up to a maximum of 6 patients—an amount equal to $16.00 divided by the number of patients so attended; or

(ii) for each patient attended at a single attendance if the number of patients so attended is in excess of 6—$1.10; and

(b) in the case of item 25, 33 or 35—the sum of the fee set out in item 23 and:

(i) for each patient attended at a single attendance up to a maximum of 6 patients—an amount equal to $16.00 divided by the number of patients so attended; or

(ii) for each patient attended at a single attendance if the number of patients so attended is in excess of 6—$1.10; and

SCHEDULE—continued

(c) in the case of item 38, 40 or 43—the sum of the fee set out in item 36 and:

(i) for each patient attended at a single attendance up to a maximum of 6 patients—an amount equal to $16.00 divided by the number of patients so attended; or

(ii) for each patient attended at a single attendance if the number of patients so attended is in excess of 6—$1.10; and

(d) in the case of item 48, 50 or 51—the sum of the fee set out in item 44 and:

(i) for each patient attended at a single attendance up to a maximum of 6 patients—an amount equal to $16.00 divided by the number of patients so attended; or

(ii) for each patient attended at a single attendance if the number of patients so attended is in excess of 6—$1.10; and

(e) in the case of item 81, 87 or 92—the sum of the fee set out in item 52 and:

(i) for each patient attended at a single attendance up to a maximum of 6 patients—an amount equal to $10.00 divided by the number of patients so attended; or

(ii) for each patient attended at a single attendance if the number of patients so attended is in excess of 6—65 cents; and

(f) in the case of item 83, 89 or 93—the sum of ;the fee set out in item 53 and:

(i) for each patient attended at a single attendance up to a maximum of 6 patients—an amount equal to $10.00 divided by the number of patients so attended; or

(ii) for each patient attended at a single attendance if the number of patients so attended is in excess of 6—65 cents; and

(g) in the case of item 84, 90 or 95—the sum of the fee set out in item 54 and:

(i) for each patient attended at a single attendance up to a maximum of 6 patients—an amount equal to $10.00 divided by the number of patients so attended; or

(ii) for each patient attended at a single attendance if the number of patients so attended is in excess of 6—65 cents; and

(h) in the case of item 86, 91 or 96—the sum of the fee set out in item 57 and:

(i) for each patient attended at a single attendance up to a maximum of 6 patients—an amount equal to $10.00 divided by the number of patients so attended; or

(ii) for each patient attended at a single attendance if the number- of patients so attended is in excess of 6—65 cents.

53. A service that is rendered as part of a treatment cycle and specified in an item in Division 3A of Part 6 is not a medical service specified in an item that is not included in that Division.

54. A reference in an item in Division 3Aof Part 6 to a treatment cycle is a reference to a series of treatments of a patient that begins:

(a) on the day on which the treatment with superovulatory drugs commences; or

(b) on the first day of a menstrual cycle of the patient;

and ends not more than 30 days after that day.

SCHEDULE—continued

55. A reference in item 840 or 842 to embryology laboratory services includes a reference to:

(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;

but does not include a reference to semen preparation.

56. A service in relation to a patient's pregnancy, or intended pregnancy, that is the subject of an arrangement under which the patient agrees that guardianship or custodial rights in respect of a child born as a result of the pregnancy will be transferred to another person, is not a medical service for the purposes of an item in Division 3A of Part 6.

SERVICES AND FEES

Item

Medical service

Fee

PART 1

$

3

Professional attendance at consulting rooms (not being an attendance covered by any other item in this Part) by a vocationally registered 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

10.80

4

Professional attendance, other than an attendance covered by any other item in this Part and not being an attendance at consulting rooms, an institution, a hospital or a nursing home by a vocationally registered 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

27.00

13

Professional attendance at an institution (not being an attendance covered by any other item in this Part) by a vocationally registered 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 one or more patients at the one institution on the one occasion—each patient

Amount under rule 52

19

Professional attendance at a hospital (not being an attendance covered by any other item in this Part) by a vocationally registered 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 one or more patients at the one hospital on the one occasion—each patient

Amount under rule 52

SCHEDULE—continued

Item

Medical service

Fee

20

Professional attendance (not being an attendance covered by any other item in this Part) at a nursing home including aged persons' accommodation attached to a nursing home or aged persons' accommodation' situated within a complex that includes a nursing home (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 nursing home or aged persons' accommodation (not being accommodation in a self contained unit) by a vocationally registered 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 one or more patients at the one nursing home on the one occasion—each patient

Amount under rule 52

$

23

Professional attendance at consulting rooms (not being an attendance covered by any other item in this Part) by a vocationally registered general practitioner involving taking a selective history, examination of the patient with implementation of a management plan in relation to one or more problems, OR a professional attendance of less than 20 minutes duration involving components of an attendance of the type otherwise covered by item 36 or 44—each attendance

22.50

24

Professional attendance, other than an attendance covered by any other item in this Part and not being an attendance at consulting rooms, an institution, a hospital or a nursing home by a vocationally registered general practitioner involving taking a selective history, examination of the patient with implementation of a management plan in relation to one or more problems, OR a professional attendance of less than 20 minutes duration involving components of an attendance of the type otherwise covered by item 37 or 47—each attendance

38.50

25

Professional attendance at an institution (not being an attendance covered by any other item in this Part) by a vocationally registered general practitioner involving taking a selective history, examination of the patient with implementation of a management plan in relation to one or more problems, OR a professional attendance of less than 20 minutes duration involving components of an attendance of the type otherwise covered by item 38 or 48—an attendance on one or more patients at the one institution on the one occasion—each patient

Amount under rule 52

 

SCHEDULE—continued

Item

Medical service

Fee

33

Professional attendance at a hospital (not being an attendance covered by any other item in this Part) by a vocationally registered general practitioner involving taking a selective history, examination of the patient with implementation of a management plan in relation to one or more problems, OR a professional attendance of less than 20 minutes duration involving components of an attendance of the type otherwise covered by item 40 or 50—an attendance on one or more patients at the one hospital on the one occasion—each patient

Amount under rule 52

35

Professional attendance (not being an attendance covered by any other item in this Part) at a nursing home, including aged persons' accommodation attached to a nursing home or aged persons' accommodation situated within a complex that includes a nursing home (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 nursing home or aged persons' accommodation (not being accommodation in a self-contained unit) by a vocationally registered general practitioner involving taking a selective history, examination of the patient with implementation of a management plan in relation to one or more problems, OR a professional attendance of less than 20 minutes duration involving components of an attendance of the type otherwise covered by item 43 or 51—an attendance on one or more patients at the one nursing home on the one occasion—each patient

Amount under rule 52

$

36

Professional attendance at consulting rooms (not being an attendance covered by any other item in this Part) by a vocationally registered general practitioner involving taking a detailed history, an examination of multiple systems, arranging any necessary investigations and implementing a management plan in relation to one or more problems, and lasting at least 20 minutes, OR a professional attendance of less than 40 minutes duration involving components of an attendance of the type otherwise covered by item 44—each attendance

41.00

37

Professional attendance, other than an attendance covered by any other item in this Part and not being an attendance at consulting rooms, an institution, a hospital or a nursing home by a vocationally registered general practitioner involving taking a detailed history, an examination of multiple systems, arranging any necessary investigations and implementing a management plan in relation to one or more problems, and lasting at least 20 minutes, OR a professional attendance of less than 40 minutes duration involving components of an attendance of the type otherwise covered by item 47— each attendance

57.00

SCHEDULE—continued

Item

Medical service

Fee

38

Professional attendance at an institution (not being an attendance covered by any other item in this Part) by a vocationally registered general practitioner involving taking a detailed history, an examination of multiple systems, arranging any necessary investigations and implementing a management plan in relation to one or more problems, and lasting at least 20 minutes, OR a professional attendance of less than 40 minutes duration involving components of an attendance of the type otherwise covered by item 48—an attendance on one or more patients at the one institution on the one occasion—each patient

Amount under rule 52

40

Professional attendance at a hospital (not being an attendance covered by any other item in this Part) by a vocationally registered general practitioner involving taking a detailed history, an examination of multiple systems, arranging any necessary investigations and implementing a management plan in relation to one or more problems, and lasting at least 20 minutes, OR a professional attendance of less than 40 minutes duration involving components of an attendance of the type otherwise covered by item 50—an attendance on one or more patients at the one hospital on the one occasion—each patient

Amount under rule 52

43

Professional attendance (not being an attendance covered by any other item in this Part) at a nursing, home, including aged persons' accommodation attached to a nursing home or aged persons' accommodation situated within a complex that includes a nursing home (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 nursing home or aged persons' accommodation (not being accommodation in a self-contained unit) by a vocationally registered general practitioner involving taking a detailed history, an examination of multiple systems, arranging any necessary investigations and implementing a management plan in relation to one or more problems, and lasting at least 20 minutes, OR a professional attendance of less than 40 minutes duration involving components of an attendance of the type otherwise covered by item 51— an attendance on one or more patients at the one nursing home on the one occasion—each patient

Amount under rule 52

$

44

Professional attendance at consulting rooms (not being an attendance covered by any other item in this Part) by a vocationally registered 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 one 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

60.00

 

SCHEDULE—continued

Item

Medical service

Fee

$

47

Professional attendance, other than an attendance covered by any other item in this Part and not being an attendance at consulting rooms, an institution, a hospital or a nursing home by a vocationally registered 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 one 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

76.00

48

Professional attendance at an institution (not being an attendance covered by any other item in this Part) by a vocationally registered 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 one 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 one or more patients at the one institution on the one occasion— each patient

Amount under rule 52

50

Professional attendance at a hospital (not being an attendance covered by any other item in this Part) by a vocationally registered 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 one 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 one or more patients at the one hospital on the one occasion—each patient

Amount under rule 52

SCHEDULE—continued

Item

Medical service

Fee

51

Professional attendance (not being an attendance covered by any other item in this Part) at a nursing home, including aged persons' accommodation attached to a nursing home or aged persons' accommodation situated within a complex that includes a nursing home (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 nursing home or aged persons' accommodation (not being accommodation in a self-contained unit) by a vocationally registered 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 one 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 one or more patients at the one nursing home on the one occasion—each patient

Amount under rule 52

$

52

Professional attendance at consulting rooms of not more than 5 minutes duration (not being an attendance covered by any other item in this Part) by a medical practitioner (not being a vocationally registered general practitioner)—each attendance

10.60

53

Professional attendance at consulting rooms of more than 5 minutes duration but not more than 25 minutes duration (not being an attendance covered by any other item in this Part) by a medical practitioner (not being a vocationally registered general practitioner)—each attendance

20.50

54

Professional attendance at consulting rooms of more than 25 minutes duration but not more than 45 minutes duration (not being an attendance covered by any other item in this Part) by a medical practitioner (not being a vocationally registered general practitioner)—each attendance

37.00

57

Professional attendance at consulting rooms of more than 45 minutes duration (not being an attendance covered by any other item in this Part) by a medical practitioner (not being a vocationally registered general practitioner)—each attendance

59.00

58

Professional attendance (not being an attendance at consulting rooms, an institution, a hospital or a nursing home) of not more than 5 minutes duration (not being an attendance covered by any other item in this Part) by a medical practitioner (not being a vocationally registered general practitioner)—each attendance

23.00

 

SCHEDULE—continued

Item

Medical service

Fee

$

59

Professional attendance (not being an attendance at consulting rooms, an institution, a hospital or a nursing home) of more than 5 minutes duration but not more than 25 minutes duration (not being an attendance covered by any other item in this Part) by a medical practitioner (not being a vocationally registered general practitioner)—each attendance

30.50

60

Professional attendance (not being an attendance at consulting rooms, an institution, a hospital or a nursing home) of more than 25 minutes duration but not more than 45 minutes duration (not being an attendance covered by any other item in this Part) by a medical practitioner (not being a vocationally registered general practitioner)—each attendance

49.50

65

Professional attendance (not being an attendance at consulting rooms, an institution, a hospital or a nursing home) of more than 45 minutes duration (not being an attendance covered by any other item in this Part) by a medical practitioner (not being a vocationally registered general practitioner)—each attendance

71.00

81

Professional attendance at an institution of not more than 5 minutes duration (not being an attendance covered by any other item in this Part) by a medical practitioner (not being a vocationally registered general practitioner)—an attendance on one or more patients at the one institution on the one occasion—each patient

Amount under rule 52

83

Professional attendance at an institution of more than 5 minutes duration but not more than 25 minutes duration (not being an attendance covered by any other item in this Part) by a medical practitioner (not being a vocationally registered general practitioner)—an attendance on one or more patients at the one institution on the one occasion—each patient

Amount under rule 52

84

Professional attendance at an institution of more than 25 minutes duration but not more than 45 minutes duration (not being an attendance covered by any other item in this Part) by a medical practitioner (not being a vocationally registered general practitioner)—an attendance on one or more patients at the one institution on the one occasion—each patient

Amount under rule 52

86

Professional attendance at an institution of more than 45 minutes duration (not being an attendance covered by any other item in this Part) by a medical practitioner (not being a vocationally registered general practitioner)—an attendance on one or more patients at the one institution on the one occasion—each patient

Amount under rule 52

87

Professional attendance at a hospital of not more than 5 minutes duration (not being an attendance covered by any other item in this Part) by a medical practitioner (not being a vocationally registered general practitioner)—an attendance on one or more patients at the one hospital on the one occasion—each patient

Amount under rule 52

SCHEDULE—continued

Item

Medical service

Fee

89

Professional attendance at a hospital of more than 5 minutes duration but not more than 25 minutes duration (not being an attendance covered by any other item in this Part) by a medical practitioner (not being a vocationally registered general practitioner)—an attendance on one or more patients at the one hospital on the one occasion—each patient

Amount under rule 52

90

Professional attendance at a hospital of more than 25 minutes duration but not more than 45 minutes duration (not being an attendance covered by any other item in this Part) by a medical practitioner (not being a vocationally registered general practitioner)—an attendance on one or more patients at the one hospital on the one occasion—each patient

Amount under rule 52

91

Professional attendance at a hospital of more than 45 minutes duration (not being an attendance covered by any other item in this Part) by a medical practitioner (not being a vocationally registered general practitioner)—an attendance on one or more patients at the one hospital on the one occasion—each patient

Amount under rule 52

92

Professional attendance (not being an attendance covered by any other item in this Part) at a nursing home, including aged persons' accommodation attached to a nursing home or aged persons' accommodation situated within a complex that includes a nursing home (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 nursing home or aged persons' accommodation (not being accommodation in a self-contained unit) of not more than 5 minutes duration (not being an attendance covered by any other item in this Part) by a medical practitioner (not being a vocationally registered general practitioner)—an attendance on one or more patients at the one nursing home on the one occasion—each patient

Amount under rule 52

93

Professional attendance (not being an attendance covered by any other item in this Part) at a nursing home, including aged persons' accommodation attached to a nursing home or aged persons' accommodation situated within a complex that includes a nursing home (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 nursing home or aged persons' accommodation (not being accommodation in a self-contained unit) of more than 5 minutes duration but not more than 25 minutes duration (not being an attendance covered by any other item in this Part) by $ medical practitioner (not being a vocationally registered general practitioner)—an attendance on one or more patients at the one nursing home on the one occasion—each patient

Amount under rule 52

 

SCHEDULE—continued

Item

Medical service

Fee

95

Professional attendance (not being an attendance covered by any other item in this Part) at a nursing home, including aged persons' accommodation attached to a nursing home or aged persons' accommodation situated within a complex that includes a nursing home (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 nursing home or aged persons' accommodation (not being accommodation in a self-contained unit) of more than 25 minutes duration but not more than 45 minutes duration (not being an attendance covered by any other item in this Part) by a medical practitioner (not being a vocationally registered general practitioner)—an attendance on one or more patients at the one nursing home on the one occasion-each patient

Amount under rule 52

96

Professional attendance (not being an attendance covered by any other item in this Part) at a nursing home, including aged persons' accommodation attached to a nursing home or aged persons' accommodation situated within a complex that includes a nursing home (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 nursing home or aged persons' accommodation (not being accommodation in a self-contained unit) of more than 45 minutes duration (not being an attendance covered by any other item in this Part) by a medical practitioner (not being a vocationally registered general practitioner)—an attendance on one or more patients at the one nursing home on the one occasion—each patient

Amount under rule 52

97

Professional attendance being an attendance at other than consulting rooms, on not more than one patient on the one occasion by a medical practitioner—each attendance on a public holiday, on a Sunday, before 8 a.m. or after 1 p.m. on a Saturday or at any time other than between 8 a.m. and 8 p.m. 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

$

42.50

98

Professional attendance being an attendance at consulting rooms, on not more than one patient on the one occasion by a medical practitioner—each attendance on a public holiday, on a Sunday, before 8 a.m. or after 1 p.m. on a Saturday or at any time other than between 8 a.m. and 8 p.m. 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, 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

42.50

SCHEDULE—continued

Item

Medical service

Fee

$

101

Examination of a patient in preparation for the administration of an anaesthetic, being an examination carried out at an attendance other than that at which the anaesthetic is administered (G)

20.50

102

Examination of a patient in preparation for the administration of an anaesthetic, being an examination carried out at an attendance other than that at which the anaesthetic is administered (S)

28.50

104

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

57.00

105

Professional attendance by a specialist in the practice of his/her specialty where the patient is referred to him/ her—each attendance subsequent to the first in a single course of treatment where that attendance is at consulting rooms, hospital or nursing home

28.50

107

Professional attendance by a specialist in the practice of his/her specialty where the patient is referred to his/ 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, hospital or nursing home

83.00

108

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

53.00

110

Professional attendance at consulting rooms, hospital or nursing home by a consultant physician in the practice of his/her specialty (other than psychiatry) where the patient is referred to him/her by a medical practitioner— initial attendance in a single course of treatment.

100.00

116

Professional attendance at consulting rooms, hospital or nursing home by a consultant physician in the practice of his/her specialty (other than psychiatry) where the patient is referred to him/her by a medical practitioner— each attendance (other than an attendance covered by item 119) subsequent to the first in a single course of treatment.

50.00

119

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

28.50

122

Professional attendance at a place other than consulting rooms, hospital or nursing home by a consultant physician in the practice of his/her specialty (other than in psychiatry) where the patient is referred to him/her by a medical practitioner—initial attendance in a single course of treatment.

122.00

SCHEDULE—continued

Item

Medical service

Fee

$

128

Professional attendance at a place other than consulting rooms, hospital or nursing home by a consultant physician in the practice of his/her specialty (other than in psychiatry) where the patient is referred to him/her by a medical practitioner—each attendance (other than an attendance covered by item 131) subsequent to the first in a single course of treatment.

74.00

131

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

53.00

134

Professional attendance by a consultant physician in the practice of his/her specialty of psychiatry where the patient is referred to him/her by a medical practitioner—an attendance of not more than 15 minutes duration where that attendance is at consulting rooms, hospital or nursing home

29.00

136

Professional attendance by a consultant physician in the practice of his/her specialty of psychiatry where the patient is referred to him/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 consulting rooms, hospital or nursing home

58.00

138

Professional attendance by a consultant physician in the practice of his/her specialty of psychiatry where the patient is referred to him/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 consulting rooms, hospital or nursing home

84.00

140

Professional attendance by a consultant physician in the practice of his/her specialty of psychiatry where the patient is referred to him/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 consulting rooms, hospital or nursing home

1180.00

8667

Complex bilateral osteotomies or osteectomies of mandible or maxilla, involving three or more such procedures of one jaw and two such procedures of the other jaw, including genioplasty (when performed) and transposition of nerves and vessels and bone grafts taken from the same site (D) (AU 32)

1180.00

8668

Complex bilateral osteotomies or osteectomies of mandible or maxilla, involving three or more such procedures of each jaw, including genioplasty (when performed) and transposition of nerves and vessels and bone grafts taken from the same site (AU 34)

1285.00

8669

Complex bilateral osteotomies or osteectomies of mandible or maxilla, involving three or more such procedures of each jaw, including genioplasty (when performed) and transposition of nerves and vessels and bone grafts taken from the same site (D) (AU 34)

1285.00

8670

Genioplasty not associated with item 8658, 8660, 8662, 8664, 8666, or 8668 including transposition of nerves and vessels and bone grafts taken from the site (AU 10)

500.00

 

SCHEDULE—continued

Item

Medical service

Fee

$

8671

Genioplasty not associated with item 8659, 8661, 8663, 8665, 8667 or 8669 including transposition of nerves and vessels and bone grafts taken from the site (D) (AU 10)

500.00

8672

Genioplasty associated with item 8658, 8660, 8662 or 8664 (AU 8)

290.00

8673

Genioplasty associated with item 8659, 8661, 8663 or 8665 (D) (AU 8)

290.00

8675

Hypertelorism, correction of, intra-cranial (AU 47)

1675.00

8676

Hypertelorism, correction of, sub-cranial (AU 26)

1280.00

8677

Peri-orbital correction of Treacher Collins Syndrome, with rib and iliac bone grafts (AU 30)

1165.00

8678

Correction of unilateral orbital dystopia—total repositioning of one orbit intra-cranial (AU 35)

1165.00

8679

Correction of unilateral orbital dystopia—sub-total repositioning of one orbit, extra-cranial (AU 18)

855.00

8680

Unilateral fronto-orbital advancement (AU 19)

655.00

8681

Cranial vault reconstruction for oxycephaly, brachycephaly, turricephaly or similar condition—(bilateral frontoorbital advancement) (AU 39)

1110.00

8682

Reconstruction of glenoid fossa, zygomatic arch and temporal bone (Obwegeser technique) (AU 19)

1095.00

8683

Construction of absent condyle and ascending ramus in hemifacial microsomia (AU 15)

590.00

PART 11—NUCLEAR MEDICINE

8701

Blood volume estimation

144.00

8703

Erythrocyte radioactive uptake survival time test or iron kinetic test

280.00

8705

Gastrointestinal blood loss estimation involving examination of stool specimens

200.00

8707

Gastrointestinal protein loss

144.00

8714

Radioactive B12 absorption test—one isotope

70.00

8715

Radioactive B12 absorption test—two isotopes

152.00

8718

Thyroid uptake (using probe)

70.00

8719

Perchlorate discharge study

84.00

8722

Renal function test (without imaging procedure)

106.00

8725

Renal function test (associated with imaging and at least 2 blood samples)

56.00

8726

Whole body count—not associated with any other item

84.00

8727

Myocardial perfusion study using thallium—single study for stress OR reperfusion (C)

345.00

8728

Myocardial perfusion study using thallium—single study for stress OR reperfusion (NC)

255.00

8732

Myocardial perfusion study using thallium—combined study for stress AND reperfusion (C)

545.00

8733

Myocardial perfusion study using thallium—combined study for stress AND reperfusion (NC)

405.00

8734

Myocardial infarct-avid imaging study (C)

200.00

8735

Myocardial infarct-avid imaging study (NC)

150.00

8740

Gated cardiac blood pool (equilibrium) study (C)

235.00

8741

Gated cardiac blood pool study with intervention (C)

290.00

8744

Cardiac first pass blood flow study, cardiac shunt study or cardiac output study (not part of other investigation) (C)

176.00

 

SCHEDULE—continued

Item

Medical service

Fee

$

8745

Cardiac first pass blood flow study, cardiac shunt study or cardiac output study (not part of other investigation) (NC)

130.00

8748

Cardiac first pass blood flow study, cardiac shunt study or cardiac output study when associated with another item in this Part (C)

Amount under rule 49

8749

Cardiac first pass blood flow study, cardiac shunt study or cardiac output study when associated with another item in this Part (NC)

Amount under rule 49

$

8751

Lung perfusion study (C)

166.00

8752

Lung perfusion study (NC)

124.00

8753

Lune ventilation studv using Xel27 gas (O

275.00

8754

Lung ventilation study using Xel27 gas (NC)

210.00

8757

Lung ventilation study using Xel33 gas (C)

156.00

8758

Lung ventilation study using Xel33 gas (NC)

116.00

8761

Lung ventilation study using aerosol (C)

192.00

8762

Lung ventilation study using aerosol (NC)

144.00

8765

Lung perfusion study and lung ventilation study using either Xel27 or Xel33 gas (C)

300.00

8766

Lung perfusion study and lung ventilation study using either Xel27 or Xel33 gas (NC)

220.00

8767

Lung perfusion study and lung ventilation study using aerosol (C)

330.00

8768

Lung perfusion study and lung ventilation study using aerosol (NC)

250.00

8771

Liver and spleen study (colloid) (C)

198.00

8772

Liver and spleen study (colloid) (NC)

148.00

8775

Red blood cell spleen or liver study (C)

200.00

8776

Red blood cell spleen or liver study (NC)

150.00

8777

Hepatobiliary study (C)

320.00

8778

Hepatobiliary study (NC)

240.00

8781

Bowel haemorrhage study (C)

370.00

8782

Bowel haemorrhage study (NC)

275.00

8785

Meckel's diverticulum study (C)

170.00

8786

Meckel's diverticulum study (NC)

128.00

8789

Salivary study (C)

170.00

8790

Salivary study (NC)

128.00

8791

Gastro-oesophageal reflux study (C)

365.00

8792

Gastro-oesophaeeal reflux study (NC)

270.00

8795

Oesophaeeal clearance study (C)

110.00

8796

Oesophaeeal clearance study (NO

82.00

8801

Gastric emptying study using single tracer (C)

545.00

8802

Gastric emptying study using dual tracer (C)

580.00

8805

Renal study with or without dynamic flow study and with or without computer extraction of functional parameters (C)

250.00

8809

Renal study with intervention (C)

305.00

8810

Renal study with intervention (NO

225.00

8811

Cystoureterogram (O

188.00

8812

Cystoureterogram (NC)

142.00

8815

Testicular study (C)

124.00

8816

Testicular study (NC)

93.00

8819

Brain study with blood brain barrier agent (C)

168.00

8820

Brain study with blood brain barrier agent (NC)

126.00

8822

Cerebro-spinal fluid transport study (C)

660.00

SCHEDULE—continued

Item

Medical service

Fee

$

8823

Cerebro-spinal fluid transport study (NC)

495.00

8826

Cerebro-spinal fluid shunt patency study (C)

172.00

8827

Cerebro-spinal fluid shunt patency study (NC)

128.00

8830

Dynamic blood flow study or regional blood volume quantitative study (not associated with any other item in this Part) (C)

91.00

8831

Dynamic blood flow study or regional blood volume quantitative study (not associated with any other item in this Part) (NC)

68.00

8832

Bone study—whole body (C)

365.00

8833

Bone study—whole body (NC)

270.00

8834

Bone study—whole body and dynamic blood flow or regional blood volume quantitative study (C)

455.00

8835

Bone study—whole body and dynamic blood flow or regional blood volume quantitative study (NC)

345.00

8836

Whole body study using iodine (C)

415.00

8837

Whole body study using iodine (NC)

310.00

8838

Whole body study using gallium (C)

415.00

8839

Whole body study using gallium (NC)

310.00

8840

Whole body study using cells labelled with technetium (C)

370.00

8841

Whole body study using cells labelled with technetium (NC)

275.00

8842

Bone marrow study—whole body (C)

365.00

8843

Bone marrow study—whole body (NC)

270.00

8844

Repeat whole body study on different occasion using same administration of radiopharmaceutical (C)

168.00

8845

Repeat whole body study on different occasion using same administration of radiopharmaceutical (NC)

126.00

8846

Localised bone or joint study including flow and blood pool studies (C)

255.00

8847

Localised bone or joint study including flow and blood pool studies (NC)

190.00

8848

Localised bone, joint, tumour, infection or inflammation seeking study using gallium (C)

305.00

8849

Localised bone, joint, tumour, infection or inflammation seeking study using gallium (NC)

225.00

8851

Localised bone, joint, tumour, infection or inflammation seeking study using cells labelled with technetium (C)

260.00

8852

Localised bone, joint, tumour, infection or inflammation seeking study using cells labelled with technetium (NC)

194.00

8853

Repeat localised bone, joint, tumour, infection or inflammation seeking study on different occasion using same administration of radiopharmaceutical (C)

112.00

8854

Repeat localised bone, joint, tumour, infection or inflammation seeking study on different occasion using same administration of radiopharmaceutical (NC)

84.00

8855

Venography (including blood pool study, active uptake study or dynamic blood flow study) (C)

200.00

8856

Venography (including blood pool study, active uptake study or dynamic blood flow study) (NC)

150.00

8857

Lymphoscintigraphy (C)

260.00

8858

Lymphoscintigraphy (NC)

194.00

8859

Thyroid Study (C)

116.00

8860

Thyroid Study (NC)

86.00

8861

Thyroid uptake study performed on gamma camera (C)

56.00

 

SCHEDULE—continued

Item

Medical service

Fee

$

8862

Thyroid uptake study performed on gamma camera (NC)

42.00

8863

Parathyroid (C)

290.00

8864

Adrenal Study using Selenocholesterol (C)

665.00

8865

Adrenal Study using Selenocholesterol (NC)

500.00

8866

Adrenal Study (not covered by Item 8864/8865) (C)

340.00

8867

Adrenal Study (not covered by Item 8864/8865) (NC)

255.00

8868

Single photon emission tomography when associated with another item in this Part (C)

Amount under rule 50

$

8869

Tear Duct Study (C)

170.00

8870

Tear Duct Study (NC)

128.00

8871

Particle perfusion study (intra-arterial) or Le Veen Shunt study (C)

192.00

8872

Particle perfusion study (intra-arterial) or Le Veen Shunt study (NC)

144.00

8873

Study of region or organ not covered by any other item in this Part (C)

11.00

8874

Study of region or organ not covered by any other item in this Part (NC)

8.30

8878

Administration of a therapeutic dose of a radioisotope— not covered by any other item in this Part

27.00

8880

Intra-cavitary administration of a therapeutic dose of Yttrium 90 (not including preliminary paracentesis) (AU 5)

435.00

8882

Administration of a therapeutic dose of Iodine 131 for thyroid cancer by single dose technique

330.00

8884

Administration of a therapeutic dose of Iodine L31 for thyrotoxicosis by single dose technique

225.00

8886

Intravenous administration of a therapeutic dose of Phosphorous 32

196.00

PART 12—SERVICES FOR THE TREATMENT OF CLEFT LIP AND CLEFT

PALATE CONDITIONS

Division 1—Orthodontic Services

8901

Professional attendance not covered by item 8902 (AO)

27.00

8902

Professional attendance and treatment planning where treatment is deferred (AO)

55.00

8903

Production of dental study models not associated with item 8902 or with a service covered by item 8914, 8915, 8917, 8918, 8919, 8922, 8923, 8924, 8925, or 8928 (AO)

27.00

8905

Orthodontic radiography—orthopantomography (AO)

45.50

8906

Orthodontic radiography—anteroposterior cephalometric radiography with cephalometric tracings or lateral cephalometric radiography with cephalometric tracings (AO)

72.00

8907

Orthodontic radiography—anteroposterior and lateral cephalometric radiography, with cephalometric tracings (AO)

99.00

8908

Orthodontic radiography—anteroposterior and lateral cephalometric radiography, with cephalometric tracings and orthopantomography (AO)

126.00

 

SCHEDULE—continued

Item

Medical service

Fee

$

8909

Orthodontic radiography—anteroposterior and lateral cephalometric radiography, with cephalometric tracings, orthopantomography and hand-wrist studies (including growth prediction) (AO)

154.00

8914

Pre-surgical infant maxillary arch repositioning, including supply of appliances and all associated consultations— where one appliance is used (AO)

365.00

8915

Pre-surgical infant maxillary arch repositioning, including supply of appliances and all associated consultations— where two appliances are used (AO)

435.00

8917

Deciduous dentition treatment—maxillary arch expansion, including supply of appliances and all associated consultations, treatment planning and retention services beyond the period of active treatment (AO)

485.00

8918

Deciduous and permanent dentition treatment-incisor alignment using fixed appliances in maxillary arch, including supply of appliances and all associated consultations, treatment-planning and retention services beyond the period of active treatment (AO)

800.00

8919

Deciduous and permanent dentition treatment (not being treatment associated with treatment covered by item 8918)—lateral arch expansion and incisor alignment using fixed appliances in maxillary arch, including supply of appliances and all associated attendances, treatment-planning and retention services beyond the period of active treatment (AO)

1105.00

8922

Permanent dentition treatment (not being treatment associated with treatment covered by item 8924 or 8925)—single arch (mandibular or maxillary) treatment (correction or alignment, or both) using fixed appliances, including supply of appliances and all associated consultations, treatment-planning and retention services beyond the period of active treatment—initial three months of active treatment (AO)

365.00

8923

Permanent dentition treatment (not being treatment associated with treatment covered by item 8924 or 8925)—single arch (mandibular or maxillary) treatment (correction or alignment, or both) using fixed appliances, including supply of appliances and all associated consultations, treatment-planning and retention services beyond the period of active treatment—each three months of active treatment after the first for a maximum of a further 33 months (AO)

138.00

8924

Permanent dentition treatment (not being treatment associated with treatment covered by item 8922 or 8923)—two-arch (mandibular and maxillary) treatment (correction or alignment, or both) using fixed appliances, including supply of appliances and all associated consultations, treatment-planning and retention services beyond the period of active treatment—initial three months of active treatment (AO)

715.00

 

SCHEDULE—continued

Item

Medical service

Fee

$

8925

Permanent dentition treatment (not being treatment associated with treatment covered by item 8922 or 8923)—two-arch (mandibular and maxillary) treatment (correction or alignment, or both) using fixed appliances, including supply of appliances and all associated consultations, treatment-planning and retention services beyond the period of active treatment—each three months of active treatment after the first for a maximum of a further 33 months (AO)

190.00

8928

Pre-sugical or post-sugrical jaw growth guidance using removable appliances, including supply of appliances and all associated consultations and treatment-planning (AO)

485.00

Division 2—Oral Surgical Services

8931

Removal of tooth or tooth fragment (not being treatment covered by item 8936, 8937, 8938, 8939, 8940 or 8941), where the patient is referred by a recognized orthodontist (AD)

36.50

8932

Removal of tooth or tooth fragment under general anaesthesia, where the patient is referred by a recognized orthodontist (AD)

55.00

8933

Removal of each additional tooth or tooth fragment at the same attendance at which a service referred to in item 8931 or 8932 is rendered (AD)

18.20

Surgical Extractions

8936

Surgical removal of erupted tooth, where the patient is referred by a recognized orthodontist (AOS)

110.00

8937

Surgical removal of tooth with soft tissue impaction, where the patient is referred by a recognized orthodontist (AOS)

126.00

8938

Surgical removal of tooth with partial bone impaction, where the patient is referred by a recognized orthodontist (AOS)

144.00

8939

Surgical removal of tooth with complete bone impaction, where the patient is referred by a recognized orthodontist (AOS)

162.00

8940

Surgical removal of tooth fragment requiring incision of soft tissue only, where the patient is referred by a recognized orthodontist (AOS)

91.00

8941

Surgical removal of tooth fragment requiring removal of bone, where the patient is referred by a recognized orthodontist (AOS)

110.00

Other Surgical Procedures

8945

Surgical exposure, stimulation and packing of unerupted tooth, where the patient is referred by a recognized orthodontist (AOS)

154.00

8946

Surgical exposure of unerupted tooth for the purpose of fitting a traction device, where the patient is referred by a recognized orthodontist (AOS)

182.00

8947

Surgical repositioning of unerupted tooth, where the patient is referred by a recognized orthodontist (AOS)

182.00

8948

Transplantation of tooth bud, where the patient is referred by a recognized orthodontist (AOS)

270.00

SCHEDULE—continued

Item

Medical service

Fee

$

Division 3—General and Prosthodontic Services

8960

Attendance comprising consultation, preventive treatment and prophylaxis, of not less than thirty minutes duration—each attendance to a maximum of three attendances in any period of twelve months (AD)

55.00

8961

Provision and fitting of acrylic base partial denture, including retainers—one tooth (AD)

220.00

8962

Provision and fitting of acrylic base partial denture, including retainers—two teeth (AD)

255.00

8963

Provision and fitting of acrylic base partial denture, including retainers—three teeth (AD)

305.00

8964

Provision and fitting of acrylic base partial denture, including retainers—four teeth (AD)

340.00

8965

Provision and fitting of acrylic base partial denture, including retainers—five to nine teeth (AD)

415.00

8966

Provision and fitting of acrylic base partial denture, including retainers—ten to twelve teeth (AD)

485.00

8971

Provision and fitting of cast metal base (cobalt chromium alloy) partial denture including casting and retainers— one tooth (AD)

390.00

8972

Provision and fitting of cast metal base (cobalt chromium alloy) partial denture including casting and retainers— two teeth (AD)

455.00

8973

Provision and fitting of cast metal base (cobalt chromium alloy) partial denture including casting and retainers— three teeth (AD)

520.00

8974

Provision and fitting of cast metal base (cobalt chromium alloy) partial denture including casting and retainers— four teeth (AD)

575.00

8975

Provision and fitting of cast metal base (cobalt chromium alloy) partial denture including casting and retainers— five to nine teeth (AD)

705.00

8976

Provision and fitting of cast metal base (cobalt chromium alloy) partial denture including casting and retainers— ten to twelve teeth (AD)

805.00

8980

Provision and fitting of retainers (not being treatment associated with treatment covered by item 8961, 8962, 8963, 8964, 8965, 8966, 8971, 8972, 8973, 8974, 8975 or 8976)—each retainer (AD)

18.20

8982

Adjustment of partial denture (not being treatment associated with treatment covered by item 8961, 8962, 8963, 8964, 8965, 8966, 8971, 8972, 8973, 8974, 8975 or 8976) (AD)

27.00

8984

Reclining of partial denture by laboratory process and associated fitting (AD)

136.00

8986

Remodelling and fitting of partial denture of more than four teeth (AD)

162.00

8988

Repair to cast metal base of partial denture—one or more points (AD)

81.00

8990

Addition of a tooth or teeth to a partial denture to replace extracted tooth or teeth, including taking of necessary impression (AD)

81.00

81.00

 

NOTE

1. Notified in the Commonwealth of Australia Gazette

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