Health Insurance (General Medical Services Table) Regulations 2001 (Cth)
made under the
This compilation was prepared on 1 May 2002
taking into account amendments up to SR 2002 No. 76
Prepared by the Office of Legislative Drafting,
Attorney-General’s Department, Canberra
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These Regulations are the
Health Insurance (General Medical Services Table) Regulations 2001 .
These Regulations commence on 1 November 2001.
The following Statutory Rules are repealed:
· 2000 Nos. 292 and 356
· 2001 No. 79.
In these Regulations:
Act means theHealth Insurance Act 1973 .
this table means the table of general medical services set out in Schedule 1.
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.
(regulation 5)
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.
An item in Part 3 does not apply to a service provided in contravention of a law of the Commonwealth or of a State or Territory.
(1) In this table, unless the contrary intention appears:
attendance of a minor nature orminor 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 theAged Care Act 1997 ) is provided.(2) A reference to a
Group in the table includes every item in the Group, and a reference to aSubgroup 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.
(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 6 (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 theHealth 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.
(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.
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.
(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 theNational 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.
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.
In rule 21 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.
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.
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.
(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.
(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.
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.
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.
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.
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.
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.
(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.
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.
(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.
(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).
(1) A multidisciplinary care plan 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.
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.
(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.
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.
55A Application of Subgroup 2 of Group A18 and Subgroup 2 of Group A19 (1) An item in Subgroup 2 of Group A18 or Subgroup 2 of Group A19 does not apply to a service that is provided to a patient who has already been provided, in the previous 12 months, with another service to which an item in either of those Subgroups applies.
(2) For any item in Subgroup 2 of Group A18 or Subgroup 2 of Group A19, a professional attendance
completes the minimum requirements for an annual cycle of care of a patient with established diabetes mellitus if the attendance involves the following:
(a) provision of the necessary services to a patient so that, at the completion of the attendance, the patient will have:
(i) at least 1 assessment of diabetes control, by having his or her HbA
1c measured, in the previous 12 months; and(ii) at least 1 comprehensive eye examination in the previous 24 months; and
(iii) his or her weight and height measured and his or her BMI calculated at least once every 6 months in the previous 12 months; and
(iv) his or her feet examined at least once every 6 months in the previous 12 months; and
(v) his or her total cholesterol, triglycerides and HDL cholesterol measured at least once in the previous 12 months; and
(vi) his or her microalbuminuria tested at least once in the previous 12 months;
(b) provision of self-management education to the patient regarding diabetes;
(c) a review of the patient’s diet, and provision of information to the patient about appropriate dietary choices;
(d) a review of the patient’s level of physical activity, and provision of information to the patient about the appropriate level of physical activity;
(e) checking the patient’s smoking status, and, if relevant, encouraging the patient to stop smoking;
(f) a review of the patient’s medication.
56 Application of Subgroup 3 of Group A18 and Subgroup 3 of Group A19 (1) An item in Subgroup 3 of Group A18 or Subgroup 3 of Group A19 does not apply to a service that:
(a) is provided to a patient who has already been provided, in the previous 12 months, with another service to which an item in either of those Subgroups applies; and
(b) is not clinically indicated.
(2) For any item in Subgroup 3 of Group A18 or Subgroup 3 of Group A19, a professional attendance
completes the minimum requirements of the Asthma 3+ Visit Plan if the attendance completes a series of attendances that involve, 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) documented diagnosis and documented assessment of severity;
(c) a review of the patient’s use of asthma related medication;
(d) provision of:
(i) a written asthma action plan; and
(ii) self-management education to the patient regarding asthma;
(e) a review of the patient’s asthma action plan.
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), 22060, 23010 to 24136, 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).
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.
(1) An item in the range 23010 to 24136 applies to perfusion in addition to any other item that applies to the perfusion.
(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 in addition to any other item that applies to the perfusion.
(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 22900 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.
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 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 37 or 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 | ||||
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 | |||||
111.75 | ||||||
52102 | Buried wire, pin or screw, 1 or more, which were inserted for internal fixation purposes into maxilla or mandible or zygoma, removal of, requiring anaesthesia, incision, dissection and suturing, where undertaken in the operating theatre of a hospital or approved day‑hospital facility, per bone (Anaes.) | 111.75 | ||||
52105 | Plate, 1 or more of, and associated screw and wire which were inserted for internal fixation purposes into maxilla or mandible or zygoma, removal of, requiring anaesthesia, incision, dissection and suturing, per bone, not being a service associated with a service to which item 52099 or 52102 applies (Anaes.) (Assist.) | 208.55 | ||||
52106 | Arch bars, 1 or more, which were inserted for dental fixation purposes to the maxilla or mandible, removal of, requiring general anaesthesia where undertaken in the operating theatre of a hospital or approved day-hospital facility (Anaes.) | 86.15 | ||||
52108 | Lip, full thickness wedge excision of, with repair by direct sutures (Anaes.) (Assist.) | 257.85 | ||||
52111 | Vermilionectomy (Anaes.) (Assist.) | 257.85 | ||||
52114 | Mandible or maxilla, segmental resection of, for tumours or cysts (Anaes.) (Assist.) | 464.85 | ||||
52117 | Mandible, including lower border, or maxilla, sub-total resection of (Anaes.) (Assist.) | 553.25 | ||||
52120 | Mandible, hemimandiblectomy of, including condylectomy where performed (Anaes.) (Assist.) | 652.20 | ||||
52122 | Mandible, hemi-mandibular reconstruction of, or maxilla reconstruction of, with bone graft, plate, tray or alloplast, not being a service associated with a service to which item 52123 applies (Anaes.) (Assist.) | 654.35 | ||||
52123 | Mandible, total resection of both sides, including condylectomies where performed (Anaes.) (Assist.) | 740.85 | ||||
52126 | Maxilla, total resection of (Anaes.) (Assist.) | 712.25 | ||||
52129 | Maxilla, total resection of both maxillae (Anaes.) (Assist.) | 953.40 | ||||
52130 | Bone graft in the oral and maxillofacial region, not being a service to which another item in Groups O3 to O9 applies (Anaes.) (Assist.) | 350.00 | ||||
52131 | Bone graft with internal fixation, in the oral and maxillofacial region, not being a service to which another item in Groups O3 to O9 applies (Anaes.) (Assist.) | 484.05 | ||||
52132 | Tracheostomy (Anaes.) | 188.95 | ||||
52133 | Cricothyrostomy by direct stab or Seldinger technique, using Minitrach or similar device (Anaes.) | 72.00 | ||||
52135 | Post-operative or post-nasal haemorrhage, or both, control of, where undertaken in the operating theatre of a hospital or approved day-hospital facility (Anaes.) | 114.20 | ||||
52138 | Maxillary artery, ligation of (Anaes.) (Assist.) | 352.35 | ||||
52141 | Facial, mandibular or lingual artery or vein or artery and vein, ligation of, not being a service to which item 52138 applies (Anaes.) (Assist.) | 350.95 | ||||
52144 | Foreign body, deep, removal of using interventional imaging techniques (Anaes.) (Assist.) | 327.10 | ||||
52147 | Duct of major salivary gland, transposition of (Anaes.) (Assist.) | 308.70 | ||||
52148 | Parotid duct, repair of, using micro-surgical techniques (Anaes.) (Assist.) | 545.60 | ||||
52158 | Submandibular ducts, relocation of, for surgical control of drooling (Anaes.) (Assist.) | 878.55 | ||||
52180 | Aggressive or potentially malignant bone or deep soft tissue tumour in the oral and maxillofacial region, biopsy of (not including after-care) (Anaes.) | 148.95 | ||||
52182 | Bone or malignant deep soft tissue tumour in the oral and maxillofacial region, lesional or marginal excision of (Anaes.) (Assist.) | 327.65 | ||||
52184 | Bone tumour in the oral and maxillofacial region, lesional or marginal excision of, combined with any 1 of liquid nitrogen freezing, autograft, allograft or cementation (Anaes.) (Assist.) | 484.05 | ||||
52186 | Bone tumour in the oral and maxillofacial region, lesional or marginal excision of, combined with any 2 or more of liquid nitrogen freezing, autograft, allograft or cementation (Anaes.) (Assist.) | 595.80 | ||||
52300 | Single-stage local flap, where indicated, repair to 1 defect, with skin or mucosa (Anaes.) (Assist.) | 224.95 | ||||
52303 | Single-stage local flap, where indicated, repair to 1 defect, with buccal pad of fat (Anaes.) (Assist.) | 321.10 | ||||
52306 | Single-stage local flap, where indicated, repair to 1 defect, using temporalis muscle (Anaes.) (Assist.) | 476.60 | ||||
52309 | Free grafting (mucosa or split skin) of a granulating area (Anaes.) | 161.95 | ||||
52312 | Free grafting (mucosa, split skin or connective tissue) to 1 defect, including elective dissection (Anaes.) (Assist.) | 224.95 | ||||
52315 | Free grafting, full thickness, to 1 defect (mucosa or skin) (Anaes.) (Assist.) | 374.80 | ||||
52318 | Bone graft, harvesting of, via separate incision, being a service associated with a service to which another item in Groups O3 to O9 applies — Autogenous, small quantity (Anaes.) | 111.75 | ||||
52319 | Bone graft, harvesting of, via separate incision, being a service associated with a service to which another item in Groups O3 to O9 applies — Autogenous, large quantity (Anaes.) | 185.95 | ||||
52321 | Foreign implant (non-biological), insertion of, for contour reconstruction of pathological deformity, not being a service associated with a service to which item 52624 applies (Anaes.) (Assist.) | 374.80 | ||||
52324 | Direct flap repair, using tongue, first stage (Anaes.) (Assist.) | 374.80 | ||||
52327 | Direct flap repair, using tongue, second stage (Anaes.) | 185.95 | ||||
52330 | Palatal defect (oro-nasal fistula), plastic closure of, including services to which item 52300, 52303, 52306 or 52324 applies (Anaes.) (Assist.) | 618.55 | ||||
52333 | Cleft palate, primary repair (Anaes.) (Assist.) | 618.55 | ||||
52336 | Cleft palate, secondary repair, closure of fistula using local flaps (Anaes.) (Assist.) | 386.60 | ||||
52337 | Alveolar cleft (congenital) unilateral, grafting of, including plastic closure of associated oro-nasal fistulae and ridge augmentation (Anaes.) (Assist.) | 845.65 | ||||
52339 | Cleft palate, secondary repair, lengthening procedure (Anaes.) (Assist.) | 440.30 | ||||
52342 | Mandible or maxilla, unilateral osteotomy or osteectomy of, including transposition of nerves and vessels and bone grafts taken from the same site (Anaes.) (Assist.) | 764.75 | ||||
52345 | Mandible or maxilla, unilateral osteotomy or osteectomy of, including transposition of nerves and vessels and bone grafts taken from the same site and stabilisation with fixation by wires, screws, plates or pins, or any combination (Anaes.) (Assist.) | 862.45 | ||||
52348 | Mandible or maxilla, bilateral osteotomy or osteectomy of, including transposition of nerves and vessels and bone grafts taken from the same site (Anaes.) (Assist.) | 974.60 | ||||
52351 | Mandible or maxilla, bilateral osteotomy or osteectomy of, including transposition of nerves and vessels and bone grafts taken from the same site and stabilisation with fixation by wires, screws, plates or pins, or any combination (Anaes.) (Assist.) | 1 094.45 | ||||
52354 | Mandible or maxilla, osteotomies or osteectomies of, involving 3 or more such procedures on the 1 jaw, including transposition of nerves and vessels and bone grafts taken from the same site (Anaes.) (Assist.) | 1 109.50 | ||||
52357 | Mandible or maxilla, osteotomies or osteectomies of, involving 3 or more such procedures on the 1 jaw, including transposition of nerves and vessels and bone grafts taken from the same site and stabilisation with fixation by wires, screws, plates or pins, or any combination (Anaes.) (Assist.) | 1 249.15 | ||||
52360 | Mandible and maxilla, osteotomies or osteectomies of, involving 2 such procedures of each jaw including transposition of nerves and vessels and bone grafts taken from the same site (Anaes.) (Assist.) | 1 274.35 | ||||
52363 | Mandible and maxilla, osteotomies or osteectomies of, involving 2 such procedures of each jaw, including transposition of nerves and vessels and bone grafts taken from the same site and stabilisation with fixation by wires, screws, plates or pins, or any combination (Anaes.) (Assist.) | 1 433.55 | ||||
52366 | Mandible and maxilla, complex bilateral osteotomies or osteectomies of, involving 3 or more such procedures of 1 jaw and 2 such procedures of the other jaw, including genioplasty when performed and transposition of nerves and vessels and bone grafts taken from the same site (Anaes.) (Assist.) | 1 401.90 | ||||
52369 | Mandible and maxilla, complex bilateral osteotomies or osteectomies of, involving 3 or more such procedures of 1 jaw and 2 such procedures of the other jaw, including genioplasty when performed and transposition of nerves and vessels and bone grafts taken from the same site and stabilisation with fixation by wires, screws, plates or pins, or any combination (Anaes.) (Assist.) | 1 576.20 | ||||
52372 | Mandible and maxilla, complex bilateral osteotomies or osteectomies of, involving 3 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 (Anaes.) (Assist.) | 1 529.40 | ||||
52375 | Mandible and maxilla, complex bilateral osteotomies or osteectomies of, involving 3 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 and stabilisation with fixation by wires, screws, plates or pins, or any combination (Anaes.) (Assist.) | 1 713.10 | ||||
52378 | Genioplasty including transposition of nerves and vessels and bone grafts taken from the same site (Anaes.) (Assist.) | 592.20 | ||||
52379 | Face, contour reconstruction of 1 region, using autogenous bone or cartilage graft (Anaes.) (Assist.) | 1 011.15 | ||||
52380 | Midfacial osteotomies — Le Fort II, Modified Le Fort III (Nasomalar), Modified Le Fort III (Malar-Maxillary), Le Fort III involving 3 or more osteotomies of the midface including transposition of nerves and vessels and bone grafts taken from the same site (Anaes.) (Assist.) | 1 723.35 | ||||
52382 | Midfacial osteotomies — Le Fort II, Modified Le Fort III (Nasomalar), Modified Le Fort III (Malar-Maxillary), Le Fort III involving 3 or more osteotomies of the midface including transposition of nerves and vessels and bone grafts taken from the same site and stabilisation with fixation by wires, screws, plates or pins, or any combination (Anaes.) (Assist.) | 2 065.75 | ||||
52420 | Mandible, fixation by intermaxillary wiring, excluding wiring for obesity | 190.75 | ||||
52424 | Dermis, dermofat or fascia graft (excluding transfer of fat by injection) in the oral and maxillofacial region (Anaes.) (Assist.) | 374.70 | ||||
52430 | Microvascular repair of the oral and maxillofacial region using microsurgical techniques, with restoration of continuity of artery or vein of distal extremity or digit (Anaes.) (Assist.) | 862.45 | ||||
52440 | Cleft lip, unilateral — primary repair, 1 stage, without anterior palate repair (Anaes.) (Assist.) | 428.25 | ||||
52442 | Cleft lip, unilateral — primary repair, 1 stage, with anterior palate repair (Anaes.) (Assist.) | 535.40 | ||||
52444 | Cleft lip, bilateral — primary repair, 1 stage, without anterior palate repair (Anaes.) (Assist.) | 594.80 | ||||
52446 | Cleft lip, bilateral — primary repair, 1 stage, with anterior palate repair (Anaes.) (Assist.) | 701.95 | ||||
52450 | Cleft lip, partial revision, including minor flap revision alignment and adjustment, including revision of minor whistle deformity if performed (Anaes.) | 237.90 | ||||
52452 | Cleft lip, total revision, including major flap revision, muscle reconstruction and revision of major whistle deformity (Anaes.) (Assist.) | 386.60 | ||||
52456 | Cleft lip reconstruction using full thickness flap (Abbe or similar), first stage (Anaes.) (Assist.) | 654.35 | ||||
52458 | Cleft lip reconstruction using full thickness flap (Abbe or similar), second stage (Anaes.) | 237.90 | ||||
52460 | Velo-pharyngeal incompetence, pharyngeal flap for, or pharyngoplasty for (Anaes.) | 618.55 | ||||
52480 | Composite graft (chondro-cutaneous or chondro-mucosal) to nose, ear or eyelid (Anaes.) (Assist.) | 397.30 | ||||
52482 | Macrocheilia or macroglossia, operation for (Anaes.) (Assist.) | 382.25 | ||||
52484 | Macrostomia, operation for (Anaes.) (Assist.) | 455.05 | ||||
52600 | Mandibular or palatal exostosis, excision of (Anaes.) (Assist.) | 267.60 | ||||
52603 | Mylohyoid ridge, reduction of (Anaes.) (Assist.) | 255.80 | ||||
52606 | Maxillary tuberosity, reduction of (Anaes.) | 195.10 | ||||
52609 | Papillary hyperplasia of the palate, removal of — less than 5 lesions (Anaes.) (Assist.) | 255.80 | ||||
52612 | Papillary hyperplasia of the palate, removal of — 5 to 20 lesions (Anaes.) (Assist.) | 321.10 | ||||
52615 | Papillary hyperplasia of the palate, removal of — more than 20 lesions (Anaes.) (Assist.) | 398.60 | ||||
52618 | Vestibuloplasty, submucosal or open, including excision of muscle and skin or mucosal graft when performed — unilateral or bilateral (Anaes.) (Assist.) | 463.85 | ||||
52621 | Floor of mouth lowering (Obwegeser or similar procedure), including excision of muscle and skin or mucosal graft when performed — unilateral (Anaes.) (Assist.) | 463.85 | ||||
52624 | Alveolar ridge augmentation with bone or alloplast or both — unilateral (Anaes.) (Assist.) | 374.70 | ||||
52626 | Alveolar ridge augmentation — unilateral, insertion of tissue expanding device into maxillary or mandibular alveolar ridge region for (Anaes.) (Assist.) | 229.75 | ||||
52627 | Osseo-integration procedure — extra oral implantation of titanium fixture (Anaes.) (Assist.) | 398.60 | ||||
52630 | Osseo-integration procedure — fixation of transcutaneous abutment (Anaes.) | 147.50 | ||||
52633 | Osseo-integration procedure — intra-oral implantation of titanium fixture to facilitate restoration of the dentition following resection of part of the maxilla or mandible for benign or malignant tumours (Anaes.) | 398.60 | ||||
52636 | Osseo-integration procedure — fixation of transmucosal abutment to fixtures placed following resection of part of the maxilla or mandible for benign or malignant tumours (Anaes.) | 147.50 | ||||
52800 | Neurolysis by open operation, without transposition, not being a service associated with a service to which item 52803 applies (Anaes.) (Assist.) | 218.90 | ||||
52803 | Nerve trunk, internal (interfascicular), neurolysis of, using microsurgical techniques (Anaes.) (Assist.) | 315.20 | ||||
52806 | Neurectomy, neurotomy or removal of tumour from superficial peripheral nerve (Anaes.) (Assist.) | 218.90 | ||||
52809 | Neurectomy, neurotomy or removal of tumour from deep peripheral nerve (Anaes.) (Assist.) | 374.80 | ||||
52812 | Nerve trunk, primary repair of, using microsurgical techniques (Anaes.) (Assist.) | 535.40 | ||||
52815 | Nerve trunk, secondary repair of, using microsurgical techniques (Anaes.) (Assist.) | 565.00 | ||||
52818 | Nerve, transposition of (Anaes.) (Assist.) | 374.80 | ||||
52821 | Nerve graft to nerve trunk (cable graft) including harvesting of nerve graft using microsurgical techniques (Anaes.) (Assist.) | 814.85 | ||||
52824 | Peripheral branches of the trigeminal nerve, cryosurgery of, for pain relief (Anaes.) (Assist.) | 350.95 | ||||
52826 | Injection of primary branch of trigeminal nerve with alcohol, cortisone, phenol, or similar substance (Anaes.) | 187.95 | ||||
52828 | Cutaneous nerve, primary repair of, using microsurgical techniques (Anaes.) (Assist.) | 279.55 | ||||
52830 | Cutaneous nerve, secondary repair of, using microsurgical techniques (Anaes.) (Assist.) | 368.70 | ||||
52832 | Cutaneous nerve, nerve graft to, using microsurgical techniques (Anaes.) (Assist.) | 505.60 | ||||
53000 | Maxillary antrum, proof puncture and lavage of (Anaes.) | 25.70 | ||||
53003 | Maxillary antrum, proof puncture and lavage of, under general anaesthesia (requiring admission to hospital) not being a service associated with a service to which another item in Groups 03 to 09 applies (Anaes.) | 72.80 | ||||
53004 | Maxillary antrum, lavage of — each attendance at which the procedure is performed, including any associated consultation (Anaes.) | 26.55 | ||||
53006 | Antrostomy (radical) (Anaes.) (Assist.) | 412.30 | ||||
53009 | Antrum, intranasal operation on or removal of foreign body from (Anaes.) (Assist.) | 233.90 | ||||
53012 | Antrum, drainage of, through tooth socket (Anaes.) | 92.95 | ||||
53015 | Oro-antral fistula, plastic closure of (Anaes.) (Assist.) | 464.85 | ||||
53016 | Nasal septum, septoplasty, submucous resection or closure of septal perforation (Anaes.) (Assist.) | 382.25 | ||||
53017 | Nasal septum, reconstruction of (Anaes.) (Assist.) | 476.95 | ||||
53019 | Maxillary sinus, bone graft to floor of maxillary sinus following elevation of mucosal lining (sinus lift procedure), unilateral (Anaes.) (Assist.) | 459.45 | ||||
53052 | Post-nasal space, direct examination of, with or without biopsy (Anaes.) | 97.10 | ||||
53054 | Nasendoscopy or sinoscopy or fibreoptic examination of nasopharynx — 1 or more of these procedures (Anaes.) | 97.05 | ||||
53056 | Examination of nasal cavity or post-nasal space, or nasal cavity and post-nasal space, under general anaesthesia, not being a service associated with a service to which another item in this group applies (Anaes.) | 56.95 | ||||
53058 | Nasal haemorrhage, posterior, arrest of, with posterior nasal packing with or without cauterisation and with or without anterior pack (excluding after-care) (Anaes.) | 97.05 | ||||
53060 | Cauterisation (other than by chemical means) or cauterisation by chemical means when performed under general anaesthesia or diathermy of septum or turbinates for obstruction or haemorrhage secondary to surgery (or trauma) — 1 or more of these procedures (including any consultation on the same occasion) not being a service associated with any other operation on the nose (Anaes.) | 79.45 | ||||
53062 | Post-surgical nasal haemorrhage, arrest of during an episode of epistaxis by cauterisation or nasal cavity packing or both (Anaes.) | 71.15 | ||||
53064 | Cryotherapy to nose in the treatment of nasal haemorrhage (Anaes.) | 128.95 | ||||
53068 | Turbinectomy or turbinectomies, partial or total, unilateral (Anaes.) | 106.70 | ||||
53070 | Turbinates, submucous resection of, unilateral (Anaes.) | 140.85 | ||||
53200 | Mandible, treatment of a dislocation of, not requiring open reduction(Anaes.) | 55.90 | ||||
53203 | Mandible, treatment of a dislocation of, requiring open reduction (Anaes.) | 94.00 | ||||
53206 | Temporomandibular joint, manipulation of, performed in the operating theatre of a hospital or approved day‑hospital facility, not being a service associated with a service to which another item in Groups O3 to O9 applies (Anaes.) | 113.00 | ||||
53209 | Glenoid fossa, zygomatic arch and temporal bone, reconstruction of (Obwegeser technique) (Anaes.) (Assist.) | 1 304.40 | ||||
53212 | Absent condyle and ascending ramus in hemifacial microsomia, construction of, not including harvesting of graft material (Anaes.) (Assist.) | 704.70 | ||||
53215 | Temporomandibular joint, arthroscopy of, with or without biopsy, not being a service associated with any other arthroscopic procedure of that joint (Anaes.) (Assist.) | 323.20 | ||||
53218 | Temporomandibular joint, arthroscopy of, removal of loose bodies, debridement, or treatment of adhesions — 1 or more of such procedures (Anaes.) (Assist.) | 517.10 | ||||
53220 | Temporomandibular joint, arthrotomy of, not being a service to which another item in this group applies (Anaes.) (Assist.) | 260.70 | ||||
53221 | Temporomandibular joint, open surgical exploration of, with or without microsurgical techniques (Anaes.) (Assist.) | 690.00 | ||||
53224 | Temporomandibular joint, open surgical exploration of, with condylectomy or condylotomy, with or without microsurgical techniques (Anaes.) (Assist.) | 764.90 | ||||
53225 | Arthrocentesis, irrigation of temporomandibular joint after insertion of 2 cannuli into the appropriate joint space(s) (Anaes.) (Assist.) | 229.75 | ||||
53226 | Temporomandibular joint, synovectomy of, not being a service to which another item in this group applies (Anaes.) (Assist.) | 247.00 | ||||
53227 | Temporomandibular joint, open surgical exploration of, with or without meniscus or capsular surgery, including meniscectomy when performed, with or without microsurgical techniques (Anaes.) (Assist.) | 939.85 | ||||
53230 | Temporomandibular joint, open surgical exploration of, with meniscus, capsular and condylar head surgery, with or without microsurgical techniques (Anaes.) (Assist.) | 1 058.75 | ||||
53233 | Temporomandibular joint, surgery of, involving procedures to which items 53224, 53226, 53227 and 53230 apply and also involving the use of tissue flaps, or cartilage graft, or allograft implants, with or without microsurgical techniques (Anaes.) (Assist.) | 1 189.65 | ||||
53236 | Temporomandibular joint, stabilisation of, involving 1 or more of: repair of capsule, repair of ligament or internal fixation, not being a service to which another item in this group applies (Anaes.) (Assist.) | |||||
372.30 | ||||||
53239 | Temporomandibular joint, arthrodesis of, not being a service to which another item in this group applies (Anaes.) (Assist.) | 372.30 | ||||
53242 | Temporomandibular joint or joints, application of external fixator to, other than for treatment of fractures (Anaes.) (Assist.) | 247.00 | ||||
53400 | Maxilla, unilateral or bilateral, treatment of fracture of, not requiring splinting | 102.20 | ||||
53403 | Mandible, treatment of fracture of, not requiring splinting | 124.85 | ||||
53406 | Maxilla, treatment of fracture of, requiring splinting, wiring of teeth, circumosseous fixation or external fixation (Anaes.) (Assist.) | 321.65 | ||||
53409 | Mandible, treatment of fracture of, requiring splinting, wiring of teeth, circumosseous fixation or external fixation (Anaes.) (Assist.) | 321.65 | ||||
53410 | Zygomatic bone, treatment of fracture of, not requiring surgical reduction | 67.75 | ||||
53411 | Zygomatic bone, treatment of fracture of, requiring surgical reduction, by temporal, intra-oral or other approach (Anaes.) | 188.95 | ||||
53412 | Zygomatic bone, treatment of fracture of, requiring surgical reduction and involving internal or external fixation at 1 site (Anaes.) (Assist.) | 310.15 | ||||
53413 | Zygomatic bone, treatment of fracture of, requiring surgical reduction and involving internal or external fixation or both at 2 sites (Anaes.) (Assist.) | 379.00 | ||||
53414 | Zygomatic bone, treatment of, requiring surgical reduction and involving internal or external fixation or both at 3 sites (Anaes.) (Assist.) | 436.45 | ||||
53415 | Maxilla, treatment of fracture of, requiring open reduction (Anaes.) (Assist.) | 344.65 | ||||
53416 | Mandible, treatment of fracture of, requiring open reduction (Anaes.) (Assist.) | 344.65 | ||||
53418 | Maxilla, treatment of fracture of, requiring open reduction and internal fixation not involving plate(s) (Anaes.) (Assist.) | 447.95 | ||||
53419 | Mandible, treatment of fracture of, requiring open reduction and internal fixation not involving plate(s) (Anaes.) (Assist.) | 447.95 | ||||
53422 | Maxilla, treatment of fracture of, requiring open reduction and internal fixation involving plate(s) (Anaes.) (Assist.) | 568.55 | ||||
53423 | Mandible, treatment of fracture of, requiring open reduction and internal fixation involving plate(s) (Anaes.) (Assist.) | 568.55 | ||||
53424 | Maxilla, treatment of a complicated fracture of, involving viscera, blood vessels or nerves, requiring open reduction not involving plate(s) (Anaes.) (Assist.) | 487.80 | ||||
53425 | Mandible, treatment of a complicated fracture of, involving viscera, blood vessels or nerves, requiring open reduction not involving plate(s) (Anaes.) (Assist.) | 487.80 | ||||
53427 | Maxilla, treatment of a complicated fracture of, involving viscera, blood vessels or nerves, requiring open reduction involving the use of plate(s) (Anaes.) (Assist.) | 666.25 | ||||
53429 | Mandible, treatment of a complicated fracture of, involving viscera, blood vessels or nerves, requiring open reduction involving the use of plate(s) (Anaes.) (Assist.) | 666.25 | ||||
53439 | Mandible, treatment of a closed fracture of, involving a joint surface (Anaes.) | 188.95 | ||||
53453 | Orbital cavity, reconstruction of a wall or floor with or without foreign implant (Anaes.) (Assist.) | 382.25 | ||||
53455 | Orbital cavity, bone or cartilage graft to orbital wall or floor including reduction of prolapsed or entrapped orbital contents (Anaes.) (Assist.) | 449.00 | ||||
53458 | Nasal bones, treatment of fracture of, not being a service to which item 53459 or 53460 applies | 34.00 | ||||
53459 | Nasal bones, treatment of fracture of, by reduction (Anaes.) | 186.25 | ||||
53460 | Nasal bones, treatment of fractures of, by open reduction involving osteotomies (Anaes.) (Assist.) | 379.90 | ||||
53600 | Skin sensitivity testing for allergens to anaesthetics and materials used in oral and maxillofacial surgery, using 1 to 20 allergens | 30.80 | ||||
53700 | Trigeminal nerve, primary division of, injection of an anaesthetic agent | 98.75 | ||||
53702 | Trigeminal nerve, peripheral branch of, injection of an anaesthetic agent | 49.45 | ||||
53704 | Facial nerve, injection of an anaesthetic agent | 29.75 | ||||
53706 | Nerve branch in the oral and maxillofacial region, destruction by a neurolytic agent, not being a service to which any other item in this group applies | 98.75 | ||||
75001 | Initial professional attendance in a single course of treatment by an accredited orthodontist (AO) | 67.65 | ||||
75004 | Professional attendance by an accredited orthodontist subsequent to the first professional attendance by the orthodontist in a single course of treatment (AO) | 33.95 | ||||
75006 | Production of dental study models (not being a service associated with a service to which item 75004 applies) prior to provision of a service to which:
in a single course of treatment (AO) | 60.30 | ||||
75009 | Orthodontic radiography — orthopantomography (panoramic radiography), including any consultation on the same occasion (AOS) (AO) | 53.90 | ||||
75012 | Orthodontic radiography — anteroposterior cephalometric radiography with cephalometric tracings or lateral cephalometric radiography with cephalometric tracings including any consultation on the same occasion (AOS) (AO) | 85.40 | ||||
75015 | Orthodontic radiography — anteroposterior and lateral cephalometric radiography, with cephalometric tracings including any consultation on the same occasion (AOS) (AO) | 117.50 | ||||
75018 | Orthodontic radiography — anteroposterior and lateral cephalometric radiography, with cephalometric tracings and orthopantomography including any consultation on the same occasion (AOS) (AO) | 149.65 | ||||
75021 | Orthodontic radiography — hand-wrist studies (including growth prediction) including any consultation on the same occasion (AOS) | 183.55 | ||||
75023 | Intraoral radiography — single area, periapical or bitewing film (AOS) | 36.75 | ||||
75024 | Pre-surgical infant maxillary arch repositioning, including supply of appliances and all adjustments of appliances and supervision — where 1 appliance is used (AO) | 474.75 | ||||
75027 | Pre-surgical infant maxillary arch repositioning, including supply of appliances and all adjustments of appliances and supervision — where 2 appliances are used (AO) | 650.90 | ||||
75030 | Maxillary ach expansion not being a service associated with a service to which item 75039, 75042, 75045 or 75048 applies, including supply of appliances, all adjustments of the appliances, removal of the appliances and retention (AO) | 579.60 | ||||
75033 | Mixed dentition treatment — incisor alignment using fixed appliances in maxillary arch, including supply of appliances, all adjustments of appliances, removal of the appliances and retention (AO) | 949.90 | ||||
75034 | Mixed dentition treatment — incisor alignment with or without lateral arch expansion using a removable appliance in the maxillary arch, including supply of appliances, associated adjustments and retention (AO) | 483.50 | ||||
75036 | Mixed dentition treatment — lateral arch expansion and incisor alignment using fixed appliances in maxillary arch, including supply of appliances, all adjustments of appliances, removal of appliances and retention (AO) | 1 312.10 | ||||
75037 | Mixed dentition treatment — lateral arch expansion and incisor correction — 2 arch (maxillary and mandibular) using fixed appliances in both maxillary and mandibular arches, including supply of appliances, all adjustments of appliances, removal of appliances and retention (AO) | 1 652.55 | ||||
75039 | Permanent dentition treatment — single arch (mandibular or maxillary) treatment (correction and alignment) using fixed appliances, including supply of appliances — initial 3 months of active treatment (AO) | 439.15 | ||||
75042 | Permanent dentition treatment — single arch (mandibular or maxillary) treatment (correction and alignment) using fixed appliances, including supply of appliances — each 3 months of active treatment (including all adjustments and maintenance and removal of the appliances) after the first for a maximum of a further 33 months (AO) | 164.25 | ||||
75045 | Permanent dentition treatment — 2 arch (mandibular and maxillary) treatment (correction and alignment) using fixed appliances, including supply of appliances — initial 3 months of active treatment (AO) | 879.20 | ||||
75048 | Permanent dentition treatment — 2 arch (mandibular and maxillary) treatment (correction and alignment) using fixed appliances, including supply of appliances — each subsequent 3 months of active treatment (including all adjustments and maintenance, and removal of the appliances) after the first for a maximum of a further 33 months (AO) | 225.45 | ||||
75049 | Retention, fixed or removable, single arch (mandibular or maxillary) — supply of retainer and supervision of retention (AO) | 263.90 | ||||
75050 | Retention, fixed or removable, 2-arch (mandibular and maxillary) — supply of retainers and supervision of retention (AO) | 509.40 | ||||
75051 | Jaw growth guidance using removable or functional appliances, including supply of appliances and all adjustments to appliances (AO) | 782.05 | ||||
75150 | Initial professional attendance in a single course of treatment by an accredited oral and maxillofacial surgeon where the patient is referred to the surgeon by an accredited orthodontist (AOS) | 67.65 | ||||
75153 | Professional attendance by an accredited oral and maxillofacial surgeon subsequent to the first professional attendance by the surgeon in a single course of treatment where the patient is referred to the surgeon by an accredited orthodontist (AOS) | 33.95 | ||||
75156 | Production of dental study models (not being a service associated with a service to which item 75153 applies) prior to provision of a service:
in a single course of treatment (AOS) | 60.30 | ||||
75200 | Removal of tooth or tooth fragment (not being treatment to which item 75400, 75403, 75406, 75409, 75412 or 75415 applies), where the patient is referred by an accredited orthodontist (AD) | 43.45 | ||||
75203 | Removal of tooth or tooth fragment under general anaesthesia, where the patient is referred by an accredited orthodontist (AOS) | 65.20 | ||||
75206 | Removal of each additional tooth or tooth fragment at the same attendance at which a service to which item 75200 or 75203 applies is rendered (AOS) | 21.60 | ||||
75400 | Surgical removal of erupted tooth, where the patient is referred by an accredited orthodontist (AOS) | 130.35 | ||||
75403 | Surgical removal of tooth with soft tissue impaction, where the patient is referred by an accredited orthodontist (AOS) | 149.65 | ||||
75406 | Surgical removal of tooth with partial bone impaction, where the patient is referred by an accredited orthodontist (AOS) | 170.65 | ||||
75409 | Surgical removal of tooth with complete bone impaction, where the patient is referred by an accredited orthodontist (AOS) | 193.20 | ||||
75412 | Surgical removal of tooth fragment requiring incision of soft tissue only, where the patient is referred by an accredited orthodontist (AOS) | 107.90 | ||||
75415 | Surgical removal of tooth fragment requiring removal of bone, where the patient is referred by an accredited orthodontist (AOS) | 130.35 | ||||
75600 | Surgical exposure, stimulation and packing of unerupted tooth, where the patient is referred by an accredited orthodontist (AOS) | 183.55 | ||||
75603 | Surgical exposure of unerupted tooth for the purpose of fitting a traction device, where the patient is referred by an accredited orthodontist (AOS) | 215.70 | ||||
75606 | Surgical repositioning of unerupted tooth, where the patient is referred by an accredited orthodontist (AOS) | 215.70 | ||||
75609 | Transplantation of tooth bud, where the patient is referred by an accredited orthodontist (AOS) | 322.05 | ||||
75612 | Surgical procedure for intra oral implantation of osseointegrated fixture (first stage) (AOS) | 398.60 | ||||
75615 | Surgical procedure for fixation of trans-mucosal abutment (second stage of osseointegrated implant) (AOS) | 147.50 | ||||
75618 | Provision and fitting of a bite rising appliance or dental splint for the management of temporomandibular joint dysfunction syndrome (AOS) | 183.20 | ||||
75621 | The provision and fitting of surgical template in conjunction with orthognathic surgical procedures in association with:
| 183.20 | ||||
75800 | Attendance comprising consultation, preventive treatment and prophylaxis, of not less than 30 minutes duration — each attendance to a maximum of 3 attendances in any period of 12 months (AD) | 65.20 | ||||
75803 | Provision and fitting of acrylic base partial denture, including retainers — 1 tooth (AD) | 260.85 | ||||
75806 | Provision and fitting of acrylic base partial denture, including retainers — 2 teeth (AD) | 305.90 | ||||
75809 | Provision and fitting of acrylic base partial denture, including retainers — 3 teeth (AD) | 362.25 | ||||
75812 | Provision and fitting of acrylic base partial denture, including retainers — 4 teeth (AD) | 402.50 | ||||
75815 | Provision and fitting of acrylic base partial denture, including retainers — 5 to 9 teeth (AD) | 491.05 | ||||
75818 | Provision and fitting of acrylic base partial denture, including retainers — 10 to 12 teeth (AD) | 579.60 | ||||
75821 | Provision and fitting of cast metal base (cobalt chromium alloy) partial denture including casting and retainers — 1 tooth (AD) | 466.85 | ||||
75824 | Provision and fitting of cast metal base (cobalt chromium alloy) partial denture including casting and retainers — 2 teeth (AD) | 539.35 | ||||
75827 | Provision and fitting of cast metal base (cobalt chromium alloy) partial denture including casting and retainers — 3 teeth (AD) | 619.85 | ||||
75830 | Provision and fitting of cast metal base (cobalt chromium alloy) partial denture including casting and retainers — 4 teeth (AD) | 684.30 | ||||
75833 | Provision and fitting of cast metal base (cobalt chromium alloy) partial denture including casting and retainers — 5 to 9 teeth (AD) | 837.15 | ||||
75836 | Provision and fitting of cast metal base (cobalt chromium alloy) partial denture including casting and retainers — 10 to 12 teeth (AD) | 957.90 | ||||
75839 | Provision and fitting of retainers (not being treatment associated with treatment to which item 75803, 75806, 75809, 75812, 75815, 75818, 75821, 75824, 75827, 75830, 75833 or 75836 applies) — each retainer (AD) | 21.60 | ||||
75842 | Adjustment of partial denture (not being treatment associated with treatment to which item 75803, 75806, 75809, 75812, 75815, 75818, 75821, 75824, 75827, 75830, 75833 or 75836 applies) (AD) | 32.20 | ||||
75845 | Relining of partial denture by laboratory process and associated fitting (AD) | 161.05 | ||||
75848 | Remodelling and fitting of partial denture of more than 4 teeth (AD) | 193.20 | ||||
75851 | Repair to cast metal base of partial denture — 1 or more points (AD) | 96.60 | ||||
75854 | Addition of a tooth or teeth to a partial denture to replace extracted tooth or teeth, including taking of necessary impression (AD) | 96.60 | ||||
The
2001 No. 280 | 5 Oct 2001 | 1 Nov 2001 | |
2002 No. 76 | 18 Apr 2002 | 1 May 2002 | — |
am. = amended rep. = repealed rs. = repealed and substituted | |
Schedule 1............................. | am. 2002 No. 76 |
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