Health Insurance (General Medical Services Table) Regulations 2005 (Cth)
made under the
This compilation was prepared on 1 May 2006
taking into account amendments up to SLI 2006 No. 86
Prepared by the Office of Legislative Drafting and Publishing,
Attorney‑General’s Department, Canberra
These Regulations are the
Health Insurance (General Medical Services Table) Regulations 2005 .
These Regulations commence on 1 November 2005.
The
Health Insurance (General Medical Services Table) Regulations 2004 are repealed.
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; and
(c) in Part 4 — additional supporting information.
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:
2004 General Medical Services Table (or2004 GMST ) means the table prescribed for subsection 4 (1) of the Act by theHealth Insurance (General Medical Services Table )Regulations 2004 as in force immediately before 1 November 2005.ACRRM means the Australian College of Rural and Remote Medicine.approved day hospital facility means a day hospital facility within the meaning of theNational Health Act 1953 .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 of 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; or
(e) a practitioner who is undertaking a placement in general practice as part of the Pre‑vocational General Practice Placements Program administered by the ACRRM, RACGP or GPET.
GPET means the body registered under theCorporations Act 2001 as General Practice Education and Training Limited (ACN 095 433 140).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.Rural, Remote and Metropolitan Areas Classification means the document so titled, as in force on 1 January 2001, setting out certain categories of areas in Australia that have been determined by the Department 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.(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) a medical practitioner (including an overseas trained practitioner or a temporary resident medical practitioner) who:
(i) is registered as a medical practitioner under the Rural Other Medical Practitioners’ Program; and
(ii) is providing general medical services in accordance with that Program; or
(b) a medical practitioner who:
(i) is registered as a medical practitioner under the Outer Metropolitan (Other Medical Practitioners) Relocation Incentive Program; and
(ii) is providing general medical services in accordance with that Program; and
(iii) is not vocationally registered under section 3F of the Act, but is required under that Program to undertake additional training or other activities:
(A) that could enable vocational registration within 4 years or, on written application, 5 years, after commencing the training or other activities; and
(B) of which the Medicare Australia CEO has written notice; or
(c) a medical practitioner who:
(i) is registered as a medical practitioner under the MedicarePlus for Other Medical Practitioners Program; and
(ii) is providing general medical services in accordance with that Program; and
(iii) is not vocationally registered under section 3F of the Act; or
(d) a medical practitioner who:
(i) is registered as a medical practitioner under the After Hours Other Medical Practitioners Program; and
(ii) is providing general medical services in accordance with that Program; and
(iii) is not vocationally registered under section 3F of the Act.
(4) For subrule (3):
(a) the
Rural Other Medical Practitioners’ Program is a program administered by the Medicare Australia CEO that, in relation to medical services provided in accordance with the Program, provides a particular level of medicare benefits; and(b) the
Outer Metropolitan (Other Medical Practitioners) Relocation Incentive Program is a program administered by the Department that, in relation to medical services provided in accordance with the Program, provides a particular level of medicare benefits; and(c) the
MedicarePlus for Other Medical Practitioners Program is a program administered by the Medicare Australia CEO that, in relation to medical services provided in accordance with the Program, provides a particular level of medicare benefits; and(d) the
After Hours Other Medical Practitioners Program is a program administered by the Medicare Australia CEO that, in relation to medical services provided in accordance with the Program, 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).
An item including the symbol
( H ) applies only to a service performed or provided in a hospital or approved day hospital facility.
(1) In subrules 3 (1), 4 (1) and 8 (1) and items 104, 105, 106, 107, 108, 109, 110, 116, 119, 122, 128, 131, 385, 386, 387, 388, 2801, 2806, 2814, 2824, 2832, 2840, 3005, 3010, 3014, 3018, 3023 and 3028,
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.
(1)In items 1 to 338, 348 to 388, 410 to 417, 501 to 536, 601, 602, 697, 698, 2501 to 2727, 2801 to 2840, 3005 to 3028, 5000 to 5267 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 and 5000 to 5267, 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.
(1) In items 104 to 131, 291 to 388, 2801 to 2840 and 3005 to 3028, 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 9 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 — $22.00 divided by the number of patients attended; or
(ii) if more than 6 patients are attended at a single attendance — $1.60.
(2) In items 24, 25, 33 and 35,
amount under rule 9 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 — $22.00 divided by the number of patients attended; or
(ii) if more than 6 patients are attended at a single attendance — $1.60.
(3) In items 37, 38, 40 and 43,
amount under rule 9 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 — $22.00 divided by the number of patients attended; or
(ii) if more than 6 patients are attended at a single attendance — $1.60.
(4) In items 47, 48, 50 and 51,
amount under rule 9 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 — $22.00 divided by the number of patients attended; or
(ii) if more than 6 patients are attended at a single attendance — $1.60.
(5) In items 58, 81, 87 and 92,
amount under rule 9 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 9 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, 2675 and 2707,
amount under rule 9 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, 2677 and 2708,
amount under rule 9 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 9 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 — $22.00 divided by the number of patients attended; or
(ii) if more than 6 patients are attended at a single attendance — $1.60.
(10) In item 414,
amount under rule 9 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 — $22.00 divided by the number of patients attended; or
(ii) if more than 6 patients are attended at a single attendance — $1.60.
(11) In item 415,
amount under rule 9 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 — $22.00 divided by the number of patients attended; or
(ii) if more than 6 patients are attended at a single attendance — $1.60.
(12) In item 416,
amount under rule 9 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 — $22.00 divided by the number of patients attended; or
(ii) if more than 6 patients are attended at a single attendance — $1.60.
(13) In item 417,
amount under rule 9 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 — $22.00 divided by the number of patients attended; or
(ii) if more than 6 patients are attended at a single attendance — $1.60.
(13A) In item 716,
amount under rule 9 means an amount equal to the sum of:(a) the fee for item 714; and
(b) either:
(i) if not more than 6 patients are attended at a single attendance — $22.00 divided by the number of patients attended; or
(ii) if more than 6 patients are attended at a single attendance — $1.60.
(14) In items 5003, 5007 and 5010,
amount under rule 9 means an amount equal to the sum of:(a) the fee for item 5000; and
(b) either:
(i) if not more than 6 patients are attended at a single attendance — $22.00 divided by the number of patients attended; or
(ii) if more than 6 patients are attended at a single attendance — $1.60.
(15) In items 5023, 5026 and 5028,
amount under rule 9 means an amount equal to the sum of:(a) the fee for item 5020; and
(b) either:
(i) if not more than 6 patients are attended at a single attendance — $22.00 divided by the number of patients attended; or
(ii) if more than 6 patients are attended at a single attendance — $1.60.
(16) In items 5043, 5046 and 5049,
amount under rule 9 means an amount equal to the sum of:(a) the fee for item 5040; and
(b) either:
(i) if not more than 6 patients are attended at a single attendance — $22.00 divided by the number of patients attended; or
(ii) if more than 6 patients are attended at a single attendance — $1.60.
(17) In items 5063, 5064 and 5067,
amount under rule 9 means an amount equal to the sum of:(a) the fee for item 5060; and
(b) either:
(i) if not more than 6 patients are attended at a single attendance — $22.00 divided by the number of patients attended; or
(ii) if more than 6 patients are attended at a single attendance — $1.60.
(18) In items 5220, 5240 and 5260,
amount under rule 9 means an amount equal to the sum of:(a) $18.50; 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.
(19) In items 5223, 5243 and 5263,
amount under rule 9 means an amount equal to the sum of:(a) $26.00; 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.
(20) In items 5227, 5247 and 5265,
amount under rule 9 means an amount equal to the sum of:(a) $45.50; 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.
(21) In items 5228, 5248 and 5267,
amount under rule 9 means an amount equal to the sum of:(a) $67.50; 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.
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.
(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 698, 2497 to 10816, 11012, 11015, 11018, 11021, 11212, 11304, 11500, 11600, 11627, 11701, 11712, 11724, 11921, 12000, 12003, 12201, 13030, 13100, 13103, 13104, 13106, 13109, 13110, 13112, 13209, 13290, 13292, 13300, 13303, 13306, 13309, 13312, 13318, 13319, 13400, 13500, 13503, 13506, 13700, 13815, 13818, 13830, 13839, 13842, 13847, 13848, 13851, 13854, 13857, 13870, 13873, 13876, 13881, 13882, 13885, 13888, 14100, 14106, 14109, 14112, 14115, 14118, 14124, 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.
(4) Items 700 to 727, 900 and 903 apply only to a service provided in the course of personal attendance by a single medical practitioner on a single patient.
(5) For this rule, each of the following is taken to be personal attendance by the medical practitioner on a patient:
(a) an attendance by a medical practitioner on a patient by way of a telepsychiatry consultation to which any of items 353 to 358 applies;
(b) an attendance by a medical practitioner on a patient in relation to the planning, management and supervision of the patient on home dialysis to which item 13104 applies.
(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 727, 900 to 10816, 11012, 11015, 11018, 11021, 11212, 11304, 11500, 11600, 11627, 11701, 11712, 11722, 11724, 11820, 11921, 12000, 12003, 12201, 13030, 13100, 13103, 13104, 13106, 13109, 13110, 13112, 13209, 13290, 13292, 13300, 13303, 13306, 13309, 13312, 13318, 13319, 13400, 13500, 13503, 13506, 13700, 13815, 13818, 13830, 13839, 13842, 13847, 13848, 13851, 13854, 13857, 13870, 13873, 13876, 13881, 13882, 13885, 13888, 14100, 14106, 14109, 14112, 14115, 14118, 14124, 14200, 14203, 14206, 14209, 14212, 14215, 14224, 15600, 16003 to 16512, 16515 to 16573 and 16600 to 51318.
(4) For this rule, each of the following is taken to be personal attendance by the medical practitioner on a patient:
(a) an attendance by a medical practitioner on a patient by way of a telepsychiatry consultation to which any of items 353 to 358 applies;
(b) an attendance by a medical practitioner on a patient in relation to the planning, management and supervision of the patient on home dialysis to which item 13104 applies.
(1) Items 729 to 866 apply only to a service provided 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.
(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, 11004, 11005, 11006, 11009, 11024, 11027, 11200, 11203, 11204, 11205, 11210, 11211, 11215, 11218, 11221, 11222, 11224, 11225, 11235, 11237, 11240, 11241, 11242, 11243, 11300, 11303, 11306, 11309, 11312, 11315, 11318, 11321, 11324, 11327, 11330, 11332, 11333, 11336, 11339, 11503, 11506, 11509, 11512, 11602, 11604, 11605, 11610, 11611, 11612, 11614, 11615, 11700, 11702, 11708, 11709, 11710, 11711, 11713, 11715, 11718, 11721, 11800, 11810, 11830, 11833, 11900, 11903, 11906, 11909, 11912, 11915, 11919, 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 15357, 15500 to 15539 and 16514.
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.
An item in the range 1 to 10943 does not apply to the service described in that item if the service is provided at the same time as, or in connection with, any of the services specified in Part 4 of this table.
An item in the range 5000 to 5267 applies only to a professional attendance that is initiated:
(a) on a public holiday; or
(b) on a Sunday; or
(c) before 8 am, or after 1 pm, on a Saturday; or
(d) before 8 am, or after 8 pm, on any day other than a Saturday, Sunday or public holiday.
Items 51700 to 53706 apply only to a service provided in the course of dental practice by a dental practitioner approved by the Minister before 1 November 2004 for the purposes of the definition of
professional service in subsection 3 (1) of the Act.
(1) In item 15003,
amount under rule 17 means an amount equal to the sum of:(a) the fee for item 15000; and
(b) $14.80 for each field separately treated in excess of 1.
(2) In item 15009,
amount under rule 17 means an amount equal to the sum of:(a) the fee for item 15006; and
(b) $16.05 for each field separately treated in excess of 1.
(3) In item 15103,
amount under rule 17 means an amount equal to the sum of:(a) the fee for item 15100; and
(b) $16.30 for each field separately treated in excess of 1.
(4) In item 15109,
amount under rule 17 means an amount equal to the sum of:(a) the fee for item 15106; and
(b) $19.65 for each field separately treated in excess of 1.
(5) In item 15115,
amount under rule 17 means an amount equal to the sum of:(a) the fee for item 15112; and
(b) $40.95 for each field separately treated in excess of 1.
(6) In item 15214,
amount under rule 17 means an amount equal to the sum of:(a) the fee for item 15211; and
(b) $27.60 for each field separately treated in excess of 1.
(7) In items 15230, 15233, 15236, 15239, 15242, 15260, 15263, 15266, 15269 and 15272,
amount under rule 17 means an amount equal to the sum of:(a) $51.65; and
(b) $32.80 for each field separately treated in excess of 1.
In item 44376 (reamputation),
amount under rule 18 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.
An item in Group C1, C2 or C3 applies only to a service provided to a prescribed dental patient.
Note For the meaning ofprescribed dental patient , see section 3BA of the Act.
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.
(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.
In items 11000 to 12217,
report means a report prepared by a medical practitioner.
In rule 25 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.
(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.
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.
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.
In items 45720 to 45752 and 52342 to 52375,
maxilla includes the zygoma.
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.
In items 51303 and 51803,
amount under rule 32 , 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 33 ,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.
(1) In item 18219,
amount under rule 34 means an amount equal to the sum of:(a) the fee for item 18216; and
(b) $16.50 for each additional period of 15 minutes, and part of a period of 15 minutes, of continuous attendance beyond the first hour of attendance.
(2) In item 18227,
amount under rule 34 means an amount equal to the sum of:(a) the fee for item 18226; and
(b) $24.75 for each additional period of 15 minutes, and part of a period of 15 minutes, of continuous attendance beyond the first hour of attendance.
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.
(1) In item 16633,
amount under rule 36 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 36 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 37 , 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 38 , 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.
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 40 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.
(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 approved day hospital facility, or a care recipient in a residential aged care facility.
(2) Item 710 applies only to a service in relation to a patient who is:
(a) of Aboriginal or Torres Strait Islander descent; and
(b) at least 15 years old and less than 55 years old; and
(c) not an in‑patient of a hospital or approved day hospital facility, or a care recipient in a residential aged care facility.
(2A) Item 714 applies only to a service in relation to a patient who:
(a) has been a humanitarian visa holder for less than 12 months at the time of the service; or
(b) first entered Australia less than 12 months before the service.
(2B) Item 716 applies only to a service in relation to a patient who:
(a) is a person who:
(i) has been a humanitarian visa holder for less than 12 months at the time of the service; or
(ii) first entered Australia less than 12 months before the service; and
(b) is not an in‑patient of a hospital or approved day hospital facility, or a care recipient in a residential aged care facility.
(3) For items 704, 706, 708 and 710, a person is of
Aboriginal or Torres Strait Islander descent if the person identifies himself or herself as being of that descent.
(1) Items 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 approved day hospital facility, or a care recipient in a residential aged care facility.
(1A) Items 721 and 725 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 person who:
(i) is not:
(A) an in‑patient of a hospital or approved day hospital facility; or
(B) a care recipient in a residential aged care facility; or
(ii) being an in‑patient of a hospital or approved day hospital facility, is a private patient of that hospital or facility.
(2) Items 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 approved day hospital facility; and
(c) is not a care recipient in a residential aged care facility.
(2A) Items 723 and 727 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) requires ongoing care from at least 3 collaborating providers, each of whom provides a different kind of treatment or service to the patient, and at least 1 of whom is a medical practitioner; and
(c) is a person who:
(i) is not:
(A) an in‑patient of a hospital or approved day hospital facility; or
(B) a care recipient in a residential aged care facility; or
(ii) being an in‑patient of a hospital or approved day hospital facility, is a private patient of that hospital or facility.
(2B) Item 729 applies 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) requires ongoing care from at least 3 collaborating providers, each of whom provides a different kind of treatment or service to the patient, and at least 1 of whom is a medical practitioner; and
(c) is not a care recipient in a residential aged care facility.
(3) Items 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 approved day hospital facility.
(4) Item 731 applies 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) requires ongoing care from at least 3 collaborating providers, each of whom provides a different kind of treatment or service to the patient, and at least 1 of whom is a medical practitioner; and
(c) is a care recipient in a residential aged care facility.
(5) In this rule:
collaborating provider is a person who:(a) provides treatment or a service to a patient; and
(b) is not a family carer of the patient.
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.
(1) For any particular patient, unless exceptional circumstances exist in relation to the patient, item 721:
(a) is not applicable if:
(i) in the 3 months preceding the performance of the service, a service has been performed in respect of which a payment has been made under item 725, 727, 729 or 731 in respect of the patient; or
(ii) in the 12 months preceding the performance of the service, a service has been performed in respect of which a payment was made under item 720 of the 2004 General Medical Services Table in respect of the patient; and
(b) is applicable not more than once in a 12 month period.
(2) For any particular patient, unless exceptional circumstances exist in relation to the patient, item 723:
(a) is not applicable if:
(i) in the 3 months preceding the performance of the service, a service has been performed in respect of which a payment has been made under item 727 in respect of the patient; or
(ii) in the 12 months preceding the performance of the service, a service has been performed in respect of which a payment was made under item 720 of the 2004 General Medical Services Table in respect of the patient; and
(b) is applicable not more than once in a 12 month period.
(3) For any particular patient, unless exceptional circumstances exist in relation to the patient, item 725:
(a) is not applicable if, in the 3 months preceding the performance of the service, a service has been performed in respect of which a payment has been made under item 721 in respect of the patient; and
(b) is applicable not more than once in a 3 month period.
(4) For any particular patient, unless exceptional circumstances exist in relation to the patient, item 727:
(a) is not applicable if, in the 3 months preceding the performance of the service, a service has been performed in respect of which a payment has been made under item 723 in respect of the patient; and
(b) is applicable not more than once in a 3 month period.
(5) For any particular patient, unless exceptional circumstances exist in relation to the patient, item 729:
(a) is not applicable if:
(i) in the 3 months preceding the performance of the service, a service has been performed in respect of which a payment has been made under item 725, 727 or 731 in respect of the patient; or
(ii) in the 3 months preceding the performance of the service, a service has been performed in respect of which a payment was made under item 726 or 728 of the 2004 General Medical Services Table in respect of the patient; or
(iii) in the 12 months preceding the performance of the service, a service has been performed in respect of the patient:
(A) by the medical practitioner who performs the service to which item 729 would, but for this subrule, apply; and
(B) in respect of which a payment has been made under item 721 or 723; and
(b) is applicable not more than once in a 3 month period.
(6) For any particular patient, unless exceptional circumstances exist in relation to the patient, item 731:
(a) is not applicable if:
(i) in the 3 months preceding the performance of the service, a service has been performed in respect of which a payment has been made under item 721, 723, 725, 727 or 729 in respect of the patient; or
(ii) in the 3 months preceding the performance of the service, a service has been performed in respect of which a payment was made under item 730 of the 2004 General Medical Services Table in respect of the patient; and
(b) is applicable not more than once in a 3 month period.
(7) For this rule,
exceptional circumstances exist in relation to a patient if there has been a significant change in the patient’s clinical condition or care circumstances that necessitates the performance of the service in respect of the patient.
(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 or 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 item 708, a
child health check means the assessment of:(a) a patient’s health and physical, psychological and social function; and
(b) whether preventative health care, education and other assistance should be offered to the patient, or the patient’s parent or carer, to improve the patient’s health and physical, psychological or social function.
(2) A child health check of a patient involves all of the following:
(a) a personal attendance by a medical practitioner;
(b) taking the patient’s medical history, including the following:
(i) mother’s pregnancy history;
(ii) birth and neo‑natal history;
(iii) breastfeeding history;
(iv) weaning, food access and dietary history;
(v) physical activity;
(vi) previous presentations, hospital admissions and medication usage;
(vii) relevant family medical history;
(viii) immunisation status;
(ix) vision and hearing (including neonatal hearing screening);
(x) development (including achievement of age appropriate milestones);
(xi) family relationships, social circumstances and whether the person is cared for by another person;
(xii) exposure to environmental factors (including tobacco smoke);
(xiii) environmental and living conditions;
(xiv) educational progress;
(xv) stressful life events;
(xvi) mood (including incidence of depression and risk of self‑harm);
(xvii) substance use;
(xviii) sexual and reproductive health;
(xix) dental hygiene (including access to dental services);
(c) examination of the patient, including the following:
(i) measurement of height and weight to calculate body mass index and position on the growth curve;
(ii) newborn baby check (if not previously completed);
(iii) vision (including red reflex in a newborn);
(iv) ear examination (including otoscopy);
(v) oral examination (including gums and dentition);
(vi) trachoma check, if indicated;
(vii) skin examination, if indicated;
(viii) respiratory examination, if indicated;
(ix) cardiac auscultation, if indicated;
(x) development assessment, if indicated, to determine whether age appropriate milestones have been achieved;
(xi) assessment of parent and child interaction, if indicated;
(xii) other examinations:
(A) in accordance with national or regional guidelines or specific regional needs; or
(B) as indicated by a previous child health assessment;
(d) undertaking or arranging any required investigation, considering the need for the following tests, in particular:
(i) haemoglobin testing for those at a high risk of anaemia;
(ii) audiometry, if required, especially for those of school age;
(e) assessing the patient using the information gained in the child health check;
(f) making or arranging any necessary interventions and referrals, and documenting a simple strategy for the good health of the patient.
(3) A child health check also includes:
(a) keeping a record of the child health check; and
(b) offering the patient, or the patient’s parent or carer, a written report about the health check, with recommendations about matters covered by the health check (including a simple strategy for the good health of the patient).
(1) For item 710, an
adult health check means the assessment of:(a) a patient’s health and physical, psychological and social function; and
(b) whether preventative health care, education and other assistance should be offered to that patient, to improve the patient’s health and physical, psychological or social function.
(2) An adult health check of a patient involves all of the following:
(a) a personal attendance by a medical practitioner;
(b) taking the patient’s medical history, including the following:
(i) current health problems and risk factors;
(ii) relevant family medical history;
(iii) medication usage (including medication obtained without prescription or from other doctors);
(iv) immunisation status, by reference to the appropriate current age and sex immunisation schedule;
(v) sexual and reproductive health;
(vi) physical activity, nutrition and alcohol, tobacco or other substance use;
(vii) hearing loss;
(viii) mood (including incidence of depression and risk of self‑harm);
(ix) family relationships and whether the patient is a carer, or is cared for by another person;
(c) examination of the patient, including the following:
(i) measurement of the patient’s blood pressure, pulse rate and rhythm;
(ii) measurement of height and weight to calculate body mass index and, if indicated, measurement of waist circumference for central obesity;
(iii) oral examination (including gums and dentition);
(iv) ear and hearing examination (including otoscopy and, if indicated, a whisper test);
(v) urinalysis (by dipstick) for proteinurea;
(d) undertaking or arranging any required investigation, considering the need for the following tests, in particular, (in accordance with national or regional guidelines or specific regional needs):
(i) fasting blood sugar and lipids (by laboratory based test on venous sample) or, if necessary, random blood glucose levels;
(ii) pap smear;
(iii) examination for sexually transmitted infection (by urine or endocervical swab for chlamydia and gonorrhoea, especially for those aged from 15 to 35 years);
(iv) mammography, where eligible (by scheduling appointments with visiting services or facilitating direct referral);
(e) assessing the patient using the information gained in the adult health check;
(f) making or arranging any necessary interventions and referrals, and documenting a simple strategy for the good health of the patient.
(3) An adult health check also includes:
(a) keeping a record of the adult health check; and
(b) offering the patient a written report about the health check, with recommendations about matters covered by the health check (including a simple strategy for the good health of the patient).
(1) For item 712, a
comprehensive medical assessment of a resident of a residential aged care facilityis a full systems review of the resident, including an assessment of the resident’s health and physical and psychological function.(2) A comprehensive medical assessment involves all of the following:
(a) a personal attendance by a medical practitioner;
(b) taking a detailed relevant medical history;
(c) conducting a comprehensive medical examination of the resident;
(d) developing a list of diagnoses and medical problems based on the medical history and examination;
(e) providing, for the resident’s records, a written summary of the outcomes of the assessment to inform the provision of care for the resident and to assist in the provision of medication management review services for the resident.
(3) A comprehensive medical assessment also includes:
(a) making a written summary of the comprehensive medical assessment; and
(b) providing a copy of the summary to the residential aged care facility; and
(c) offering the resident a copy of the summary or relevant parts of the summary.
(1) In items 714 and 716,
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 or social function.
(2) A health assessment involves all of the following:
(a) a personal attendance by a medical practitioner;
(b) taking the patient’s medical history;
(c) examination of the patient;
(d) undertaking or arranging any required investigations;
(e) assessing the patient using the information gained in paragraphs (b) to (d);
(f) developing a management plan addressing the patient’s health care needs, health problems and relevant conditions;
(g) making or arranging any necessary interventions and referrals.
(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.
In items 714 and 716:
humanitarian visa holder means a person who is the holder of a visa of any of the following subclasses granted under theMigration Act 1958 :
(a) Subclass 200 (Refugee) visa;
(b) Subclass 201 (In‑country Special Humanitarian) visa;
(c) Subclass 202 (Global Special Humanitarian) visa;
(d) Subclass 203 (Emergency Rescue) visa;
(e) Subclass 204 (Woman at Risk) visa;
(f) Subclass 447 (Secondary Movement Offshore Entry (Temporary)) visa;
(g) Subclass 451 (Secondary Movement Relocation (Temporary)) visa;
(h) Subclass 785 (Temporary Protection) visa;
(i) Subclass 786 (Temporary (Humanitarian Concern)) visa;
(j) Subclass 866 (Protection) visa.
(1) For item 721, preparation of a
GP management plan means the preparation of a comprehensive written plan describing all of the following matters:(a) the patient’s health care needs, health problems and relevant conditions;
(b) management goals with which the patient agrees;
(c) actions to be taken by the patient;
(d) treatment and services the patient is likely to need;
(e) arrangements for providing the treatment and services referred to in paragraph (d);
(f) arrangements to review the plan by a day specified in the plan.
(2) Preparation of the plan also includes:
(a) explaining to the patient and the patient’s carer (if any, and if the practitioner considers it appropriate and the patient agrees) the steps involved in preparing the plan; and
(b) recording the plan; and
(c) recording the patient’s agreement to the preparation of the plan; and
(d) offering a copy of the plan to the patient and the patient’s carer (if any, and if the practitioner considers it appropriate and the patient agrees); and
(e) adding a copy of the plan to the patient’s medical records.
For items 725 and 727, a
multidisciplinary discharge care plan is a multidisciplinary care plan that is prepared for a patient before the patient is discharged from a hospital.
(1) For item 723, co‑ordinating the development of
team care arrangements means a process by which the medical practitioner:(a) in consultation with at least 2 collaborating providers, each of whom provides a different kind of treatment or service, and 1 of whom may be another medical practitioner — makes arrangements for the multidisciplinary care of the patient; and
(b) prepares a document that describes all of the matters specified in subrule (2); and
(c) undertakes all of the activities specified in subrule (3).
(2) The matters to be described for paragraph (1) (b) are:
(a) treatment and service goals for the patient; and
(b) treatment and services that collaborating providers will provide to the patient; and
(c) actions to be taken by the patient; and
(d) arrangements to review the matters mentioned in paragraphs (a), (b) and (c) by a day specified in the document.
(3) The activities to be undertaken for paragraph (1) (c) are:
(a) explaining the steps involved in the development of the arrangements to the patient and the patient’s carer (if any, and if the practitioner considers it appropriate and the patient agrees); and
(b) discussing with the patient the collaborating providers who will contribute to the development of the team care arrangements, and provide treatment and services to the patient under those arrangements; and
(c) recording the patient’s agreement to the development of team care arrangements; and
(d) giving copies of the relevant parts of the document to the collaborating providers; and
(e) offering a copy of the document to the patient and the patient’s carer (if any, and if the practitioner considers it appropriate and the patient agrees); and
(f) adding a copy of the document to the patient’s medical records.
(4) In this rule:
collaborating provider is a person who:(a) provides treatment or a service to a patient; and
(b) is not a family carer of the patient.
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.
(1) For item 725 and item 727, an
associated medical practitioner is a medical practitioner (including a general practitioner, but not including a specialist or consultant physician) who, if not engaged in same general practice as the medical practitioner mentioned in that item, performs the service mentioned in the item at the request of the patient (or the patient’s guardian).(2) In subrule (1):
general practice means a business, consisting of one or more medical practitioners, that provides a general practice of medical services.
(1) For item 725,
review of a GP management plan, a multidisciplinary community care plan, or a multidisciplinary discharge care plan, means a process by which the medical practitioner:(a) reviews the matters mentioned in subrule 49 (1) of the 2004 General Medical Services Table or subrule 49A (1), as applicable; and
(b) if different arrangements need to be made, makes amendments to the plan that:
(i) state those new arrangements; and
(ii) provide for further review of the amended plan by a date specified in the plan.
(2) Review of the plan also includes:
(a) explaining to the patient and the patient’s carer (if any, and if the practitioner considers it appropriate and the patient agrees) the steps involved in the review; and
(b) recording the patient’s agreement to the review of the plan; and
(c) if amendments are made to the plan:
(i) offering a copy of the amended plan to the patient and the patient’s carer (if any, and if the practitioner considers it appropriate and the patient agrees); and
(ii) adding a copy of the amended plan to the patient’s medical records.
(1) For item 727, to
co‑ordinate a review of team care arrangements, a multidisciplinary community care plan, or a multidisciplinary discharge care plan, means a process by which the medical practitioner:(a) in consultation with at least 2 collaborating providers, each of whom provides a different kind of treatment or service, and 1 of whom may be another medical practitioner, reviews the matters mentioned in subrule 49 (1) of the 2004 General Medical Services Table or subrule 51A (2), as applicable; and
(b) if different arrangements need to be made, makes amendments to the document mentioned in paragraph 51A (1) (b), or to the plan, that:
(i) state those new arrangements; and
(ii) provide for the review of the amended document or plan by a date specified in the document or plan.
(2) Co‑ordinating a review of team care arrangements or of a multidisciplinary care plan also includes:
(a) explaining the steps involved in the review to 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 the review of the team care arrangements or the plan; and
(c) giving copies of the relevant parts of the amended document mentioned in paragraph (1) (b), or the amended plan, to the collaborating providers; and
(d) offering a copy of the amended document or plan to the patient and the patient’s carer (if any, and if the practitioner considers it appropriate and the patient agrees); and
(e) adding a copy of the amended document or plan to the patient’s medical records.
(3) In this rule:
collaborating provider is a person who:(a) provides treatment or a service to a patient; and
(b) is not a family carer of the patient.
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.
(1) For items 729 and 731, to
contribute to a multidisciplinary care plan or to the review of a plan includes:(a) preparing part of the plan or amendments to the plan, and adding a copy of that part or those amendments to the patient’s medical records; or
(b) giving advice to a person who prepares or reviews the plan, and recording in writing, on the patient’s medical records, any advice provided to such a person.
(2) In subrule (1):
multidisciplinary care plan means a written plan that:(a) is prepared for a patient by:
(i) a medical practitioner, in consultation with 2 other collaborating providers, each of whom provides a different kind of treatment or service to the patient, and 1 of whom may be another medical practitioner; or
(ii) a collaborating provider (other than a medical practitioner), in consultation with at least 2 other collaborating providers, each of whom provides a different kind of treatment or service to the patient; and
(b) describes, at least, treatment and services to be provided to the patient by the collaborating providers.
(3) In this rule:
collaborating provider :(a) is a person who:
(i) provides treatment or a service to a patient; and
(ii) is not a
family carer of the patient; and
(b) includes a medical practitioner.
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.
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 57) 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.
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 approved day hospital 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.
(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.
(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 54, 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 54, 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.
For item 880,
co‑ordinating a case conference means undertaking all of the following activities in relation to a case conference:
(a) co‑ordinating and facilitating the case conference;
(b) resolving any disagreement or conflict to enable the members of the case conference team giving care and service to the patient to agree on the outcomes to be achieved;
(c) identifying tasks that need to be undertaken to achieve these outcomes, and allocating those tasks to members of the case conference team;
(d) recording the input of each member and the outcome of the conference.
(1) For item 880, a
case conference team :(a) includes a specialist, or consultant physician, in the practice of his or her specialty of geriatric or rehabilitation medicine; and
(b) includes at least 2 other allied health professionals, each of whom provides a different kind of care or service to the patient and is not a medical practitioner or family carer of the patient; and
794.70 | ||||||||
52126 |
Maxilla, total resection of (Anaes.) (Assist.) |
764.00 | ||||||
52129 |
Maxilla, total resection of both maxillae (Anaes.) (Assist.) |
1 022.75 | ||||||
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.) |
375.40 | ||||||
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.) |
519.25 | ||||||
52132 |
Tracheostomy (Anaes.) |
202.65 | ||||||
52133 |
Cricothyrostomy by direct stab or Seldinger technique, using Minitrach or similar device (Anaes.) |
77.25 | ||||||
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.) |
122.50 | ||||||
52138 |
Maxillary artery, ligation of (Anaes.) (Assist.) |
377.95 | ||||||
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.) |
376.45 | ||||||
52144 |
Foreign body, deep, removal of using interventional imaging techniques (Anaes.) (Assist.) |
350.90 | ||||||
52147 |
Duct of major salivary gland, transposition of (Anaes.) (Assist.) |
331.10 | ||||||
52148 |
Parotid duct, repair of, using micro‑surgical techniques (Anaes.) (Assist.) |
585.30 | ||||||
52158 |
Submandibular ducts, relocation of, for surgical control of drooling (Anaes.) (Assist.) |
942.40 | ||||||
52180 |
Aggressive or potentially malignant bone or deep soft tissue tumour in the oral and maxillofacial region, biopsy of (not including after‑care) (Anaes.) |
159.75 | ||||||
52182 |
Bone or malignant deep soft tissue tumour in the oral and maxillofacial region, lesional or marginal excision of (Anaes.) (Assist.) |
351.50 | ||||||
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.) |
519.25 | ||||||
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.) |
639.10 | ||||||
52300 |
Single‑stage local flap, where indicated, repair to 1 defect, with skin or mucosa (Anaes.) (Assist.) |
241.25 | ||||||
52303 |
Single‑stage local flap, where indicated, repair to 1 defect, with buccal pad of fat (Anaes.) (Assist.) |
344.50 | ||||||
52306 |
Single‑stage local flap, where indicated, repair to 1 defect, using temporalis muscle (Anaes.) (Assist.) |
511.20 | ||||||
52309 |
Free grafting (mucosa or split skin) of a granulating area (Anaes.) |
173.70 | ||||||
52312 |
Free grafting (mucosa, split skin or connective tissue) to 1 defect, including elective dissection (Anaes.) (Assist.) |
241.25 | ||||||
52315 |
Free grafting, full thickness, to 1 defect (mucosa or skin) (Anaes.) (Assist.) |
402.00 | ||||||
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.) |
119.85 | ||||||
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.) |
199.45 | ||||||
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.) |
402.00 | ||||||
52324 |
Direct flap repair, using tongue, first stage (Anaes.) (Assist.) |
402.00 | ||||||
52327 |
Direct flap repair, using tongue, second stage (Anaes.) |
199.45 | ||||||
52330 |
Palatal defect (oro‑nasal fistula), plastic closure of, including services to which item 52300, 52303, 52306 or 52324 applies (Anaes.) (Assist.) |
663.50 | ||||||
52333 |
Cleft palate, primary repair (Anaes.) (Assist.) |
663.50 | ||||||
52336 |
Cleft palate, secondary repair, closure of fistula using local flaps (Anaes.) (Assist.) |
414.70 | ||||||
52337 |
Alveolar cleft (congenital) unilateral, grafting of, including plastic closure of associated oro‑nasal fistulae and ridge augmentation (Anaes.) (Assist.) |
907.10 | ||||||
52339 |
Cleft palate, secondary repair, lengthening procedure (Anaes.) (Assist.) |
472.30 | ||||||
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.) |
820.30 | ||||||
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.) |
925.15 | ||||||
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.) |
1 045.40 | ||||||
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.) |
1 174.00 | ||||||
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.) |
1 190.20 | ||||||
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.) |
1 339.95 | ||||||
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.) |
1 366.95 | ||||||
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.) |
1 537.80 | ||||||
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.) |
1 503.80 | ||||||
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.) |
1 690.80 | ||||||
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.) |
1 640.60 | ||||||
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.) |
1 837.65 | ||||||
52378 |
Genioplasty including transposition of nerves and vessels and bone grafts taken from the same site (Anaes.) (Assist.) |
635.25 | ||||||
52379 |
Face, contour reconstruction of 1 region, using autogenous bone or cartilage graft (Anaes.) (Assist.) |
1 084.65 | ||||||
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.) |
1 848.60 | ||||||
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.) |
2 215.95 | ||||||
52420 |
Mandible, fixation by intermaxillary wiring, excluding wiring for obesity |
204.60 | ||||||
52424 |
Dermis, dermofat or fascia graft (excluding transfer of fat by injection) in the oral and maxillofacial region (Anaes.) (Assist.) |
401.90 | ||||||
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.) |
925.15 | ||||||
52440 |
Cleft lip, unilateral — primary repair, 1 stage, without anterior palate repair (Anaes.) (Assist.) |
459.35 | ||||||
52442 |
Cleft lip, unilateral — primary repair, 1 stage, with anterior palate repair (Anaes.) (Assist.) |
574.30 | ||||||
52444 |
Cleft lip, bilateral — primary repair, 1 stage, without anterior palate repair (Anaes.) (Assist.) |
638.00 | ||||||
52446 |
Cleft lip, bilateral — primary repair, 1 stage, with anterior palate repair (Anaes.) (Assist.) |
753.00 | ||||||
52450 |
Cleft lip, partial revision, including minor flap revision alignment and adjustment, including revision of minor whistle deformity if performed (Anaes.) |
255.20 | ||||||
52452 |
Cleft lip, total revision, including major flap revision, muscle reconstruction and revision of major whistle deformity (Anaes.) (Assist.) |
414.70 | ||||||
52456 |
Cleft lip reconstruction using full thickness flap (Abbe or similar), first stage (Anaes.) (Assist.) |
701.90 | ||||||
52458 |
Cleft lip reconstruction using full thickness flap (Abbe or similar), second stage (Anaes.) |
255.20 | ||||||
52460 |
Velo‑pharyngeal incompetence, pharyngeal flap for, or pharyngoplasty for (Anaes.) |
663.50 | ||||||
52480 |
Composite graft (chondro‑cutaneous or chondro‑mucosal) to nose, ear or eyelid (Anaes.) (Assist.) |
426.20 | ||||||
52482 |
Macrocheilia or macroglossia, operation for (Anaes.) (Assist.) |
410.05 | ||||||
52484 |
Macrostomia, operation for (Anaes.) (Assist.) |
488.15 | ||||||
52600 |
Mandibular or palatal exostosis, excision of (Anaes.) (Assist.) |
287.05 | ||||||
52603 |
Mylohyoid ridge, reduction of (Anaes.) (Assist.) |
274.40 | ||||||
52606 |
Maxillary tuberosity, reduction of (Anaes.) |
209.30 | ||||||
52609 |
Papillary hyperplasia of the palate, removal of — less than 5 lesions (Anaes.) (Assist.) |
274.40 | ||||||
52612 |
Papillary hyperplasia of the palate, removal of — 5 to 20 lesions (Anaes.) (Assist.) |
344.50 | ||||||
52615 |
Papillary hyperplasia of the palate, removal of — more than 20 lesions (Anaes.) (Assist.) |
427.55 | ||||||
52618 |
Vestibuloplasty, submucosal or open, including excision of muscle and skin or mucosal graft when performed — unilateral or bilateral (Anaes.) (Assist.) |
497.60 | ||||||
52621 |
Floor of mouth lowering (Obwegeser or similar procedure), including excision of muscle and skin or mucosal graft when performed — unilateral (Anaes.) (Assist.) |
497.60 | ||||||
52624 |
Alveolar ridge augmentation with bone or alloplast or both — unilateral (Anaes.) (Assist.) |
401.90 | ||||||
52626 |
Alveolar ridge augmentation — unilateral, insertion of tissue expanding device into maxillary or mandibular alveolar ridge region for (Anaes.) (Assist.) |
246.45 | ||||||
52627 |
Osseo‑integration procedure — extra oral implantation of titanium fixture (Anaes.) (Assist.) |
427.55 | ||||||
52630 |
Osseo‑integration procedure — fixation of transcutaneous abutment (Anaes.) |
158.25 | ||||||
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.) |
427.55 | ||||||
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.) |
158.25 | ||||||
52800 |
Neurolysis by open operation, without transposition, not being a service associated with a service to which item 52803 applies (Anaes.) (Assist.) |
234.80 | ||||||
52803 |
Nerve trunk, internal (interfascicular), neurolysis of, using microsurgical techniques (Anaes.) (Assist.) |
338.15 | ||||||
52806 |
Neurectomy, neurotomy or removal of tumour from superficial peripheral nerve (Anaes.) (Assist.) |
234.80 | ||||||
52809 |
Neurectomy, neurotomy or removal of tumour from deep peripheral nerve (Anaes.) (Assist.) |
402.00 | ||||||
52812 |
Nerve trunk, primary repair of, using microsurgical techniques (Anaes.) (Assist.) |
574.30 | ||||||
52815 |
Nerve trunk, secondary repair of, using microsurgical techniques (Anaes.) (Assist.) |
606.10 | ||||||
52818 |
Nerve, transposition of (Anaes.) (Assist.) |
402.00 | ||||||
52821 |
Nerve graft to nerve trunk (cable graft) including harvesting of nerve graft using microsurgical techniques (Anaes.) (Assist.) |
874.10 | ||||||
52824 |
Peripheral branches of the trigeminal nerve, cryosurgery of, for pain relief (Anaes.) (Assist.) |
376.45 | ||||||
52826 |
Injection of primary branch of trigeminal nerve with alcohol, cortisone, phenol, or similar substance (Anaes.) |
201.60 | ||||||
52828 |
Cutaneous nerve, primary repair of, using microsurgical techniques (Anaes.) (Assist.) |
299.85 | ||||||
52830 |
Cutaneous nerve, secondary repair of, using microsurgical techniques (Anaes.) (Assist.) |
395.50 | ||||||
52832 |
Cutaneous nerve, nerve graft to, using microsurgical techniques (Anaes.) (Assist.) |
542.35 | ||||||
53000 |
Maxillary antrum, proof puncture and lavage of (Anaes.) |
27.55 | ||||||
53003 |
Maxillary antrum, proof puncture and lavage of, under general anaesthesia, not being a service associated with a service to which another item in Groups O3 to O9 applies (H) (Anaes.) |
78.05 | ||||||
53004 |
Maxillary antrum, lavage of — each attendance at which the procedure is performed, including any associated consultation (Anaes.) |
28.50 | ||||||
53006 |
Antrostomy (radical) (Anaes.) (Assist.) |
442.25 | ||||||
53009 |
Antrum, intranasal operation on or removal of foreign body from (Anaes.) (Assist.) |
250.90 | ||||||
53012 |
Antrum, drainage of, through tooth socket (Anaes.) |
99.70 | ||||||
53015 |
Oro‑antral fistula, plastic closure of (Anaes.) (Assist.) |
498.60 | ||||||
53016 |
Nasal septum, septoplasty, submucous resection or closure of septal perforation (Anaes.) (Assist.) |
410.05 | ||||||
53017 |
Nasal septum, reconstruction of (Anaes.) (Assist.) |
511.55 | ||||||
53019 |
Maxillary sinus, bone graft to floor of maxillary sinus following elevation of mucosal lining (sinus lift procedure), unilateral (Anaes.) (Assist.) |
492.85 | ||||||
53052 |
Post‑nasal space, direct examination of, with or without biopsy (Anaes.) |
104.20 | ||||||
53054 |
Nasendoscopy or sinoscopy or fibreoptic examination of nasopharynx — 1 or more of these procedures (Anaes.) |
104.15 | ||||||
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.) |
61.05 | ||||||
53058 |
Nasal haemorrhage, posterior, arrest of, with posterior nasal packing with or without cauterisation and with or without anterior pack (excluding after‑care) (Anaes.) |
104.15 | ||||||
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.) |
85.25 | ||||||
53062 |
Post‑surgical nasal haemorrhage, arrest of during an episode of epistaxis by cauterisation or nasal cavity packing or both (Anaes.) |
76.30 | ||||||
53064 |
Cryotherapy to nose in the treatment of nasal haemorrhage (Anaes.) |
138.30 | ||||||
53068 |
Turbinectomy or turbinectomies, partial or total, unilateral (Anaes.) |
114.45 | ||||||
53070 |
Turbinates, submucous resection of, unilateral (Anaes.) |
151.05 | ||||||
53200 |
Mandible, treatment of a dislocation of, not requiring open reduction(Anaes.) |
60.00 | ||||||
53203 |
Mandible, treatment of a dislocation of, requiring open reduction (Anaes.) |
100.80 | ||||||
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.) |
121.25 | ||||||
53209 |
Glenoid fossa, zygomatic arch and temporal bone, reconstruction of (Obwegeser technique) (Anaes.) (Assist.) |
1 399.25 | ||||||
53212 |
Absent condyle and ascending ramus in hemifacial microsomia, construction of, not including harvesting of graft material (Anaes.) (Assist.) |
755.90 | ||||||
53215 |
Temporomandibular joint, arthroscopy of, with or without biopsy, not being a service associated with any other arthroscopic procedure of that joint (Anaes.) (Assist.) |
346.75 | ||||||
53218 |
Temporomandibular joint, arthroscopy of, removal of loose bodies, debridement, or treatment of adhesions — 1 or more of such procedures (Anaes.) (Assist.) |
554.70 | ||||||
53220 |
Temporomandibular joint, arthrotomy of, not being a service to which another item in this group applies (Anaes.) (Assist.) |
279.65 | ||||||
53221 |
Temporomandibular joint, open surgical exploration of, with or without microsurgical techniques (Anaes.) (Assist.) |
740.15 | ||||||
53224 |
Temporomandibular joint, open surgical exploration of, with condylectomy or condylotomy, with or without microsurgical techniques (Anaes.) (Assist.) |
820.50 | ||||||
53225 |
Arthrocentesis, irrigation of temporomandibular joint after insertion of 2 cannuli into the appropriate joint space(s) (Anaes.) (Assist.) |
246.45 | ||||||
53226 |
Temporomandibular joint, synovectomy of, not being a service to which another item in this group applies (Anaes.) (Assist.) |
265.00 | ||||||
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.) |
1 008.20 | ||||||
53230 |
Temporomandibular joint, open surgical exploration of, with meniscus, capsular and condylar head surgery, with or without microsurgical techniques (Anaes.) (Assist.) |
1 135.70 | ||||||
53233 |
Temporomandibular joint, surgery of, involving procedures to which item 53224, 53226, 53227 or 53230 applies and also involving the use of tissue flaps, or cartilage graft, or allograft implants, with or without microsurgical techniques (Anaes.) (Assist.) |
1 276.15 | ||||||
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.) |
399.35 | ||||||
53239 |
Temporomandibular joint, arthrodesis of, not being a service to which another item in this group applies (Anaes.) (Assist.) |
399.35 | ||||||
53242 |
Temporomandibular joint or joints, application of external fixator to, other than for treatment of fractures (Anaes.) (Assist.) |
265.00 | ||||||
53400 |
Maxilla, unilateral or bilateral, treatment of fracture of, not requiring splinting |
109.60 | ||||||
53403 |
Mandible, treatment of fracture of, not requiring splinting |
133.90 | ||||||
53406 |
Maxilla, treatment of fracture of, requiring splinting, wiring of teeth, circumosseous fixation or external fixation (Anaes.) (Assist.) |
345.05 | ||||||
53409 |
Mandible, treatment of fracture of, requiring splinting, wiring of teeth, circumosseous fixation or external fixation (Anaes.) (Assist.) |
345.05 | ||||||
53410 |
Zygomatic bone, treatment of fracture of, not requiring surgical reduction |
|||||||
72.70 | ||||||||
53411 |
Zygomatic bone, treatment of fracture of, requiring surgical reduction, by temporal, intra‑oral or other approach (Anaes.) |
202.65 | ||||||
53412 |
Zygomatic bone, treatment of fracture of, requiring surgical reduction and involving internal or external fixation at 1 site (Anaes.) (Assist.) |
332.70 | ||||||
53413 |
Zygomatic bone, treatment of fracture of, requiring surgical reduction and involving internal or external fixation or both at 2 sites (Anaes.) (Assist.) |
406.55 | ||||||
53414 |
Zygomatic bone, treatment of, requiring surgical reduction and involving internal or external fixation or both at 3 sites (Anaes.) (Assist.) |
468.20 | ||||||
53415 |
Maxilla, treatment of fracture of, requiring open reduction (Anaes.) (Assist.) |
369.70 | ||||||
53416 |
Mandible, treatment of fracture of, requiring open reduction (Anaes.) (Assist.) |
369.70 | ||||||
53418 |
Maxilla, treatment of fracture of, requiring open reduction and internal fixation not involving plate(s) (Anaes.) (Assist.) |
480.55 | ||||||
53419 |
Mandible, treatment of fracture of, requiring open reduction and internal fixation not involving plate(s) (Anaes.) (Assist.) |
480.55 | ||||||
53422 |
Maxilla, treatment of fracture of, requiring open reduction and internal fixation involving plate(s) (Anaes.) (Assist.) |
609.85 | ||||||
53423 |
Mandible, treatment of fracture of, requiring open reduction and internal fixation involving plate(s) (Anaes.) (Assist.) |
609.85 | ||||||
53424 |
Maxilla, treatment of a complicated fracture of, involving viscera, blood vessels or nerves, requiring open reduction not involving plate(s) (Anaes.) (Assist.) |
523.25 | ||||||
53425 |
Mandible, treatment of a complicated fracture of, involving viscera, blood vessels or nerves, requiring open reduction not involving plate(s) (Anaes.) (Assist.) |
523.25 | ||||||
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.) |
714.65 | ||||||
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.) |
714.65 | ||||||
53439 |
Mandible, treatment of a closed fracture of, involving a joint surface (Anaes.) |
202.65 | ||||||
53453 |
Orbital cavity, reconstruction of a wall or floor with or without foreign implant (Anaes.) (Assist.) |
410.05 | ||||||
53455 |
Orbital cavity, bone or cartilage graft to orbital wall or floor including reduction of prolapsed or entrapped orbital contents (Anaes.) (Assist.) |
481.65 | ||||||
53458 |
Nasal bones, treatment of fracture of, not being a service to which item 53459 or 53460 applies |
36.45 | ||||||
53459 |
Nasal bones, treatment of fracture of, by reduction (Anaes.) |
199.75 | ||||||
53460 |
Nasal bones, treatment of fractures of, by open reduction involving osteotomies (Anaes.) (Assist.) |
407.55 | ||||||
53600 |
Skin sensitivity testing for allergens to anaesthetics and materials used in oral and maxillofacial surgery, using 1 to 20 allergens |
33.05 | ||||||
53700 |
Trigeminal nerve, primary division of, injection of an anaesthetic agent |
105.95 | ||||||
53702 |
Trigeminal nerve, peripheral branch of, injection of an anaesthetic agent |
53.05 | ||||||
53704 |
Facial nerve, injection of an anaesthetic agent |
31.90 | ||||||
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 |
105.95 | ||||||
75001 | Initial professional attendance in a single course of treatment by an accredited orthodontist (AO) | 74.05 | ||||||
75004 | Professional attendance by an accredited orthodontist subsequent to the first professional attendance by the orthodontist in a single course of treatment (AO) | 37.15 | ||||||
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) | 66.00 | ||||||
75009 | Orthodontic radiography — orthopantomography (panoramic radiography), including any consultation on the same occasion (AOS) (AO) | 59.00 | ||||||
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) | 93.50 | ||||||
75015 | Orthodontic radiography — anteroposterior and lateral cephalometric radiography, with cephalometric tracings including any consultation on the same occasion (AOS) (AO) | 128.55 | ||||||
75018 | Orthodontic radiography — anteroposterior and lateral cephalometric radiography, with cephalometric tracings and orthopantomography including any consultation on the same occasion (AOS) (AO) | 163.75 | ||||||
75021 | Orthodontic radiography — hand‑wrist studies (including growth prediction) including any consultation on the same occasion (AOS) (AO) | 200.85 | ||||||
75023 | Intraoral radiography — single area, periapical or bitewing film (AOS) (AO) | 40.20 | ||||||
75024 | Pre‑surgical infant maxillary arch repositioning, including supply of appliances and all adjustments of appliances and supervision — where 1 appliance is used (AO) | 519.40 | ||||||
75027 | Pre‑surgical infant maxillary arch repositioning, including supply of appliances and all adjustments of appliances and supervision — where 2 appliances are used (AO) | 712.15 | ||||||
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) | 634.20 | ||||||
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) | 1 039.35 | ||||||
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) | 529.00 | ||||||
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) | 1 435.60 | ||||||
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) | 1 808.10 | ||||||
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) | 480.50 | ||||||
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) | 179.65 | ||||||
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) | 962.00 | ||||||
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) | 246.70 | ||||||
75049 | Retention, fixed or removable, single arch (mandibular or maxillary) — supply of retainer and supervision of retention (AO) | 288.70 | ||||||
75050 | Retention, fixed or removable, 2‑arch (mandibular and maxillary) — supply of retainers and supervision of retention (AO) | 557.40 | ||||||
75051 | Jaw growth guidance using removable or functional appliances, including supply of appliances and all adjustments to appliances (AO) | 855.70 | ||||||
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) | 74.05 | ||||||
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) | 37.15 | ||||||
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, where the patient is referred by an accredited orthodontist (AOS) | 66.00 | ||||||
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) | 47.55 | ||||||
75203 | Removal of tooth or tooth fragment under general anaesthesia, where the patient is referred by an accredited orthodontist (AD) | 71.35 | ||||||
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, where the patient is referred by an accredited orthodontist (AD) | 23.65 | ||||||
75400 | Surgical removal of erupted tooth, where the patient is referred by an accredited orthodontist (AOS) | 142.65 | ||||||
75403 | Surgical removal of tooth with soft tissue impaction, where the patient is referred by an accredited orthodontist (AOS) | 163.75 | ||||||
75406 | Surgical removal of tooth with partial bone impaction, where the patient is referred by an accredited orthodontist (AOS) | 186.65 | ||||||
75409 | Surgical removal of tooth with complete bone impaction, where the patient is referred by an accredited orthodontist (AOS) | 211.40 | ||||||
75412 | Surgical removal of tooth fragment requiring incision of soft tissue only, where the patient is referred by an accredited orthodontist (AOS) | 118.05 | ||||||
75415 | Surgical removal of tooth fragment requiring removal of bone, where the patient is referred by an accredited orthodontist (AOS) | 142.65 | ||||||
75600 | Surgical exposure, stimulation and packing of unerupted tooth, where the patient is referred by an accredited orthodontist (AOS) | 200.85 | ||||||
75603 | Surgical exposure of unerupted tooth for the purpose of fitting a traction device, where the patient is referred by an accredited orthodontist (AOS) | 236.05 | ||||||
75606 | Surgical repositioning of unerupted tooth, where the patient is referred by an accredited orthodontist (AOS) | 236.05 | ||||||
75609 | Transplantation of tooth bud, where the patient is referred by an accredited orthodontist (AOS) | 352.35 | ||||||
75612 | Surgical procedure for intra oral implantation of osseointegrated fixture (first stage), where the patient is referred by an accredited orthodontist (AOS) | 436.10 | ||||||
75615 | Surgical procedure for fixation of trans‑mucosal abutment (second stage of osseointegrated implant), where the patient is referred by an accredited orthodontist (AOS) | 161.40 | ||||||
75618 | Provision and fitting of a bite rising appliance or dental splint for the management of temporomandibular joint dysfunction syndrome, where the patient is referred by an accredited orthodontist (AOS) | 200.50 | ||||||
75621 | The provision and fitting of surgical template in conjunction with orthognathic surgical procedures in association with:
where the patient is referred by an accredited orthodontist (AOS) | 200.50 | ||||||
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) | 71.35 | ||||||
75803 | Provision and fitting of acrylic base partial denture, including retainers — 1 tooth (AD) | 285.40 | ||||||
75806 | Provision and fitting of acrylic base partial denture, including retainers — 2 teeth (AD) | 334.70 | ||||||
75809 | Provision and fitting of acrylic base partial denture, including retainers — 3 teeth (AD) | 396.35 | ||||||
75812 | Provision and fitting of acrylic base partial denture, including retainers — 4 teeth (AD) | 440.40 | ||||||
75815 | Provision and fitting of acrylic base partial denture, including retainers — 5 to 9 teeth (AD) | 537.35 | ||||||
75818 | Provision and fitting of acrylic base partial denture, including retainers — 10 to 12 teeth (AD) | 634.20 | ||||||
75821 | Provision and fitting of cast metal base (cobalt chromium alloy) partial denture including casting and retainers — 1 tooth (AD) | 510.75 | ||||||
75824 | Provision and fitting of cast metal base (cobalt chromium alloy) partial denture including casting and retainers — 2 teeth (AD) | 590.10 | ||||||
75827 | Provision and fitting of cast metal base (cobalt chromium alloy) partial denture including casting and retainers — 3 teeth (AD) | 678.25 | ||||||
75830 | Provision and fitting of cast metal base (cobalt chromium alloy) partial denture including casting and retainers — 4 teeth (AD) | 748.75 | ||||||
75833 | Provision and fitting of cast metal base (cobalt chromium alloy) partial denture including casting and retainers — 5 to 9 teeth (AD) | 915.95 | ||||||
75836 | Provision and fitting of cast metal base (cobalt chromium alloy) partial denture including casting and retainers — 10 to 12 teeth (AD) | 1 048.10 | ||||||
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) | 23.65 | ||||||
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) | 35.25 | ||||||
75845 | Relining of partial denture by laboratory process and associated fitting (AD) | 176.25 | ||||||
75848 | Remodelling and fitting of partial denture of more than 4 teeth (AD) | 211.40 | ||||||
75851 | Repair to cast metal base of partial denture — 1 or more points (AD) | 105.70 | ||||||
75854 | Addition of a tooth or teeth to a partial denture to replace extracted tooth or teeth, including taking of necessary impression (AD) | 105.70 | ||||||
1. Endoluminal gastroplication, for the treatment of gastro‑oesophageal reflux disease
2. Endovenous laser treatment, for varicose veins
3. Gamma knife surgery
4. Intradiscal electro thermal arthroplasty
5. Intravascular ultrasound (except where used in conjunction with intravascular brachytherapy)
6. Intro‑articular viscosupplementation, for the treatment of osteoarthritis of the knee
7. Low intensity ultrasound treatment, for the acceleration of bone fracture healing, using a bone growth stimulator
8. Lung volume reduction surgery, for advanced emphysema
9. Photodynamic therapy, for skin and mucosal cancer
10. Placement of artificial bowel sphincters, in the management of faecal incontinence
11. Sacral nerve stimulation, for urinary incontinence
12. Selective internal radiation therapy for any condition other than hepatic metastases that are secondary to colorectal cancer
13. Specific mass measurement of bone alkaline phosphatase
14. Transmyocardial laser revascularisation
15. Vertebral axial decompression therapy, for chronic back pain
The
2005 No. 238 | 26 Oct 2005 ( | 1 Nov 2005 | |
2005 No. 272 | 1 Dec 2005 ( | 1 Nov 2005 | — |
2005 No. 312 | 19 Dec 2005 ( | 1 Jan 2006 | — |
2006 No. 71 | 31 Mar 2006 ( | 1 Nov 2005 | — |
2006 No. 86 | 28 Apr 2006 ( | 1 May 2006 | — |
| |
Schedule 1............................. | am. 2005 Nos. 272 and 312; 2006 Nos. 71 and 86 |
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