Health Insurance Legislation Amendment (Group Numbers) Determination 2017 (Cth)

Case

Health Insurance Legislation Amendment (Group Numbers) Determination 2017

I, JACK QUINANE, delegate of the Minister for Health, make this Determination under subsection 3C(1) of the Health Insurance Act 1973. 

Dated           8 August 2017

JACK QUINANE

Acting Assistant Secretary

Primary Care Analytics and Pathology Branch

Medical Benefits Division

Department of Health

Contents

1.                   Name of Determination

2.                   Commencement

3.                   Authority

4.                   Schedules

Schedule 1     Midwifery services

Part 2             Telehealth midwifery services and fees

Schedule 2     Nurse practitioner services

Part 1      Nurse practitioner pathology services and fees

Part 2      Nurse practitioner services and fees

Part 3      Telehealth nurse practitioner services and fees

Schedule 3     Allied health services

Part 1             Services and fees—general

Part 2             Services and fees—psychological therapy and focussed               psychological strategies

Part 3             Services and fees—pregnancy support counselling

Part 4             Services and fees—group services

Part 5             Services and fees—pervasive developmental disorder   or disability services

Part 6             Services and fees—Aboriginal and Torres Strait Islander services

Part 7             Services and fees—audiology services (diagnostic)

  1. Name of Determination

This Determination is the Health Insurance Legislation Amendment (Group Numbers) Determination 2017.

  1. Commencement

This Determination commences on the day after it is registered on the Federal Register of Legislation.

  1. Authority

This Determination is made under subsection 3C(1) of the Health Insurance Act 1973.

  1. Schedules

Each instrument that is specified in a Schedule to this instrument is amended or repealed as set out in the applicable items in the Schedule concerned, and any other item in a Schedule to this instrument has effect according to its terms.

Schedule 1 – Midwifery services

Health Insurance (Midwife and Nurse Practitioner) Determination 2015

  1. Schedule 1        Midwifery services and fees

Repeal the Schedule, substitute:

Schedule 1           Midwifery services and fees

(section 5)

Part 1            Midwifery services and fees

Group M13 – Midwifery services
Subgroup 1 – MBS items for participating midwives
Item Service Fee ($)
82100

Initial antenatal professional attendance by a participating midwife, lasting at least 40 minutes, including all of the following:

   (a)  taking a detailed patient history;

  (b)  performing a comprehensive examination;

   (c)  performing a risk assessment;

  (d)  based on the risk assessment — arranging referral or transfer of the patient’s care to an obstetrician;

   (e)  requesting pathology and diagnostic imaging services, when necessary;

(f) discussing with the patient the collaborative arrangements for her maternity care and recording the arrangements in the midwife’s written records in accordance with section 2E of the Health Insurance Regulations 1975

Payable only once for any pregnancy

 53.40
82105 Short antenatal professional attendance by a participating midwife, lasting up to 40 minutes 32.30
82110 Long antenatal professional attendance by a participating midwife, lasting at least 40 minutes 53.40
82115

Professional attendance by a participating midwife, lasting at least 90 minutes, for assessment and preparation of a maternity care plan for a patient whose pregnancy has progressed beyond 20 weeks, if:

   (a)  the patient is not an admitted patient of a hospital; and

  (b)  the participating midwife undertakes a comprehensive assessment of the patient; and

   (c)  the participating midwife develops a written maternity care plan that contains:

         (i)   outcomes of the assessment; and

        (ii)   details of agreed expectations for care during pregnancy, labour and delivery; and

       (iii)   details of any health problems or care needs; and

       (iv)   details of collaborative arrangements that apply to the patient; and

 319.00

        (v)   details of any medication taken by the patient during the pregnancy, and any additional medication that may be required by the patient; and

       (vi)   details of any referrals or requests for pathology services or diagnostic imaging services for the patient during the pregnancy, and any additional referrals or requests that may be required for the patient; and

  (d)  the maternity care plan is explained and agreed with the patient; and

   (e)  the fee does not include any amount for the management of labour and delivery

(Includes any antenatal attendance provided on the same occasion)

Payable only once for any pregnancy
82120

Management of confinement for up to 12 hours by a participating midwife, including delivery (if undertaken), if:

   (a)  the patient is an admitted patient of a hospital; and

  (b)  the attendance is by a participating midwife who:

         (i)   provided the patient’s antenatal care; or

        (ii)   is a member of a practice that provided the patient’s antenatal care

(Includes all attendances related to the confinement by the participating midwife)

Payable once only for any pregnancy, unless paragraph 8(3)(c) of this Determination applies (H)

 753.30
82125

Management of confinement, including delivery (if undertaken), when care is transferred from 1 participating midwife to another participating midwife (the second participating midwife), if:

   (a)  the patient is an admitted patient of a hospital; and

  (b)  the patient’s confinement is for longer than 12 hours; and

   (c)  the second participating midwife:

         (i)   has provided the patient’s antenatal care; or

        (ii)   is a member of a practice that provided the patient’s antenatal care

(Includes all attendances related to the confinement by the second participating midwife)

Payable only once for any pregnancy (H)

 753.30  
82130 Short postnatal professional attendance by a participating midwife, lasting up to 40 minutes, within 6 weeks after delivery 53.40
82135 Long postnatal professional attendance by a participating midwife, lasting at least 40 minutes, within 6 weeks after delivery 78.50
82140

Postnatal professional attendance by a participating midwife on a patient, not less than 6 weeks but not more than 7 weeks after delivery of a baby, including:

   (a)  a comprehensive examination of the patient and baby to ensure normal postnatal recovery; and

  (b)  referral of the patient to a general practitioner for the ongoing care of the patient and baby

Payable only once for any pregnancy

 53.40  

Part 2        Telehealth midwifery services and fees

Group M13 – Midwifery services
Subgroup 2 – Telehealth attendances
Item Service Fee ($)
82150

A professional attendance lasting less than 20 minutes (whether or not continuous) by a participating midwife that requires the provision of clinical support to a patient who:

    a)  is participating in a video consultation with a specialist practising in his or her speciality of obstetrics or a specialist or consultant physician practising in his or her speciality of paediatrics; and

    b)  is not an admitted patient; and

    c)  is located:

         (i)   both:

(A)   within a telehealth eligible area; and

(B)   at the time of the attendance—at least 15 kms by road from the specialist or consultant physician mentioned in paragraph (a); or

        (ii)   in Australia if the patient is a patient of:

(A)   an Aboriginal Medical Service; or

(B) an Aboriginal Community Controlled Health Service for which a direction made under subsection 19(2) of the Act applies.

 28.30
82151

A professional attendance lasting at least 20 minutes (whether or not continuous) by a participating midwife that requires the provision of clinical support to a patient who:

    a)  is participating in a video consultation with a specialist practising in his or her speciality of obstetrics or a specialist or consultant physician practising in his or her speciality of paediatrics; and

    b)  is not an admitted patient; and

    c)  is located:

         (i)   both:

(A)   within a telehealth eligible area; and

(B)   at the time of the attendance—at least 15 kms by road from the specialist or consultant physician mentioned in paragraph (a); or

        (ii)   in Australia if the patient is a patient of:

(A)   an Aboriginal Medical Service; or

(B) an Aboriginal Community Controlled Health Service for which a direction made under subsection 19(2) of the Act applies.

 53.70
82152

professional attendance lasting at least 40 minutes (whether or not continuous) by a participating midwife that requires the provision of clinical support to a patient who:

    a)  is participating in a video consultation with a specialist practising in his or her speciality of obstetrics or a specialist or consultant physician practising in his or her speciality of paediatrics; and

    b)  is not an admitted patient; and

    c)  is located:

         (i)   both:

(A)   within a telehealth eligible area; and

(B)   at the time of the attendance—at least 15 kms by road from the specialist or consultant physician mentioned in paragraph (a); or

        (ii)   in Australia if the patient is a patient of:

(A)   an Aboriginal Medical Service; or

(B) an Aboriginal Community Controlled Health Service for which a direction made under subsection 19(2) of the Act applies.

 78.95

Schedule 2 – Nurse Practitioner services

Health Insurance (Midwife and Nurse Practitioner) Determination 2015

  1. Schedule 2        Nurse practitioner services and fees

Repeal the Schedule, substitute:

Schedule 2           Nurse practitioner services and fees

(sections 9 and 9A)

Part 1      Nurse practitioner pathology services and fees

Group P9 – Simple basic pathology tests
Item Service Fee ($)
73828 Semen examination for presence of spermatozoa by a participating nurse practitioner 6.90
73829 Leucocyte count, erythrocyte sedimentation rate, examination of blood film (including differential leucocyte count), haemoglobin, haematocrit or erythrocyte count by a participating nurse practitioner  ‑ 1 test 4.55
73830 2 tests described in item 73829 by a participating nurse practitioner 6.35
73831 3 or more tests described in item 73829 by a participating nurse practitioner 8.15
73832 Microscopy of urine, whether stained or not, or catalase test by a participating nurse practitioner 4.55
73833 Pregnancy test by 1 or more immunochemical methods by a participating nurse practitioner 10.15
73834 Microscopy for wet film other than urine, including any relevant stain by a participating nurse practitioner 6.90
73835 Microscopy of Gram‑stained film, including (if performed) a service described in item 73832 or 73834 by a participating nurse practitioner 8.65
73836 Chemical tests for occult blood in faeces by reagent stick, strip, tablet or similar method by a participating nurse practitioner 2.35
73837 Microscopy for fungi in skin, hair or nails by a participating nurse practitioner  – 1 or more sites 6.90

Part 2      Nurse practitioner services and fees

Group M14 – Nurse practitioners
Subgroup 1 - Nurse practitioners
Item Service Fee ($)
82200 Professional attendance by a participating nurse practitioner for an obvious problem characterised by the straightforward nature of the task that requires a short patient history and, if required, limited examination and management 9.60
82205

Professional attendance by a participating nurse practitioner lasting less than 20 minutes and including any of the following:

   (a)  taking a history;

  (b)  undertaking clinical examination;

   (c)  arranging any necessary investigation;

  (d)  implementing a management plan;

   (e)  providing appropriate preventive health care;

for 1 or more health related issues, with appropriate documentation

 20.95
82210

Professional attendance by a participating nurse practitioner lasting at least 20 minutes and including any of the following:

   (a)  taking a detailed history;

  (b)  undertaking clinical examination;

   (c)  arranging any necessary investigation;

  (d)  implementing a management plan;

   (e)  providing appropriate preventive health care;

for 1 or more health related issues, with appropriate documentation

 39.75
82215

Professional attendance by a participating nurse practitioner lasting at least 40 minutes and including any of the following:

   (a)  taking an extensive history;

  (b)  undertaking clinical examination;

   (c)  arranging any necessary investigation;

  (d)  implementing a management plan;

   (e)  providing appropriate preventive health care;

for 1 or more health related issues, with appropriate documentation

 58.55

Part 3      Telehealth nurse practitioner services and fees

Group M14 – Nurse practitioners
Subgroup 2 – Telehealth attendance
Item Service Fee ($)
82220

A professional attendance lasting less than 20 minutes (whether or not continuous) by a participating nurse practitioner that requires the provision of clinical support to a patient who:

    a)  is participating in a video consultation with a specialist or consultant physician; and

    b)  is not an admitted patient; and

    c)  is located:

         (i)   both:

(A)   within a telehealth eligible area; and

(B)   at the time of the attendance—at least 15 kms by road from the specialist or consultant physician mentioned in paragraph (a); or

        (ii)   in Australia if the patient is a patient of:

(A)   an Aboriginal Medical Service; or

(B) an Aboriginal Community Controlled Health Service for which a direction made under subsection 19(2) of the Act applies.

 28.30
82221

A professional attendance lasting at least 20 minutes (whether or not continuous) by a participating nurse practitioner that requires the provision of clinical support to a patient who:

    a)  is participating in a video consultation with a specialist or consultant physician; and

    b)  is not an admitted patient; and

    c)  is located:

         (i)   both:

(A)   within a telehealth eligible area; and

(B)   at the time of the attendance—at least 15 kms by road from the specialist or consultant physician mentioned in paragraph (a); or

        (ii)   in Australia if the patient is a patient of:

(A)   an Aboriginal Medical Service; or

(B) an Aboriginal Community Controlled Health Service for which a direction made under subsection 19(2) of the Act applies.

 53.70
82222

A professional attendance lasting at least 40 minutes (whether or not continuous) by a participating nurse practitioner that requires the provision of clinical support to a patient who:

    a)  is participating in a video consultation with a specialist or consultant physician; and

    b)  is not an admitted patient; and

    c)  is located:

         (i)   both:

(A)   within a telehealth eligible area; and

(B)   at the time of the attendance—at least 15 kms by road from the specialist or consultant physician mentioned in paragraph (a); or

        (ii)   in Australia if the patient is a patient of:

(A)   an Aboriginal Medical Service; or

(B) an Aboriginal Community Controlled Health Service for which a direction made under subsection 19(2) of the Act applies.

78.95
Group M14 – Nurse practitioners
Subgroup 3 – Telehealth attendance at a residential aged care facility
Item Service Fee ($)
82223

A professional attendance lasting less than 20 minutes (whether or not continuous) by a participating nurse practitioner that requires the provision of clinical support to a patient who:

    a)  is participating in a video consultation with a specialist or consultant physician; and

    b)  either:

         (i)   is a care recipient receiving care in a residential care service; or

        (ii)   is at consulting rooms situated within such a complex if the patient is a care recipient receiving care in a residential aged care service; and

    c)  the professional attendance is not provided at a self-contained unit.

28.30
82224

A professional attendance lasting at least 20 minutes (whether or not continuous) by a participating nurse practitioner that requires the provision of clinical support to a patient who:

    a)  is participating in a video consultation with a specialist or consultant physician; and

    b)  either:

         (i)   is a care recipient receiving care in a residential care service; or

        (ii)   is at consulting rooms situated within such a complex if the patient is a care recipient receiving care in a residential aged care service; and

    c)  the professional attendance is not provided at a self-contained unit.

 53.70
82225

A professional attendance lasting at least 40 minutes (whether or not continuous) by a participating nurse practitioner that requires the provision of clinical support to a patient who:

    a)  is participating in a video consultation with a specialist or consultant physician; and

    b)  either:

         (i)   is a care recipient receiving care in a residential care service; or

        (ii)   is at consulting rooms situated within such a complex if the patient is a care recipient receiving care in a residential aged care service; and

    c)  the professional attendance is not provided at a self-contained unit.

 78.95

Schedule 3 – Allied health services

Health Insurance (Allied Health Services) Determination 2014

  1. Schedule 2        Allied health services and fees

Repeal the Schedule, substitute:

Schedule 2           Allied health services and fees

(section 6)

Part 1 - Services and fees—general

Group M3 – Allied health services
Item Service Fee ($)
10950

Aboriginal and Torres Strait Islander health service provided to a person by an eligible Aboriginal health worker or eligible Aboriginal and Torres Strait Islander health practitioner if:

   (a)  the service is provided to a person who has:

         (i)   a chronic condition; and

       (ii)   complex care needs being managed by a medical practitioner (including a general practitioner, but not a specialist or consultant physician) under both a GP Management Plan and Team Care Arrangements or, if the person is a resident of an aged care facility, the person’s medical practitioner has contributed to a multidisciplinary care plan; and

  (b)  the service is recommended in the person’s Team Care Arrangements or multidisciplinary care plan as part of the management of the person’s chronic condition and complex care needs; and

   (c)  the person is referred to the eligible Aboriginal health worker or eligible Aboriginal and Torres Strait Islander health practitioner by the medical practitioner using a referral form that has been issued by the Department or a referral form that contains all the components of the form issued by the Department; and

  (d)  the person is not an admitted patient of a hospital; and

   (e)  the service is provided to the person individually and in person; and

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

   (g)  after the service, the eligible Aboriginal health worker or eligible Aboriginal and Torres Strait Islander health practitioner gives a written report to the referring medical practitioner mentioned in paragraph (c):

         (i)   if the service is the only service under the referral—in relation to that service; or

        (ii)   if the service is the first or last service under the referral—in relation to that service; or

       (iii)   if neither subparagraph (i) nor (ii) applies but the service involves matters that the referring medical practitioner would reasonably expect to be informed of —in relation to those matters;

to a maximum of 5 services (including any services to which this item or any other item in Part 1 of this Schedule applies) in a calendar year

This item is subject to section 9

 62.25
10951

Diabetes education health service provided to a person by an eligible diabetes educator if:

   (a)  the service is provided to a person who has:

         (i)   a chronic condition; and

 62.25

       (ii)   complex care needs being managed by a medical practitioner (including a general practitioner, but not a specialist or consultant physician) under both a GP Management Plan and Team Care Arrangements or, if the person is a resident of an aged care facility, the person’s medical practitioner has contributed to a multidisciplinary care plan; and

  (b)  the service is recommended in the person’s Team Care Arrangements or multidisciplinary care plan as part of the management of the person’s chronic condition and complex care needs; and

   (c)  the person is referred to the eligible diabetes educator by the medical practitioner using a referral form that has been issued by the Department or a referral form that contains all the components of the form issued by the Department; and

  (d)  the person is not an admitted patient of a hospital; and

   (e)  the service is provided to the person individually and in person; and

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

   (g)  after the service, the eligible diabetes educator gives a written report to the referring medical practitioner mentioned in paragraph (c):

         (i)   if the service is the only service under the referral—in relation to that service; or

        (ii)   if the service is the first or last service under the referral—in relation to that service; or

       (iii)   if neither subparagraph (i) nor (ii) applies but the service involves matters that the referring medical practitioner would reasonably expect to be informed of—in relation to those matters;

to a maximum of 5 services (including any services to which this item or any other item in Part 1 of this Schedule applies) in a calendar year

This item is subject to section 9
10952

Audiology health service provided to a person by an eligible audiologist if:

   (a)  the service is provided to a person who has:

         (i)   a chronic condition; and

       (ii)   complex care needs being managed by a medical practitioner (including a general practitioner, but not a specialist or consultant physician) under both a GP Management Plan and Team Care Arrangements or, if the person is a resident of an aged care facility, the person’s medical practitioner has contributed to a multidisciplinary care plan; and

  (b)  the service is recommended in the person’s Team Care Arrangements or multidisciplinary care plan as part of the management of the person’s chronic condition and complex care needs; and

   (c)  the person is referred to the eligible audiologist by the medical practitioner using a referral form that has been issued by the Department or a referral form that contains all the components of the form issued by the Department; and

  (d)  the person is not an admitted patient of a hospital; and

 62.25

   (e)  the service is provided to the person individually and in person; and

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

   (g)  after the service, the eligible audiologist gives a written report to the referring medical practitioner mentioned in paragraph (c):

         (i)   if the service is the only service under the referral—in relation to that service; or

        (ii)   if the service is the first or last service under the referral—in relation to that service; or

       (iii)   if neither subparagraph (i) nor (ii) applies but the service involves matters that the referring medical practitioner would reasonably expect to be informed of—in relation to those matters;

to a maximum of 5 services (including any services to which this item or any other item in Part 1 of this Schedule applies) in a calendar year

This item is subject to section 9
10953

Exercise physiology health service provided to a person by an eligible exercise physiologist if:

   (a)  the service is provided to a person who has:

         (i)   a chronic condition; and

       (ii)   complex care needs being managed by a medical practitioner (including a general practitioner, but not a specialist or consultant physician) under both a GP Management Plan and Team Care Arrangements or, if the person is a resident of an aged care facility, the person’s medical practitioner has contributed to a multidisciplinary care plan; and

  (b)  the service is recommended in the person’s Team Care Arrangements or multidisciplinary care plan as part of the management of the person’s chronic condition and complex care needs; and

   (c)  the person is referred to the eligible exercise physiologist by the medical practitioner using a referral form that has been issued by the Department or a referral form that contains all the components of the form issued by the Department; and

  (d)  the person is not an admitted patient of a hospital; and

   (e)  the service is provided to the person individually and in person; and

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

   (g)  after the service, the eligible exercise physiologist gives a written report to the referring medical practitioner mentioned in paragraph (c):

         (i)   if the service is the only service under the referral—in relation to that service; or

        (ii)   if the service is the first or last service under the referral—in relation to that service; or

       (iii)   if neither subparagraph (i) nor (ii) applies but the service involves matters that the referring medical practitioner would reasonably expect to be informed of—in relation to those matters;

to a maximum of 5 services (including any services to which this item or any other item in Part 1 of this Schedule applies) in a calendar year

This item is subject to section 9

 62.25
10954

Dietetics health service provided to a person by an eligible dietician if:

   (a)  the service is provided to a person who has:

         (i)   a chronic condition; and

       (ii)   complex care needs being managed by a medical practitioner (including a general practitioner, but not a specialist or consultant physician) under both a GP Management Plan and Team Care Arrangements or, if the person is a resident of an aged care facility, the person’s medical practitioner has contributed to a multidisciplinary care plan; and

  (b)  the service is recommended in the person’s Team Care Arrangements or multidisciplinary care plan as part of the management of the person’s chronic condition and complex care needs; and

 62.25

   (c)  the person is referred to the eligible dietician by the medical practitioner using a referral form that has been issued by the Department or a referral form that contains all the components of the form issued by the Department; and

  (d)  the person is not an admitted patient of a hospital; and

   (e)  the service is provided to the person individually and in person; and

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

   (g)  after the service, the eligible dietician gives a written report to the referring medical practitioner mentioned in paragraph (c):

         (i)   if the service is the only service under the referral—in relation to that service; or

        (ii)   if the service is the first or last service under the referral—in relation to that service; or

       (iii)   if neither subparagraph (i) nor (ii) applies but the service involves matters that the referring medical practitioner would reasonably expect to be informed of—in relation to those matters;

to a maximum of 5 services (including any services to which this item or any other item in Part 1 of this Schedule applies) in a calendar year

This item is subject to section 9
10956

Mental health service provided to a person by an eligible mental health worker if:

   (a)  the service is provided to a person who has:

         (i)   a chronic condition; and

       (ii)   complex care needs being managed by a medical practitioner (including a general practitioner, but not a specialist or consultant physician) under both a GP Management Plan and Team Care Arrangements or, if the person is a resident of an aged care facility, the person’s medical practitioner has contributed to a multidisciplinary care plan; and

  (b)  the service is recommended in the person’s Team Care Arrangements or multidisciplinary care plan as part of the management of the person’s chronic condition and complex care needs; and

   (c)  the person is referred to the eligible mental health worker by the medical practitioner using a referral form that has been issued by the Department or a referral form that contains all the components of the form issued by the Department; and

 62.25

  (d)  the person is not an admitted patient of a hospital; and

   (e)  the service is provided to the person individually and in person; and

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

   (g)  after the service, the eligible mental health worker gives a written report to the referring medical practitioner mentioned in paragraph (c):

         (i)   if the service is the only service under the referral—in relation to that service; or

        (ii)   if the service is the first or last service under the referral—in relation to that service; or

(iii)  if neither subparagraph (i) nor (ii) applies but the service involves matters that the referring medical practitioner would reasonably expect to be informed of—in relation to those matters;

to a maximum of 5 services (including any services to which this item or any other item in Part 1 of this Schedule applies) in a calendar year

This item is subject to section 9
10958

Occupational therapy health service provided to a person by an eligible occupational therapist if:

   (a)  the service is provided to a person who has:

         (i)   a chronic condition; and

       (ii)   complex care needs being managed by a medical practitioner (including a general practitioner, but not a specialist or consultant physician) under both a GP Management Plan and Team Care Arrangements or, if the person is a resident of an aged care facility, the person’s medical practitioner has contributed to a multidisciplinary care plan; and

  (b)  the service is recommended in the person’s Team Care Arrangements or multidisciplinary care plan as part of the management of the person’s chronic condition and complex care needs; and

   (c)  the person is referred to the eligible occupational therapist by the medical practitioner using a referral form that has been issued by the Department or a referral form that contains all the components of the form issued by the Department; and

  (d)  the person is not an admitted patient of a hospital; and

   (e)  the service is provided to the person individually and in person; and

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

   (g)  after the service, the eligible occupational therapist gives a written report to the referring medical practitioner mentioned in paragraph (c):

         (i)   if the service is the only service under the referral—in relation to that service; or

        (ii)   if the service is the first or last service under the referral—in relation to that service; or

 62.25

       (iii)   if neither subparagraph (i) nor (ii) applies but the service involves matters that the referring medical practitioner would reasonably expect to be informed of—in relation to those matters;

to a maximum of 5 services (including any services to which this item or any other item in Part 1 of this Schedule applies) in a calendar year

This item is subject to section 9
10960

Physiotherapy health service provided to a person by an eligible physiotherapist if:

   (a)  the service is provided to a person who has:

         (i)   a chronic condition; and

       (ii)   complex care needs being managed by a medical practitioner (including a general practitioner, but not a specialist or consultant physician) under both a GP Management Plan and Team Care Arrangements or, if the person is a resident of an aged care facility, the person’s medical practitioner has contributed to a multidisciplinary care plan; and

  (b)  the service is recommended in the person’s Team Care Arrangements or multidisciplinary care plan as part of the management of the person’s chronic condition and complex care needs; and

   (c)  the person is referred to the eligible physiotherapist by the medical practitioner using a referral form that has been issued by the Department or a referral form that contains all the components of the form issued by the Department; and

  (d)  the person is not an admitted patient of a hospital; and

   (e)  the service is provided to the person individually and in person; and

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

   (g)  after the service, the eligible physiotherapist gives a written report to the referring medical practitioner mentioned in paragraph (c):

         (i)   if the service is the only service under the referral—in relation to that service; or

        (ii)   if the service is the first or last service under the referral—in relation to that service; or

       (iii)   if neither subparagraph (i) nor (ii) applies but the service involves matters that the referring medical practitioner would reasonably expect to be informed of—in relation to those matters;

to a maximum of 5 services (including any services to which this item or any other item in Part 1 of this Schedule applies) in a calendar year

This item is subject to section 9

 62.25
10962

Podiatry health service provided to a person by an eligible podiatrist if:

   (a)  the service is provided to a person who has:

         (i)   a chronic condition; and

       (ii)   complex care needs being managed by a medical practitioner (including a general practitioner, but not a specialist or consultant physician) under both a GP Management Plan and Team Care Arrangements or, if the person is a resident of an aged care facility, the person’s medical practitioner has contributed to a multidisciplinary care plan; and

  (b)  the service is recommended in the person’s Team Care Arrangements or multidisciplinary care plan as part of the management of the person’s chronic condition and complex care needs; and

   (c)  the person is referred to the eligible podiatrist by the medical practitioner using a referral form that has been issued by the Department or a referral form that contains all the components of the form issued by the Department; and

 62.25

  (d)  the person is not an admitted patient of a hospital; and

   (e)  the service is provided to the person individually and in person; and

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

   (g)  after the service, the eligible podiatrist gives a written report to the referring medical practitioner mentioned in paragraph (c):

         (i)   if the service is the only service under the referral—in relation to that service; or

        (ii)   if the service is the first or last service under the referral—in relation to that service; or  

(iii)  if neither subparagraph (i) nor (ii) applies but the service involves matters that the referring medical practitioner would reasonably expect to be informed of—in relation to those matters;

to a maximum of 5 services (including any services to which this item or any other item in Part 1 of this Schedule applies) in a calendar year

This item is subject to section 9
10964

Chiropractic health service provided to a person by an eligible chiropractor if:

   (a)  the service is provided to a person who has:

         (i)   a chronic condition; and

       (ii)   complex care needs being managed by a medical practitioner (including a general practitioner, but not a specialist or consultant physician) under both a GP Management Plan and Team Care Arrangements or, if the person is a resident of an aged care facility, the person’s medical practitioner has contributed to a multidisciplinary care plan; and

  (b)  the service is recommended in the person’s Team Care Arrangements or multidisciplinary care plan as part of the management of the person’s chronic condition and complex care needs; and

   (c)  the person is referred to the eligible chiropractor by the medical practitioner using a referral form that has been issued by the Department or a referral form that contains all the components of the form issued by the Department; and

  (d)  the person is not an admitted patient of a hospital; and

   (e)  the service is provided to the person individually and in person; and

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

   (g)  after the service, the eligible chiropractor gives a written report to the referring medical practitioner mentioned in paragraph (c):

         (i)   if the service is the only service under the referral—in relation to that service; or

        (ii)   if the service is the first or last service under the referral—in relation to that service; or

 62.25

       (iii)   if neither subparagraph (i) nor (ii) applies but the service involves matters that the referring medical practitioner would reasonably expect to be informed of —in relation to those matters;

to a maximum of 5 services (including any services to which this item or any other item in Part 1 of this Schedule applies) in a calendar year

This item is subject to section 9
10966

Osteopathy health service provided to a person by an eligible osteopath if:

   (a)  the service is provided to a person who has:

         (i)   a chronic condition; and

       (ii)   complex care needs being managed by a medical practitioner (including a general practitioner, but not a specialist or consultant physician) under both a GP Management Plan and Team Care Arrangements or, if the person is a resident of an aged care facility, the person’s medical practitioner has contributed to a multidisciplinary care plan; and

  (b)  the service is recommended in the person’s Team Care Arrangements or multidisciplinary care plan as part of the management of the person’s chronic condition and complex care needs; and

   (c)  the person is referred to the eligible osteopath by the medical practitioner using a referral form that has been issued by the Department or a referral form that contains all the components of the form issued by the Department; and

  (d)  the person is not an admitted patient of a hospital; and

   (e)  the service is provided to the person individually and in person; and

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

   (g)  after the service, the eligible osteopath gives a written report to the referring medical practitioner mentioned in paragraph (c):

         (i)   if the service is the only service under the referral—in relation to that service; or

        (ii)   if the service is the first or last service under the referral—in relation to that service; or

       (iii)   if neither subparagraph (i) nor (ii) applies but the service involves matters that the referring medical practitioner would reasonably expect to be informed of —in relation to those matters;

to a maximum of 5 services (including any services to which this item or any other item in Part 1 of this Schedule applies) in a calendar year

This item is subject to section 9

 62.25
10968

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

   (a)  the service is provided to a person who has:

         (i)   a chronic condition; and

       (ii)   complex care needs being managed by a medical practitioner (including a general practitioner, but not a specialist or consultant physician) under both a GP Management Plan and Team Care Arrangements or, if the person is a resident of an aged care facility, the person’s medical practitioner has contributed to a multidisciplinary care plan; and

  (b)  the service is recommended in the person’s Team Care Arrangements or multidisciplinary care plan as part of the management of the person’s chronic condition and complex care needs; and

   (c)  the person is referred to the eligible psychologist by the medical practitioner using a referral form that has been issued by the Department or a referral form that contains all the components of the form issued by the Department; and

  (d)  the person is not an admitted patient of a hospital; and

   (e)  the service is provided to the person individually and in person; and

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

   (g)  after the service, the eligible psychologist gives a written report to the referring medical practitioner mentioned in paragraph (c):

         (i)   if the service is the only service under the referral—in relation to that service; or

        (ii)   if the service is the first or last service under the referral—in relation to that service; or

       (iii)   if neither subparagraph (i) nor (ii) applies but the service involves matters that the referring medical practitioner would reasonably expect to be informed of—in relation to those matters;

to a maximum of 5 services (including any services to which this item or any other item in Part 1 of this Schedule applies) in a calendar year

This item is subject to section 9
10970

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

   (a)  the service is provided to a person who has:

         (i)   a chronic condition; and

       (ii)   complex care needs being managed by a medical practitioner (including a general practitioner, but not a specialist or consultant physician) under both a GP Management Plan and Team Care Arrangements or, if the person is a resident of an aged care facility, the person’s medical practitioner has contributed to a multidisciplinary care plan; and

  (b)  the service is recommended in the person’s Team Care Arrangements or multidisciplinary care plan as part of the management of the person’s chronic condition and complex care needs; and

   (c)  the person is referred to the eligible speech pathologist by the medical practitioner using a referral form that has been issued by the Department or a referral form that contains all the components of the form issued by the Department; and

  (d)  the person is not an admitted patient of a hospital; and

 62.25

   (e)  the service is provided to the person individually and in person; and

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

   (g)  after the service, the eligible speech pathologist gives a written report to the referring medical practitioner mentioned in paragraph (c):

         (i)   if the service is the only service under the referral—in relation to that service; or

        (ii)   if the service is the first or last service under the referral—in relation to that service; or

       (iii)   if neither subparagraph (i) nor (ii) applies but the service involves matters that the referring medical practitioner would reasonably expect to be informed of —in relation to those matters;

to a maximum of 5 services (including any services to which this item or any other item in Part 1 of this Schedule applies) in a calendar year

This item is subject to section 9

Part 2 - Services and fees—psychological therapy and focussed psychological strategies

Group M6 – Psychological therapy services
Item Service Fee($)
80000

Psychological therapy health service provided to a person in consulting rooms (but not as an admitted patient of a hospital) by an eligible clinical psychologist if:

   (a)  the person is referred by:

         (i)   a medical practitioner, either as part of a GP Mental Health Treatment Plan or as part of a psychiatrist assessment and management plan; or

        (ii)   a specialist or consultant physician specialising in the practice of his or her field of psychiatry; or

       (iii)   a specialist or consultant physician specialising in the practice of his or her field of paediatrics; and

(aa)  the service is provided to the person individually and in person; and

  (b)  at the completion of a course of treatment, the referring medical practitioner reviews the need for a further course of treatment; and

   (c)  on the completion of the course of treatment, the eligible clinical psychologist gives a written report to the referring medical practitioner on assessments carried out, treatment provided and recommendations on future management of the person’s condition; and

  (d)  the service is at least 30 minutes but less than 50 minutes duration

This item is subject to sections 6, 7 and 9

 99.75
80005

Psychological therapy health service provided to a person at a place other than consulting rooms (but not as an admitted patient of a hospital) by an eligible clinical psychologist in accordance with the requirements of item 80000

This item is subject to sections 6, 7 and 9

 124.65
80010

Psychological therapy health service provided to a person in consulting rooms (but not as an admitted patient of a hospital) by an eligible clinical psychologist if:

   (a)  the person is referred by:

         (i)   a medical practitioner, either as part of a GP Mental Health Treatment Plan or as part of a psychiatrist assessment and management plan; or

        (ii)   a specialist or consultant physician specialising in the practice of his or her field of psychiatry; or

       (iii)   a specialist or consultant physician specialising in the practice of his or her field of paediatrics; and

(aa)  the service is provided to the person individually and in person; and

  (b)  at the completion of a course of treatment, the referring medical practitioner reviews the need for a further course of treatment; and

 146.45

   (c)  on the completion of the course of treatment, the eligible clinical psychologist gives a written report to the referring medical practitioner on assessments carried out, treatment provided and recommendations on future management of the person’s condition; and

  (d)  the service is at least 50 minutes duration

This item is subject to sections 6, 7 and 9
80015

Psychological therapy health service provided to a person at a place other than consulting rooms (but not as an admitted patient of a hospital) by an eligible clinical psychologist in accordance with the requirements of item 80010

This item is subject to sections 6, 7 and 9

 171.35
80020

Psychological therapy health service provided to a person as part of a group of 6 to 10 patients (but not as an admitted patient of a hospital) by an eligible clinical psychologist if:

   (a)  the person is referred by:

        (i)   a medical practitioner, either as part of a GP Mental Health Treatment Plan or as part of a psychiatrist assessment and management plan; or

        (ii)   a specialist or consultant physician specialising in the practice of his or her field of psychiatry; or

       (iii)   a specialist or consultant physician specialising in the practice of his or her field of paediatrics; and

(aa)  the service is provided in person; and

  (b)  the service is at least 60 minutes duration;

This item is subject to sections 6A, 7 and 9

 37.20
Group M7 – Focussed psychological strategies (allied health)
Item Service Fee($)
80100

Focussed psychological strategies health service provided to a person in consulting rooms (but not as an admitted patient of a hospital) by an eligible psychologist if:

   (a)  the person is referred by:

        (i)   a medical practitioner, either as part of a GP Mental Health Treatment Plan or as part of a psychiatrist assessment and management plan; or

        (ii)   a specialist or consultant physician specialising in the practice of his or her field of psychiatry; or

       (iii)   a specialist or consultant physician specialising in the practice of his or her field of paediatrics; and

(aa)  the service is provided to the person individually and in person; and

  (b)  at the completion of a course of treatment, the referring medical practitioner reviews the need for a further course of treatment; and

 70.65

   (c)  on the completion of the course of treatment, the eligible psychologist gives a written report to the referring medical practitioner on assessments carried out, treatment provided and recommendations on future management of the person’s condition; and

  (d)  the service is at least 20 minutes but less than 50 minutes duration

This item is subject to sections 6, 7 and 9
80105

Focussed psychological strategies health service provided to a person at a place other than consulting rooms (but not as an admitted patient of a hospital) by an eligible psychologist in accordance with the requirements of item 80100

This item is subject to sections 6, 7 and 9

 96.15
80110

Focussed psychological strategies health service provided to a person in consulting rooms (but not as an admitted patient of a hospital) by an eligible psychologist if:

   (a)  the person is referred by:

        (i)   a medical practitioner, either as part of a GP Mental Health Treatment Plan or as part of a psychiatrist assessment and management plan; or

        (ii)   a specialist or consultant physician specialising in the practice of his or her field of psychiatry; or

       (iii)   a specialist or consultant physician specialising in the practice of his or her field of paediatrics; and

(aa)  the service is provided to the person individually and in person; and

  (b)  at the completion of a course of treatment, the referring medical practitioner reviews the need for a further course of treatment; and

   (c)  on the completion of the course of treatment, the eligible psychologist gives a written report to the referring medical practitioner on assessments carried out, treatment provided and recommendations on future management of the person’s condition; and

  (d)  the service is at least 50 minutes duration

This item is subject to sections 6, 7 and 9

 99.75
80115

Focussed psychological strategies health service provided to a person at a place other than consulting rooms (but not as an admitted patient of a hospital) by an eligible psychologist in accordance with the requirements of item 80110

This item is subject to sections 6, 7 and 9

 125.30
80120

Focussed psychological strategies health service provided to a person as part of a group of 6 to 10 patients (but not as an admitted patient of a hospital) by an eligible psychologist if:

   (a)  the person is referred by:

        (i)   a medical practitioner, either as part of a GP Mental Health Treatment Plan or as part of a psychiatrist assessment and management plan; or

        (ii)   a specialist or consultant physician specialising in the practice of his or her field of psychiatry; or

       (iii)   a specialist or consultant physician specialising in the practice of his or her field of paediatrics; and

(aa)  the service is provided in person; and

  (b)  the service is at least 60 minutes duration;

This item is subject to sections 6A, 7 and 9

 25.45
80125

Focussed psychological strategies health service provided to a person in consulting rooms (but not as an admitted patient of a hospital) by an eligible occupational therapist if:

   (a)  the person is referred by:

        (i)   a medical practitioner, either as part of a GP Mental Health Treatment Plan or as part of a psychiatrist assessment and management plan; or

        (ii)   a specialist or consultant physician specialising in the practice of his or her field of psychiatry; or

       (iii)   a specialist or consultant physician specialising in the practice of his or her field of paediatrics; and

(aa)  the service is provided to the person individually and in person; and

  (b)  at the completion of a course of treatment, the referring medical practitioner reviews the need for a further course of treatment; and

   (c)  on the completion of the course of treatment, the eligible occupational therapist gives a written report to the referring medical practitioner on assessments carried out, treatment provided and recommendations on future management of the person’s condition; and

  (d)  the service is at least 20 minutes but less than 50 minutes duration

This item is subject to sections 6, 7 and 9

 62.25
80130

Focussed psychological strategies health service provided to a person at a place other than consulting rooms (but not as an admitted patient of a hospital) by an eligible occupational therapist in accordance with the requirements of item 80125

This item is subject to sections 6, 7 and 9

 87.70
80135

Focussed psychological strategies health service provided to a person in consulting rooms (but not as an admitted patient of a hospital) by an eligible occupational therapist if:

   (a)  the person is referred by:

        (i)   a medical practitioner, either as part of a GP Mental Health Treatment Plan or as part of a psychiatrist assessment and management plan; or

        (ii)   a specialist or consultant physician specialising in the practice of his or her field of psychiatry; or

       (iii)   a specialist or consultant physician specialising in the practice of his or her field of paediatrics; and

(aa)  the service is provided to the person individually and in person; and

  (b)  at the completion of a course of treatment, the referring medical practitioner reviews the need for a further course of treatment; and

   (c)  on the completion of the course of treatment, the eligible occupational therapist gives a written report to the referring medical practitioner on assessments carried out, treatment provided and recommendations on future management of the person’s condition; and

  (d)  the service is at least 50 minutes duration

This item is subject to sections 6, 7 and 9

 87.95
80140

Focussed psychological strategies health service provided to a person at a place other than consulting rooms (but not as an admitted patient of a hospital) by an eligible occupational therapist in accordance with the requirements of item 80135

This item is subject to sections 6, 7 and 9

 113.35
80145

Focussed psychological strategies health service provided to a person as part of a group of 6 to 10 patients (but not as an admitted patient of a hospital) by an eligible occupational therapist if:

   (a)  the person is referred by:

         (i)   a medical practitioner, either as part of a GP Mental Health Treatment Plan or as part of a psychiatrist assessment and management plan; or

        (ii)   a specialist or consultant physician specialising in the practice of his or her field of psychiatry; or

       (iii)   a specialist or consultant physician specialising in the practice of his or her field of paediatrics; and

(aa)  the service is provided in person; and

  (b)  the service is at least 60 minutes duration;

This item is subject to sections 6A, 7 and 9

 22.35
80150

Focussed psychological strategies health service provided to a person in consulting rooms (but not as an admitted patient of a hospital) by an eligible social worker if:

   (a)  the person is referred by:

        (i)   a medical practitioner, either as part of a GP Mental Health Treatment Plan or as part of a psychiatrist assessment and management plan; or

        (ii)   a specialist or consultant physician specialising in the practice of his or her field of psychiatry; or

       (iii)   a specialist or consultant physician specialising in the practice of his or her field of paediatrics; and

(aa)  the service is provided to the person individually and in person; and

  (b)  at the completion of a course of treatment, the referring medical practitioner reviews the need for a further course of treatment; and

 62.25

   (c)  on the completion of the course of treatment, the eligible social worker gives a written report to the referring medical practitioner on assessments carried out, treatment provided and recommendations on future management of the person’s condition; and

  (d)  the service is at least 20 minutes but less than 50 minutes duration

This item is subject to sections 6, 7 and 9
80155

Focussed psychological strategies health service provided to a person at a place other than consulting rooms (but not as an admitted patient of a hospital) by an eligible social worker in accordance with the requirements of item 80150

This item is subject to sections 6, 7 and 9

 87.70
80160

Focussed psychological strategies health service provided to a person in consulting rooms (but not as an admitted patient of a hospital) by an eligible social worker if:

   (a)  the person is referred by:

        (i)   a medical practitioner, either as part of a GP Mental Health Treatment Plan or as part of a psychiatrist assessment and management plan; or

        (ii)   a specialist or consultant physician specialising in the practice of his or her field of psychiatry; or

       (iii)   a specialist or consultant physician specialising in the practice of his or her field of paediatrics; and

(aa)  the service is provided to the person individually and in person; and

  (b)  at the completion of a course of treatment, the referring medical practitioner reviews the need for a further course of treatment; and

   (c)  on the completion of the course of treatment, the eligible social worker gives a written report to the referring medical practitioner on assessments carried out, treatment provided and recommendations on future management of the person’s condition; and

  (d)  the service is at least 50 minutes duration

This item is subject to sections 6, 7 and 9

 87.95
80165

Focussed psychological strategies health service provided to a person at a place other than consulting rooms (but not as an admitted patient of a hospital) by an eligible social worker in accordance with the requirements of item 80160

This item is subject to sections 6, 7 and 9

 113.35
80170

Focussed psychological strategies health service provided to a person as part of a group of 6 to 10 patients (but not as an admitted patient of a hospital) by an eligible social worker if:

   (a)  the person is referred by:

        (i)   a medical practitioner, either as part of a GP Mental Health Treatment Plan or as part of a psychiatrist assessment and management plan; or

        (ii)   a specialist or consultant physician specialising in the practice of his or her field of psychiatry; or

       (iii)   a specialist or consultant physician specialising in the practice of his or her field of paediatrics; and

(aa)  the service is provided in person; and

  (b)  the service is at least 60 minutes duration;

This item is subject to sections 6A, 7 and 9

 22.35

Part 3 - Services and fees—pregnancy support counselling

Group M8 – Pregnancy support counselling
Item Service Fee($)
81000

Non‑directive pregnancy support counselling health service provided to a person, who is currently pregnant or who has been pregnant in the preceding 12 months, (but not as an admitted patient of a hospital) by an eligible psychologist if:

   (a)  the person is concerned about a current pregnancy or a pregnancy that occurred in the 12 months preceding the provision of the first service; and

  (b)  the person is referred by a medical practitioner who is not a specialist or consultant physician; and

(ba)  the service is provided to the person individually and in person; and

   (c)  the eligible psychologist does not have a direct pecuniary interest in a health service that has as its primary purpose the provision of services for pregnancy termination; and

  (d)  the service is at least 30 minutes duration;

to a maximum of 3 services (including services to which items 81000, 81005, 81010 and 4001* apply) for each pregnancy

The service may be used to address any pregnancy related issues for which non‑directive counselling is appropriate

This item is subject to section 9

[* in the general medical services table]

 73.15
81005

Non‑directive pregnancy support counselling health service provided to a person, who is currently pregnant or who has been pregnant in the preceding 12 months, (but not as an admitted patient of a hospital) by an eligible social worker if:

   (a)  the person is concerned about a current pregnancy or a pregnancy that occurred in the 12 months preceding the provision of the first service; and

  (b)  the person is referred by a medical practitioner who is not a specialist or consultant physician; and

(ba)  the service is provided to the person individually and in person; and

   (c)  the eligible social worker does not have a direct pecuniary interest in a health service that has as its primary purpose the provision of services for pregnancy termination; and

  (d)  the service is at least 30 minutes duration;

to a maximum of 3 services (including services to which items 81000, 81005, 81010 and 4001* apply) for each pregnancy

The service may be used to address any pregnancy related issues for which non‑directive counselling is appropriate

This item is subject to section 9

[* in the general medical services table]

 73.15
81010

Non‑directive pregnancy support counselling health service provided to a person, who is currently pregnant or who has been pregnant in the preceding 12 months, (but not as an admitted patient of a hospital) by an eligible mental health nurse if:

   (a)  the person is concerned about a current pregnancy or a pregnancy that occurred in the 12 months preceding the provision of the first service; and

  (b)  the person is referred by a medical practitioner who is not a specialist or consultant physician; and

(ba)  the service is provided to the person individually and in person; and

   (c)  the eligible mental health nurse does not have a direct pecuniary interest in a health service that has as its primary purpose the provision of services for pregnancy termination; and

  (d)  the service is at least 30 minutes duration;

to a maximum of 3 services (including services to which items 81000, 81005, 81010 and 4001* apply) for each pregnancy

The service may be used to address any pregnancy related issues for which non‑directive counselling is appropriate

This item is subject to section 9

[* in the general medical services table]

 73.15

Part 4 - Services and fees—group services

Division 4.1 - Diabetes education services

Group M9 – Allied health group services
Item Service Fee($)
81100

Diabetes education health service provided to a person by an eligible diabetes educator for assessing the person’s suitability for group services for the management of type 2 diabetes, including taking a comprehensive patient history, identifying an appropriate group services program based on the patient’s needs and preparing the person for the group services if:

   (a)  the person has type 2 diabetes; and

  (b)  the person is being managed by a medical practitioner (including a general practitioner, but not a specialist or consultant physician) under a GP Management Plan or, if the person is a resident of an aged care facility, the person’s medical practitioner has contributed to a multidisciplinary care plan; and

   (c)  the person is referred to an eligible diabetes educator by the medical practitioner using a referral form that has been issued by the Department, or a referral form that contains all the components of the form issued by the Department; and

  (d)  the person is not an admitted patient of a hospital; and

   (e)  the service is provided to the person individually and in person; and

   (f)  the service is of at least 45 minutes duration; and

   (g)  after the service, the eligible diabetes educator gives a written report to the referring medical practitioner mentioned in paragraph (c);

payable once in a calendar year for this or any other assessment for group services item (including services in items 81100, 81110 and 81120)

This item is subject to section 9

 79.85
81105

Diabetes education health service provided to a person by an eligible diabetes educator, as a group service for the management of type 2 diabetes if:

   (a)  the person has been assessed as suitable for a type 2 diabetes group service under assessment item 81100, 81110 or 81120; and

  (b)  the service is provided to a person who is part of a group of between 2 and 12 patients; and

   (c)  the person is not an admitted patient of a hospital; and

  (d)  the service is provided in person; and

   (e)  the service is of at least 60 minutes duration; and

 19.90
   (f)  after the last service in the group services program provided to the person under item 81105, 81115 or 81125, the eligible diabetes educator prepares, or contributes to, a written report to be provided to the referring medical practitioner; and

   (g)  an attendance record for the group is maintained by the eligible diabetes educator;

to a maximum of 8 group services in a calendar year (including services in items 81105, 81115 and 81125)

This item is subject to section 9

Division 4.2 - Exercise physiology services

Group M9 – Allied health group services
Item Service Fee($)
81110

Exercise physiology health service provided to a person by an eligible exercise physiologist for assessing the person’s suitability for group services for the management of type 2 diabetes, including taking a comprehensive patient history, identifying an appropriate group services program based on the patient’s needs and preparing the person for the group services if:

   (a)  the person has type 2 diabetes; and

  (b)  the person is being managed by a medical practitioner (including a general practitioner, but not a specialist or consultant physician) under a GP Management Plan or, if the person is a resident of an aged care facility, the person’s medical practitioner has contributed to a multidisciplinary care plan; and

   (c)  the person is referred to an eligible exercise physiologist by the medical practitioner using a referral form that has been issued by the Department, or a referral form that contains all the components of the form issued by the Department; and

  (d)  the person is not an admitted patient of a hospital; and

   (e)  the service is provided to the person individually and in person; and

   (f)  the service is of at least 45 minutes duration; and

   (g)  after the service, the eligible exercise physiologist gives a
written report to the referring medical practitioner mentioned
in paragraph (c);

payable once in a calendar year for this or any other assessment for group services item (including services in items 81100, 81110 and 81120)

This item is subject to section 9

 79.85
81115

Exercise physiology health service provided to a person by an eligible exercise physiologist, as a group service for the management of type 2 diabetes if:

   (a)  the person has been assessed as suitable for a type 2 diabetes group service under assessment item 81100, 81110 or 81120; and

  (b)  the service is provided to a person who is part of a group of between 2 and 12 patients; and

   (c)  the person is not an admitted patient of a hospital; and

  (d)  the service is provided in person; and

 19.90

   (e)  the service is of at least 60 minutes duration; and

   (f)  after the last service in the group services program provided to the person under item 81105, 81115 or 81125, the eligible exercise physiologist prepares, or contributes to, a written report to be provided to the referring medical practitioner; and

   (g)  an attendance record for the group is maintained by the eligible exercise physiologist;

to a maximum of 8 group services in a calendar year (including services in items 81105, 81115 and 81125)

This item is subject to section 9

Division 4.3 - Dietetics services

Group M9 – Allied health group services
Item Service Fee($)
81120

Dietetics health service provided to a person by an eligible dietician for assessing the person’s suitability for group services for the management of type 2 diabetes, including taking a comprehensive patient history, identifying an appropriate group services program based on the patient’s needs and preparing the person for the group services if:

   (a)  the person has type 2 diabetes; and

  (b)  the person is being managed by a medical practitioner (including a general practitioner, but not a specialist or consultant physician) under a GP Management Plan or, if the person is a resident of an aged care facility, the person’s medical practitioner has contributed to a multidisciplinary care plan; and

   (c)  the person is referred to an eligible dietician by the medical practitioner using a referral form that has been issued by the Department, or a referral form that contains all the components of the form issued by the Department; and

  (d)  the person is not an admitted patient of a hospital; and

   (e)  the service is provided to the person individually and in person; and

   (f)  the service is of at least 45 minutes duration; and

   (g)  after the service, the eligible dietician gives a written report to the referring medical practitioner mentioned in paragraph (c);

payable once in a calendar year for this or any other assessment for group services item (including services in items 81100, 81110 and 81120)

This item is subject to section 9

 79.85
81125

Dietetics health service provided to a person by an eligible dietician, as a group service for the management of type 2 diabetes if:

   (a)  the person has been assessed as suitable for a type 2 diabetes group service under assessment item 81100, 81110 or 81120; and

  (b)  the service is provided to a person who is part of a group of between 2 and 12 patients; and

   (c)  the person is not an admitted patient of a hospital; and

  (d)  the service is provided in person; and

   (e)  the service is of at least 60 minutes duration; and

   (f)  after the last service in the group services program provided to the person under item 81105, 81115 or 81125, the eligible dietician prepares, or contributes to, a written report to be provided to the referring medical practitioner; and

   (g)  an attendance record for the group is maintained by the eligible dietician;

to a maximum of 8 group services in a calendar year (including services to which items 81105, 81115 and 81125 apply)

This item is subject to section 9

 19.90

Part 5—Services and fees—pervasive developmental disorder or disability services

Group M10 – Autism, pervasive developmental disorder and disability services
Item Service Fee($)
82000

Psychology health service provided to a child aged under 13 years by an eligible psychologist if:

   (a)  the child was referred to the eligible psychologist by an eligible practitioner:

         (i)   to assist with the diagnosis of the child by the practitioner; or

        (ii)   to contribute to the child’s PDD or disability treatment and management plan, developed by the practitioner; and

  (b)  the eligible practitioner is:

(i)    for a child with PDD, a consultant physician specialising in the practice of his or her field of psychiatry or paediatrics; or

(ii)   for a child with disability, a specialist or consultant physician practising in his or her specialty, or a general practitioner; and

   (c)  the eligible psychologist attending the child is registered with the Department of Human Services as meeting the credentialing requirements for the provision of that service; and

  (d)  the child is not an admitted patient of a hospital; and

   (e)  the service is provided to the child individually and in person; and

   (f)  the service is at least 50 minutes duration;

to a maximum of 4 services (including services to which this item or items 82005, 82010 and 82030 apply)

Up to 4 services may be provided to the same child on the same day

This item is subject to sections 8, 8A, 9 and 9A

 99.75
82005

Speech pathology health service provided to a child aged under 13 years by an eligible speech pathologist if:

   (a)  the child was referred to the eligible speech pathologist by an eligible practitioner:

         (i)   to assist with the diagnosis of the child by the practitioner: or

        (ii)   to contribute to the child’s PDD or disability treatment and management plan, developed by the practitioner; and

  (b)  the eligible practitioner is:

(i)    for a child with PDD, a consultant physician specialising in the practice of his or her field of psychiatry or paediatrics;

(ii)   for a child with disability, a specialist or consultant physician practising in his or her specialty, or a general practitioner; and

   (c)  the eligible speech pathologist attending the child is registered with the Department of Human Services as meeting the credentialing requirements for the provision of that service; and

  (d)  the child is not an admitted patient of a hospital; and

   (e)  the service is provided to the child individually and in person; and

 87.95

   (f)  the service is at least 50 minutes duration;

to a maximum of 4 services (including services to which this item or items 82000, 82010 and 82030 apply)

Up to 4 services may be provided to the same child on the same day

This item is subject to sections 8, 8A, 9 and 9A
82010

Occupational therapy health service provided to a child aged under 13 years by an eligible occupational therapist if:

   (a)  the child was referred to the eligible occupational therapist by an eligible practitioner:

         (i)   to assist with the diagnosis of the child by the practitioner: or

        (ii)   to contribute to the child’s PDD or disability treatment and management plan, developed by the practitioner; and

  (b)  the eligible practitioner is:

(i)    for a child with PDD, a consultant physician specialising in the practice of his or her field of psychiatry or paediatrics;

(ii)   for a child with disability, a specialist or consultant physician practising in his or her field of specialty, or a general practitioner; and

   (c)  the eligible occupational therapist attending the child is registered with the Department of Human Services as meeting the credentialing requirements for the provision of that service; and

  (d)  the child is not an admitted patient of a hospital; and

   (e)  the service is provided to the child individually and in person; and

   (f)  the service is at least 50 minutes duration;

to a maximum of 4 services (including services to which this item or items 82000, 82005 and 82030 apply)

Up to 4 services may be provided to the same child on the same day

This item is subject to sections 8, 8A, 9 and 9A

 87.95
82015

Psychology health service provided to a child aged under 15 years for treatment of a pervasive developmental disorder (PDD) or eligible disability by an eligible psychologist, if:

   (a)  the child has been diagnosed with a PDD or an eligible disability; and

  (b)  the child, while aged under 13 years, received a PDD or disability treatment and management plan as prepared by the eligible practitioner; and

   (c)  the child was referred by an eligible practitioner for services consistent with the child’s PDD or disability treatment and management plan; and

  (d)  the eligible practitioner is:

(i)    for a child with PDD, a consultant physician specialising in the practice of his or her field of psychiatry or paediatrics;

(ii)   for a child with disability, a specialist or consultant physician practising in his or her field of specialty, or a general practitioner; and

   (e)  the eligible psychologist attending the child is registered with the Department of Human Services as meeting the credentialing requirements for the provision of those services; and

 99.75

   (f)  on the completion of the course of treatment, the eligible psychologist gives a written report to the referring eligible practitioner on assessments carried out, treatment provided and recommendations on future management of the child’s condition; and

   (g)  the eligible practitioner is:

(i)    for a child with PDD, a consultant physician specialising in the practice of his or her field of psychiatry or paediatrics;

(ii)   for a child with disability, a specialist or consultant physician practising in his or her specialty, or a general practitioner; and

  (h)  the child is not an admitted patient of a hospital; and

   (i)  the service is provided to the child individually and in person; and

   (j)  the service is at least 30 minutes duration;

to a maximum of 20 services (including services to which this item or items 82020, 82025 and 82035 apply)

Up to 4 services may be provided to the same child on the same day

This item is subject to sections 8, 8A and 9

82020

Speech pathology health service provided to a child aged under 15 years for treatment of a pervasive developmental disorder (PDD) or eligible disability by an eligible speech pathologist, if:

   (a)  the child has been diagnosed with a PDD or an eligible disability; and

  (b)  the child, while aged under 13 years, received a PDD or disability treatment and management plan as prepared by the eligible practitioner; and

   (c)  the child was referred by an eligible practitioner for services consistent with the child’s PDD or disability treatment and management plan; and

  (d)  the eligible practitioner is:

(i)    for a child with PDD, a consultant physician specialising in the practice of his or her field of psychiatry or paediatrics;

(ii)   for a child with disability, a specialist or consultant physician practising in his or her specialty, or a general practitioner; and

   (e)  the eligible speech pathologist attending the child is registered with the Department of Human Services as meeting the credentialing requirements for the provision of those services; and

   (f)  on the completion of the course of treatment, the eligible speech pathologist gives a written report to the referring eligible practitioner on assessments carried out, treatment provided and recommendations on future management of the child’s condition; and

   (g)  the child is not an admitted patient of a hospital; and

  (h)  the service is provided to the child individually and in person; and

   (i)  the service is at least 30 minutes duration;

to a maximum of 20 services (including services to which this item or items 82015, 82025 and 82035 apply)

Up to 4 services may be provided to the same child on the same day

This item is subject to sections 8, 8A and 9

 87.95
82025

Occupational therapy health service provided to a child aged under 15 years for treatment of a pervasive developmental disorder (PDD) or eligible disability by an eligible occupational therapist if:

   (a)  the child has been diagnosed with a PDD or an eligible disability; and

  (b)  the child, while aged under 13 years, received a PDD or disability treatment and management plan as prepared by the eligible practitioner; and

   (c)  the child was referred by an eligible practitioner for services consistent with the child’s PDD or disability treatment and management plan; and

  (d)  the eligible practitioner is:

(i)    for a child with PDD, a consultant physician specialising in the practice of his or her field of psychiatry or paediatrics;

(ii)   for a child with disability, a specialist or consultant physician practising in his or her specialty, or a general practitioner; and

   (e)  the eligible occupational therapist attending the child is registered with the Department of Human Services as meeting the credentialing requirements for the provision of those services; and

   (f)  on the completion of the course of treatment, the eligible occupational therapist gives a written report to the referring eligible practitioner on assessments carried out, treatment provided and recommendations on future management of the child’s condition; and

 87.95

   (g)  the child is not an admitted patient of a hospital; and

  (h)  the service is provided to the child individually and in person; and

   (i)  the service is at least 30 minutes duration;

to a maximum of 20 services (including services to which this item or items 82015, 82020 and 82035 apply)

Up to 4 services may be provided to the same child on the same day

This item is subject to sections 8, 8A and 9
82030

Audiology, optometry, orthoptic or physiotherapy health service provided to a child aged under 13 years by an eligible audiologist, optometrist, orthoptist or physiotherapist if:

   (a)  the child was referred to the eligible audiologist, optometrist, orthoptist or physiotherapist by an eligible practitioner:

         (i)   to assist with the diagnosis of the child by the practitioner; or

        (ii)   to contribute to the child’s PDD or disability treatment and management plan, developed by the practitioner; and

  (b)  the eligible practitioner is:

(i)    for a child with PDD, a consultant physician specialising in the practice of his or her field of psychiatry or paediatrics;

(ii)   for a child with disability, a specialist or consultant physician practising in his or her specialty, or a general practitioner; and

   (c)  the eligible audiologist, optometrist, orthoptist or physiotherapist attending the child is registered with the Department of Human Services as meeting the credentialing requirements for the provision of that service; and

  (d)  the child is not an admitted patient of a hospital; and

 87.95

   (e)  the service is provided to the child individually and in person; and

   (f)  the service is at least 50 minutes duration;

to a maximum of 4 services (including services to which this item or items 82000, 82005 and 82010 apply)

Up to 4 services may be provided to the same child on the same day

This item is subject to sections 8, 8A, 9 and 9A
82035

Audiology, optometry, orthoptic or physiotherapy health service provided to a child aged under 15 years for treatment of a pervasive developmental disorder (PDD) or eligible disability by an eligible audiologist, optometrist, orthoptist or physiotherapist, if:

   (a)  the child has been diagnosed with a PDD or an eligible disability; and

  (b)  the child, while aged under 13 years, received a PDD or disability treatment and management plan as prepared by the eligible practitioner; and

   (c)  the child was referred by an eligible practitioner for services consistent with the child’s PDD or disability treatment and management plan; and

  (d)  the eligible practitioner is:

(i)    for a child with PDD, a consultant physician specialising in the practice of his or her field of psychiatry or paediatrics;

(ii)   for a child with disability, a specialist or consultant physician practising in his or her specialty, or a general practitioner; and

   (e)  the eligible audiologist, optometrist, orthoptist or physiotherapist attending the child is registered with the Department of Human Services as meeting the credentialing requirements for the provision of those services; and

   (f)  on the completion of the course of treatment, the eligible audiologist, optometrist, orthoptist or physiotherapist gives a written report to the referring eligible practitioner on assessments carried out, treatment provided and recommendations on future management of the child’s condition; and

   (g)  the child is not an admitted patient of a hospital; and

  (h)  the service is provided to the child individually and in person; and

   (i)  the service is at least 30 minutes duration;

to a maximum of 20 services (including services to which this item or items 82015, 82020 and 82025 apply)

Up to 4 services may be provided to the same child on the same day

This item is subject to sections 8, 8A and 9 

87.95

Part 6—Services and fees—Aboriginal and Torres Strait Islander services

Group M11 – Allied health services for Indigenous Australians who have had a health check
Item Service Fee($)
81300

Aboriginal and Torres Strait Islander health service provided to a person of Aboriginal or Torres Strait Islander descent by an eligible Aboriginal health worker or eligible Aboriginal and Torres Strait Islander health practitioner if:

   (a)  a medical practitioner has undertaken a health assessment and identified a need for follow‑up allied health services; and

  (b)  the person is referred to the eligible Aboriginal health worker or eligible Aboriginal and Torres Strait Islander health practitioner by a medical practitioner using a referral form issued by the Department or a referral form that contains all the components of the form issued by the Department; and

   (c)  the person is not an admitted patient of a hospital; and

  (d)  the service is provided to the person individually and in person; and

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

   (f)  after the service, the eligible Aboriginal health worker or eligible Aboriginal and Torres Strait Islander health practitioner gives a written report to the referring medical practitioner mentioned in paragraph (b):

         (i)   if the service is the only service under the referral—in relation to that service; or

        (ii)   if the service is the first or the last service under the referral—in relation to that service; or

       (iii)   if neither subparagraph (i) nor (ii) applies but the service involves matters that the referring medical practitioner would reasonably expect to be informed of—in relation to those matters;

to a maximum of 5 services (including any services to which this item or any other item in Part 6 of this Schedule applies) in a calendar year

This item is subject to section 9

 62.25
81305

Diabetes education health service provided to a person who is of Aboriginal or Torres Strait Islander descent by an eligible diabetes educator if:

   (a)  a medical practitioner has undertaken a health assessment and identified a need for follow‑up allied health services; and

  (b)  the person is referred to the eligible diabetes educator by a medical practitioner using a referral form issued by the Department or a referral form that contains all the components of the form issued by the Department; and

   (c)  the person is not an admitted patient of a hospital; and

  (d)  the service is provided to the person individually and in person; and

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

 62.25

   (f)  after the service, the eligible diabetes educator gives a written report to the referring medical practitioner mentioned in paragraph (b):

         (i)   if the service is the only service under the referral—in relation to that service; or

        (ii)   if the service is the first or the last service under the referral—in relation to that service; or

       (iii)   if neither subparagraph (i) nor (ii) applies but the service involves matters that the referring medical practitioner would reasonably expect to be informed of—in relation to those matters;

to a maximum of 5 services (including any services to which this item or any other item in Part 6 of this Schedule applies) in a calendar year

This item is subject to section 9
81310

Audiology health service provided to a person who is of Aboriginal or Torres Strait Islander descent by an eligible audiologist if:

   (a)  a medical practitioner has undertaken a health assessment and identified a need for follow‑up allied health services; and

  (b)  the person is referred to the eligible audiologist by a medical practitioner using a referral form issued by the Department or a referral form that contains all the components of the form issued by the Department; and

   (c)  the person is not an admitted patient of a hospital; and

  (d)  the service is provided to the person individually and in person; and

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

   (f)  after the service, the eligible audiologist gives a written report to the referring medical practitioner mentioned in paragraph (b):

         (i)   if the service is the only service under the referral—in relation to that service; or

        (ii)   if the service is the first or the last service under the referral—in relation to that service; or

       (iii)   if neither subparagraph (i) nor (ii) applies but the service involves matters that the referring medical practitioner would reasonably expect to be informed of—in relation to those matters;

to a maximum of 5 services (including any services to which this item or any other item in Part 6 of this Schedule applies) in a calendar year

This item is subject to section 9

 62.25
81315

Exercise physiology health service provided to a person who is of Aboriginal or Torres Strait Islander descent by an eligible exercise physiologist if:

   (a)  a medical practitioner has undertaken a health assessment and identified a need for follow‑up allied health services; and

  (b)  the person is referred to the eligible exercise physiologist by a medical practitioner using a referral form issued by the Department or a referral form that contains all the components of the form issued by the Department; and

   (c)  the person is not an admitted patient of a hospital; and

  (d)  the service is provided to the person individually and in person; and

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

 62.25

   (f)  after the service, the eligible exercise physiologist gives a written report to the referring medical practitioner mentioned in paragraph (b):

         (i)   if the service is the only service under the referral—in relation to that service; or

        (ii)   if the service is the first or the last service under the referral—in relation to that service; or

       (iii)   if neither subparagraph (i) nor (ii) applies but the service involves matters that the referring medical practitioner would reasonably expect to be informed of—in relation to those matters;

to a maximum of 5 services (including any services to which this item or any other item in Part 6 of this Schedule applies) in a calendar year

This item is subject to section 9
81320

Dietetics health service provided to a person who is of Aboriginal or Torres Strait Islander descent by an eligible dietician if:

   (a)  a medical practitioner has undertaken a health assessment and identified a need for follow‑up allied health services; and

  (b)  the person is referred to the eligible dietician by a medical practitioner using a referral form issued by the Department or a referral form that contains all the components of the form issued by the Department; and

   (c)  the person is not an admitted patient of a hospital; and

  (d)  the service is provided to the person individually and in person; and

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

   (f)  after the service, the eligible dietician gives a written report to the referring medical practitioner mentioned in paragraph (b):

         (i)   if the service is the only service under the referral—in relation to that service; or

        (ii)   if the service is the first or the last service under the referral—in relation to that service; or

       (iii)   if neither subparagraph (i) nor (ii) applies but the service involves matters that the referring medical practitioner would reasonably expect to be informed of—in relation to those matters;

to a maximum of 5 services (including any services to which this item or any other item in Part 6 of this Schedule applies) in a calendar year

This item is subject to section 9

 62.25
81325

Mental health service provided to a person who is of Aboriginal or Torres Strait Islander descent by an eligible mental health worker if:

   (a)  a medical practitioner has undertaken a health assessment and identified a need for follow‑up allied health services; and

  (b)  the person is referred to the eligible mental health worker by a medical practitioner using a referral form issued by the Department or a referral form that contains all the components of the form issued by the Department; and

   (c)  the person is not an admitted patient of a hospital; and

  (d)  the service is provided to the person individually and in person; and

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

 62.25

   (f)  after the service, the eligible mental health worker gives a written report to the referring medical practitioner mentioned in paragraph (b):

         (i)   if the service is the only service under the referral—in relation to that service; or

        (ii)   if the service is the first or the last service under the referral—in relation to that service; or

       (iii)   if neither subparagraph (i) nor (ii) applies but the service involves matters that the referring medical practitioner would reasonably expect to be informed of—in relation to those matters;

to a maximum of 5 services (including any services to which this item or any other item in Part 6 of this Schedule applies) in a calendar year

This item is subject to section 9
81330

Occupational therapy health service provided to a person who is of Aboriginal or Torres Strait Islander descent by an eligible occupational therapist if:

   (a)  a medical practitioner has undertaken a health assessment and identified a need for follow‑up allied health services; and

  (b)  the person is referred to the eligible occupational therapist by a medical practitioner using a referral form issued by the Department or a referral form that contains all the components of the form issued by the Department; and

   (c)  the person is not an admitted patient of a hospital; and

  (d)  the service is provided to the person individually and in person; and

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

 62.25

   (f)  after the service, the eligible occupational therapist gives a written report to the referring medical practitioner mentioned in paragraph (b):

         (i)   if the service is the only service under the referral—in relation to that service; or

        (ii)   if the service is the first or the last service under the referral—in relation to that service; or

       (iii)   if neither subparagraph (i) nor (ii) applies but the service involves matters that the referring medical practitioner would reasonably expect to be informed of—in relation to those matters;

to a maximum of 5 services (including any services to which this item or any other item in Part 6 of this Schedule applies) in a calendar year

This item is subject to section 9
81335

Physiotherapy health service provided to a person who is of Aboriginal or Torres Strait Islander descent by an eligible physiotherapist if:

   (a)  a medical practitioner has undertaken a health assessment and identified a need for follow‑up allied health services; and

 62.25

  (b)  the person is referred to the eligible physiotherapist by a medical practitioner using a referral form issued by the Department or a referral form that contains all the components of the form issued by the Department; and

   (c)  the person is not an admitted patient of a hospital; and

  (d)  the service is provided to the person individually and in person; and

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

   (f)  after the service, the eligible physiotherapist gives a written report to the referring medical practitioner mentioned in paragraph (b):

         (i)   if the service is the only service under the referral—in relation to that service; or

        (ii)   if the service is the first or the last service under the referral—in relation to that service; or

       (iii)   if neither subparagraph (i) nor (ii) applies but the service involves matters that the referring medical practitioner would reasonably expect to be informed of—in relation to those matters;

to a maximum of 5 services (including any services to which this item or any other item in Part 6 of this Schedule applies) in a calendar year

This item is subject to section 9
81340

Podiatry health service provided to a person who is of Aboriginal or Torres Strait Islander descent by an eligible podiatrist if:

   (a)  a medical practitioner has undertaken a health assessment and identified a need for follow‑up allied health services; and

  (b)  the person is referred to the eligible podiatrist by a medical practitioner using a referral form issued by the Department or a referral form that contains all the components of the form issued by the Department; and

   (c)  the person is not an admitted patient of a hospital; and

  (d)  the service is provided to the person individually and in person; and

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

   (f)  after the service, the eligible podiatrist gives a written report to the referring medical practitioner mentioned in paragraph (b):

         (i)   if the service is the only service under the referral—in relation to that service; or

        (ii)   if the service is the first or the last service under the referral – in relation to that service; or

       (iii)   if neither subparagraph (i) nor (ii) applies but the service involves matters that the referring medical practitioner would reasonably expect to be informed of—in relation to those matters;

to a maximum of 5 services (including any services to which this item or any other item in Part 6 of this Schedule applies) in a calendar year

This item is subject to section 9

 62.25
81345

Chiropractic health service provided to a person who is of Aboriginal or Torres Strait Islander descent by an eligible chiropractor if:

   (a)  a medical practitioner has undertaken a health assessment and identified a need for follow‑up allied health services; and

  (b)  the person is referred to the eligible chiropractor by a medical practitioner using a referral form issued by the Department or a referral form that contains all the components of the form issued by the Department; and

   (c)  the person is not an admitted patient of a hospital; and

  (d)  the service is provided to the person individually and in person; and

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

 62.25

   (f)  after the service, the eligible chiropractor gives a written report to the referring medical practitioner mentioned in paragraph (b):

         (i)   if the service is the only service under the referral—in relation to that service; or

        (ii)   if the service is the first or the last service under the referral—in relation to that service; or

       (iii)   if neither subparagraph (i) nor (ii) applies but the service involves matters that the referring medical practitioner would reasonably expect to be informed of—in relation to those matters;

to a maximum of 5 services (including any services to which this item or any other item in Part 6 of this Schedule applies) in a calendar year

This item is subject to section 9
81350

Osteopathy health service provided to a person who is of Aboriginal or Torres Strait Islander descent by an eligible osteopath if:

   (a)  a medical practitioner has undertaken a health assessment and identified a need for follow‑up allied health services; and

  (b)  the person is referred to the eligible osteopath by a medical practitioner using a referral form issued by the Department or a referral form that contains all the components of the form issued by the Department; and

   (c)  the person is not an admitted patient of a hospital; and

  (d)  the service is provided to the person individually and in person; and

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

   (f)  after the service, the eligible osteopath gives a written report to the referring medical practitioner mentioned in paragraph (b):

         (i)   if the service is the only service under the referral—in relation to that service; or

        (ii)   if the service is the first or the last service under the referral—in relation to that service; or

       (iii)   if neither subparagraph (i) nor (ii) applies but the service involves matters that the referring medical practitioner would reasonably expect to be informed of—in relation to those matters;

to a maximum of 5 services (including any services to which this item or any other item in Part 6 of this Schedule applies) in a calendar year

This item is subject to section 9

 62.25
81355

Psychology health service provided to a person who is of Aboriginal or Torres Strait Islander descent by an eligible psychologist if:

   (a)  a medical practitioner has undertaken a health assessment and identified a need for follow‑up allied health services; and

  (b)  the person is referred to the eligible psychologist by a medical practitioner using a referral form issued by the Department or a referral form that contains all the components of the form issued by the Department; and

   (c)  the person is not an admitted patient of a hospital; and

  (d)  the service is provided to the person individually and in person; and

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

 62.25

   (f)  after the service, the eligible psychologist gives a written report to the referring medical practitioner mentioned in paragraph (b):

         (i)   if the service is the only service under the referral—in relation to that service; or

        (ii)   if the service is the first or the last service under the referral—in relation to that service; or

       (iii)   if neither subparagraph (i) nor (ii) applies but the service involves matters that the referring medical practitioner would reasonably expect to be informed of—in relation to those matters;

to a maximum of 5 services (including any services to which this item or any other item in Part 6 of this Schedule applies) in a calendar year

This item is subject to section 9
81360

Speech pathology health service provided to a person who is of Aboriginal or Torres Strait Islander descent by an eligible speech pathologist if:

   (a)  a medical practitioner has undertaken a health assessment and identified a need for follow‑up allied health services; and

  (b)  the person is referred to the eligible speech pathologist by a medical practitioner using a referral form issued by the Department or a referral form that contains all the components of the form issued by the Department; and

   (c)  the person is not an admitted patient of a hospital; and

  (d)  the service is provided to the person individually and in person; and

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

   (f)  after the service, the eligible speech pathologist gives a written report to the referring medical practitioner mentioned in paragraph (b):

         (i)   if the service is the only service under the referral—in relation to that service; or

        (ii)   if the service is the first or the last service under the referral—in relation to that service; or

       (iii)   if neither subparagraph (i) nor (ii) applies but the service involves matters that the referring medical practitioner would reasonably expect to be informed of—in relation to those matters;

to a maximum of 5 services (including any services to which this item or any other item in Part 6 of this Schedule applies) in a calendar year

This item is subject to section 9

 62.25

Part 7—Services and fees—audiology services (diagnostic)

Group M15 – Diagnostic audiology services
Item Service Fee($)
82300

Audiology health service, consisting of brain stem evoked response audiometry, performed on a person by an eligible audiologist if:

   (a)  the service is performed pursuant to a written request made by an eligible practitioner to assist the eligible practitioner in the diagnosis and/or treatment and/or management of ear disease or a related disorder in the person; and

  (b)  the eligible practitioner is a specialist in the specialty of otolaryngology head and neck surgery; and

   (c)  the service is not performed for the purpose of a hearing screening; and

  (d)  the person is not an admitted patient of a hospital; and

   (e)  the service is performed on the person individually and in person; and

   (f)  after the service, the eligible audiologist provides a copy of the results of the service performed, together with relevant comments in writing that the eligible audiologist has on those results, to the eligible practitioner who requested the service; and

   (g)  a service to which item 11300 applies has not been performed on the person on the same day. 

This item is subject to sections 9 and 12.

 153.95

82306

Audiology health service, consisting of non-determinate audiometry performed on a person by an eligible audiologist if:

   (a)  the service is performed pursuant to a written request made by an eligible practitioner to assist the eligible practitioner in the diagnosis and/or treatment and/or management of ear disease or a related disorder in the person; and

  (b)  the eligible practitioner is a specialist in the specialty of otolaryngology head and neck surgery; and

   (c)  the service is not performed for the purpose of a hearing screening; and

  (d)  the person is not an admitted patient of a hospital; and

   (e)  the service is performed on the person individually and in person; and

   (f)  after the service, the eligible audiologist provides a copy of the results of the service performed, together with relevant comments in writing that the eligible audiologist has on those results, to the eligible practitioner who requested the service; and

   (g)  a service to which item 11306 applies has not been performed on the person on the same day. 

This item is subject to sections 9 and 12.

 17.50
82309

Audiology health service, consisting of an air conduction audiogram performed on a person by an eligible audiologist if:

   (a)  the service is performed pursuant to a written request made by an eligible practitioner to assist the eligible practitioner in the diagnosis and/or treatment and/or management of ear disease or a related disorder in the person; and

  (b)  the eligible practitioner is:       

        (i)   a specialist in the specialty of otolaryngology head and neck surgery; or

        (ii)   a specialist or consultant physician in the specialty of neurology; and

   (c)  the service is not performed for the purpose of a hearing screening; and

  (d)  the person is not an admitted patient of a hospital; and

   (e)  the service is performed on the person individually and in person; and

   (f)  after the service, the eligible audiologist provides a copy of the results of the service performed, together with relevant comments in writing that the eligible audiologist has on those results, to the eligible practitioner who requested the service; and

   (g)  a service to which item 11309 applies has not been performed on the person on the same day. 

This item is subject to sections 9 and 12.

 21.05
82312

Audiology health service, consisting of an air and bone conduction audiogram or air conduction and speech discrimination audiogram performed on a person by an eligible audiologist if:

   (a)  the service is performed pursuant to a written request made by an eligible practitioner to assist the eligible practitioner in the diagnosis and/or treatment and/or management of ear disease or a related disorder in the person; and

  (b)  the eligible practitioner is:       

        (i)   a specialist in the specialty of otolaryngology head and neck surgery; or

        (ii)   a specialist or consultant physician in the specialty of neurology; and

   (c)  the service is not performed for the purpose of a hearing screening; and

  (d)  the person is not an admitted patient of a hospital; and

   (e)  the service is performed on the person individually and in person; and

   (f)  after the service, the eligible audiologist provides a copy of the results of the service performed, together with relevant comments in writing that the eligible audiologist has on those results, to the eligible practitioner who requested the service; and

   (g)  a service to which item 11312 applies has not been performed on the person on the same day.

This item is subject to sections 9 and 12.

 29.70
82315

Audiology health service, consisting of an air and bone conduction and speech discrimination audiogram performed on a person by an eligible audiologist if:

   (a)  the service is performed pursuant to a written request made by an eligible practitioner to assist the eligible practitioner in the diagnosis and/or treatment and/or management of ear disease or a related disorder in the person; and

  (b)  the eligible practitioner is:       

        (i)   a specialist in the specialty of otolaryngology head and neck surgery; or

        (ii)   a specialist or consultant physician in the specialty of neurology; and

   (c)  the service is not performed for the purpose of a hearing screening; and

  (d)  the person is not an admitted patient of a hospital; and

   (e)  the service is performed on the person individually and in person; and

   (f)  after the service, the eligible audiologist provides a copy of the results of the service performed, together with relevant comments in writing that the eligible audiologist has on those results, to the eligible practitioner who requested the service; and

   (g)  a service to which item 11315 applies has not been performed on the person on the same day.

This item is subject to sections 9 and 12.

 39.35
82318

Audiology health service, consisting of an air and bone conduction and speech discrimination audiogram with other cochlear tests performed on a person by an eligible audiologist if:

   (a)  the service is performed pursuant to a written request made by an eligible practitioner to assist the eligible practitioner in the diagnosis and/or treatment and/or management of ear disease or a related disorder in the person; and

  (b)  the eligible practitioner is:       

        (i)   a specialist in the specialty of otolaryngology head and neck surgery; or

        (ii)   a specialist or consultant physician in the specialty of neurology; and

   (c)  the service is not performed for the purpose of a hearing screening; and

  (d)  the person is not an admitted patient of a hospital; and

   (e)  the service is performed on the person individually and in person; and

   (f)  after the service, the eligible audiologist provides a copy of the results of the service performed, together with relevant comments in writing that the eligible audiologist has on those results, to the eligible practitioner who requested the service; and

   (g)  a service to which item 11318 applies has not been performed on the person on the same day.

This item is subject to sections 9 and 12.

 48.60
82324

Audiology health service, consisting of an impedance audiogram involving tympanometry and measurement of static compliance and acoustic reflex performed on a person by an eligible audiologist (not being a service associated with a service to which item 82309, 82312, 82315 or 82318 applies) if:

   (a)  the service is performed pursuant to a written request made by an eligible practitioner to assist the eligible practitioner in the diagnosis and/or treatment and/or management of ear disease or a related disorder in the person; and

  (b)  the eligible practitioner is:       

        (i)   a specialist in the specialty of otolaryngology head and neck surgery; or

        (ii)   a specialist or consultant physician in the specialty of neurology; and

   (c)  the service is not performed for the purpose of a hearing screening; and

  (d)  the person is not an admitted patient of a hospital; and

   (e)  the service is performed on the person individually and in person; and

   (f)  after the service, the eligible audiologist provides a copy of the results of the service performed, together with relevant comments in writing that the eligible audiologist has on those results, to the eligible practitioner who requested the service; and

   (g)  a service to which item 11324 applies has not been performed on the person on the same day.

This item is subject to sections 9 and 12.

 26.30
82327

Audiology health service, consisting of an impedance audiogram involving tympanometry and measurement of static compliance and acoustic reflex performed on a person by an eligible audiologist (being a service associated with a service to which item 82309, 82312, 82315 or 82318 applies) if:

   (a)  the service is performed pursuant to a written request made by an eligible practitioner to assist the eligible practitioner in the diagnosis and/or treatment and/or management of ear disease or a related disorder in the person; and

  (b)  the eligible practitioner is:       

        (i)   a specialist in the specialty of otolaryngology head and neck surgery; or

        (ii)   a specialist or consultant physician in the specialty of neurology; and

   (c)  the service is not performed for the purpose of a hearing screening; and

  (d)  the person is not an admitted patient of a hospital; and

   (e)  the service is performed on the person individually and in person; and

   (f)  after the service, the eligible audiologist provides a copy of the results of the service performed, together with relevant comments in writing that the eligible audiologist has on those results, to the eligible practitioner who requested the service; and

15.80

   (g)  a service to which item 11327 applies has not been performed on the person on the same day.

This item is subject to sections 9 and 12.
82332

Audiology health service, consisting of an oto-acoustic emission audiometry for the detection of permanent congenital hearing impairment performed by an eligible audiologist on an infant or child in circumstances in which:

   (a)  the service is performed pursuant to a written request made by an eligible practitioner who is:

        (i)   a specialist in the specialty of otolaryngology head and neck surgery; or

        (ii)   a specialist or consultant physician in the specialty of neurology; and

  (b)  the infant or child is at risk due to 1 or more of the following factors:

        (i)   admission to a neonatal intensive care unit;

        (ii)   family history of hearing impairment;

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

       (iv)   birthweight less than 1.5kg;

        (v)   craniofacial deformity;

       (vi)   birth asphyxia;

      (vii)   chromosomal abnormality, including Down Syndrome;

     (viii)   exchange transfusion; and

   (c)  middle ear pathology has been excluded by specialist opinion; and

  (d)  the infant or child is not an admitted patient of a hospital; and

   (e)  the service is performed on the infant or child individually and in person; and

   (f)  after the service, the eligible audiologist provides a copy of the results of the service performed, together with relevant comments in writing that the eligible audiologist has on those results, to the eligible practitioner who requested the service; and

   (g)  a service to which item 11332 applies has not been performed on the infant or child on the same day.

This item is subject to sections 9 and 12.

 46.85
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