Medicare Benefits Schedule

Summary of Changes

Effective 1 July 2011

© Commonwealth of Australia 2011

Online ISBN: 978-1-74241-480-5
Print Copyright

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Publications Approval Number: D0424
Summary of Additions, Deletions, and Revisions undertaken since 1 January 2011

New Items are indicated as “New”, Amended item descriptions are indicated as “Amend” and amended fees are indicated as “Fee”.
New Items (New)
1 July 2011

99		112		137		139		149		288		389		2100		2122	
2125		2126		2137		2138		2143		2147		2179		2195		2199
2220		2820		3015		6016		10983	10984	13210	14201	14202
16399	17609	18361	37217	55005	55007	55008	55010	55011
55013	55014	55016	55017	55019	55020	55022	55023	55025
55026	55059	55060	55061	55062	55063	55064	55119	55120
55121	55122	55123	55125	55131	55136	55220	55221	55222
55223	55224	55226	55227	55228	55229	55230	55232	55233
55235	55236	55601	55604	55701	55702	55710	55711	55713
55714	55716	55717	55719	55720	55722	55724	55726	55727
55730	55732	55734	55735	55737	55760	55763	55765	55767
55769	55771	55773	55775	55801	55803	55805	55807	55809
55811	55813	55815	55817	55819	55821	55823	55825	55827
55829	55831	55833	55835	55837	55839	55841	55843	55845
55847	55849	55851	55853	55855	56025	56026	57360	57361
57529	57530	57532	57533	57535	57536	57538	57539	57702
57705	57708	57711	57714	57717	57723	57911	57914	57917
57920	57923	57926	57929	57932	57935	57938	57941	57944
57947	57950	57953	57956	57959	57962	57965	57968	58102
58105	58111	58114	58117	58123	58124	58126	58127	58302
58308	58502	58505	58508	58511	58523	58526	58529	58702
58708	58717	58720	58723	58902	58905	58911	58914	58917
58920	58923	58926	58929	58935	58938	58941	59104	59301
59304	59307	59310	59313	59315	59319	59504	59701	59704
59713	59716	59719	59725	59734	59737	59740	59752	59755
59761	59764	60101	60501	60504	60507	60510	61110	61575
61620	61632	61651	61652	61653	61654	61655	61656	61657
61658	61659	61660	61661	61662	61663	61664	61665	61666
61667	61668	61669	61670	61671	61672	61673	61674	61675
61676	61677	61678	61679	61680	61681	61682	61683	61684
61685	61686	61687	61688	61689	61690	61691	61692	61693
61694	61695	61696	61697	61698	61699	61700	61701	61702
61703	61704	61705	61706	61707	61708	61709	61710	61711
61712	61713	61714	61715	61716	61717	61718	61719	61729
63013	63014	63016	63017	63074	63075	63076	63077	63078
63079	63080	63081	63082	63083	63084	63085	63104	63117
63119	63134	63135	63136	63157	63158	63186	63187	63188
63189	63190	63191	63192	63193	63194	63207	63208	63257
63258	63259	63260	63261	63262	63263	63264	63265	63282
63283	63284	63285	63310	63311	63313	63341	63342	63343
63345	63346	63347	63348	63364	63392	63393	63394	63407
63408	63419	63432	63433	63447	63448	63449	63455	63457
63458	63479	63481	63484	63486	66610	69380	73066	73067
73325	73326	73327	82030	82035	82150	82151	82152	82220
82221	82222	82223	82224	82225

Deleted Items
1 July 2011

15360	15363	15541	38321	38324	38327	38330	61535	61544
61556	61562	61568	61574	61580	61589	61592	61613	61619
61625	61631	61634	61637	61643	61649

Amended Description (Amend)
1 July 2011

135		289		12250	21981	37218	41767	41861	47915	47916
49833	49836	49837	49838	55600	55603	61538	61541	61553
61565	61571	61616	61622	61628	61640	61646	66605	66607
69333	71059	73051	73063	82000	82005	82010	82015	82020
82025

Assist (Added)

No assist added to items.

Amended Fee (Fee)
1 July 2011

66659	66660	71057	71059	71200		

SUMMARY OF CHANGES 
REVIEW OF GENERAL MEDICAL SERVICES

•	Better Start for Children with Disability – This initiative will deliver services on a similar basis to the Helping Children with Autism Program.  A new group has been created, ‘Group A29 – Early intervention services for children with autism, pervasive developmental disorder or disability’ which contains three items, 135, 137 and 139: item 135 has been moved into Group A29 from Group A4; items 137 and 139 are new items for disability.  A new Explanatory Note A14 has been included.  ‘Group M10 – Autism, pervasive developmental disorder and disability services’ contains the amended items 82000-82025 and the new items 80230 and 80235 for allied health professional services for children with autism, pervasive developmental disorder or disability.  Explanatory Note M.10.1 has been amended.
•	Telehealth - 33  new items have been introduced on 1 July 2011 to allow Medicare Benefits to be paid for eligible Telehealth specialist consultations and clinical support services. These items have been introduced as part of the 2010-2011 budget  initiative, "Connecting Health Services with the Future: Modernising Medicare by Providing Rebates for Online Consultations.”
•	Facial Injections of Poly-L-lactic acid  - items 14201 and 14202 are being introduced following an MSAC recommendation that public funding be supported for the procedure for severe facial lipoatrophy caused by antiretroviral therapy.
•	Botulinum toxin - New item for Injection of Botulinum toxin (Botox) for the treatment of moderate to severe spasticity in the upper limbs due to cerebral palsy, in a patient aged 2 to 17 years.
•	Intravascular Brachytherapy (IVBT) for Coronary Artery Restenoses - IVBT items 15360, 15363, 15541, 38321, 38324, 38327, 38330 are being removed from the MBS following an MSAC recommendation that the procedure is no longer clinically relevant.
•	Anaesthetic amendment - the operational restriction that the anaesthetic allergy testing be performed in association with anaesthetic has been removed
•	Gold fiducial seeds - New interim item 37217 for the insertion of gold fiducial seeds into the prostate as markers for image guided radiotherapy (IGRT).
•	Amendments to Ear, Nose and Throat items – item 41767 has been amended to expand the range of clinically relevant approaches that may be used for nasopharyngeal tumours. Item 41861 has been amended to allow for the removal of all benign lesions of the larynx.

REVIEW OF THE DIAGNOSTIC IMAGING SERVICES

From 1 July 2011 all services listed in the Diagnostic Imaging Services Table of the Medicare Benefits Schedule (MBS), excluding Positron Emission Tomography (PET) services, preparation items 60918 and 60927 and MRI modifier items in subgroup 22, will have a mirror NK item (50% of the Schedule Fee) for diagnostic imaging services provided on aged equipment.  This rule, known as ‘capital sensitivity’, is currently in place for computed tomography (CT) and angiography and will be extended to improve the quality of diagnostic imaging services by encouraging providers to upgrade and replace aged equipment as appropriate.

REVIEW OF THE  PATHOLOGY SERVICES

Seven new items, 66610, 69380, 73066, 73067, 73325, 73326 and 73327 have been introduced into the Pathology Services Table with a further six items, 66605, 66607, 69333, 71057, 71059 and 71200 amended to reflect a change either the descriptor or schedule fee.

SPECIALIST	SPECIALIST	
	GROUP A3 - SPECIALIST ATTENDANCES TO WHICH NO OTHER ITEM APPLIES	
New
99	
The initiation of a professional attendance via video conference by a specialist in the practice of his or her specialty, rendered to a patient who is:
a)	a care recipient receiving care in a residential aged care service; or
b)	at an Aboriginal Medical Service or Aboriginal Community Controlled Health Service in relation to which a direction made under subsection 19(2) of the Act applies; or
c)	located outside an inner metropolitan area, not being an admitted patient;
	being a service associated with item 104 or 105.

Derived Fee: 50% of the fee for the associated item. Benefit: 85% of derived fee.	
CONSULTANT PHYSICIAN	CONSULTANT PHYSICIAN	
	GROUP A4 - CONSULTANT PHYSICIAN ATTENDANCES TO WHICH NO OTHER ITEM APPLIES	
New
112	
The initiation of a professional attendance via video conference by a consultant physician in the practice of his or her specialty, rendered to a patient who is:
a)	a care recipient receiving care in a residential aged care service; or
b)	at an Aboriginal Medical Service or Aboriginal Community Controlled Health Service in relation to which a direction made under subsection 19(2) of the Act applies; or
c)	located outside an inner metropolitan area, not being an admitted patient;
	being a service associated with item 110, 116, 119, 132 or 133.

Derived Fee: 50% of the fee for the associated item. Benefit: 85% of derived fee.	

ATTENDANCES	ATTENDANCES	
	GROUP A29 - EARLY INTERVENTION SERVICES FOR CHILDREN WITH AUTISM, PERVASIVE DEVELOPMENTAL DISORDER OR DISABILITY	
Amend
135	
CONSULTANT PAEDIATRICIAN, REFERRED CONSULTATION FOR ASSESSMENT, DIAGNOSIS AND DEVELOPMENT OF A TREATMENT AND MANAGEMENT PLAN FOR AUTISM OR ANY OTHER PERVASIVE DEVELOPMENTAL DISORDER - SURGERY OR HOSPITAL 

Professional attendance of at least 45 minutes duration at consulting rooms or hospital, by a consultant physician in his or her specialty of paediatrics, for assessment, diagnosis and the preparation of a treatment and management plan for a child aged under 13 years, with autism or any other pervasive developmental disorder, who has been referred to the consultant paediatrician by a medical practitioner, if the consultant paediatrician does the following:

(a)	undertakes a comprehensive assessment of the child and forms a diagnosis (using the assistance of one or more 	allied health providers where appropriate)
(b)	develops a treatment and management plan which must include the following:
	(i)	the outcomes of the assessment;
	(ii)	the diagnosis or diagnoses;
	(iii)	opinion on risk assessment;
	(iv)	treatment options and decisions;
	(v)	appropriate medication recommendations, where necessary.
(c)	provides a copy of the treatment and management plan to the:
	(i)	referring practitioner; and
	(ii)	relevant allied health providers (where appropriate).

Not being an attendance on a child in respect of whom payment has previously been made under this item or items 137, 139 or 289.
(See para A13 of explanatory notes to this Category)
Fee: $253.90	Benefit: 75% = $190.45	85% = $215.85	
New
137	
SPECIALIST OR CONSULTANT PHYSICIAN, REFERRED CONSULTATION FOR ASSESSMENT, DIAGNOSIS AND DEVELOPMENT OF A TREATMENT AND MANAGEMENT PLAN FOR A CHILD WITH AN ELIGIBLE DISABILITY - SURGERY OR HOSPITAL 

Professional attendance of at least 45 minutes duration, at consulting rooms or hospital, by a specialist or consultant physician, for assessment, diagnosis and the preparation of a treatment and management plan for a child aged under 13 years, with an eligible disability, who has been referred to the specialist or consultant physician by a medical practitioner, if the specialist or consultant physician does the following:

(a)	undertakes a comprehensive assessment of the child and forms a diagnosis (using the assistance of one or more 	allied health providers where appropriate)
(b)	develops a treatment and management plan which must include the following:
	(i)	the outcomes of the assessment;
	(ii)	the diagnosis or diagnoses;
	(iii)	opinion on risk assessment;
	(iv)	treatment options and decisions;
	(v)	appropriate medication recommendations, where necessary.
(c)	provides a copy of the treatment and management plan to the:
	(i)	referring practitioner; and
	(ii)	relevant allied health providers (where appropriate).

Not being an attendance on a child in respect of whom payment has previously been made under this item or items 135, 139 or 289.
(See para A14 of explanatory notes to this Category)
Fee: $253.90	Benefit: 75% = $190.45	85% = $215.85	

ATTENDANCES	ATTENDANCES	
New
139	
GENERAL PRACTITIONER CONSULTATION FOR ASSESSMENT, DIAGNOSIS AND DEVELOPMENT OF A TREATMENT AND MANAGEMENT PLAN FOR A CHILD WITH AN ELIGIBLE DISABILITY

Professional attendance of at least 45 minutes duration, at consulting rooms, by a general practitioner, for assessment, diagnosis and the preparation of a treatment and management plan for a child aged under 13 years, with an eligible disability, if the general practitioner does the following:

(a)	undertakes a comprehensive assessment of the child and forms a diagnosis (using the assistance of one or more 	allied health providers where appropriate)
(b)	develops a treatment and management plan which must include the following:
	(i)	the outcomes of the assessment;
	(ii)	the diagnosis or diagnoses;
	(iii)	opinion on risk assessment;
	(iv)	treatment options and decisions;
	(v)	appropriate medication recommendations, where necessary.
(c)	provides a copy of the treatment and management plan to the:
	(i)	relevant allied health providers (where appropriate).

Not being an attendance on a child in respect of whom payment has previously been made under this item or items 135, 139 or 289.
(See para A14 of explanatory notes to this Category)
Fee: $125.00	Benefit: 100% = $125.00	
CONSULT PHYSICIAN/SPECIALIST	CONSULT PHYSICIAN/SPECIALIST	
	GROUP A28 - GERIATRIC MEDICINE	
New
149	
The initiation of a professional attendance via video conference rendered by a consultant physician or specialist practising in the specialty of geriatric medicine to a patient who is:
a)	a care recipient receiving care in a residential aged care service; or
b)	at an Aboriginal Medical Service or Aboriginal Community Controlled Health Service in relation to which a direction made under subsection 19(2) of the Act applies; or
c)	located outside an inner metropolitan area, not being an admitted patient;
	being a service associated with item 141 or 143.

Derived Fee: 50% of the fee for the associated item. Benefit: 85% of derived fee.	

CONSULTANT PSYCHIATRIST	CONSULTANT PSYCHIATRIST	
	GROUP A8 - CONSULTANT PSYCHIATRIST ATTENDANCES TO WHICH NO OTHER ITEM APPLIES	
New
288	
The initiation of a professional attendance via video conference rendered by a consultant physician practising in the specialty of psychiatry to a patient who is:
a)	a care recipient receiving care in a residential aged care service; or
b)	at an Aboriginal Medical Service or Aboriginal Community Controlled Health Service in relation to which a direction made under subsection 19(2) of the Act applies; or
c)	located outside an inner metropolitan area, not being an admitted patient;
	being a service associated with item 291, 293, 296, 300, 302, 304, 306, 308, 310, 312, 314, 316, 318, 319, 348, 350 or 352.

Derived Fee: 50% of the fee for the associated item. Benefit: 85% of derived fee.	
Amend
289	
CONSULTANT PSYCHIATRIST, REFERRED CONSULTATION FOR ASSESSMENT, DIAGNOSIS AND DEVELOPMENT OF A TREATMENT AND MANAGEMENT PLAN FOR AUTISM OR ANY OTHER PERVASIVE DEVELOPMENTAL DISORDER - SURGERY OR HOSPITAL 

Professional attendance of at least 45 minutes duration, at consulting rooms or hospital, by a consultant physician in his or her specialty of psychiatry, for assessment, diagnosis and the preparation of a treatment and management plan for a child aged under 13 years, with autism or any other pervasive developmental disorder, who has been referred to the consultant psychiatrist by a medical practitioner, if the consultant psychiatrist does the following:

(a)	undertakes a comprehensive assessment of the child and forms a diagnosis (using the assistance of one or more 	allied health providers where appropriate)
(b)	develops a treatment and management plan which must include the following:
	(i)	the outcomes of the assessment;
	(ii)	the diagnosis or diagnoses;
	(iii)	opinion on risk assessment;
	(iv)	treatment options and decisions;
	(v)	appropriate medication recommendations, where necessary.
(c)	provides a copy of the treatment and management plan to the:
	(i)	referring practitioner; and
	(ii)	relevant allied health providers (where appropriate).

Not being an attendance on a child in respect of whom payment has previously been made under this item or items 135, 137 or 139.
(See para A13 of explanatory notes to this Category)
Fee: $253.90	Benefit: 75% = $190.45	85% = $215.85	
CONSULT OCCUPATIONAL PHYSICIAN	CONSULT OCCUPATIONAL PHYSICIAN	
	GROUP A12 - CONSULTANT OCCUPATIONAL PHYSICIAN ATTENDANCES TO WHICH NO OTHER ITEM APPLIES	
New
389	
The initiation of a professional attendance via video conference rendered by a consultant occupational physician practising in the specialty of occupational medicine, to a patient who is:
a)	a care recipient receiving care in a residential aged care service; or
b)	at an Aboriginal Medical Service or Aboriginal Community Controlled Health Service in relation to which a direction made under subsection 19(2) of the Act applies; or
c)	located outside an inner metropolitan area, not being an admitted patient;
	being a service associated with item 385 or 386.

Derived Fee: 50% of the fee for the associated item. Benefit: 85% of derived fee.	

ATTENDANCES	TELEHEALTH ATTENDANCES	
	GROUP A30 - MEDICAL PRACTITIONER (INCLUDING A GENERAL PRACTITIONER, SPECIALIST OR CONSULTANT PHYSICIAN) TELEHEALTH ATTENDANCES	
	SUBGROUP 1 - TELEHEALTH ATTENDANCE AT CONSULTING ROOMS, HOME VISITS OR OTHER INSTITUTIONS	
New
2100	
Level A – Telehealth attendance at consulting rooms
A professional attendance at consulting rooms (not being a service to which any other item applies) lasting at least 5 minutes (whether or not continuous) by a medical practitioner that requires the provision of clinical support to a patient who is:
a)	located outside an inner metropolitan area, who is not an admitted patient; or
b)	at an Aboriginal Medical Service or Aboriginal Community Controlled Health Service in relation to which a direction made under subsection 19(2) of the Act applies; 
and who is participating in a video consultation with a specialist or consultant physician.
Fee: $21.60	Benefit: 100% = $21.60	
New
2122	
Level A – Telehealth attendance other than at consulting rooms
A professional attendance other than at consulting rooms (not being a service to which any other item applies) lasting at least 5 minutes (whether or not continuous) by a medical practitioner that requires the provision of clinical support to a patient who is located outside an inner metropolitan area, not being an admitted patient, and who is participating in a video consultation with a specialist or consultant physician, on 1 occasion - each patient.
Derived Fee: The fee for item 2100 plus $24.50 divided by the number of patients seen, up to a maximum of six patients. For seven or more patients - the fee for item 2100 plus $1.85 per patient.	
	SUBGROUP 2 - TELEHEALTH ATTENDANCE AT A RESIDENTIAL AGED CARE FACILITY	
New
2125	
Level A - Telehealth attendance at a residential aged care facility
A professional attendance by a medical practitioner (not being a service to which any other item applies) lasting at least 5 minutes (whether or not continuous) that requires the provision of clinical support to a patient who is:
a)	a care recipient receiving care in a residential aged care service (other than a professional attendance at a self-contained unit); or 
b)	at consulting rooms situated within such a complex where the patient is a resident of the aged care service (excluding accommodation in a self-contained unit) 
and who is participating in a video consultation with a specialist or consultant physician, on 1 occasion - each patient.
Derived Fee: The fee for item 2100 plus $44.05 divided by the number of patients seen, up to a maximum of six patients. For seven or more patients - the fee for item 2100 plus $3.15 per patient.	
	SUBGROUP 1 - TELEHEALTH ATTENDANCE AT CONSULTING ROOMS, HOME VISITS OR OTHER INSTITUTIONS	
New
2126	
Level B - Telehealth attendance at consulting rooms
A professional attendance at consulting rooms (not being a service to which any other item applies) lasting less than 20 minutes (whether or not continuous) by a medical practitioner that requires the provision of clinical support to a patient who is:
a)	located outside an inner metropolitan area, who is not an admitted patient; or
b)	at an Aboriginal Medical Service or Aboriginal Community Controlled Health Service in relation to which a direction made under subsection 19(2) of the Act applies 
and who is participating in a video consultation with a specialist or consultant physician.
Fee: $47.10	Benefit: 100% = $47.10	
New
2137	
Level B – Telehealth attendance other than at consulting rooms
A professional attendance other than at consulting rooms (not being a service to which any other item applies) lasting less than 20 minutes (whether or not continuous) by a medical practitioner that requires the provision of clinical support to a patient who is located outside an inner metropolitan area, not being an admitted patient, and who is participating in a video consultation with a specialist or consultant physician, on 1 occasion - each patient.
Derived Fee: The fee for item 2126 plus $24.50 divided by the number of patients seen, up to a maximum of six patients. For seven or more patients - the fee for item 2126 plus $1.85 per patient.	

ATTENDANCES	TELEHEALTH ATTENDANCES	
	SUBGROUP 2 - TELEHEALTH ATTENDANCE AT A RESIDENTIAL AGED CARE FACILITY	
New
2138	
Level B - Telehealth attendance at residentail aged care facility
A professional attendance by a medical practitioner (not being a service to which any other item applies) lasting less than 20 minutes (whether or not continuous) that requires the provision of clinical support to a patient who is:
a)	a care recipient receiving care in a residential aged care service (other than a professional attendance at a self-contained unit); or 
b)	at consulting rooms situated within such a complex where the patient is a resident of the aged care service (excluding accommodation in a self-contained unit); 
and who is participating in a video consultation with a specialist or consultant physician, on 1 occasion - each patient.
Derived Fee: The fee for item 2126 plus $44.05 divided by the number of patients seen, up to a maximum of six patients. For seven or more patients - the fee for item 2126 plus $3.15 per patient.	
	SUBGROUP 1 - TELEHEALTH ATTENDANCE AT CONSULTING ROOMS, HOME VISITS OR OTHER INSTITUTIONS	
New
2143	
Level C - Telehealth attendance at consulting rooms
A professional attendance at consulting rooms (not being a service to which any other item applies) lasting at least 20 minutes (whether or not continuous) by a medical practitioner that requires the provision of clinical support to a patient who is:
a)	located outside an inner metropolitan area, who is not an admitted patient;
b)	at an Aboriginal Medical Service or Aboriginal Community Controlled Health Service in relation to which a direction made under subsection 19(2) of the Act applies; 
and who is participating in a video consultation with a specialist or consultant physician.
Fee: $91.35	Benefit: 100% = $91.35	
New
2147	
Level C –Telehealth attendance other than at consulting rooms 
A professional attendance other than at consulting rooms (not being a service to which any other items applies) lasting at least 20 minutes (whether or not continuous) by a medical practitioner that requires the provision of clinical support to a patient who is located outside an inner metropolitan area, not being an admitted patient, and who is participating in a video consultation with a specialist or consultant physician, on 1 occasion - each patient.
Derived Fee: The fee for item 2143 plus $24.50 divided by the number of patients seen, up to a maximum of six patients.  For seven or more patients - the fee for item 2143 plus $1.85 per patient.	
	SUBGROUP 2 - TELEHEALTH ATTENDANCE AT A RESIDENTIAL AGED CARE FACILITY	
New
2179	
Level C - Telehealth attendance at residentail aged care facility
A professional attendance by a medical practitioner (not being a service to which any other item applies) lasting at least 20 minutes (whether or not continuous) that requires the provision of clinical support to a patient who is:
a)	a care recipient receiving care in a residential aged care service (other than a professional attendance at a self-contained unit); or 
b)	at consulting rooms situated within such a complex where the patient is a resident of the aged care service (excluding accommodation in a self-contained unit);
and who is participating in a video consultation with a specialist or consultant physician, on 1 occasion - each patient.
Derived Fee: The fee for item 2143 plus $44.05 divided by the number of patients seen, up to a maximum of six patients. For seven or more patients - the fee for item 2143 plus $3.15 per patient.	
	SUBGROUP 1 - TELEHEALTH ATTENDANCE AT CONSULTING ROOMS, HOME VISITS OR OTHER INSTITUTIONS	
New
2195	
Level D - Telehealth attendance at consulting rooms
A professional attendance at consulting rooms (not being a service to which any other item applies) lasting at least 40 minutes (whether or not continuous) by a medical practitioner that requires the provision of clinical support to a patient who is:
a)	located outside an inner metropolitan area, who is not an admitted patient; or
b)	at an Aboriginal Medical Service or Aboriginal Community Controlled Health Service in relation to which a direction made under subsection 19(2) of the Act applies;
and who is participating in a video consultation with a specialist or consultant physician.
Fee: $134.40	Benefit: 100% = $134.40	
New
2199	
Level D – Telehealth attendance other than at consulting rooms
A professional attendance other than at consulting rooms (not being a service to which any other item applies) lasting at least 40 minutes (whether or not continuous) by a medical practitioner that requires the provision of clinical support to a patient who is located outside an inner metropolitan area, not being an admitted patient, and who is participating in a video consultation with a specialist or consultant physician, on 1 occasion - each patient.
Derived Fee: The fee for item 2195 plus $24.50 divided by the number of patients seen, up to a maximum of six patients.  For seven or more patients - the fee for item 2195 plus $1.85 per patient.	

ATTENDANCES	TELEHEALTH ATTENDANCE	
	SUBGROUP 2 - TELEHEALTH ATTENDANCE AT A RESIDENTIAL AGED CARE FACILITY	
New
2220	
Level D - Telehealth attendance at residentail aged care facility
A professional attendance by a medical practitioner (not being a service to which any other item applies) lasting at least 40 minutes (whether or not continuous) that requires the provision of clinical support to a patient who is:
a)	a care recipient receiving care in a residential aged care service (other than a professional attendance at a self-contained unit); or 
b)	at consulting rooms situated within such a complex where the patient is a resident of the aged care service (excluding accommodation in a self-contained unit);
and who is participating in a video consultation with a specialist or consultant physician, on 1 occasion - each patient.
Derived Fee: The fee for item 2195 plus $44.05 divided by the number of patients seen, up to a maximum of six patients.  For seven or more patients - the fee for item 2195 plus $3.15 per patient.	
PAIN AND PALLIATIVE MEDICINE	PAIN MEDICINE	
	GROUP A24 - PAIN AND PALLIATIVE MEDICINE	
	SUBGROUP 1 - PAIN MEDICINE ATTENDANCES	
New
2820	
The initiation of a professional attendance via video conference rendered by a consultant physician or specialist practising in the specialty of pain medicine to a patient who is:
a)	a care recipient receiving care in a residential aged care service; or
b)	at an Aboriginal Medical Service or Aboriginal Community Controlled Health Service in relation to which a direction made under subsection 19(2) of the Act applies; or
c)	located outside an inner metropolitan area, not being an admitted patient;
	being a service associated with item 2801, 2806 or 2814.

Derived Fee: 50% of the fee for the associated item.  Benefit: 85% of derived fee.	
	SUBGROUP 3 - PALLIATIVE MEDICINE ATTENDANCES	
New
3015	
The initiation of a professional attendance via video conference rendered by a consultant physician or specialist practising in the specialty of palliative medicine to a patient who is:
a)	a care recipient receiving care in a residential aged care service; or
b)	at an Aboriginal Medical Service or Aboriginal Community Controlled Health Service in relation to which a direction made under subsection 19(2) of the Act applies; or
c)	located outside an inner metropolitan area, not being an admitted patient;
	being a service associated with item 3005, 3010 or 3014.

Derived Fee: 50% of the fee for the associated item.  Benefit: 85% of derived fee.	
ATTENDANCES	ATTENDANCES	
	GROUP A26 - NEUROSURGERY ATTENDANCES TO WHICH NO OTHER ITEM APPLIES	
New
6016	
The initiation of a professional attendance via video conference rendered by a specialist practising in the specialty of neurosurgery to a patient who is:
a)	a care recipient receiving care in a residential aged care service; or
b)	at an Aboriginal Medical Service or Aboriginal Community Controlled Health Service in relation to which a direction made under subsection 19(2) of the Act applies; or
b)	located outside an inner metropolitan area, not being an admitted patient;
	being a service associated with item 6007, 6009, 6011, 6013 or 6015.

Derived Fee: 50% of the fee for the associated item.  Benefit: 85% of derived fee.	

DIAGNOSTIC	OTHER	
	GROUP D1 - MISCELLANEOUS DIAGNOSTIC PROCEDURES AND INVESTIGATIONS	
	SUBGROUP 10 - OTHER DIAGNOSTIC PROCEDURES AND INVESTIGATIONS	
Amend
12250	
Overnight investigation for sleep apnoea for a period of at least 8 hours duration for a patient aged 18 years or more, if all of the following requirements are met:

(a)  the patient has, before the overnight investigation, been referred to a qualified adult sleep medicine practitioner by a medical practitioner whose clinical opinion is that there is a high probability that the patient has obstructive sleep apnoea; and

(b) the investigation takes place after the qualified adult sleep medicine practitioner has:
      (i)  confirmed the necessity for the investigation; and 
      (ii) communicated this confirmation to the referring medical practitioner; and

(c) during a period of sleep, the investigation involves recording a minimum of seven physiological parameters which must include:
      (i) continuous electro-encephalogram (EEG); and
      (ii) continuous electro-cardiogram (ECG; and
      (iii) airflow; and
      (iv) thoraco-abdominal movement; and
      (v) oxygen saturation; and
      (vi) 2 or more of the following:
           (A) electro-oculogram (EOG);
           (B) chin electro-myogram (EMG);
           (C) body position; and

(d) in the report on of the investigation, the qualified adult sleep medicine practitioner uses the data specified in paragraph (c) to:
      (i) analyse sleep stage, arousals and respiratory events; and
      (ii) assess clinically significant alteration in heart rate; and

(e) the qualified adult sleep medicine practitioner: 
      (i) before the investigation takes place, establishes quality assurance procedures for data acquisition; and
      (ii) personally analyses the data and writes the report on the results of the investigation.
Payable only once in a 12 month period.
(See para D1.26 of explanatory notes to this Category)
Fee: $322.60	Benefit: 75% = $241.95	85% = $274.25	

MISCELLANEOUS	ASSISTED REPRODUCTIVE SERVICES	
	GROUP T1 - MISCELLANEOUS THERAPEUTIC PROCEDURES	
	SUBGROUP 3 - ASSISTED REPRODUCTIVE SERVICES	
New
13210	
The initiation of a professional attendance via video conference rendered by a specialist practising in his or her specialty to a patient who is:
a)	a care recipient receiving care in a residential aged care service; or
b)	at an Aboriginal Medical Service or Aboriginal Community Controlled Health Service in relation to which a direction made under subsection 19(2) of the Act applies; or
c)	located outside an inner metropolitan area, not being an admitted patient;
	being a service associated with item 13209.

Derived Fee: 50% of the fee for the associated item.   Benefit: 85% of derived fee
Extended Medicare Safety Net Cap: $5.00	
	SUBGROUP 13 - OTHER THERAPEUTIC PROCEDURES	
New
14201	
POLY-L-LACTIC ACID, one or more injections of, for the initial session only, for the treatment of severe facial lipoatrophy caused by antiretroviral therapy, when prescribed in accordance with the National Health Act 1953 - once per patient
(See para T1.16 of explanatory notes to this Category)
Fee: $227.90	Benefit: 75% = $170.95	85% = $193.75
Extended Medicare Safety Net Cap: $34.15	
New
14202	
POLY-L-LACTIC ACID, one or more injections of (subsequent sessions), for the continuation of treatment of severe facial lipoatrophy caused by antiretroviral therapy, when prescribed in accordance with the National Health Act 1953
(See para T1.16 of explanatory notes to this Category)
Fee: $115.35	Benefit: 75% = $86.55	85% = $98.05
Extended Medicare Safety Net Cap: $17.30	
OBSTETRICS	OBSTETRICS	
	GROUP T4 - OBSTETRICS	
New
16399	
The initiation of a professional attendance via video conference rendered by a specialist practising in the specialty of obstetrics to a patient who is
a)	a care recipient receiving care in a residential aged care service; or
b)	at an Aboriginal Medical Service or Aboriginal Community Controlled Health Service in relation to which a direction made under subsection 19(2) of the Act applies; or
c)	located outside an inner metropolitan area, not being an admitted patient being a service associated with item 16401, 16404, 16406, 16500, 16590 or 16591.

Derived Fee: 50% of the fee for the associated item.  Benefit: 85% of derived fee
Extended Medicare Safety Net Cap: $22.95	
ANAESTHETICS	CONSULTATIONS	
	GROUP T6 - ANAESTHETICS	
	SUBGROUP 1 - ANAESTHESIA CONSULTATIONS	
New
17609	
The initiation of a professional attendance via video conference rendered by a specialist practising in the specialty of anaesthesia to a patient who is 
a)	a care recipient receiving care in a residential aged care service; or
b)	at an Aboriginal Medical Service or Aboriginal Community Controlled Health Service in relation to which a direction made under subsection 19(2) of the Act applies; or
c)	located outside an inner metropolitan area, not being an admitted patient being a service associated with item 17610, 17615, 17620, 17625, 17640, 17645, 17650, 17655 or 17690.

Derived Fee: 50% of the fee for the associated item.  Benefit: 85% of derived fee	

BOTULINUM TOXIN INJECTIONS	BOTULINUM TOXIN INJECTIONS	
	GROUP T11 - BOTULINUM TOXIN INJECTIONS	
New
18361	
Botulinum toxin (Botox), injection of, for the treatment of moderate to severe upper limb spasticity due to cerebral palsy, in a patient who is at least 2 years but less than 18 years, in association with either: 
(a) physiotherapy or occupational therapy or both; or 
(b) electrical stimulation or ultrasound for muscle localisation; 
including all injections for any or all of the muscles sub-serving one functional activity supplied by one motor nerve — with a maximum of four treatments per patient on any one day, and with a maximum of two treatments per limb (Anaes.)
(See para T11.1 of explanatory notes to this Category)
Fee: $120.10	Benefit: 75% = $90.10	85% = $102.10	
RELATIVE VALUE GUIDE	ANAESTHESIA	
	GROUP T10 - RELATIVE VALUE GUIDE FOR ANAESTHESIA - Medicare Benefits are only payable for anaesthesia performed in association with an eligible service	
	SUBGROUP 17 - ANAESTHESIA FOR RADIOLOGICAL OR OTHER DIAGNOSTIC OR THERAPEUTIC PROCEDURES	
Amend
21981	
ANAESTHETIC AGENT ALLERGY TESTING, using skin sensitivity methods in a patient with a history of prior anaphylactic or anaphylactoid reaction or cardiovascular collapse associated with the management of anaesthesia agents (4 basic units)
Fee: $76.20	Benefit: 75% = $57.15	85% = $64.80	
OPERATIONS	UROLOGICAL	
	GROUP T8 - SURGICAL OPERATIONS	
	SUBGROUP 5 - UROLOGICAL	
	OPERATIONS ON PROSTATE	
New
37217	
Prostate, implantation of gold fiducial markers into the prostate gland or prostate surgical bed (Anaes.)
(See para T8.56 of explanatory notes to this Category)
Fee: $133.05	Benefit: 75% = $99.80	85% = $113.10	
Amend
37218	
PROSTATE, needle biopsy of, or injection into, excluding for insertion of radiopaque markers (Anaes.)
Fee: $133.05	Benefit: 75% = $99.80	85% = $113.10	
	SUBGROUP 8 - EAR, NOSE AND THROAT	
Amend
41767	
NASOPHARYNGEAL ANGIOFIBROMA, removal of (Anaes.) (Assist.)
Fee: $709.05	Benefit: 75% = $531.80	85% = $637.85	
Amend
41861	
MICROLARYNGOSCOPY with removal of benign lesions of the larynx by laser surgery (Anaes.) (Assist.)
Fee: $581.40	Benefit: 75% = $436.05	
	SUBGROUP 15 - ORTHOPAEDIC	
	GENERAL	
Amend
47915	
INGROWING NAIL OF TOE, wedge resection for, with removal of segment of nail, ungual fold and portion of the nail bed (Anaes.)
Fee: $163.10	Benefit: 75% = $122.35	85% = $138.65	
Amend
47916	
INGROWING NAIL OF TOE, partial resection of nail, with destruction of nail matrix by phenolisation, electrocautery, laser, sodium hydroxide or acid but not including excision of nail bed (Anaes.)
Fee: $81.90	Benefit: 75% = $61.45	85% = $69.65	

OPERATIONS	ORTHOPAEDIC	
	SUBGROUP 15 - ORTHOPAEDIC	
	GENERAL	
	FOOT	
Amend
49833	
FOOT, correction of hallux valgus by osteotomy of first metatarsal with or without internal fixation and with or without excision of exostoses associated with the first metatarsophalangeal joint - unilateral (Anaes.) (Assist.)
Fee: $498.20	Benefit: 75% = $373.65	
Amend
49836	
FOOT, correction of hallux valgus by osteotomy of first metatarsal with or without internal fixation and with or without excision of exostoses associated with the first metatarsophalangeal joint - bilateral (Anaes.) (Assist.)
Fee: $860.50	Benefit: 75% = $645.40	
Amend
49837	
FOOT, correction of hallux valgus by osteotomy of first metatarsal and transfer of adductor hallicus tendon, with or without internal fixation and with or without excision of exostoses associated with the first metatarsophalangeal joint - unilateral (Anaes.) (Assist.)
Fee: $622.75	Benefit: 75% = $467.10	
Amend
49838	
FOOT, correction of hallux valgus by osteotomy of first metatarsal and transfer of adductor hallicus tendon, with or without internal fixation and with or without excision of exostoses associated with the first metatarsophalangeal joint - bilateral (Anaes.) (Assist.)
Fee: $1,075.40	Benefit: 75% = $806.55	

ULTRASOUND	GENERAL	
	GROUP I1 - ULTRASOUND	
	SUBGROUP 1 - GENERAL	
New
55005	
HEAD, ultrasound scan of, where:
(a)	the patient is referred by a medical practitioner for ultrasonic examination not being a service associated with a
	service to which an item in Subgroups 2 or 3 of this Group applies; and 
(b)	the referring medical practitioner is not a member of a group of practitioners of which the providing practitioner
	is a member (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $54.55	Benefit: 75% = $40.95	85% = $46.40	
New
55007	
HEAD, ultrasound scan of, where the patient is not referred by a medical practitioner, not being a service associated with a service to which an item in Subgroups 2 or 3 of this Group applies (NR) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $18.95	Benefit: 75% = $14.25	85% = $16.15	
New
55008	
ORBITAL CONTENTS, ultrasound scan of, where: 
(a)	the patient is referred by a medical practitioner for ultrasonic examination not being a service associated with a
	service to which an item in Subgroups 2 or 3 of this Group applies; and
(b)	the referring medical practitioner is not a member of a group of practitioners of which the providing practitioner
	is a member (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $54.55	Benefit: 75% = $40.95	85% = $46.40	
New
55010	
ORBITAL CONTENTS, ultrasound scan of, where the patient is not referred by a medical practitioner, not being a service associated with a service to which an item in Subgroups 2 or 3 of this Group applies (NR) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $18.95	Benefit: 75% = $14.25	85% = $16.15	
New
55011	
NECK, 1 or more structures of, ultrasound scan of, where:
(a)	the patient is referred by a medical practitioner for ultrasonic examination not being a service associated with a
	service to which an item in Subgroups 2 or 3 of this Group applies; and
(b)	the referring medical practitioner is not a member of a group of practitioners of which the providing practitioner
	is a member (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $54.55	Benefit: 75% = $40.95	85% = $46.40	
New
55013	
NECK, 1 or more structures of, ultrasound scan of, where the patient is not referred by a medical practitioner, not being a service associated with a service to which an item in Subgroups 2 or 3 of this Group applies (NR) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $18.95	Benefit: 75% = $14.25	85% = $16.15	
New
55014	
ABDOMEN, ultrasound scan of, including scan of urinary tract when undertaken but not being a service associated with the service to which an item in Subgroup 4,applies,  where: 
(a)	the patient is referred by a medical practitioner for ultrasonic examination not being a service associated with a
	service to which an item in Subgroups 2 or 3 of this Group applies;
(b)	the referring medical practitioner is not a member of a group of practitioners of which the providing practitioner
	is a member; and
(c)	the service is not performed with item 55017, 55020, 55038, 55044, 55731 or 55732 on the same patient within 24 hours (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $55.65	Benefit: 75% = $41.75	85% = $47.35	
New
55016	
ABDOMEN, ultrasound scan of, including scan of urinary tract when undertaken but not being a service associated with the service to which an item in Subgroup 4,applies  where the patient is not referred by a medical practitioner, not being a service associated with a service to which an item in Subgroups 2 or 3 of this Group applies (NR) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $18.95	Benefit: 75% = $14.25	85% = $16.15	

ULTRASOUND	GENERAL	
New
55017	
URINARY TRACT, ultrasound scan of but not being a service associated with the service to which an item in Subgroup 4,applies,,where: 
(a)	the patient is referred by a medical practitioner for ultrasonic examination not being a service associated with a
	service to which an item in Subgroups 2 or 3 of this Group applies; and 
(b)	the referring medical practitioner is not a member of a group of practitioners of which the providing practitioner
	is a member; and
(c)	the service is not performed with item 55041, 55020, 55036, 55044, 55731 or 55732 on the same patient within 24 hours (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $54.55	Benefit: 75% = $40.95	85% = $46.40	
New
55019	
URINARY TRACT, ultrasound scan of, but not being a service associated with the service to which an item in Subgroup 4,applies, where the patient is not referred by a medical practitioner, not being a service associated with a service to which an item in Subgroups 2 or 3 of this Group applies (NR) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $18.95	Benefit: 75% = $14.25	85% = $16.15	
New
55020	
PELVIS, male, ultrasound scan of, by any or all approaches, but not being a service associated with the service to which an item in Subgroup 4,applies, where: 
(a)	the patient is referred by a medical practitioner for ultrasonic examination not being a service associated with a
	service to which an item in Subgroups 2 or 3 of this Group applies;  
(b)	the referring medical practitioner is not a member of a group of practitioners of which the providing practitioner
	is a member; and 
(c)	the service is not performed with item 55014, 55017, 55036 or 55038 on the same patient within 24 hours (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $55.65	Benefit: 75% = $41.75	85% = $47.35	
New
55022	
PELVIS, male, ultrasound scan of, by any or all approaches, but not being a service associated with the service to which an item in Subgroup 4,applies, where the patient is not referred by a medical practitioner, not being a service associated with a service to which an item in Subgroups 2 or 3 of this Group applies (NR) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $18.95	Benefit: 75% = $14.25	85% = $16.15	
New
55023	
SCROTUM, ultrasound scan of, where: 
(a)	the patient is referred by a medical practitioner for ultrasonic examination not being a service associated with a
	service to which an item in Subgroups 2 or 3 of this Group applies; and 
(b)	the referring medical practitioner is not a member of a group of practitioners of which the providing practitioner
	is a member (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $54.75	Benefit: 75% = $41.10	85% = $46.55	
New
55025	
SCROTUM, ultrasound scan of, where the patient is not referred by a medical practitioner, not being a service associated with a service to which an item in Subgroups 2 or 3 of this Group applies (NR) (NK)
Fee: $18.95	Benefit: 75% = $14.25	85% = $16.15	
New
55026	
ULTRASONIC CROSS-SECTIONAL ECHOGRAPHY, in conjunction with a surgical procedure using interventional techniques, not being a service associated with a service to which any other item in this Group applies (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $54.55	Benefit: 75% = $40.95	85% = $46.40	
New
55059	
BREAST, one, ultrasound scan of, where:
(a)	the patient is referred by a medical practitioner; and
(b)	the service is not associated with a service to which an item in Subgroup 2 or 3 of this group applies; and
(c)	the referring medical practitioner is not a member of a group of practitioners of which the providing practitioner is a
	member (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $49.15	Benefit: 75% = $36.90	85% = $41.80	
New
55060	
BREAST, one, ultrasound scan of, where:
(a)	the patient is not referred by a medical practitioner; and
(b)	the service is not associated with a service to which an item in Subgroup 2 or 3 of this group applies (NR) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $17.05	Benefit: 75% = $12.80	85% = $14.50	

ULTRASOUND	CARDIAC	
New
55061	
BREASTS, both, ultrasound scan of, where:
(a)	the patient is referred by a medical practitioner; and
(b)	the service is not associated with a service to which an item in Subgroup 2 or 3 of this group applies; and
(c)	the referring medical practitioner is not a member of a group of practitioners of which the providing practitioner is a member (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $54.55	Benefit: 75% = $40.95	85% = $46.40	
New
55062	
BREASTS, both, ultrasound scan of, where:
(a)	the patient is not referred by a medical practitioner; and
(b)	the service is not associated with a service to which an item in Subgroup 2 or 3 of this group applies (NR) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $18.95	Benefit: 75% = $14.25	85% = $16.15	
New
55063	
URINARY BLADDER, ultrasound scan of, by any or all approaches, where:
	(a) the patient is referred by a medical practitioner for ultrasonic examination not being a service associated with a service to which an item in Subgroups 2 or 3 of the Group applies; and
	(b) the referring medical practitioner is not a member of a group of practitioners of which the providing practitioner is a member; and
	(c) the service is not performed with item 55600, 55601, 55603, 55604, 55014, 55017, 55020, 55036, 55038, 55044, 55731, 55732 or 11917 on the same date of service (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $49.15	Benefit: 75% = $36.90	85% = $41.80	
New
55064	
URINARY BLADDER, ultrasound scan of, by any or all approaches, where the patient is not referred by a medical practitioner, not being a service associated with a service to which an item in Subgroups 2 or 3 applies; and the service is not performed with item 55600, 55601, 55603, 55604, 55016, 55019, 55022, 55037, 55039, 55045, 55733, 55734 or 11917 on the same date of service (NR) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $17.05	Benefit: 75% = $12.80	85% = $14.50	
	SUBGROUP 2 - CARDIAC	
New
55119	
M-MODE and 2 DIMENSIONAL REAL TIME ECHOCARDIOGRAPHIC EXAMINATION of the heart from at least 2 acoustic windows, with measurement of blood flow velocities across the cardiac valves using pulsed wave and continuous wave Doppler techniques, and real time colour flow mapping from at least 2 acoustic windows, with recordings on video tape or digital medium, not being a service associated with a service to which an item in Subgroups 1 (with the exception of items 55026 and 55054) or 3, or another item in this Subgroup (with the exception of items 55118, 55125, 55130 and 55131), applies, for the investigation of symptoms or signs of cardiac failure, or suspected or known ventricular hypertrophy or dysfunction, or chest pain (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $115.35	Benefit: 75% = $86.55	85% = $98.05	
New
55120	
M-MODE and 2 DIMENSIONAL REAL TIME ECHOCARDIOGRAPHIC EXAMINATION of the heart from at least 2 acoustic windows, with measurement of blood flow velocities across the cardiac valves using pulsed wave and continuous wave Doppler techniques, and real time colour flow mapping from at least 2 acoustic windows, with recordings on video tape or digital medium, not being a service associated with a service to which an item in Subgroups 1 (with the exception of items 55026 and 55054) or 3, or another item in this Subgroup (with the exception of items 55118, 55125, 55130 and 55131), applies, for the investigation of suspected or known acquired valvular, aortic, pericardial, thrombotic, or embolic disease, or heart tumour (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $115.35	Benefit: 75% = $86.55	85% = $98.05	
New
55121	
M-MODE and 2 DIMENSIONAL REAL TIME ECHOCARDIOGRAPHIC EXAMINATION of the heart from at least 2 acoustic windows, with measurement of blood flow velocities across the cardiac valves using pulsed wave and continuous wave Doppler techniques, and real time colour flow mapping from at least 2 acoustic windows, with recordings on video tape or digital medium, not being a service associated with a service to which an item in Subgroups 1 (with the exception of items 55026 and 55054) or 3, or another item in this Subgroup (with the exception of items 55118, 55125, 55130 and 55131), applies, for the investigation of symptoms or signs of congenital heart disease (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $115.35	Benefit: 75% = $86.55	85% = $98.05	
New
55122	
EXERCISE STRESS ECHOCARDIOGRAPHY performed in conjunction with item 11712, with two-dimensional recordings before exercise (baseline) from at least three acoustic windows and matching recordings from the same windows at, or immediately after, peak exercise, not being a service associated with a service to which an item in Subgroups 1 (with the exception of items 55026 and 55054) or 3, or another item in this Subgroup applies (with the exception of items 55118, 55125, 55130 and 55131). Recordings must be made on digital media with equipment permitting display of baseline and matching peak images on the same screen (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $130.85	Benefit: 75% = $98.15	85% = $111.25	

ULTRASOUND	VASCULAR	
New
55123	
PHARMACOLOGICAL STRESS ECHOCARDIOGRAPHY performed in conjunction with item 11712, with two-dimensional recordings before drug infusion (baseline) from at least three acoustic windows and matching recordings from the same windows at least twice during drug infusion, including a recording at the peak drug dose not being a service associated with a service to which an item in Subgroups 1 (with the exception of items 55026 and 55054) or 3, or another item in this Subgroup, applies (with the exception of items 55118, 55125, 55130 and 55131). Recordings must be made on digital media with equipment permitting display of baseline and matching peak images on the same screen (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $130.85	Benefit: 75% = $98.15	85% = $111.25	
New
55125	
HEART, 2 DIMENSIONAL REAL TIME TRANSOESOPHAGEAL EXAMINATION of, from at least two levels, and in more than one plane at each level:
(a)	with:
	(i)	real time colour flow mapping and, if indicated, pulsed wave Doppler examination; and
	(ii)	recordings on video tape or digital medium; and
(b)	not being an intra-operative service or a service associated with a service to which an item
in Subgroups 1 (with the exception of items 55026 and 55054) or 3, applies (R) (NK) (Anaes.)
(See para DIQ of explanatory notes to this Category)
Fee: $137.75	Benefit: 75% = $103.35	85% = $117.10	
New
55131	
INTRA-OPERATIVE 2 DIMENSIONAL REAL TIME TRANSOESOPHAGEAL ECHOCARDIOGRAPHY incorporating Doppler techniques with colour flow mapping and recording onto video tape or digital medium, performed during cardiac surgery incorporating sequential assessment of cardiac function before and after the surgical procedure - not associated with items 55135 and 55136 (R) (NK) (Anaes.)
(See para DIQ of explanatory notes to this Category)
Fee: $85.00	Benefit: 75% = $63.75	85% = $72.25	
New
55136	
INTRA-OPERATIVE 2 DIMENSIONAL REAL TIME TRANSOESOPHAGEAL ECHOCARDIOGRAPHY incorporating Doppler techniques with colour flow mapping and recording onto video tape or digital medium, performed during cardiac valve surgery (repair or replacement) incorporating sequential assessment of cardiac function and valve competence before and after the surgical procedure - not associated with items 55130 and 55131 (R) (NK) (Anaes.)
(See para DIQ of explanatory notes to this Category)
Fee: $176.80	Benefit: 75% = $132.60	85% = $150.30	
	SUBGROUP 3 - VASCULAR	
New
55220	
DUPLEX SCANNING, unilateral, involving B mode ultrasound imaging and integrated Doppler flow measurements by spectral analysis of arteries or bypass grafts in the lower limb OR of arteries and bypass grafts in the lower limb, below the inguinal ligament, not being a service associated with a service to which an item in Subgroups 1 (with the exception of items 55026 and 55054) or 4 of this Group applies  (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $84.75	Benefit: 75% = $63.60	85% = $72.05	
New
55221	
DUPLEX SCANNING, unilateral, involving B mode ultrasound imaging and integrated Doppler flow measurements by spectral analysis of veins in the lower limb, below the inguinal ligament, for acute venous thrombosis, not being a service associated with a service to which an item in Subgroups 1 (with the exception of items 55026 and 55054) or 4 of this Group applies (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $84.75	Benefit: 75% = $63.60	85% = $72.05	
New
55222	
DUPLEX SCANNING, unilateral, involving B mode ultrasound imaging and integrated Doppler flow measurements by spectral analysis of veins in the lower limb, below the inguinal ligament, for chronic venous disease, not being a service associated with a service to which an item in Subgroups 1 (with the exception of items 55026 and 55054) or 4 of this Group applies (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $84.75	Benefit: 75% = $63.60	85% = $72.05	
New
55223	
DUPLEX SCANNING, unilateral, involving B mode ultrasound imaging and integrated Doppler flow measurements by spectral analysis of arteries or bypass grafts in the upper limb OR of arteries and bypass grafts in the upper limb, not being a service associated with a service to which an item in Subgroups 1 (with the exception of items 55026 and 55054) or 4 of this Group applies (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $84.75	Benefit: 75% = $63.60	85% = $72.05	
New
55224	
DUPLEX SCANNING, unilateral, involving B mode ultrasound imaging and integrated Doppler flow measurements by spectral analysis of veins in the upper limb, not being a service associated with a service to which an item in Subgroups 1 (with the exception of items 55026 and 55054) or 4 of this Group applies (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $84.75	Benefit: 75% = $63.60	85% = $72.05	

ULTRASOUND	VASCULAR	
New
55226	
DUPLEX SCANNING, bilateral, involving B mode ultrasound imaging and integrated Doppler flow measurements by spectral analysis of extra-cranial bilateral carotid and vertebral vessels, with or without subclavian and innominate vessels, with or without oculoplethysmography or peri-orbital Doppler examination, not being a service associated with a service to which an item in Subgroups 1 (with the exception of items 55026 and 55054) or 4 of this Groups applies (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $84.75	Benefit: 75% = $63.60	85% = $72.05	
New
55227	
DUPLEX SCANNING involving B mode ultrasound imaging and integrated Doppler flow measurements by spectral analysis of intra-abdominal, aorta and iliac arteries or inferior vena cava and iliac veins OR of intra-abdominal, aorta and iliac arteries and inferior vena cava and iliac veins, excluding pregnancy related studies, not being a service associated with a service to which an item in Subgroups 1 (with the exception of items 55026 and 55054) or 4 of this Group applies (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $84.75	Benefit: 75% = $63.60	85% = $72.05	
New
55228	
DUPLEX SCANNING involving B mode ultrasound imaging and integrated Doppler flow measurements by spectral analysis of renal or visceral vessels OR of renal and visceral vessels, including aorta, inferior vena cava and iliac vessels as required excluding pregnancy related studies, not being a service associated with a service to which an item in Subgroups 1 (with the exception of items 55026 and 55054) or 4 of this Group applies (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $84.75	Benefit: 75% = $63.60	85% = $72.05	
New
55229	
DUPLEX SCANNING involving B mode ultrasound imaging and integrated Doppler flow measurements by spectral analysis of intra-cranial vessels, not being a service associated with a service to which an item in Subgroups 1 (with the exception of items 55026 and 55054) or 4 of this Group applies (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $84.75	Benefit: 75% = $63.60	85% = $72.05	
New
55230	
DUPLEX SCANNING involving B mode ultrasound imaging and integrated Doppler flow measurements by spectral analysis of cavernosal artery of the penis following intracavernosal administration of a vasoactive agent, performed during the period of pharmacological activity of the injected agent, to confirm a diagnosis of vascular aetiology for impotence, where a specialist in diagnostic radiology, nuclear medicine, urology, general surgery (sub-specialising in vascular surgery) or a consultant physician in nuclear medicine attends the patient in person at the practice location where the service is rendered, immediately prior to or for a period during the rendering of the service, and that specialist or consultant physician interprets the results and prepares a report, not being a service associated with a service to which an item in Subgroups 1 (with the exception of items 55026 and 55054) or 4 of this Group applies (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $84.75	Benefit: 75% = $63.60	85% = $72.05	
New
55232	
DUPLEX SCANNING involving B mode ultrasound imaging and integrated Doppler flow measurements by spectral analysis of cavernosal tissue of the penis to confirm a diagnosis and, where indicated, assess the progress and management of:
(a) priapism; or
(b) fibrosis of any type; or
(c) fracture of the tunica; or
(d) arteriovenous malformations;
where a specialist in diagnostic radiology, nuclear medicine, urology, general surgery (sub-specialising in vascular surgery) or a consultant physician in nuclear medicine attends the patient in person at the practice location where the service is rendered, immediately prior to or for a period during the rendering of the service, and that specialist or consultant physician interprets the results and prepares a report, not being a service associated with a service to which an item in Subgroups 1 (with the exception of items 55026 and 55054) or 4 of this Groups applies (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $84.75	Benefit: 75% = $63.60	85% = $72.05	
New
55233	
DUPLEX SCANNING, unilateral, involving B mode ultrasound imaging and integrated Doppler flow measurements by spectral analysis of surgically created arteriovenous fistula or surgically created arteriovenous access graft in the upper or lower limb, not being a service associated with a service to which an item in Subgroups 1 (with the exception of items 55026 and 55054) or 4 of this Group applies (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $84.75	Benefit: 75% = $63.60	85% = $72.05	
New
55235	
DUPLEX SCANNING, involving B mode ultrasound imaging and integrated Doppler flow measurements by spectral analysis of arteries or veins OR arteries and veins, for mapping of bypass conduit prior to vascular surgery, not being a service associated with a service to which an item in Subgroups 1 (with the exception of items 55026 and 55054), 3 or 4 of this Group applies - including any associated skin marking (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $84.75	Benefit: 75% = $63.60	85% = $72.05	

ULTRASOUND	UROLOGICAL	
New
55236	
DUPLEX SCANNING, unilateral, involving B mode ultrasound imaging and integrated Doppler flow spectral analysis and marking of veins in the lower limb below the inguinal ligament prior to varicose vein surgery, not being a service associated with a service to which an item in Subgroups 1 (with the exception of items 55026 and 55054), 3 or 4 of this Group applies - including any associated skin marking (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $55.55	Benefit: 75% = $41.70	85% = $47.25	
	SUBGROUP 4 - UROLOGICAL	
Amend
55600	
PROSTATE, bladder base and urethra, ultrasound scan of, where performed: 
(a)	personally by a medical practitioner (not being the medical practitioner who assessed the patient as specified in (c)) using a transducer probe or probes that:
(i) have a nominal frequency of 7 to 7.5 megahertz or a nominal frequency range which includes frequencies of 7 to 7.5 megahertz; and 
(ii) can obtain both axial and sagittal scans in 2 planes at right angles; and 
(b)	following a digital rectal examination of the prostate by that medical practitioner; and 
(c)	on a patient who has been assessed by a specialist in urology, radiation oncology or medical oncology or a consultant physician in medical oncology who has:
(i)examined the patient in the 60 days prior to the scan; and 
(ii)recommended the scan for the management of the patient's current prostatic disease (R) (K)
(See para DIQ of explanatory notes to this Category)
Fee: $109.10	Benefit: 75% = $81.85	85% = $92.75	
New
55601	
PROSTATE, bladder base and urethra, ultrasound scan of, where performed:
(a) personally by a medical practitioner (not being the medical practitioner who assessed the patient as specified in (c)) using a transducer probe or probes that: 
(i) have a nominal frequency of 7 to 7.5 megahertz or a nominal frequency range which includes frequencies of 7 to 7.5 megahertz; and 
(ii) can obtain both axial and sagittal scans in 2 planes at right angles; and 
(b)    following a digital rectal examination of the prostate by that medical practitioner; and 
(c)    on a patient who has been assessed by a specialist in urology, radiation oncology or medical oncology or a consultant physician in medical oncology who has: 
(i) examined the patient in the 60 days prior to the scan; and 
(ii) recommended the scan for the management of the patient's current prostatic disease (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $54.55	Benefit: 75% = $40.95	85% = $46.40	
Amend
55603	
PROSTATE, bladder base and urethra, ultrasound scan of, where performed: 
(a)	personally by a medical practitioner who undertook the assessment referred to in (c) using a transducer probe or probes that: 
(i) have a nominal frequency of 7 to 7.5 megahertz or a nominal frequency range which includes frequencies of 7 to 7.5 megahertz; and
(ii) can obtain both axial and sagittal scans in 2 planes at right angles; and 
(b)	following a digital rectal examination of the prostate by that medical practitioner; and 
(c)	on a patient who has been assessed by a specialist in urology, radiation oncology or medical oncology or a consultant physician in medical oncology who has:
(i)examined the patient in the 60 days prior to the scan; and 
(ii)recommended the scan for the management of the patient's current prostatic disease (R) (K)
(See para DIQ of explanatory notes to this Category)
Fee: $109.10	Benefit: 75% = $81.85	85% = $92.75	
New
55604	
PROSTATE, bladder base and urethra, ultrasound scan of, where performed: 
(a)  personally by a medical practitioner who undertook the assessment referred to in (c) using a transducer probe or probes that: 
(i) have a nominal frequency of 7 to 7.5 megahertz or a nominal frequency range which includes frequencies of 7 to 7.5 megahertz; and 
(ii) can obtain both axial and sagittal scans in 2 planes at right angles; and 
(b) following a digital rectal examination of the prostate by that medical practitioner; and 
(c) on a patient who has been assessed by a specialist in urology, radiation oncology or medical oncology or a consultant physician in medical oncology who has: 
(i) examined the patient in the 60 days prior to the scan; and 
(ii) recommended the scan for the management of the patient's current prostatic disease (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $54.55	Benefit: 75% = $40.95	85% = $46.40	

ULTRASOUND	OBSTETRIC AND GYNAECOLOGICAL	
	SUBGROUP 5 - OBSTETRIC AND GYNAECOLOGICAL	
New
55701	
PELVIS OR ABDOMEN, pregnancy related or pregnancy complication, ultrasound scan of, by any or all approaches, where:
(a)	the patient is referred by a medical practitioner; and
(b)	the dating of the pregnancy (as confirmed by ultrasound) is less than 12 weeks of gestation; and
(c)	the service is not associated with a service to which an item in Subgroup 2 or 3 of this group applies; and
(d)	the referring practitioner is not a member of a group of practitioners of which the providing practitioner is a member; and
(e)	one or more of the following conditions are present:
	(i)	hyperemesis gravidarum;
	(ii)	diabetes mellitus;
	(iii)	hypertension;
	(iv)	toxaemia of pregnancy;
	(v)	liver or renal disease;
	(vi)	autoimmune disease;
	(vii)	cardiac disease;
	(viii)	alloimmunisation;
	(ix)	maternal infection;
	(x)	inflammatory bowel disease;
	(xi)	bowel stoma;
	(xii)	abdominal wall scarring;
	(xiii)	previous spinal or pelvic trauma or disease;
	(xiv)	drug dependency;
	(xv)	thrombophilia;
	(xvi)	significant maternal obesity;
	(xvii)	advanced maternal age;
	(xviii)	abdominal pain or mass;
	(xix)	uncertain dates;
	(xx)	high risk pregnancy;
	(xxi)	previous post dates delivery;
	(xxii)	previous caesarean section;
	(xxiii)	poor obstetric history;
	(xxiv)	suspicion of ectopic pregnancy;
	(xxv)	risk of miscarriage;
	(xxvi)	diminished symptoms of pregnancy;
	(xxvii)	suspected or known cervical incompetence;
	(xxviii)	suspected or known uterine abnormality;
	(xxix)	pregnancy after assisted reproduction;
	(xxx)	risk of fetal abnormality (R)

Footnote: For nuchal translucency measurements performed when the pregnancy is dated by a crown rump length of 45 to 84mm, refer to item number 55707 or 55714 (R) (NK). Fee is payable only for item 55700 or 55701, or, or item 55707 or 55714, not both items
(See para DIQ of explanatory notes to this Category)
Fee: $30.00	Benefit: 75% = $22.50	85% = $25.50
Extended Medicare Safety Net Cap: $15.70	

ULTRASOUND	OBSTETRIC AND GYNAECOLOGICAL	
New
55702	
PELVIS OR ABDOMEN, pregnancy related or pregnancy complication, ultrasound scan of, by any or all approaches, where:
(a)	the patient is not referred by a medical practitioner; and
(b)	the dating of the pregnancy (as confirmed by ultrasound) is less than 12 weeks of gestation; and
(c)	the service is not associated with a service to which an item in Subgroup 2 or 3 of this group applies; and
(d)	one or more of the following conditions are present:
	(i)	hyperemesis gravidarum;
	(ii)	diabetes mellitus;
	(iii)	hypertension;
	(iv)	toxaemia of pregnancy;
	(v)	liver or renal disease;
	(vi)	autoimmune disease;
	(vii)	cardiac disease;
	(viii)	alloimmunisation;
	(ix)	maternal infection;
	(x)	inflammatory bowel disease;
	(xi)	bowel stoma;
	(xii)	abdominal wall scarring;
	(xiii)	previous spinal or pelvic trauma or disease;
	(xiv)	drug dependency;
	(xv)	thrombophilia;
	(xvi)	significant maternal obesity;
	(xvii)	advanced maternal age;
	(xviii)	abdominal pain or mass;
	(xix)	uncertain dates;
	(xx)	high risk pregnancy;
	(xxi)	previous post dates delivery;
	(xxii)	previous caesarean section;
	(xxiii)	poor obstetric history;
	(xxiv)	suspicion of ectopic pregnancy;
	(xxv)	risk of miscarriage;
	(xxvi)	diminished symptoms of pregnancy;
	(xxvii)	suspected or known cervical incompetence;
	(xxviii)	suspected or known uterine abnormality;
	(xxix)	pregnancy after assisted reproduction;
	(xxx)	risk of fetal abnormality (NR)

Footnote: For nuchal translucency measurements performed when the pregnancy is dated by a crown rump length of 45 to 84mm, refer to item number 55708 or 55716 (R) (NK). Fee is payable only for item 55702 or 55703, or, item 55707 or 55714, not both items
(See para DIQ of explanatory notes to this Category)
Fee: $17.50	Benefit: 75% = $13.15	85% = $14.90
Extended Medicare Safety Net Cap: $7.90	

ULTRASOUND	OBSTETRIC AND GYNAECOLOGICAL	
New
55710	
PELVIS OR ABDOMEN, pregnancy related or pregnancy complication, fetal development and anatomy, ultrasound scan of, by any or all approaches, where:
(a)	the patient is referred by a medical practitioner; and
(b)	the dating of the pregnancy (as confirmed by ultrasound) is 12 to 16 weeks of gestation; and
(c)	the service is not associated with a service to which an item in Subgroup 2 or 3 of this group applies; and 
(d)	the referring practitioner is not a member of a group of practitioners of which the providing practitioner is a member;
	and
(e)	one or more of the following conditions are present:
	(i)	hyperemesis gravidarum;
	(ii)	diabetes mellitus;
	(iii)	hypertension;
	(iv)	toxaemia of pregnancy;
	(v)	liver or renal disease;
	(vi)	autoimmune disease;
	(vii)	cardiac disease;
	(viii)	alloimmunisation;
	(ix)	maternal infection;
	(x)	inflammatory bowel disease;
	(xi)	bowel stoma;
	(xii)	abdominal wall scarring;
	(xiii)	previous spinal or pelvic trauma or disease;
	(xiv)	drug dependency;
	(xv)	thrombophilia;
	(xvi)	significant maternal obesity;
	(xvii)	advanced maternal age;
	(xviii)	abdominal pain or mass;
	(xix)	uncertain dates;
	(xx)	high risk pregnancy;
	(xxi)	previous post dates delivery;
	(xxii)	previous caesarean section;
	(xxiii)	poor obstetric history;
	(xxiv)	suspicion of ectopic pregnancy;
	(xxv)	risk of miscarriage;
	(xxvi)	diminished symptoms of pregnancy;
	(xxvii)	suspected or known cervical incompetence;
	(xxviii)	suspected or known uterine abnormality;
	(xxix)	pregnancy after assisted reproduction;
	(xxx)	risk of fetal abnormality (R)

Footnote: For nuchal translucency measurements performed when the pregnancy is dated by a crown rump length of 45 to 84mm, refer to item 55704 or 55707 (R) (NK). Fee is payable only for item 55704 or 55710, or, item 55707 or 55714, not both items
(See para DIQ of explanatory notes to this Category)
Fee: $35.00	Benefit: 75% = $26.25	85% = $29.75
Extended Medicare Safety Net Cap: $18.35	

ULTRASOUND	OBSTETRIC AND GYNAECOLOGICAL	
New
55711	
PELVIS OR ABDOMEN, pregnancy related or pregnancy complication, fetal development and anatomy, ultrasound scan of, by any or all approaches, where:
(a)	the patient is not referred by a medical practitioner; and
(b)	the dating of the pregnancy (as confirmed by ultrasound) is 12 to 16 weeks of gestation; and
(c)	the service is not associated with a service to which an item in Subgroup 2 or 3 of this group applies; and
(d)	one or more of the following conditions are present:
	(i)	hyperemesis gravidarum
	(ii)	diabetes mellitus;
	(iii)	hypertension;
	(iv)	toxaemia of pregnancy;
	(v)	liver or renal disease;
	(vi)	autoimmune disease;
	(vii)	cardiac disease;
	(viii)	alloimmunisation;
	(ix)	maternal infection;
	(x)	inflammatory bowel disease;
	(xi)	bowel stoma;
	(xii)	abdominal wall scarring;
	(xiii)	previous spinal or pelvic trauma or disease;
	(xiv)	drug dependency;
	(xv)	thrombophilia;
	(xvi)	significant maternal obesity;
	(xvii)	advanced maternal age;
	(xviii)	abdominal pain or mass;
	(xix)	uncertain dates;
	(xx)	high risk pregnancy;
	(xxi)	previous post dates delivery;
	(xxii)	previous caesarean section;
	(xxiii)	poor obstetric history;
	(xxiv)	suspicion of ectopic pregnancy;
	(xxv)	risk of miscarriage;
	(xxvi)	diminished symptoms of pregnancy;
	(xxvii)	suspected or known cervical incompetence;
	(xxviii)	suspected or known uterine abnormality;
	(xxix)	pregnancy after assisted reproduction;
	(xxx)	risk of fetal abnormality (NR)

Footnote: For nuchal translucency measurements performed when the pregnancy is dated by a crown rump length of 45 to 84mm, refer to item 55708 or 55716 (R) (NK). Fee is payable only for item 55705 or 55711, or,  item 55708 or 55716, not both items
(See para DIQ of explanatory notes to this Category)
Fee: $17.50	Benefit: 75% = $13.15	85% = $14.90
Extended Medicare Safety Net Cap: $7.90	
New
55713	
PELVIS OR ABDOMEN, pregnancy related or pregnancy complication, fetal development and anatomy, ultrasound scan (not exceeding 1 service in any 1 pregnancy) of, by any or all approaches, with measurement of all parameters for dating purposes, where:
(a)	the patient is referred by a medical practitioner; and
(b)	the dating for the pregnancy (as confirmed by ultrasound) is 17 to 22 weeks of gestation; and
(c)	the service is not associated with a service to which an item in Subgroup 2 or 3 of this group applies; and
(d)	the referring practitioner is not a member of a group of practitioners of which the providing practitioner is a member;	and
(e)	the service is not performed in the same pregnancy as item 55709 or 55717 (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $50.00	Benefit: 75% = $37.50	85% = $42.50
Extended Medicare Safety Net Cap: $26.20	

ULTRASOUND	OBSTETRIC AND GYNAECOLOGICAL	
New
55714	
PELVIS OR ABDOMEN, pregnancy related or pregnancy complication, fetal development and anatomy, ultrasound scan (not exceeding 1 service in any 1 pregnancy) of, by any or all approaches, where;
(a)	the patient is referred by a medical practitioner; and
(b)	the pregnancy (as confirmed by ultrasound) is dated by a crown rump length of 45 to 84mm; and
(c)	the service is not associated with a service to which an item in Subgroup 2 or 3 of this group applies; and
(d)	the referring practitioner is not a member of a group of practitioners of which the providing practitioner is a member;	and
(e)	one or more of the conditions mentioned in subparagraphs (e) (i) to (xxx) of item 55704 or 55710 are present; and
(f)	nuchal translucency measurement is performed to assess the risk of fetal abnormality; and
(g)	the service is not performed with item 55700, 55701, 55702, 55703, 55704, 55705, 55710 or 55711 on the same patient within 24 hours (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $35.00	Benefit: 75% = $26.25	85% = $29.75
Extended Medicare Safety Net Cap: $18.35	
New
55716	
PELVIS OR ABDOMEN, pregnancy related or pregnancy complication, fetal development and anatomy, ultrasound scan (not exceeding 1 service in any 1 pregnancy) of, by any or all approaches, where;
(a)	the patient is not referred by a medical practitioner; and
(b)	the pregnancy (as confirmed by ultrasound) is dated by a crown rump length of 45 to 84mm; and
(c)	the service is not associated with a service to which an item in Subgroup 2 or 3 of this group applies; and
(d)	one or more of the conditions in subparagraphs (e) (i) to (xxx) of item 55704 or 55710 are present; and
(e)	nuchal translucency measurement is performed to assess the risk of fetal abnormality; and
(f)	the service is not performed in conjunction with item 55700, 55701, 55702, 55703, 55704, 55705, 55710 or 55711 on the same patient within 24 hours (NR) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $17.50	Benefit: 75% = $13.15	85% = $14.90
Extended Medicare Safety Net Cap: $7.90	
New
55717	
PELVIS OR ABDOMEN, pregnancy related or pregnancy complication, fetal development and anatomy, ultrasound scan (not exceeding 1 service in any 1 pregnancy) of, by any or all approaches, with measurement of all parameters for dating purposes, where:
(a)	the patient is not referred by a medical practitioner; and
(b)	the dating of the pregnancy (as confirmed by ultrasound) is 17 to 22 weeks of gestation; and
(c)	the service is not associated with a service to which an item in Subgroup 2 or 3 of this group applies; and
(d)	the service is not performed in the same pregnancy as item 55706 or 55713 (NR) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $19.00	Benefit: 75% = $14.25	85% = $16.15
Extended Medicare Safety Net Cap: $10.50	
New
55719	
PELVIS OR ABDOMEN, pregnancy related or pregnancy complication, fetal development and anatomy, ultrasound scan of, by any or all approaches, with measurement of all parameters for dating purposes, where:
(a)	the patient is referred by a medical practitioner who is a Member or a Fellow of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists or who has a Diploma of Obstetrics or has a qualification recognised by the Royal Australian and New Zealand College of Obstetricians and Gynaecologists as being  equivalent to a Diploma of Obstetrics or has obstetric privileges at a non-metropolitan hospital; and 
(b)	the dating of the pregnancy (as confirmed by ultrasound) is 17 to 22 weeks of gestation; and
(c)	the service is not associated with a service to which an item in Subgroup 2 or 3 of this group applies; and
(d)	the referring practitioner is not a member of a group of practitioners of which the providing practitioner is a member;	and
(e)	further examination is clinically indicated in the same pregnancy to which item 55706, 55709, 55713 or 55717 applies (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $57.50	Benefit: 75% = $43.15	85% = $48.90
Extended Medicare Safety Net Cap: $31.40	
New
55720	
PELVIS OR ABDOMEN, pregnancy related or pregnancy complication, fetal development and anatomy, ultrasound scan of, by any or all approaches, with measurement of all parameters for dating purposes, performed by or on behalf of a medical practitioner who is a Member or a Fellow of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists, where:
(a)	the patient is not referred by a medical practitioner; and
(b)	the dating of the pregnancy (as confirmed by ultrasound) is 17 to 22 weeks of gestation; and
(c)	the service is not associated with a service to which an item in Subgroup 2 or 3 of this group applies; and
(d)	further examination is clinically indicated in the same pregnancy to which item 55706, 55709, 55713 or 55717 applies (NR) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $20.00	Benefit: 75% = $15.00	85% = $17.00
Extended Medicare Safety Net Cap: $10.50	

ULTRASOUND	OBSTETRIC AND GYNAECOLOGICAL	
New
55722	
PELVIS OR ABDOMEN, pregnancy related or pregnancy complication, fetal development and anatomy, ultrasound scan (not exceeding 1 service in any 1 pregnancy) of, by any or all approaches, where:
(a)	the patient is referred by a medical practitioner; and
(b)	the dating of the pregnancy (as confirmed by ultrasound) is after 22 weeks of gestation; and
(c)	the service is not associated with a service to which an item in Subgroup 2 or 3 of this group applies; and
(d)	the referring practitioner is not a member of a group of practitioners of which the providing practitioner is a member;
and
(e)	the service is not performed in the same pregnancy as item 55723 or 55726; and
(f)	one or more of the following conditions are present:
	(i)		known or suspected fetal abnormality or fetal cardiac arrhythmia;
	(ii)		fetal anatomy (late booking or incomplete mid-trimester scan);
	(iii)		malpresentation;
	(iv)		cervical assessment;
	(v)		clinical suspicion of amniotic fluid abnormality;
	(vi)		clinical suspicion of placental or umbilical cord abnormality;
	(vii)		previous complicated delivery;
	(viii)		uterine scar assessment;
	(ix)		uterine fibroid;
	(x)		previous fetal death in utero or neonatal death;
	(xi)		antepartum haemorrhage;
	(xii)		clinical suspicion of intrauterine growth retardation;
	(xiii)		clinical suspicion of macrosomia;
	(xiv)		reduced fetal movements;
	(xv)		suspected fetal death;
	(xvi)		abnormal cardiotocography;
	(xvii)		prolonged pregnancy;
	(xviii)		premature labour;
	(xix)		fetal infection;
	(xx)		pregnancy after assisted reproduction;
	(xxi)		trauma;
	(xxii)		diabetes mellitus;
	(xxiii)		hypertension;
	(xxiv)		toxaemia of pregnancy;
	(xxv)		liver or renal disease;
	(xxvi)		autoimmune disease;
	(xxvii)		cardiac disease;
	(xxviii)		alloimmunisation;
	(xxix)		maternal infection;
	(xxx)		inflammatory bowel disease;
	(xxxi)		bowel stoma;
	(xxxii)		abdominal wall scarring;
	(xxxiii)		previous spinal or pelvic trauma or disease;
	(xxxiv)		drug dependency;
	(xxxv)		thrombophilia;
	(xxxvi)		significant maternal obesity;
	(xxxvii)		advanced maternal age;
	(xxxviii)		abdominal pain or mass (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $50.00	Benefit: 75% = $37.50	85% = $42.50
Extended Medicare Safety Net Cap: $26.20	
New
55724	
PELVIS OR ABDOMEN, pregnancy related or pregnancy complication, fetal development and anatomy, ultrasound scan of by any or all approaches, where:
(a)	the patient is referred by a medical practitioner who is a Member or a Fellow of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists or who has a Diploma of Obstetrics or has qualifications recognised by the Royal Australian and New Zealand College of Obstericians and Gynaecologists as being equivalent to a Diploma of obstetrics or has obstetric privileges at a non-metropolitan hospital; and
(b)	the dating of the pregnancy (as confirmed by ultrasound) is after 22 weeks of gestation; and
(c)	the service is not associated with a service to which an item in Subgroup 2 or 3 of this group applies; and
(d)	the referring practitioner is not a member of a group of practitioners of which the providing practitioner is a member; and
(e)	further examination is clinically indicated in the same pregnancy to which item 55718, 55722, 55723 or 55726 applies (R) NK)
(See para DIQ of explanatory notes to this Category)
Fee: $57.50	Benefit: 75% = $43.15	85% = $48.90
Extended Medicare Safety Net Cap: $31.40	

ULTRASOUND	OBSTETRIC AND GYNAECOLOGICAL	
New
55726	
PELVIS OR ABDOMEN, pregnancy related or pregnancy complication, fetal development and anatomy, ultrasound scan (not exceeding 1 service in any 1 pregnancy) of, by any or all approaches, where:
(a)	the patient is not referred by a medical practitioner; and
(b)	the dating of the pregnancy (as confirmed by ultrasound) is after 22 weeks of gestation; and
(c)	the service is not associated with a service to which an item in Subgroup 2 or 3 of this group applies; and
(d)	the service is not performed in the same pregnancy as item 55718 or 55722; and
(e)	one or more of the following conditions are present:
	(i)		known or suspected fetal abnormality or fetal cardiac arrhythmia;
	(ii)		fetal anatomy (late booking or incomplete mid-trimester scan);
	(iii)		malpresentation;
	(iv)		cervical assessment;
	(v)		clinical suspicion of amniotic fluid abnormality;
	(vi)		clinical suspicion of placental or umbilical cord abnormality;
	(vii)		previous complicated delivery;
	(viii)		uterine scar assessment;
	(ix)		uterine fibroid;
	(x)		previous fetal death in utero or neonatal death;
	(xi)		antepartum haemorrhage;
	(xii)		clinical suspicion of intrauterine growth retardation;
	(xiii)		clinical suspicion of macrosomia;
	(xiv)		reduced fetal movements;
	(xv)		suspected fetal death;
	(xvi)		abnormal cardiotocography;
	(xvii)		prolonged pregnancy;
	(xviii)		premature labour;
	(xix)		fetal infection;
	(xx)		pregnancy after assisted reproduction;
	(xxi)		trauma;
	(xxii)		diabetes mellitus;
	(xxiii)		hypertension;
	(xxiv)		toxaemia of pregnancy;
	(xxv)		liver or renal disease;
	(xxvi)		autoimmune disease;
	(xxvii)		cardiac disease;
	(xxviii)		alloimmunisation;
	(xxix)		maternal infection;
	(xxx)		inflammatory bowel disease;
	(xxxi)		bowel stoma;
	(xxxii)		abdominal wall scarring;
	(xxxiii)		previous spinal or pelvic trauma or disease;
	(xxxiv)		drug dependency;
	(xxxv)		thrombophilia;
	(xxxvi)		significant maternal obesity;
	(xxxvii)		advanced maternal age;
	(xxxviii)		abdominal pain or mass (NR) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $19.00	Benefit: 75% = $14.25	85% = $16.15
Extended Medicare Safety Net Cap: $10.50	
New
55727	
PELVIS OR ABDOMEN, pregnancy related or pregnancy complication, fetal development and anatomy, ultrasound scan of, by any or all approaches, performed by or on behalf of a medical practitioner who is a Member or a Fellow of the Royal Australian and New Zealand College of Obstetricans and Gynaecologists, where:
(a)	the patient is not referred by a medical practitioner; and
(b)	the dating of the pregnancy (as confirmed by ultrasound) is after 22 weeks of gestation; and 
(c)	the service is not associated with a service to which an item in Subgroup 2 or 3 of this group applies; and
(d)	further examination is clinically indicated in the same pregnancy to which item 55718, 55722, 55723 or 55726 applies (NR) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $20.00	Benefit: 75% = $15.00	85% = $17.00
Extended Medicare Safety Net Cap: $10.50	
New
55730	
Duplex scanning involving B mode ultrasound imaging and integrated Doppler flow measurements by spectral analysis of the umbilical artery, and measured assessment of amniotic fluid volume after the 24th week of gestation where the patient is referred by a medical practitioner for this procedure and where there is reason to suspect intrauterine growth retardation or a significant risk of foetal death, not being a service associated with a service to which an item in this Group applies  (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $13.65	Benefit: 75% = $10.25	85% = $11.65
Extended Medicare Safety Net Cap: $7.90	

ULTRASOUND	OBSTETRIC AND GYNAECOLOGICAL	
New
55732	
PELVIS, FEMALE, ultrasound scan of, by any or all approaches, where:
(a)	the patient is referred by a medical practitioner; and
(b)	the service is not associated with a service to which an item in Subgroup 2 or 3 of this group applies; and
(c)	the referring practitioner is not a member of a group of practitioners of which the providing practitioner is a member;
	and
(d)	the service is not performed with item 55014, 55017, 55036 or 55038 on the same patient within 24 hours (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $49.00	Benefit: 75% = $36.75	85% = $41.65	
New
55734	
PELVIS, FEMALE, ultrasound scan of, by any or all approaches, where:
(a)	the patient is not referred by a medical practitioner; and
(b)	the service is not associated with a service to which an item in Subgroup 2 or 3 of this group applies (NR) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $17.50	Benefit: 75% = $13.15	85% = $14.90	
New
55735	
PELVIS, FEMALE, ultrasound scan of, in association with saline infusion of the endometrial cavity, by any or all approaches, where:
(a)	the patient is referred by a medical practitioner; and
(b)	the service is not associated with a service to which an item in Subgroup 2 or 3 of this group applies; and
(c)	the referring medical practitioner is not a member of a group of medical practitioners of which the providing
	practitioner is a member; and
(d)	a previous transvaginal ultrasound has revealed an abnormality of the uterus or fallopian tube (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $63.50	Benefit: 75% = $47.65	85% = $54.00	
New
55737	
PELVIS, FEMALE, ultrasound scan of, in association with saline infusion of the endometrial cavity, by any or all approaches, where:
(a)	the patient is not referred by a medical practitioner; and
(b)	the service is not associated with a service to which an item in Subgroup 2 or 3 of this group applies; and
(c)	a previous transvaginal ultrasound has revealed an abnormality of the uterus or fallopian tube (NR) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $28.50	Benefit: 75% = $21.40	85% = $24.25	
New
55760	
PELVIS OR ABDOMEN, pregnancy related or pregnancy complication, fetal development and anatomy, ultrasound scan (not exceeding 1 service in any 1 pregnancy) of, by any or all approaches, with measurement of all parameters for dating purposes, where:
(a)	the patient is referred by a medical practitioner; and
(b)	ultrasound of the same pregnancy confirms a multiple pregnancy; and
(c)	the dating of the pregnancy (as confirmed by ultrasound) is 17 to 22 weeks gestation; and
(d)	the service is not associated with a service to which an item in Subgroup 2 or 3 of this group applies; and
(e)	the referring practitioner is not a member of a group of practitioners to which the providing practitioner is a member; and
(f)	the service is not performed in conjunction with item 55706, 55709, 55712, 55713, 55715, 55717, 55719, 57721, 55762 or 55763 during the same pregnancy (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $75.00	Benefit: 75% = $56.25	85% = $63.75	
New
55763	
PELVIS OR ABDOMEN, pregnancy related or pregnancy complication, fetal development and anatomy, ultrasound scan (not exceeding 1 service in any 1 pregnancy) of, by any or all approaches, with measurement of all parameters for dating purposes, where:
(a)	the patient is not referred by a medical practitioner; and
(b)	ultrasound of the same pregnancy confirms a multiple pregnancy; and
(c)	the dating of the pregnancy (as confirmed by ultrasound) is 17 to 22 weeks gestation; and
(d)	the service is not performed in conjunction with item 55706, 55709, 55712, 55713, 55715, 55717, 55719, 55720, 55759 or 55760 during the same pregnancy; and
(e)	the service is not associated with a service to which an item in Subgroups 2 or 3 of this group applies (NR) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $30.00	Benefit: 75% = $22.50	85% = $25.50
Extended Medicare Safety Net Cap: $15.70	

ULTRASOUND	OBSTETRIC AND GYNAECOLOGICAL	
New
55765	
PELVIS OR ABDOMEN, pregnancy related or pregnancy complication, fetal development and anatomy, ultrasound scan of, by any or all approaches, with measurement of all parameters for dating purposes, where:
(a)	the patient is referred by a medical practitioner who is a Member or Fellow of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists or who has a Diploma of Obstetrics or has a qualification recognised by the Royal Australian and New Zealand College of Obstericians and Gynaecologists as equivalent to a Diploma of obstetrics or has obstetric privileges at a non-metropolitan hospital; and
(b)	ultrasound of the same pregnancy confirms a multiple pregnancy; and
(c)	the dating of the pregnancy (as confirmed by ultrasound) is 17 to 22 weeks gestation; and
(d)	the service is not associated with a service to which an item in Subgroup 2 or 3 of this group applies; and
(e)	the referring practitioner is not a member of a group of practitioners to which the providing practitioner is a member; and
(f)	further examination is clinically indicated in the same pregnancy to which item 55759, 55760, 55762 or 55763 has been performed; and
(g)	not performed in conjunction with item 55706, 55709, 55712, 55713, 55715, 55717, 55719 during the same pregnancy (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $80.00	Benefit: 75% = $60.00	85% = $68.00
Extended Medicare Safety Net Cap: $41.90	
New
55767	
PELVIS OR ABDOMEN, pregnancy related or pregnancy complication, fetal development and anatomy, ultrasound scan of, by any or all approaches, with measurement of all parameters for dating purposes, performed by or on behalf of a medical practitioner who is a Member or Fellow of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists, where:
(a)	the patient is not referred by a medical practitioner; and
(b)	ultrasound of the same pregnancy confirms a multiple pregnancy; and
(c)	the dating of the pregnancy (as confirmed by ultrasound) is 17 to 22 weeks of gestation; and
(d)	the service is not associated with a service to which an item in Subgroup 2 or 3 of this group applies; 
(e)	further examination is clinically indicated in the same pregnancy to which item 55759, 55760, 55762 or 55763 has been performed; and
(f)	not performed in conjunction with item 55706, 55709, 55712, 55713, 55715, 55717, 55719 or 55720 during the same pregnancy (NR) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $32.50	Benefit: 75% = $24.40	85% = $27.65
Extended Medicare Safety Net Cap: $15.70	
New
55769	
PELVIS OR ABDOMEN, pregnancy related or pregnancy complication, fetal development and anatomy, ultrasound scan (not exceeding 1 service in any 1 pregnancy) of, by any or all approaches, where:
(a)	dating of the pregnancy (as confirmed by ultrasound) is after 22 weeks of gestation; and
(b)	the ultrasound confirms a multiple pregnancy; and
(c)	the patient is referred by a medical practitioner or participating nurse practitioner; and
(d)	the service is not performed in the same pregnancy as item 55770 or 55771; and 
(e)	the service is not associated with a service to which an item in Subgroups 2 or 3 of this group applies; and
(f)	the referring practitioner is not a member of a group of practitioners of which the providing practitioner is a member;
	and
(g)	the service is not performed in conjunction with item 55718, 55721, 55722, 55723, 55724, 55725, 55726 or 55727 during the same pregnancy (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $75.00	Benefit: 75% = $56.25	85% = $63.75
Extended Medicare Safety Net Cap: $39.30	
New
55771	
PELVIS OR ABDOMEN, pregnancy related or pregnancy complication, fetal development and anatomy, ultrasound scan (not exceeding 1 service in any 1 pregnancy), by any or all approaches, where:
(a)	dating of the pregnancy as confirmed by ultrasound is after 22 weeks of gestation; and
(b)	the patient is not referred by a medical practitioner; and
(c)	the service is not performed in the same pregnancy as item 55768 or 55759; and
(d)	the pregnancy as confirmed by ultrasound is a multiple pregnancy; and
(e)	the service is not associated with a service to which an item in Subgroups 2 or 3 of this group applies; and
(f)	the service is not performed in conjunction with item 55718, 55721, 55723, 55724,,55725, 55726 or 55727 during the same pregnancy (NR) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $30.00	Benefit: 75% = $22.50	85% = $25.50
Extended Medicare Safety Net Cap: $15.70	

ULTRASOUND	MUSCULOSKELETAL	
New
55773	
PELVIS OR ABDOMEN, pregnancy related or pregnancy complication, fetal development and anatomy, ultrasound scan of, by any or all approaches, where:
(a)	dating of the pregnancy as confirmed by ultrasound is after 22 weeks of gestation; and
(b)	the patient is referred by a medical practitioner who is a Member or Fellow of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists or who has a Diploma of Obstetrics or has a qualification recognised by the Royal Australian and New Zealand College of Obstericians and Gynaecologists as equivalent to a Diploma of obstetrics or has obstetric privileges at a non-metropolitan hospital; and
(c)	further examination is clinically indicated in the same pregnancy to which item 55768, 55769, 55770 or 55771 has been performed; and
(d)	the pregnancy as confirmed by ultrasound is a multiple pregnancy; and
(e)	the service is not associated with a service to which an item in Subgroups 2 or 3 of this group applies; and
(f)	the referring practitioner is not a member of a group of practitioners of which the providing practitioner is a member; and
(g)	the service is not performed in conjunction with item 55718, 55721, 55722, 55723, 55724, 55725, 55726 or 55727 during the same pregnancy (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $80.00	Benefit: 75% = $60.00	85% = $68.00
Extended Medicare Safety Net Cap: $41.90	
New
55775	
PELVIS OR ABDOMEN, pregnancy related or pregnancy complication, fetal development and anatomy, ultrasound scan of, by any or all approaches, performed by or on behalf of a medical practitioner who is a Member or a Fellow of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists, where:
(a)	dating of the pregnancy as confirmed by ultrasound is after 22 weeks of gestation; and
(b)	the patient is not referred by a medical practitioner; and
(c)	further examination is clinically indicated in the same pregnancy to which item 55768, 55769, 55770 or 5571 has been performed; and
(d)	the pregnancy as confirmed by ultrasound is a multiple pregnancy; and
(e)	the service is not associated with a service to which an item in Subgroups 2 or 3 of this group applies; and
(f)	the service is not performed in conjunction with item 55718, 55721, 55722, 55723, 55724, 55725, 55726 or 55727 during the same pregnancy (NR) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $32.50	Benefit: 75% = $24.40	85% = $27.65
Extended Medicare Safety Net Cap: $18.35	
	SUBGROUP 6 - MUSCULOSKELETAL	
New
55801	
HAND OR WRIST, 1 or both sides, ultrasound scan of, where:
(a)	the service is not associated with a service to which an item in Subgroups 2 or 3 of this Group applies; and
(b)	the referring practitioner is not a member of a group of practitioners of which the providing practitioner is a member (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $54.55	Benefit: 75% = $40.95	85% = $46.40	
New
55803	
HAND OR WRIST, 1 or both sides, ultrasound scan of, where:
(a)	the service is not associated with a service to which an item in Subgroups 2 or 3 of this Group applies; and
(b)	the patient is not referred by a medical practitioner (NR) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $18.95	Benefit: 75% = $14.25	85% = $16.15	
New
55805	
FOREARM OR ELBOW, 1 or both sides, ultrasound scan of, where:
(a)	the service is not associated with a service to which an item in Subgroups 2 or 3 of this Group applies; and
(b)	the referring practitioner is not a member of a group of practitioners of which the providing practitioner is a member (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $54.55	Benefit: 75% = $40.95	85% = $46.40	
New
55807	
FOREARM OR ELBOW, 1 or both sides, ultrasound scan of, where:
(a)	the service is not associated with a service to which an item in Subgroups 2 or 3 of this Group applies; and
(b)	the patient is not referred by a medical practitioner (NR) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $18.95	Benefit: 75% = $14.25	85% = $16.15	

ULTRASOUND	MUSCULOSKELETAL	
New
55809	
Note: Benefits are only payable when referred based on the clinical indicators outlined in the item descriptions. Benefits are not payable when referred for non-specific shoulder pain alone.

SHOULDER OR UPPER ARM, 1 or both sides, ultrasound scan of, where:
(a)	the service is not associated with a service to which an item in Subgroups 2 or 3 of this Group applies; and
(b)	the referring practitioner is not a member of a group of practitioners of which the providing practitioner is a member,
	and where the service is provided, for the assessment of one or more of the following conditions or suspected
	conditions:
-	evaluation of injury to tendon, muscle or muscle/tendon junction; or
-	rotator cuff tear/calcification/tendinosis (biceps, subscapular, suspraspinatus, infraspinatus); or
-	biceps subluxation; or
-	capsulitis and bursitis; or
-	evaluation of mass including ganglion; or
-	occult fracture; or
-	acromioclavicular joint pathology (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $54.55	Benefit: 75% = $40.95	85% = $46.40	
New
55811	
Note: Benefits are only payable when referred based on the clinical indicators outlined in the item descriptions. Benefits are not payable when referred for non-specific shoulder pain alone.

SHOULDER OR UPPER ARM, 1 or both sides, ultrasound scan of, where:
(a)	the service is not associated with a service to which an item in Subgroups 2 or 3 of this Group applies; and
(b)	the patient is not referred by a medical practitioner,
	and where the service is provided, for the assessment of one or more of the following conditions or suspected
	conditions:
-	evaluation of injury to tendon, muscle or muscle/tendon junction; or
-	rotator cuff tear/calcification/tendinosis (biceps, subscapular, suspraspinatus, infraspinatus); or
-	biceps subluxation; or
-	capsulitis and bursitis; or
-	evaluation of mass including ganglion; or
-	occult fracture; or
-	acromioclavicular joint pathology (NR) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $18.95	Benefit: 75% = $14.25	85% = $16.15	
New
55813	
CHEST OR ABDOMINAL WALL, 1 or more areas, ultrasound scan of, where:
(a)	the service is not associated with a service to which an item in Subgroups 2 or 3 of this Group applies; and
(b)	the referring practitioner is not a member of a group of practitioners of which the providing practitioner is a member (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $54.55	Benefit: 75% = $40.95	85% = $46.40	
New
55815	
CHEST OR ABDOMINAL WALL, 1 or more areas, ultrasound scan of, where:
(a)	the service is not associated with a service to which an item in Subgroups 2 or 3 of this Group applies; and
(b)	the patient is not referred by a medical practitioner (NR) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $18.95	Benefit: 75% = $14.25	85% = $16.15	
New
55817	
HIP OR GROIN, 1 or both sides, ultrasound scan of, where:
(a)	the service is not associated with a service to which an item in Subgroups 2 or 3 of this Group applies; and
(b)	the referring practitioner is not a member of a group of practitioners of which the providing practitioner is a member (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $54.55	Benefit: 75% = $40.95	85% = $46.40	
New
55819	
HIP OR GROIN, 1 or both sides, ultrasound scan of, where:
(a)	the service is not associated with a service to which an item in Subgroups 2 or 3 of this Group applies: and
(b)	the patient is not referred by a medical practitioner (NR) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $18.95	Benefit: 75% = $14.25	85% = $16.15	
New
55821	
PAEDIATRIC HIP EXAMINATION FOR DYSPLASIA, 1 or both sides, ultrasound scan of, where:
(a)	the service is not associated with a service to which an item in Subgroups 2 or 3 of this Group applies; and
(b)	the referring practitioner is not a member of a group of practitioners of which the providing  practitioner is a member (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $54.55	Benefit: 75% = $40.95	85% = $46.40	

ULTRASOUND	MUSCULOSKELETAL	
New
55823	
PAEDIATRIC HIP EXAMINATION FOR DYSPLASIA, 1 or both sides, ultrasound scan of, where:
(a)	the service is not associated with a service to which an item in Subgroups 2 or 3 of this Group applies; and
(b)	the patient is not referred by a medical practitioner (NR) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $18.95	Benefit: 75% = $14.25	85% = $16.15	
New
55825	
BUTTOCK OR THIGH, 1 or both sides, ultrasound scan of, where:
(a)	the service is not associated with a service to which an item in Subgroups 2 or 3 of this Group applies; and
(b)	the referring practitioner is not a member of a group of practitioners of which the providing practitioner is a member (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $54.55	Benefit: 75% = $40.95	85% = $46.40	
New
55827	
BUTTOCK OR THIGH, 1 or both sides, ultrasound scan of, where:
(a)	the service is not associated with a service to which an item in Subgroups 2 or 3 of this Group applies; and
(b)	the patient is not referred by a medical practitioner (NR) (NK)
Fee: $18.95	Benefit: 75% = $14.25	85% = $16.15	
New
55829	
Note: Benefits are only payable when referred based on the clinical indicators outlined in the item descriptions. Benefits are not payable when referred for non-specific knee pain alone or other knee condition including:
-	meniscal and cruciate ligament tears
-	assessment of chondral surfaces

KNEE, 1 or both sides, ultrasound scan of, where:
(a)	the service is not associated with a service to which an item in Subgroups 2 or 3 of this Group applies; and
(b)	the referring practitioner is not a member of a group of practitioners of which the providing practitioner is a member,
	and where the service is provided for the assessment of one or more of the following conditions or suspected
	conditions:
-	abnormality of tendons or bursae about the knee; or
-	meniscal cyst, popliteal fossa cyst, mass or pseudomass; or
-	nerve entrapment, nerve or nerve sheath tumour; or
-	injury of collateral ligaments (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $54.55	Benefit: 75% = $40.95	85% = $46.40	
New
55831	
Note: Benefits are only payable when referred based on the clinical indicators outlined in the item descriptions. Benefits are not payable when referred for non-specific knee pain alone or other knee condition including:
-	meniscal and cruciate ligament tears
-	assessment of chondral surfaces

KNEE, 1 or both sides, ultrasound scan of, where:
(a)	the service is not associated with a service to which an item in Subgroups 2 or 3 of this Group applies; and
(b)	the patient is not referred by a medical practitioner and where the service is provided for the assessment of one
	or more of the following conditions or suspected conditions:
-	abnormality of tendons or bursae about the knee; or
-	meniscal cyst, popliteal fossa cyst, mass or pseudomass; or
-	nerve entrapment, nerve or nerve sheath tumour; or
-	injury of collateral ligaments (NR) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $18.95	Benefit: 75% = $14.25	85% = $16.15	
New
55833	
LOWER LEG, 1 or both sides, ultrasound scan of, where:
(a)	the service is not associated with a service to which an item in Subgroups 2 or 3 of this Group applies; and
(b)	the referring practitioner is not a member of a group of practitioners of which the providing practitioner is a member (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $54.55	Benefit: 75% = $40.95	85% = $46.40	
New
55835	
LOWER LEG, 1 or both sides, ultrasound scan of, where:
(a)	the service is not associated with a service to which an item in Subgroups 2 or 3 of this Group applies; and
(b)	the patient is not referred by a medical practitioner (NR) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $18.95	Benefit: 75% = $14.25	85% = $16.15	

ULTRASOUND	MUSCULOSKELETAL	
New
55837	
ANKLE OR HIND FOOT, 1 or both sides, ultrasound scan of, where:
(a)	the services is not associated with a service to which an item in Subgroups 2 or 3 of this Group applies; and
(b)	the referring practitioner is not a member of a group of practitioners of which the providing practitioner is a member (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $54.55	Benefit: 75% = $40.95	85% = $46.40	
New
55839	
ANKLE OR HIND FOOT, 1 or both sides, ultrasound scan of, where:
(a)	the service is not associated with a service to which an item in Subgroups 2 or 3 of this Group applies; and
(b)	the patient is not referred by a medical practitioner (NR) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $18.95	Benefit: 75% = $14.25	85% = $16.15	
New
55841	
MID FOOT OR FORE FOOT, 1 or both sides, ultrasound scan of, where:
(a)	the service is not associated with a service to which an item in Subgroups 2 or 3 of this Group applies; and
(b)	the referring practitioner is not a member of a group of practitioners of which the providing practitioner is a member (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $54.55	Benefit: 75% = $40.95	85% = $46.40	
New
55843	
MID FOOT OR FORE FOOT, 1 or both sides, ultrasound scan of, where:
(a)	the service is not associated with a service to which an item in Subgroups 2 or 3 of this Group applies; and
(b)	the patient is not referred by a medical practitioner (NR) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $18.95	Benefit: 75% = $14.25	85% = $16.15	
New
55845	
ASSESSMENT OF A MASS ASSOCIATED WITH THE SKIN OR SUBCUTANEOUS STRUCTURES, NOT BEING A PART OF THE MUSCULOSKELETAL SYSTEM, 1 or more areas, ultrasound scan of, where:
(a)	the service is not associated with a service to which an item in Subgroups 2 or 3 of this Group applies; and
(b)	the referring practitioner is not a member of a group of practitioners of which the providing practitioner is a member (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $43.70	Benefit: 75% = $32.80	85% = $37.15	
New
55847	
ASSESSMENT OF A MASS ASSOCIATED WITH THE SKIN OR SUBCUTANEOUS STRUCTURES, NOT BEING A PART OF THE MUSCULOSKELETAL SYSTEM, 1 or more areas, ultrasound scan of, where:
(a)	the service is not associated with a service to which an item in Subgroups 2 or 3 of this Group applies; and
(b)	the patient is not referred by a medical practitioner (NR) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $18.95	Benefit: 75% = $14.25	85% = $16.15	
New
55849	
MUSCULOSKELETAL CROSS-SECTIONAL ECHOGRAPHY, in conjunction with a surgical procedure using interventional techniques, not being a service associated with a service to which any other item in this group applies, and not performed in conjunction with item 55054 or 55026 (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $54.55	Benefit: 75% = $40.95	85% = $46.40	
New
55851	
MUSCULOSKELETAL CROSS-SECTIONAL ECHOGRAPHY, in conjunction with a surgical procedure using interventional techniques, inclusive of a diagnostic musculoskeletal ultrasound service, where:
(a)	the referring practitioner has indicated on a referral for a musculoskeletal ultrasound that a ultrasound guided
	intervention be performed if clinically indicated;
(b)	the service is not performed in conjunction with items 55026, 55054, or 55800 to 55849, and 
(c)	the referring practitioner is not a member of a group of practitioners of which the providing practitioner is a member (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $76.45	Benefit: 75% = $57.35	85% = $65.00	
New
55853	
PAEDIATRIC SPINE, SPINAL CORD AND OVERLYING SUBCUTANEOUS TISSUES, Ultrasound scan of, where:
a)	the patient is referred by a medical practitioner
b)	the service is not associated with a service to which an item in Subgroups 2 or 3 of this Group applies; and
c)	the referring practitioner is not a member of a group of practitioners of which the providing practitioner is a member (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $54.55	Benefit: 75% = $40.95	85% = $46.40	

ULTRASOUND	MUSCULOSKELETAL	
New
55855	
PAEDIATRIC SPINE, SPINAL CORD AND OVERLYING SUBCUTANEOUS TISSUES, Ultrasound scan of, where: 
a)	the service is not associated with a service to which an item in Subgroups 2 or 3 of this Group applies; and
b)	the patient is not referred by a medical practitioner (NR) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $18.95	Benefit: 75% = $14.25	85% = $16.15	

COMPUTED TOMOGRAPHY	COMPUTED TOMOGRAPHY	
	GROUP I2 - COMPUTED TOMOGRAPHY	
New
56025	
CONE BEAM COMPUTED TOMOGRAPHY of teeth and supporting bone structures (R) (K) (Anaes.)
(See para DID and DIQ of explanatory notes to this Category)
Fee: $113.15	Benefit: 75% = $84.90	85% = $96.20	
New
56026	
CONE BEAM COMPUTED TOMOGRAPHY of teeth and supporting bone structures (R) (NK) (Anaes.)
(See para DID and DIQ of explanatory notes to this Category)
Fee: $56.60	Benefit: 75% = $42.45	85% = $48.15	
New
57360	
COMPUTED TOMOGRAPHY OF THE CORONARY ARTERIES performed on a minimum of a 64 slice (or equivalent) scanner, where the request is made by a specialist or consultant physician, and:
a)	the patient has stable symptoms consistent with coronary ischaemia, is at low to intermediate risk of coronary artery disease and would have been considered for coronary angiography; or
b)	the patient requires exclusion of coronary artery anomaly or fistula; or
c)	the patient will be undergoing non-coronary cardiac surgery (R) (K)
 (Anaes.)
(See para DIL and DIQ of explanatory notes to this Category)
Fee: $700.00	Benefit: 75% = $525.00	85% = $628.80	
New
57361	
COMPUTED TOMOGRAPHY OF THE CORONARY ARTERIES performed on a minimum of a 64 slice (or equivalent) scanner, where the request is made by a specialist or consultant physician, and:
a)	the patient has stable symptoms consistent with coronary ischaemia, is at low to intermediate risk of coronary artery disease and would have been considered for coronary angiography; or
b)	the patient requires exclusion of coronary artery anomaly or fistula; or
c)	the patient will be undergoing non-coronary cardiac surgery (R) (NK)
 (Anaes.)
(See para DIL and DIQ of explanatory notes to this Category)
Fee: $350.00	Benefit: 75% = $262.50	85% = $297.50	

DIAGNOSTIC RADIOLOGY	EXTREMITIES	
	GROUP I3 - DIAGNOSTIC RADIOLOGY	
	SUBGROUP 1 - RADIOGRAPHIC EXAMINATION OF EXTREMITIES	
New
57529	
HAND, WRIST, FOREARM, ELBOW OR HUMERUS (NR) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $14.90	Benefit: 75% = $11.20	85% = $12.70	
New
57530	
HAND, WRIST, FOREARM, ELBOW OR HUMERUS (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $19.90	Benefit: 75% = $14.95	85% = $16.95	
New
57532	
HAND AND WRIST OR HAND, WRIST AND FOREARM OR FOREARM AND ELBOW OR ELBOW AND HUMERUS (NR) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $20.25	Benefit: 75% = $15.20	85% = $17.25	
New
57533	
HAND AND WRIST OR HAND, WRIST AND FOREARM OR FOREARM AND ELBOW OR ELBOW AND HUMERUS (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $27.00	Benefit: 75% = $20.25	85% = $22.95	
New
57535	
FOOT, ANKLE, LEG, KNEE OR FEMUR (NR) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $16.25	Benefit: 75% = $12.20	85% = $13.85	
New
57536	
FOOT, ANKLE, LEG, KNEE OR FEMUR (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $21.70	Benefit: 75% = $16.30	85% = $18.45	
New
57538	
FOOT AND ANKLE, OR ANKLE AND LEG, OR LEG AND KNEE, OR KNEE AND FEMUR (NR) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $24.70	Benefit: 75% = $18.55	85% = $21.00	
New
57539	
FOOT AND ANKLE, OR ANKLE AND LEG, OR LEG AND KNEE, OR KNEE AND FEMUR (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $32.90	Benefit: 75% = $24.70	85% = $28.00	
	SUBGROUP 2 - RADIOGRAPHIC EXAMINATION OF SHOULDER OR PELVIS	
New
57702	
SHOULDER OR SCAPULA (NR) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $20.25	Benefit: 75% = $15.20	85% = $17.25	
New
57705	
SHOULDER OR SCAPULA (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $27.00	Benefit: 75% = $20.25	85% = $22.95	
New
57708	
CLAVICLE (NR) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $16.25	Benefit: 75% = $12.20	85% = $13.85	
New
57711	
CLAVICLE (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $21.70	Benefit: 75% = $16.30	85% = $18.45	
New
57714	
HIP JOINT (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $23.60	Benefit: 75% = $17.70	85% = $20.10	
New
57717	
PELVIC GIRDLE (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $30.45	Benefit: 75% = $22.85	85% = $25.90	
New
57723	
FEMUR, internal fixation of neck or intertrochanteric (pertrochanteric) fracture (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $49.65	Benefit: 75% = $37.25	85% = $42.25	

DIAGNOSTIC RADIOLOGY	HEAD	
	SUBGROUP 3 - RADIOGRAPHIC EXAMINATION OF HEAD	
New
57911	
SKULL, not in association with item 57902 or 57914 (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $32.25	Benefit: 75% = $24.20	85% = $27.45	
New
57914	
CEPHALOMETRY, not in association with item 57901 or 57911 (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $32.25	Benefit: 75% = $24.20	85% = $27.45	
New
57917	
SINUSES (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $23.65	Benefit: 75% = $17.75	85% = $20.15	
New
57920	
MASTOIDS (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $32.25	Benefit: 75% = $24.20	85% = $27.45	
New
57923	
PETROUS TEMPORAL BONES (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $32.25	Benefit: 75% = $24.20	85% = $27.45	
New
57926	
FACIAL BONES  orbit, maxilla or malar, any or all (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $23.60	Benefit: 75% = $17.70	85% = $20.10	
New
57929	
MANDIBLE, not by orthopantomography technique (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $23.60	Benefit: 75% = $17.70	85% = $20.10	
New
57932	
SALIVARY CALCULUS (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $23.60	Benefit: 75% = $17.70	85% = $20.10	
New
57935	
NOSE (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $23.60	Benefit: 75% = $17.70	85% = $20.10	
New
57938	
EYE (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $23.60	Benefit: 75% = $17.70	85% = $20.10	
New
57941	
TEMPOROMANDIBULAR JOINTS (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $24.85	Benefit: 75% = $18.65	85% = $21.15	
New
57944	
TEETH  SINGLE AREA (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $16.45	Benefit: 75% = $12.35	85% = $14.00	
New
57947	
TEETH  FULL MOUTH (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $39.15	Benefit: 75% = $29.40	85% = $33.30	
New
57950	
PALATOPHARYNGEAL STUDIES with fluoroscopic screening (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $32.25	Benefit: 75% = $24.20	85% = $27.45	
New
57953	
PALATOPHARYNGEAL STUDIES without fluoroscopic screening (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $24.85	Benefit: 75% = $18.65	85% = $21.15	
New
57956	
LARYNX, LATERAL AIRWAYS AND SOFT TISSUES OF THE NECK, not being a service associated with a service to which item 57939, 57942, 57950 or 57953 applies (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $21.70	Benefit: 75% = $16.30	85% = $18.45	

DIAGNOSTIC RADIOLOGY	SPINE	
New
57959	
Orthopantomography, for diagnosis and/or management of trauma, infection, tumours, congenital conditions or surgical conditions of the teeth or maxillofacial region (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $23.70	Benefit: 75% = $17.80	85% = $20.15	
New
57962	
Orthopantomography, for diagnosis and/or management of impacted teeth, caries, periodontal or peripical pathology where signs or symptoms of those conditions are evident (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $23.70	Benefit: 75% = $17.80	85% = $20.15	
New
57965	
Orthopantomography, for diagnosis and/or management of missing or crowded teeth, or developmental anomalies of the teeth or jaws (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $23.70	Benefit: 75% = $17.80	85% = $20.15	
New
57968	
Orthopantomography, for diagnosis and/or management of temporomandibular joint arthroses or dysfunction (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $23.70	Benefit: 75% = $17.80	85% = $20.15	
	SUBGROUP 4 - RADIOGRAPHIC EXAMINATION OF SPINE	
New
58102	
SPINE  CERVICAL (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $33.60	Benefit: 75% = $25.20	85% = $28.60	
New
58105	
SPINE  THORACIC (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $27.55	Benefit: 75% = $20.70	85% = $23.45	
New
58111	
SPINE  LUMBOSACRAL (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $38.50	Benefit: 75% = $28.90	85% = $32.75	
New
58114	
Spine, four regions, cervical, thoracic, lumbosacral and sacrococcygeal (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $55.00	Benefit: 75% = $41.25	85% = $46.75	
New
58117	
SPINE  SACROCOCCYGEAL (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $23.50	Benefit: 75% = $17.65	85% = $20.00	
New
58123	
NOTE:  An account issued or a patient assignment form must show the item numbers of the examinations performed under this item

Spine, two examinations of the kind referred to in items 58100, 58102, 58103, 58105, 58106, 58109, 58111 and 58117 (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $48.65	Benefit: 75% = $36.50	85% = $41.40	
New
58124	
NOTE:  An account issued or a patient assignment form must show the item numbers of the examinations performed under this item

Spine, three examinations of the kind mentioned in items 58100, 58102, 58103, 58105, 58106, 58109, 58111 and 58117 (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $55.00	Benefit: 75% = $41.25	85% = $46.75	
New
58126	
Spine, four regions, cervical, thoracic, lumbosacral and sacrococcygeal, if the service to which item 58120, 58121, 58126 or 58127 applies has not been performed on the same patient within the same calendar year (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $55.00	Benefit: 75% = $41.25	85% = $46.75	

DIAGNOSTIC RADIOLOGY	BONE AGE STUDY	
New
58127	
NOTE:  An account issued or a patient assignment form must show the item numbers of the examinations performed under this item

Spine, three examinations of the kind mentioned in items 58100, 58102, 58103, 58105, 58106 and 58109, 58111 and 58117 if the service to which item 58120, 58121, 58126 or 58127 applies has not been performed on the same patient within the same calendar year (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $55.00	Benefit: 75% = $41.25	85% = $46.75	
	SUBGROUP 5 - BONE AGE STUDY AND SKELETAL SURVEYS	
New
58302	
BONE AGE STUDY (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $20.05	Benefit: 75% = $15.05	85% = $17.05	
New
58308	
SKELETAL SURVEY (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $44.70	Benefit: 75% = $33.55	85% = $38.00	
	SUBGROUP 6 - RADIOGRAPHIC EXAMINATION OF THORACIC REGION	
New
58502	
CHEST (lung fields) by direct radiography (NR) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $17.70	Benefit: 75% = $13.30	85% = $15.05	
New
58505	
CHEST (lung fields) by direct radiography (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $23.60	Benefit: 75% = $17.70	85% = $20.10	
New
58508	
CHEST (lung fields) by direct radiography with fluoroscopic screening (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $30.40	Benefit: 75% = $22.80	85% = $25.85	
New
58511	
THORACIC INLET OR TRACHEA (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $19.90	Benefit: 75% = $14.95	85% = $16.95	
New
58523	
LEFT RIBS, RIGHT RIBS OR STERNUM (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $21.70	Benefit: 75% = $16.30	85% = $18.45	
New
58526	
LEFT AND RIGHT RIBS, LEFT RIBS AND STERNUM, OR RIGHT RIBS AND STERNUM (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $28.25	Benefit: 75% = $21.20	85% = $24.05	
New
58529	
LEFT RIBS, RIGHT RIBS AND STERNUM (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $34.70	Benefit: 75% = $26.05	85% = $29.50	
	SUBGROUP 7 - RADIOGRAPHIC EXAMINATION OF URINARY TRACT	
New
58702	
PLAIN RENAL ONLY (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $23.05	Benefit: 75% = $17.30	85% = $19.60	
New
58708	
INTRAVENOUS PYELOGRAPHY, with or without preliminary plain films and with or without tomography - (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $78.95	Benefit: 75% = $59.25	85% = $67.15	
New
58717	
ANTEGRADE OR RETROGRADE PYELOGRAPHY, with or without preliminary plain films and with preparation and contrast injection - 1 side - (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $75.80	Benefit: 75% = $56.85	85% = $64.45	

DIAGNOSTIC RADIOLOGY	ALIMENTARY/BILIARY	
New
58720	
RETROGRADE CYSTOGRAPHY OR RETROGRADE URETHROGRAPHY with or without preliminary plain films and with preparation and contrast injection - (R) (NK)  (Anaes.)
(See para DIQ of explanatory notes to this Category)
Fee: $63.05	Benefit: 75% = $47.30	85% = $53.60	
New
58723	
RETROGRADE MICTURATING CYSTOURETHROGRAPHY, with preparation and contrast injection - (R) (NK)  (Anaes.)
(See para DIQ of explanatory notes to this Category)
Fee: $69.15	Benefit: 75% = $51.90	85% = $58.80	
	SUBGROUP 8 - RADIOGRAPHIC EXAMINATION OF ALIMENTARY TRACT AND BILIARY SYSTEM	
New
58902	
PLAIN ABDOMINAL ONLY, not being a service associated with a service to which item 58909, 58911, 58912, 58914, 58915, 58917, 58924 or 58926 applies (NR) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $17.85	Benefit: 75% = $13.40	85% = $15.20	
New
58905	
PLAIN ABDOMINAL ONLY, not being a service associated with a service to which item 58909, 58911, 58912, 58914, 58915, 58917, 58924 or 58926 applies (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $23.80	Benefit: 75% = $17.85	85% = $20.25	
New
58911	
BARIUM or other opaque meal of 1 or more of PHARYNX, OESOPHAGUS, STOMACH OR DUODENUM, with or without preliminary plain films of pharynx, chest or duodenum, not being a service associated with a service to which item 57939, 57942, 57945, 57950, 57953 or 57956 applies - (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $45.00	Benefit: 75% = $33.75	85% = $38.25	
New
58914	
BARIUM or other opaque meal OF OESOPHAGUS, STOMACH, DUODENUM AND FOLLOW THROUGH TO COLON, with or without screening of chest, with or without preliminary plain film (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $55.15	Benefit: 75% = $41.40	85% = $46.90	
New
58917	
BARIUM or other opaque meal, SMALL BOWEL SERIES ONLY, with or without preliminary plain film (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $39.50	Benefit: 75% = $29.65	85% = $33.60	
New
58920	
SMALL BOWEL ENEMA, barium or other opaque study of the small bowel, including DUODENAL INTUBATION, with or without preliminary plain films, not being a service associated with a service to which item 30488 applies - (R) (NK)  (Anaes.)
(See para DIQ of explanatory notes to this Category)
Fee: $69.25	Benefit: 75% = $51.95	85% = $58.90	
New
58923	
OPAQUE ENEMA, with or without air contrast study and with or without preliminary plain films - (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $67.65	Benefit: 75% = $50.75	85% = $57.55	
New
58926	
GRAHAM'S TEST (cholecystography), with preliminary plain films and with or without tomography - (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $42.05	Benefit: 75% = $31.55	85% = $35.75	
New
58929	
CHOLEGRAPHY DIRECT, with or without preliminary plain films and with preparation and contrast injection, not being a service associated with a service to which item 30439 applies - (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $38.25	Benefit: 75% = $28.70	85% = $32.55	
New
58935	
CHOLEGRAPHY, percutaneous transhepatic, with or without preliminary plain films and with preparation and contrast injection - (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $102.80	Benefit: 75% = $77.10	85% = $87.40	
New
58938	
CHOLEGRAPHY, drip infusion, with or without preliminary plain films, with preparation and contrast injection and with or without tomography - (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $98.00	Benefit: 75% = $73.50	85% = $83.30	
New
58941	
DEFAECOGRAM (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $69.65	Benefit: 75% = $52.25	85% = $59.25	

DIAGNOSTIC RADIOLOGY	LOCALISATION OF FOREIGN BODIES	
	SUBGROUP 9 - RADIOGRAPHIC EXAMINATION FOR LOCALISATION OF FOREIGN BODIES	
New
59104	
Localisation of foreign body, if provided in conjunction with a service described in Subgroups 1 to 12 of Group I3 (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $10.65	Benefit: 75% = $8.00	85% = $9.10	
	SUBGROUP 10 - RADIOGRAPHIC EXAMINATION OF BREASTS	
New
59301	
(Note: These items are intended for use in the investigation of a clinical abnormality  of the breast/s and NOT for individual, group or opportunistic screening of asymptomatic patients)

MAMMOGRAPHY OF BOTH BREASTS, if there is a reason to suspect the presence of malignancy because of:
	(i)	the past occurrence of breast malignancy in the patient or members of the patient's family; or
	(ii)	symptoms or indications of malignancy found on an examination of the patient by a medical practitioner.  Unless otherwise indicated, mammography includes both breasts (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $44.75	Benefit: 75% = $33.60	85% = $38.05	
New
59304	
MAMMOGRAPHY OF ONE BREAST,  if:
(a)	the patient is referred with a specific request for a unilateral mammogram; and
(b)	there is reason to suspect the presence of malignancy because of:
	(i)      the past occurrence of breast malignancy in the patient or members of the patient's family; or
	(ii)     symptoms or indications of malignancy found on an examination of the patient by a medical practitioner (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $27.00	Benefit: 75% = $20.25	85% = $22.95	
New
59307	
MAMMARY DUCTOGRAM (galactography) - 1 breast (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $50.15	Benefit: 75% = $37.65	85% = $42.65	
New
59310	
MAMMARY DUCTOGRAM (galactography) - 2 breasts (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $100.30	Benefit: 75% = $75.25	85% = $85.30	
New
59313	
RADIOGRAPHIC EXAMINATION OF BOTH BREASTS, in conjunction with a surgical procedure on each breast, using interventional techniques - (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $43.50	Benefit: 75% = $32.65	85% = $37.00	
New
59315	
RADIOGRAPHIC EXAMINATION OF 1 BREAST, in conjunction with a surgical procedure using interventional techniques - (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $26.25	Benefit: 75% = $19.70	85% = $22.35	
New
59319	
RADIOGRAPHIC EXAMINATION OF EXCISED BREAST TISSUE to confirm satisfactory excision of 1 or more lesions in 1 breast or both following pre-operative localisation in conjunction with a service under item 31536 - (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $23.55	Benefit: 75% = $17.70	85% = $20.05	
	SUBGROUP 11 - RADIOGRAPHIC EXAMINATION IN CONNECTION WITH PREGNANCY	
New
59504	
PELVIMETRY, not being a service associated with a service to which item 57201 or 57247 applies (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $44.70	Benefit: 75% = $33.55	85% = $38.00	
	SUBGROUP 12 - RADIOGRAPHIC EXAMINATION WITH OPAQUE OR CONTRAST MEDIA	
New
59701	
DISCOGRAPHY, each disc, with or without preliminary plain films and with preparation and contrast injection - (R) (NK) (Anaes.)
(See para DIQ of explanatory notes to this Category)
Fee: $48.30	Benefit: 75% = $36.25	85% = $41.10	
New
59704	
DACRYOCYSTOGRAPHY, 1 side, with or without preliminary plain film and with preparation and contrast injection - (R)  (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $37.95	Benefit: 75% = $28.50	85% = $32.30	

DIAGNOSTIC RADIOLOGY	TOMOGRAPHY	
New
59713	
HYSTEROSALPINGOGRAPHY, with or without preliminary plain films and with preparation and contrast injection - (R)  (NK) (Anaes.)
(See para DIQ of explanatory notes to this Category)
Fee: $56.85	Benefit: 75% = $42.65	85% = $48.35	
New
59716	
BRONCHOGRAPHY, 1 side, with or without preliminary plain films and with preparation and contrast injection - (R) (NK) (Anaes.)
(See para DIQ of explanatory notes to this Category)
Fee: $71.80	Benefit: 75% = $53.85	85% = $61.05	
New
59719	
PHLEBOGRAPHY, 1 side, with or without preliminary plain films and with preparation and contrast injection - (R) (NK) (Anaes.)
(See para DIQ of explanatory notes to this Category)
Fee: $67.35	Benefit: 75% = $50.55	85% = $57.25	
New
59725	
MYELOGRAPHY, 1 or more regions, with or without preliminary plain films and with preparation and contrast injection, not being a service associated with a service to which item 56219 or 56259 applies - (R) (NK) (Anaes.)
(See para DIQ of explanatory notes to this Category)
Fee: $113.25	Benefit: 75% = $84.95	85% = $96.30	
New
59734	
SIALOGRAPHY, 1 side, with preparation and contrast injection, not being a service associated with a service to which item 57918 or 57932 applies - (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $53.85	Benefit: 75% = $40.40	85% = $45.80	
New
59737	
VASOEPIDIDYMOGRAPHY, 1 side, -  (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $31.00	Benefit: 75% = $23.25	85% = $26.35	
New
59740	
SINOGRAM OR FISTULOGRAM, 1 or more regions, with or without preliminary plain films and with preparation and contrast injection - (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $36.90	Benefit: 75% = $27.70	85% = $31.40	
New
59752	
ARTHROGRAPHY, each joint, excluding the facet (zygapophyseal) joints of the spine, single or double contrast study, with or without preliminary plain films and with preparation and contrast injection - (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $69.60	Benefit: 75% = $52.20	85% = $59.20	
New
59755	
LYMPHANGIOGRAPHY, one or both sides, with preliminary plain films and follow-up radiography and with preparation and contrast injection - (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $109.70	Benefit: 75% = $82.30	85% = $93.25	
New
59761	
PERITONEOGRAM (herniography) with or without contrast medium including preparation - performed on a person over 14 years of age (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $57.60	Benefit: 75% = $43.20	85% = $49.00	
New
59764	
AIR INSUFFLATION during video - fluoroscopic imaging including associated consultation (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $66.95	Benefit: 75% = $50.25	85% = $56.95	
	SUBGROUP 14 - TOMOGRAPHY	
New
60101	
TOMOGRAPHY OF ANY REGION (R) (NK)  (Anaes.)
(See para DIQ of explanatory notes to this Category)
Fee: $30.40	Benefit: 75% = $22.80	85% = $25.85	
	SUBGROUP 15 - FLUOROSCOPIC EXAMINATION	
New
60501	
FLUOROSCOPY, with general anaesthesia (not being a service associated with a radiographic examination) (R) (NK)  (Anaes.)
(See para DIQ of explanatory notes to this Category)
Fee: $21.70	Benefit: 75% = $16.30	85% = $18.45	
New
60504	
FLUOROSCOPY, without general anaesthesia (not being a service associated with a radiographic examination) (R) (NK)
Fee: $14.90	Benefit: 75% = $11.20	85% = $12.70	

DIAGNOSTIC RADIOLOGY	INTERVENTIONAL TECHNIQUES	
New
60507	
FLUOROSCOPY using a mobile image intensifier, in conjunction with a surgical procedure lasting less than 1 hour, not being a service associated with a service to which another item in this Table applies (R) (NK)
Fee: $31.90	Benefit: 75% = $23.95	85% = $27.15	
New
60510	
FLUOROSCOPY using a mobile image intensifier, in conjunction with a surgical procedure lasting 1 hour or more, not being a service associated with a service to which another item in this Table applies (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $49.45	Benefit: 75% = $37.10	85% = $42.05	
	SUBGROUP 17 - INTERVENTIONAL TECHNIQUES	
New
61110	
FLUOROSCOPY in an ANGIOGRAPHY SUITE with image intensification, in conjunction with a surgical procedure, using interventional techniques, not being a service associated with a service to which another item in this Table applies (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $129.45	Benefit: 75% = $97.10	85% = $110.05	

NUCLEAR MEDICINE IMAGING	NUCLEAR MEDICINE IMAGING	
	GROUP I4 - NUCLEAR MEDICINE IMAGING	
Amend
61538	
FDG PET study of the brain for evaluation of suspected residual or recurrent malignant brain tumour based on anatomical imaging findings, after definitive therapy (or during ongoing chemotherapy) in patients who are considered suitable for further active therapy. (R)
Fee: $901.00	Benefit: 75% = $675.75	85% = $829.80	
Amend
61541	
Whole body FDG PET study, following initial therapy, for the evaluation of suspected residual, metastatic or recurrent colorectal carcinoma in patients considered suitable for active therapy (R)
(See para DIQ of explanatory notes to this Category)
Fee: $953.00	Benefit: 75% = $714.75	85% = $881.80	
Amend
61553	
Whole body FDG PET study, following initial therapy, performed for the evaluation of suspected metastatic or recurrent malignant melanoma in patients considered suitable for active therapy (R)
(See para DIQ of explanatory notes to this Category)
Fee: $999.00	Benefit: 75% = $749.25	85% = $927.80	
Amend
61565	
Whole body FDG PET study, following initial therapy, performed for the evaluation of suspected residual, metastatic or recurrent ovarian carcinoma in patients considered suitable for active therapy. (R)
(See para DIQ of explanatory notes to this Category)
Fee: $953.00	Benefit: 75% = $714.75	85% = $881.80	
Amend
61571	
Whole body FDG PET study, for the further primary staging of  patients with histologically proven carcinoma of the uterine cervix, at FIGO stage IB2 or greater by conventional staging, prior to planned radical radiation therapy or combined modality therapy with curative intent. (R)
Fee: $953.00	Benefit: 75% = $714.75	85% = $881.80	
New
61575	
Whole body FDG PET study, for the further staging of patients with confirmed local recurrence of carcinoma of the uterine cervix considered suitable for salvage pelvic chemoradiotherapy or pelvic exenteration with curative intent. (R)
Fee: $953.00	Benefit: 75% = $714.75	85% = $881.80	
Amend
61616	
Whole body FDG PET study for the initial staging of indolent non–Hodgkin’s lymphoma where clinical, pathological and imaging findings indicate that the stage is I or IIA and the proposed management is definitive radiotherapy with curative intent. (R)
Fee: $953.00	Benefit: 75% = $714.75	85% = $881.80	
New
61620	
Whole body FDG PET study for the initial staging of newly diagnosed or previously untreated Hodgkin’s or non-Hodgkin’s lymphoma (excluding indolent non-Hodgkin's lymphoma. (R)
Fee: $953.00	Benefit: 75% = $714.75	85% = $881.80	
Amend
61622	
Whole body FDG PET study to assess response to first line therapy either during treatment or within three months of completing definitive first line treatment for Hodgkin’s or non-Hodgkin’s lymphoma (excluding indolent non-Hodgkin’s lymphoma), (R)
Fee: $953.00	Benefit: 75% = $714.75	85% = $881.80	
Amend
61628	
Whole body FDG PET study for restaging following confirmation of recurrence of Hodgkin’s or non-Hodgkin’s lymphoma (excluding indolent non-Hodgkin’s lymphoma). (R)
Fee: $953.00	Benefit: 75% = $714.75	85% = $881.80	
New
61632	
Whole body FDG PET study to assess response to second-line chemotherapy when stem cell transplantation is being considered, for Hodgkin’s or non-Hodgkin’s lymphoma (excluding indolent non-Hodgkin’s lymphoma). (R)
Fee: $953.00	Benefit: 75% = $714.75	85% = $881.80	
Amend
61640	
Whole body FDG PET study for initial staging of patients with biopsy-proven bone or soft tissue sarcoma (excluding gastrointestinal stromal tumour) considered by conventional staging to be potentially curable. (R)
Fee: $999.00	Benefit: 75% = $749.25	85% = $927.80	
Amend
61646	
Whole body FDG PET study for the evaluation of patients with suspected residual or recurrent sarcoma (excluding gastrointestinal stromal tumour) after the initial course of definitive therapy to determine suitability for subsequent therapy with curative intent. (R)
Fee: $999.00	Benefit: 75% = $749.25	85% = $927.80	
New
61651	
SINGLE STRESS OR REST MYOCARDIAL PERFUSION STUDY - planar imaging (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $224.45	Benefit: 75% = $168.35	85% = $190.80	

NUCLEAR MEDICINE IMAGING	NUCLEAR MEDICINE IMAGING	
New
61652	
SINGLE STRESS OR REST MYOCARDIAL PERFUSION STUDY - with single photon emission tomography and with planar imaging when undertaken (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $282.65	Benefit: 75% = $212.00	85% = $240.30	
New
61653	
COMBINED STRESS AND REST, stress and re-injection or rest and redistribution myocardial perfusion study, including delayed imaging or re-injection protocol on a subsequent occasion - planar imaging (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $354.85	Benefit: 75% = $266.15	85% = $301.65	
New
61654	
COMBINED STRESS AND REST, stress and re-injection or rest and redistribution myocardial perfusion study, including delayed imaging or re-injection protocol on a subsequent occasion - with single photon emission tomography and with planar imaging when undertaken (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $417.45	Benefit: 75% = $313.10	85% = $354.85	
New
61655	
MYOCARDIAL INFARCT-AVID-STUDY, with planar imaging and single photon emission tomography, OR planar imaging or single photon emission tomography (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $183.65	Benefit: 75% = $137.75	85% = $156.15	
New
61656	
GATED CARDIAC BLOOD POOL STUDY, (equilibrium), with planar imaging and single photon emission tomography OR  planar imaging or single photon emission tomography (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $151.70	Benefit: 75% = $113.80	85% = $128.95	
New
61657	
GATED CARDIAC BLOOD POOL STUDY, and first pass blood flow or cardiac shunt study, with planar imaging and single photon emission tomography, OR planar imaging, or single photon emission tomography (R) (NK) 
(See para DIQ of explanatory notes to this Category)
Fee: $210.00	Benefit: 75% = $157.50	85% = $178.50	
New
61658	
GATED CARDIAC BLOOD POOL STUDY, with intervention, with planar imaging and single photon emission tomography, OR planar imaging, or single photon emission tomography (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $190.60	Benefit: 75% = $142.95	85% = $162.05	
New
61659	
GATED CARDIAC BLOOD POOL STUDY, with intervention and first pass blood flow study or cardiac shunt study, with planar imaging and single photon emission tomography OR planar imaging, or single photon emission tomography (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $246.20	Benefit: 75% = $184.65	85% = $209.30	
New
61660	
CARDIAC FIRST PASS BLOOD FLOW STUDY OR CARDIAC SHUNT STUDY, not being a service to which another item in this Group applies (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $114.45	Benefit: 75% = $85.85	85% = $97.30	
New
61661	
LUNG PERFUSION STUDY, with planar imaging and single photon emission tomography OR planar imaging, or single photon emission tomography (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $113.85	Benefit: 75% = $85.40	85% = $96.80	
New
61662	
LUNG VENTILATION STUDY using aerosol, technegas or xenon gas, with planar imaging and single photon emission tomography OR planar imaging or single photon emission tomography (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $126.50	Benefit: 75% = $94.90	85% = $107.55	
New
61663	
LUNG PERFUSION STUDY AND LUNG VENTILATION STUDY using aerosol, technegas or xenon gas, with planar imaging and single photon emission tomography, OR planar imaging, or single photon emission tomography (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $221.70	Benefit: 75% = $166.30	85% = $188.45	
New
61664	
LIVER AND SPLEEN STUDY (colloid) - planar imaging (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $129.70	Benefit: 75% = $97.30	85% = $110.25	

NUCLEAR MEDICINE IMAGING	NUCLEAR MEDICINE IMAGING	
New
61665	
LIVER AND SPLEEN STUDY (colloid), with single photon emission tomography and with planar imaging when undertaken (R) (NK) 
(See para DIQ of explanatory notes to this Category)
Fee: $193.30	Benefit: 75% = $145.00	85% = $164.35	
New
61666	
RED BLOOD CELL SPLEEN OR LIVER STUDY, including single photon emission tomography when undertaken (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $196.40	Benefit: 75% = $147.30	85% = $166.95	
New
61667	
HEPATOBILIARY STUDY, including morphine administration or pre-treatment with cholecystokinin (CCK) when undertaken (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $201.70	Benefit: 75% = $151.30	85% = $171.45	
New
61668	
HEPATOBILIARY STUDY with formal quantification following baseline imaging, using an infusion of cholecystokinin (CCK) (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $230.70	Benefit: 75% = $173.05	85% = $196.10	
New
61669	
BOWEL HAEMORRHAGE STUDY (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $248.50	Benefit: 75% = $186.40	85% = $211.25	
New
61670	
MECKEL'S DIVERTICULUM STUDY (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $111.55	Benefit: 75% = $83.70	85% = $94.85	
New
61671	
INDIUM-LABELLED OCTREOTIDE STUDY - including single photon emission tomography when undertaken, where:
(a)	there is a suspected gastro-entero-pancreatic endocrine tumour, based on biochemical evidence, with negative or
	equivocal conventional imaging; or
(b)	a surgically amenable gastro-entero-pancreatic endocrine tumour has been identified based on conventional
	techniques, in order to exclude additional disease sites. (Ministerial Determination) (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $1,007.90	Benefit: 75% = $755.95	85% = $936.70	
New
61672	
SALIVARY STUDY (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $111.55	Benefit: 75% = $83.70	85% = $94.85	
New
61673	
GASTRO-OESOPHAGEAL REFLUX STUDY, including delayed imaging on a separate occasion when undertaken (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $244.85	Benefit: 75% = $183.65	85% = $208.15	
New
61674	
OESOPHAGEAL CLEARANCE STUDY (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $71.70	Benefit: 75% = $53.80	85% = $60.95	
New
61675	
GASTRIC EMPTYING STUDY, using single tracer (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $287.20	Benefit: 75% = $215.40	85% = $244.15	
New
61676	
COMBINED SOLID AND LIQUID GASTRIC EMPTYING STUDY using dual isotope technique or the same isotope on separate days (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $312.50	Benefit: 75% = $234.40	85% = $265.65	
New
61677	
RADIONUCLIDE COLONIC TRANSIT STUDY (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $343.85	Benefit: 75% = $257.90	85% = $292.30	
New
61678	
RENAL STUDY, including perfusion and renogram images and computer analysis OR cortical study with planar imaging (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $166.25	Benefit: 75% = $124.70	85% = $141.35	

NUCLEAR MEDICINE IMAGING	NUCLEAR MEDICINE IMAGING	
New
61679	
RENAL CORTICAL STUDY, with single photon emission tomography and planar quantification (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $215.40	Benefit: 75% = $161.55	85% = $183.10	
New
61680	
SINGLE RENAL STUDY with pre-procedural administration of a diuretic or angiotensin converting enzyme (ACE) inhibitor (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $185.30	Benefit: 75% = $139.00	85% = $157.55	
New
61681	
RENAL STUDY with diuretic administration following a baseline study (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $205.00	Benefit: 75% = $153.75	85% = $174.25	
New
61682	
COMBINED EXAMINATION INVOLVING A RENAL STUDY following angiotensin converting enzyme (ACE) inhibitor provocation and a baseline study, in either order and related to a single referral episode (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $302.75	Benefit: 75% = $227.10	85% = $257.35	
New
61683	
CYSTOURETEROGRAM (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $123.45	Benefit: 75% = $92.60	85% = $104.95	
New
61684	
TESTICULAR STUDY (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $81.15	Benefit: 75% = $60.90	85% = $69.00	
New
61685	
CEREBRAL PERFUSION STUDY, with single photon emission tomography and with planar imaging when undertaken (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $302.55	Benefit: 75% = $226.95	85% = $257.20	
New
61686	
BRAIN STUDY WITH BLOOD BRAIN BARRIER AGENT, with planar imaging and single photon emission tomography, OR planar imaging, or single photon emission tomography (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $173.00	Benefit: 75% = $129.75	85% = $147.05	
New
61687	
CEREBRO-SPINAL FLUID TRANSPORT STUDY, with imaging on 2 or more separate occasions (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $436.75	Benefit: 75% = $327.60	85% = $371.25	
New
61688	
CEREBRO-SPINAL FLUID SHUNT PATENCY STUDY (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $113.00	Benefit: 75% = $84.75	85% = $96.05	
New
61689	
DYNAMIC BLOOD FLOW STUDY OR REGIONAL BLOOD VOLUME QUANTITATIVE STUDY, not being a service associated with a service to which another item in this Group applies (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $59.45	Benefit: 75% = $44.60	85% = $50.55	
New
61690	
BONE STUDY - whole body, with, when undertaken, blood flow, blood pool and delayed imaging on a separate occasion (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $239.90	Benefit: 75% = $179.95	85% = $203.95	
New
61691	
BONE STUDY - whole body and single photon emission tomography, with, when undertaken, blood flow, blood pool and delayed imaging on a separate occasion (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $300.35	Benefit: 75% = $225.30	85% = $255.30	
New
61692	
WHOLE BODY STUDY using iodine (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $277.40	Benefit: 75% = $208.05	85% = $235.80	
New
61693	
WHOLE BODY STUDY using gallium (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $271.50	Benefit: 75% = $203.65	85% = $230.80	

NUCLEAR MEDICINE IMAGING	NUCLEAR MEDICINE IMAGING	
New
61694	
WHOLE BODY STUDY using gallium, with single photon emission tomography (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $329.75	Benefit: 75% = $247.35	85% = $280.30	
New
61695	
WHOLE BODY STUDY using cells labelled with technetium (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $248.50	Benefit: 75% = $186.40	85% = $211.25	
New
61696	
WHOLE BODY STUDY using cells labelled with technetium, with single photon emission tomography (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $307.70	Benefit: 75% = $230.80	85% = $261.55	
New
61697	
WHOLE BODY STUDY using thallium (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $271.40	Benefit: 75% = $203.55	85% = $230.70	
New
61698	
WHOLE BODY STUDY using thallium, with single photon emission tomography (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $336.50	Benefit: 75% = $252.40	85% = $286.05	
New
61699	
BONE MARROW STUDY - whole body using technetium labelled bone marrow agents (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $244.85	Benefit: 75% = $183.65	85% = $208.15	
New
61700	
WHOLE BODY STUDY, using gallium - with single photon emission tomography of 2 or more body regions acquired separately (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $376.20	Benefit: 75% = $282.15	85% = $319.80	
New
61701	
BONE MARROW STUDY - localised using technetium labelled agent (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $143.40	Benefit: 75% = $107.55	85% = $121.90	
New
61702	
LOCALISED BONE OR JOINT STUDY, including when undertaken, blood flow, blood pool and repeat imaging on a separate occasion (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $166.80	Benefit: 75% = $125.10	85% = $141.80	
New
61703	
LOCALISED BONE OR JOINT STUDY and single photon emission tomography, including when undertaken, blood flow, blood pool and imaging on a separate occasion (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $228.10	Benefit: 75% = $171.10	85% = $193.90	
New
61704	
LOCALISED STUDY using gallium (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $198.80	Benefit: 75% = $149.10	85% = $169.00	
New
61705	
LOCALISED STUDY using gallium, with single photon emission tomography (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $257.35	Benefit: 75% = $193.05	85% = $218.75	
New
61706	
LOCALISED STUDY using cells labelled with technetium (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $174.05	Benefit: 75% = $130.55	85% = $147.95	
New
61707	
LOCALISED STUDY using cells labelled with technetium, with single photon emission tomography (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $235.25	Benefit: 75% = $176.45	85% = $200.00	
New
61708	
LOCALISED STUDY using thallium (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $198.50	Benefit: 75% = $148.90	85% = $168.75	
New
61709	
LOCALISED STUDY using thallium, with single photon emission tomography (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $263.95	Benefit: 75% = $198.00	85% = $224.40	

NUCLEAR MEDICINE IMAGING	NUCLEAR MEDICINE IMAGING	
New
61710	
REPEAT PLANAR AND SINGLE PHOTON EMISSION TOMOGRAPHY IMAGING, OR REPEAT PLANAR IMAGING OR SINGLE PHOTON EMISSION TOMOGRAPHY IMAGING on an occasion subsequent to the performance of any one of items 61364, 61426, 61429, 61430, 61442, 61450, 61453, 61469, 61484, 61485, 61669, 61692, 61693, 61694, 61700, 61704, 61705, 61712, 61715 or 61716 where there is no additional administration of radiopharmaceutical and where the previous radionuclide scan was abnormal or equivocal. (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $64.50	Benefit: 75% = $48.40	85% = $54.85	
New
61711	
VENOGRAPHY (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $132.75	Benefit: 75% = $99.60	85% = $112.85	
New
61712	
LYMPHOSCINTIGRAPHY (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $174.05	Benefit: 75% = $130.55	85% = $147.95	
New
61713	
THYROID STUDY including uptake measurement when undertaken (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $87.70	Benefit: 75% = $65.80	85% = $74.55	
New
61714	
PARATHYROID STUDY, planar imaging and single photon emission tomography when undertaken (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $193.45	Benefit: 75% = $145.10	85% = $164.45	
New
61715	
ADRENAL STUDY (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $440.45	Benefit: 75% = $330.35	85% = $374.40	
New
61716	
ADRENAL STUDY, with single photon emission tomography  (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $499.60	Benefit: 75% = $374.70	85% = $428.40	
New
61717	
TEAR DUCT STUDY (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $111.55	Benefit: 75% = $83.70	85% = $94.85	
New
61718	
PARTICLE PERFUSION STUDY (intra-arterial) or Le Veen shunt study (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $126.50	Benefit: 75% = $94.90	85% = $107.55	
New
61719	
CT scan performed at the same time and covering the same body area as single photon emission tomography for the purpose of anatomic localisation or attenuation correction where no separate diagnostic CT report is issued and only in association with items 61302 - 61729 (R) (NK)
(See para DIQ of explanatory notes to this Category)
Fee: $50.00	Benefit: 75% = $37.50	85% = $42.50	
New
61729	
LEUKOSCAN STUDY, for use in diagnostic imaging of the long bones and feet in patients with suspected osteomyelitis, and where patients do not have access to ex-vivo WBC scanning. (Ministerial Determination) (NK) 

Note LeukoScan is only indicated for diagnostic imaging in patients suspected of infection in the long bones and feet, including those with diabetic ulcers. The descriptor does not cover patients who are being investigated for other sites of infection
(See para DIQ of explanatory notes to this Category)
Fee: $439.35	Benefit: 75% = $329.55	85% = $373.45	

MAGNETIC RESONANCE IMAGING	MRI	
	GROUP I5 - MAGNETIC RESONANCE IMAGING	
	SUBGROUP 1 - SCAN OF HEAD - FOR SPECIFIED CONDITIONS	
New
63013	
MAGNETIC RESONANCE IMAGING (including Magnetic Resonance Angiography if performed), performed under the professional supervision of an eligible provider at an eligible location where the patient is referred by a specialist or by a consultant physician - scan of head for:

- tumour of the brain or meninges (R) (NK) (Contrast)  (Anaes.)
(See para DIQ of explanatory notes to this Category)
Fee: $201.60	Benefit: 75% = $151.20	85% = $171.40	
New
63014	
- inflammation of the brain or meninges (R) (NK) (Contrast) (Anaes.)
(See para DIQ of explanatory notes to this Category)
Fee: $201.60	Benefit: 75% = $151.20	85% = $171.40	
New
63016	
- skull base or orbital tumour (R) (NK) (Contrast)  (Anaes.)
(See para DIQ of explanatory notes to this Category)
Fee: $201.60	Benefit: 75% = $151.20	85% = $171.40	
New
63017	
- stereotactic scan of brain, with Fiducials in place, for the sole purpose to allow planning for stereotactic neurosurgery (R) (NK) (Contrast) (Anaes.)
(See para DIQ of explanatory notes to this Category)
Fee: $168.00	Benefit: 75% = $126.00	85% = $142.80	
	SUBGROUP 2 - SCAN OF HEAD - FOR SPECIFIED CONDITIONS	
New
63074	
NOTE: Benefits are payable for each service included by Subgroup 2 on three occasions only in any 12 month period

MAGNETIC RESONANCE IMAGING (including Magnetic Resonance Angiography if performed), performed under the professional supervision of an eligible provider at an eligible location where the patient is referred by a specialist or by a consultant physician - scan of head for:

- acoustic neuroma (R) (NK) (Contrast) (Anaes.)
(See para DIQ of explanatory notes to this Category)
Fee: $168.00	Benefit: 75% = $126.00	85% = $142.80	
New
63075	
- pituitary tumour (R) (NK) (Contrast)  (Anaes.)
(See para DIQ of explanatory notes to this Category)
Fee: $179.20	Benefit: 75% = $134.40	85% = $152.35	
New
63076	
- toxic or metabolic or ischaemic encephalopathy (R) (NK) (Contrast)  (Anaes.)
(See para DIQ of explanatory notes to this Category)
Fee: $201.60	Benefit: 75% = $151.20	85% = $171.40	
New
63077	
- demyelinating disease of the brain (R) (NK) (Contrast) (Anaes.)
(See para DIQ of explanatory notes to this Category)
Fee: $201.60	Benefit: 75% = $151.20	85% = $171.40	
New
63078	
- congenital malformation of the brain or meninges (R) (NK) (Contrast)  (Anaes.)
(See para DIQ of explanatory notes to this Category)
Fee: $201.60	Benefit: 75% = $151.20	85% = $171.40	
New
63079	
- venous sinus thrombosis (R) (NK) (Contrast)  (Anaes.)
(See para DIQ of explanatory notes to this Category)
Fee: $201.60	Benefit: 75% = $151.20	85% = $171.40	
New
63080	
- head trauma (R) (NK) (Contrast)  (Anaes.)
(See para DIQ of explanatory notes to this Category)
Fee: $201.60	Benefit: 75% = $151.20	85% = $171.40	
New
63081	
- epilepsy (R) (NK) (Contrast) (Anaes.)
(See para DIQ of explanatory notes to this Category)
Fee: $201.60	Benefit: 75% = $151.20	85% = $171.40	

MAGNETIC RESONANCE IMAGING	MRI	
New
63082	
- stroke (R) (NK) (Contrast)  (Anaes.)
(See para DIQ of explanatory notes to this Category)
Fee: $201.60	Benefit: 75% = $151.20	85% = $171.40	
New
63083	
- carotid or vertebral artery desection (R) (NK) (Contrast)  (Anaes.)
(See para DIQ of explanatory notes to this Category)
Fee: $201.60	Benefit: 75% = $151.20	85% = $171.40	
New
63084	
- intracranial aneurysm (R) (NK) (Contrast)  (Anaes.)
(See para DIQ of explanatory notes to this Category)
Fee: $201.60	Benefit: 75% = $151.20	85% = $171.40	
New
63085	
- intracranial arteriovenous malformation (R) (NK) (Contrast) (Anaes.)
(See para DIQ of explanatory notes to this Category)
Fee: $201.60	Benefit: 75% = $151.20	85% = $171.40	
	SUBGROUP 3 - SCAN OF HEAD AND NECK VESSELS - FOR SPECIFIED CONDITIONS	
New
63104	
NOTE: Benefits are payable for each service included by Subgroup 3 on three occasions only in any 12 month period

MAGNETIC RESONANCE IMAGING AND MAGNETIC RESONANCE ANGIOGRAPHY of extra and/or intracranial circulation, performed under the professional supervision of an eligible provider at an eligible location where the patient is referred by a specialist or by a consultant physician - scan of head and neck vessels for:

- stroke (R) (NK) (Contrast) (Anaes.)
(See para DIQ of explanatory notes to this Category)
Fee: $246.40	Benefit: 75% = $184.80	85% = $209.45	
New
63117	
MAGNETIC RESONANCE IMAGING (including Magnetic Resonance Angiography if performed), performed under the professional supervision of an eligible provider at an eligible location where the patient is referred by a specialist or by a consultant physician - scan of head and cervical spine for:

- tumour of the central nervous system or meninges (R) (NK) (Contrast)  (Anaes.)
(See para DIQ of explanatory notes to this Category)
Fee: $246.40	Benefit: 75% = $184.80	85% = $209.45	
New
63119	
- inflammation of the central nervous system or meninges (R) (NK) (Contrast)  (Anaes.)
(See para DIQ of explanatory notes to this Category)
Fee: $246.40	Benefit: 75% = $184.80	85% = $209.45	
	SUBGROUP 5 - SCAN OF HEAD AND CERVICAL SPINE - FOR SPECIFIED CONDITIONS	
New
63134	
NOTE: Benefits are payable for each service included by Subgroup 5 on three occasions only in any 12 month period

MAGNETIC RESONANCE IMAGING (including Magnetic Resonance Angiography if performed), performed under the professional supervision of an eligible provider at an eligible location where the patient is referred by a specialist or by a consultant physician - scan of head and cervical spine for:

- demyelinating disease of the central nervous system (R) (NK) (Contrast)  (Anaes.)
(See para DIQ of explanatory notes to this Category)
Fee: $246.40	Benefit: 75% = $184.80	85% = $209.45	
New
63135	
- congenital malformation of the central nervous system or meninges (R) (NK) (Contrast)  (Anaes.)
(See para DIQ of explanatory notes to this Category)
Fee: $246.40	Benefit: 75% = $184.80	85% = $209.45	
New
63136	
- syrinx (congenital or aquired) (R) (NK) (Contrast)  (Anaes.)
(See para DIQ of explanatory notes to this Category)
Fee: $246.40	Benefit: 75% = $184.80	85% = $209.45	

MAGNETIC RESONANCE IMAGING	MRI	
	SUBGROUP 6 - SCAN OF SPINE - ONE REGION OR TWO CONTIGUOUS REGIONS - FOR SPECIFIED CONDITIONS	
New
63157	
MAGNETIC RESONANCE IMAGING performed under the professional supervision of an eligible provider at an eligible location where the patient is referred by a specialist or by a consultant physician - scan of one region or two contiguous regions of the spine for:

- infection (R) (NK) (Contrast) (Anaes.)
(See para DIQ of explanatory notes to this Category)
Fee: $179.20	Benefit: 75% = $134.40	85% = $152.35	
New
63158	
- tumour (R) (NK) (Contrast)  (Anaes.)
(See para DIQ of explanatory notes to this Category)
Fee: $179.20	Benefit: 75% = $134.40	85% = $152.35	
	SUBGROUP 7 - SCAN OF SPINE - ONE REGION OR TWO CONTIGUOUS REGIONS - FOR SPECIFIED CONDITIONS	
New
63186	
NOTE: Benefits are payable for each service included by Subgroup 7 on three occasions only in any 12 month period

MAGNETIC RESONANCE IMAGING performed under the professional supervision of an eligible provider at an eligible location where the patient is referred by a specialist or by a consultant physician - scan of one region or two contiguous regions of the spine for:

- demyelinating (R) (NK) (Contrast)  (Anaes.)
(See para DIQ of explanatory notes to this Category)
Fee: $179.20	Benefit: 75% = $134.40	85% = $152.35	
New
63187	
- congenital malformation of the spinal cord or the cauda equina or the meninges (R) (NK) (Contrast)  (Anaes.)
(See para DIQ of explanatory notes to this Category)
Fee: $179.20	Benefit: 75% = $134.40	85% = $152.35	
New
63188	
- myelopathy (R) (NK) (Contrast)  (Anaes.)
(See para DIQ of explanatory notes to this Category)
Fee: $179.20	Benefit: 75% = $134.40	85% = $152.35	
New
63189	
- syrinx (congenital or aquired) (R) (NK) (Contrast)  (Anaes.)
(See para DIQ of explanatory notes to this Category)
Fee: $179.20	Benefit: 75% = $134.40	85% = $152.35	
New
63190	
- cervical radiculopathy (R) (NK) (Contrast)  (Anaes.)
(See para DIQ of explanatory notes to this Category)
Fee: $179.20	Benefit: 75% = $134.40	85% = $152.35	
New
63191	
- sciatica (R) (NK) (Contrast)  (Anaes.)
(See para DIQ of explanatory notes to this Category)
Fee: $179.20	Benefit: 75% = $134.40	85% = $152.35	
New
63192	
- spinal canal stenosis (R) (NK) (Contrast)  (Anaes.)
(See para DIQ of explanatory notes to this Category)
Fee: $179.20	Benefit: 75% = $134.40	85% = $152.35	
New
63193	
- previous spinal surgery (R) (NK) (Contrast)  (Anaes.)
(See para DIQ of explanatory notes to this Category)
Fee: $179.20	Benefit: 75% = $134.40	85% = $152.35	
New
63194	
- trauma (R) (NK)  (Anaes.)
(See para DIQ of explanatory notes to this Category)
Fee: $179.20	Benefit: 75% = $134.40	85% = $152.35	

MAGNETIC RESONANCE IMAGING	MRI	
	SUBGROUP 8 - SCAN OF SPINE - THREE CONTIGUOUS REGIONS OR TWO NON-CONTIGUOUS REGIONS - FOR SPECIFIED CONDITIONS	
New
63207	
MAGNETIC RESONANCE IMAGING performed under the professional supervision of an eligible provider at an eligible location where the patient is referred by a specialist or by a consultant physician - scan of three contiguous regions or two non contiguous regions of the spine for:

- infection (R) (NK) (Contrast) (Anaes.)
(See para DIQ of explanatory notes to this Category)
Fee: $224.00	Benefit: 75% = $168.00	85% = $190.40	
New
63208	
- tumour (R) (NK) (Contrast)  (Anaes.)
(See para DIQ of explanatory notes to this Category)
Fee: $224.00	Benefit: 75% = $168.00	85% = $190.40	
	SUBGROUP 9 - SCAN OF SPINE - THREE CONTIGUOUS REGIONS OR TWO NON-CONTIGUOUS REGIONS - FOR SPECIFIED CONDITIONS	
New
63257	
NOTE: Benefits are payable for each service included by Subgroup 9 on three occasions only in any 12 month period

MAGNETIC RESONANCE IMAGING performed under the professional supervision of an eligible provider at an eligible location where the patient is referred by a specialist or by a consultant physician - scan of three contiguous regions or two non  contiguous regions of the spine for:

- demyelinating disease (R) (NK) (Contrast)  (Anaes.)
(See para DIQ of explanatory notes to this Category)
Fee: $224.00	Benefit: 75% = $168.00	85% = $190.40	
New
63258	
- congenital malformation of the spinal cord or the cauda equina or the meninges (R) (NK) (Contrast)  (Anaes.)
(See para DIQ of explanatory notes to this Category)
Fee: $224.00	Benefit: 75% = $168.00	85% = $190.40	
New
63259	
- myelopathy (R) (NK) (Contrast)  (Anaes.)
(See para DIQ of explanatory notes to this Category)
Fee: $224.00	Benefit: 75% = $168.00	85% = $190.40	
New
63260	
- syrinx (congenital or aquired ) (R) (NK) (Contrast)  (Anaes.)
(See para DIQ of explanatory notes to this Category)
Fee: $224.00	Benefit: 75% = $168.00	85% = $190.40	
New
63261	
- cervical radiculopathy (R) (NK) (Contrast)  (Anaes.)
(See para DIQ of explanatory notes to this Category)
Fee: $224.00	Benefit: 75% = $168.00	85% = $190.40	
New
63262	
- sciatica (R) (NK) (Contrast)  (Anaes.)
(See para DIQ of explanatory notes to this Category)
Fee: $224.00	Benefit: 75% = $168.00	85% = $190.40	
New
63263	
- spinal canal stenosis (R) (NK) (Contrast)  (Anaes.)
(See para DIQ of explanatory notes to this Category)
Fee: $224.00	Benefit: 75% = $168.00	85% = $190.40	
New
63264	
- previous spinal surgery (R) (NK) (Contrast)  (Anaes.)
(See para DIQ of explanatory notes to this Category)
Fee: $224.00	Benefit: 75% = $168.00	85% = $190.40	
New
63265	
- trauma (R) (NK)  (Anaes.)
(See para DIQ of explanatory notes to this Category)
Fee: $224.00	Benefit: 75% = $168.00	85% = $190.40	

MAGNETIC RESONANCE IMAGING	MRI	
	SUBGROUP 10 - SCAN OF CERVICAL SPINE AND BRACHIAL PLEXUS - FOR SPECIFIED CONDITIONS	
New
63282	
NOTE: Benefits are payable for each service included by Subgroup 10 on three occasions only in any 12 month period

MAGNETIC RESONANCE IMAGING performed under the professional supervision of an eligible provider at an eligible location where the patient is referred by a specialist or by a consultant physician - scan of cervical spine and brachial plexus for:

- tumour (R) (NK) (Contrast)  (Anaes.)
(See para DIQ of explanatory notes to this Category)
Fee: $246.40	Benefit: 75% = $184.80	85% = $209.45	
New
63283	
- trauma (R) (NK) (Contrast)  (Anaes.)
(See para DIQ of explanatory notes to this Category)
Fee: $246.40	Benefit: 75% = $184.80	85% = $209.45	
New
63284	
- cervical radiculopathy (R) (NK) (Contrast)  (Anaes.)
(See para DIQ of explanatory notes to this Category)
Fee: $246.40	Benefit: 75% = $184.80	85% = $209.45	
New
63285	
- previous surgery (R) (NK) (Contrast)  (Anaes.)
(See para DIQ of explanatory notes to this Category)
Fee: $246.40	Benefit: 75% = $184.80	85% = $209.45	
	SUBGROUP 11 - SCAN OF MUSCULOSKELETAL SYSTEM - FOR SPECIFIED CONDITIONS	
New
63310	
MAGNETIC RESONANCE IMAGING performed under the professional supervision of an eligible provider at an eligible location where the patient is referred by a specialist or by a consultant physician - scan of musculoskeletal system for:

- tumour arising in bone or musculoskeletal system, this excludes tumours arising in breast, prostate or rectum (R) (NK) (Contrast)  (Anaes.)
(See para DIQ of explanatory notes to this Category)
Fee: $190.40	Benefit: 75% = $142.80	85% = $161.85	
New
63311	
- infection arising in bone or musculoskeletal system, this excludes infection arising in breast, prostate or rectum (R) (NK)  (Contrast)  (Anaes.)
(See para DIQ of explanatory notes to this Category)
Fee: $190.40	Benefit: 75% = $142.80	85% = $161.85	
New
63313	
- osteonecrosis (R) (NK) (Contrast) (Anaes.)
(See para DIQ of explanatory notes to this Category)
Fee: $190.40	Benefit: 75% = $142.80	85% = $161.85	
	SUBGROUP 12 - SCAN OF MUSCULOSKELETAL SYSTEM - FOR SPECIFIED CONDITIONS	
New
63341	
NOTE: Benefits are payable for each service included by Subgroup 12 on three occasions only in any 12 month period

MAGNETIC RESONANCE IMAGING performed under the professional supervision of an eligible provider at an eligible location where the patient is referred by a specialist or by a consultant physician - scan of musculoskeletal system for:

- derangement of hip or its supporting structures (R) (NK) (Contrast)  (Anaes.)
(See para DIQ of explanatory notes to this Category)
Fee: $201.60	Benefit: 75% = $151.20	85% = $171.40	
New
63342	
- derangement of shoulder or its supporting structures (R) (NK) (Contrast) (Anaes.)
(See para DIQ of explanatory notes to this Category)
Fee: $201.60	Benefit: 75% = $151.20	85% = $171.40	
New
63343	
- derangement of knee or its supporting structures (R) (NK) (Contrast)  (Anaes.)
(See para DIQ of explanatory notes to this Category)
Fee: $201.60	Benefit: 75% = $151.20	85% = $171.40	
New
63345	
- derangement of ankle and/or foot or its supporting structures (R) (NK) (Contrast)  (Anaes.)
(See para DIQ of explanatory notes to this Category)
Fee: $201.60	Benefit: 75% = $151.20	85% = $171.40	

MAGNETIC RESONANCE IMAGING	MRI	
New
63346	
- derangement of one or both temporomandibular joints or their supporting structures (R) (NK) (Contrast) (Anaes.)
(See para DIQ of explanatory notes to this Category)
Fee: $168.00	Benefit: 75% = $126.00	85% = $142.80	
New
63347	
- derangement of wrist and/or hand or its supporting structures (R) (NK) (Contrast)  (Anaes.)
(See para DIQ of explanatory notes to this Category)
Fee: $224.00	Benefit: 75% = $168.00	85% = $190.40	
New
63348	
- derangement of elbow or its supporting structures (R) (NK) (Contrast)  (Anaes.)
(See para DIQ of explanatory notes to this Category)
Fee: $201.60	Benefit: 75% = $151.20	85% = $171.40	
	SUBGROUP 13 - SCAN OF MUSCULOSKELETAL SYSTEM - FOR SPECIFIED CONDITIONS	
New
63364	
NOTE: Benefits are payable for each service included by Subgroup 13 on two occasions only in any 12 month period

MAGNETIC RESONANCE IMAGING performed under the professional supervision of an eligible provider at an eligible location where the patient is referred by a specialist or by a consultant physician - scan of musculoskeletal system for:

- Gaucher disease (R) (NK)  (Anaes.)
(See para DIQ of explanatory notes to this Category)
Fee: $201.60	Benefit: 75% = $151.20	85% = $171.40	
	SUBGROUP 14 - SCAN OF CARDIOVASCULAR SYSTEM - FOR SPECIFIED CONDITIONS	
New
63392	
NOTE: Benefits are payable for each service included by Subgroup 14 on two occasions only in any 12 month period

MAGNETIC RESONANCE IMAGING (including Magnetic Resonance Angiography if performed), performed under the professional supervision of an eligible provider at an eligible location where the patient is referred by a specialist or by a consultant physician - scan of cardiovascular system for:

- congenital disease of the heart or a great vessel (R) (NK) (Contrast) (Anaes.)
(See para DIQ of explanatory notes to this Category)
Fee: $224.00	Benefit: 75% = $168.00	85% = $190.40	
New
63393	
- tumour of the heart or a great vessel (R) (NK) (Contrast)  (Anaes.)
(See para DIQ of explanatory notes to this Category)
Fee: $224.00	Benefit: 75% = $168.00	85% = $190.40	
New
63394	
- abnormality of thoracic aorta (R) (NK) (Contrast)  (Anaes.)
(See para DIQ of explanatory notes to this Category)
Fee: $201.60	Benefit: 75% = $151.20	85% = $171.40	
	SUBGROUP 15 - MAGNETIC RESONANCE ANGIOGRAPHY - SCAN OF CARDIOVASCULAR SYSTEM - FOR SPECIFIED CONDITIONS	
New
63407	
NOTE: Benefits are payable for each service included by Subgroup 15 on three occasions only in any 12 month period

MAGNETIC RESONANCE ANGIOGRAPHY performed under the professional supervision of an eligible provider at an eligible location where the patient is referred by a specialist or by a consultant physician and where the request for the scan specifically identifies the clinical indication for the scan - scan of cardiovascular system for:

- vascular abnormality in a patient with a previous anaphylactic reaction to an iodinated contrast medium (R) (NK) (Contrast) (Anaes.)
(See para DIQ of explanatory notes to this Category)
Fee: $201.60	Benefit: 75% = $151.20	85% = $171.40	
New
63408	
- obstruction of the superior vena cava, inferior vena cava or a major pelvic vein (R) (NK) (Contrast)  (Anaes.)
(See para DIQ of explanatory notes to this Category)
Fee: $201.60	Benefit: 75% = $151.20	85% = $171.40	

MAGNETIC RESONANCE IMAGING	MRI	
	SUBGROUP 16 - MAGNETIC RESONANCE ANGIOGRAPHY - FOR SPECIFIED CONDITIONS - PERSON UNDER THE AGE OF 16 YEARS	
New
63419	
NOTE: Benefits are payable for each service included by Subgroup 16 on one occasion only in any 12 month period

MAGNETIC RESONANCE ANGIOGRAPHY performed under the professional supervision of an eligible provider at an eligible location where the patient is referred by a specialist or by a consultant physician - scan of person under the age of 16 for:

- the vasculature of limbs prior to limb or digit transfer surgery in congenital limb deficiency syndrome (R) NK) (Contrast)  (Anaes.)
(See para DIQ of explanatory notes to this Category)
Fee: $201.60	Benefit: 75% = $151.20	85% = $171.40	
	SUBGROUP 17 - MAGNETIC RESONANCE IMAGING - FOR SPECIFIED CONDITIONS - PERSON UNDER THE AGE OF 16 YEARS	
New
63432	
NOTE: Benefits are payable for each service included by Subgroup 17 on two occasions only in any 12 month period, for previously diagnosed conditions

MAGNETIC RESONANCE IMAGING performed under the professional supervision of an eligible provider at an eligible location where the patient is referred by a specialist or by a consultant physician - scan of person under the age of 16 for:

- post-inflammatory or post-traumatic physeal fusion (R) (NK) (Anaes.)
(See para DIQ of explanatory notes to this Category)
Fee: $201.60	Benefit: 75% = $151.20	85% = $171.40	
New
63433	
- Gaucher disease (R) (NK)  (Anaes.)
(See para DIQ of explanatory notes to this Category)
Fee: $201.60	Benefit: 75% = $151.20	85% = $171.40	
	SUBGROUP 18 - MAGNETIC RESONANCE IMAGING - FOR SPECIFIED CONDITIONS - PERSON UNDER THE AGE OF 16 YEARS	
New
63447	
MAGNETIC RESONANCE IMAGING performed under the professional supervision of an eligible provider at an eligible location where the patient is referred by a specialist or by a consultant physician - scan of person under the age of 16 for:

- pelvic or abdominal mass (R) (NK) (Contrast)  (Anaes.)
(See para DIQ of explanatory notes to this Category)
Fee: $201.60	Benefit: 75% = $151.20	85% = $171.40	
New
63448	
- mediastinal mass (R) (NK) (Contrast) (Anaes.)
(See para DIQ of explanatory notes to this Category)
Fee: $201.60	Benefit: 75% = $151.20	85% = $171.40	
New
63449	
- congenital uterine or anorectal abnormality (R) (NK) (Contrast)  (Anaes.)
(See para DIQ of explanatory notes to this Category)
Fee: $201.60	Benefit: 75% = $151.20	85% = $171.40	
	SUBGROUP 19 - SCAN OF BODY - FOR SPECIFIED CONDITIONS	
New
63455	
NOTE: Benefits are payable for each service included by Subgroup 19 on one occasion only in any 12 month period

MAGNETIC RESONANCE IMAGING performed under the professional supervision of an eligible provider at an eligible location where the patient is referred by a specialist or by a consultant physician - scan of body for:

- adrenal mass in a patient with malignancy which is otherwise resectable (R) (NK)  (Anaes.)
(See para DIQ of explanatory notes to this Category)
Fee: $179.20	Benefit: 75% = $134.40	85% = $152.35	

MAGNETIC RESONANCE IMAGING	MRI	
New
63457	
MAGNETIC RESONANCE IMAGING performed under the professional supervision of an eligible provider at an eligible location where the patient is referred by a specialist or by a consultant physician and where:  
(a)     a dedicated breast coil is used; and
(b)     the request for scan identifies that the woman is asymptomatic and is less than 50 years of age; and 
(c)     the request for scan identifies either:
	(i)     that the patient is at high risk of developing breast cancer, due to 1 of the following:
	(A) 3 or more first or second degree relatives on the same side of the family diagnosed with breast or ovarian cancer;
	(B) 2 or more first or second degree relatives on the same side of the family diagnosed with breast or ovarian cancer,  if any of the following applies to at least 1 of the relatives:                                                              
		- has been diagnosed with bilateral breast cancer;
		- had onset of breast cancer before the age of 40 years;
		- had onset of ovarian cancer before the age of 50 years;
		- has been diagnosed with breast and ovarian cancer, at the same time or at different times;
		- has Ashkenazi Jewish ancestry;
		- is a male relative who has been diagnosed with breast cancer;

	(C) 1 first or second degree relative diagnosed with breast cancer at age 45 years or younger, plus another first or second degree relative on the same side of the family with bone or soft tissue sarcoma at age 45 years or younger; or

	(ii)    that genetic testing has identified the presence of a high risk breast cancer gene mutation. 

Scan of both breasts for:

- detection of cancer (R) 

NOTE: Benefits are payable on one occasion only in any 12 month period
(NK) (Anaes.)
(See para DIQ of explanatory notes to this Category)
Fee: $345.00	Benefit: 75% = $258.75	85% = $293.25	
New
63458	
MAGNETIC RESONANCE IMAGING performed under the professional supervision of an eligible provider at an eligible location where the patient is referred by a specialist or by a consultant physician and where:
(a)     a dedicated breast coil is used; and 
(b)   the woman has had an abnormality detected as a result of a service described in item 63464 or 63457 performed in the previous 12 months

Scan of both breasts for: 

- detection of cancer (R) 
NOTE 1:	Benefits are payable on one occasion only in any 12 month period

NOTE 2:	This item is intended for follow-up imaging of abnormalities diagnosed on a scan described by item 63464 or 63457

(NK) (Anaes.)
(See para DIQ of explanatory notes to this Category)
Fee: $345.00	Benefit: 75% = $258.75	85% = $293.25	
	SUBGROUP 20 - SCAN OF PELVIS AND UPPER ABDOMEN - FOR SPECIFIED CONDITIONS	
New
63479	
NOTE: Benefits are payable for a service included by Subgroup 20 on one occasion only.
MAGNETIC RESONANCE IMAGING performed under the professional supervision of an eligible provider at an eligible location where:
(a)	the patient is referred by a specialist or by a consultant physician and
(b)	the request for scan identifies that (i) a histological diagnosis of carcinoma of the cervix has been made and (ii) the patient has been diagnosed with cervical cancer at FIGO stage 1B or greater

Scan of:

- Pelvis for the staging of histologically diagnosed cervical cancer at FIGO stages 1B or greater (R) (NK) (Contrast)  (Anaes.)
(See para DIQ of explanatory notes to this Category)
Fee: $201.60	Benefit: 75% = $151.20	85% = $171.40	
New
63481	
- Pelvis and upper abdomen, in a single examination, for the staging of histologically diagnosed cervical cancer at FIGO stages 1B or greater (R) (NK) (Contrast)  (Anaes.)
(See para DIQ of explanatory notes to this Category)
Fee: $313.60	Benefit: 75% = $235.20	85% = $266.60	

MAGNETIC RESONANCE IMAGING	MRI	
New
63484	
NOTE: benefits are payable for a service included by Subgroup 20 on one occasion only.
MAGNETIC RESONANCE IMAGING performed under the professional supervision of an eligible provider at an eligible location where the patient is referred by a specialist or by a consultant physician and where:  
(a)     a phased array body coil is used, and
(b)     the request for scan identifies that the indication is for the initial staging of rectal cancer (including cancer of the rectosigmoid and anorectum).

Scan of:

- Pelvis for the initial staging of rectal cancer (R) (NK) (contrast) (Anaes.)
(See para DIQ of explanatory notes to this Category)
Fee: $201.60	Benefit: 75% = $151.20	85% = $171.40	
	SUBGROUP 21 - SCAN OF BODY - FOR SPECIFIED CONDITIONS	
New
63486	
NOTE: Benefits are only payable for each service included by Subgroup 21 on three occasions only in any 12 month period

MAGNETIC RESONANCE IMAGING performed under the professional supervision of an eligible provider at an eligible location where the patient is referred by a specialist or by a consultant physician - scan of pancreas and biliary tree for:

- suspected biliary or pancreatic pathology (R) (NK) (Contrast)  (Anaes.)
(See para DIQ of explanatory notes to this Category)
Fee: $201.60	Benefit: 75% = $151.20	85% = $171.40	

PATHOLOGY	PATHOLOGY	
	GROUP P2 - CHEMICAL	
Amend
66605	
Vitamins - quantitation of vitamins B1, B2, B3, B6 or C  in blood, urine or other body fluid - 1 or more tests
Fee: $30.80	Benefit: 75% = $23.10	85% = $26.20	
Amend
66607	
Vitamins - quantitation of vitamins A or E in blood, urine or other body fluid - 1 or more tests within a 6 month period 
Fee: $76.25	Benefit: 75% = $57.20	85% = $64.85	
New
66610	
A test described in item 66607 if rendered by a receiving APP - 1 or more tests
Fee: $76.25	Benefit: 75% = $57.20	85% = $64.85	
Fee
66659	
Prostate specific antigen - quantitation of 2 or more fractions of PSA and any derived index including (if performed) a test described in item 66656, in the followup of a PSA result that lies at or above the age related median but below the age related, method specific 97.5% reference limit - 1 of this item in a 12 month period
(Item is subject to rule 25)
Fee: $37.55	Benefit: 75% = $28.20	85% = $31.95	
Fee
66660	
Prostate specific antigen – quantitation of 2 or more fractions of PSA and any derived index including (if performed) a test described in item 66656, in the follow up of a PSA result that lies at or above the age related, method specific 97.5% reference limit, but below a value of 10 ug/L – 4 of this item in a 12 month period.
(Item is subject to rule 25)
Fee: $37.55	Benefit: 75% = $28.20	85% = $31.95	
	GROUP P3 - MICROBIOLOGY	
Amend
69333	
Urine examination (including serial examination) by any means other than simple culture by dip slide, including:
(a)	cell count; and
(b)	culture; and
(c)	colony count; and
(d)	(if performed) stained preparations; and
(e)	(if performed) identification of cultured pathogens; and
(f)	(if performed) antibiotic suseptibility testing; and
(g)	(if performed) examination for pH, specific gravity, blood, protein, urobilinogen, sugar, acetone or bile salts
Fee: $20.70	Benefit: 75% = $15.55	85% = $17.60	
New
69380	
Genotypic testing for HIV antiretroviral resistance in a patient with confirmed HIV infection if the patient's viral load is greater than 1,000 copies per ml at any of the following times:
a.	at presentation; or 
b.	before antiretroviral therapy: or
c.	when treatment with combination antiretroviral agents fails;
maximum of 2 tests in a 12 month period
Fee: $775.50	Benefit: 75% = $581.65	85% = $704.30	
	GROUP P4 - IMMUNOLOGY	
Fee
71057	
Electrophoresis, quantitative and qualitative, of serum, urine or other body fluid all collected within a 28 day period, to demonstrate:
(a)	protein classes; or
(b)	presence and amount of paraprotein;
including the preliminary quantitation of total protein, albumin and globulin - 1 specimen type
Fee: $33.10	Benefit: 75% = $24.85	85% = $28.15	
Amend
Fee
71059	
Immunofixation or immunoelectrophoresis or isoelectric focusing of:
(a)	urine for detection of Bence Jones proteins; or
(b)	serum, plasma or other body fluid; 
and characterisation of a paraprotein or cryoglobulin  -
examination of 1 specimen type (eg. serum, urine or CSF)
Fee: $35.90	Benefit: 75% = $26.95	85% = $30.55	
Fee
71200	
Detection and quantitation, if present, of free kappa and lambda light chains in serum for the diagnosis or monitoring of amyloidosis, myeloma or plasma cell dyscrasias.
Fee: $60.00	Benefit: 75% = $45.00	85% = $51.00	

PATHOLOGY	PATHOLOGY	
	GROUP P6 - CYTOLOGY	
Amend
73051	
Cytology of material obtained directly from a patient at one identified site by fine needle aspiration of solid tissue or tissues if a recognized pathologist:
(a)	performs the aspiration; or
(b)	attends the aspiration and performs cytological examination during the attendance
Fee: $171.50	Benefit: 75% = $128.65	85% = $145.80	
Amend
73063	
Cytology of material obtained directly from a patient at one identified site by fine needle aspiration of solid tissue or tissues if an employee of an approved pathology authority attends the aspiration for confirmation of sample adequacy 
Fee: $100.00	Benefit: 75% = $75.00	85% = $85.00	
New
73066	
Cytology of material obtained directly from a patient at 2 or more separately identified sites by fine needle aspiration of solid tissue or tissues if a recognized pathologist:
(a)	performs the aspiration; or
(b)   attends the aspiration and performs cytological examination during the attendance
Fee: $222.95	Benefit: 75% = $167.25	85% = $189.55	
New
73067	
Cytology of material obtained directly from a patient at 2 or more separately identified sites by fine needle aspiration of solid tissue or tissues if an employee of an approved pathology authority attends the aspiration for confirmation of sample adequacy
Fee: $130.00	Benefit: 75% = $97.50	85% = $110.50	
	GROUP P7 - GENETICS	
New
73325	
Characterisation of mutations in:
(a) the JAK2 gene; or  
(b) the MPL gene; or
(c) both genes;
in the diagnostic work-up, by, or on behalf of, the specialist or consultant physician, of a patient with clinical and laboratory evidence of:
a)  polycythaemia vera; or
b)  essential thrombocythaemia;

1 or more tests
Fee: $75.00	Benefit: 75% = $56.25	85% = $63.75	
New
73326	
Characterisation of the gene rearrangement FIP1L1-PDGFRA in the diagnostic work-up and management of a patient with laboratory evidence of:
a)  mast cell disease; or
b)  idiopathic hypereosinophilic syndrome; or
c)  chronic eosinophilic leukaemia;.

1 or more tests
Fee: $232.50	Benefit: 75% = $174.40	85% = $197.65	
New
73327	
Detection of genetic polymorphisms in the Thiopurine S-methyltransferase gene for the prevention of dose-related toxicity during treatment with thiopurine drugs; including (if performed) any service described in item 65075. 
  
1 or more tests
Fee: $52.30	Benefit: 75% = $39.25	85% = $44.50	

MISCELLANEOUS	TELEHEALTH SUPPORT SERVICE	
	GROUP M12 - SERVICES PROVIDED BY A PRACTICE NURSE OR REGISTERED ABORIGINAL HEALTH WORKER ON BEHALF OF A MEDICAL PRACTITIONER	
	SUBGROUP 1 - TELEHEALTH SUPPORT SERVICE ON BEHALF OF A MEDICAL PRACTITIONER	
New
10983	
Service by a practice nurse or Aboriginal health worker provided on behalf of, and under the supervision of, a medical practitioner that requires the provision of clinical support to a patient who is:
a)	located at an Aboriginal Medical Service or Aboriginal Community Controlled Health Service in relation to which a 	direction made under subsection 19(2) of the Act applies; or 
b)	located outside an inner metropolitan area, not being an admitted patient;
	and who is participating in a video consultation with a specialist or consultant physician.
Fee: $31.20	Benefit: 100% = $31.20	
	SUBGROUP 2 - TELEHEALTH SUPPORT SERVICE ON BEHALF OF A MEDICAL PRACTITIONER AT A RESIDENTIAL AGED CARE FACILITY	
New
10984	
Service by a practice nurse or Aboriginal health worker provided on behalf of, and under the supervision of, a medical practitioner that requires the provision of clinical support to a patient who is:
a)	a care recipient receiving care in a residential aged care service (other than a self-contained unit); or 
b)	at consulting rooms situated within such a complex if the patient is a care recipient receiving care in a residential aged care 	service (excluding accommodation in a self-contained unit);
and who is participating in a video consultation with a specialist or consultant physician.
Fee: $31.20	Benefit: 100% = $31.20	

MISCELLANEOUS	MISCELLANEOUS	
	GROUP M10 - AUTISM, PERVASIVE DEVELOPMENTAL DISORDER AND DISABILITY SERVICES	
Amend
82000	
PSYCHOLOGY
Psychology health service provided to a child, aged under 13 years, by an eligible psychologist where:

(a) the child is referred by an eligible practitioner for the purpose of assisting the practitioner with their diagnosis of the child; 
or
(b) the child is referred by an eligible practitioner for the purpose of contributing to the child’s pervasive developmental disorder
     (PDD) or disability treatment plan, developed by the practitioner; and
(c) for a child with PDD, the eligible practitioner is a consultant physician in the practice of his or her field of psychiatry or paediatrics; or for a child with disability, the eligible practitioner is a specialist, consultant physician or general practitioner; and
(d) the psychologist attending the child is registered with Medicare Australia as meeting the credentialing requirements for 
     provision of these services; and
(e) the child is not an admitted patient of a hospital; and
(f) the service is provided to the child individually and in person; and
(g) the service lasts at least 50 minutes in duration.

These items are limited to a maximum of four services per patient, consisting of any combination of the following items 
─ 82000, 82005, 82010 and 82030
(See para M10.1 of explanatory notes to this Category)
Fee: $96.00	Benefit: 85% = $81.60	
Amend
82005	
SPEECH PATHOLOGY
Speech pathology health service provided to a child, aged under 13 years, by an eligible speech pathologist where:

(a) the child is referred by an eligible practitioner for the purpose of assisting the practitioner with their diagnosis of the child; 
or
(b) the child is referred by an eligible practitioner for the purpose of contributing to the child’s pervasive developmental disorder
     (PDD) or disability treatment plan, developed by the practitioner; and
(c) for a child with PDD, the eligible practitioner is a consultant physician in the practice of his or her field of psychiatry or paediatrics; or for a child with disability, the eligible practitioner is a specialist, consultant physician or general practitioner: and
(d) the speech pathologist attending the child is registered with Medicare Australia as meeting the credentialing requirements for 
     provision of these services; and
(e) the child is not an admitted patient of a hospital; and
(f) the service is provided to the child individually and in person; and
(g) the service lasts at least 50 minutes in duration.

These items are limited to a maximum of four services per patient, consisting of any combination of the following items 
─ 82000, 82005, 82010 and 82030
(See para M10.1 of explanatory notes to this Category)
Fee: $84.60	Benefit: 85% = $71.95	
Amend
82010	
OCCUPATIONAL THERAPY
Occupational therapy health service provided to a child, aged under 13 years, by an eligible occupational therapist where:

(a) the child is referred by an eligible practitioner for the purpose of assisting the practitioner with their diagnosis of the child; 
or
(b) the child is referred by an eligible practitioner for the purpose of contributing to the child’s pervasive developmental disorder
     (PDD) or disability treatment plan, developed by the practitioner; and
(c) for a child with PDD, the eligible practitioner is a consultant physician in the practice of his or her field of psychiatry or paediatrics; or for a child with disability, the eligible practitioner is a specialist, consultant physician or general practitioner; and
(d) the occupational therapist attending the child is registered with Medicare Australia as meeting the credentialing requirements
     for provision of these services; and
(e) the child is not an admitted patient of a hospital; and
(f) the service is provided to the child individually and in person; and
(g) the service lasts at least 50 minutes in duration.

These items are limited to a maximum of four services per patient, consisting of any combination of the following items 
─ 82000, 82005, 82010 and 82030
(See para M10.1 of explanatory notes to this Category)
Fee: $84.60	Benefit: 85% = $71.95	

MISCELLANEOUS	MISCELLANEOUS	
Amend
82015	
PSYCHOLOGY
Psychology health service provided to a child, aged under 15 years, for treatment of a pervasive developmental disorder (PDD) or an eligible disability by an eligible psychologist where:

(a) the child has been diagnosed with PDD or an eligible disability; and
(b) the child has received a PDD or disability treatment plan (while aged under 13 years) as prepared by an eligible practitioner; and
(c) the child has been referred by an eligible practitioner for the provision of services that are consistent with the PDD or disability treatment plan; and
(d) for a child with PDD, the eligible practitioner is a consultant physician in the practice of his or her field of psychiatry or paediatrics; or for a child with disability, the eligible practitioner is a specialist, consultant physician or general practitioner; and
(e) the psychologist attending the child is registered with Medicare Australia as meeting the credentialing requirements for 
     provision of these services; and
(f) the child is not an admitted patient of a hospital; and
(g) the service is provided to the child individually and in person; and
(h) the service lasts at least 30 minutes in duration.

These items are limited to a maximum of 20 services per patient, consisting of any combination of items 
─ 82015, 82020, 82025 and 82035
(See para M10.1 of explanatory notes to this Category)
Fee: $96.00	Benefit: 85% = $81.60	
Amend
82020	
SPEECH PATHOLOGY
Speech pathology health service provided to a child, aged under 15 years, for treatment of a pervasive developmental disorder (PDD) or an eligible disability by an eligible speech pathologist where:

(a) the child has been diagnosed with PDD or an eligible disability; and 
(b) the child has received a PDD or disability treatment plan (while aged under 13 years) as prepared by an eligible practitioner; and
(c) the child has been referred by an eligible practitioner for the provision of services that are consistent with the PDD or disability treatment plan; and
(d) for a child with PDD, the eligible practitioner is a consultant physician in the practice of his or her field of psychiatry or paediatrics; or for a child with disability, the eligible practitioner is a specialist, consultant physician or general practitioner; and
(e) the speech pathologist attending the child is registered with Medicare Australia as meeting the credentialing requirements for 
     provision of these services; and
(f) the child is not an admitted patient of a hospital; and
(g) the service is provided to the child individually and in person; and
(h) the service lasts at least 30 minutes in duration.

These items are limited to a maximum of 20 services per patient, consisting of any combination of items
 ─ 82015, 82020, 82025 and 82035
(See para M10.1 of explanatory notes to this Category)
Fee: $84.60	Benefit: 85% = $71.95	
Amend
82025	
OCCUPATIONAL THERAPY
Occupational therapy health service provided to a child, aged under 15 years, for treatment of a pervasive developmental disorder (PDD) or an eligible disability by an eligible occupational therapist where:

(a) the child has been diagnosed with PDD or an eligible disability; and 
(b) the child has received a PDD or disability treatment plan (while aged under 13 years) as prepared by an eligible practitioner; and
(c) the child has been referred by an eligible practitioner for the provision of services that are consistent with the PDD or disability treatment plan; and
(d) for a child with PDD, the eligible practitioner is a consultant physician in the practice of his or her field of psychiatry or paediatrics; or for a child with disability, the eligible practitioner is a specialist, consultant physician or general practitioner; and
(e) the occupational therapist attending the child is registered with Medicare Australia as meeting the credentialing requirements 
     for provision of these services; and
(f) the child is not an admitted patient of a hospital; and
(g) the service is provided to the child individually and in person; and
(h) the service lasts at least 30 minutes in duration.

These items are limited to a maximum of 20 services per patient, consisting of any combination of items
 ─ 82015, 82020, 82025 and 82035
(See para M10.1 of explanatory notes to this Category)
Fee: $84.60	Benefit: 85% = $71.95	

MISCELLANEOUS	MISCELLANEOUS	
New
82030	
AUDIOLOGY, OPTOMETRY, ORTHOPTIC OR PHYSIOTHERAPY
Audiology, optometry, orthoptic or physiotherapy health service provided to a child, aged under 13 years, by an eligible audiologist, optometrist, orthoptist or physiotherapist where:

(a) the child is referred by an eligible practitioner for the purpose of assisting the practitioner with their diagnosis of the child; 
or
(b) the child is referred by an eligible practitioner for the purpose of contributing to the child’s pervasive developmental disorder
(PDD) or disability treatment plan, developed by the practitioner; and
(c) for a child with PDD, the eligible practitioner is a consultant physician in the practice of his or her field of psychiatry or paediatrics; or for a child with disability, the eligible practitioner is a specialist, consultant physician or general practitioner; and 
(d) the audiologist, optometrist, orthoptist or physiotherapist attending the child is registered with Medicare Australia as meeting the credentialing requirements for provision of these services; and
(e) the child is not an admitted patient of a hospital; and
(f) the service is provided to the child individually and in person; and
(g) the service lasts at least 50 minutes in duration.

These items are limited to a maximum of four services per patient, consisting of any combination of the following items 
- 82000, 82005, 82010 and 82030
(See para M10.1 of explanatory notes to this Category)
Fee: $84.60	Benefit: 85% = $71.95	
New
82035	
AUDIOLOGY, OPTOMETRY, ORTHOPTIC OR PHYSIOTHERAPY
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 where:

(a) the child has been diagnosed with PDD or eligible disability; and 
(b) the child has received a PDD or disability treatment plan (while aged under 13 years) as prepared by an eligible practitioner; and
(c) the child has been referred by an eligible practitioner for the provision of services that are consistent with the PDD or  disability treatment  plan; and
(d) for a child with PDD, the eligible practitioner is a consultant physician in the practice of his or her field of psychiatry or paediatrics; or for a child with disability, the eligible practitioner is a specialist, consultant physician or general practitioner; and 
 (e) the audiologist, optometrist, orthoptist or physiotherapist attending the child is registered with Medicare Australia as meeting the credentialing requirements for provision of these services; and
(f) the child is not an admitted patient of a hospital; and
(g) the service is provided to the child individually and in person; and
(h) the service lasts at least 30 minutes in duration.

These items are limited to a maximum of 20 services per patient, consisting of any combination of items
 - 82015, 82020, 82025 and 82035
(See para M10.1 of explanatory notes to this Category)
Fee: $84.60	Benefit: 85% = $71.95	

MISCELLANEOUS	MISCELLANEOUS	
	GROUP M13 - MIDWIFERY SERVICES	
	SUBGROUP 2 - TELEHEALTH  ATTENDANCES	
New
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 is:
a)	located outside an inner metropolitan area, not being an admitted patient; or
b)	at an Aboriginal Medical Service or Aboriginal Community Controlled Health Service in relation to which a direction made under subsection 19(2) of the Act applies;
and who is participating in a video consultation with a specialist practising in their specialty of obstetrics or paediatrics.
Fee: $27.20	Benefit: 85% = $23.15	
New
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 is:
a)	located outside an inner metropolitan area, not being an admitted patient; or
b)	at an Aboriginal Medical Service or Aboriginal Community Controlled Health Service in relation to which a direction made under subsection 19(2) of the Act applies;
and who is participating in a video consultation with a specialist practising in their specialty of obstetrics or paediatrics.
Fee: $51.65	Benefit: 85% = $43.95	
New
82152	
A 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 is:
a)	located outside an inner metropolitan area, not being an admitted patient; or
b)	at an Aboriginal Medical Service or Aboriginal Community Controlled Health Service in relation to which a direction made under subsection 19(2) of the Act applies;
and who is participating in a video consultation with a specialist practising in their specialty of obstetrics or paediatrics.
Fee: $76.00	Benefit: 85% = $64.60	

MISCELLANEOUS	MISCELLANEOUS	
	GROUP M14 - NURSE PRACTITIONERS	
	SUBGROUP 2 - TELEHEALTH  ATTENDANCE	
New
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 is:
a)	located outside an inner metropolitan area, not being an admitted patient; or
b)	at an Aboriginal Medical Service or Aboriginal Community Controlled Health Service in relation to which a direction made under subsection 19(2) of the Act applies;
and who is participating in a video consultation with a specialist or consultant physician.
Fee: $27.20	Benefit: 85% = $23.15	
New
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 is:
a)	located outside an inner metropolitan area, not being an admitted patient; or 
b)	at an Aboriginal Medical Service or Aboriginal Community Controlled Health Service in relation to which a direction made under subsection 19(2) of the Act applies;
and who is participating in a video consultation with a specialist or consultant physician.
Fee: $51.65	Benefit: 85% = $43.95	
New
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 is:
a)	located outside an inner metropolitan area, not being an admitted patient; or
b)	at an Aboriginal Medical Service or Aboriginal Community Controlled Health Service in relation to which a direction made under subsection 19(2) of the Act applies;
and who is participating in a video consultation with a specialist or consultant physician.
Fee: $76.00	Benefit: 85% = $64.60	
	SUBGROUP 3 - TELEHEALTH  ATTENDANCE AT A RESIDENTIAL AGED CARE FACILITY	
New
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 is:
a)	a care recipient receiving care in a residential aged care service (other than a professional attendance at a self-contained unit); or 
b)	at consulting rooms situated within such a complex if the patient is an approved care recipient receiving care in a residential aged care service (excluding accommodation in a self-contained unit);
and who is participating in a video consultation with a specialist or consultant physician.
Fee: $27.20	Benefit: 85% = $23.15	
New
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 is:
a)	a care recipient receiving care in a residential aged care service (other than a professional attendance at a self-contained unit); or 
b)	at consulting rooms situated within such a complex if the patient is an approved care recipient receiving care in a residential aged care service (excluding accommodation in a self-contained unit);
and who is participating in a video consultation with a specialist or consultant physician.
Fee: $51.65	Benefit: 85% = $43.95	
New
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 is:
a)	a care recipient receiving care in a residential aged care service (other than a professional attendance at a self-contained unit); or 
b)	at consulting rooms situated within such a complex if the patient is an approved care recipient receiving care in a residential aged care service (excluding accommodation in a self-contained unit);
and who is participating in a video consultation with a specialist or consultant physician
Fee: $76.00	Benefit: 85% = $64.60