Changes to cataract and coronary angiography items (PDF 17 KB)
Changes to cataract and coronary angiography items, and the removal of items 50124 and 50125
Information on changes to these items as announced in the 2009-10 Budget
As part of the 2009-10 Federal Budget, it was announced that as a result of improved technology and skill, taxpayers are paying more for some Medicare-funded medical services than necessary. To address this issue, the Schedule fee for cataract and coronary angiography procedures will be adjusted to more appropriately reflect the time and complexity for these services. These changes will take effect from 1 November 2009.
In addition, items 50124 and 50125, which currently provide for joint injections, will be removed from the Schedule, as the service can be delivered as part of a standard consultation.
What Medicare Benefits Schedule (MBS) items are changing?
Cataract items
In regard to the cataract items, the Schedule fee for three cataract surgery items will be adjusted. In addition, a new item is being introduced to provide for more complex cataract procedures, with a higher Schedule fee of $900.75, in recognition that some procedures are more complex and timely. Details of the fee changes are outlined below:
Item | Description of service | Current Schedule Fee at 1 Nov 08 | Schedule Fee at 1 Nov 09 |
| 42698 | Lens extraction | $650.25 | $350.95 |
| 42701 | Lens insertion | $362.60 | $206.75 |
| 42702 | Lens extraction and insertion | $831.60 | $454.35 |
Coronary angiography items
The Schedule fee for eleven coronary angiography items (38215 - 38240 and 38246) will be reduced by 20 per cent. Details of the fee changes are outlined below:
Item | Description of service | Current Schedule Fee at 1 Nov 08 | Schedule Fee at 1 Nov 09 |
| 38215 | SELECTIVE CORONARY ANGIOGRAPHY, placement of catheters and injection of opaque material into the native coronary arteries. | $409.80 | $335.40 |
| 38218 | SELECTIVE CORONARY ANGIOGRAPHY, placement of catheters and injection of opaque material with right or left heart catheterisation or both, or aortography. | $614.70 | $503.05 |
| 38220 | SELECTIVE CORONARY GRAFT ANGIOGRAPHY placement of catheter(s) and injection of opaque material into free coronary graft(s) attached to the aorta (irrespective of the number of grafts). | $204.90 | $167.70 |
| 38222 | SELECTIVE CORONARY GRAFT ANGIOGRAPHY, placement of catheter(s) and injection of opaque material into direct internal mammary artery graft(s) to one or more coronary arteries (irrespective of the number of grafts). | $409.80 | $335.40 |
| 38225 | SELECTIVE CORONARY ANGIOGRAPHY, placement of catheters and injection of opaque material into the native coronary arteries and placement of catheter(s) and injection of opaque material into free coronary graft(s) attached to the aorta (irrespective of the number of grafts). | $614.75 | $503.10 |
| 38228 | SELECTIVE CORONARY ANGIOGRAPHY, placement of catheters and injection of opaque material into the native coronary arteries and placement of catheter(s) and injection of opaque material into direct internal mammary artery graft(s) to one or more coronary arteries (irrespective of the number of grafts). | $819.75 | $670.90 |
| 38231 | SELECTIVE CORONARY ANGIOGRAPHY, placement of catheters and injection of opaque material into the native coronary arteries and placement of catheter(s) and injection of opaque material into the free coronary graft(s) attached to the aorta (irrespective of the number of grafts), and placement of catheter(s) and injection of opaque material into direct internal mammary artery graft(s) to one or more coronary arteries (irrespective of the number of grafts). | $1,024.60 | $838.55 |
| 38234 | SELECTIVE CORONARY ANGIOGRAPHY, placement of catheters and injection of opaque material with right or left heart catheterisation or both, or aortography and placement of catheter(s) and injection of opaque material into free coronary graft(s) attached to the aorta (irrespective of the number of grafts). | $819.65 | $670.80 |
| 38237 | SELECTIVE CORONARY ANGIOGRAPHY, placement of catheters and injection of opaque material with right or left heart catheterisation or both, or aortography and placement of catheter(s) and injection of opaque material into direct internal mammary artery graft(s) to one or more coronary arteries (irrespective of the number of grafts). | $1,024.55 | $838.50 |
| 38240 | SELECTIVE CORONARY ANGIOGRAPHY, placement of catheters and injection of opaque material with right or left heart catheterisation or both, or aortography and placement of catheter(s) and injection of opaque material into free coronary graft(s) attached to the aorta (irrespective of the number of grafts) and placement of catheter(s) and injection of opaque material into direct internal mammary artery graft(s) to one or more coronary arteries (irrespective of the number of grafts). | $1,229.40 | $1,006.15 |
| 38246 | SELECTIVE CORONARY ANGIOGRAPHY, placement of catheters and injection of opaque material with right or left heart catheterisation or both, or aortography followed by placement of catheters prior to any coronary interventional procedure. | $1,024.55 | $838.50 |
Joint injection items
Items 50124 and 50125 will be removed from the Schedule, with benefits payable under existing consultation items. Under the current Medicare benefits arrangements, there are some procedural services which are not specifically listed because they are regarded as forming part of a consultation, or attract benefits on an attendance basis.