Changes to the 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

Page last updated: 14 July 2009

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 $850.75, 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
42698Lens extraction
$650.25
$325.95
42701Lens insertion
$362.60
$181.75
42702Lens extraction and insertion
$831.60
$416.85


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
38215SELECTIVE CORONARY ANGIOGRAPHY, placement of catheters and injection of opaque material into the native coronary arteries.
$409.80
$335.40
38218SELECTIVE CORONARY ANGIOGRAPHY, placement of catheters and injection of opaque material with right or left heart catheterisation or both, or aortography.
$614.70
$503.05
38220SELECTIVE 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
38222SELECTIVE 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
38225SELECTIVE 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
38228SELECTIVE 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
38231SELECTIVE 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
38234SELECTIVE 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
38237SELECTIVE 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
38240SELECTIVE 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
38246SELECTIVE 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.