Australian Government Department of Health and Ageing Medicare Benefits Schedule Book Pathology Services Category 6 Operating from 01 January 2011



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PATHOLOGY

PATHOLOGY



GROUP P8 - INFERTILITY AND PREGNANCY TESTS


73521

Semen examination for presence of spermatozoa or examination of cervical mucus for spermatozoa (Huhner's test)



Fee: $9.75 Benefit: 75% = $7.35 85% = $8.30

73523

Semen examination (other than post-vasectomy semen examination), including:

(a) measurement of volume, sperm count and motility; and

(b) examination of stained preparations; and

(c) morphology; and (if performed)

(d) differential count and 1 or more chemical tests;

(Item is subject to rule 25)

Fee: $42.05 Benefit: 75% = $31.55 85% = $35.75


73525

Sperm antibodies - sperm-penetrating ability - 1 or more tests



Fee: $28.55 Benefit: 75% = $21.45 85% = $24.30

73527

Human chorionic gonadotrophin (HCG) - detection in serum or urine by 1 or more methods for diagnosis of pregnancy - 1 or more tests



Fee: $10.05 Benefit: 75% = $7.55 85% = $8.55

73529

Human chorionic gonadotrophin (HCG), quantitation in serum by 1 or more methods (except by latex, membrane, strip or other pregnancy test kit) for diagnosis of threatened abortion, or followup of abortion or diagnosis of ectopic pregnancy, including any services performed in item 73527 - 1 test



Fee: $28.85 Benefit: 75% = $21.65 85% = $24.55



PATHOLOGY

PATHOLOGY



GROUP P9 - SIMPLE BASIC PATHOLOGY TESTS


73801

Semen examination for presence of spermatozoa



Fee: $6.95 Benefit: 75% = $5.25 85% = $5.95

73802

Leucocyte count, erythrocyte sedimentation rate, examination of blood film (including differential leucocyte count), haemoglobin, haematocrit or erythrocyte count - 1 test



Fee: $4.60 Benefit: 75% = $3.45 85% = $3.95

73803

2 tests described in item 73802



Fee: $6.40 Benefit: 75% = $4.80 85% = $5.45

73804

3 or more tests described in item 73802



Fee: $8.20 Benefit: 75% = $6.15 85% = $7.00

73805

Microscopy of urine, whether stained or not, or catalase test



Fee: $4.60 Benefit: 75% = $3.45 85% = $3.95

73806

Pregnancy test by 1 or more immunochemical methods



Fee: $10.20 Benefit: 75% = $7.65 85% = $8.70

73807

Microscopy for wet film other than urine, including any relevant stain



Fee: $6.95 Benefit: 75% = $5.25 85% = $5.95

73808

Microscopy of Gram-stained film, including (if performed) a service described in item 73805 or 73807



Fee: $8.70 Benefit: 75% = $6.55 85% = $7.40

73809

Chemical tests for occult blood in faeces by reagent stick, strip, tablet or similar method



Fee: $2.35 Benefit: 75% = $1.80 85% = $2.00

73810

Microscopy for fungi in skin, hair or nails - 1 or more sites



Fee: $6.95 Benefit: 75% = $5.25 85% = $5.95

73811

Mantoux test



Fee: $11.30 Benefit: 75% = $8.50 85% = $9.65



PATHOLOGY

PATHOLOGY



GROUP P10 - PATIENT EPISODE INITIATION


73920

Initiation of a patient episode by collection of a specimen for 1 or more services (other than those services described in items 73922, 73924 or 73926) if the specimen is collected in an approved collection centre that the APA operates in the same premises as it operates a category GX or GY pathology laboratory



Fee: $2.40 Benefit: 75% = $1.80 85% = $2.05

73922

Initiation of a patient episode that consists only of a service described in item 73053, 73055 or 73057. Unless item 73923 applies



Fee: $8.25 Benefit: 75% = $6.20 85% = $7.05

73923

Initiation of a patient episode that consists only of a service described in items 73053, 73055 or 73057 from a person who is a private patient in a recognised hospital or the service is rendered by a prescribed laboratory



Fee: $2.40 Benefit: 75% = $1.80 85% = $2.05

73924

Initiation of a patient episode that consists only of 1 or more services described in items 72813, 72816, 72817, 72818, 72823, 72824, 72825, 72826, 72830 and 72836 from a person who is an in-patient of a hospital. Unless item 73925 applies



Fee: $14.75 Benefit: 75% = $11.10 85% = $12.55

73925

Initiation of a patient episode that consists only of 1 or more services described in items 72813, 72816, 72817, 72818, 72823, 72824, 72825, 72826, 72830 and 72836 from a person who is a private patient in a recognised hospital or the service is rendered to a private patient in a hospital by a prescribed laboratory



Fee: $2.40 Benefit: 75% = $1.80 85% = $2.05

73926

Initiation of a patient episode that consists only of 1 or more services described in items 72813, 72816, 72817, 72818, 72823, 72824, 72825, 72826, 72830 and 72836 from a person who is not an in-patient of a private hospital. Unless item 73927 applies.



Fee: $8.25 Benefit: 75% = $6.20 85% = $7.05

73927

Initiation by a prescribed laboratory of a patient episode that consists only of 1 or more services described in items 72813, 72816, 72817, 72818, 72823, 72824, 72825, 72826, 72830 and 72836 from a person who is not a private patient in a recognised hospital nor a patient in a private hospital



Fee: $2.40 Benefit: 75% = $1.80 85% = $2.05

73928

Initiation of a patient episode by collection of a specimen for 1 or more services (other than those services described in items 73922, 73924 or 73926) if the specimen is collected in an approved collection centre. Unless item 73920 or 73929 applies



Fee: $6.00 Benefit: 75% = $4.50 85% = $5.10

73929

Initiation of a patient episode by collection of a specimen for 1 or more services (other than those services described in items 73922, 73924 or 73926) if the specimen is collected by an approved pathology practitioner for a prescribed laboratory or by an employee of an approved pathology authority, who conducts a prescribed laboratory, if the specimen is collected in an approved pathology collection centre



Fee: $2.40 Benefit: 75% = $1.80 85% = $2.05

73930

Initiation of a patient episode by collection of a specimen for a service for 1 or more services (other than those services described in items 73922, 73924 or 73926) if the specimen is collected by an approved pathology practitioner or an employee of an approved pathology authority from a person who is an in-patient of a hospital other than a recognised hospital. Unless item 73931 applies



Fee: $6.00 Benefit: 75% = $4.50 85% = $5.10

73931

Initiation of a patient episode by collection of a specimen for 1 or more services (other than those services described in items 73922, 73924 or 73926) if:



  1. the specimen is collected by an approved pathology practitioner for a prescribed laboratory or by an employee of an approved pathology authority, who conducts a prescribed laboratory, from a person who is a private patient in a hospital or

  2. the person is a private patient in a recognised hospital and the specimen is collected by an approved pathology practitioner or an employee of an approved pathology authority


Fee: $2.40 Benefit: 75% = $1.80 85% = $2.05

73932

Initiation of a patient episode by collection of a specimen for 1 or more services (other than those services described in items 73922, 73924 or 73926) if the specimen is collected by an approved pathology practitioner or an employee of an approved pathology authority from a person in the place where the person was residing. Unless item 73933 applies



Fee: $10.30 Benefit: 75% = $7.75 85% = $8.80




PATHOLOGY

PATHOLOGY

73933

Initiation of a patient episode by collection of a specimen for 1 or more services (other than those services described in items 73922, 73924 or 73926) if the specimen is collected by an approved pathology practitioner for a prescribed laboratory or by an employee of an approved pathology authority, who conducts a prescribed laboratory, from a person in the place where the person is residing



Fee: $2.40 Benefit: 75% = $1.80 85% = $2.05

73934

Initiation of a patient episode by collection of a specimen for 1 or more services (other than those services described in items 73922, 73924 and 73926) if the specimen is collected by an approved pathology practitioner or an employee of an approved pathology authority from a person in a residential aged care home or institution. Unless 73935 applies



Fee: $17.70 Benefit: 75% = $13.30 85% = $15.05

73935

Initiation of a patient episode by collection of a specimen for 1 or more services (other than those services described in items 73922, 73924 or 73926) if the specimen is collected by an approved pathology practitioner or by an employee of an approved pathology authority, who conducts a prescribed laboratory, from a person in a residential aged care home or institution



Fee: $2.40 Benefit: 75% = $1.80 85% = $2.05

73936

Initiation of a patient episode by collection of a specimen for 1 or more services (other than those services described in items 73922, 73924 or 73926) if the specimen is collected from the person by the person.



Fee: $6.00 Benefit: 75% = $4.50 85% = $5.10

73937

Initiation of a patient episode by collection of a specimen for 1 or more services (other than those services described in items 73922, 73924 or 73926), if the specimen is collected from the person by the person and if:



  1. the service is performed in a prescribed laboratory or

  2. the person is a private patient in a recognised hospital


Fee: $2.40 Benefit: 75% = $1.80 85% = $2.05

73938

Initiation of a patient episode by collection of a specimen for 1 or more services (other than those services described in items 73922, 73924 or 73926) if the specimen is collected by or on behalf of the treating practitioner. Unless item 73939 applies



Fee: $8.00 Benefit: 75% = $6.00 85% = $6.80

73939

Initiation of a patient episode by collection of a specimen for 1 or more services (other than those services described in items 73922, 73924 or 73926), if the specimen is collected by or on behalf of the treating practitioner and if:



  1. the service is performed in a prescribed laboratory or

  2. the person is a private patient in a recognised hospital


Fee: $2.40 Benefit: 75% = $1.80 85% = $2.05

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