Group D1: Miscellaneous Diagnostic Procedures And Investigations
135 items with their schedule fees and Medicare benefits.
| Item | Fee | 75% | Out of hospital |
|---|---|---|---|
| 11000EEG recording for diagnostic purposes, excluding EEGs done with specific neuroimaging techniques, quantitative mapping, or as part of certain anesthesia services. | $147.35 | $110.55 | $125.25 (85%) |
| 11003Prolonged EEG recording of at least 3 hours using multi-channel electrodes, excluding quantitative mapping studies and certain associated procedures. | $389.80 | $292.35 | $331.35 (85%) |
| 11004Prolonged ambulatory or video EEG recording (3-24 hours) using multi-channel standard electrode placement on the first day, excluding quantitative mapping or certain concurrent services. | $389.80 | $292.35 | $331.35 (85%) |
| 11005Ambulatory or video EEG recording (3–24 hours, multi-channel, standard 10-20 placement) on each day after the first day, excluding certain quantitative mapping or other specified procedures. | $389.80 | $292.35 | $331.35 (85%) |
| 11009Surgical recording of electrical activity directly from the brain surface to identify seizure focus or functional areas during epilepsy or brain tumour procedures. | $389.80 | $292.35 | $331.35 (85%) |
| 11012Single nerve conduction study or electromyography of one or more muscles using concentric needle electrodes, performed independently of items 11015 or 11018. | $134.00 | $100.50 | $113.90 (85%) |
| 11015Nerve conduction studies on 2–3 nerves, with or without electromyography, when not part of a service billed under item 11012 or 11018. | $179.40 | $134.55 | $152.50 (85%) |
| 11018Electrodiagnostic testing of 4+ nerves with conduction studies and/or electromyography and/or single fibre recordings to assess neuromuscular function. | $268.10 | $201.10 | $227.90 (85%) |
| 11021Nerve stimulation and/or needle electromyography with computerised analysis to assess neuromuscular conduction and muscle electrical activity. | $179.40 | $134.55 | $152.50 (85%) |
| 11024Computerised averaging of central nervous system evoked responses to investigate neurological function, limited to 1 or 2 studies, excluding topographic mapping or multifocal perimetry. | $136.25 | $102.20 | $115.85 (85%) |
| 11027Central nervous system assessment using computerised averaging of evoked responses (3 or more studies), excluding topographic mapping or multifocal perimetry. | $202.05 | $151.55 | $171.75 (85%) |
| 11200Diagnostic test(s) to assess intraocular pressure response in suspected or confirmed open angle glaucoma, including water drinking challenge. | $48.80 | $36.60 | $41.50 (85%) |
| 11204Computerised electroretinography testing of one or both eyes with 3+ studies per current guidelines, performed by or under a specialist/consultant physician. | $129.55 | $97.20 | $110.15 (85%) |
| 11205Electrooculography testing of one or both eyes performed by or under a specialist/consultant physician, excluding cases already covered by items 11000, 11340, 11341, or 11343. | $129.55 | $97.20 | $110.15 (85%) |
| 11210Pattern electroretinography of one or both eyes using computerised averaging with 3 or more studies per current guidelines, performed by or under a specialist or consultant physician. | $129.55 | $97.20 | $110.15 (85%) |
| 11211Measurement of light sensitivity in one or both eyes after 45 minutes of dark adaptation to assess visual function, performed by or under an ophthalmologist's supervision. | $129.55 | $97.20 | $110.15 (85%) |
| 11215Retinal angiography with intravenous dye injection and multiple exposures of one eye to visualise blood vessels and detect retinal or choroidal abnormalities. | $147.20 | $110.40 | $125.15 (85%) |
| 11218Photographic imaging of blood vessels in both eyes using injected dye to detect retinal and choroidal vascular abnormalities. | $181.90 | $136.45 | $154.65 (85%) |
| 11219Optical coherence tomography for diagnosis of an eye condition treatable with PBS-listed intraocular medication; once per 12 months. | $47.80 | $35.85 | $40.65 (85%) |
| 11220OCT scan to assess whether treatment is needed after receiving PBS-subsidised ocriplasmin, limited to once per eye in a patient's lifetime. | $47.80 | $35.85 | $40.65 (85%) |
| 11221Automated visual field testing (both eyes) for eye disease or visual pathway/brain pathology, performed by a specialist with assessment and report, maximum 3 tests per 12 months. | $81.15 | $60.90 | $69.00 (85%) |
| 11224Full automated perimetry (visual field test) for one eye, performed by a specialist for ocular disease or visual pathway pathology, with report; maximum 3 tests per 12 months. | $48.85 | $36.65 | $41.55 (85%) |
| 11235Impression cytology of the cornea to investigate ocular surface dysplasia, including cell collection, processing, examination and report preparation. | $146.85 | $110.15 | $124.85 (85%) |
| 11237Simultaneous A-scan and B-scan ultrasound of one eye to diagnose, monitor or measure choroidal/ciliary melanomas, retinoblastoma or suspicious naevi, when not part of a Group I1 Category 5 service. | $97.50 | $73.15 | $82.90 (85%) |
| 11240Ultrasound or optical measurement of one eye's internal length before cataract surgery, not performed with other eye procedures on the same day. | $97.50 | $73.15 | $82.90 (85%) |
| 11241Ultrasound or optical imaging of both eyes to measure orbital structures before cataract surgery on both eyes, when not associated with other Group I1 eye services. | $124.10 | $93.10 | $105.50 (85%) |
| 11242Ultrasound or optical measurement of the eye after previous lens surgery to plan further lens surgery in that eye. | $95.95 | $72.00 | $81.60 (85%) |
| 11243Ultrasound or optical measurement of the other eye after cataract/refractive surgery on the first eye if that surgery resulted in over 1 dioptre of error or if more than 3 years have passed since the first surgery. | $95.95 | $72.00 | $81.60 (85%) |
| 11244Ultrasound scan of the eye socket and its contents performed by an ophthalmologist, when not part of a broader diagnostic imaging service. | $92.15 | $69.15 | $78.35 (85%) |
| 11300Auditory brainstem response testing to assess hearing in patients not undergoing auditory implant programming, when not performed with item 82300 on the same day. | $230.40 | $172.80 | $195.85 (85%) |
| 11302Programming a unilateral auditory implant sound processor when no implant insertion/replacement surgery occurs that day; up to 4 programming services allowed per day. | $230.40 | $172.80 | $195.85 (85%) |
| 11303Measurement of electrical activity in the inner ear using electrodes placed outside the eardrum, performed on one or both ears. | $230.40 | $172.80 | $195.85 (85%) |
| 11304Measurement of inner ear electrical activity via electrode placed through the eardrum to assess hearing and balance disorders in one or both ears. | $379.35 | $284.55 | $322.45 (85%) |
| 11306Audiometry testing for patients unable to cooperate with standard hearing tests, not performed on the same day as item 82306. | $26.20 | $19.65 | $22.30 (85%) |
| 11309Audiogram measuring air conduction hearing thresholds, not performed on same day as item 82309 service. | $31.45 | $23.60 | $26.75 (85%) |
| 11312Audiogram testing measuring air and bone conduction or air conduction with speech discrimination, not performed on the same day as item 82312. | $44.45 | $33.35 | $37.80 (85%) |
| 11315Audiogram assessing air and bone conduction plus speech testing, if item 82315 hasn't been done on the same day. | $58.85 | $44.15 | $50.05 (85%) |
| 11318Comprehensive hearing assessment including air/bone conduction, speech testing, and cochlear function tests, not performed on same day as item 82318. | $72.70 | $54.55 | $61.80 (85%) |
| 11324Impedance audiogram with tympanometry, static compliance and acoustic reflex measurement, not on same day as item 82324. | $23.75 | $17.85 | $20.20 (85%) |
| 11332Oto-acoustic emission test to assess inner ear hair cell function in at-risk patients (infants, children, ototoxicity risk, noise exposure, or suspected auditory neuropathy) when middle ear disease excluded and not done same day as item 82332. | $70.15 | $52.65 | $59.65 (85%) |
| 11340Vestibular function testing using up to 2 recognised tests to assess peripheral vestibular organs, vestibular-induced eye or muscle responses, static vestibular signs, or central ocular-motor function for diagnosis and management of vestibular disord… | $222.80 | $167.10 | $189.40 (85%) |
| 11341Vestibular function testing using 3–4 recognised tests to assess peripheral vestibular organs, eye movements, central ocular-motor function, or static vestibular dysfunction signs for diagnosis and management. | $446.65 | $335.00 | $379.70 (85%) |
| 11342Remote programming of a unilateral auditory implant or sound processor by a medical practitioner, not on the same day as initial fitting; up to 4 services daily with items 11302 or 11345. | $184.25 | — | $156.65 (85%) |
| 11343Comprehensive vestibular function testing using 5+ recognised tests to assess peripheral vestibular organs, eye movements, and central ocular-motor function for diagnosing and managing vestibular disorders. | $668.25 | $501.20 | $568.05 (85%) |
| 11345Remote programming of a unilateral auditory implant or sound processor by a medical practitioner, not on the same day as implant fitting or replacement; up to 4 services allowed per day. | $184.25 | — | $156.65 (85%) |
| 11503Complex respiratory function testing in a respiratory laboratory under specialist supervision, including lung volumes, diffusion capacity, airway resistance, bronchoprovocation, exercise testing, muscle strength, altitude simulation, shunt calculatio… | $165.95 | $124.50 | $141.10 (85%) |
| 11505Spirometry with bronchodilator response testing to diagnose asthma, COPD, or airflow limitation; performed once per 12 months when 3+ recordings are made. | $49.30 | $37.00 | $41.95 (85%) |
| 11506Spirometry with pre- and post-bronchodilator tracings to diagnose or monitor COPD, asthma, and other obstructive or restrictive lung diseases. | $24.60 | $18.45 | $20.95 (85%) |
| 11507Spirometry with flow-volume loops and FeNO measurement performed by a respiratory scientist under specialist supervision in a respiratory laboratory, with at least 3 recordings and a written report. | $119.95 | $90.00 | $102.00 (85%) |
| 11508Maximal symptom-limited exercise test on cycle ergometer or treadmill for unexplained breathlessness, assessing cardiac/pulmonary disease severity, or perioperative risk; requires specialist referral, respiratory scientist and doctor present, equippe… | $348.05 | $261.05 | $295.85 (85%) |
| 11512Spirometry with flow-volume measurement before and after bronchodilator, performed by respiratory scientist in accredited laboratory under specialist supervision, with 3+ recordings and written report. | $73.95 | $55.50 | $62.90 (85%) |
| 11600Daily monitoring of central venous, pulmonary arterial, systemic arterial or cardiac pressure via indwelling catheter, excluding services during general anaesthesia or covered by item 13876. | $82.95 | $62.25 | — |
| 11602Doppler ultrasound to check for abnormal blood flow in leg veins using compression or Valsalva techniques; limited to 2 per year, not with sclerotherapy. | $69.10 | $51.85 | $58.75 (85%) |
| 11604Plethysmography testing to investigate chronic venous disease in upper and/or lower limbs, including examination, hard copy trace and written report, not associated with item 32500. | $90.55 | $67.95 | $77.00 (85%) |
| 11605Infrared photoplethysmography of lower limbs at rest and after exercise to assess chronic venous reflux or obstruction and guide treatment decisions for deep vein thrombosis, including trace analysis and written report. | $90.55 | $67.95 | $77.00 (85%) |
| 1160724-hour continuous ambulatory blood pressure monitoring for untreated patients with clinic BP 140-180 systolic or 90-110 diastolic, including interpretation and treatment plan; once per 12 months. | $123.20 | $92.40 | $104.75 (85%) |
| 11610Bilateral measurement of ankle and brachial artery pressures using Doppler or plethysmography to calculate indices and assess waveforms for diagnosing lower limb arterial disease, with examination, trace and report. | $76.25 | $57.20 | $64.85 (85%) |
| 11611Doppler or plethysmographic measurement of radial, ulnar, finger and brachial pressures bilaterally to calculate wrist-brachial indices and assess arterial waveforms for diagnosing upper limb arterial disease, including hard copy trace and report. | $76.25 | $57.20 | $64.85 (85%) |
| 11612Doppler or plethysmographic measurement of ankle/toe and brachial pressures at rest and after exercise (treadmill or ergometer) to calculate indices for evaluating lower extremity arterial disease, with examination and report. | $134.50 | $100.90 | $114.35 (85%) |
| 11614Ultrasound examination of blood flow in arteries inside the brain using Doppler technology, with waveform recording and report. | $90.55 | $67.95 | $77.00 (85%) |
| 11615Digital temperature measurement before and for 10+ minutes after cold stress testing, with hard copy recording of results. | $90.75 | $68.10 | $77.15 (85%) |
| 11627Pulmonary artery pressure monitoring during open heart surgery for patients under 12 years of age. | $273.65 | $205.25 | — |
| 11704Twelve-lead ECG with formal report by specialist or consultant physician, when requested by another practitioner and not part of hospital care, concurrent procedures, or attendance items. | $37.40 | — | $31.80 (85%) |
| 11705Twelve-lead ECG formal report by specialist/consultant physician when requested, not bundled with other ECG services, up to twice daily, with report provided to requesting practitioner. | $22.00 | $16.50 | $18.70 (85%) |
| 1170712-lead ECG recording by a doctor for specialist review, up to twice daily, excluding hospital settings and specific allied health or other ECG services. | $22.00 | — | $18.70 (85%) |
| 11713Signal-averaged ECG recording of at least 100 QRS complexes using 3+ leads at ≥1000Hz sampling, with analysis and report by a specialist or consultant physician. | $83.45 | $62.60 | $70.95 (85%) |
| 1171412-lead ECG with trace and clinical interpretation by a medical practitioner to inform clinical decision-making, with documented clinical indication and contextual analysis; limited to twice daily and not bundled with other ECG items or attendance se… | $29.00 | — | $24.65 (85%) |
| 11716Specialist continuous ambulatory ECG recording for 12+ hours to evaluate syncope, pre-syncope, frequent palpitations (>weekly), suspected asymptomatic arrhythmia (>weekly), or post-cardiac surgery dysrhythmia risk, once per 4 weeks, excluding hospita… | $200.55 | — | $170.50 (85%) |
| 11717Specialist ambulatory ECG monitoring using a patient-activated device worn for 7–30 days to investigate recurrent syncope, palpitations, or suspected arrhythmias; includes transmission, analysis, and reporting; limited to once per 3 months and not du… | $117.85 | — | $100.20 (85%) |
| 11719Remote monitoring review of an implanted pacemaker or cardiac resynchronisation pacemaker via analysis of arrhythmias, leads and device parameters, provided at least once per 12 months. | $79.95 | $60.00 | $68.00 (85%) |
| 11720Remote monitoring detected pacemaker abnormality requiring in-person testing, ECG, stimulus measurement, and reprogramming if needed. | $79.95 | $60.00 | $68.00 (85%) |
| 11721Testing and reprogramming of implanted AV sequential, rate responsive, or antitachycardia pacemakers, excluding cases requiring the associated surgical procedures listed. | $83.45 | $62.60 | $70.95 (85%) |
| 11723Specialist ambulatory electrocardiogram monitoring using a patient-activated device worn for up to 7 days, with transmission and formal report, for investigation of recurrent unexplained syncope, palpitations, or suspected arrhythmias; limited to onc… | $62.20 | — | $52.90 (85%) |
| 11724Tilt table test for investigating suspected heart-related syncope, including ECG and blood pressure monitoring, IV access, and specialist supervision in a fully equipped facility. | $202.05 | $151.55 | $171.75 (85%) |
| 11725Remote monitoring reviews of implanted defibrillators or cardiac resynchronisation defibrillators for arrhythmias and device parameters, requiring at least 2 reviews within 12 months and payable once per 12-month period. | $226.85 | $170.15 | $192.85 (85%) |
| 11726Testing of an implanted defibrillator following remote monitoring detection of an abnormality, including ECG and measurement of device parameters, with patient attendance and excluding services under item 11727. | $113.40 | $85.05 | $96.40 (85%) |
| 11727Testing of implanted defibrillators including ECG, pacing/sensing thresholds, stored event review, electrogram interpretation, and programming as needed, excluding services bundled with device implantation or replacement procedures. | $113.40 | $85.05 | $96.40 (85%) |
| 11728Implanted loop recorder monitoring for patients with embolic stroke of undetermined source to investigate atrial fibrillation, including data retrieval, analysis and reporting; up to 4 times per 12 months. | $41.60 | $31.20 | $35.40 (85%) |
| 11729Exercise or pharmacological stress ECG monitoring (≥20 minutes including rest ECG) for patients aged 17+ with cardiac ischemia symptoms, cardiac disease, or family history of heritable arrhythmia; not within 24 months of prior stress testing or coron… | $182.15 | $136.65 | $154.85 (85%) |
| 11730Exercise ECG monitoring and recording (treadmill or cycle ergometer) for patients under 17 with cardiac ischemia symptoms, other cardiac disease worsened by exercise, or family history of heritable arrhythmia; minimum 20 minutes including resting ECG… | $182.15 | $136.65 | $154.85 (85%) |
| 11731Interrogation and analysis of implanted loop recorder in patients with cryptogenic stroke or recurrent unexplained syncope, including device reprogramming and reporting; limited to once per 4 weeks. | $41.60 | $31.20 | $35.40 (85%) |
| 11732Exercise electrocardiogram monitoring by a cardiologist with genetic heart disease expertise for patients with or at risk of long QT syndrome, catecholaminergic polymorphic ventricular tachycardia, or arrhythmogenic cardiomyopathy, including at least… | $182.15 | $136.65 | $154.85 (85%) |
| 11735Seven-day continuous ambulatory ECG monitoring with intelligent microprocessor analysis for suspected intermittent arrhythmia or syncope, or arrhythmia in patients with prior/at-risk stroke, by specialist, with interpretation; max 4 times per 12 mont… | $153.15 | — | $130.20 (85%) |
| 11736Remote monitoring of an implanted loop recorder to investigate atrial fibrillation in patients with embolic stroke of undetermined source, including data retrieval, analysis and reprogramming if needed; limited to 4 times per 12 months. | $41.60 | $31.20 | $35.40 (85%) |
| 11737Remote monitoring of implanted loop recorder for cryptogenic stroke or recurrent unexplained syncope, including device reprogramming, data retrieval, analysis and report; limited to once per 4 weeks. | $41.60 | $31.20 | $35.40 (85%) |
| 11800Pressure measurement study of the oesophagus to diagnose swallowing and motility disorders. | $208.75 | $156.60 | $177.45 (85%) |
| 1180148-hour wireless pH monitoring for gastro-oesophageal reflux disease when catheter-based monitoring has failed or is anatomically unsuitable, performed by a trained endoscopist including device placement, endoscopy, data analysis and all associated a… | $314.85 | $236.15 | — |
| 1181024-hour pH monitoring for gastro-oesophageal reflux disease assessment, including analysis, interpretation, and report with consultation. | $208.75 | $156.60 | $177.45 (85%) |
| 11820Capsule endoscopy to investigate obscure gastrointestinal bleeding after upper endoscopy and colonoscopy have been non-diagnostic, limited to 2 procedures per 12 months and performed by qualified gastroenterology specialists. | $1,471.40 | $1,103.55 | $1,366.90 (85%) |
| 11823Capsule endoscopy for small bowel surveillance in Peutz-Jeghers Syndrome patients, performed by trained specialists, once per 2 years, including capsule administration, imaging and interpretation. | $1,471.40 | $1,103.55 | $1,366.90 (85%) |
| 11830Diagnostic testing of pelvic floor function using anal manometry, anorectal sensation testing, or rectosphincteric reflex measurement to identify abnormalities affecting bowel control. | $223.55 | $167.70 | $190.05 (85%) |
| 11833Assessment of pelvic floor and sphincter muscle function using electromyography or pudendal and spinal nerve motor latency testing to diagnose abnormalities. | $298.85 | $224.15 | $254.05 (85%) |
| 11900Standalone urine flow study measuring peak flow rate, not performed as part of urodynamic services billed under items 11912, 11917, or 11919. | $32.95 | $24.75 | $28.05 (85%) |
| 11912Cystometrography with measurement of urine flow, urethral pressure and/or sphincter activity, plus simultaneous rectal, stomal or vaginal pressure measurement, not with concurrent specified urological or imaging services. | $236.40 | $177.30 | $200.95 (85%) |
| 11917Cystometrography with real-time ultrasound of the urinary tract, measuring urine flow rate, urethral pressure profile and/or sphincter electromyography, plus simultaneous rectal, stomal or vaginal pressure measurement, including all associated imagin… | $512.75 | $384.60 | $435.85 (85%) |
| 11919Combined bladder pressure measurement and contrast imaging study with urinary flow, urethral pressure, rectal pressure, and/or sphincter electromyography, when associated with items 60506 or 60509 but not items 11012-11027, 11900-11917, or 36800. | $512.75 | $384.60 | $435.85 (85%) |
| 12000Skin prick testing for aeroallergens performed by a specialist or consultant physician, including all allergens tested on the same day, when not associated with other specified specialist services. | $46.60 | $34.95 | $39.65 (85%) |
| 12001Skin prick testing for aeroallergens on a single day, limited to once per 12 months, when not done alongside certain other allergy or immunology services. | $46.60 | $34.95 | $39.65 (85%) |
| 12002Repeat skin prick testing for aeroallergens in the same 12-month period, limited to once per 12 months and not on the same day as other specified allergy testing items. | $46.60 | $34.95 | $39.65 (85%) |
| 12003Skin prick testing for food and latex allergens performed on the same day, when not associated with other specified allergen testing services. | $46.60 | $34.95 | $39.65 (85%) |
| 12004Skin testing for antibiotic, non-general anaesthetic, or venom allergens using prick and intradermal methods with multiple dilutions on the same day, excluding cases already associated with related allergy testing items. | $70.45 | $52.85 | $59.90 (85%) |
| 12005Skin testing by a specialist to investigate anaphylaxis or cardiovascular collapse from anaesthetics using prick and intradermal testing with multiple dilutions, including all allergens tested same day. | $94.75 | $71.10 | $80.55 (85%) |
| 12012Patch testing with up to 25 allergens to identify contact allergens causing allergic dermatitis. | $24.90 | $18.70 | $21.20 (85%) |
| 12017Patch testing using 26–50 allergens to investigate allergic contact dermatitis. | $84.05 | $63.05 | $71.45 (85%) |
| 12021Epicutaneous patch testing using 51-75 allergens to investigate allergic dermatitis, performed by or under a specialist/consultant physician. | $138.20 | $103.65 | $117.50 (85%) |
| 12022Patch testing with 76–100 allergens by or on behalf of a specialist or consultant physician investigating allergic dermatitis. | $162.25 | $121.70 | $137.95 (85%) |
| 12024Epicutaneous patch testing with more than 100 allergens to investigate allergic dermatitis, performed by or under a specialist or consultant physician. | $184.90 | $138.70 | $157.20 (85%) |
| 12200Collection of sweat specimen via iontophoresis for diagnostic testing, typically used to confirm cystic fibrosis diagnosis. | $44.50 | $33.40 | $37.85 (85%) |
| 12201Specialist administration of thyrotropin alfa to detect recurrent well-differentiated thyroid cancer in post-thyroidectomy patients on thyroid hormone therapy who cannot safely withdraw due to psychiatric disturbance or medical contraindications; onc… | $2,864.10 | $2,148.10 | $2,759.60 (85%) |
| 12203Overnight in-lab sleep study (minimum 8 hours) with continuous monitoring and technician supervision to diagnose sleep disorders including obstructive/central sleep apnoea, hypoventilation, parasomnias, or movement disorders in patients aged 18+, lim… | $703.80 | $527.85 | $599.30 (85%) |
| 12204Overnight assessment of positive airway pressure therapy (minimum 8 hours) with continuous monitoring and manual scoring of sleep parameters for adults with diagnosed sleep-related breathing disorder, not on PAP in previous 6 months, supervised by sl… | $703.80 | $527.85 | $599.30 (85%) |
| 12205Follow-up overnight sleep study for adults with sleep-related breathing disorder after prior specialist assessment, if symptoms recur unexplained, weight/co-morbidity changes occur, or treatment response is suboptimal; requires continuous technician… | $703.80 | $527.85 | $599.30 (85%) |
| 12207Overnight sleep study for adults to diagnose sleep-related breathing disorders, requiring referral, sleep medicine specialist assessment, continuous monitoring of airflow/heart/brain/oxygen/movement, technician supervision, manual scoring, and specia… | $703.80 | $527.85 | $599.30 (85%) |
| 12208Overnight sleep study (8+ hours) with continuous monitoring of airflow, heart rhythm, brain/eye activity, muscle tone, oxygen levels and body position, performed by a sleep technician under supervision, with manual analysis by a sleep medicine specia… | $703.80 | $527.85 | $599.30 (85%) |
| 12210Overnight sleep study (minimum 8 hours) for children under 12 years, referred by a doctor and assessed by a paediatric sleep specialist, with continuous monitoring of breathing, oxygen, heart rhythm, brain and eye activity, manually scored by special… | $840.10 | $630.10 | $735.60 (85%) |
| 12213Overnight sleep study (minimum 8 hours) for patients aged 12–17 years with GP referral and sleep medicine practitioner assessment, including continuous multi-channel monitoring of airflow, breathing, heart rhythm, brain/eye/muscle activity, and oxyge… | $756.80 | $567.60 | $652.30 (85%) |
| 12215Overnight paediatric sleep study (minimum 8 hours) for children under 12, referred by a medical practitioner and assessed by a qualified paediatric sleep medicine practitioner, with continuous multi-channel monitoring of airflow, breathing, oxygen, h… | $840.10 | $630.10 | $735.60 (85%) |
| 12217Overnight sleep study for adolescents aged 12-17 years referred by a doctor, requiring sleep medicine specialist assessment and continuous monitoring of airflow, heart rhythm, brain/eye activity, oxygen and carbon dioxide levels with manual scoring b… | $756.80 | $567.60 | $652.30 (85%) |
| 12218Unattended overnight sleep study (minimum 8 hours) for children aged 3–11 years, referred by a doctor to a paediatric sleep specialist, to diagnose or reassess sleep apnoea or respiratory support needs; includes continuous monitoring of airflow, hear… | $489.90 | — | $416.45 (85%) |
| 12219Unattended overnight sleep study (minimum 8 hours) for patients aged 12–17 years referred by a medical practitioner to confirm sleep apnoea diagnosis, assess treatment effectiveness, or determine respiratory support needs after clinical change, with… | $455.25 | — | $387.00 (85%) |
| 12250Overnight sleep study (minimum 8 hours) with continuous monitoring of airflow, heart rhythm, brain activity, eye movement, oxygen and breathing effort to diagnose obstructive sleep apnoea in adults, performed under sleep specialist supervision with m… | $401.25 | $300.95 | $341.10 (85%) |
| 12254Multiple sleep latency test for adults with unexplained hypersomnolence, following overnight sleep study and daytime nap assessment, performed and interpreted by a qualified sleep medicine practitioner to confirm central hypersomnolence disorder or p… | $1,093.55 | $820.20 | $989.05 (85%) |
| 12258Maintenance of wakefulness test for adults aged 18+, requiring overnight sleep study (8+ hours with full polysomnography monitoring) followed by daytime wakefulness trials, performed by qualified sleep practitioner with continuous technician supervis… | $1,093.55 | $820.20 | $989.05 (85%) |
| 12261Multiple sleep latency test for adolescents aged 12–17 years with unexplained hypersomnolence, requiring overnight 8+ hour polysomnography, daytime nap study with 4+ periods, sleep medicine practitioner supervision, manual scoring, and specialist int… | $1,146.65 | $860.00 | $1,042.15 (85%) |
| 12265Maintenance of wakefulness test for patients aged 12–17 years following overnight sleep study, requiring qualified sleep medicine practitioner assessment, continuous technician supervision, comprehensive polygraphic monitoring, at least 4 daytime wak… | $1,146.65 | $860.00 | $1,042.15 (85%) |
| 12268Multiple sleep latency test for children under 12 years with suspected central hypersomnolence disorder, requiring overnight polysomnography (8+ hours) plus daytime nap study with specialist paediatric sleep medicine supervision and interpretation; l… | $1,229.90 | $922.45 | $1,125.40 (85%) |
| 12272Maintenance of wakefulness test for children under 12 years with overnight sleep study (minimum 8 hours with multi-channel monitoring) followed by daytime wakefulness trials, supervised by qualified paediatric sleep practitioner, with manual polygrap… | $1,229.90 | $922.45 | $1,125.40 (85%) |
| 12306Dual-energy X-ray absorptiometry scan of 2 or more bone sites to confirm low bone mineral density after minimal trauma fractures or monitor previously diagnosed low bone mineral density (minimum 12 months prior); once per 24 months. | $122.55 | $91.95 | $104.20 (85%) |
| 12312Dual energy X-ray absorptiometry scanning of 2+ bone sites to assess bone loss from glucocorticoid use/excess, hypogonadism, or related conditions; once per 12 months. | $122.55 | $91.95 | $104.20 (85%) |
| 12315Dual energy X-ray absorptiometry bone density scan at 2+ sites for diagnosing or monitoring bone loss in hyperparathyroidism, chronic liver/renal disease, malabsorption, rheumatoid arthritis, or thyroxine excess; once per 24 months. | $122.55 | $91.95 | $104.20 (85%) |
| 12320Bone density scan (DXA or QCT) measuring 2+ sites for patients aged 70+ years with no prior scan or T-score ≥−1.5; once per 5 years. | $122.55 | $91.95 | $104.20 (85%) |
| 12321DEXA scan of 2+ bone sites to assess or confirm low bone mineral density, performed at least 12 months after therapy change; once per patient per 12 months. | $122.55 | $91.95 | $104.20 (85%) |
| 12322Bone density scan (DEXA or QCT) at 2+ sites for patients aged 70+ with T-score between -1.5 and -2.5, once per 2 years. | $122.55 | $91.95 | $104.20 (85%) |
| 12325Visual acuity assessment and bilateral non-mydriatic retinal photography to screen for diabetic retinopathy in Aboriginal and Torres Strait Islander patients with diabetes, performed by their primary diabetes care doctor, once per 12 months, if no ex… | $59.75 | $44.85 | $50.80 (85%) |
| 12326GP screening for diabetic retinopathy using visual acuity testing and non-mydriatic retinal photography in diabetic patients without existing retinopathy, vision worse than 6/12, or significant vision difference between eyes, if not done in preceding… | $59.75 | $44.85 | $50.80 (85%) |