Group T1: Miscellaneous Therapeutic Procedures
109 items with their schedule fees and Medicare benefits.
| Item | Fee | 75% | Out of hospital |
|---|---|---|---|
| 13015Hyperbaric oxygen therapy for non-neurological soft tissue radiation injuries (excluding arm lymphoedema after breast cancer) in a qualified facility, 90–180 minutes per session. | $304.95 | $228.75 | — |
| 13020Hyperbaric oxygen therapy in a specialised facility for decompression illness, gas gangrene, air/gas embolism, diabetic wounds, necrotising soft tissue infections, or osteoradionecrosis prevention/treatment; 1.5–3 hours per session under supervision… | $309.80 | $232.35 | — |
| 13025Hyperbaric oxygen therapy for decompression illness or air/gas embolism in a qualified facility, supervised by a hyperbaric medicine specialist, charged per hour or part-hour for sessions exceeding 3 hours. | $138.45 | $103.85 | — |
| 13030Emergency hyperbaric oxygen therapy provided by a medical practitioner inside the pressurised chamber for continuous life-saving treatment in a comprehensive facility, charged per hour or part thereof. | $195.55 | $146.70 | — |
| 13100Medical specialist supervision of dialysis (haemodialysis, haemofiltration, haemoperfusion or peritoneal dialysis) in hospital when total attendance time exceeds 45 minutes in one day. | $163.60 | $122.70 | — |
| 13103Medical specialist supervision of dialysis (haemodialysis, haemofiltration, haemoperfusion or peritoneal) in hospital with total attendance time not exceeding 45 minutes per day. | $85.25 | $63.95 | — |
| 13104Consultant renal physician planning, management and supervision of home dialysis for end-stage renal disease patients, up to 12 claims yearly. | $177.05 | — | $150.50 (85%) |
| 13105Haemodialysis for end-stage renal disease provided by a nurse or Aboriginal health worker under medical practitioner supervision, with nephrologist management and 3-6 monthly reviews, in Modified Monash 7 areas only. | $708.55 | — | $708.55 (100%) |
| 13106Mechanical or thrombolytic intervention to restore blood flow through a blocked arteriovenous fistula or graft used for dialysis access. | $145.20 | $108.90 | $123.45 (85%) |
| 13109Surgical insertion and fixation of an indwelling peritoneal catheter (Tenckhoff or similar) for dialysis, including anaesthesia. | $272.55 | $204.45 | $231.70 (85%) |
| 13110Surgical removal of an indwelling peritoneal dialysis catheter (Tenckhoff or similar) including cuffs, performed under anaesthesia. | $273.50 | $205.15 | $232.50 (85%) |
| 13200Superovulation treatment cycle with hormone monitoring, ultrasound, counselling and embryology services for oocyte retrieval, excluding insemination or embryo transfer, limited to initial cycle per calendar year. | $3,723.25 | $2,792.45 | $3,618.75 (85%) |
| 13201Assisted reproductive technology superovulation cycle with oocyte retrieval, including hormone drugs, ultrasound, counselling and embryology services; each cycle after the first per calendar year. | $3,482.70 | $2,612.05 | $3,378.20 (85%) |
| 13202Cancelled IVF superovulation cycle including hormone monitoring and ultrasound scans before oocyte retrieval is abandoned. | $557.20 | $417.90 | $473.65 (85%) |
| 13203Ovulation monitoring during one fertility treatment cycle using hormone tests and ultrasound, excluding services already covered by items 13200, 13201, 13202, 13212, 13215 or 13218. | $582.50 | $436.90 | $495.15 (85%) |
| 13207Embryo biopsy for pre-implantation genetic testing in eligible assisted reproductive treatment cycles, with testing performed on the obtained sample. | $132.25 | $99.20 | $112.45 (85%) |
| 13209Specialist consultation and management planning for a patient referred for assisted reproductive technology or artificial insemination, provided once per treatment cycle. | $101.30 | $76.00 | $86.15 (85%) |
| 13212Surgical retrieval of eggs for assisted reproductive technology procedures, performed under anaesthesia as part of embryo creation or transfer services. | $424.25 | $318.20 | $360.65 (85%) |
| 13215Transfer of embryos or ova and sperm into the uterus or fallopian tubes as part of an IVF/assisted reproduction treatment cycle (requires anaesthesia). | $133.05 | $99.80 | $113.10 (85%) |
| 13218Preparation of frozen or donated embryos or oocytes for uterine or fallopian tube transfer, including hormone testing and counselling, but excluding artificial insemination in the same cycle. | $949.75 | $712.35 | $845.25 (85%) |
| 13221Preparation of semen for artificial insemination when provided as part of a service covered by item 13203. | $60.80 | $45.60 | $51.70 (85%) |
| 13241Microsurgical retrieval of sperm from one testicle under operating microscope with tissue biopsy for intracytoplasmic sperm injection in male factor infertility, excluding cases already covered by items 13218 or 37604. | $1,017.40 | $763.05 | — |
| 13251Intracytoplasmic sperm injection procedure for male factor infertility in assisted reproductive technology, not covered under items 13203 or 13218. | $500.30 | $375.25 | $425.30 (85%) |
| 13260Semen collection and cryopreservation for fertility preservation in males aged 12-60 before or after gonadotoxic treatment for malignancy or non-malignant conditions, with specialist referral; covers one of maximum two lifetime collection cycles. | $496.70 | $372.55 | $422.20 (85%) |
| 13290Collection of semen from patients with spinal injuries or medically induced impotence using vibrator or electro-ejaculation, including catheterisation if needed, for analysis, storage or assisted reproduction. | $244.40 | $183.30 | $207.75 (85%) |
| 13300Insertion of a catheter into an umbilical or scalp vein in a newborn, with or without infusion or cannulation. | $68.15 | $51.15 | — |
| 13303Insertion of a catheter into the umbilical artery for monitoring or infusion in a newborn, typically in neonatal intensive care settings. | $101.00 | $75.75 | — |
| 13306Collection of blood from a donor, venesection and complete blood replacement in a patient, including all associated procedures. | $399.90 | $299.95 | — |
| 13309Autologous blood transfusion involving collection of patient's own blood with complete replacement, performed as one procedure. | $340.95 | $255.75 | — |
| 13312Blood collection from femoral or external jugular vein puncture in infants for pathology testing. | $34.05 | $25.55 | $28.95 (85%) |
| 13318Open surgical placement of a central venous catheter in a child under 12 years, performed by an anaesthetist. | $272.20 | $204.15 | — |
| 13319Insertion of a central venous catheter in a newborn by threading it through a peripheral vein, performed by an anaesthetist. | $272.20 | $204.15 | — |
| 13400Electrical cardioversion to restore normal heart rhythm in non-surgical patients, performed under anaesthesia. | $115.95 | $87.00 | — |
| 13506Insertion of a balloon tube into the stomach and oesophagus to temporarily control bleeding from varices, typically as emergency treatment before definitive therapy. | $220.75 | $165.60 | — |
| 13700Harvesting of bone marrow (autologous or allogeneic) for transplantation purposes, including anaesthesia. | $398.95 | $299.25 | — |
| 13703Intra-operative blood collection and transfusion for normovolaemic haemodilution, excluding cases already covered under item 22052. | $142.95 | $107.25 | — |
| 13706Transfusion of blood or bone marrow that has been previously collected and stored. | $99.75 | $74.85 | $84.80 (85%) |
| 13750Therapeutic removal of blood plasma or cells using continuous or intermittent flow techniques with full nursing supervision and vital sign monitoring, excluding services covered by item 13755. | $163.60 | $122.70 | — |
| 13755Collection of blood products from a donor using continuous or intermittent flow haemapheresis, including cell testing, vital sign monitoring, and registered nurse supervision by a consultant physician. | $163.60 | $122.70 | — |
| 13757Removal of blood to treat haemochromatosis, polycythemia vera, or porphyria cutanea tarda. | $87.30 | $65.50 | $74.25 (85%) |
| 13760In vitro processing and cryopreservation of bone marrow or peripheral blood stem cells for autologous transplantation in patients receiving high-dose chemotherapy for aggressive or treatment-refractory malignancy. | $912.80 | $684.60 | — |
| 13761Extracorporeal photopheresis using methoxsalen for steroid-refractory, steroid-dependent, or steroid-intolerant chronic graft-versus-host disease after allogeneic stem cell transplantation, delivered by haematology or oncology specialist with bone ma… | $2,195.20 | $1,646.40 | — |
| 13762Extracorporeal photopheresis for steroid-refractory, steroid-dependent or steroid-intolerant chronic graft-versus-host disease after allogeneic stem cell transplant, in patients with prior documented partial or complete response, delivered by haemato… | $2,195.20 | $1,646.40 | — |
| 13815Insertion of a central vein catheter by percutaneous or open technique, with ultrasound guidance when clinically appropriate, performed by an anaesthetist (excludes item 13318). | $136.05 | $102.05 | — |
| 13818Insertion of a right heart balloon catheter to measure pulmonary wedge pressure and cardiac output, performed under anaesthesia. | $136.10 | $102.10 | — |
| 13830Daily monitoring of intracranial pressure using an intraventricular catheter, subdural catheter, subarachnoid bolt or similar device by a specialist or consultant physician. | $90.15 | $67.65 | — |
| 13832Insertion of a peripheral tube into a vein or artery for veno-arterial cardiopulmonary bypass support, with ultrasound guidance used as clinically appropriate. | $1,055.40 | $791.55 | — |
| 13834Management of a patient on veno-arterial cardiopulmonary extracorporeal life support on the first day of support. | $590.80 | $443.10 | — |
| 13835Daily management of a patient on veno-arterial cardiopulmonary extracorporeal life support, from the second day onwards. | $137.45 | $103.10 | — |
| 13837Management of veno-venous pulmonary extracorporeal life support on the first day of treatment. | $590.80 | $443.10 | — |
| 13838Daily management of a patient receiving veno-venous extracorporeal life support for pulmonary failure, from day two onwards. | $137.45 | $103.10 | — |
| 13839Percutaneous puncture of an artery to collect blood for laboratory testing or diagnostic analysis. | $27.65 | $20.75 | $23.55 (85%) |
| 13840Insertion of a peripheral vein catheter with ultrasound guidance as needed for veno-venous extracorporeal life support in the lungs. | $707.10 | $530.35 | — |
| 13842Insertion of an arterial line for blood pressure monitoring or blood sampling, with ultrasound guidance available if needed. | $111.95 | $84.00 | $95.20 (85%) |
| 13848Intra-aortic balloon pump management including consultations, haemodynamic monitoring, and parameter assessment on multiple occasions daily. | $186.85 | $140.15 | — |
| 13851Management of a ventricular assist device on day one of ICU admission for implantation or related complications. | $590.80 | $443.10 | — |
| 13854Daily management of a ventricular assist device for an ICU patient, including complication care, for each day after the first day. | $137.45 | $103.10 | — |
| 13857Emergency establishment of airway access and initiation of mechanical ventilation outside ICU to prepare patient for subsequent ICU admission for ongoing ventilatory support. | $175.25 | $131.45 | $149.00 (85%) |
| 13870Specialist or consultant physician's management of a patient in an Intensive Care Unit on the first day, including ECG monitoring, arterial sampling, and bladder catheterisation, with physician immediately available and exclusively rostered. | $433.45 | $325.10 | — |
| 13873Daily specialist physician management of an intensive care patient, including continuous availability, monitoring, and invasive procedures from the second day onwards. | $321.45 | $241.10 | — |
| 13876Continuous monitoring of central venous, pulmonary arterial, systemic arterial, or cardiac intracavity pressure via indwelling catheter in ICU by a specialist physician on exclusive ICU roster, maximum once per pressure type per day. | $92.05 | $69.05 | — |
| 13881Establishment of airway access and initiation of mechanical ventilation in ICU by a specialist or consultant physician for ongoing ventilatory support, excluding anaesthetic procedures. | $175.25 | $131.45 | — |
| 13882Daily management of patients on invasive or non-invasive ventilatory support in ICU by an immediately available specialist physician exclusively rostered for intensive care. | $137.95 | $103.50 | — |
| 13885Specialist or consultant physician management of continuous arteriovenous or venovenous haemofiltration in ICU on the first day, with physician immediately available and exclusively rostered for intensive care. | $183.90 | $137.95 | — |
| 13888Management of continuous arteriovenous or venovenous haemofiltration in ICU by an immediately available specialist physician, for each day after the first day. | $92.05 | $69.05 | — |
| 13899Specialist intensive care physician prepares goals of care for a gravely ill patient outside ICU in at least 60 minutes; cannot be claimed with items 13870 or 13873 on the same day. | $320.55 | $240.45 | $272.50 (85%) |
| 13950Specialist or consultant physician administration of one or more parenteral antineoplastic agents (cytotoxic chemotherapy or monoclonal antibodies) in one or more episodes, including accessing long-term drug delivery devices. | $129.30 | $97.00 | $109.95 (85%) |
| 14050Whole body or hand and foot UVA/UVB phototherapy administered in a cabinet, including consultations, when initiated and supervised by a dermatologist; up to 150 treatments per 12 months. | $63.20 | $47.40 | $53.75 (85%) |
| 14100Laser treatment of visible vascular abnormalities on the head or neck, with photographic documentation, up to 4 sessions per 12 months, including consultation. | $182.45 | $136.85 | $155.10 (85%) |
| 14106Laser treatment of vascular malformations, infantile haemangiomas, café au lait macules, or naevi of Ota visible from 3 metres; maximum 6 sessions per 12 months for areas under 150 cm². | $191.70 | $143.80 | $162.95 (85%) |
| 14115Laser treatment of vascular malformations, haemangiomas, café au lait macules and Ota naevi on areas 150–300 cm², maximum 6 sessions per 12 months, including consultation. | $307.00 | $230.25 | $260.95 (85%) |
| 14118Laser treatment of vascular malformations, haemangiomas, café au lait macules and Ota naevi for areas exceeding 300 cm², maximum 6 sessions per 12 months, under anaesthesia. | $389.85 | $292.40 | $331.40 (85%) |
| 14124Laser treatment of vascular malformations, haemangiomas, café-au-lait spots and Ota naevi from the 7th session onwards within 12 months, with documented photographic evidence. | $182.45 | $136.85 | $155.10 (85%) |
| 14201Poly-L-lactic acid injections for severe facial lipoatrophy caused by antiretroviral therapy; initial session only, once per patient lifetime. | $283.50 | $212.65 | $241.00 (85%) |
| 14202Subsequent injections of poly-L-lactic acid for continuing treatment of severe facial wasting caused by antiretroviral therapy, as prescribed under the National Health Act 1953. | $143.50 | $107.65 | $122.00 (85%) |
| 14203Surgical implantation of hormone pellets or living tissue requiring an incision and sutures, performed under anaesthesia. | $61.20 | $45.90 | $52.05 (85%) |
| 14206Insertion of hormone or living tissue implant using a cannula (needle-like tube), typically for contraception or hormone therapy. | $103.00 | $77.25 | $87.55 (85%) |
| 14212Management of intussusception by fluid or gas reduction under anaesthesia. | $221.70 | $166.30 | — |
| 14216Psychiatrist assessment and treatment mapping for rTMS in patients aged 18+ with treatment-resistant major depression (failed ≥2 antidepressant classes at therapeutic dose for ≥3 weeks each, with documented adherence and psychology referral where app… | $214.45 | $160.85 | $182.30 (85%) |
| 14217rTMS treatment session by a trained psychiatrist for patients who have already received an initial rTMS assessment, limited to a maximum of 35 treatment sessions. | $184.00 | $138.00 | $156.40 (85%) |
| 14218Refilling the reservoir of an implanted infusion pump delivering therapeutic agents to the subarachnoid space, or accessing the side port to check catheter function, with optional reprogramming, for chronic or cancer pain management. | $117.25 | $87.95 | $99.70 (85%) |
| 14219Psychiatrist treatment mapping for rTMS in patients aged 18+ with major depression who have failed adequate trials of 2+ antidepressant classes, completed psychological therapy if appropriate, and previously responded to initial rTMS mapping. | $214.45 | $160.85 | $182.30 (85%) |
| 14220rTMS treatment session provided by a trained psychiatrist for patients who have had prior assessment and one previous rTMS session, limited to 15 services total. | $184.00 | $138.00 | $156.40 (85%) |
| 14221Accessing a long-term implanted device for therapeutic agent delivery, excluding services related to item 13950. | $62.85 | $47.15 | $53.45 (85%) |
| 14224Electroconvulsive therapy administered under anaesthesia, with optional stimulus dosing and EEG monitoring, including related consultation. | $184.00 | $138.00 | — |
| 14227Refilling baclofen infusion pump reservoir in the subarachnoid or epidural space, with optional re-programming, for severe chronic spasticity management. | $117.25 | $87.95 | $99.70 (85%) |
| 14234Removal or replacement of an intrathecal or epidural infusion pump for baclofen delivery, including reservoir loading and pump programming, for severe chronic spasticity management. | $433.15 | $324.90 | — |
| 14237Surgical implantation of a subcutaneous infusion pump with intrathecal or epidural catheter for baclofen delivery to manage severe chronic spasticity, including pump programming and reservoir loading. | $789.80 | $592.35 | — |
| 14245Intravenous infusion of an immunomodulating agent lasting at least 2 hours, payable once per day when the agent is PBS-listed under section 100. | $117.25 | $87.95 | $99.70 (85%) |
| 14247Extracorporeal photopheresis for erythrodermic stage III-IVa cutaneous T-cell lymphoma in adults within first 6 months of treatment, using closed system with methoxsalen, after prior systemic treatment failure, supervised by haematology specialist. | $2,215.00 | $1,661.25 | — |
| 14249Extracorporeal photopheresis for continuing treatment of advanced erythrodermic cutaneous T-cell lymphoma in patients aged 18+ who responded to prior treatment, using a closed system with methoxsalen under haematologist supervision, once per cycle. | $2,215.00 | $1,661.25 | — |
| 14255Emergency medicine specialist resuscitation of at least 30 minutes but less than 1 hour at a private hospital emergency department, with concurrent attendance by an anaesthetist. | $177.55 | $133.20 | $150.95 (85%) |
| 14256Emergency medicine specialist resuscitation of at least 1 hour but less than 2 hours at a private hospital emergency department, with concurrent attendance by an anaesthetist. | $341.50 | $256.15 | $290.30 (85%) |
| 14257Emergency medicine specialist resuscitation lasting at least 2 hours at a private hospital emergency department, performed together with an anaesthetist attendance. | $680.15 | $510.15 | $578.15 (85%) |
| 14258Resuscitation provided for 30 minutes to under 1 hour by a non-emergency medicine specialist at a private hospital emergency department, working with an anaesthetist. | $133.30 | $100.00 | $113.35 (85%) |
| 14259Resuscitation by a non-emergency medicine specialist at a private hospital emergency department for 1–2 hours, working with an anaesthetist. | $256.15 | $192.15 | $217.75 (85%) |
| 14260Resuscitation of a patient for at least 2 hours by a medical practitioner at a private hospital emergency department, working with an anaesthetist. | $510.10 | $382.60 | $433.60 (85%) |
| 14263Minor surgical procedure performed by an emergency medicine specialist at a private hospital emergency department, alongside an anaesthetist attendance. | $62.55 | $46.95 | $53.20 (85%) |
| 14264Procedure by an emergency medicine specialist at a private hospital emergency department, performed together with an anaesthetist attendance. | $140.70 | $105.55 | $119.60 (85%) |
| 14265Minor procedure performed by a medical practitioner (non-emergency specialist) at a private hospital emergency department, conducted alongside an anaesthetist. | $46.85 | $35.15 | $39.85 (85%) |
| 14266Non-minor procedure performed by a medical practitioner at a private hospital emergency department, done alongside an anaesthetist attendance. | $105.50 | $79.15 | $89.70 (85%) |
| 14270Emergency medicine specialist manages fractures and dislocations at a private hospital emergency department in conjunction with another listed specialist, without follow-up care. | $157.75 | $118.35 | $134.10 (85%) |
| 14272Management of all fractures and dislocations at a private hospital emergency department by a medical practitioner working with an allied health practitioner, excluding emergency medicine specialists and aftercare. | $118.35 | $88.80 | $100.60 (85%) |
| 14277Specialist emergency medicine physician applying chemical or physical restraint to a patient in a private hospital emergency department. | $177.55 | $133.20 | $150.95 (85%) |
| 14278Medical practitioner applies chemical or physical restraint to a patient in a private hospital emergency department (excludes emergency medicine specialists). | $133.30 | $100.00 | $113.35 (85%) |
| 14280Anaesthesia provided by an emergency medicine specialist at a private hospital emergency department in conjunction with a specified emergency attendance, excluding cases managed by a specialist anaesthetist. | $177.55 | $133.20 | $150.95 (85%) |
| 14283Anaesthesia administered by a medical practitioner (non-emergency specialist) at a private hospital emergency department, provided alongside specified emergency attendances and not by a specialist anaesthetist. | $133.30 | $100.00 | $113.35 (85%) |
| 14285Emergency medicine specialist performing emergent intubation or airway management in a private hospital emergency department, concurrent with a specified emergency attendance, excluding anaesthesia by an anaesthetist. | $177.55 | $133.20 | $150.95 (85%) |
| 14288Emergent intubation or airway management by a non-emergency medicine specialist doctor at a private hospital ED, provided during a related emergency attendance (items 5001–5036), excluding cases managed by an anaesthetist. | $133.30 | $100.00 | $113.35 (85%) |