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Commonwealth legislation
This Act has been repealed and is no longer in force. It is retained for historical reference.
The 1990–91 Medicare Benefits Schedule is Australia’s official price list for medical services covered by Medicare. It assigns item numbers and fees that determine government rebates for consultations, procedures, tests and treatments, affecting patients, doctors who bill Medicare, and private insurers.
Fees vary by setting and provider, often require GP referrals for specialist rebates, and include formula-based calculations for some group or complex services.
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Direct links to the current provisions in Health Insurance (1990-91 General Medical Services Table) Regulations.
Sourced from the Federal Register of Legislation (legislation.gov.au), CC BY 4.0.
Statutory Rules 1990 No. 3421
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Health Insurance (1990-91 General Medical Services Table) Regulations
I, THE GOVERNOR-GENERAL of the Commonwealth of Australia, acting with the advice of the Federal Executive Council, hereby make the following Regulations under the Health Insurance Act 1973.
Dated 25 October 1990.
BILL HAYDEN
Governor-General
By His Excellency's Command,
B. HOWE
Minister of State for Community Services
and Health
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Citation
Commencement
Repeal
General medical services table
SCHEDULE Regulation 4
TABLE OF MEDICAL SERVICES
RULES OF INTERPRETATION
"item" means an item in the list of services and fees in this table;
"Division" means a Division of a Part of that list;
"Part" means a Part of that list.
If an item in Part 1, in Division 3 of Part 3 or in Part 4 includes the symbol "(S)", the item is taken to relate to the service specified in the item when rendered by a specialist in the practice of his or her specialty.
If an item in Part 1, in Division 3 of Part 3 or in Part 4 includes the symbol "(G)", the item is taken to relate to the service specified in the item when rendered otherwise than by a specialist in the practice of his or her specialty.
If an item (other than an item in Part 1, in Division 3 of Part 3 or in Part 4) includes the symbol "(S)", the item is taken to relate to a service specified in the item when rendered by a specialist in the practice of his or her specialty:
(a) to a patient who has been referred to the specialist, where the service is the first service rendered to the patient by the specialist after the referral; or
(b) to a patient who has been referred to the specialist, where the service constitutes part of a single course of treatment rendered to the patient for the condition identified in the referral, or, if no condition was identified in the referral, for the condition identified by the specialist, and that service is rendered within the period of 12 months (or such lesser period, if any, specified by the medical practitioner who referred the patient) after the day on which the first service rendered pursuant to that referral was rendered; or
(c) to a patient who has declared that a written referral was completed by a specified medical practitioner and that the referral has been lost, stolen or destroyed before the rendering of the service, where that service is the first service rendered by the specialist pursuant to that referral or where that service constitutes part of a single course of treatment rendered to the patient for the condition identified by the specialist when he or she rendered the first service rendered to that patient after the making of the declaration and that service is rendered within the period of 12 months after the day on which the first service rendered pursuant to that referral was rendered; or
(d) to a patient who has not been referred to the specialist, where the specialist was, at the time that the service was rendered, of the opinion that it was necessary that that service be rendered as quickly as possible.
If an item (other than an item in Part 1, in Division 3 of Part 3 or in Part 4) includes the symbol "(G)", the item is taken to relate to the service specified in the item when rendered otherwise than by a specialist in accordance with rule 4.
A reference in rule 4 or 5 or in Part 1 to the referring of a patient to a specialist is a reference to a referring by a medical practitioner and:
(a) if the specialist concerned is an ophthalmologist—includes a reference to a referring by a registered optometrist or by a registered optician; and
SCHEDULE—continued
(b) if a referring arises out of a dental service rendered to the person who has been referred—includes a reference to a referring by a dental practitioner.
(a) the patient has declared that a written referral in respect of the patient was completed by a medical practitioner named in the declaration and that the referral has been lost, stolen or destroyed before the attendance specified in the item; or
(b) the patient has not been referred to the specialist or consultant physician and the specialist or consultant physician was, at the time of the attendance specified in the item, of the opinion that it was necessary that that attendance occur as quickly as possible;
but does not include a reference to an attendance by a specialist or consultant physician in the practice of his or her specialty if the attendance forms part of a single course of treatment for which the first service was rendered on a day more than 12 months before the day on which that service was rendered, unless a later referral has been made.
(2) This rule applies to each of the following items:
(a) all items in Part 1 (other than items 170, 171 and 172);
(b) items 190, 192, 198, 246, 247, 248 and 273 in Part 2;
(c) items 821, 824, 890, 893 and 980 in Part 6;
(d) items 5264, 6835, 6904, 7601, 7605, 7694, 7697, 7701, 7706, 7774, 7781 and 7785 in Part 10.
(a) an item in Part 2, 3, 4, 5, 9 or 10; or
(b) an item in Part 6 to which rule 10 applies;
other than:
(c) item 290 in Part 2; or
(d) item 887, 888 or 889 in Part 6; or
(e) an item to which rule 8 applies; or
(f) an item in Part 10 that includes the symbol "D";
is a medical service only if the service is performed personally by a medical practitioner on not more than 1 patient on a single occasion.
(2) A service specified in:
(a) item 170, 171 or 172 in Part 1; or
(b) item 887, 888 or 889 in Part 6;
is a medical service only if the service is performed personally by a medical practitioner.
(a) an item in Part 1, 2, 3, 4, 5, 9 or 10; or
(b) an item in Part 6 to which this rule applies;
other than:
(c) item 180, 182, 184 or 186 in Part 1; or
(d) an item in Part 10 that includes the symbol "D";
SCHEDULE—continued
is a medical service for the purposes of the Act only if the service is rendered by a medical practitioner, being:
(e) a medical practitioner other than a medical practitioner employed by the proprietor of a hospital; or
(f) a medical practitioner who is employed by the proprietor of a hospital and renders that medical service otherwise than in the course of his or her employment by that proprietor;
whether or not essential assistance is provided, in accordance with accepted medical practice, to the medical practitioner rendering that service.
(2) This rule applies to each of the following items in Part 6, that is to say, items. 770, 774, 777, 787, 790, 810, 811, 813, 814, 819, 821, 824, 831, 833, 836, 839, 851, 852, 856, 886, 887, 888, 889, 890, 893, 895, 897, 902, 904, 907, 916, 917, 918, 922, 923, 924, 925, 931, 932, 934, 936, 938, 939, 940, 944, 947, 949, 950, 951, 953, 954, 956, 957, 960, 963, 968, 970, 974, 976, 977, 980, 987 and 989.
(a) a medical practitioner; or
(b) a person, other than a medical practitioner, who is employed by a medical practitioner or, in accordance with accepted medical practice, acts under the supervision of a medical practitioner.
(a) in conditions that allow the establishment of determinate thresholds; and
(b) in a sound-attenuated environment with background noise conditions that comply with Australian Standard AS 1269-1983 of the Standards Association of Australia, being that Standard as in force on 1 August 1987; and
(c) using calibrated equipment that complies with Australian Standard AS 2586-1983 of the Standards Association of Australia, being that Standard as in force on 1 August 1987.
(a) disadvantaged children; or
(b) juvenile offenders; or
(c) aged persons; or
(d) chronically ill psychiatric patients; or
(e) homeless persons; or
(f) unemployed persons; or
(g) persons suffering from alcoholism; or
(h) persons addicted to drugs; or
(i) physically or mentally handicapped persons.
SCHEDULE—continued
(a) if the anaesthetic is administered by a medical practitioner other than a specialist anaesthetist—the relevant item in Division 1 of Part 3; or
(b) if the anaesthetic is administered by a specialist anaesthetist—the relevant item in Division 2 of Part 3.
(a) radiology units operated by the Commonwealth;
(b) radiology units operated by a State or an authority of a State;
(c) radiology units operated by the Northern Territory;
(d) radiology units operated by the Australian Capital Territory Community and Health Service;
(e) radiology units operated by Australian tertiary education institutions.
If an item includes the symbol "(D)", the item relates to the service specified in the item when rendered in the course of dental practice by a dental practitioner approved by the Minister for the purposes of the definition of "professional service" in subsection 3(1).
A reference in an item in Division 1 of Part 3 to the administration of an anaesthetic is a reference to the administration of an anaesthetic by a medical practitioner other than a specialist anaesthetist.
A reference in an item in Division 2 of Part 3 to the administration of an anaesthetic is a reference to the administration of an anaesthetic by a specialist anaesthetist.
A reference in an item in Division 3 of Part 3 to the administration of an anaesthetic is a reference to the administration of an anaesthetic in connection with a dental service other than a service that is a prescribed medical service for the purposes of paragraph (b) of the definition of "professional service" in subsection 3(1).
In item 793, "group of practitioners" has the same meaning as in section 16A.
A reference in an item referred to in a paragraph of this rule to an amount under this rule is a reference to an amount equal to the sum of the fee set out in the item that relates to a radiographic examination of the kind referred to in the first-mentioned item and:
(a) in the case of item 2732—$19.80; or
(b) in the case of item 2782—$21.00; or
(c) in the case of item 2798—$12.60.
(a) in the case of item 2863—$11.40 for each field separately treated in excess of 1 up to a maximum of 5 additional fields; and
(b) in the case of item 2877—$12.60 for each field separately treated in excess of 1 up to a maximum of 5 additional fields; and
(c) in the case of item 2881—$15.00 for each field separately treated in excess of 1 up to a maximum of 5 additional fields; and
SCHEDULE—continued
(d) in the case of item 2889—$20.00 for each field separately treated in excess of 1 up to a maximum of 5 additional fields; and
(e) in the case of item 2893—$16.60 for each field separately treated in excess of 1 up to a maximum of 5 additional fields.
(a) in the case of item 2871—$12.40 for each field separately treated in excess of 1 up to a maximum of 5 additional fields; and
(b) in the case of item 2885—$31.50 for each field separately treated in excess of 1 up to a maximum of 5 additional fields.
A reference in item 2953 to an amount under this rule, being an amount payable for assistance at an operation, is a reference to an amount equal to one-fifth of the sum of the fees payable under this Act for the services at that operation of the practitioner to whom the assistance was rendered.
(1) A reference in item 2957 to an amount under this rule, being an amount payable for assistance at a series or combination of operations, is a reference to an amount equal to one-fifth of the sum of the fees payable under this Act for the services at those operations of the practitioner to whom the assistance was rendered.
(2) For the purposes of subrule (1), the amount payable for the Caesarean section component of the operations is the fee applicable to item 210.
(a) in the case of item 7483, 7809, 7812, 7817 or 7818—one-half of that fee; or
(b) in the case of item 7803, 7804, 7847 or 7849—one-third of that fee; or
(c) in the case of item 7823 or 7824—three-quarters of that fee.
(a) the fee set out in the item relating to the administration of an anaesthetic that is referred to in the item relating to a dislocation of the kind treated (being an item relating to a dislocation that is referred to in items 7397 to 7472 (inclusive)); and
(b) one-half of the fee referred to in paragraph (a).
(a) the fee set out in the item relating to the administration of an anaesthetic that is referred to in the item relating to a fracture of the kind treat
This is an opening excerpt, not the complete document.