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Commonwealth legislation
This Act has been repealed and is no longer in force. It is retained for historical reference.
This regulation is Medicare’s price list and rule book for diagnostic imaging (ultrasound, CT and X‑ray), specifying which scans are subsidised, how much Medicare pays, and the conditions for claiming. It covers referral vs non‑referral fees, equipment‑age differentials, reduced payments for multiple same‑day services, bulk‑billing incentives, who may perform scans, and limits on pregnancy ultrasounds. It determines patient out‑of‑pocket costs and quality/eligibility standards.
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Direct links to the current provisions in Health Insurance (Diagnostic Imaging Services Table) Regulations 2010.
A reference to a diagnostic imaging service in an item in Part 2 includes a reference to the undertaking of the diagnostic imaging procedure used for rendering the service.
Division 1.2 General application provisions
(1) An item including the symbol (R) is an R‑type diagnostic imaging service.
(2) An item including the symbol (NR) is an NR‑type diagnostic imaging service.
Unless the contrary intention appears, items in this table relating to diagnostic imaging services apply whether the service is provided by:
(a) a medical practitioner; or
(b) a person, other than a medical practitioner, who:
(i) is employed by a medical practitioner; or
(ii) provides the service under the supervision of a medical practitioner in accordance with accepted medical practice.
(1) An item in Part 2 (except an item to which subclause (2) applies) applies only if the providing practitioner gives a report of the service performed to the practitioner, participating midwife or participating nurse practitioner who requested the service.
(2) This subclause applies to the following items:
(a) items 55054, 55130, 55135, 55848, 55850, 57341, 57345, 59312, 59314, 60506, 60509 and 61109, being items of services performed in conjunction with a surgical procedure;
(b) items 60918 and 60927, being items of service performed in preparation for a radiological procedure.
(1) An item that includes the symbol (NK) at the end of the item applies to a service that is performed on equipment that is at least 10 years old.
(2) An item that includes the symbol (K) at the end of the item applies to a service that is performed on equipment that is less than 10 years old.
(3) The date from which the age of equipment is worked out for this clause is:
(a) the date that the equipment was first installed in Australia; or
(b) if the equipment was imported as used equipment — the date of manufacture of the oldest component of the equipment.
(1) This clause applies if:
(a) a service that is mentioned in an item in Division 2.1 to 2.5 of this table is provided; and
(b) the service is not provided in a hospital; and
(c) the service is bulk‑billed.
(2) The fee for the service is 95% of the fee mentioned in this table for the service.
(3) For subsection 10 (2) of the Act, the benefit payable is the amount calculated under subclause (2).
Note Under regulation 6EF of the Health Insurance Regulations 1975, the medicare benefit payable is 100% of the amount calculated under subclause (2).
(4) This clause does not apply to the service specified in item 61369.
Note Item 61369 is taken to be an item in the table — see the Health Insurance (Indium‑labelled Octreotide Study) Determination HS/09/2006.
(1) If a medical practitioner provides 2 or more vascular ultrasound services for the same patient on the same day, the fees specified for the items that apply to the services are affected as follows:
(a) the second highest fee is reduced by 40%;
(b) any other fee, except the highest, is reduced by 50%.
(2) For subclause (1):
(a) if 2 or more applicable fees are equally the highest, one only of those fees is taken to be the highest fee; and
(b) if paragraph (a) applies — the other, or another, highest fee is taken to be the second highest fee; and
(c) if 2 or more fees are equally second highest, any 1 of those fees may be taken to be the second highest for the purpose of paragraph (1) (b); and
(d) if a reduced fee calculated under subclause (1) is not a multiple of 5 cents, the reduced fee is taken to be the nearest amount that is a multiple of 5 cents.
(3) This clause does not apply to the fee specified in item 64990 or 64991.
(1) If a medical practitioner renders 2 or more diagnostic imaging services for the same patient on the same day, the fees set out in the items that apply to the services, other than the item with the highest fee, are reduced by $5.
(2) If a medical practitioner renders at least 1 R‑type diagnostic imaging service and at least 1 consultation service for the same patient on the same day, the highest fee, set out in the items that apply to diagnostic imaging services rendered by the practitioner for that patient on that day, is reduced:
(a) if the fee for the relevant consultation is at least $40 — by $35; or
(b) if that fee is less than $40 but more than $15 — by $15; or
(c) if that fee is less than $15 — by the amount of that fee.
(3) For subclause (2), if more than 1 consultation has occurred, the relevant consultation is the consultation having the highest fee set out in the items that apply to the consultation.
(4) If a medical practitioner renders at least 1 R‑type diagnostic imaging service and at least 1 non‑consultation service for the same patient on the same day, the highest fee that applies to any diagnostic imaging services performed by the medical practitioner for the same patient on the same day, is reduced by $5.
(5) If a medical practitioner renders an R‑type diagnostic imaging service, a consultation and a non‑consultation service for the same patient on the same day, the sum of the reductions under subclauses (2) and (4) must not exceed the highest fee that applies to any diagnostic imaging services rendered by the medical practitioner for the same patient on the same day.
(6) Clauses 1.2.6 and 2.5.8 apply, subject to subclauses (7) and (8), in addition to this clause.
(7) For clause 1.2.6, if a medical practitioner provides:
(a) 2 or more vascular ultrasound services for the same patient on the same day; and
(b) 1 or more other diagnostic imaging services for that patient on that day;
the amount of the fees payable for the vascular ultrasound services is taken, for this clause, to be an amount payable for 1 diagnostic imaging service.
(8) For clause 2.5.8, if a medical practitioner provides:
(a) 2 or more MRI services described in Subgroup 12 or 13 of Division 2.5 in this table for the same patient on the same day; and
(b) 1 or more other diagnostic imaging services for that patient on that day;
the amount of the fees payable for the MRI services is taken, for this clause, to be an amount payable for 1 diagnostic imaging service.
(9) This clause does not apply to diagnostic imaging services that are rendered in a remote area by a medical practitioner for whom a remote area exemption under section 23DX of the Act is in force for that area.
(10) This clause does not apply to the fee specified in item 59103, 64990 or 64991.
(11) In this clause:
consultation means a service under an item listed in Divisions 2.1 to 2.14 of the general medical services table.
highest fee means the highest fee specified for an item in the first claim submitted to the Chief Executive Medicare for the services provided.
non‑consultation service means a service under an item listed in the general medical services table other than in Divisions 2.1 to 2.14 of the general medical services table.
Part 2 Services and fees
Division 2.1 Group I1 — Ultrasound
Subdivision A General
Clause 1.2.3 does not apply to items 55054, 55130, 55135, 55848 and 55850.
Items in this Division (except items 55600 and 55603) apply to an ultrasound service only if the service is performed:
(a) by a medical practitioner; or
(b) by a registered sonographer on behalf of a medical practitioner.
(1) Items in this Division (except items 55600 and 55603) marked with the symbol (R) apply to an ultrasound service (the eligible service) only if the service is performed:
(a) under the professional supervision of a specialist or a consultant physician in the practice of his or her specialty who is available:
(i) to monitor and influence the conduct and diagnostic quality of the examination; and
(ii) if necessary, to attend on the patient personally; or
(b) under the professional supervision of a practitioner who:
(i) is not a specialist or consultant physician; and
(ii) meets the requirement of subclause (2); and
(iii) is available to monitor and influence the conduct and diagnostic quality of the examination and, if necessary, to attend on the patient personally; or
(c) in the circumstance mentioned in subclause (3), and under the professional supervision of a practitioner who is available:
(i) to monitor and influence the conduct and diagnostic quality of the examination; and
(ii) if necessary, to attend on the patient personally; or
(d) if paragraph (a), (b) or (c) cannot be complied with:
(i) in an emergency; or
(ii) in a location that is not less than 30 kilometres by the most direct road route from another practice where services that comply with paragraph (a) or (b) are available.
(2) For subparagraph (1) (b) (ii), the requirement is that, between 1 September 1997 and 31 August 1999, at least 50 services were rendered by or on behalf of the practitioner at the location where the eligible service was rendered, and the rendering of those services entitled payment of medicare benefits.
(3) For paragraph (1) (c), the circumstance is that, between 1 September 1997 and 31 August 1999, at least 50 services were rendered in nursing homes or patients’ residences by or on behalf of the practitioner, and the rendering of those services entitled payment of medicare benefits.
Subdivision B Subgroup 1 to 4 of Group I1
In items 55028, 55030 and 55032, medical practitioner in the phrase referred by a medical practitioner or the referring medical practitioner includes a dental practitioner who is approved by the Minister under paragraph (b) of the definition of professional service in subsection 3 (1) of the Act.
<table cellspacing="0" cellpadding="0" style="width:375.15pt; border-collapse:collapse"><thead><tr><td colspan="3" style="width:372.05pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableColHead" style="margin-bottom:0pt"><span>Group I1</span><span> </span><span>— Ultrasound</span></p></td></tr><tr><td style="width:34.45pt; border-bottom:0.75pt solid #000000; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableColHead"><span>Item</span></p></td><td style="width:295.25pt; border-bottom:0.75pt solid #000000; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableColHead"><span>Diagnostic imaging service</span></p></td><td style="width:36.15pt; border-bottom:0.75pt solid #000000; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableColHead"><span>Fee ($)</span></p></td></tr></thead><tbody><tr><td colspan="3" style="width:372.05pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableColHead2"><span>Subgroup 1</span><span> </span><span>— General</span></p></td></tr><tr><td style="width:34.45pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText"><span>55028</span></p></td><td style="width:295.25pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText"><span>Head, ultrasound scan of, if:</span></p><p class="TableP1a"><span style="width:8.19pt; text-indent:0pt; display:inline-block"></span><span>(a)</span><span style="width:6.25pt; text-indent:0pt; display:inline-block"> </span><span>the patient is referred by a medical practitioner for ultrasonic examination not being a service associated with a service to which an item in Subgroup 2 or 3 applies; and</span></p><p class="TableP1a"><span style="width:7.57pt; text-indent:0pt; display:inline-block"></span><span>(b)</span><span style="width:6.25pt; text-indent:0pt; display:inline-block"> </span><span>the referring medical practitioner is not a member of a group of practitioners of which the providing practitioner is a member (R)</span></p></td><td style="width:36.15pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText" style="text-align:right"><span>109.10</span></p></td></tr><tr><td style="width:34.45pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText"><span>55029</span></p></td><td style="width:295.25pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText"><span>Head, ultrasound scan of, if the patient is not referred by a medical practitioner, not being a service associated with a service to which an item in Subgroup</span><span> </span><span>2 or 3 applies (NR)</span></p></td><td style="width:36.15pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText" style="text-align:right"><span>37.85</span></p></td></tr><tr><td style="width:34.45pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText"><span>55030</span></p></td><td style="width:295.25pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText"><span>Orbital contents, ultrasound scan of, if:</span></p><p class="TableP1a"><span style="width:8.19pt; text-indent:0pt; display:inline-block"></span><span>(a)</span><span style="width:6.25pt; text-indent:0pt; display:inline-block"> </span><span>the patient is referred by a medical practitioner for ultrasonic examination not being a service associated with a service to which an item in Subgroup 2</span><span> </span><span>or 3 applies; and</span></p><p class="TableP1a"><span style="width:7.57pt; text-indent:0pt; display:inline-block"></span><span>(b)</span><span style="width:6.25pt; text-indent:0pt; display:inline-block"> </span><span>the referring medical practitioner is not a member of a group of practitioners of which the providing practitioner is a member (R)</span></p></td><td style="width:36.15pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText" style="text-align:right"><span>109.10</span></p></td></tr><tr><td style="width:34.45pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText"><span>55031</span></p></td><td style="width:295.25pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText"><span>Orbital contents, ultrasound scan of, if the patient is not referred by a medical practitioner, not being a service associated with a service to which an item in Subgroup</span><span> </span><span>2</span><span> </span><span>or 3 applies (NR)</span></p></td><td style="width:36.15pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText" style="text-align:right"><span>37.85</span></p></td></tr><tr><td style="width:34.45pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText"><span>55032</span></p></td><td style="width:295.25pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText"><span>Neck, 1 or more structures of, ultrasound scan of, if:</span></p><p class="TableP1a"><span style="width:8.19pt; text-indent:0pt; display:inline-block"></span><span>(a)</span><span style="width:6.25pt; text-indent:0pt; display:inline-block"> </span><span>the patient is referred by a medical practitioner for ultrasonic examination not being a service associated with a service to which an item in Subgroup 2</span><span> </span><span>or 3 applies; and</span></p><p class="TableP1a"><span style="width:7.57pt; text-indent:0pt; display:inline-block"></span><span>(b)</span><span style="width:6.25pt; text-indent:0pt; display:inline-block"> </span><span>the referring medical practitioner is not a member of a group of practitioners of which the providing practitioner is a member (R)</span></p></td><td style="width:36.15pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText" style="text-align:right"><span>109.10</span></p></td></tr><tr><td style="width:34.45pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText"><span>55033</span></p></td><td style="width:295.25pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText"><span>Neck, 1 or more structures of, ultrasound scan of, if the patient is not referred by a medical practitioner, not being a service associated with a service to which an item in Subgroup 2</span><span> </span><span>or 3</span><span> </span><span>applies (NR)</span></p></td><td style="width:36.15pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText" style="text-align:right"><span>37.85</span></p></td></tr><tr style="height:36.65pt"><td style="width:34.45pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText"><span>55036</span></p></td><td style="width:295.25pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText"><span>Abdomen, ultrasound scan of (including scan of urinary tract when performed), if:</span></p><p class="TableP1a"><span style="width:8.19pt; text-indent:0pt; display:inline-block"></span><span>(a)</span><span style="width:6.25pt; text-indent:0pt; display:inline-block"> </span><span>the patient is referred by a medical practitioner or participating nurse practitioner for ultrasonic examination; and</span></p></td><td style="width:36.15pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText" style="text-align:right"><span>111.30</span></p></td></tr><tr><td style="width:34.45pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText"><span></span></p></td><td style="width:295.25pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableP1a"><span style="width:7.57pt; text-indent:0pt; display:inline-block"></span><span>(b)</span><span style="width:6.25pt; text-indent:0pt; display:inline-block"> </span><span>if the patient is referred by a medical practitioner</span><span> </span><span>— the referring medical practitioner is not a member of a group of practitioners of which the providing practitioner is a member; and</span></p><p class="TableP1a"><span style="width:8.19pt; text-indent:0pt; display:inline-block"></span><span>(c)</span><span style="width:6.25pt; text-indent:0pt; display:inline-block"> </span><span>if the patient is referred by a participating nurse practitioner</span><span> </span><span>— the referring nurse practitioner does not have a business or financial arrangement with the providing practitioner; and</span></p><p class="TableP1a"><span style="width:7.57pt; text-indent:0pt; display:inline-block"></span><span>(d)</span><span style="width:6.25pt; text-indent:0pt; display:inline-block"> </span><span>the service is not a service associated with a service to which an item in Subgroup 2</span><span> </span><span>or 3 applies; and</span></p></td><td style="width:36.15pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText" style="text-align:right"><span></span></p></td></tr><tr><td style="width:34.45pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText"><span></span></p></td><td style="width:295.25pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableP1a"><span style="width:8.19pt; text-indent:0pt; display:inline-block"></span><span>(e)</span><span style="width:6.25pt; text-indent:0pt; display:inline-block"> </span><span>the service is not solely a transrectal ultrasonic examination of the prostate gland, bladder base and urethra, or any of those organs; and</span></p></td><td style="width:36.15pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText" style="text-align:right"><span></span></p></td></tr><tr><td style="width:34.45pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText"><span></span></p></td><td style="width:295.25pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableP1a"><span style="width:9.41pt; text-indent:0pt; display:inline-block"></span><span>(f)</span><span style="width:6.25pt; text-indent:0pt; display:inline-block"> </span><span>within 24</span><span> </span><span>hours of the service, a service described in item</span><span> </span><span>55038, 55044 or 55731 is not performed on the same patient by the providing practitioner (R)</span></p></td><td style="width:36.15pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText" style="text-align:right"><span></span></p></td></tr><tr style="height:52.5pt"><td style="width:34.45pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText"><span>55037</span></p></td><td style="width:295.25pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText"><span>Abdomen, ultrasound scan of (including scan of urinary tract when performed), if:</span></p><p class="TableP1a"><span style="width:8.19pt; text-indent:0pt; display:inline-block"></span><span>(a)</span><span style="width:6.25pt; text-indent:0pt; display:inline-block"> </span><span>the patient is not referred by a medical practitioner or participating nurse practitioner; and</span></p></td><td style="width:36.15pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText" style="text-align:right"><span>37.85</span></p></td></tr><tr style="height:45.2pt"><td style="width:34.45pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText"><span></span></p></td><td style="width:295.25pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableP1a"><span style="width:7.57pt; text-indent:0pt; display:inline-block"></span><span>(b)</span><span style="width:6.25pt; text-indent:0pt; display:inline-block"> </span><span>the service is not a service associated with a service to which an item in Subgroup 2</span><span> </span><span>or 3 applies; and</span></p><p class="TableP1a"><span style="width:8.19pt; text-indent:0pt; display:inline-block"></span><span>(c)</span><span style="width:6.25pt; text-indent:0pt; display:inline-block"> </span><span>the service is not solely a transrectal ultrasonic examination of the prostate gland, bladder base and urethra, or any of those organs (NR)</span></p></td><td style="width:36.15pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText" style="text-align:right"><span></span></p></td></tr><tr><td style="width:34.45pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText"><span>55038</span></p></td><td style="width:295.25pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText"><span>Urinary tract, ultrasound scan of, if:</span></p><p class="TableP1a"><span style="width:8.19pt; text-indent:0pt; display:inline-block"></span><span>(a)</span><span style="width:6.25pt; text-indent:0pt; display:inline-block"> </span><span>the patient is referred by a medical practitioner for ultrasonic examination; and</span></p><p class="TableP1a"><span style="width:7.57pt; text-indent:0pt; display:inline-block"></span><span>(b)</span><span style="width:6.25pt; text-indent:0pt; display:inline-block"> </span><span>the referring medical practitioner is not a member of a group of practitioners of which the providing practitioner is a member; and</span></p></td><td style="width:36.15pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText" style="text-align:right"><span>109.10</span></p></td></tr><tr><td style="width:34.45pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText"><span></span></p></td><td style="width:295.25pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableP1a" style="margin-top:3pt"><span style="width:8.19pt; text-indent:0pt; display:inline-block"></span><span>(c)</span><span style="width:6.25pt; text-indent:0pt; display:inline-block"> </span><span>the service is not a service associated with a service to which an item in Subgroup 2</span><span> </span><span>or 3 applies; and</span></p></td><td style="width:36.15pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText" style="text-align:right"><span></span></p></td></tr><tr><td style="width:34.45pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText"><span></span></p></td><td style="width:295.25pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableP1a"><span style="width:7.57pt; text-indent:0pt; display:inline-block"></span><span>(d)</span><span style="width:6.25pt; text-indent:0pt; display:inline-block"> </span><span>the service is not solely a transrectal ultrasonic examination of the prostate gland, bladder base and urethra, or any of those organs; and</span></p><p class="TableP1a"><span style="width:8.19pt; text-indent:0pt; display:inline-block"></span><span>(e)</span><span style="width:6.25pt; text-indent:0pt; display:inline-block"> </span><span>within 24</span><span> </span><span>hours of the service, a service described in item</span><span> </span><span>55036, 55044 or 55731 is not performed on the same patient by the providing practitioner (R)</span></p></td><td style="width:36.15pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText" style="text-align:right"><span></span></p></td></tr><tr><td style="width:34.45pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText"><span>55039</span></p></td><td style="width:295.25pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText"><span>Urinary tract, ultrasound scan of, if:</span></p><p class="TableP1a"><span style="width:8.19pt; text-indent:0pt; display:inline-block"></span><span>(a)</span><span style="width:6.25pt; text-indent:0pt; display:inline-block"> </span><span>the patient is not referred by a medical practitioner; and</span></p><p class="TableP1a"><span style="width:7.57pt; text-indent:0pt; display:inline-block"></span><span>(b)</span><span style="width:6.25pt; text-indent:0pt; display:inline-block"> </span><span>the service is not a service associated with a service to which an item in Subgroup 2</span><span> </span><span>or 3 applies; and</span></p><p class="TableP1a"><span style="width:8.19pt; text-indent:0pt; display:inline-block"></span><span>(c)</span><span style="width:6.25pt; text-indent:0pt; display:inline-block"> </span><span>the service is not solely a transrectal ultrasonic examination of the prostate gland, bladder base and urethra, or any of those organs (NR)</span></p></td><td style="width:36.15pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText" style="text-align:right"><span>37.85</span></p></td></tr><tr style="height:82.55pt"><td style="width:34.45pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText"><span>55044</span></p></td><td style="width:295.25pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText"><span>Pelvis, male, ultrasound scan of, by any or all approaches, if:</span></p><p class="TableP1a"><span style="width:8.19pt; text-indent:0pt; display:inline-block"></span><span>(a)</span><span style="width:6.25pt; text-indent:0pt; display:inline-block"> </span><span>the patient is referred by a medical practitioner for ultrasonic examination; and</span></p><p class="TableP1a"><span style="width:7.57pt; text-indent:0pt; display:inline-block"></span><span>(b)</span><span style="width:6.25pt; text-indent:0pt; display:inline-block"> </span><span>the referring medical practitioner is not a member of a group of practitioners of which the providing practitioner is a member; and</span></p><p class="TableP1a"><span style="width:8.19pt; text-indent:0pt; display:inline-block"></span><span>(c)</span><span style="width:6.25pt; text-indent:0pt; display:inline-block"> </span><span>the service is not a service associated with a service to which an item in Subgroup 2</span><span> </span><span>or 3 applies; and</span></p></td><td style="width:36.15pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText" style="text-align:right"><span>111.30</span></p></td></tr><tr style="height:75.75pt"><td style="width:34.45pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText"><span></span></p></td><td style="width:295.25pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableP1a"><span style="width:7.57pt; text-indent:0pt; display:inline-block"></span><span>(d)</span><span style="width:6.25pt; text-indent:0pt; display:inline-block"> </span><span>the service is not solely a transrectal ultrasonic examination of the prostate gland, bladder base and urethra, or any of those organs; and</span></p><p class="TableP1a"><span style="width:8.19pt; text-indent:0pt; display:inline-block"></span><span>(e)</span><span style="width:6.25pt; text-indent:0pt; display:inline-block"> </span><span>within 24</span><span> </span><span>hours of the service, a service described in item</span><span> </span><span>55036 or 55038 is not performed on the same patient by the providing practitioner (R)</span></p></td><td style="width:36.15pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText" style="text-align:right"><span></span></p></td></tr><tr><td style="width:34.45pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText"><span>55045</span></p></td><td style="width:295.25pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText"><span>Pelvis, male, ultrasound scan of, by any or all approaches, if:</span></p><p class="TableP1a"><span style="width:8.19pt; text-indent:0pt; display:inline-block"></span><span>(a)</span><span style="width:6.25pt; text-indent:0pt; display:inline-block"> </span><span>the patient is not referred by a medical practitioner; and</span></p><p class="TableP1a"><span style="width:7.57pt; text-indent:0pt; display:inline-block"></span><span>(b)</span><span style="width:6.25pt; text-indent:0pt; display:inline-block"> </span><span>the service is not a service associated with a service to which an item in Subgroup 2</span><span> </span><span>or 3 applies; and</span></p><p class="TableP1a"><span style="width:8.19pt; text-indent:0pt; display:inline-block"></span><span>(c)</span><span style="width:6.25pt; text-indent:0pt; display:inline-block"> </span><span>the service is not solely a transrectal ultrasonic examination of the prostate gland, bladder base and urethra, or any of those organs (NR)</span></p></td><td style="width:36.15pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText" style="text-align:right"><span>37.85</span></p></td></tr><tr style="height:72.65pt"><td style="width:34.45pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText"><span>55048</span></p></td><td style="width:295.25pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText"><span>Scrotum, ultrasound scan of, if:</span></p><p class="TableP1a"><span style="width:8.19pt; text-indent:0pt; display:inline-block"></span><span>(a)</span><span style="width:6.25pt; text-indent:0pt; display:inline-block"> </span><span>the patient is referred by a medical practitioner for ultrasonic examination not being a service associated with a service to which an item in Subgroup 2</span><span> </span><span>or 3 applies; and</span></p><p class="TableP1a"><span style="width:7.57pt; text-indent:0pt; display:inline-block"></span><span>(b)</span><span style="width:6.25pt; text-indent:0pt; display:inline-block"> </span><span>the referring medical practitioner is not a member of a group of practitioners of which the providing practitioner is a member (R)</span></p></td><td style="width:36.15pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText" style="text-align:right"><span>109.50</span></p></td></tr><tr><td style="width:34.45pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText"><span>55049</span></p></td><td style="width:295.25pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText"><span>Scrotum, ultrasound scan of, if the patient is not referred by a medical practitioner, not being a service associated with a service to which an item in Subgroup</span><span> </span><span>2</span><span> </span><span>or 3 applies (NR)</span></p></td><td style="width:36.15pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText" style="text-align:right"><span>37.85</span></p></td></tr><tr><td style="width:34.45pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText"><span>55054</span></p></td><td style="width:295.25pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText"><span>Ultrasonic cross</span><span>‑</span><span>sectional echography, in conjunction with a surgical procedure using interventional techniques, not being a service associated with a service to which any other item in this group applies (R)</span></p></td><td style="width:36.15pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText" style="text-align:right"><span>109.10</span></p></td></tr><tr><td style="width:34.45pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText"><span>55070</span></p></td><td style="width:295.25pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText"><span>Breast, one, ultrasound scan of, if:</span></p><p class="TableP1a"><span style="width:8.19pt; text-indent:0pt; display:inline-block"></span><span>(a)</span><span style="width:6.25pt; text-indent:0pt; display:inline-block"> </span><span>the patient is referred by a medical practitioner or participating nurse practitioner; and</span></p><p class="TableP1a"><span style="width:7.57pt; text-indent:0pt; display:inline-block"></span><span>(b)</span><span style="width:6.25pt; text-indent:0pt; display:inline-block"> </span><span>the service is not associated with a service to which an item in Subgroup</span><span> </span><span>2 or 3 applies; and</span></p><p class="TableP1a"><span style="width:8.19pt; text-indent:0pt; display:inline-block"></span><span>(c)</span><span style="width:6.25pt; text-indent:0pt; display:inline-block"> </span><span>if the patient is referred by a medical practitioner</span><span> </span><span>— the referring medical practitioner is not a member of a group of practitioners of which the providing practitioner is a member; and</span></p><p class="TableP1a"><span style="width:7.57pt; text-indent:0pt; display:inline-block"></span><span>(d)</span><span style="width:6.25pt; text-indent:0pt; display:inline-block"> </span><span>if the patient is referred by a participating nurse practitioner</span><span> </span><span>— the referring nurse practitioner does not have a business or financial arrangement with the providing practitioner (R)</span></p></td><td style="width:36.15pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText" style="text-align:right"><span>98.25</span></p></td></tr><tr><td style="width:34.45pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText"><span>55073</span></p></td><td style="width:295.25pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText"><span>Breast, one, ultrasound scan of, if:</span></p><p class="TableP1a"><span style="width:8.19pt; text-indent:0pt; display:inline-block"></span><span>(a)</span><span style="width:6.25pt; text-indent:0pt; display:inline-block"> </span><span>the patient is not referred by a medical practitioner or participating nurse practitioner; and</span></p><p class="TableP1a"><span style="width:7.57pt; text-indent:0pt; display:inline-block"></span><span>(b)</span><span style="width:6.25pt; text-indent:0pt; display:inline-block"> </span><span>the service is not associated with a service to which an item in Subgroup 2 or 3 applies (NR)</span></p></td><td style="width:36.15pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText" style="text-align:right"><span>34.05</span></p></td></tr><tr><td style="width:34.45pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText"><span>55076</span></p></td><td style="width:295.25pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText"><span>Breasts, both, ultrasound scan of, if:</span></p><p class="TableP1a"><span style="width:8.19pt; text-indent:0pt; display:inline-block"></span><span>(a)</span><span style="width:6.25pt; text-indent:0pt; display:inline-block"> </span><span>the patient is referred by a medical practitioner or participating nurse practitioner; and</span></p><p class="TableP1a"><span style="width:7.57pt; text-indent:0pt; display:inline-block"></span><span>(b)</span><span style="width:6.25pt; text-indent:0pt; display:inline-block"> </span><span>the service is not associated with a service to which an item in Subgroup</span><span> </span><span>2 or 3 applies; and</span></p><p class="TableP1a"><span style="width:8.19pt; text-indent:0pt; display:inline-block"></span><span>(c)</span><span style="width:6.25pt; text-indent:0pt; display:inline-block"> </span><span>if the patient is referred by a medical practitioner</span><span> </span><span>— the referring medical practitioner is not a member of a group of practitioners of which the providing practitioner is a member; and</span></p><p class="TableP1a"><span style="width:7.57pt; text-indent:0pt; display:inline-block"></span><span>(d)</span><span style="width:6.25pt; text-indent:0pt; display:inline-block"> </span><span>if the patient is referred by a participating nurse practitioner</span><span> </span><span>— the referring nurse practitioner does not have a business or financial arrangement with the providing practitioner (R)</span></p></td><td style="width:36.15pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText" style="text-align:right"><span>109.10</span></p></td></tr><tr><td style="width:34.45pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText"><span>55079</span></p></td><td style="width:295.25pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText"><span>Breasts, both, ultrasound scan of, if:</span></p><p class="TableP1a"><span style="width:8.19pt; text-indent:0pt; display:inline-block"></span><span>(a)</span><span style="width:6.25pt; text-indent:0pt; display:inline-block"> </span><span>the patient is not referred by a medical practitioner or participating nurse practitioner; and</span></p><p class="TableP1a"><span style="width:7.57pt; text-indent:0pt; display:inline-block"></span><span>(b)</span><span style="width:6.25pt; text-indent:0pt; display:inline-block"> </span><span>the service is not associated with a service to which an item in Subgroup 2 or 3 applies (NR)</span></p></td><td style="width:36.15pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText" style="text-align:right"><span>37.85</span></p></td></tr><tr style="height:69.05pt"><td style="width:34.45pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText"><span>55084</span></p></td><td style="width:295.25pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText"><span>Urinary bladder, ultrasound scan of, by any or all approaches, if:</span></p><p class="TableP1a"><span style="width:8.19pt; text-indent:0pt; display:inline-block"></span><span>(a)</span><span style="width:6.25pt; text-indent:0pt; display:inline-block"> </span><span>the patient is referred by a medical practitioner for ultrasonic examination; and</span></p><p class="TableP1a"><span style="width:7.57pt; text-indent:0pt; display:inline-block"></span><span>(b)</span><span style="width:6.25pt; text-indent:0pt; display:inline-block"> </span><span>the referring medical practitioner is not a member of a group of practitioners of which the providing practitioner is a member; and</span></p></td><td style="width:36.15pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText" style="text-align:right"><span>98.25</span></p></td></tr><tr style="height:52.85pt"><td style="width:34.45pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText"><span></span></p></td><td style="width:295.25pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableP1a"><span style="width:8.19pt; text-indent:0pt; display:inline-block"></span><span>(c)</span><span style="width:6.25pt; text-indent:0pt; display:inline-block"> </span><span>the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and</span></p><p class="TableP1a"><span style="width:7.57pt; text-indent:0pt; display:inline-block"></span><span>(d)</span><span style="width:6.25pt; text-indent:0pt; display:inline-block"> </span><span>within 24 hours of the service, a service described in item</span><span> </span><span>11917, 55036, 55038, 55044, 55600, 55603 or 55731 is not performed on the same patient by the providing practitioner (R)</span></p></td><td style="width:36.15pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText" style="text-align:right"><span></span></p></td></tr><tr style="height:4pt"><td style="width:34.45pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText"><span>55085</span></p></td><td style="width:295.25pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText"><span>Urinary bladder, ultrasound scan of, by any or all approaches, if:</span></p><p class="TableP1a"><span style="width:8.19pt; text-indent:0pt; display:inline-block"></span><span>(a)</span><span style="width:6.25pt; text-indent:0pt; display:inline-block"> </span><span>the patient is not referred by a medical practitioner; and</span></p><p class="TableP1a"><span style="width:7.57pt; text-indent:0pt; display:inline-block"></span><span>(b)</span><span style="width:6.25pt; text-indent:0pt; display:inline-block"> </span><span>the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and</span></p></td><td style="width:36.15pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText" style="text-align:right"><span>34.05</span></p></td></tr><tr style="height:54.75pt"><td style="width:34.45pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText"><span></span></p></td><td style="width:295.25pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableP1a" style="margin-top:3pt"><span style="width:8.19pt; text-indent:0pt; display:inline-block"></span><span>(c)</span><span style="width:6.25pt; text-indent:0pt; display:inline-block"> </span><span>within 24 hours of the service, a service described in item</span><span> </span><span>11917, 55037, 55039, 55045, 55600, 55603 or 55733 is not performed on the same patient by the providing practitioner (NR)</span></p></td><td style="width:36.15pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText" style="text-align:right"><span></span></p></td></tr><tr><td colspan="3" style="width:372.05pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableColHead2" style="margin-right:5.65pt; widows:0; orphans:0"><span>Subgroup 2 — Cardiac</span></p></td></tr><tr style="height:37.55pt"><td style="width:34.45pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText" style="widows:0; orphans:0"><span>55113</span></p></td><td style="width:295.25pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText" style="widows:0; orphans:0"><span>M</span><span>‑</span><span>mode and two</span><span>‑</span><span>dimensional real time echocardiographic examination of the heart from at least 2 acoustic windows for the investigation of symptoms or signs of cardiac failure, or suspected or known ventricular hypertrophy or dysfunction, or chest pain:</span></p></td><td style="width:36.15pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText" style="text-align:right; widows:0; orphans:0"><span>230.65</span></p></td></tr><tr style="height:144pt"><td style="width:34.45pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText" style="page-break-after:avoid"><span></span></p></td><td style="width:295.25pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableP1a" style="page-break-after:avoid"><span style="width:8.19pt; text-indent:0pt; display:inline-block"></span><span>(a)</span><span style="width:6.25pt; text-indent:0pt; display:inline-block"> </span><span>with:</span></p><p class="TableP2i" style="page-break-after:avoid"><span style="width:25.92pt; text-indent:0pt; display:inline-block"></span><span>(i)</span><span style="width:7.1pt; text-indent:0pt; display:inline-block"> </span><span>measurement of blood flow velocities across the cardiac valves using pulsed wave and continuous wave Doppler techniques; and</span></p><p class="TableP2i" style="page-break-after:avoid"><span style="width:22.86pt; text-indent:0pt; display:inline-block"></span><span>(ii)</span><span style="width:7.1pt; text-indent:0pt; display:inline-block"> </span><span>real time colour flow mapping from at least 2</span><span> </span><span>acoustic windows; and</span></p><p class="TableP2i" style="page-break-after:avoid"><span style="width:19.81pt; text-indent:0pt; display:inline-block"></span><span>(iii)</span><span style="width:7.1pt; text-indent:0pt; display:inline-block"> </span><span>recordings on video tape or digital media; and</span></p><p class="TableP1a" style="page-break-after:avoid"><span style="width:7.57pt; text-indent:0pt; display:inline-block"></span><span>(b)</span><span style="width:6.25pt; text-indent:0pt; display:inline-block"> </span><span>not being a service associated with a service to which an item in Subgroup 1 (except item</span><span> </span><span>55054) or</span><span> </span><span>3, or another item in this Subgroup (except items</span><span> </span><span>55118 and 55130), applies (R)</span></p></td><td style="width:36.15pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText" style="text-align:right; page-break-after:avoid"><span></span></p></td></tr><tr><td style="width:34.45pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText"><span>55114</span></p></td><td style="width:295.25pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText"><span>M</span><span>‑</span><span>mode and two</span><span>‑</span><span>dimensional real time echocardiographic examination of the heart from at least 2 acoustic windows for the investigation of suspected or known acquired valvular, aortic, pericardial, thrombotic or embolic disease or heart tumour:</span></p><p class="TableP1a"><span style="width:8.19pt; text-indent:0pt; display:inline-block"></span><span>(a)</span><span style="width:6.25pt; text-indent:0pt; display:inline-block"> </span><span>with:</span></p><p class="TableP2i" style="margin-top:3pt; margin-left:43.2pt; text-indent:-43.2pt"><span style="width:25.92pt; text-indent:0pt; display:inline-block"></span><span>(i)</span><span style="width:6.9pt; text-indent:0pt; display:inline-block"> </span><span>measurement of blood flow velocities across the cardiac valves using pulsed wave and continuous wave Doppler techniques; and</span></p><p class="TableP2i"><span style="width:22.86pt; text-indent:0pt; display:inline-block"></span><span>(ii)</span><span style="width:7.1pt; text-indent:0pt; display:inline-block"> </span><span>real time colour flow mapping from at least 2</span><span> </span><span>acoustic windows; and</span></p><p class="TableP2i"><span style="width:19.81pt; text-indent:0pt; display:inline-block"></span><span>(iii)</span><span style="width:7.1pt; text-indent:0pt; display:inline-block"> </span><span>recordings on video tape or digital media; and</span></p></td><td style="width:36.15pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText" style="text-align:right"><span>230.65</span></p></td></tr><tr><td style="width:34.45pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText"><span></span></p></td><td style="width:295.25pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableP1a" style="margin-top:3pt"><span style="width:7.57pt; text-indent:0pt; display:inline-block"></span><span>(b)</span><span style="width:6.25pt; text-indent:0pt; display:inline-block"> </span><span>not being a service associated with a service to which an item in Subgroup 1 (except item</span><span> </span><span>55054) or</span><span> </span><span>3, or another item in this Subgroup (except items</span><span> </span><span>55118 and 55130), applies (R)</span></p></td><td style="width:36.15pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText" style="text-align:right"><span></span></p></td></tr><tr style="height:3.7pt"><td style="width:34.45pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText"><span>55115</span></p></td><td style="width:295.25pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText" style="page-break-inside:avoid"><span>M</span><span>‑</span><span>mode and two</span><span>‑</span><span>dimensional real time echocardiographic examination of the heart from at least 2 acoustic windows for the investigation of symptoms or signs of congenital heart disease:</span></p><p class="TableP1a"><span style="width:8.19pt; text-indent:0pt; display:inline-block"></span><span>(a)</span><span style="width:6.25pt; text-indent:0pt; display:inline-block"> </span><span>with:</span></p><p class="TableP2i"><span style="width:25.92pt; text-indent:0pt; display:inline-block"></span><span>(i)</span><span style="width:7.1pt; text-indent:0pt; display:inline-block"> </span><span>measurement of blood flow velocities across the cardiac valves using pulsed wave and continuous wave Doppler techniques; and</span></p></td><td style="width:36.15pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText" style="text-align:right"><span>230.65</span></p></td></tr><tr style="height:93.75pt"><td style="width:34.45pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText"><span></span></p></td><td style="width:295.25pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableP2i"><span style="width:22.86pt; text-indent:0pt; display:inline-block"></span><span>(ii)</span><span style="width:7.1pt; text-indent:0pt; display:inline-block"> </span><span>real time colour flow mapping from at least 2</span><span> </span><span>acoustic windows; and</span></p><p class="TableP2i"><span style="width:19.81pt; text-indent:0pt; display:inline-block"></span><span>(iii)</span><span style="width:7.1pt; text-indent:0pt; display:inline-block"> </span><span>recordings on video tape or digital media; and</span></p><p class="TableP1a"><span style="width:7.57pt; text-indent:0pt; display:inline-block"></span><span>(b)</span><span style="width:6.25pt; text-indent:0pt; display:inline-block"> </span><span>not being a service associated with a service to which an item in Subgroup 1 (except item</span><span> </span><span>55054) or</span><span> </span><span>3, or another item in this Subgroup (except items</span><span> </span><span>55118 and 55130), applies (R)</span></p></td><td style="width:36.15pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText" style="text-align:right"><span></span></p></td></tr><tr style="height:70.5pt"><td style="width:34.45pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText"><span>55116</span></p></td><td style="width:295.25pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText"><span>Exercise stress echocardiography performed in conjunction with item 11712:</span></p><p class="TableP1a"><span style="width:8.19pt; text-indent:0pt; display:inline-block"></span><span>(a)</span><span style="width:6.25pt; text-indent:0pt; display:inline-block"> </span><span>with:</span></p><p class="TableP2i"><span style="width:25.92pt; text-indent:0pt; display:inline-block"></span><span>(i)</span><span style="width:7.1pt; text-indent:0pt; display:inline-block"> </span><span>two</span><span>‑</span><span>dimensional recordings before exercise (baseline) from at least 3</span><span> </span><span>acoustic windows; and</span></p></td><td style="width:36.15pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText" style="text-align:right"><span>261.65</span></p></td></tr><tr style="height:117.75pt"><td style="width:34.45pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText"><span></span></p></td><td style="width:295.25pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableP2i"><span style="width:22.86pt; text-indent:0pt; display:inline-block"></span><span>(ii)</span><span style="width:7.1pt; text-indent:0pt; display:inline-block"> </span><span>matching recordings from the same windows at, or immediately after, peak exercise; and</span></p><p class="TableP2i"><span style="width:19.81pt; text-indent:0pt; display:inline-block"></span><span>(iii)</span><span style="width:7.1pt; text-indent:0pt; display:inline-block"> </span><span>recordings on digital media with equipment permitting display of baseline and matching peak images on the same screen; and</span></p><p class="TableP1a"><span style="width:7.57pt; text-indent:0pt; display:inline-block"></span><span>(b)</span><span style="width:6.25pt; text-indent:0pt; display:inline-block"> </span><span>not being a service associated with a service to which an item in Subgroup 1 (except item</span><span> </span><span>55054) or</span><span> </span><span>3, or another item in this Subgroup (except items</span><span> </span><span>55118 and 55130), applies (R)</span></p></td><td style="width:36.15pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText" style="text-align:right"><span></span></p></td></tr><tr><td style="width:34.45pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText"><span>55117</span></p></td><td style="width:295.25pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText"><span>Pharmacological stress echocardiography performed in conjunction with item 11712:</span></p><p class="TableP1a"><span style="width:8.19pt; text-indent:0pt; display:inline-block"></span><span>(a)</span><span style="width:6.25pt; text-indent:0pt; display:inline-block"> </span><span>with:</span></p><p class="TableP2i"><span style="width:25.92pt; text-indent:0pt; display:inline-block"></span><span>(i)</span><span style="width:7.1pt; text-indent:0pt; display:inline-block"> </span><span>two</span><span>‑</span><span>dimensional recordings before drug</span><span> </span><span>infusion (baseline) from at least 3</span><span> </span><span>acoustic windows; and</span></p><p class="TableP2i"><span style="width:22.86pt; text-indent:0pt; display:inline-block"></span><span>(ii)</span><span style="width:7.1pt; text-indent:0pt; display:inline-block"> </span><span>matching recordings from the same windows at least twice during drug infusion, including a recording at the peak drug dose; and</span></p></td><td style="width:36.15pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText" style="text-align:right"><span>261.65</span></p></td></tr><tr><td style="width:34.45pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText"><span></span></p></td><td style="width:295.25pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableP2i" style="margin-top:3pt; margin-left:43.2pt; text-indent:-43.2pt"><span style="width:19.81pt; text-indent:0pt; display:inline-block"></span><span>(iii)</span><span style="width:6.9pt; text-indent:0pt; display:inline-block"> </span><span>recordings on digital media with equipment permitting display of baseline and matching peak images on the same screen; and</span></p><p class="TableP1a"><span style="width:7.57pt; text-indent:0pt; display:inline-block"></span><span>(b)</span><span style="width:6.25pt; text-indent:0pt; display:inline-block"> </span><span>not being a service associated with a service to which an item in Subgroup 1 (except item</span><span> </span><span>55054) or</span><span> </span><span>3, or another item in this Subgroup (except items</span><span> </span><span>55118 and 55130), applies (R)</span></p></td><td style="width:36.15pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText"><span></span></p></td></tr><tr style="height:51.05pt"><td style="width:34.45pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText"><span>55118</span></p></td><td style="width:295.25pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText"><span>Heart, two</span><span>‑</span><span>dimensional real time transoesophageal examination of, from at least 2 levels, and in more than 1</span><span> </span><span>plane at each level:</span></p><p class="TableP1a"><span style="width:8.19pt; text-indent:0pt; display:inline-block"></span><span>(a)</span><span style="width:6.25pt; text-indent:0pt; display:inline-block"> </span><span>with:</span></p><p class="TableP2i"><span style="width:25.92pt; text-indent:0pt; display:inline-block"></span><span>(i)</span><span style="width:7.1pt; text-indent:0pt; display:inline-block"> </span><span>real time colour flow mapping and, if indicated, pulsed wave Doppler examination; and</span></p><p class="TableP2i"><span style="width:22.86pt; text-indent:0pt; display:inline-block"></span><span>(ii)</span><span style="width:7.1pt; text-indent:0pt; display:inline-block"> </span><span>recordings on video tape or digital medium; and</span></p></td><td style="width:36.15pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText" style="text-align:right"><span>275.50</span></p></td></tr><tr style="height:9.2pt"><td style="width:34.45pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText"><span></span></p></td><td style="width:295.25pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableP1a"><span style="width:7.57pt; text-indent:0pt; display:inline-block"></span><span>(b)</span><span style="width:6.25pt; text-indent:0pt; display:inline-block"> </span><span>not being an intra</span><span>‑</span><span>operative service or a service associated with a service to which an item in Subgroup 1 (except item</span><span> </span><span>55054) or 3 applies (R) (Anaes.)</span></p></td><td style="width:36.15pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText" style="text-align:right"><span></span></p></td></tr><tr><td style="width:34.45pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText"><span>55130</span></p></td><td style="width:295.25pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText"><span>Intra</span><span>‑</span><span>operative 2 dimensional real time transoesophageal echocardiography incorporating Doppler techniques with colour flow mapping and recording onto video tape or digital medium, performed during cardiac surgery incorporating sequential assessment of cardiac function before and after the surgical procedure, not being a service associated with a service to which item 55135 applies (R) (Anaes.)</span></p></td><td style="width:36.15pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText" style="text-align:right"><span>170.00</span></p></td></tr><tr><td style="width:34.45pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText"><span>55135</span></p></td><td style="width:295.25pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText"><span>Intra</span><span>‑</span><span>operative 2 dimensional real time transoesophageal echocardiography incorporating Doppler techniques with colour flow mapping and recording onto video tape or digital medium, performed during cardiac valve surgery (replacement or repair) incorporating sequential assessment of cardiac function and valve competence before and after the surgical procedure, not being a service associated with a service to which item 55130 applies (R) (Anaes.)</span></p></td><td style="width:36.15pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText" style="text-align:right"><span>353.60</span></p></td></tr><tr><td colspan="3" style="width:372.05pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableColHead2" style="margin-right:5.65pt"><span>Subgroup 3</span><span> </span><span>— Vascular</span></p></td></tr><tr><td style="width:34.45pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText"><span>55238</span></p></td><td style="width:295.25pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText"><span>Duplex scanning, unilateral, involving B</span><span> </span><span>mode ultrasound imaging and integrated Doppler flow measurements by spectral analysis of arteries or bypass grafts in the lower limb or of arteries and bypass grafts in the lower limb, below the inguinal ligament, not being a service associated with a service to which an item in Subgroup 1 (with the exception of item 55054) or 4 applies</span><span> </span><span>(R)</span></p></td><td style="width:36.15pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText" style="text-align:right"><span>169.50</span></p></td></tr><tr><td style="width:34.45pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText"><span>55244</span></p></td><td style="width:295.25pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText"><span>Duplex scanning, unilateral, involving B</span><span> </span><span>mode ultrasound imaging and integrated Doppler flow measurements by spectral analysis of veins in the lower limb, below the inguinal ligament, for acute venous thrombosis, not being a service associated with a service to which an item in</span><span> </span><span>Subgroup</span><span> </span><span>1 (with the exception of item 55054) or 4</span><span> </span><span>applies</span><span> </span><span>(R)</span></p></td><td style="width:36.15pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText" style="text-align:right"><span>169.50</span></p></td></tr><tr><td style="width:34.45pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText"><span>55246</span></p></td><td style="width:295.25pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText"><span>Duplex scanning, unilateral, involving B</span><span> </span><span>mode ultrasound imaging and integrated Doppler flow measurements by spectral analysis of veins in the lower limb, below the inguinal ligament, for chronic venous disease, not being a service associated with a service to which an item in Subgroup</span><span> </span><span>1 (with the exception of item</span><span> </span><span>55054) or 4</span><span> </span><span>applies</span><span> </span><span>(R)</span></p></td><td style="width:36.15pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText" style="text-align:right"><span>169.50</span></p></td></tr><tr><td style="width:34.45pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText"><span>55248</span></p></td><td style="width:295.25pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText"><span>Duplex scanning, unilateral, involving B</span><span> </span><span>mode ultrasound imaging and integrated Doppler flow measurements by spectral analysis of arteries or bypass grafts in the upper limb or of arteries and bypass grafts in the upper limb, not being a service associated with a service to which an item in Subgroup</span><span> </span><span>1 (with the exception of item</span><span> </span><span>55054) or 4</span><span> </span><span>applies</span><span> </span><span>(R)</span></p></td><td style="width:36.15pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText" style="text-align:right"><span>169.50</span></p></td></tr><tr><td style="width:34.45pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText"><span>55252</span></p></td><td style="width:295.25pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText"><span>Duplex scanning, unilateral, involving B</span><span> </span><span>mode ultrasound imaging and integrated Doppler flow measurements by spectral analysis of veins in the upper limb, not being a service associated with a service to which an item in Subgroup</span><span> </span><span>1 (with the exception of item</span><span> </span><span>55054) or 4</span><span> </span><span>applies</span><span> </span><span>(R)</span></p></td><td style="width:36.15pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText" style="text-align:right"><span>169.50</span></p></td></tr><tr style="height:87.05pt"><td style="width:34.45pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText"><span>55274</span></p></td><td style="width:295.25pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText"><span>Duplex scanning, bilateral, involving B</span><span> </span><span>mode ultrasound imaging and integrated Doppler flow measurements by spectral analysis of extra</span><span>‑</span><span>cranial bilateral carotid and vertebral vessels, with or without subclavian and innominate vessels, with or without oculoplethysmography or peri</span><span>‑</span><span>orbital Doppler examination, not being a service associated with a service to which an item in Subgroup</span><span> </span><span>1 (with the exception of item</span><span> </span><span>55054) or 4 applies</span><span> </span><span>(R)</span></p></td><td style="width:36.15pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText" style="text-align:right"><span>169.50</span></p></td></tr><tr><td style="width:34.45pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText"><span>55276</span></p></td><td style="width:295.25pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText"><span>Duplex scanning involving B</span><span> </span><span>mode ultrasound imaging and integrated Doppler flow measurements by spectral analysis of intra</span><span>‑</span><span>abdominal, aorta and iliac arteries or inferior vena cava and iliac veins or of intra</span><span>‑</span><span>abdominal, aorta and iliac arteries and inferior vena cava and iliac veins, excluding pregnancy related studies, not being a service associated with a service to which an item in Subgroup</span><span> </span><span>1 (with the exception of item</span><span> </span><span>55054) or 4</span><span> </span><span>applies</span><span> </span><span>(R)</span></p></td><td style="width:36.15pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText" style="text-align:right"><span>169.50</span></p></td></tr><tr><td style="width:34.45pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText"><span>55278</span></p></td><td style="width:295.25pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText"><span>Duplex scanning involving B</span><span> </span><span>mode ultrasound imaging and integrated Doppler flow measurements by spectral analysis of renal or visceral vessels or of renal and visceral vessels, including aorta, inferior vena cava and iliac vessels as required excluding pregnancy related studies, not being a service associated with a service to which an item in Subgroup</span><span> </span><span>1 (with the exception of item</span><span> </span><span>55054) or 4 applies</span><span> </span><span>(R)</span></p></td><td style="width:36.15pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText" style="text-align:right"><span>169.50</span></p></td></tr><tr><td style="width:34.45pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText"><span>55280</span></p></td><td style="width:295.25pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText"><span>Duplex scanning involving B</span><span> </span><span>mode ultrasound imaging and integrated Doppler flow measurements by spectral analysis of intra</span><span>‑</span><span>cranial vessels, not being a service associated with a service to which an item in Subgroup</span><span> </span><span>1</span><span> </span><span>(with the exception of item</span><span> </span><span>55054) or 4</span><span> </span><span>applies</span><span> </span><span>(R)</span></p></td><td style="width:36.15pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText" style="text-align:right"><span>169.50</span></p></td></tr><tr><td style="width:34.45pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText"><span>55282</span></p></td><td style="width:295.25pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText"><span>Duplex scanning involving B</span><span> </span><span>mode ultrasound imaging and integrated Doppler flow measurements:</span></p><p class="TableP1a"><span style="width:8.19pt; text-indent:0pt; display:inline-block"></span><span>(a)</span><span style="width:6.25pt; text-indent:0pt; display:inline-block"> </span><span>by spectral analysis of cavernosal artery of the penis following intracavernosal administration of a vasoactive agent; and</span></p><p class="TableP1a"><span style="width:7.57pt; text-indent:0pt; display:inline-block"></span><span>(b)</span><span style="width:6.25pt; text-indent:0pt; display:inline-block"> </span><span>performed during the period of pharmacological activity of the injected agent, to confirm a diagnosis of vascular aetiology for impotence; and</span></p></td><td style="width:36.15pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText" style="text-align:right"><span>169.50</span></p></td></tr><tr style="height:54.2pt"><td style="width:34.45pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText" style="widows:0; orphans:0"><span></span></p></td><td style="width:295.25pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableP1a" style="widows:0; orphans:0"><span style="width:8.19pt; text-indent:0pt; display:inline-block"></span><span>(c)</span><span style="width:6.25pt; text-indent:0pt; display:inline-block"> </span><span>if a specialist in diagnostic radiology, nuclear medicine, urology, general surgery (sub</span><span>‑</span><span>specialising in vascular surgery) or a consultant physician in nuclear medicine attends the patient in person at the practice location where the service is performed, immediately before or for a period during the performance of the service; and</span></p></td><td style="width:36.15pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText" style="text-align:right; widows:0; orphans:0"><span></span></p></td></tr><tr style="height:15.05pt"><td style="width:34.45pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText" style="widows:0; orphans:0"><span></span></p></td><td style="width:295.25pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableP1a" style="widows:0; orphans:0"><span style="width:7.57pt; text-indent:0pt; display:inline-block"></span><span>(d)</span><span style="width:6.25pt; text-indent:0pt; display:inline-block"> </span><span>if the specialist or consultant physician interprets the results and prepares a report, not being a service associated with a service to which an item in Subgroup</span><span> </span><span>1 (with the exception of item</span><span> </span><span>55054) or</span><span> </span><span>4</span><span> </span><span>applies</span><span> </span><span>(R)</span></p></td><td style="width:36.15pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText" style="text-align:right; widows:0; orphans:0"><span></span></p></td></tr><tr><td style="width:34.45pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText"><span>55284</span></p></td><td style="width:295.25pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText"><span>Duplex scanning involving B</span><span> </span><span>mode ultrasound imaging and integrated Doppler flow measurements:</span></p><p class="TableP1a"><span style="width:8.19pt; text-indent:0pt; display:inline-block"></span><span>(a)</span><span style="width:6.25pt; text-indent:0pt; display:inline-block"> </span><span>by spectral analysis of cavernosal tissue of the penis to confirm a diagnosis; and</span></p><p class="TableP1a"><span style="width:7.57pt; text-indent:0pt; display:inline-block"></span><span>(b)</span><span style="width:6.25pt; text-indent:0pt; display:inline-block"> </span><span>if indicated, assess the progress and management of:</span></p><p class="TableP2i"><span style="width:25.92pt; text-indent:0pt; display:inline-block"></span><span>(i)</span><span style="width:7.1pt; text-indent:0pt; display:inline-block"> </span><span>priapism; or</span></p><p class="TableP2i"><span style="width:22.86pt; text-indent:0pt; display:inline-block"></span><span>(ii)</span><span style="width:7.1pt; text-indent:0pt; display:inline-block"> </span><span>fibrosis of any type; or</span></p></td><td style="width:36.15pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText" style="text-align:right"><span>169.50</span></p></td></tr><tr style="height:3.7pt"><td style="width:34.45pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText"><span></span></p></td><td style="width:295.25pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableP2i" style="margin-top:3pt; margin-left:43.2pt; text-indent:-43.2pt"><span style="width:19.81pt; text-indent:0pt; display:inline-block"></span><span>(iii)</span><span style="width:6.9pt; text-indent:0pt; display:inline-block"> </span><span>fracture of the tunica; or</span></p><p class="TableP2i"><span style="width:20.42pt; text-indent:0pt; display:inline-block"></span><span>(iv)</span><span style="width:7.1pt; text-indent:0pt; display:inline-block"> </span><span>arteriovenous malformations; and</span></p></td><td style="width:36.15pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText" style="text-align:right"><span></span></p></td></tr><tr><td style="width:34.45pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText"><span></span></p></td><td style="width:295.25pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableP1a"><span style="width:8.19pt; text-indent:0pt; display:inline-block"></span><span>(c)</span><span style="width:6.25pt; text-indent:0pt; display:inline-block"> </span><span>if a specialist in diagnostic radiology, nuclear medicine, urology, general surgery (sub</span><span>‑</span><span>specialising in vascular surgery) or a consultant physician in nuclear medicine attends the patient in person at the practice location where the service is performed, immediately before or for a period during the performance of the service; and</span></p></td><td style="width:36.15pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText" style="text-align:right"><span></span></p></td></tr><tr><td style="width:34.45pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText"><span></span></p></td><td style="width:295.25pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableP1a"><span style="width:7.57pt; text-indent:0pt; display:inline-block"></span><span>(d)</span><span style="width:6.25pt; text-indent:0pt; display:inline-block"> </span><span>if the specialist or consultant physician interprets the results and prepares a report, not being a service associated with a service to which an item in Subgroup 1 (with the exception of item</span><span> </span><span>55054) or 4</span><span> </span><span>applies</span><span> </span><span>(R)</span></p></td><td style="width:36.15pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText" style="text-align:right"><span></span></p></td></tr><tr><td style="width:34.45pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText"><span>55292</span></p></td><td style="width:295.25pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText"><span>Duplex scanning, unilateral, involving B mode ultrasound imaging and integrated Doppler flow measurements by spectral analysis of surgically created arteriovenous fistula or surgically created arteriovenous access grafts in the upper or lower limbs, not being a service associated with a service to which an item in Subgroup 1 (with the exception of item 55054) or 4 applies</span><span> </span><span>(R)</span></p></td><td style="width:36.15pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText" style="text-align:right"><span>169.50</span></p></td></tr><tr><td style="width:34.45pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText"><span>55294</span></p></td><td style="width:295.25pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText"><span>Duplex scanning involving B mode ultrasound imaging and integrated Doppler flow measurements by spectral analysis of arteries or veins, or both, including any associated skin marking, for mapping of bypass conduit before vascular surgery, not being a service associated with a service to which an item in Subgroup 1 (with the exception of item 55054), 3 or 4 applies</span><span> </span><span>(R)</span></p></td><td style="width:36.15pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText" style="text-align:right"><span>169.50</span></p></td></tr><tr><td style="width:34.45pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText"><span>55296</span></p></td><td style="width:295.25pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText"><span>Duplex scanning, unilateral, involving B mode ultrasound imaging and integrated Doppler flow spectral analysis and marking of veins in the lower limbs below the inguinal ligament before varicose vein surgery, including any associated skin marking, not being a service associated with a service to which an item in Subgroup 1 (with the exception of item 55054), 3 or 4 applies</span><span> </span><span>(R)</span></p></td><td style="width:36.15pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText" style="text-align:right"><span>111.05</span></p></td></tr><tr><td colspan="3" style="width:372.05pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableColHead2" style="margin-right:5.65pt; page-break-inside:avoid"><span>Subgroup 4</span><span> </span><span>— Urological</span></p></td></tr><tr style="height:134.75pt"><td style="width:34.45pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText"><span>55600</span></p></td><td style="width:295.25pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText"><span>Prostate, bladder base and urethra, l ultrasound scan of, if performed:</span></p><p class="TableP1a"><span style="width:8.19pt; text-indent:0pt; display:inline-block"></span><span>(a)</span><span style="width:6.25pt; text-indent:0pt; display:inline-block"> </span><span>personally by a medical practitioner (not being the medical practitioner who assessed the patient as specified in paragraph (c)) or a participating nurse practitioner using 1 or more transducer probes that:</span></p><p class="TableP2i"><span style="width:25.92pt; text-indent:0pt; display:inline-block"></span><span>(i)</span><span style="width:7.1pt; text-indent:0pt; display:inline-block"> </span><span>have a nominal frequency of 7 to 7.5</span><span> </span><span>MHz or a nominal frequency range that includes frequencies of 7 to 7.5</span><span> </span><span>MHz; and</span></p><p class="TableP2i"><span style="width:22.86pt; text-indent:0pt; display:inline-block"></span><span>(ii)</span><span style="width:7.1pt; text-indent:0pt; display:inline-block"> </span><span>can obtain both axial and sagittal scans in 2</span><span> </span><span>planes at right angles; and</span></p><p class="TableP1a"><span style="width:7.57pt; text-indent:0pt; display:inline-block"></span><span>(b)</span><span style="width:6.25pt; text-indent:0pt; display:inline-block"> </span><span>following a digital rectal examination of the prostate by that medical practitioner; and</span></p></td><td style="width:36.15pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText" style="text-align:right"><span>109.10</span></p></td></tr><tr style="height:90pt"><td style="width:34.45pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText"><span></span></p></td><td style="width:295.25pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableP1a"><span style="width:8.19pt; text-indent:0pt; display:inline-block"></span><span>(c)</span><span style="width:6.25pt; text-indent:0pt; display:inline-block"> </span><span>on a patient who has been assessed by a specialist in urology, radiation oncology or medical oncology, a consultant physician in medical oncology, who has:</span></p><p class="TableP2i"><span style="width:25.92pt; text-indent:0pt; display:inline-block"></span><span>(i)</span><span style="width:7.1pt; text-indent:0pt; display:inline-block"> </span><span>examined the patient in the 60</span><span> </span><span>days before the scan; and</span></p><p class="TableP2i"><span style="width:22.86pt; text-indent:0pt; display:inline-block"></span><span>(ii)</span><span style="width:7.1pt; text-indent:0pt; display:inline-block"> </span><span>recommended the scan for the management of the patient’s current prostatic disease</span><span> </span><span>(R)</span></p></td><td style="width:36.15pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText" style="text-align:right"><span></span></p></td></tr><tr><td style="width:34.45pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText"><span>55603</span></p></td><td style="width:295.25pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText"><span>Prostate, bladder base and urethra, ultrasound scan of, if performed:</span></p><p class="TableP1a"><span style="width:8.19pt; text-indent:0pt; display:inline-block"></span><span>(a)</span><span style="width:6.25pt; text-indent:0pt; display:inline-block"> </span><span>personally by a medical practitioner who made the assessment mentioned in paragraph</span><span> </span><span>(c) using 1 or more transducer probes that:</span></p><p class="TableP2i"><span style="width:25.92pt; text-indent:0pt; display:inline-block"></span><span>(i)</span><span style="width:7.1pt; text-indent:0pt; display:inline-block"> </span><span>have a nominal frequency of 7</span><span> </span><span>to 7.5</span><span> </span><span>MHz or a nominal frequency range that includes frequencies of 7 to 7.5</span><span> </span><span>MHz; and</span></p><p class="TableP2i"><span style="width:22.86pt; text-indent:0pt; display:inline-block"></span><span>(ii)</span><span style="width:7.1pt; text-indent:0pt; display:inline-block"> </span><span>can obtain both axial and sagittal scans in 2</span><span> </span><span>planes at right angles; and</span></p><p class="TableP1a"><span style="width:7.57pt; text-indent:0pt; display:inline-block"></span><span>(b)</span><span style="width:6.25pt; text-indent:0pt; display:inline-block"> </span><span>following a digital rectal examination of the prostate by that medical practitioner; and</span></p></td><td style="width:36.15pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText" style="text-align:right"><span>109.10</span></p></td></tr><tr><td style="width:34.45pt; border-bottom:0.75pt solid #000000; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText"><span></span></p></td><td style="width:295.25pt; border-bottom:0.75pt solid #000000; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableP1a" style="margin-top:3pt"><span style="width:8.19pt; text-indent:0pt; display:inline-block"></span><span>(c)</span><span style="width:6.25pt; text-indent:0pt; display:inline-block"> </span><span>on a patient who has been assessed by a specialist in urology, radiation oncology or medical oncology or a consultant physician in medical oncology who has:</span></p><p class="TableP2i"><span style="width:25.92pt; text-indent:0pt; display:inline-block"></span><span>(i)</span><span style="width:7.1pt; text-indent:0pt; display:inline-block"> </span><span>examined the patient in the 60</span><span> </span><span>days before the scan; and</span></p><p class="TableP2i"><span style="width:22.86pt; text-indent:0pt; display:inline-block"></span><span>(ii)</span><span style="width:7.1pt; text-indent:0pt; display:inline-block"> </span><span>recommended the scan for the management of the patient’s current prostatic disease</span><span> </span><span>(R)</span></p></td><td style="width:36.15pt; border-bottom:0.75pt solid #000000; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText" style="text-align:right"><span></span></p></td></tr></tbody></table>
Subdivision C Subgroup 5 of Group I1 — Obstetric and gynaecological
(1) For NR‑type diagnostic imaging services described in an item in this Subdivision, the specified fee for no more than 3 services provided to the same patient in any 1 pregnancy applies.
(2) For any patient, items 55706, 55707, 55708, 55709, 55718, 55723, 55759, 55762, 55768 and 55770 are applicable not more than once in a pregnancy.
(1) For items in which clinical conditions are listed (items 55700, 55704, 55707, 55718, 55759 and 55768), or for which a clinical indication is required for performance of subsequent scans (items 55712, 55721, 55764 and 55772), the referral must identify the relevant clinical indication for the service.
(2) If the service is self‑determined (items 55703, 55705, 55708, 55715, 55723, 55725, 55762, 55766, 55770 and 55774), the clinical condition or indication must be recorded in the medical practitioner’s clinical notes.
Sourced from the Federal Register of Legislation (legislation.gov.au), CC BY 4.0.
A reference to a diagnostic imaging service in an item in Part 2 includes a reference to the undertaking of the diagnostic imaging procedure used for rendering the service.
Division 1.2 General application provisions
(1) An item including the symbol (R) is an R‑type diagnostic imaging service.
(2) An item including the symbol (NR) is an NR‑type diagnostic imaging service.
Unless the contrary intention appears, items in this table relating to diagnostic imaging services apply whether the service is provided by:
(a) a medical practitioner; or
(b) a person, other than a medical practitioner, who:
(i) is employed by a medical practitioner; or
(ii) provides the service under the supervision of a medical practitioner in accordance with accepted medical practice.
(1) An item in Part 2 (except an item to which subclause (2) applies) applies only if the providing practitioner gives a report of the service performed to the practitioner, participating midwife or participating nurse practitioner who requested the service.
(2) This subclause applies to the following items:
(a) items 55054, 55130, 55135, 55848, 55850, 57341, 57345, 59312, 59314, 60506, 60509 and 61109, being items of services performed in conjunction with a surgical procedure;
(b) items 60918 and 60927, being items of service performed in preparation for a radiological procedure.
(1) An item that includes the symbol (NK) at the end of the item applies to a service that is performed on equipment that is at least 10 years old.
(2) An item that includes the symbol (K) at the end of the item applies to a service that is performed on equipment that is less than 10 years old.
(3) The date from which the age of equipment is worked out for this clause is:
(a) the date that the equipment was first installed in Australia; or
(b) if the equipment was imported as used equipment — the date of manufacture of the oldest component of the equipment.
(1) This clause applies if:
(a) a service that is mentioned in an item in Division 2.1 to 2.5 of this table is provided; and
(b) the service is not provided in a hospital; and
(c) the service is bulk‑billed.
(2) The fee for the service is 95% of the fee mentioned in this table for the service.
(3) For subsection 10 (2) of the Act, the benefit payable is the amount calculated under subclause (2).
Note Under regulation 6EF of the Health Insurance Regulations 1975, the medicare benefit payable is 100% of the amount calculated under subclause (2).
(4) This clause does not apply to the service specified in item 61369.
Note Item 61369 is taken to be an item in the table — see the Health Insurance (Indium‑labelled Octreotide Study) Determination HS/09/2006.
(1) If a medical practitioner provides 2 or more vascular ultrasound services for the same patient on the same day, the fees specified for the items that apply to the services are affected as follows:
(a) the second highest fee is reduced by 40%;
(b) any other fee, except the highest, is reduced by 50%.
(2) For subclause (1):
(a) if 2 or more applicable fees are equally the highest, one only of those fees is taken to be the highest fee; and
(b) if paragraph (a) applies — the other, or another, highest fee is taken to be the second highest fee; and
(c) if 2 or more fees are equally second highest, any 1 of those fees may be taken to be the second highest for the purpose of paragraph (1) (b); and
(d) if a reduced fee calculated under subclause (1) is not a multiple of 5 cents, the reduced fee is taken to be the nearest amount that is a multiple of 5 cents.
(3) This clause does not apply to the fee specified in item 64990 or 64991.
(1) If a medical practitioner renders 2 or more diagnostic imaging services for the same patient on the same day, the fees set out in the items that apply to the services, other than the item with the highest fee, are reduced by $5.
(2) If a medical practitioner renders at least 1 R‑type diagnostic imaging service and at least 1 consultation service for the same patient on the same day, the highest fee, set out in the items that apply to diagnostic imaging services rendered by the practitioner for that patient on that day, is reduced:
(a) if the fee for the relevant consultation is at least $40 — by $35; or
(b) if that fee is less than $40 but more than $15 — by $15; or
(c) if that fee is less than $15 — by the amount of that fee.
(3) For subclause (2), if more than 1 consultation has occurred, the relevant consultation is the consultation having the highest fee set out in the items that apply to the consultation.
(4) If a medical practitioner renders at least 1 R‑type diagnostic imaging service and at least 1 non‑consultation service for the same patient on the same day, the highest fee that applies to any diagnostic imaging services performed by the medical practitioner for the same patient on the same day, is reduced by $5.
(5) If a medical practitioner renders an R‑type diagnostic imaging service, a consultation and a non‑consultation service for the same patient on the same day, the sum of the reductions under subclauses (2) and (4) must not exceed the highest fee that applies to any diagnostic imaging services rendered by the medical practitioner for the same patient on the same day.
(6) Clauses 1.2.6 and 2.5.8 apply, subject to subclauses (7) and (8), in addition to this clause.
(7) For clause 1.2.6, if a medical practitioner provides:
(a) 2 or more vascular ultrasound services for the same patient on the same day; and
(b) 1 or more other diagnostic imaging services for that patient on that day;
the amount of the fees payable for the vascular ultrasound services is taken, for this clause, to be an amount payable for 1 diagnostic imaging service.
(8) For clause 2.5.8, if a medical practitioner provides:
(a) 2 or more MRI services described in Subgroup 12 or 13 of Division 2.5 in this table for the same patient on the same day; and
(b) 1 or more other diagnostic imaging services for that patient on that day;
the amount of the fees payable for the MRI services is taken, for this clause, to be an amount payable for 1 diagnostic imaging service.
(9) This clause does not apply to diagnostic imaging services that are rendered in a remote area by a medical practitioner for whom a remote area exemption under section 23DX of the Act is in force for that area.
(10) This clause does not apply to the fee specified in item 59103, 64990 or 64991.
(11) In this clause:
consultation means a service under an item listed in Divisions 2.1 to 2.14 of the general medical services table.
highest fee means the highest fee specified for an item in the first claim submitted to the Chief Executive Medicare for the services provided.
non‑consultation service means a service under an item listed in the general medical services table other than in Divisions 2.1 to 2.14 of the general medical services table.
Part 2 Services and fees
Division 2.1 Group I1 — Ultrasound
Subdivision A General
Clause 1.2.3 does not apply to items 55054, 55130, 55135, 55848 and 55850.
Items in this Division (except items 55600 and 55603) apply to an ultrasound service only if the service is performed:
(a) by a medical practitioner; or
(b) by a registered sonographer on behalf of a medical practitioner.
(1) Items in this Division (except items 55600 and 55603) marked with the symbol (R) apply to an ultrasound service (the eligible service) only if the service is performed:
(a) under the professional supervision of a specialist or a consultant physician in the practice of his or her specialty who is available:
(i) to monitor and influence the conduct and diagnostic quality of the examination; and
(ii) if necessary, to attend on the patient personally; or
(b) under the professional supervision of a practitioner who:
(i) is not a specialist or consultant physician; and
(ii) meets the requirement of subclause (2); and
(iii) is available to monitor and influence the conduct and diagnostic quality of the examination and, if necessary, to attend on the patient personally; or
(c) in the circumstance mentioned in subclause (3), and under the professional supervision of a practitioner who is available:
(i) to monitor and influence the conduct and diagnostic quality of the examination; and
(ii) if necessary, to attend on the patient personally; or
(d) if paragraph (a), (b) or (c) cannot be complied with:
(i) in an emergency; or
(ii) in a location that is not less than 30 kilometres by the most direct road route from another practice where services that comply with paragraph (a) or (b) are available.
(2) For subparagraph (1) (b) (ii), the requirement is that, between 1 September 1997 and 31 August 1999, at least 50 services were rendered by or on behalf of the practitioner at the location where the eligible service was rendered, and the rendering of those services entitled payment of medicare benefits.
(3) For paragraph (1) (c), the circumstance is that, between 1 September 1997 and 31 August 1999, at least 50 services were rendered in nursing homes or patients’ residences by or on behalf of the practitioner, and the rendering of those services entitled payment of medicare benefits.
Subdivision B Subgroup 1 to 4 of Group I1
In items 55028, 55030 and 55032, medical practitioner in the phrase referred by a medical practitioner or the referring medical practitioner includes a dental practitioner who is approved by the Minister under paragraph (b) of the definition of professional service in subsection 3 (1) of the Act.
<table cellspacing="0" cellpadding="0" style="width:375.15pt; border-collapse:collapse"><thead><tr><td colspan="3" style="width:372.05pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableColHead" style="margin-bottom:0pt"><span>Group I1</span><span> </span><span>— Ultrasound</span></p></td></tr><tr><td style="width:34.45pt; border-bottom:0.75pt solid #000000; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableColHead"><span>Item</span></p></td><td style="width:295.25pt; border-bottom:0.75pt solid #000000; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableColHead"><span>Diagnostic imaging service</span></p></td><td style="width:36.15pt; border-bottom:0.75pt solid #000000; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableColHead"><span>Fee ($)</span></p></td></tr></thead><tbody><tr><td colspan="3" style="width:372.05pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableColHead2"><span>Subgroup 1</span><span> </span><span>— General</span></p></td></tr><tr><td style="width:34.45pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText"><span>55028</span></p></td><td style="width:295.25pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText"><span>Head, ultrasound scan of, if:</span></p><p class="TableP1a"><span style="width:8.19pt; text-indent:0pt; display:inline-block"></span><span>(a)</span><span style="width:6.25pt; text-indent:0pt; display:inline-block"> </span><span>the patient is referred by a medical practitioner for ultrasonic examination not being a service associated with a service to which an item in Subgroup 2 or 3 applies; and</span></p><p class="TableP1a"><span style="width:7.57pt; text-indent:0pt; display:inline-block"></span><span>(b)</span><span style="width:6.25pt; text-indent:0pt; display:inline-block"> </span><span>the referring medical practitioner is not a member of a group of practitioners of which the providing practitioner is a member (R)</span></p></td><td style="width:36.15pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText" style="text-align:right"><span>109.10</span></p></td></tr><tr><td style="width:34.45pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText"><span>55029</span></p></td><td style="width:295.25pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText"><span>Head, ultrasound scan of, if the patient is not referred by a medical practitioner, not being a service associated with a service to which an item in Subgroup</span><span> </span><span>2 or 3 applies (NR)</span></p></td><td style="width:36.15pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText" style="text-align:right"><span>37.85</span></p></td></tr><tr><td style="width:34.45pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText"><span>55030</span></p></td><td style="width:295.25pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText"><span>Orbital contents, ultrasound scan of, if:</span></p><p class="TableP1a"><span style="width:8.19pt; text-indent:0pt; display:inline-block"></span><span>(a)</span><span style="width:6.25pt; text-indent:0pt; display:inline-block"> </span><span>the patient is referred by a medical practitioner for ultrasonic examination not being a service associated with a service to which an item in Subgroup 2</span><span> </span><span>or 3 applies; and</span></p><p class="TableP1a"><span style="width:7.57pt; text-indent:0pt; display:inline-block"></span><span>(b)</span><span style="width:6.25pt; text-indent:0pt; display:inline-block"> </span><span>the referring medical practitioner is not a member of a group of practitioners of which the providing practitioner is a member (R)</span></p></td><td style="width:36.15pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText" style="text-align:right"><span>109.10</span></p></td></tr><tr><td style="width:34.45pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText"><span>55031</span></p></td><td style="width:295.25pt; padding-right:1.55pt; padding-left:1.55pt; vertical-align:top"><p class="TableText"><span>Orbital contents, ultrasound scan of, if the patient is not referred by a medical practitioner, not being a service associated with a service to which an item in Subgroup</span><span> </span><span>2</span><span> </span><span>or 3 applies (NR)</span></p><
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