4. Maximum increases for items under sections 10ACA and 10ADA of the Act
(1) For section 10B of the Act:
(a) subsections 10ACA(7A) and 10ADA(8A) apply to the items of the general medical services table, and items in a determination made under subsection 3C(1) of the Act, listed in column 1 of the table below; and
(b) the maximum increases for these items are listed in column 2.
Item
Maximum increase ($)
13200
2118.30
13201
3074.90
13202
81.90
13203
136.50
13209
13.60
13212
88.70
13215
61.40
13218
888.30
13221
27.30
13251
136.50
13260
65 percent of the Schedule fee for the item
14201
15 percent of the Schedule fee for the item
14202
15 percent of the Schedule fee for the item
14216
617.70
14217
391.10
14219
617.70
14220
391.10
16400
13.80
16401
69.30
16404
41.40
16406
136.50
16407
65 percent of the Schedule fee for the item
16408
65 percent of the Schedule fee for the item
16500
41.40
16501
83.00
16502
27.60
16505
27.60
16508
27.60
16509
27.60
16511
138.40
16512
41.40
16514
20.70
16515
221.80
16518
221.80
16519
415.80
16527
221.80
16530
65 percent of the Schedule fee for the item
16567
277.20
16570
277.20
16571
277.20
16590
277.20
16591
138.40
16600
41.40
16603
83.00
16606
166.30
16609
319.00
16618
131.60
32500
110 percent of the Schedule fee for the item
32520
15 percent of the Schedule fee for the item
32522
10 percent of the Schedule fee for the item
32523
15 percent of the Schedule fee for the item
32526
10 percent of the Schedule fee for the item
32528
15 percent of the Schedule fee for the item
32529
10 percent of the Schedule fee for the item
42505
15 percent of the Schedule fee for the item
45560
35 percent of the Schedule fee for the item
82100
27.30
82105
20.40
82110
27.30
82115
68.20
82130
20.40
82135
27.30
82140
20.40
91850
13.80
91851
65 percent of the Schedule fee for the item
91852
65 percent of the Schedule fee for the item
91853
41.40
91855
13.80
91856
65 percent of the Schedule fee for the item
91857
65 percent of the Schedule fee for the item
91858
41.40
(2) For section 10B of the Act:
(a) subsections 10ACA(7A) and 10ADA(8A) apply to items 11602, 11604, 11607, 11610, 18270, 18272, 30216, 30219, 14100, 30071, 31560, 32504, 34106, 42590, 43030, 43032, 43034, 43036, 43038, 43040, 45003, 45025, 45026, 45200, 45203, 45206, 45545, 45614, 45617, 45620, 45623, 45624 and 45652 of the general medical services table; and
(b) the maximum increase for each item is 80 percent of the Schedule fee for that item.
(3) For section 10B of the Act:
(a) subsections 10ACA(7A) and 10ADA(8A) apply to each item in the Group of the general medical services table, and items in a determination made under subsection 3C(1) of the Act relating to services within those Groups, listed in the column of the table below; and
(b) the maximum increase for each item is 300 percent of the Schedule fee for that item or $500.00 for that item whichever represents the lesser amount.
Group
A1
A2
A3
A4
A5
A6
A7
A9
A10
A11
A12
A13
A14
A17
A18
A19
A20
A21
A22
A23
A24
A26
A27
A28
A29
A30
A31
A32
A33
A35
A36
A39
A40
A41
A42
A45
A46
T6
(3A) For section 10B of the Act:
(a) subsections 10ACA(7A) and 10ADA(8A) apply to all items in Group A8 (except item 297) in a determination made under subsection 3C(1) of the Act; and
(b) the maximum increase for each item is 300 percent of the Schedule fee for that item or $500.00 for that item whichever represents the lesser amount.
(3B) For section 10B of the Act:
(a) subsections 10ACA(7A) and 10ADA(8A) apply to all items in Group A15 (except item 880) in a determination made under subsection 3C(1) of the Act; and
(b) the maximum increase for each item is 300 percent of the Schedule fee for that item or $500.00 for that item whichever represents the lesser amount.
(4) For section 10B of the Act:
(a) subsections 10ACA(7A) and 10ADA(8A) apply to each item in the Group of the general medical services table, and items in a determination made under subsection 3C(1) of the Act relating to services within those Groups, listed in the column of the table below; and
(b) the maximum increase for each item is 300 percent of the Schedule fee for that item or $500.00 for that item whichever represents the lesser amount.
Group
M3
M6
M7
M8
M9
M10
M11
M12
M14
M15
M16
M17
M18
M19
M25
M26
M27
M28
M32
O1
(5) For section 10B of the Act:
(a) subsections 10ACA(7A) and 10ADA(8A) apply to item 13899 of the general medical services table and items 75002, 75005, 75150, 75153, 82150, 82151, 82152, 90183, 90188, 90202 and 90212 in a determination made under subsection 3C(1) of the Act; and
(b) the maximum increase for each item is 300 percent of the Schedule fee for that item or $500.00 for that item whichever represents the lesser amount.
(6) For section 10B of the Act:
(a) subsections 10ACA(7A) and 10ADA(8A) apply to the items of the diagnostic imaging services table, and items in a determination made under subsection 3C(1) of the Act, listed in column 1 of the table below; and
(b) the maximum increases for these items are listed in column 2.
Item
Maximum increase ($)
11704
80 percent of the Schedule fee for the item
55054
80 percent of the Schedule fee for the item
55238
80 percent of the Schedule fee for the item
55244
80 percent of the Schedule fee for the item
55246
80 percent of the Schedule fee for the item
55252
80 percent of the Schedule fee for the item
55276
80 percent of the Schedule fee for the item
55296
80 percent of the Schedule fee for the item
55700
40.70
55703
20.40
55704
47.70
55705
20.40
55706
68.20
55707
47.70
55708
20.40
55709
27.20
55712
81.80
55715
27.20
55718
68.20
55721
81.80
55723
27.20
55725
27.20
55729
20.40
55740
71.00
55741
30.50
55742
71.00
55743
30.50
55757
33.70
55758
10.90
55762
40.70
55764
109.00
55766
40.70
55768
102.40
55770
40.70
55772
109.00
55774
47.70
Part 4. Maximum increases for items under sec - Health Insurance (Extended Medicare Safety Net) Determination 2017 - 4. Maximum increases for items under sections 10ACA and 10ADA of the Act | Zoe