fees and rebates for psychiatry appointments
In my quest for sessions with a psychiatrist, I have found a slightly confusing situation with fees and rebates that I am hoping to get informed and/or clarifying feedback on.
The fees and rebates I researched apparently vary and don’t all seem to fit the same schedule. (Although, not all their emails provided a full explanation, and I assume there is some dollar rounding.) Now this looks like an algebra problem to work out what to expect from total fee costs.
I am assuming I will need four appointments minimum:
– one, introductory,
– two, a full evaluation,
– three, a diagnosis report with prescription
– four, review after an initial medication period.
Could be wrong, but lets start with that.
Clinic A advised:
Initial appt $207 ($440 base fee less $233 Medicare rebate)
Followup appts: $171 ($290 base fee less $119 Medicare rebate)
So three appts would cost $213 + 3 x $171 = $726
Clinic B advised:
Initial appt $300 ($533 base fee? less $233 Medicare rebate?)
Followup appts: $100 ($219 base fee? less $119 Medicare rebate?)
So three appts would cost $300 + 3 x $100 = $600
Clinic C advised:
Initial appt $207 ($440 base fee less $233 Medicare rebate)
Followup appts: $100? ($219 base fee? less $119 Medicare rebate?)
So three appts would cost $207 + 3 x $100 = $507?
I am afraid that I mistook details heard over the phone e.g. “one ninety ” versus “one nineteen”.
Thank you for your question. Let us start with the item for a follow-up appointment.
The follow-up item you are referring to is this:
304
GroupA8 – Consultant Psychiatrist Attendances To Which No Other Item Applies
Professional attendance by a consultant physician in the practice of the consultant physician’s specialty of psychiatry following referral of the patient to him or her by a referring practitioner-an attendance of more than 30 minutes, but not more than 45 minutes, in duration at consulting rooms), if that attendance and another attendance to which item 296 or any of items 300 to 308 applies have not exceeded 50 attendances in a calendar year for the patient
Fee: $140.55 Benefit: 75% = $105.45 85% = $119.50
(See para AN.40.1 of explanatory notes to this Category)
There are other follow up items as well.
Most of the consultation items in the Medicare Schedule are divided into 3-4 time-related bands.
The follow-up items are:
0-15 minutes item 300 Rebate $38.90
15-30 minutes item 302 Rebate $77.65
30-45 minutes item 304 Rebate $119.50
45+ minutes item 306 Rebate: $164.90
You are correct.
Normally, there is an initial consultation:
Item 296
GroupA8 – Consultant Psychiatrist Attendances To Which No Other Item Applies
Professional attendance of more than 45 minutes in duration by a consultant physician in the practice of the consultant physician’s speciality of psychiatry following referral of the patient to him or her by a referring practitioner-an attendance at consulting rooms if the patient:
(a) is a new patient for this consultant psychiatrist; or
(b) has not received a professional attendance from this consultant psychiatrist in the preceding 24 months;
other than attendance on a patient in relation to whom this item, or item 297 or 299 or any of items 300 to 308, has applied in the preceding 24 months
Fee: $274.95 Benefit: 75% = $206.25 85% = $233.75
(See para AN.0.30, AN.40.1 of explanatory notes to this Category)
Extended Medicare Safety Net Cap: $500.00
This will follow with the items I explained above.
Please, note, the Safety net. The Government will cover up to 80% of out of pocket fees once the safety net is reached.
fees and rebates for psychiatry appointments
In my quest for sessions with a psychiatrist, I have found a slightly confusing situation with fees and rebates that I am hoping to get informed and/or clarifying feedback on.
The fees and rebates I researched apparently vary and don’t all seem to fit the same schedule. (Although, not all their emails provided a full explanation, and I assume there is some dollar rounding.) Now this looks like an algebra problem to work out what to expect from total fee costs.
I am assuming I will need four appointments minimum:
– one, introductory,
– two, a full evaluation,
– three, a diagnosis report with prescription
– four, review after an initial medication period.
Could be wrong, but lets start with that.
Clinic A advised:
Initial appt $207 ($440 base fee less $233 Medicare rebate)
Followup appts: $171 ($290 base fee less $119 Medicare rebate)
So three appts would cost $213 + 3 x $171 = $726
Clinic B advised:
Initial appt $300 ($533 base fee? less $233 Medicare rebate?)
Followup appts: $100 ($219 base fee? less $119 Medicare rebate?)
So three appts would cost $300 + 3 x $100 = $600
Clinic C advised:
Initial appt $207 ($440 base fee less $233 Medicare rebate)
Followup appts: $100? ($219 base fee? less $119 Medicare rebate?)
So three appts would cost $207 + 3 x $100 = $507?
I am afraid that I mistook details heard over the phone e.g. “one ninety ” versus “one nineteen”.
The schedules I found at
http://www9.health.gov.au/mbs/search.cfm
include #296
http://www9.health.gov.au/mbs/fullDisplay.cfm?type=item&q=296&qt=ItemID
“more than 45 minutes in duration by a consultant physician … new patient ”
“Fee: $274.95 Benefit: 75% = $206.25 85% = $233.75”
But I can’t narrow down the hundreds of listings to confirm the item for follow-up appointment rebates.
Thank you for your question. Let us start with the item for a follow-up appointment.
The follow-up item you are referring to is this:
304
GroupA8 – Consultant Psychiatrist Attendances To Which No Other Item Applies
Professional attendance by a consultant physician in the practice of the consultant physician’s specialty of psychiatry following referral of the patient to him or her by a referring practitioner-an attendance of more than 30 minutes, but not more than 45 minutes, in duration at consulting rooms), if that attendance and another attendance to which item 296 or any of items 300 to 308 applies have not exceeded 50 attendances in a calendar year for the patient
Fee: $140.55 Benefit: 75% = $105.45 85% = $119.50
(See para AN.40.1 of explanatory notes to this Category)
Extended Medicare Safety Net Cap: $421.65
There are other follow up items as well.
Most of the consultation items in the Medicare Schedule are divided into 3-4 time-related bands.
The follow-up items are:
0-15 minutes item 300 Rebate $38.90
15-30 minutes item 302 Rebate $77.65
30-45 minutes item 304 Rebate $119.50
45+ minutes item 306 Rebate: $164.90
You are correct.
Normally, there is an initial consultation:
Item 296
GroupA8 – Consultant Psychiatrist Attendances To Which No Other Item Applies
Professional attendance of more than 45 minutes in duration by a consultant physician in the practice of the consultant physician’s speciality of psychiatry following referral of the patient to him or her by a referring practitioner-an attendance at consulting rooms if the patient:
(a) is a new patient for this consultant psychiatrist; or
(b) has not received a professional attendance from this consultant psychiatrist in the preceding 24 months;
other than attendance on a patient in relation to whom this item, or item 297 or 299 or any of items 300 to 308, has applied in the preceding 24 months
Fee: $274.95 Benefit: 75% = $206.25 85% = $233.75
(See para AN.0.30, AN.40.1 of explanatory notes to this Category)
Extended Medicare Safety Net Cap: $500.00
This will follow with the items I explained above.
Please, note, the Safety net. The Government will cover up to 80% of out of pocket fees once the safety net is reached.