Anaesthetic services assessing rules in Medicare 011-42060010
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Medicare Benefits Schedule (MBS) Online
Category 3 – Therapeutic Procedures Group T6 - Anaesthetics
Category 3 – Therapeutic Procedures Group T7 - Regional or Field Nerve Blocks
Category 3 – Therapeutic Procedures Group T10 - Relative Value Guide For Anaesthesia
Medicare Benefits Schedule – Note GN.10.26 (Schedule fees and Medicare benefits)
Principal anaesthetist - single anaesthetic - example invoice/receipt
Table 1: provides an example of an invoice/receipt for principal anaesthetist - single anaesthetic, including the memorandum of fees.
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TAX INVOICE |
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XXXX & XXXX Anaesthetic Practice |
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Dr J XXXX MBBS FANZCA |
<number/suite>,<street name> |
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Prov No: 999999A |
<suburb>, <state>, <postcode> |
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ABN: 99 999 999 999 |
Telephone: (00) 9999 9999 |
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Facsimile: (00) 9999 9999 |
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Invoice Ref: 999/999 |
Date: 1 December 2022 |
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Mr Joe XXXX |
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<number/suite>,<street name> |
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<suburb>, <state>, <postcode> |
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Date |
Item |
Description |
Amount + GST |
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01/12/2022 |
17615H |
Pre-anaesthetic exam |
$94.00 |
|
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21482H |
Anaesthesia for radical resection of the bone |
$110.50 |
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23300H |
Anaesthesia time 6:11 to 6:20 hours |
$683.40 |
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25005H |
Physical status indicator 4 |
$40.20 |
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25014H |
Age modifier |
$20.10 |
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22031H |
Intrathecal or epidural injection |
$105.50 |
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Charges |
$1053.70 |
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Invoice total |
$1053.70 |
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Payments |
$0.00 |
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Amount due |
$1053.70 |
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Proceduralist: Dr F XXXX |
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Principal anaesthetist - single anaesthetic - example Medicare statement of benefit
Table 2: provides an example of a Medicare statement of benefit for principle anaesthetist - single anaesthetic.
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Patient |
Prov No |
Date |
Item |
Charge |
Sch Fee |
Benefit |
Exp |
|
Joe |
999999A |
01/12/2022 |
17615+ |
$94.00 |
$91.80 |
$68.85 |
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01/12/2022 |
21482+ |
$110.00 |
$104.75 |
$78.60 |
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01/12/2022 |
23300+ |
$683.40 |
$712.30 |
$534.25 |
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01/12/2022 |
25005+ |
$40.20 |
$41.90 |
$30.45 |
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01/12/2022 |
25014+ |
$20.10 |
$20.95 |
$15.75 |
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01/12/2022 |
22031+ |
$105.50 |
$104.75 |
$78.60 |
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Explanation of codes + Inpatient service - May be eligible for private gap benefit |
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Principal anaesthetist - multiple anaesthetic and emergency after hours - example invoice/receipt
Table 3: provides an example invoice/receipt for principal anaesthetist, multiple anaesthetic, emergency after hours and memorandum of fees.
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TAX INVOICE |
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XXXX & XXXX Anaesthetic Practice |
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Dr A XXXX MBBS FANZCA |
<number/suite>,<street name> |
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Prov No: 999999A |
<suburb>, <state>, <postcode> |
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ABN: 99 999 999 999 |
Telephone: (00) 9999 9999 |
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Facsimile: (00) 9999 9999 |
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Invoice ref: 999/999 |
Date: 12 December 2022 |
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Mrs Anne XXXX |
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<number/suite>,<street name> |
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<suburb>, <state>, <postcode> |
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Date |
Item |
Description |
Amount |
|
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17/11/2007 |
17610H |
Pre-anaesthetic exam |
$44.00 |
|
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21482H |
Anaesthesia for radical resection of bone involving lower leg, ankle, or foot |
$154.00 |
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20846H |
Anaesthesia for radical hysterectomy |
$220.00 |
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23270H |
Anaesthesia time 5:41 to 5:50 hours |
$594.00 |
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22031H |
Intrathecal or Epidural Injection |
$98.00 |
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25025H |
Emergency after hours anaesthesia |
$528.00 |
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Charges |
$1638.00 |
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Invoice total |
$1638.00 |
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Payments |
$0.00 |
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Amount due |
$1638.00 |
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Proceduralist: Dr G XXXX |
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Start time: 16:30 |
End time: 22:15 |
Total time: 5:45 |
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Principal anaesthetist - multiple anaesthetic and emergency after hours - example Medicare statement of benefit
Table 4: provides an example for a Medicare statement of benefit for a principal anaesthetist, multiple anaesthetic and emergency after hours.
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Patient |
Prov No |
Date |
Item |
Charge |
Sch Fee |
Benefit |
Exp |
|
Anne |
999999A |
17/11/2007 |
17610+ |
$44.00 |
$46.15 |
$29.10 |
|
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17/11/2007 |
21482+ |
$154.00 |
562 |
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17/11/2007 |
20846+ |
$220.00 |
$209.50 |
$157.15 |
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17/11/2007 |
23270+ |
$594.00 |
$649.45 |
$487.10 |
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17/11/2007 |
22031+ |
$98.00 |
$104.75 |
$78.60 |
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17/11/2007 |
25025+ |
$528.00 |
$481.85 |
$361.40 |
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Explanation of codes 562 Benefit paid on associated RVG anaesthetic item + Inpatient service - May be eligible for private gap benefit |
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Principal anaesthetist - dental anaesthesia and after hours emergency - example invoice/receipt
Table 5: provides an example invoice/receipt for a principal anaesthetist – dental anaesthesia, including memorandum of fees.
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Dr Tanya XXXX, MBBS, FANZCA |
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ANAESTHETIST Provider no: 999999A |
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TAX INVOICE |
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Date of invoice: 25/03/2008 |
<number/suite>,<street name> |
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Invoice number: 99999 |
<suburb>, <state>, <postcode> |
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Telephone: (00) 9999999999 |
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Facsimile: (00) 9999999999 |
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Master Alan XXXX |
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<number/suite>,<street name> |
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<suburb>, <state>, <postcode> |
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Start time: 22:30 |
End time:23:27 |
Total time: 0:57 |
Surgeon: Dr Sunita XXXX |
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Date |
Item |
Description |
Fee |
|
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13/03/2008 |
17610H |
Pre-anaesthetic exam |
$44.00 |
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22900H |
Anaesthesia for extraction of tooth or teeth |
$110.00 |
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23043H |
Anaesthesia time 0:56 mins to 1:00 hour |
$88.00 |
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25025H |
Emergency anaesthesia |
$99.00 |
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Charges |
$341.00 |
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Invoice total |
$341.00 |
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Payments |
$0.00 |
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Amount due |
$341.00 |
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Principal anaesthetist - dental anaesthesia and after hours emergency - example Medicare statement of benefit
Table 6: provides an example for the Medicare statement of benefit relating to Table 5.
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Patient |
Prov No |
Date |
Item |
Charge |
Sch Fee |
Benefit |
Exp |
|
Alan |
999999A |
13/03/2008 |
17610+ |
$44.00 |
$46.15 |
$34.65 |
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13/03/2008 |
22900+ |
$110.00 |
$125.70 |
$94.30 |
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13/03/2008 |
23043+ |
$88.00 |
$83.80 |
$62.85 |
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13/03/2008 |
25025+ |
$99.00 |
$104.75 |
$78.60 |
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Explanation of codes + Inpatient service - May be eligible for private gap benefit |
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Assistant anaesthetist - after hours emergency - example invoice/receipt
Table 7: provides an invoice/receipt for assistant anaesthetist after hour’s emergency.
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Principle Anaesthetist: Dr J XXXX |
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Proceduralist: Dr T XXXX Provider no: 999999A |
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TAX INVOICE |
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Date of invoice: 11/05/2023 |
<number/suite>,<street name> |
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Invoice number: 99999 |
<suburb>, <state>, <postcode> |
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Telephone: (00) 9999999999 |
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Facsimile: (00) 9999999999 |
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Start time: 17:30 End time: 23:45 Total time: 6:15 Surgeon: Dr Danielle XXXX |
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Miss Sarah XXXX |
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<number/suite>,<street name> |
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<suburb>, <state>, <postcode> |
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Date |
Item |
Description |
Amount |
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10/05/2023 |
25200H |
Assistance at anaesthesia |
$168.00 |
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23300H |
Anaesthesia time 6:11 to 6:20 hours |
$900.00 |
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25010H |
Physical status indicator 5 |
$150.00 |
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25013H |
Age modifier |
$50.00 |
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25030H |
Assistance at after hours emergency anaesthesia |
$674.00 |
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Charges |
$1942.00 |
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Invoice total |
$1942.00 |
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Payments |
$0.00 |
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Amount due |
$1942.00 |
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Assistant anaesthetist - after hours emergency - example Medicare statement of benefit
Table 8: provides an example of a Medicare statement of benefit for assistant anaesthetist - after hours service.
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Patient |
Prov No |
Date |
Item |
Charge |
Sch Fee |
Benefit |
Exp |
|
Sarah |
999999A |
10/05/2023 |
25200+ |
$1942.00 |
$900.85 |
$675.65 |
554 |
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10/05/2023 |
23300+ |
555 |
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10/05/2023 |
25010+ |
555 |
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10/05/2023 |
25013+ |
555 |
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10/05/2023 |
25030+ |
$674.00 |
$450.40 |
$337.80 |
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Explanation of codes 554 Total benefit for anaesthetic service 555 Benefit paid on main RVG anaesthetic item + Inpatient service - May be eligible for private gap benefit |
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Assistant anaesthetist - dental anaesthesia - example invoice/receipt
Table 9: provides an example invoice/receipt for assistant anaesthetist - dental anaesthesia.
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Dr Tony XXXX, MBBS, FANZCA |
<number/suite>,<street name> |
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Anaesthetist |
<suburb>, <state>, <postcode> |
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Provider no: 999999A |
Telephone: (00) 9999 9999 |
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Facsimile: (00) 9999 9999 |
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TAX INVOICE |
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Date of invoice: 25/03/2023 |
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Master Alan XXXX |
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<number/suite>,<street name> |
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<suburb>, <state>, <postcode> |
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Date |
Item |
Description |
Fee |
|
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13/11/2022 |
25200H |
Assistance at anaesthesia |
$110.00 |
|
|
23045H |
Anaesthesia time 0:46 mins to 1:00 hour |
$88.00 |
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Charges |
$198.00 |
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Invoice total |
$198.00 |
|||
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Payments |
$0.00 |
|||
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Amount due |
$198.00 |
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Assistant anaesthetist - dental anaesthesia - example Medicare statement of benefit
Table 10: provides an example of a Medicare statement of benefit for assistant anaesthetist - dental anaesthesia.
|
Patient |
Prov no |
Date |
Item |
Charge |
Sch Fee |
Benefit |
Exp |
|
Alan |
999999A |
13/11/2022 |
25200+ |
$110.00 |
$198.00 |
$141.40 |
554 |
|
13/11/2022 |
23045+ |
$88.00 |
555 |
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Explanation of codes 554 Total benefit for anaesthetic service 555 Benefit paid on main RVG anaesthetic item + Inpatient service - May be eligible for private gap benefit |
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Perfusionist - isolated limb perfusion - example invoice/receipt
Table 11: provides an example invoice/receipt for Perfusionist - isolated limb perfusion.
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Dr Barry XXXX MBBS FFARACS |
FANZCA |
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SPECIALIST ANAESTHETIST |
PROV # 999999A |
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<number/suite>,<street name> <suburb>, <state>, <postcode> |
Phone: (00) 9999 9999 Fax: (00) 9999 9999 |
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ABN: 99 999 999 999 |
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TAX INVOICE FOR PROFESSIONAL ANAESTHETIC SERVICES |
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|
Mr Malcolm XXXX |
Date of service: 13/03/2005 |
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<number/suite>,<street name> |
Invoice date: 20/11/2005 |
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<suburb>, <state>, <postcode> |
Invoice Ref: 999999 |
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Surgeon: Dr F XXXX |
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Hospital: Holy Spirit |
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Anaesthetic Item No and Description |
$ Charge |
|
22055H Leg Perfusion |
$264.00 |
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INPATIENT TOTAL CHARGE $0.00 |
$264.00 |
Perfusionist - isolated limb perfusion - example Medicare statement of benefit
Table 12: provides an example of Medicare statement of benefit for Perfusionist - isolated limb perfusion.
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Patient |
Prov no |
Date |
Item |
Charge |
Sch Fee |
Benefit |
Exp |
|
Malcolm |
999999A |
13/03/2005 |
22055+ |
$264.00 |
$202.20 |
$151.65 |
|
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Explanation of codes + Inpatient service - May be eligible for private gap benefit |
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Perfusionist - whole body perfusion and after hours emergency - example invoice/receipt
Table 13: provides an example invoice/receipt for perfusionist - whole body perfusion and after hours emergency.
|
Dr Barry XXXX MBBS FFARACS |
FANZCA |
|
SPECIALIST ANAESTHETIST |
PROV # 999999A |
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<number/suite>,<street name>, <suburb>, <state>, <postcode> |
Phone: (00) 9999 9999 Fax: (00) 9999 9999 |
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ABN: 99 999 999 999 |
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TAX INVOICE FOR PROFESSIONAL ANAESTHETIC SERVICES |
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|
Miss Jennifer XXXX |
Date of service: 05/11/2022 |
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<number/suite>,<street name> |
Invoice date: 11/11/2022 |
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<suburb>, <state>, <postcode> |
Invoice Ref: 999999 |
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Surgeon: Dr R XXXX |
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Hospital: Holy Spirit |
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Start time: 8:03 End time: 15:47 Total time: 7:44 hours |
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Anaesthetic Item No and Description |
$ Charge |
|
22060H Whole body perfusion |
$650.00 |
|
23390H Time units |
$920.00 |
|
25000H Physical modifier |
$22.00 |
|
25050H After hours emergency |
$770.00 |
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INPATIENT GST: $0.00 |
|
|
Amount Total |
$2362.00 |
Perfusionist – whole body perfusion and after hours emergency - example Medicare statement of benefit
Table 14: provides an example of Medicare statement of benefit for Perfusionist – whole body perfusion.
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Patient |
Prov no. |
Date |
Item |
Charge |
Sch Fee |
Benefit |
Exp |
|
Jennifer |
999999A |
05/11/2022 |
22060+ |
$650.00 |
$628.50 |
$471.40 |
|
|
05/11/2022 |
23390+ |
$920.00 |
$900.85 |
$675.65 |
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05/11/2022 |
25000+ |
$22.00 |
$20.95 |
$15.75 |
|||
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05/11/2022 |
25050+ |
$770.00 |
$775.15 |
$581.35 |
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Explanation of codes + Inpatient service - May be eligible for private gap benefit |
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