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