Premier Medicine Billing Policy

Premier Medicine is a Private Practice. 

We charge the patient directly for all medical services and products.

There is a gap between what is charged to you and the amount Medicare will reimburse. 

For those eligible to claim Medicare rebates for medical services provided we will help the patient claim their rebate by submitting the rebate request on line - when the system allows to do so.

Correct demographic and Medicare details have to be provided to practice in order to do this. 

There are occasions when more than one item of service is provided when Medicare might not allow an on line rebate - in this instance the patient will need to organise this.

Consultation Costs

The cost of a consultation at Premier Medicine has remained stable for over 3 years but does increase from time to time.

The cost of consultation is dependent upon the time taken, sometimes the complexity of the problems presented or the number of problems presented plus the costs of a specific procedure if one is carried out and possibly equipment/dressing costs.

The charges listed here are not an exhaustive list of costs you might incur and are only up to date at the time of writing ie 1.6.2021.

Should you require more detailed information of possible charges please email us with the details of the likely consultation time length and any procedure you are expecting to have and we will reply to you ASAP.

Medicare has some complex rulings which can mean that the doctor cannot always cover all the things you want to have done on the one day or one appointment time and still retain eligibility for a Medicare rebate for all services provided. Should his be the case the doctor will discuss this you.

INDICATIVE charges for adults for some of the commonly used Medicare Item Numbers in our practice.

                     We charge children under 16 yo 85% of the adult rate. 

  • Item 3 less than 5 minutes - $40 Medicare reimburses $17.90

  • Item 23 5-20 minute consultation -$100 Medicare reimburses $39.10

  • Item 36 20-40 minute more complex consultation - $190 Medicare reimburses $75.75

  • Item 44 over 40 minute - $260 Medicare reimburses $111.50

  • Item 2715 20-40 minute Mental Health Treatment Plan preparation $200 Medicare reimburses $ 94.75

  • Item 2717 40+ minute Mental Health Plan Treatment preparation $260 Medicare reimburses $ 139.55

  • Item 2712 Review Mental Health Treatment Plan 20-40 minutes $200 Medicare reimburses $72.60

  • Item 2713 Mental Health Consultation 20-40 minutes $200 Medicare reimburses $74.60

  • Item 16500 Antenatal Care attendance up to 20 minutes $110  Medicare reimburses $49.05

  • Item 73806 Pregnancy Test $15 Medicare reimburses $10.15

  • Item 721 Preparation of a Care Plan Medicare reimburses $150.10

  • Item 723 Organisation of Communication of between participants in a Care Plan medicare reimburses $118.95

NB 1 both item numbers 721 and 723 are charged together on the same day but NO other Medicare service can be offered to the patient on that day in order to be eligible for a Medicare rebate.

NB 2 There are thousands of Medicare Item numbers, your doctor/health practitioner can tell you which ones pertain to your consultation, the fees they incur and amount of Medicare rebate you might be eligible for.

NB 3 The Medicare Safety Net can help. It kicks in once you spend a certain amount on out-patient healthcare and gives you a bigger rebate from the government. 

Medicare automatically tracks your spending - including out-of-pocket costs.

The Original Medicare Safety Net (OMSN) works in conjunction with the Extended Medicare Safety Net (EMSN). Under the OMSN, once the annual threshold is reached, Medicare benefits increase to 100 per cent of the Medicare Benefits Schedule (MBS) Fee for all out-of-hospital services for the rest of the calendar year. Only the ‘gap amount’ counts towards the OMSN threshold. The ‘gap amount’ is the difference between the Medicare rebate and the MBS Fee. The OMSN is calculated prior to the EMSN.

The OMSN threshold is indexed by the Consumer Price Index (CPI) on 1 January each year. From 1 January 2021 the annual OMSN threshold is $481.20