C004

PDF page 55 / GP41

Payment rules:
A933/C933/C003/C004 are not eligible for payment for an admission assessment for an elective
surgery patient when a pre-operative assessment has been rendered to the same patient within 30
days of admission by the same physician.

PDF page 56 / GP42

GENERAL PREAMBLE
HOSPITAL AND INSTITUTIONAL CONSULTATIONS AND ASSESSMENTS
    Admission Assessments by Emergency Physicians:
When a patient has been assessed by an emergency physician in the ER or OPD and that physician
renders a service described as a consultation, general assessment, or general re-assessment and
subsequently admits the patient to hospital as the most responsible physician or that physician is
asked to perform the admission assessment (even though the patient is admitted under a different
most responsible physician), the initial consultation, general assessment, or general re-assessment
constitutes the admission assessment.
When a patient has been assessed by an emergency physician in the ER or OPD and that physician
renders any other assessment other than those listed in the paragraph immediately above, and
subsequently renders the admission assessment, (even if the patient is admitted under a different
most responsible physician), the admission assessment is payable as C004, in addition to the initial
assessment, if both services are rendered separately.

PDF page 78 / GP64

2. Despite any other provision in this Schedule, the amount payable for the following services to
     an insured person who is at least 65 years of age, as those services are defined in this
     Schedule, is increased by 15 per cent:
     a. A general assessment (A003, C003, W102, or W109);
     b. A general re-assessment (A004, C004, W004);
     c. An intermediate assessment (A007);
     d. A focused practice assessment (A917, A927, A937, A947, A957 or A967);
     e. A periodic health visit (K132).
     f. Comprehensive assessment and care (H102, H122, H132, H152)
     g. A multiple systems assessment (H103, H123, H133, H153)

PDF page 140 / A12

Non-Emergency Hospital In-Patient Services
     See General Preamble GP40 to GP48. For emergency calls and other special visits to in-
     patients, use General Listings and Premiums when applicable - see General Preamble GP65 to
     GP78.
 C005 Consultation............................................................................  95.60
 C911 Special family and general practice consultation - subject to the
          same conditions as A911....................................................          164.95
 C912 Comprehensive family and general practice consultation -
          subject to the same conditions as A912 .............................                 247.40
 C945 Special palliative care consultation - subject to the same
          conditions as A945 .............................................................     174.25
 C320 Special Medical Assistance in Dying (MAID) consultation -
          subject to the same conditions as A320 .............................                 174.25
 C905 Limited consultation ................................................................     81.25
 C006 Repeat consultation ................................................................      47.10
 C003 General assessment...............................................................         89.65
 C004 General re-assessment ..........................................................          38.35
 C813 Midwife or Aboriginal Midwife-Requested Assessment -
        subject to the same conditions as A813 .............................                                 111.70
 C815 Midwife or Aboriginal Midwife-Requested Special Assessment
        - subject to the same conditions as A815...........................                                  186.95
 C933 On-call admission assessment - subject to the same conditions
        as A933 ..............................................................................                 82.00
 C777 Intermediate assessment - Pronouncement of death - subject
         to the same conditions as A777 .........................................                              44.55
 C771 Certification of death - subject to the same conditions as A771                                          24.20

Master, record 396. Record Layout PDF, page 1.

C00420260401999999990000038350000000000000000000000000000000000000000000000

Auxiliary master fields are preserved as raw scaled values. The linked layout calls them zero-filled, but this edition contains non-zero values. They are not presented as final dollar fees or PDF units.