Document ID: chunk:federal_register_of_legislation:C2025C00156:section:15
Version: federal_register_of_legislation:C2025C00156
Segment Type: section
Provision Reference: s 15
Character Range: 116838–118965

15  Medicare benefit in respect of 2 or more operations
 (1) Subject to this section, for the purpose of ascertaining whether medicare benefit is payable, or calculating the amount of a medicare benefit payable, in respect of the medical expenses incurred in respect of two or more operations, each constituting a professional service covered by an item, that are performed on the one occasion on the one person:
 (a) the amount specified in those items as fees, other than the greater or greatest of those amounts, shall be deemed to be reduced, as follows:
 (i) the greater or greatest of the amounts to be deemed to be reduced shall be deemed to be reduced by one‑half; and
 (ii) the other amount, or each of the other amounts, to be deemed to be reduced shall be deemed to be reduced by three‑quarters; and
 (b) the operations shall be deemed to constitute one professional service in respect of which the fee specified in the table in relation to the State in which the service was rendered is an amount equal to the aggregate of the amounts specified as fees in the items relating to those operations, being those amounts as reduced in accordance with paragraph (a).
 (2) For the purposes of paragraph (1)(a):
 (a) where two or more amounts referred to in that subsection are equal, one of those amounts shall be treated as being greater than the other or others of those amounts; and
 (b) where, by virtue of a reduction in accordance with that subsection, an amount is not a multiple of 5 cents, the amount of cents shall be increased to the nearest higher amount that is a multiple of 5 cents.
 (3) This section does not apply in relation to an operation, being one of two or more operations performed under the one anaesthetic on the one person, if the practitioner who performed the operation:
 (a) did not perform, or assist at, the other operation or any of the other operations; and
 (b) did not administer the anaesthetic.
 (4) In this section, operation does not include a medical service specified in an item in the general medical services table that relates to an amputation or a disarticulation of a limb.