Document ID: chunk:federal_register_of_legislation:F2024C01086:clause:1_90215:p5
Version: federal_register_of_legislation:F2024C01086
Segment Type: clause
Provision Reference: sch 1 cl 90215 (pt 5/6)
Character Range: 546292–548953

association with certain other services
 (3) An item in Subgroup 1 of Group A36 does not apply to a service performed in association with a service to which item 279, 235 to 244, 735 to 758, 2713, 92115, 92121, 92127 or 92133 applies.
 (4) Item 90261 does not apply to a service performed in association with a service to which item 110, 116, 119, 132, 133, 91824, 91825, 91826, 91834, 91835, 91836, 92422, 92423, 92431 or 92432 applies.
 (5) An item in Subgroup 3 of Group A36 does not apply to a service performed in association with a service to which item 279, 2713, 92115, 92121, 92127 or 92133 applies.

2.31.9  Restriction on items in Group A36—limitation on number of services providing treatments under a plan
 (1) An item in Subgroup 4 of Group A36 does not apply to a service providing a treatment to a patient under an eating disorder treatment and management plan if:
 (a) the service is provided more than 12 months after the plan is prepared; or
 (b) the patient has already been provided with 40 services under the plan; or
 (c) the service is provided after the patient has already been provided with 10 services under the plan but before a recommendation by a reviewing practitioner is given that additional services should be provided under the plan; or
 (d) the service is provided after the patient has already been provided with 20 services under the plan but before recommendations that additional services should be provided under the plan are given by each of the following:
 (i) a medical practitioner (other than a specialist or consultant physician);
 (ii) a consultant physician; or
 (e) the service is provided after the patient has already been provided with 30 services under the plan but before a recommendation is given by a reviewing practitioner that additional services should be provided.
 (1A) A reference in subclause (1) to a service providing a treatment to a patient includes any service to which item 309, 311, 313, 315, 2739, 2741, 2743, 2745, 80002, 80006, 80012, 80016, 80102, 80106, 80112, 80116, 80129, 80131, 80137, 80141, 80154, 80156, 80162, 80166, 91168, 91171, 91174, 91177, 91194, 91195, 91196, 91197, 91198, 91199, 91200, 91201, 91202, 91203, 91204, 91205, 91859, 91861, 91862, 91863, 91864, 91865, 91866, or 91867 applies that is provided to another person as part of the patient's treatment.
 (2) A reviewing practitioner may recommend that additional services be provided under a plan only if:
 (a) the recommendation is made as part of a service to which an item in Subgroup 3 of Group A36 or Subgroup 25 or 26 of Group A40 applies; and
 (b) the service is provided:
 (i) for the purposes of paragraph