Flag fall amount for residential aged care facility attendance by a general practitioner

Last reviewed: 1 November 2023

Medicare item 90001 provides a flag fall fee for the initial attendance by a general practitioner at one RACF, on one occasion, applicable only to the first patient seen on the RACF visit. 

The Medicare benefit for the single flag fall fee and the associated general consultation (Levels A to E) applies only for patients within a RACF who have a general consultation with a doctor in person.

If doctors do not bill the single flag fall fee, the benefit will not be paid.

If a doctor has to return to the RACF facility twice or more on the same day and the attendances are not a continuation of an earlier episode of treatment, another flag fall fee would apply per subsequent RACF visit.

When claiming the new attendance items there is no longer a requirement to transmit the number of patients seen. A doctor would claim each attendance item like any other consultation service.

MBS items 90001 is not to be used with existing derived fee services such as for afterhours, urgent afterhours, or telehealth (video and phone) services.  The bulk billing incentive only applies to the attendance item, not to the single flag fall fee.