Estimate Example - Standard Gap
Scenario: The Doctor/Practice does not enter into an agreement with a Health Fund, nor opts into a scheme and charges their own fees. Therefore there will be an out-of-pocket expense for the patient, which will be displayed in the Gap Column of the New Estimate of Fees window.
The calculations are based on the following:
- Doctor's fees will be displayed under Fee.
- Medicare rebate of (75%) under Medicare.
- Health Fund (25% of MBS Fee) will be displayed under Health Fund.
- Gap Difference under Gap Column.
Therefore if a practitioner charges above the Schedule Fee for Item 32090 please find example listed below:
Practitioner Charges for Item 32090 $603.00 Less Rebate Medicare ($376.90)
Health Fund ($125.60)
502.50 Gap to pay $100.50