Health (Fees) Regulations 1997 (TAS)

Health (Fees) Regulations 1997

I, the Governor in and over the State of Tasmania and its Dependencies in the Commonwealth of Australia, acting with the advice of the Executive Council, make the following regulations under the Health Act 1997 .16 October 1997

G. S. M. GREEN

Governor

By His Excellency’s Command,

PETER MCKAY

Minister for Community and Health Services

1Short titleThese regulations may be cited as the Health (Fees) Regulations 1997 . 2CommencementThese regulations take effect on 1 November 1997. 3Interpretation (1)  In these regulations – Agreement means the Agreement in force under section 24 of the Commonwealth Health Act entered into between the State and the Commonwealth; approved nursing home means approved nursing home within the meaning of the National Health Act 1953 ; Commonwealth benefit means an amount determined for the purpose of paragraph (dd) of the definition of "basic private table" in section 4(1) of the National Health Act 1953 of the Commonwealth; Commonwealth Health Act means the Health Insurance Act 1973 of the Commonwealth; compensable patient means a compensable patient within the meaning of the Agreement; extensive care means extensive care as defined by the National Health Act 1953 of the Commonwealth; fee means a fee specified in Schedule 1 , 2 or 3 ; general medical services table means the general medical services table within the meaning of the Commonwealth Health Act; Health Benefits Card means a Health Benefits Card issued to a person eligible under the Commonwealth Health Act; Health Care Card means a Health Care Card issued to a person eligible under the Commonwealth Health Act; hospital patient means a hospital patient within the meaning of the Commonwealth Health Act; in-patient means an in-patient within the meaning of the Agreement; ineligible person means an ineligible person within the meaning of the Agreement; Lilac Card means a Dependant Treatment Entitlement Card issued under the Veterans’ Entitlements Act 1986 of the Commonwealth; nursing home care means nursing home care within the meaning of the National Health Act 1953 ; nursing-home type patient means a nursing-home type patient within the meaning of the Commonwealth Health Act; out-patient means an out-patient within the meaning of the Agreement; Pensioner Health Benefits Card means a Pensioner Health Benefits Card (Pensioner Concession Card) issued to a person eligible under the National Health Act 1953 of the Commonwealth; Pharmaceutical Benefits Concession Card means a Pharmaceutical Benefits Concession Card issued to a person eligible under the National Health Act 1953 of the Commonwealth; private patient means a private patient within the meaning of the Agreement; public hospital means any hospital maintained and operated by the State, other than the Royal Derwent Hospital; public patient means a public patient within the meaning of the Agreement; Red Card means a Service Pensioner Benefits Card issued under the Veterans’ Entitlements Act 1986 of the Commonwealth; Schedule fee, in relation to a service, means the fee specified in the general medical services table in respect of that service; type-B professional attention means a type-B professional attention as defined by the National Health Act 1953 of the Commonwealth; type-C professional attention means a type-C professional attention as defined by the National Health Act 1953 of the Commonwealth; White Card means a Specific Treatment Entitlement Card issued under the Veterans’ Entitlements Act 1986 of the Commonwealth; Yellow Card means a Personal Treatment Entitlement Card issued under the Veterans’ Entitlements Act 1986 of the Commonwealth. (2)  Words and expressions used both in these regulations and the Agreement have in these regulations, unless the contrary intention appears, the same respective meanings as they have in the Agreement. 4Fees for non-nursing home careThe fees specified in Schedule 1 are prescribed as the fees payable by persons in respect of accommodation and services, other than nursing home care, provided to them in public hospitals. 5Fees for surgically implanted prostheses and appliances (1)  A person to whom Part 1 of Schedule 1 applies, in addition to any other fee payable by that person under Schedule 1 , is to pay a fee in respect of any surgically implanted prosthesis or appliance provided to that person. (2)  The fee in respect of a prosthesis or appliance is – (a) if the cost of the prosthesis or appliance is an amount less than the Commonwealth benefit, an amount equivalent to that cost; or (b) if the cost of the prosthesis or appliance is an amount equal to or more than the Commonwealth benefit, an amount equal to the benefit. 6Fees for nursing home careThe fees specified in Schedule 2 are prescribed as the fees payable in respect of the care and treatment provided to them in public hospitals by – (a) nursing-home type patients; and (b) persons who are – (i) accommodated in public hospitals; and (ii) receiving nursing home care; and (iii) not hospital patients. 7Fees for dental servicesThe fees specified in Schedule 3 are prescribed as the fees payable by persons in respect of dental services provided to them in public hospitals. 8Interest on overdue accounts (1)  If the whole or any part of a fee remains unpaid at the expiration of the period of 60 days immediately after the day on which an account for that fee was rendered, interest is payable on the unpaid amount at a rate determined by the Secretary. (2)  For the purpose of subregulation (1)  – (a) the interest is to be simple interest calculated daily from, and including, the day immediately following the last day of the 60 day period referred to in that subregulation; and (b) the rate of interest is not to exceed 12% a year. 9RescissionThe Health (Regional Boards) (Fees) Regulations 1991 are rescinded. Schedule 1Fees payable for non-nursing home care in public hospitals

Regulations 4 and 5

PART 1In-patients

Item	Accommodation or service provided	Fee
Shared Ward (each day)	Single Ward (each day)
1.	In respect of a private patient who is –
(a) an advanced surgical patient –
the first 14 days	$259	$388
each subsequent day	$179	$303
(b) a surgical/obstetric patient –
the first 14 days	$237	$371
each subsequent day	$179	$303
(c) a psychiatric patient
the first 42 days	$237	$371
the next 23 days	$207	$332
each subsequent day	$179	$303
(d) a rehabilitation patient –
the first 49 days	$237	$371
the next 16 days	$207	$332
each subsequent day	$179	$303
(e) a same-day patient –	$149	.....
Band 1: Gastro-intestinal endoscopy, certain minor surgical items and non-surgical procedures that do not normally require an anaesthetic
Band 2: Procedures (other than Band 1) carried out under local anaesthetic, no sedation, if actual time in theatre is less than one hour	$178	.....
Band 3: Procedures (other than Band 1) carried out under general or regional anaesthesia or intravenous sedation, if actual time in theatre is less than one hour	$207	.....
Band 4: Procedures carried out under general or regional anaesthesia or intravenous sedation, if actual time in theatre is one hour or more	$237	.....
(f) any other patient –
the first 14 days	$207	$332
each subsequent day	$179	$303
2.	In respect of a patient who is a compensable patient	$580	.....
3.	In respect of a patient whose injury or disease is one for which the Defence Forces of the Commonwealth accept responsibility	$250	.....
4.	In respect of a non-resident of Australia who is an ineligible person	$580	.....
5.	In respect of a diagnostic imaging service rendered to a patient specified in Group 12 in Category 5 of the general medical services table	the Schedule fee  (in addition to any fee payable under items 1, 2, 3 or 4 of this Part)

PART 2Out-patients

Item	Service provided	Fee
1.	In respect of a patient whose injury or disease is one in respect of which compensation or damages are payable or have been paid under a law in force in a State or Territory of the Commonwealth	$58 (each attendance)
2.	In respect of a patient whose injury or disease is one for which the Defence Forces of the Commonwealth accept responsibility	$58 (each occasion of service)
3.	In respect of a medical service rendered to a patient specified in any of the following categories of the general medical services table:
(a) Sub-group 1, 2, 3, 4, 5, 6, 10 or 11 of Groups D1 and D2 in Category 2	the Schedule fee (in addition to any fee payable under item 1 of this Part)
(b) Group T2 in Category 3	the Schedule fee (in addition to any fee payable under item 1 of this Part)
(c) Sub-group 1 of Group 11 and Groups 12, 13 and 15 in Category 5	the Schedule fee (in addition to any fee payable under item 1 of this Part)
(d) Category 6	the Schedule fee (in addition to any fee payable under item 1 of this Part)
4.	The supply of a pharmaceutical item in respect of –
(a) a patient who holds a valid Health Care Card, Health Benefits Card or Pharmaceutical Benefits Concession Card	$3.20 (each item)
(b) a patient who holds a valid Pensioner Health Benefits Card and to whom or in respect of whom a benefit or allowance is paid under the Social Security Act 1991 of the Commonwealth	$3.20 (each item)
(c) a patient who holds a valid Yellow Card, White Card, Lilac Card or Red Card	$3.20 (each item)
(d) any other patient	a maximum of $15 (each item)
5.	The provision of a wrist support, elbow support, neck collar (soft or reinforced), Philadelphian collar, knee support (pull-on type), torn-ligament support (jointed or unjointed), post-operative knee immobiliser, hinged knee cap, ankle support, abdominal support or similar non-consumable aid or appliance in respect of –
(a) a patient who holds a valid Health Care Card or Pensioner Health Benefits Card	no fee
(b) any other patient	optional fee (the cost of providing the aid or appliance)

PART 3Other services

Item	Service provided	Fee
1.	In respect of a diagnostic service –	the Schedule fee
(a) provided to a patient specified in Sub-groups 1 and 2 (C.T. scans) of Group 12 in Category 5 of the general medical services table –
(i) who is not a public patient; and
(ii) who is referred to a specialist diagnostician who has the approval of the public hospital to exercise limited rights of private practice; and
(b) provided by, or on behalf of, that specialist diagnostician
2.	The provision of a plaster cast, surgical boot, splint, prosthesis or similar aid or appliance in respect of a patient –	optional fee (the cost of providing both the service and the aid or appliance)
(a) who is not a public patient; and
(b) who is not eligible under the State program known as the Program of Aids for Disabled Persons for assistance in respect of the provision of such aids and appliances; and
(c) who is referred to a public hospital by a registered medical practitioner

Schedule 2Fees payable for nursing home care in public hospitals

Regulation 6

1.   Interpretation In this Schedule, prescribed formula means the following formula: 2.   Fee payable by nursing-home type patients in public hospitals The fee payable in respect of the care and treatment for each day that a nursing-home type patient is an in-patient in a public hospital is to be calculated in accordance with the prescribed formula. 3.   Fee payable for other nursing home care in public hospitals (1)This clause applies to a person who – (a) is accommodated in a public hospital; and (b) is receiving nursing home care; and (c) is not a hospital patient. (2)The fee payable by a person referred to in subclause (1) , in respect of the care and treatment for each day on which that person is accommodated in a public hospital, is a fee calculated in accordance with the prescribed formula in addition to – (a) in the case of a person who is not receiving extensive care, a fee of an amount equivalent to the benefit payable under section 47(1) of the National Health Act 1953 of the Commonwealth to the proprietor of an approved nursing home situated in the State in respect of an uninsured nursing home patient; or (b) in the case of a person who is receiving extensive care, a fee of an amount equivalent to the benefit payable under section 49 of the National Health Act 1953 of the Commonwealth to the proprietor of an approved nursing home in respect of an uninsured nursing home patient. Schedule 3Fees for dental services provided in public hospitals

Regulation 7

Item	Service provided	Fee
DIAGNOSTIC SERVICES
Examinations
011.	Initial oral examination, if radiographs are not used (initial visit or recall after 12 months)	$7.30
012.	Periodic oral examination, if radiographs are not used (recall after 6 months and within 12 months)	$6.70
014.	Consultation (includes drug prescription)	$7.30
019.	Written report	$3.40
Radiographs
021.	Complete intra-oral series of periapical radiographs (up to 14 films)	$43.00
022.	Intra-oral periapical or bitewing radiograph (single view)	$7.60
023.	Two periapical or bitewing radiographs	$12.00
024.	Each additional single periapical or bitewing radiograph	$4.70
025.	Intra-oral radiograph, occlusal, maxillary or mandibular (single view)	$12.00
031.	Extra-oral radiograph, maxillary or mandibular (single view)	$17.50
032.	Extra-oral radiograph, maxillary or mandibular (2 views)	$29.50
Other tests and examinations
051.	Biopsy of tissue	$17.50
053.	Cytological examination (exfoliative cytology)	$7.30
061.	Pulp vitality test (part of examination)	.....
071.	Diagnostic model –
upper or lower	$7.20
upper and lower	$14.80
PREVENTATIVE SERVICES
Dental prophylaxis
111.	Removal of plaque	$11.00
112.	Scaling and cleaning (includes removal of plaque)	$16.00
113.	Recontouring existing restorations and equilibration of bite	$13.00
Topical fluoride
121.	Topical application of fluoride (if application is commenced and completed at one visit)	$5.30
General
141.	Oral hygiene instruction, including dietary advice (if full appointment is used)	$14.80
151.	Provision of a mouthguard requiring construction of a model	$29.50
161.	Fissure sealing – composite acid-etch technique (each tooth)	$15.00
165.	Application of desensitising agent	$5.30
166.	Bleaching of discoloured teeth	$11.30
PERIODONTICS
All items include scaling and cleaning, oral hygiene instruction and the provision of medication relating to the condition
Periodontal management: General
211.	Subgingival curettage, root cleaning (each visit)	$16.00
213.	Treatment of acute periodontal infection (first visit)	$16.00
214.	Treatment of acute periodontal infection (for each subsequent visit up to a total of 3 subsequent visits)	$11.80
215.	Treatment of chronic periodontal infection, excluding surgery (first visit)	$15.00
216.	Treatment of chronic periodontal infection, excluding surgery (for each subsequent visit up to a total of 3 subsequent visits)	$12.30
Periodontal management: Surgical                  All items include post-operative care
231.	Gingivectomy (each quadrant)	$36.00
232.	Periodontal flap surgery	$36.00
233.	Osseous surgery	$36.00
ORAL SURGERY
Simple extraction
311.	Simple removal of tooth with local anaesthesia (includes routine post-operative care)	$12.80
316.	Simple removal of additional tooth (at the same appointment as, and as a complementary procedure to, item 311)	$8.50
317.	Removal of teeth under general anaesthesia (includes routine post-operative care) –
minimum – up to 4 teeth	$63.00
maximum – 5 or more teeth	$79.00
(only to be performed in a hospital)
Surgical extraction
All items include local anaesthesia                           and routine post-operative care
321.	Surgical removal of erupted tooth	$43.00
322.	Surgical removal of tooth, with soft tissue impaction	$43.00
323.	Surgical removal of tooth, with partial bone impaction	$52.00
325.	Surgical removal of tooth fragment, involving soft tissues only	$33.50
326.	Surgical removal of tooth fragment, involving bone	$33.50
329.	Post-operative treatment, including extra-routine post-operative care (each visit)	$12.00
Surgery for prostheses
All items include post-operative care                   Fees exclusive of fee for extraction
331.	Alveoloectomy	$25.50
334.	Excision of torus mandibularis	$36.00
335.	Excision of torus palatinus	$36.00
336.	Excision of mylohyoid ridge	$36.00
337.	Reduction of fibrons tuberosities	$36.00
338.	Reduction of flabby ridge	$36.00
341.	Excision of fibrons hyperplasia	$36.00
342.	Excision of papillary hyperplasia	$36.00
Treatment of maxillo-facial injuries
351.	Debridement of wound and repair of mucous membrane (includes post-operative care)	$36.00
353.	Fracture of maxilla with wiring of teeth (includes post-operative care)	$180.00
357.	Fracture of mandible with wiring of teeth (includes post-operative care)	$180.00
358.	Acrylic splint single, overlay or Gunning (includes post-operative care)	$180.00
359.	Cast silver splint with or without acrylic extension, single, plus the cost of silver	$180.00
360.	Dentures modified to be used as a splint –
single	$28.50
double	$63.00
Dislocations
361.	Reduction of dislocated mandible	$13.00
General surgical
All items include post-operative care
371.	Tumour, cyst or scar removal	$36.00
374.	Excision of innocent bone tumour	$36.00
375.	Surgery to salivary ducts, salivary stones	$36.00
378.	Removal of foreign body	$36.00
379.	Marsupialisation of cyst	$36.00
Other surgical procedures
381.	Surgical exposure of unerupted tooth (includes post-operative care)	$36.00
386.	Reposition and splinting of displaced tooth (includes post-operative care)	$36.00
387.	Replantation of tooth and splinting (includes post-operative care)	$36.00
391.	Frenectomy (includes post-operative care)	$36.00
392.	Incision and drainage of abscess (includes post-operative care)	$36.00
394.	Sequestrectomy (osteomyelitis)	$36.00
ENDODONTICS
Vital pulp treatment
All items include radiographs                               Fees exclusive of fees for restoration
411.	Pulp capping	$3.40
412.	Pulpotomy	$12.00
DIAGNOSTIC SERVICES
421.	Anterior tooth with one root canal	$84.00
422.	Posterior tooth with one root canal (bicuspid only)	$84.00
423.	Anterior tooth with 2 root canals	$93.00
424.	Posterior tooth with 2 root canals	$93.00
425-426.	Tooth with 3-4 root canals endontia in a molar tooth	$127.50
432.	Apisectomy (includes periapical curettage)	$36.00
434.	Retrograde amalgam root filling	$23.30
RESTORATIVE SERVICES
Amalgam filling
Permanent teeth –
511.	one surface cavity	$14.80
512.	2 surface cavity	$17.30
513.	3 or more surface cavity	$23.30
Deciduous teeth –
514.	one surface cavity	$14.80
515.	2 surface cavity	$17.30
516.	3 or more surface cavity	$23.30
517.	Pin retention (each unit pin)	$4.30
Silicate filling
521.	Silicate cement filling	$16.00
Synthetic resin filling
531.	Acrylic filling	$16.00
Composite resin filling –
532.	one surface cavity	$16.50
533.	2 surface cavity	$21.30
534.	3 surface cavity	$28.50
536.	Pin retention (each unit pin)	$4.30
Enamel bonded composite                                    resin restoration –
537.	one surface cavity	$17.50
538.	2 or more surface cavity	$21.30
Gold inlay
Fees exclusive of cost of gold
Direct technique
551.	one surface cavity	$82.50
552.	2 surface cavity	$82.50
553.	3 or more surface cavity	$82.50
Indirect tecnhique
554.	one surface cavity	$110.00
555.	2 surface cavity	$110.00
556.	3 or more surface cavity	$110.00
Other operative surfaces
571.	Re-cementing inlay	$14.80
573.	Temporary crown (as emergency procedure only)	$25.50
574.	Temporary restoration using metal band	$17.30
575.	Pin retention (each unit pin)	$4.30
576.	Stainless steel crown	$29.30
CROWN AND BRIDGE
Fees exclusive of –
(a) cost of private laboratory; and
(b) cost of gold, silver or platinum
611.	Acrylic jacket crown	$190.00
612.	Acrylic jacket crown with metal thimble	$225.00
613.	Porcelain jacket crown	$232.50
614.	Porcelain jacket crown with metal thimble	$257.50
615.	Porcelain fused to gold jacket crown	$227.50
616.	Acrylic veneer crown	$180.00
617.	Porcelain veneer crown	$180.00
618.	Cast gold crown	$180.00
619.	Cast gold crown with facing	$180.00
620.	Three-quarter cast gold crown	$150.00
621.	Cast based crown	$152.00
625.	Cast core for crown (includes post)	$31.30
632.	Amalgam crown with pin retention	$43.00
633.	Composite resin crown with pin retention	$43.00
651.	Re-cementing crown	$14.80
652.	Re-cementing bridge	$17.30
653.	Bridge (each unit)	$87.00
PROSTHETIC SERVICES
Fees exclusive of cost of casting (which includes clasps)
Complete denture
711.	Complete maxillary denture	$180.00
712.	Complete mandibular denture	$180.00
713.	Immediate denture, complete maxillary (each tooth involved in immediate replacement)	$1.80 (in addition to any fee payable under item 711 or 719)
714.	Immediate denture, complete mandibular (each tooth involved in immediate replacement)	$1.80 (in addition to any fee payable under item 712 or 719)
715.	Resilient lining	$24.30 (in addition to any fee payable under item 711, 712 or 719)
719.	Complete maxillary and mandibular denture	$320.00
Partial denture
721.	Acrylic base
one tooth	$75.00
2 teeth	$87.00
3 teeth	$105.00
4 teeth	$120.00
5 – 9 teeth	$147.50
10 – 12 teeth	$167.50
727.	Cast metal base-cobalt chromium alloy
one tooth	$93.00
2 teeth	$110.00
3 teeth	$127.00
4 teeth	$135.00
5 – 9 teeth inclusive	$167.50
10 – 12 teeth inclusive	$195.00
Additional units for partial dentures
731.	Each retainer	$8.10
732.	Occlusal rest (if not used as part of retainer)	$4.00
736.	Immediate partial denture (each tooth involved in immediate replacement)	$1.80
Denture maintenance
741.	Adjustment of complete denture (other than when associated with the provision of a new denture)	$12.00
742.	Adjustment of partial denture (other than when associated with the provision of a new denture)	$12.00
743.	Relining (processed) complete mandibular or maxillary denture	$73.00
749.	Resilient lining	$98.00
Denture repairs
761.	Re-attaching undamaged clasp on denture	$17.30
762.	Replacing broken clasp with new clasp on denture	$21.00
763.	Repairing broken complete or partial denture with no teeth damaged	$17.30
764.	Repairing broken complete or partial denture and replacing one broken tooth	$24.50
765.	Replacing additional teeth (each tooth)	$7.80
766.	Replacing broken tooth on denture (if no other repairs)	$17.30
767.	Each additional tooth replaced	$7.60
768.	Adding tooth to partial denture to replace extracted tooth (involving clasp or abutment tooth)	$36.00
769.	Each additional tooth added	$9.00
770.	Re-attaching undamaged tooth	$17.30
Other prosthetics
771.	Tissue conditioning preparatory to impressions (maxillary or mandibular)	$14.50
776.	Impression if required for denture repair	$3.50
ORTHODONTIC SERVICES
821.	Active removable appliance, including springs and clasps (one arch)	$135.00
Orthodontic appliances provided at cost
ADJUNCTIVE GENERAL SERVICES
Emergency
911.	Palliative emergency treatment and temporary dressings	$6.40
Occlusal adjustment
961.	Occlusal adjustment (minor non-restorative)	$29.30
981.	Splinting and stabilisation (if not otherwise provided for)	$36.00
991.	Acrylic bite plane for occlusal disengagement	$76.00

Displayed and numbered in accordance with the Rules Publication Act 1953.

Notified in the Gazette on 22 October 1997

These regulations are administered in the Department of Community and Health Services.

EXPLANATORY NOTE

(This note is not part of the regulation) These regulations –

(a) prescribe the fees payable under the Health Act 1997 for accommodation, services, care and treatment provided in public hospitals; and (b) rescind the Health (Regional Boards) (Fees) Regulations 1991 .