Health Insurance (1999-2000 General Medical Services Table) Amendment Regulations 2000 (No. 1) (Cth)

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Health Insurance (1999–2000 General Medical Services Table) Amendment Regulations 2000 (No. 1)

Statutory Rules 2000 No. 60

I, WILLIAM PATRICK DEANE, Governor-General of the Commonwealth of Australia, acting with the advice of the Federal Executive Council, make the following Regulations under theHealth Insurance Act 1973.

Dated 27 April 2000

WILLIAM DEANE

Governor-General

By His Excellency’s Command

MICHAEL WOOLDRIDGE

Minister for Health and Aged Care

Health Insurance (1999–2000 General Medical Services Table) Amendment Regulations 2000 (No. 1)1

Statutory Rules 2000 No. 602

made under the

Health Insurance Act 1973

   

Contents

Page

  • •
  • •
 

Do not delete: Part placeholder

Do not delete: Division placeholder

1Name of Regulations

 These Regulations are the Health Insurance (1999–2000 General Medical Services Table) Amendment Regulations 2000 (No. 1).

2Commencement

 These Regulations commence on 1 May 2000.

3Amendment of Health Insurance (1999 – 2000 General Medical Services Table) Regulations 1999

Schedule 1 amends the Health Insurance (1999–2000 General Medical Services Table) Regulations 1999.

Schedule 1Amendments

Do not delete: Schedule Part placeholder

(regulation 3)

[1]Schedule 1, Part 1, rule 7

Provision

omit

insert

subparagraph 7 (1) (b) (i)

18.35

18.75

subparagraph 7 (1) (b) (ii)

1.20

1.25

subparagraph 7 (2) (b) (i)

18.35

18.75

subparagraph 7 (2) (b) (ii)

1.20

1.25

subparagraph 7 (3) (b) (i)

18.35

18.75

subparagraph 7 (3) (b) (ii)

1.20

1.25

subparagraph 7 (4) (b) (i)

18.35

18.75

subparagraph 7 (4) (b) (ii)

1.20

1.25

subparagraph 7 (9) (b) (i)

18.35

18.75

subparagraph 7 (9) (b) (ii)

1.20

1.25

[2]Schedule 1, Part 1, subrule 11 (2)

after

11330,

insert

11332,

[3]Schedule 1, Part 1, paragraph 15 (2) (a)

omit

15000

insert

15100

[4]Schedule 1, Part 1, rule 48

substitute

48Qualified sleep medicine practitioner

 For items 12203 and 12207, a person is a qualified sleep medicine practitioner if:

  • (a)

    the person has been assessed:

    • (i)

      by the Credentialling Subcommittee (the Credentialling Subcommittee) of the Specialist Advisory Committee in Thoracic and Sleep Medicine of the Royal Australasian College of Physicians (the Advisory Committee); or

    • (ii)

      on appeal from an adverse assessment of the Credentialling Subcommittee, by the Appeal Committee of the Royal Australasian College of Physicians (the Appeal Committee);

 as having had, before 1 March 1999, sufficient training and experience in sleep medicine to be competent in independent clinical assessment and management of patients with respiratory sleep disorders and in reporting sleep studies; or

  • (b)

    the person has been assessed:

    • (i)

      by the Credentialling Subcommittee; or

    • (ii)

      on appeal from an adverse assessment of the Credentialling Subcommittee, by the Appeal Committee;

 as:

  • (iii)

    having had, before 1 March 1999, substantial training or experience in sleep medicine; but

  • (iv)

    requiring further specified training or experience in sleep medicine to be competent in independent clinical assessment and management of patients with respiratory sleep disorders and in reporting sleep studies;

 and either:

  • (v)

    the period of 2 years immediately following that assessment has not expired; or

  • (vi)

    the person has been assessed by the Credentialling Subcommittee as having satisfactorily finished the further training or gained the further experience specified for that person; or

  • (c)

    the person has attained Level I or Level II of the Advanced Training Program in Sleep Medicine of the Thoracic Society of Australia and New Zealand and the Australasian Sleep Association, after having completed at least 12 months’ core training, including clinical practice in sleep medicine and in reporting sleep studies; or

  • (d)

    the Advisory Committee has recognised, in writing, the person as having training equivalent to the training mentioned in paragraph (c).

[5]Schedule 1, Part 2, items 720, 724, 726, 728, 740, 742, 744, 759, 762, 765, 30219, 30223, 30332, 30360, 30364, 49827 and 49830

substitute each of the following items in its correct numerical position

720

Preparation by a medical practitioner (including a general practitioner, but not including a specialist or consultant physician), in consultation with a multidisciplinary care plan team, of a multidisciplinary community care plan for a patient (not being a service associated with a service to which any of items 740 to 773 apply) — payable not more than once in any 6 month period

184.20

724

Attendance by a medical practitioner (including a general practitioner, but not including a specialist or consultant physician), to review a multidisciplinary community care plan or a discharge care plan prepared by that medical practitioner for a patient and claimed for under item 720 or 722 (not being a payment for a service to which any of items 740 to 773 apply) — payable not more than once in any 3 month period, not being an attendance in relation to a patient:

(a) for whom, in the preceding 3 months, a payment has been made under item 720; or

(b) for whom, in the previous month, a payment has been made under item 722

92.10

726

Attendance by a medical practitioner (including a general practitioner, but not including a specialist or consultant physician), as a member of a multidisciplinary care plan team, to contribute to a multidisciplinary community care plan or to a review of a multidisciplinary community care plan prepared by another provider (not being a payment for a service to which any of items 740 to 773 apply) — not being an attendance in relation to a patient for whom, in the previous 6 months, a payment has been made under item 720

25.85

728

Attendance by a medical practitioner (including a general practitioner, but not including a specialist or consultant physician), as a member of a multidisciplinary care plan team, to contribute to a multidisciplinary discharge care plan or to a review of a multidisciplinary discharge care plan prepared by another provider (not being a service associated with a service to which item 722 or any of items 740 to 773 apply)

25.85

740

Attendance by a medical practitioner (including a general practitioner, but not including a specialist or consultant physician), as a member of a case conference team, to organise and coordinate a community case conference, where the conference time is at least 15 minutes, but less than 30 minutes (not being a service associated with a service to which any of items 720 to 728 apply)

71.65

742

Attendance by a medical practitioner (including a general practitioner, but not including a specialist or consultant physician), as a member of a case conference team, to organise and coordinate a community case conference, where the conference time is at least 30 minutes, but less than 45 minutes (not being a service associated with a service to which any of items 720 to 728 apply)

107.45

744

Attendance by a medical practitioner (including a general practitioner, but not including a specialist or consultant physician), as a member of a case conference team, to organise and coordinate a community case conference, where the conference time is at least 45 minutes (not being a service associated with a service to which any of items 720 to 728 apply)

143.25

759

Attendance by a medical practitioner (including a general practitioner, but not including a specialist or consultant physician), as a member of a case conference team, to participate in a community case conference (other than to organise and coordinate the conference), where the conference time is at least 15 minutes, but less than 30 minutes (not being a service associated with a service to which any of items 720 to 728 apply)

51.15

762

Attendance by a medical practitioner (including a general practitioner, but not including a specialist or consultant physician), as a member of a case conference team, to participate in a community case conference (other than to organise and coordinate the conference), where the conference time is at least 30 minutes, but less than 45 minutes (not being a service associated with a service to which any of items 720 to 728 apply)

81.85

765

Attendance by a medical practitioner (including a general practitioner, but not including a specialist or consultant physician), as a member of a case conference team, to participate in a community case conference (other than to organise and coordinate the conference), where the conference time is at least 45 minutes (not being a service associated with a service to which any of items 720 to 728 apply)

112.55

30219

Haematoma, furuncle, small abscess or similar lesion not requiring admission to a hospital or day-hospital facility, incision with drainage of, excluding aftercare

21.00

30223

Large haematoma, large abscess, carbuncle, cellulitis or similar lesion, requiring admission to a hospital or day-hospital facility, incision with drainage of, excluding aftercare

(Anaes. 17706 = 4B + 2T)

125.40

30332

Lymph nodes of axilla, limited excision of (sampling) 

(Anaes. 17709 = 5B + 4T) (Assist.)

266.80

30360

Fine needle aspiration of an impalpable breast lesion detected by mammography or ultrasound, imaging guided — but not including imaging

(Anaes. 17705 = 3B + 2T)

106.10

30364

Breast, haematoma, seroma or inflammatory condition including abscess, granulomatous mastitis or similar, exploration and drainage of when performed in the operating theatre of a hospital or day-hospital facility, excluding aftercare 

(Anaes. 17707 = 3B + 4T)

166.70

49827

Foot, correction of hallux valgus by transfer of adductor hallucis tendon — unilateral

(Anaes. 17708 = 3B + 5T) (Assist.)

362.10

49830

Foot, correction of hallux valgus by transfer of adductor hallucis tendon — bilateral

(Anaes. 17710 = 3B + 7T) (Assist.)

633.75

[6]Schedule 1, Part 2, new items 11332, 16018, 30335, 30336, 30339, 30340, 30343, 30344, 30347, 30348, 30351, 30352, 30354, 30355, 45460, 45461, 45462, 45464, 45465, 45466, 45468, 45469, 45471, 45472, 45474, 45475, 45477, 45478, 45480, 45481, 45483, 45484, 45496, 45497, 45498, 45499, 49564, 49837

and 49838

insert each of the following items in its correct numerical position

11332

Oto-acoustic emission audiometry for the detection of permanent congenital hearing impairment, performed by or on behalf of a specialist or consultant physician, on an infant or child who is at risk due to 1 or more of the following factors:

(a) admission to a neonatal intensive care unit;

45.00

(b) family history of hearing impairment;

(c) intra-uterine or perinatal infection (either suspected or confirmed);

(d) birthweight less than 1.5 kg;

(e) craniofacial deformity;

(f) birth asphyxia;

(g) chromosomal abnormality, including Down’s Syndrome;

(h) exchange transfusion;

where:

(i) the patient is referred by another medical practitioner; and

(j) middle ear pathology has been excluded by specialist opinion

16018

Administration of 153 Sm-lexidronam for the relief of bone pain due to skeletal metastases (as indicated by a positive bone scan) from:

(a) carcinoma of the prostate, where hormonal therapy has failed; or

(b) carcinoma of the breast, where both hormonal therapy and chemotherapy have failed and:

(i) the disease is poorly controlled by conventional radiotherapy; or

(ii) conventional radiotherapy is inappropriate, due to the wide distribution of sites of bone pain

1 879.00

30335

Lymph nodes of axilla, complete excision of, to level I

(Anaes. 17713 = 5B + 8T) (Assist.)

666.90

30336

Lymph nodes of axilla, complete excision of, to level II or III

(Anaes. 17715 = 5B + 10T) (Assist.)

800.35

30339

Breast, benign lesion up to and including 50 mm in diameter, including simple cyst, fibroadenoma or fibrocystic disease, open surgical biopsy or excision of, with or without frozen section histology

(Anaes. 17708 = 5B + 3T)

200.05

30340

Breast, benign lesion more than 50 mm in diameter, excision of 

(Anaes. 17709 = 5B + 4T) (Assist.)

266.80

30343

Breast, abnormality detected by mammography or ultrasound where guidewire or other localisation procedure is performed, excision

biopsy of

(Anaes. 17710 = 5B + 5T) (Assist.)

300.15

30344

Breast, malignant tumour, open surgical biopsy of, with or without frozen section histology

(Anaes. 17710 = 5B + 5T)

266.80

30347

Breast, malignant tumour, complete local excision of, with or without frozen section histology

(Anaes. 17712 = 5B + 7T) (Assist.)

500.20

30348

Breast, tumour site, re-excision of following open biopsy or incomplete excision of malignant tumour 

(Anaes. 17710 = 5B + 5T) (Assist.)

335.50

30351

Breast (female), total mastectomy 

(Anaes. 17712 = 5B + 7T) (Assist.)

566.45

30352

Breast (male), total mastectomy 

(Anaes. 17711 = 5B + 6T) (Assist.)

333.50

30354

Breast (female), subcutaneous mastectomy

(Anaes. 17713 = 5B + 8T) (Assist.)

800.35

30355

Breast (male), subcutaneous mastectomy 

(Anaes. 17711 = 5B + 6T) (Assist.)

400.15

45460

Free grafting (split skin) to burns, including excision of burnt tissue, involving 15% or more but less than 20% of total body surface — 1 surgeon 

(Anaes. 17719 = 5B + 14T) (Assist.)

964.25

45461

Free grafting (split skin) to burns, including excision of burnt tissue, involving 15% or more but less than 20% of total body surface — conjoint surgery, principal surgeon

(Anaes. 17715 = 5B + 10T) (Assist.)

687.15

45462

Free grafting (split skin) to burns, including excision of burnt tissue, involving 15% or more but less than 20% of total body surface — conjoint surgery, co-surgeon (Assist.)

518.65

45464

Free grafting (split skin) to burns, including excision of burnt tissue, involving 20% or more but less than 30% of total body surface — 1 surgeon 

(Anaes. 17721 = 5B + 16T) (Assist.)

1 471.75

45465

Free grafting (split skin) to burns, including excision of burnt tissue, involving 20% or more but less than 30% of total body surface — conjoint surgery, principal surgeon

(Anaes. 17717 = 5B + 12T) (Assist.)

1 048.50

45466

Free grafting (split skin) to burns, including excision of burnt tissue, involving 20% or more but less than 30% of total body surface — conjoint surgery, co-surgeon (Assist.)

790.70

45468

Free grafting (split skin) to burns, including excision of burnt tissue, involving 30% or more but less than 40% of total body surface — conjoint surgery, principal surgeon

(Anaes. 17724 = 10B + 14T) (Assist.)

1 409.85

45469

Free grafting (split skin) to burns, including excision of burnt tissue, involving 30% or more but less than 40% of total body surface — conjoint surgery, co-surgeon (Assist.)

1 063.70

45471

Free grafting (split skin) to burns, including excision of burnt tissue, involving 40% or more but less than 50% of total body surface — conjoint surgery, principal surgeon

(Anaes. 17728 = 12B + 16T) (Assist.)

1 772.20

45472

Free grafting (split skin) to burns, including excision of burnt tissue, involving 40% or more but less than 50% of total body surface — conjoint surgery, co-surgeon (Assist.)

1 336.75

45474

Free grafting (split skin) to burns, including excision of burnt tissue, involving 50% or more but less than 60% of total body surface — conjoint surgery, principal surgeon

(Anaes. 17734 = 14B + 20T) (Assist.)

2 133.55

45475

Free grafting (split skin) to burns, including excision of burnt tissue, involving 50% or more but less than 60% of total body surface — conjoint surgery, co-surgeon (Assist.)

1 609.80

45477

Free grafting (split skin) to burns, including excision of burnt tissue, involving 60% or more but less than 70% of total body surface — conjoint surgery, principal surgeon

(Anaes. 17738 = 16B + 22T) (Assist.)

2 494.85

45478

Free grafting (split skin) to burns, including excision of burnt tissue, involving 60% or more but less than 70% of total body surface — conjoint surgery, co-surgeon (Assist.)

1 881.80

45480

Free grafting (split skin) to burns, including excision of burnt tissue, involving 70% or more but less than 80% of total body surface — conjoint surgery, principal surgeon

(Anaes. 17742 = 18B + 24T) (Assist.)

2 856.20

45481

Free grafting (split skin) to burns, including excision of burnt tissue, involving 70% or more but less than 80% of total body surface — conjoint surgery, co-surgeon (Assist.)

2 154.85

45483

Free grafting (split skin) to burns, including excision of burnt tissue, involving 80% or more of total body surface — conjoint surgery, principal surgeon 

(Anaes. 17748 = 20B + 28T) (Assist.)

3 254.10

45484

Free grafting (split skin) to burns, including excision of burnt tissue, involving 80% or more of total body surface — conjoint surgery, co-surgeon (Assist.)

2 455.30

45496

Flap, free tissue transfer using microvascular techniques — revision of, by open operation

(Anaes. 17713 = 5B + 8T)

320.00

45497

Flap, free tissue transfer using microvascular techniques — complete revision of, by liposuction 

(Anaes. 17709 = 5B + 4T)

250.00

45498

Flap, free tissue transfer using microvascular techniques — staged revision of, by liposuction (first stage)

(Anaes. 17708 = 5B + 3T)

201.20

45499

Flap, free tissue transfer using microvascular techniques — staged revision of, by liposuction (second stage)

(Anaes. 17708 = 5B + 3T)

150.00

49564

Knee, patello-femoral stabilisation of, combined arthroscopic and open procedure, including lateral release, medial capsulorrhaphy and tendon transfer 

(Anaes. 17714 = 4B + 10T) (Assist.)

706.95

49837

Foot, correction of hallux valgus by osteotomy of first metatarsal and transfer of adductor hallicus tendon, including internal fixation if performed — unilateral

(Anaes. 17710 = 3B + 7T) (Assist.)

497.95

49838

Foot, correction of hallux valgus by osteotomy of first metatarsal and transfer of adductor hallicus tendon, including internal fixation if performed — bilateral

(Anaes. 17713 = 3B + 10T) (Assist.)

860.00

[7]Schedule 1, Part 2, items 30222, 30333, 30337, 30338, 30341, 30342, 30345, 30346, 30349, 30350, 30353, 30356, 30359 and 45419

omit

[8]Additional amendments of Schedule 1, Part 2

Item

omit

insert

1

56.95

58.25

2

56.95

58.25

3

12.30

12.60

23

25.85

26.45

36

46.70

47.75

44

68.80

70.35

160

157.15

160.70

161

261.90

267.85

162

366.70

375.00

163

471.45

482.15

164

523.90

535.80

193

25.85

26.45

601

68.10

69.65

602

68.10

69.65

16502

25.65

25.85

16504

25.65

25.85

16505

25.65

25.85

16508

25.65

25.85

30332

189.90

266.80

30360

145.70

106.10

30364

125.10

166.70

30366

256.95

333.50

30367

205.55

266.80

30369

205.55

266.80

30370

116.15

199.85

30372

97.25

100.05

Notes

1. These Regulations amend Statutory Rules 1999 No. 256.

2. Made by the Governor-General on 27 April 2000, and notified in the Commonwealth of Australia Gazette on 28 April 2000. 

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