Health Insurance (Diagnostic Imaging Capital Sensitivity) Determination 2011 (Cth)
Health Insurance (Diagnostic Imaging Capital Sensitivity) Determination 2011
as amended
made under subsection 3C(1) of the
Health Insurance Act 1973
Compilation start date: 1 November 2013
Includes amendments up to: Health Insurance (Diagnostic Imaging Capital Sensitivity) Amendment and Repeal Determination 2013
About this compilation
This compilation
This is a compilation of the Health Insurance (Diagnostic Imaging Capital Sensitivity) Determination 2011 as in force on 1 November 2013. It includes any commenced amendment affecting the legislation to that date.
This compilation was prepared on 3 December 2013.
The notes at the end of this compilation (the endnotes) include information about amending laws and the amendment history of each amended provision.
Uncommenced amendments
The effect of uncommenced amendments is not reflected in the text of the compiled law but the text of the amendments is included in the endnotes.
Application, saving and transitional provisions for provisions and amendments
If the operation of a provision or amendment is affected by an application, saving or transitional provision that is not included in this compilation, details are included in the endnotes.
Modifications
If a provision of the compiled law is affected by a modification that is in force, details are included in the endnotes.
Provisions ceasing to have effect
If a provision of the compiled law has expired or otherwise ceased to have effect in accordance with a provision of the law, details are included in the endnotes.
Contents
Contents
1. Name of Determination
2. Commencement
3. Interpretation
4. Treatment of certain diagnostic imaging services
5. Items in the diagnostic imaging services table
6. NK items
7. References in Regulations
8. Reconsideration of decisions
9. Delegation
SCHEDULE 1 – Specified health services
SCHEDULE 2 – References in regulations
Name of Determination
This Determination is the Health Insurance (Diagnostic Imaging Capital Sensitivity) Determination 2011.
Commencement
This Determination commences on 1 July 2011.
Interpretation
Definitions
(1) In this Determination, unless the contrary intention appears:
Act means the Health Insurance Act 1973.
ASGC means the Australian Standard Geographical Classification, July 2010, published by the Australian Bureau of Statistics.
DIST service means a service to which an item in the diagnostic imaging services table relates.
maximum extended life age has the meaning given in subsection (5).
new effective life age has the meaning given in subsection (4).
relevant proprietor, for diagnostic imaging equipment, means:
(a)if the diagnostic imaging equipment is ordinarily located at diagnostic imaging premises, the proprietor of the diagnostic imaging premises; or
(b)if the diagnostic imaging equipment is ordinarily located at a base for mobile diagnostic imaging equipment when not in use and is not ordinarily located at diagnostic imaging premises, the proprietor of the base for mobile diagnostic imaging equipment.
relevant service means a health service, as defined in subsection 3C(8) of the Act, that is specified in Schedule 1.
Rural, Remote and Metropolitan Areas Classification has the meaning given by the general medical services table.
Schedule means a Schedule to this Determination.
Note Unless the contrary intention appears, expressions used in this Determination have the same meanings as in the Act—see section 13 of the Legislative Instruments Act 2003.
References to legislation
(2) Unless the contrary intention appears, in this Determination a reference to a provision of the Act or regulations made under the Act or the National Health Act 1953 or regulations made under the National Health Act 1953 as applied, adopted or incorporated in relation to specifying a matter is a reference to those provisions as in force from time to time and any other reference to provisions of an Act or regulations is a reference to those provisions as in force from time to time.
Age of equipment
(3) The date from which the age of equipment is worked out for this Determination is:
(a)the date that the equipment was first installed in Australia; or
(b)if the equipment was imported as used equipment — the date of manufacture of the oldest component of the equipment.
(4) The new effective life age for diagnostic imaging equipment is the period set out in the following table for that type of diagnostic imaging equipment:
Modality New effective life age Ultrasound
diagnostic imaging equipment used to perform a service to which an item in Group I1 in Division 2.1 in Schedule 1 applies
10 years Mammography
diagnostic imaging equipment used to perform a service to which an item in Subgroup 10 of Group I3 in Division 2.3 in Schedule 1 applies
10 years Rest of diagnostic radiology
diagnostic imaging equipment used to perform a service to which an item in Subgroups 1 to 9, 11, 12, 14, 15 or 17 of Group I3 in Division 2.3 in Schedule 1 applies
15 years Nuclear medicine (excluding PET)
diagnostic imaging equipment used to perform a service to which an item in Group I4 in Division 2.4 in Schedule 1 applies
10 years MRI
diagnostic imaging equipment used to perform a service to which an item in Group I5 in Division 2.5 in Schedule 1 applies
10 years
(5) The maximum extended life age for diagnostic imaging equipment is the period set out in the following table for that type of diagnostic imaging equipment:
Modality Maximum extended life age Ultrasound
diagnostic imaging equipment used to perform a service to which an item in Group I1 in Division 2.1 in Schedule 1 applies
15 years Mammography
diagnostic imaging equipment used to perform a service to which an item in Subgroup 10 of Group I3 in Division 2.3 in Schedule 1 applies
15 years Rest of diagnostic radiology
diagnostic imaging equipment used to perform a service to which an item in Subgroups 1 to 9, 11, 12, 14, 15 or 17 of Group I3 in Division 2.3 in Schedule 1 applies
20 years Nuclear medicine (excluding PET)
diagnostic imaging equipment used to perform a service to which an item in Group I4 in Division 2.4 in Schedule 1 applies
15 years MRI
diagnostic imaging equipment used to perform a service to which an item in Group I5 in Division 2.5 in Schedule 1 applies
15 years
Upgrades
(6) For this Determination, diagnostic imaging equipment has been upgraded if:
(a)an additional reasonable investment has been made within the new effective life age for the diagnostic imaging equipment that improves the overall performance of the imaging system so that it is equivalent to new diagnostic imaging equipment supplied in Australia at the time of the improvement; or
(b)the diagnostic imaging equipment is currently accredited under The Royal Australian and New Zealand College of Radiologists' Mammography Quality Assurance Program.
Note Proprietors can obtain further information on what constitutes an upgrade from the Department's website:
Treatment of certain diagnostic imaging services
A relevant service shall in the circumstances specified in this Determination be treated for the purposes of the provisions of the Act and of regulations made under the Act and the provisions of the National Health Act 1953 and of regulations made under the National Health Act 1953 that make provision in respect of professional services or medical services as if:
(a)it was both a professional service and a medical service; and
(b)there was an item in the diagnostic imaging services table that:
(i)related to the relevant service; and
(ii)specified in respect of the relevant service a fee in relation to a State, being the fee specified in Schedule 1 in relation to the State specified.
Items in the diagnostic imaging services table
This Determination does not apply to a relevant service if a medicare benefit was paid in respect of a DIST service (other than item 63491, 63494, 63497, 64990 or 64991) rendered using the same diagnostic imaging procedure.
NK items
Application of NK items
(1) Despite clause 1.2.4 of Schedule 1 to the diagnostic imaging services table, subject to subsections (2) to (8), an item in Schedule 1 that includes the symbol (NK) at the end of the item applies where:
(a)the age of the diagnostic imaging equipment used to perform the service exceeds the new effective life age for the diagnostic imaging equipment and the diagnostic imaging equipment has not been upgraded; or
(b)the age of upgraded diagnostic imaging equipment used to perform the service exceeds the maximum extended life age for the diagnostic imaging equipment.
Exemption – outer regional, remote and very remote areas
(2) An item in Schedule 1 that includes the symbol (NK) at the end of the item does not apply where:
(a)the diagnostic imaging equipment used to perform the service is ordinarily located at diagnostic imaging premises; and
(b)the diagnostic imaging premises are located in any of the following Remoteness Areas as defined in the ASGC:
(i)Outer Regional Australia (Remoteness Area 2);
(ii)Remote Australia (Remoteness Area 3);
(iii)Very Remote Australia (Remoteness Area 4).
Note Proprietors can identify what Remoteness Area they fall under at the Department's DoctorConnect website: Proprietors should refer to the category names, rather than category numbers as the website uses different category numbers from those specified in this Determination.
(3) An item in Schedule 1 that includes the symbol (NK) at the end of the item does not apply where:
(a)the diagnostic imaging equipment used to perform the service is ordinarily located at a base for mobile diagnostic imaging equipment when not in use;
(b)the diagnostic imaging equipment used to perform the service is not ordinarily located at diagnostic imaging premises; and
(c)the base for mobile diagnostic imaging equipment is located in any of the following Remoteness Areas as defined in the ASGC:
(i)Outer Regional Australia (Remoteness Area 2);
(ii)Remote Australia (Remoteness Area 3);
(iii)Very Remote Australia (Remoteness Area 4).
Note Proprietors can identify what Remoteness Area they fall under at the Department's DoctorConnect website: Proprietors should refer to the category names, rather than category numbers as the website uses different category numbers from those specified in this Determination.
Exemption – inner regional areas
(4) An item in Schedule 1 that includes the symbol (NK) at the end of the item does not apply where:
(a)the Department has notified the relevant proprietor of the receipt of a valid application under subsection (6) in respect of the diagnostic imaging equipment used to perform the service and a decision has not been made by the Secretary under subsection (5); or
(b)the Secretary has granted an exemption in respect of the diagnostic imaging equipment used to perform the service under subsection (5); or
(c)the Secretary has notified the relevant proprietor that he or she has refused to grant an exemption under subsection (5) and either:
(i) if the proprietor has not yet applied for reconsideration under section 8, the period to apply for reconsideration has not yet expired; or
(ii) if the proprietor has applied for reconsideration under section 8, the Secretary has not yet notified the proprietor of his or her reconsideration decision.
(5) The Secretary may grant an exemption in writing in respect of diagnostic imaging equipment where the Secretary is satisfied that the diagnostic imaging equipment is operated on a rare and sporadic basis and provides crucial patient access to diagnostic imaging services.
(6) The Secretary must make a decision under subsection (5) within 28 days of the day on which the relevant proprietor was notified of the receipt of a valid application by the Department referred to in paragraph 4(a).
(7) A relevant proprietor may only apply for an exemption under
subsection (5) if:
(a)the age of the diagnostic imaging equipment exceeds the maximum extended life age for the diagnostic imaging equipment by less than three years; and
(b)either:
(i)all of the following apply:
(A)the diagnostic imaging equipment is ordinarily located at diagnostic imaging premises;
(B)the diagnostic imaging premises are located in Inner Regional Australia (Remoteness 1) as defined in the ASGC; and
(C)the diagnostic imaging premises are located in an area classified as RRMA 4 or 5 (small rural centres and other rural areas) under the Rural, Remote and Metropolitan Areas Classification; or
(ii)all of the following apply:
(A)the diagnostic imaging equipment is ordinarily located at a base for mobile diagnostic imaging equipment when not in use;
(B)the diagnostic imaging equipment is not ordinarily located at diagnostic imaging premises;
(C)the base for mobile diagnostic imaging equipment is located in Inner Regional Australia (Remoteness 1) as defined in the ASGC; and
(D)the base for mobile diagnostic imaging equipment is located in an area classified as RRMA 4 or 5 (small rural centres and other rural areas) under the Rural, Remote and Metropolitan Areas Classification.
Note Proprietors can identify what Remoteness Area they fall under at the Department's DoctorConnect website: Proprietors should refer to the category names, rather than category numbers as the website uses different category numbers from those specified in this Determination.
(8) An application under subsection (6) must be made in writing to the Department.
References in Regulations
(1) Each provision of the regulations or any instrument made under or given pursuant to the Act which refers to a Division, Subdivision, Group or Subgroup in the diagnostic imaging services table shall have effect as if the reference to the Division, Subdivision, Group or Subgroup also specified the items in the corresponding Division, Subdivision, Group or Subgroup in Schedule 1, or the relevant services to which those items are related by virtue of paragraph 4(b), as the case requires.
Note Paragraph 3C(1)(b) of the Act allows the Minister to determine that provisions of the regulations or instruments made under the Act which specify a professional service, medical service or item have effect as if they also specified a health service or item created by this Determination. Under subsection 7(1), a reference in regulations or an instrument to a Division, Subdivision, Group or Subgroup of the diagnostic imaging services table will be taken to include a reference to the items in the corresponding Division, Subdivision, Group or Subgroup in Schedule 1.
(2) For the avoidance of doubt, a reference in Schedule 1 to a Group or Subgroup has effect as if it also referred to the corresponding Group or Subgroup in the diagnostic imaging services table.
Note Subsection 7(2) is an interpretation provision which complements subsection 7(1).
(3) Each of the provisions of Schedule 1 to the diagnostic imaging services table in column 1 of the table in item 1 of Schedule 2 shall have effect as if the corresponding existing item reference in column 2 of the table in item 1 of Schedule 2 also specified the corresponding additional item reference in column 3 of the table in item 1 of Schedule 2, or the relevant service to which that item is related by virtue of paragraph 4(b), as the case requires.
(4) Each of the items in Schedule 1 to the diagnostic imaging services table in column 1 of the table in item 2 of Schedule 2
shall have effect as if the corresponding existing item reference in column 2 of the table in item 2 of Schedule 2 also specified the corresponding additional item reference in column 3 of the table in item 2 of Schedule 2, or the relevant service to which that item is related by virtue of paragraph 4(b), as the case requires.
(5) Each of the definitions in the Dictionary in the diagnostic imaging services table in column 1 of the table in item 3 of Schedule 2 shall have effect as if the corresponding existing item reference in column 2 of the table in item 3 of Schedule 2 also specified the corresponding additional item reference in column 3 of the table in item 3 of Schedule 2, or the relevant service to which that item is related by virtue of paragraph 4(b), as the case requires.
(6) Each of the provisions of the Health Insurance Regulations 1975 in column 1 of the table in item 4 of Schedule 2 shall have effect as if the corresponding existing item reference in column 2 of the table in item 4 of Schedule 2 also specified the corresponding additional item reference in column 3 of the table in item 4 of Schedule 2, or the relevant service to which that item is related by virtue of paragraph 4(b), as the case requires.
(7) Each of the provisions of Schedule 1 to the general medical services table in column 1 of the table in item 5 of Schedule 2 shall have effect as if the corresponding existing item reference in column 2 of the table in item 5 of Schedule 2 also specified the corresponding additional item reference in column 3 of the table item 5 of Schedule 2, or the relevant service to which that item is related by virtue of paragraph 4(b), as the case requires.
Note Paragraph 3C(1)(b) of the Act allows the Minister to determine that provisions of regulations which specify an item have effect as if they also specified an item created by this Determination. Subsections 7(3) to (7) and the tables in Schedule 2 provide that provisions of the diagnostic imaging services table, Health Insurance Regulations 1975 and general medical services table which specify items have effect as if they also specified the relevant NK items created by Schedule 1.
Reconsideration of decisions
(1) If the Secretary refuses to grant an exemption under subsection 6(5) the proprietor who applied for the exemption may apply to the Secretary for reconsideration of the decision within 28 days after the date of issue of the notice of the decision to the proprietor (or, if the Secretary is satisfied that special circumstances exist, within such further period (if any) as the Secretary allows).
(2) In the application for reconsideration, the proprietor:
(a)must identify the decision for reconsideration and set out the reasons for the application; and
(b)may provide new material for the Secretary to consider.
(3) The Secretary must, within 28 days after receipt of an application, reconsider the decision and:
(a)affirm the decision;
(b)vary the decision; or
(c) set aside the decision and make a decision in substitution for it.
(4) The Secretary must notify the proprietor of a reconsideration decision under subsection (3).
Delegation
(1) The Secretary may, either generally or as otherwise provided by the instrument of delegation, by writing signed by him or her, delegate to an officer of the Department any of his or her powers under this Determination, other than this power of delegation.
(2) A power so delegated, when exercised by the delegate, shall, for the purposes of this Determination, be deemed to have been exercised by the Secretary.
(3) A delegation under this section does not prevent the exercise of a power by the Secretary.
SCHEDULE 1 – Specified health services
Division 2.1 Group I1 — Ultrasound
Subdivision A Not used
Subdivision B Subgroup 1 to 4 of Group I1
| Group I1 — Ultrasound | ||
| Item | Health service | Fee ($) (for each State) |
| Subgroup 1 — General | ||
| 55005 | Head, ultrasound scan of, if: (a) the patient is referred by a medical practitioner for ultrasonic examination not being a service associated with a service to which an item in Subgroup 2 or 3 applies; and (b) the referring medical practitioner is not a member of a group of practitioners of which the providing practitioner is a member (R) (NK) | 54.55 |
| 55007 | Head, ultrasound scan of, if the patient is not referred by a medical practitioner, not being a service associated with a service to which an item in Subgroup 2 or 3 applies (NR) (NK) | 18.95 |
| 55008 | Orbital contents, ultrasound scan of, if: (a) the patient is referred by a medical practitioner for ultrasonic examination not being a service associated with a service to which an item in Subgroup 2 or 3 applies; and (b) the referring medical practitioner is not a member of a group of practitioners of which the providing practitioner is a member (R) (NK) | 54.55 |
| 55010 | Orbital contents, ultrasound scan of, if the patient is not referred by a medical practitioner, not being a service associated with a service to which an item in Subgroup 2 or 3 applies (NR) (NK) | 18.95 |
| 55011 | Neck, 1 or more structures of, ultrasound scan of, if: (a) the patient is referred by a medical practitioner for ultrasonic examination not being a service associated with a service to which an item in Subgroup 2 or 3 applies; and (b) the referring medical practitioner is not a member of a group of practitioners of which the providing practitioner is a member (R) (NK) | 54.55 |
| 55013 | Neck, 1 or more structures of, ultrasound scan of, if the patient is not referred by a medical practitioner, not being a service associated with a service to which an item in Subgroup 2 or 3 applies (NR) (NK) | 18.95 |
| 55014 | Abdomen, ultrasound scan of (including scan of urinary tract when performed), if: (a) the patient is referred by a medical practitioner or participating nurse practitioner for ultrasonic examination; and | 55.65 |
| (b) if the patient is referred by a medical practitioner — the referring medical practitioner is not a member of a group of practitioners of which the providing practitioner is a member; and (c) if the patient is referred by a participating nurse practitioner — the referring nurse practitioner does not have a business or financial arrangement with the providing practitioner; and (d) the service is not a service associated with a service to which an item in Subgroup 2 or 3 applies; and | ||
| (e) the service is not solely a transrectal ultrasonic examination of the prostate gland, bladder base and urethra, or any of those organs; and | ||
| (f) within 24 hours of the service, a service described in item 55017, 55020, 55038, 55044, 55731 or 55732 is not performed on the same patient by the providing practitioner (R) (NK) | ||
| 55016 | Abdomen, ultrasound scan of (including scan of urinary tract when performed), if: (a) the patient is not referred by a medical practitioner or participating nurse practitioner; and | 18.95 |
| (b) the service is not a service associated with a service to which an item in Subgroup 2 or 3 applies; and (c) the service is not solely a transrectal ultrasonic examination of the prostate gland, bladder base and urethra, or any of those organs (NR) (NK) | ||
| 55017 | Urinary tract, ultrasound scan of, if: (a) the patient is referred by a medical practitioner for ultrasonic examination; and (b) the referring medical practitioner is not a member of a group of practitioners of which the providing practitioner is a member; and | 54.55 |
| (c) the service is not a service associated with a service to which an item in Subgroup 2 or 3 applies; and | ||
| (d) the service is not solely a transrectal ultrasonic examination of the prostate gland, bladder base and urethra, or any of those organs; and (e) within 24 hours of the service, a service described in item 55014, 55020, 55036, 55044, 55731 or 55732 is not performed on the same patient by the providing practitioner (R) (NK) | ||
| 55019 | Urinary tract, ultrasound scan of, if: (a) the patient is not referred by a medical practitioner; and (b) the service is not a service associated with a service to which an item in Subgroup 2 or 3 applies; and (c) the service is not solely a transrectal ultrasonic examination of the prostate gland, bladder base and urethra, or any of those organs (NR) (NK) | 18.95 |
| 55020 | Pelvis, male, ultrasound scan of, by any or all approaches, if: (a) the patient is referred by a medical practitioner for ultrasonic examination; and (b) the referring medical practitioner is not a member of a group of practitioners of which the providing practitioner is a member; and (c) the service is not a service associated with a service to which an item in Subgroup 2 or 3 applies; and | 55.65 |
| (d) the service is not solely a transrectal ultrasonic examination of the prostate gland, bladder base and urethra, or any of those organs; and (e) within 24 hours of the service, a service described in item 55014, 55017, 55036 or 55038 is not performed on the same patient by the providing practitioner (R) (NK) | ||
| 55022 | Pelvis, male, ultrasound scan of, by any or all approaches, if: (a) the patient is not referred by a medical practitioner; and (b) the service is not a service associated with a service to which an item in Subgroup 2 or 3 applies; and (c) the service is not solely a transrectal ultrasonic examination of the prostate gland, bladder base and urethra, or any of those organs (NR) (NK) | 18.95 |
| 55023 | Scrotum, ultrasound scan of, if: (a) the patient is referred by a medical practitioner for ultrasonic examination not being a service associated with a service to which an item in Subgroup 2 or 3 applies; and (b) the referring medical practitioner is not a member of a group of practitioners of which the providing practitioner is a member (R) (NK) | 54.75 |
| 55025 | Scrotum, ultrasound scan of, if the patient is not referred by a medical practitioner, not being a service associated with a service to which an item in Subgroup 2 or 3 applies (NR) (NK) | 18.95 |
| 55026 | Ultrasonic cross‑sectional echography, in conjunction with a surgical procedure using interventional techniques, not being a service associated with a service to which any other item in this group applies (R) (NK) | 54.55 |
| 55059 | Breast, one, ultrasound scan of, if: (a) the patient is referred by a medical practitioner or participating nurse practitioner; and (b) the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and (c) if the patient is referred by a medical practitioner — the referring medical practitioner is not a member of a group of practitioners of which the providing practitioner is a member; and (d) if the patient is referred by a participating nurse practitioner — the referring nurse practitioner does not have a business or financial arrangement with the providing practitioner (R) (NK) | 49.15 |
| 55060 | Breast, one, ultrasound scan of, if: (a) the patient is not referred by a medical practitioner or participating nurse practitioner; and (b) the service is not associated with a service to which an item in Subgroup 2 or 3 applies (NR) (NK) | 17.05 |
| 55061 | Breasts, both, ultrasound scan of, if: (a) the patient is referred by a medical practitioner or participating nurse practitioner; and (b) the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and (c) if the patient is referred by a medical practitioner — the referring medical practitioner is not a member of a group of practitioners of which the providing practitioner is a member; and (d) if the patient is referred by a participating nurse practitioner — the referring nurse practitioner does not have a business or financial arrangement with the providing practitioner (R) (NK) | 54.55 |
| 55062 | Breasts, both, ultrasound scan of, if: (a) the patient is not referred by a medical practitioner or participating nurse practitioner; and (b) the service is not associated with a service to which an item in Subgroup 2 or 3 applies (NR) (NK) | 18.95 |
| 55063 | Urinary bladder, ultrasound scan of, by any or all approaches, if: (a) the patient is referred by a medical practitioner for ultrasonic examination; and (b) the referring medical practitioner is not a member of a group of practitioners of which the providing practitioner is a member; and | 49.15 |
| (c) the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and (d) within 24 hours of the service, a service described in item 11917, 55014, 55017, 55020, 55036, 55038, 55044, 55600, 55601, 55603, 55604, 55731 or 55732 is not performed on the same patient by the providing practitioner (R) (NK) | ||
| 55064 | Urinary bladder, ultrasound scan of, by any or all approaches, if: (a) the patient is not referred by a medical practitioner; and (b) the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and | 17.05 |
| (c) within 24 hours of the service, a service described in item 11917, 55016, 55019, 55022, 55037, 55039, 55045, 55600, 55601, 55603, 55604, 55733 or 55734 is not performed on the same patient by the providing practitioner (NR) (NK) | ||
| Subgroup 2 — Cardiac | ||
| 55119 | M‑mode and two‑dimensional real time echocardiographic examination of the heart from at least 2 acoustic windows for the investigation of symptoms or signs of cardiac failure, or suspected or known ventricular hypertrophy or dysfunction, or chest pain: | 115.35 |
| (a) with: (i) measurement of blood flow velocities across the cardiac valves using pulsed wave and continuous wave Doppler techniques; and (ii) real time colour flow mapping from at least 2 acoustic windows; and (iii) recordings on video tape or digital media; and (b) not being a service associated with a service to which an item in Subgroup 1 (except items 55026 and 55054) or 3, or another item in this Subgroup (except items 55118, 55125, 55130 and 55131), applies (R) (NK) | ||
| 55120 | M‑mode and two‑dimensional real time echocardiographic examination of the heart from at least 2 acoustic windows for the investigation of suspected or known acquired valvular, aortic, pericardial, thrombotic or embolic disease or heart tumour: (a) with: (i) measurement of blood flow velocities across the cardiac valves using pulsed wave and continuous wave Doppler techniques; and (ii) real time colour flow mapping from at least 2 acoustic windows; and (iii) recordings on video tape or digital media; and | 115.35 |
| (b) not being a service associated with a service to which an item in Subgroup 1 (except items 55026 and 55054) or 3, or another item in this Subgroup (except items 55118, 55125, 55130 and 55131), applies (R) (NK) | ||
| 55121 | M‑mode and two‑dimensional real time echocardiographic examination of the heart from at least 2 acoustic windows for the investigation of symptoms or signs of congenital heart disease: (a) with: (i) measurement of blood flow velocities across the cardiac valves using pulsed wave and continuous wave Doppler techniques; and | 115.35 |
| (ii) real time colour flow mapping from at least 2 acoustic windows; and (iii) recordings on video tape or digital media; and (b) not being a service associated with a service to which an item in Subgroup 1 (except items 55026 and 55054) or 3, or another item in this Subgroup (except items 55118, 55125, 55130 and 55131), applies (R) (NK) | ||
| 55122 | Exercise stress echocardiography performed in conjunction with item 11712: (a) with: (i) two‑dimensional recordings before exercise (baseline) from at least 3 acoustic windows; and | 130.85 |
| (ii) matching recordings from the same windows at, or immediately after, peak exercise; and (iii) recordings on digital media with equipment permitting display of baseline and matching peak images on the same screen; and (b) not being a service associated with a service to which an item in Subgroup 1 (except items 55026 and 55054) or 3, or another item in this Subgroup (except items 55118, 55125, 55130 and 55131), applies (R) (NK) | ||
| 55123 | Pharmacological stress echocardiography performed in conjunction with item 11712: (a) with: (i) two‑dimensional recordings before drug infusion (baseline) from at least 3 acoustic windows; and (ii) matching recordings from the same windows at least twice during drug infusion, including a recording at the peak drug dose; and | 130.85 |
| (iii) recordings on digital media with equipment permitting display of baseline and matching peak images on the same screen; and (b) not being a service associated with a service to which an item in Subgroup 1 (except items 55026 and 55054) or 3, or another item in this Subgroup (except items 55118, 55125, 55130 and 55131), applies (R) (NK) | ||
| 55125 | Heart, two‑dimensional real time transoesophageal examination of, from at least 2 levels, and in more than 1 plane at each level: (a) with: (i) real time colour flow mapping and, if indicated, pulsed wave Doppler examination; and (ii) recordings on video tape or digital medium; and | 137.75 |
| (b) not being an intra‑operative service or a service associated with a service to which an item in Subgroup 1 (except items 55026 and 55054) or 3 applies (R) (NK) (Anaes.) | ||
| 55131 | Intra‑operative 2 dimensional real time transoesophageal echocardiography incorporating Doppler techniques with colour flow mapping and recording onto video tape or digital medium, performed during cardiac surgery incorporating sequential assessment of cardiac function before and after the surgical procedure, not being a service associated with a service to which item 55135 or 55136 applies (R) (NK) (Anaes.) | 85.00 |
| 55136 | Intra‑operative 2 dimensional real time transoesophageal echocardiography incorporating Doppler techniques with colour flow mapping and recording onto video tape or digital medium, performed during cardiac valve surgery (replacement or repair) incorporating sequential assessment of cardiac function and valve competence before and after the surgical procedure, not being a service associated with a service to which item 55130 or 55131 applies (R) (NK) (Anaes.) | 176.80 |
| Subgroup 3 — Vascular | ||
| 55220 | Duplex scanning, unilateral, involving B mode ultrasound imaging and integrated Doppler flow measurements by spectral analysis of arteries or bypass grafts in the lower limb or of arteries and bypass grafts in the lower limb, below the inguinal ligament, not being a service associated with a service to which an item in Subgroup 1 (with the exception of items 55026 and 55054) or 4 applies (R) (NK) | 84.75 |
| 55221 | Duplex scanning, unilateral, involving B mode ultrasound imaging and integrated Doppler flow measurements by spectral analysis of veins in the lower limb, below the inguinal ligament, for acute venous thrombosis, not being a service associated with a service to which an item in Subgroup 1 (with the exception of items 55026 and 55054) or 4 applies (R) (NK) | 84.75 |
| 55222 | Duplex scanning, unilateral, involving B mode ultrasound imaging and integrated Doppler flow measurements by spectral analysis of veins in the lower limb, below the inguinal ligament, for chronic venous disease, not being a service associated with a service to which an item in Subgroup 1 (with the exception of items 55026 and 55054) or 4 applies (R) (NK) | 84.75 |
| 55223 | Duplex scanning, unilateral, involving B mode ultrasound imaging and integrated Doppler flow measurements by spectral analysis of arteries or bypass grafts in the upper limb or of arteries and bypass grafts in the upper limb, not being a service associated with a service to which an item in Subgroup 1 (with the exception of items 55026 and 55054) or 4 applies (R) (NK) | 84.75 |
| 55224 | Duplex scanning, unilateral, involving B mode ultrasound imaging and integrated Doppler flow measurements by spectral analysis of veins in the upper limb, not being a service associated with a service to which an item in Subgroup 1 (with the exception of items 55026 and 55054) or 4 applies (R) (NK) | 84.75 |
| 55226 | Duplex scanning, bilateral, involving B mode ultrasound imaging and integrated Doppler flow measurements by spectral analysis of extra‑cranial bilateral carotid and vertebral vessels, with or without subclavian and innominate vessels, with or without oculoplethysmography or peri‑orbital Doppler examination, not being a service associated with a service to which an item in Subgroup 1 (with the exception of items 55026 and 55054) or 4 applies (R) (NK) | 84.75 |
| 55227 | Duplex scanning involving B mode ultrasound imaging and integrated Doppler flow measurements by spectral analysis of intra‑abdominal, aorta and iliac arteries or inferior vena cava and iliac veins or of intra‑abdominal, aorta and iliac arteries and inferior vena cava and iliac veins, excluding pregnancy related studies, not being a service associated with a service to which an item in Subgroup 1 (with the exception of items 55026 and 55054) or 4 applies (R) (NK) | 84.75 |
| 55228 | Duplex scanning involving B mode ultrasound imaging and integrated Doppler flow measurements by spectral analysis of renal or visceral vessels or of renal and visceral vessels, including aorta, inferior vena cava and iliac vessels as required excluding pregnancy related studies, not being a service associated with a service to which an item in Subgroup 1 (with the exception of items 55026 and 55054) or 4 applies (R) (NK) | 84.75 |
| 55229 | Duplex scanning involving B mode ultrasound imaging and integrated Doppler flow measurements by spectral analysis of intra‑cranial vessels, not being a service associated with a service to which an item in Subgroup 1 (with the exception of items 55026 and 55054) or 4 applies (R) (NK) | 84.75 |
| 55230 | Duplex scanning involving B mode ultrasound imaging and integrated Doppler flow measurements: (a) by spectral analysis of cavernosal artery of the penis following intracavernosal administration of a vasoactive agent; and (b) performed during the period of pharmacological activity of the injected agent, to confirm a diagnosis of vascular aetiology for impotence; and | 84.75 |
| (c) if a specialist in diagnostic radiology, nuclear medicine, urology, general surgery (sub‑specialising in vascular surgery) or a consultant physician in nuclear medicine attends the patient in person at the practice location where the service is performed, immediately before or for a period during the performance of the service; and | ||
| (d) if the specialist or consultant physician interprets the results and prepares a report, not being a service associated with a service to which an item in Subgroup 1 (with the exception of items 55026 and 55054) or 4 applies (R) (NK) | ||
| 55232 | Duplex scanning involving B mode ultrasound imaging and integrated Doppler flow measurements: (a) by spectral analysis of cavernosal tissue of the penis to confirm a diagnosis; and (b) if indicated, assess the progress and management of: (i) priapism; or (ii) fibrosis of any type; or | 84.75 |
| (iii) fracture of the tunica; or (iv) arteriovenous malformations; and | ||
| (c) if a specialist in diagnostic radiology, nuclear medicine, urology, general surgery (sub‑specialising in vascular surgery) or a consultant physician in nuclear medicine attends the patient in person at the practice location where the service is performed, immediately before or for a period during the performance of the service; and | ||
| (d) if the specialist or consultant physician interprets the results and prepares a report, not being a service associated with a service to which an item in Subgroup 1 (with the exception of items 55026 and 55054) or 4 applies (R) (NK) | ||
| 55233 | Duplex scanning, unilateral, involving B mode ultrasound imaging and integrated Doppler flow measurements by spectral analysis of surgically created arteriovenous fistula or surgically created arteriovenous access grafts in the upper or lower limbs, not being a service associated with a service to which an item in Subgroup 1 (with the exception of items 55026 and 55054) or 4 applies (R) (NK) | 84.75 |
| 55235 | Duplex scanning involving B mode ultrasound imaging and integrated Doppler flow measurements by spectral analysis of arteries or veins, or both, including any associated skin marking, for mapping of bypass conduit before vascular surgery, not being a service associated with a service to which an item in Subgroup 1 (with the exception of items 55026 and 55054), 3 or 4 applies (R) (NK) | 84.75 |
| 55236 | Duplex scanning, unilateral, involving B mode ultrasound imaging and integrated Doppler flow spectral analysis and marking of veins in the lower limbs below the inguinal ligament before varicose vein surgery, including any associated skin marking, not being a service associated with a service to which an item in Subgroup 1 (with the exception of items 55026 and 55054), 3 or 4 applies (R) (NK) | 55.55 |
| Subgroup 4 — Urological | ||
| 55601 | Prostate, bladder base and urethra, transrectal ultrasound scan of, if performed: (a) personally by a medical practitioner (not being the medical practitioner who assessed the patient as specified in paragraph (c)) using a transducer probe that: (i) has a nominal frequency of 7 to 7.5 MHz or a nominal frequency range that includes frequencies of 7 to 7.5 MHz; and (ii) can obtain both axial and sagittal scans in 2 planes at right angles; and (b) following a digital rectal examination of the prostate by that medical practitioner; and | 54.55 |
| (c) on a patient who has been assessed by a specialist in urology, radiation oncology or medical oncology, a consultant physician in medical oncology, or a participating nurse practitioner, who has: (i) examined the patient in the 60 days before the scan; and (ii) recommended the scan for the management of the patient’s current prostatic disease (R) (NK) | ||
| 55604 | Prostate, bladder base and urethra, transrectal ultrasound scan of, if performed: (a) personally by a medical practitioner who made the assessment mentioned in paragraph (c) using a transducer probe that: (i) has a nominal frequency of 7 to 7.5 MHz or a nominal frequency range that includes frequencies of 7 to 7.5 MHz; and (ii) can obtain both axial and sagittal scans in 2 planes at right angles; and (b) following a digital rectal examination of the prostate by that medical practitioner; and | 54.55 |
| (c) on a patient who has been assessed by a specialist in urology, radiation oncology or medical oncology or a consultant physician in medical oncology who has: (i) examined the patient in the 60 days before the scan; and (ii) recommended the scan for the management of the patient’s current prostatic disease (R) (NK) | ||
Subdivision C Subgroup 5 of Group I1 — Obstetric and gynaecological
| Group I1 — Ultrasound | ||
| Item | Health service | Fee ($) (for each State) |
| Subgroup 5 — Obstetric and gynaecological | ||
| 55701 | Pelvis or abdomen, pregnancy‑related or pregnancy complication, ultrasound scan of, by any or all approaches, if: (a) the patient is referred by a medical practitioner or participating midwife; and (b) the dating of the pregnancy (as confirmed by ultrasound) is less than 12 weeks of gestation; and (c) the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and (d) if the patient is referred by a medical practitioner — the referring medical practitioner is not a member of a group of practitioners of which the providing practitioner is a member; and (e) if the patient is referred by a participating midwife — the referring midwife does not have a business or financial arrangement with the providing practitioner; and | 30.00 |
| (f) 1 or more of the following conditions are present: (i) hyperemesis gravidarum; (ii) diabetes mellitus; (iii) hypertension; (iv) toxaemia of pregnancy; (v) liver or renal disease; (vi) autoimmune disease; (vii) cardiac disease; (viii) alloimmunisation; (ix) maternal infection; (x) inflammatory bowel disease; (xi) bowel stoma; | ||
| (xii) abdominal wall scarring; (xiii) previous spinal or pelvic trauma or disease; (xiv) drug dependency; (xv) thrombophilia; (xvi) significant maternal obesity; (xvii) advanced maternal age; (xviii) abdominal pain or mass; (xix) uncertain dates; (xx) high risk pregnancy; (xxi) previous post dates delivery; (xxii) previous caesarean section; (xxiii) poor obstetric history; (xxiv) suspicion of ectopic pregnancy; (xxv) risk of miscarriage; (xxvi) diminished symptoms of pregnancy; (xxvii) suspected or known cervical incompetence; (xxviii) suspected or known uterine abnormality; (xxix) pregnancy after assisted reproduction; (xxx) risk of fetal abnormality (R) (NK) | ||
| 55702 | Pelvis or abdomen, pregnancy‑related or pregnancy complication, ultrasound scan of, by any or all approaches, if: (a) the patient is not referred by a medical practitioner or participating midwife; and (b) the dating of the pregnancy (as confirmed by ultrasound) is less than 12 weeks of gestation; and (c) the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and (d) 1 or more of the following conditions are present: (i) hyperemesis gravidarum; (ii) diabetes mellitus; (iii) hypertension; (iv) toxaemia of pregnancy; (v) liver or renal disease; (vi) autoimmune disease; | 17.50 |
| (vii) cardiac disease; (viii) alloimmunisation; (ix) maternal infection; | ||
| (x) inflammatory bowel disease; (xi) bowel stoma; | ||
| (xii) abdominal wall scarring; (xiii) previous spinal or pelvic trauma or disease; (xiv) drug dependency; | ||
| (xv) thrombophilia; (xvi) significant maternal obesity; (xvii) advanced maternal age; (xviii) abdominal pain or mass; | ||
| (xix) uncertain dates; (xx) high risk pregnancy; (xxi) previous post dates delivery; (xxii) previous caesarean section; (xxiii) poor obstetric history; | ||
| (xxiv) suspicion of ectopic pregnancy; (xxv) risk of miscarriage; (xxvi) diminished symptoms of pregnancy; (xxvii) suspected or known cervical incompetence; (xxviii) suspected or known uterine abnormality; (xxix) pregnancy after assisted reproduction; (xxx) risk of fetal abnormality (NR) (NK) | ||
| 55710 | Pelvis or abdomen, pregnancy‑related or pregnancy complication, fetal development and anatomy, ultrasound scan of, by any or all approaches, if: (a) the patient is referred by a medical practitioner or participating midwife; and (b) the dating of the pregnancy (as confirmed by ultrasound) is 12 to 16 weeks of gestation; and (c) the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and | 35.00 |
| (d) if the patient is referred by a medical practitioner — the referring medical practitioner is not a member of a group of practitioners of which the providing practitioner is a member; and (e) if the patient is referred by a participating midwife — the referring midwife does not have a business or financial arrangement with the providing practitioner; and | ||
| (f) 1 or more of the following conditions are present: (i) hyperemesis gravidarum; (ii) diabetes mellitus; (iii) hypertension; (iv) toxaemia of pregnancy; (v) liver or renal disease; (vi) autoimmune disease; (vii) cardiac disease; (viii) alloimmunisation; (ix) maternal infection; (x) inflammatory bowel disease; (xi) bowel stoma; (xii) abdominal wall scarring; (xiii) previous spinal or pelvic trauma or disease; (xiv) drug dependency; (xv) thrombophilia; (xvi) significant maternal obesity; | ||
| (xvii) advanced maternal age; (xviii) abdominal pain or mass; (xix) uncertain dates; (xx) high risk pregnancy; (xxi) previous post dates delivery; (xxii) previous caesarean section; (xxiii) poor obstetric history; | ||
| (xxiv) suspicion of ectopic pregnancy; (xxv) risk of miscarriage; (xxvi) diminished symptoms of pregnancy; (xxvii) suspected or known cervical incompetence; (xxviii) suspected or known uterine abnormality; (xxix) pregnancy after assisted reproduction; (xxx) risk of fetal abnormality (R) (NK) | ||
| 55711 | Pelvis or abdomen, pregnancy‑related or pregnancy complication, fetal development and anatomy, ultrasound scan of, by any or all approaches, if: (a) the patient is not referred by a medical practitioner or participating midwife; and (b) the dating of the pregnancy (as confirmed by ultrasound) is 12 to 16 weeks of gestation; and (c) the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and | 17.50 |
| (d) 1 or more of the following conditions are present: (i) hyperemesis gravidarum; (ii) diabetes mellitus; (iii) hypertension; (iv) toxaemia of pregnancy; (v) liver or renal disease; (vi) autoimmune disease; | ||
| (vii) cardiac disease; (viii) alloimmunisation; (ix) maternal infection; (x) inflammatory bowel disease; (xi) bowel stoma; (xii) abdominal wall scarring; (xiii) previous spinal or pelvic trauma or disease; (xiv) drug dependency; (xv) thrombophilia; (xvi) significant maternal obesity; (xvii) advanced maternal age; (xviii) abdominal pain or mass; (xix) uncertain dates; (xx) high risk pregnancy; | ||
| (xxi) previous post dates delivery; (xxii) previous caesarean section; (xxiii) poor obstetric history; (xxiv) suspicion of ectopic pregnancy; (xxv) risk of miscarriage; | ||
| (xxvi) diminished symptoms of pregnancy; (xxvii) suspected or known cervical incompetence; (xxviii) suspected or known uterine abnormality; (xxix) pregnancy after assisted reproduction; (xxx) risk of fetal abnormality (NR) (NK) | ||
| 55713 | Pelvis or abdomen, pregnancy‑related or pregnancy complication, fetal development and anatomy, ultrasound scan of, by any or all approaches, with measurement of all parameters for dating purposes, if: (a) the patient is referred by a medical practitioner or participating midwife; and (b) the dating for the pregnancy (as confirmed by ultrasound) is 17 to 22 weeks of gestation; and (c) the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and | 50.00 |
| (d) if the patient is referred by a medical practitioner — the referring medical practitioner is not a member of a group of practitioners of which the providing practitioner is a member; and (e) if the patient is referred by a participating midwife — the referring midwife does not have a business or financial arrangement with the providing practitioner; and (f) the service is not performed in the same pregnancy as item 55709 or 55717 (R) (NK) | ||
| 55714 | Pelvis or abdomen, pregnancy‑related or pregnancy complication, fetal development and anatomy, ultrasound scan of, by any or all approaches, if: (a) the patient is referred by a medical practitioner or participating midwife; and (b) the pregnancy (as confirmed by ultrasound) is dated by a fetal crown rump length of 45 to 84 mm; and | 35.00 |
| (c) the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and (d) if the patient is referred by a medical practitioner — the referring medical practitioner is not a member of a group of practitioners of which the providing practitioner is a member; and (e) if the patient is referred by a participating midwife — the referring midwife does not have a business or financial arrangement with the providing practitioner; and (f) at least 1 condition mentioned in paragraph (f) of item 55704 or 55710 is present; and | ||
| (g) nuchal translucency measurement is performed to assess the risk of fetal abnormality; and | ||
| (h) the service is not performed with item 55700, 55701, 55702, 55703, 55704, 55705, 55710 or 55711 on the same patient within 24 hours (R) (NK) | ||
| 55716 | Pelvis or abdomen, pregnancy‑related or pregnancy complication, fetal development and anatomy, ultrasound scan of, by any or all approaches, if: (a) the patient is not referred by a medical practitioner or participating midwife; and (b) the pregnancy (as confirmed by ultrasound) is dated by a crown rump length of 45 to 84 mm; and (c) the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and (d) at least 1 condition mentioned in paragraph (f) of item 55704 or 55710 is present; and (e) nuchal translucency measurement is performed to assess the risk of fetal abnormality; and (f) the service is not performed with item 55700, 55701, 55702, 55703, 55704, 55705, 55710 or 55711on the same patient within 24 hours (NR) (NK) | 17.50 |
| 55717 | Pelvis or abdomen, pregnancy‑related or pregnancy complication, fetal development and anatomy, ultrasound scan of, by any or all approaches, with measurement of all parameters for dating purposes, if: (a) the patient is not referred by a medical practitioner; and (b) the dating of the pregnancy (as confirmed by ultrasound) is 17 to 22 weeks of gestation; and | 19.00 |
| (c) the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and (d) the service is not performed in the same pregnancy as item 55706 or 55713 (NR) (NK) | ||
| 55719 | Pelvis or abdomen, pregnancy‑related or pregnancy complication, fetal development and anatomy, ultrasound scan of, by any or all approaches, with measurement of all parameters for dating purposes, if: (a) the patient is referred by a medical practitioner who: (i) is a Member or a Fellow of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists; or (ii) has a Diploma of Obstetrics; or | 57.50 |
| (iii) has a qualification recognised by the Royal Australian and New Zealand College of Obstetricians and Gynaecologists as being equivalent to a Diploma of Obstetrics; or (iv) has obstetric privileges at a non‑metropolitan hospital; and (b) the dating of the pregnancy (as confirmed by ultrasound) is 17 to 22 weeks of gestation; and | ||
| (c) the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and | ||
| (d) the referring practitioner is not a member of a group of practitioners of which the providing practitioner is a member; and | ||
| (e) further examination is clinically indicated after performance, in the same pregnancy, of a scan mentioned in item 55706, 55709, 55713 or 55717 (R) (NK) | ||
| 55720 | Pelvis or abdomen, pregnancy‑related or pregnancy complication, fetal development and anatomy, ultrasound scan of, by any or all approaches, with measurement of all parameters for dating purposes, performed by or on behalf of a medical practitioner who is a Member or a Fellow of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists, if: | 20.00 |
| (a) the patient is not referred by a medical practitioner; and | ||
| (b) the dating of the pregnancy (as confirmed by ultrasound) is 17 to 22 weeks of gestation; and (c) the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and | ||
| (d) further examination is clinically indicated after performance, in the same pregnancy, of a scan mentioned in item 55706, 55709, 55713 or 55717 (NR) (NK) | ||
| 55722 | Pelvis or abdomen, pregnancy‑related or pregnancy complication, fetal development and anatomy, ultrasound scan of, by any or all approaches, if: (a) the patient is referred by a medical practitioner or participating midwife; and (b) the dating of the pregnancy (as confirmed by ultrasound) is after 22 weeks of gestation; and (c) the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and | 50.00 |
| (d) if the patient is referred by a medical practitioner — the referring medical practitioner is not a member of a group of practitioners of which the providing practitioner is a member; and (e) if the patient is referred by a participating midwife — the referring midwife does not have a business or financial arrangement with the providing practitioner; and (f) the service is not performed in the same pregnancy as item 55723 or 55726; and (g) 1 or more of the following conditions are present: (i) known or suspected fetal abnormality or fetal cardiac arrhythmia; | ||
| (ii) fetal anatomy (late booking or incomplete mid‑trimester scan); (iii) malpresentation; (iv) cervical assessment; (v) clinical suspicion of amniotic fluid abnormality; (vi) clinical suspicion of placental or umbilical cord abnormality; (vii) previous complicated delivery; | ||
| (viii) uterine scar assessment; (ix) uterine fibroid; | ||
| (x) previous fetal death in utero or neonatal death; (xi) antepartum haemorrhage; (xii) clinical suspicion of intrauterine growth retardation; (xiii) clinical suspicion of macrosomia; | ||
| (xiv) reduced fetal movements; (xv) suspected fetal death; (xvi) abnormal cardiotocography; (xvii) prolonged pregnancy; (xviii) premature labour; (xix) fetal infection; (xx) pregnancy after assisted reproduction; (xxi) trauma; (xxii) diabetes mellitus; (xxiii) hypertension; (xxiv) toxaemia of pregnancy; (xxv) liver or renal disease; | ||
| (xxvi) autoimmune disease; (xxvii) cardiac disease; (xxviii) alloimmunisation; (xxix) maternal infection; (xxx) inflammatory bowel disease; | ||
| (xxxi) bowel stoma; (xxxii) abdominal wall scarring; (xxxiii) previous spinal or pelvic trauma or disease; (xxxiv) drug dependency; | ||
| (xxxv) thrombophilia; (xxxvi) gross maternal obesity; (xxxvii) advanced maternal age; | ||
| (xxxviii) abdominal pain or mass (R) (NK) (Item is subject to subclause 2.1.5(2) of the diagnostic imaging services table) | ||
| 55724 | Pelvis or abdomen, pregnancy‑related or pregnancy complication, fetal development and anatomy, ultrasound scan of, by any or all approaches, if: (a) the patient is referred by a medical practitioner who: (i) is a Member or a Fellow of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists; or (ii) has a Diploma of Obstetrics; or (iii) has a qualification recognised by the Royal Australian and New Zealand College of Obstetricians and Gynaecologists as being equivalent to a Diploma of Obstetrics; or | 57.50 |
| (iv) has obstetric privileges at a non‑metropolitan hospital; and | ||
| (b) the dating of the pregnancy (as confirmed by ultrasound) is after 22 weeks of gestation; and (c) the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and | ||
| (d) the referring practitioner is not a member of a group of practitioners of which the providing practitioner is a member; and (e) further examination is clinically indicated in the same pregnancy to which item 55718, 55722, 55723 or 55726 applies (R) (NK) | ||
| 55726 | Pelvis or abdomen, pregnancy‑related or pregnancy complication, fetal development and anatomy, ultrasound scan of, by any or all approaches, if: (a) the patient is not referred by a medical practitioner; and | 19.00 |
| (b) the dating of the pregnancy (as confirmed by ultrasound) is after 22 weeks of gestation; and | ||
| (c) the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and (d) the service is not performed in the same pregnancy as item 55718 or 55722; and (e) 1 or more of the following conditions are present: (i) known or suspected fetal abnormality or fetal cardiac arrhythmia; | ||
| (ii) fetal anatomy (late booking or incomplete mid‑trimester scan); (iii) malpresentation; (iv) cervical assessment; | ||
| (v) clinical suspicion of amniotic fluid abnormality; (vi) clinical suspicion of placental or umbilical cord abnormality; (vii) previous complicated delivery; (viii) uterine scar assessment; (ix) uterine fibroid; | ||
| (x) previous fetal death in utero or neonatal death; (xi) antepartum haemorrhage; (xii) clinical suspicion of intrauterine growth retardation; | ||
| (xiii) clinical suspicion of macrosomia; (xiv) reduced fetal movements; (xv) suspected fetal death; (xvi) abnormal cardiotocography; (xvii) prolonged pregnancy; (xviii) premature labour; | ||
| (xix) fetal infection; (xx) pregnancy after assisted reproduction; (xxi) trauma; (xxii) diabetes mellitus; (xxiii) hypertension; (xxiv) toxaemia of pregnancy; (xxv) liver or renal disease; | ||
| (xxvi) autoimmune disease; (xxvii) cardiac disease; (xxviii) alloimmunisation; | ||
| (xxix) maternal infection; (xxx) inflammatory bowel disease; (xxxi) bowel stoma; (xxxii) abdominal wall scarring; (xxxiii) previous spinal or pelvic trauma or disease; | ||
| (xxxiv) drug dependency; (xxxv) thrombophilia; (xxxvi) gross maternal obesity; (xxxvii) advanced maternal age; (xxxviii) abdominal pain or mass (NR) (NK) (Item is subject to subclause 2.1.5(2) of the diagnostic imaging services table) | ||
| 55727 | Pelvis or abdomen, pregnancy‑related or pregnancy complication, fetal development and anatomy, ultrasound scan of, by any or all approaches, performed by or on behalf of a medical practitioner who is a Member or a Fellow of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists, if: (a) the patient is not referred by a medical practitioner; and (b) the dating of the pregnancy (as confirmed by ultrasound) is after 22 weeks of gestation; and | 20.00 |
| (c) the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and (d) further examination is clinically indicated in the same pregnancy to which item 55718, 55722, 55723 or 55726 applies (NR) (NK) | ||
| 55730 | Duplex scanning involving B mode ultrasound imaging and integrated Doppler flow measurements by spectral analysis of the umbilical artery, and measured assessment of amniotic fluid volume after the 24th week of gestation, if the patient is referred by a medical practitioner for this procedure and if there is reason to suspect intrauterine growth retardation or a significant risk of fetal death, not being a service associated with a service to which an item in this group applies — examination and report (R) (NK) | 13.65 |
| 55732 | Pelvis, female, ultrasound scan of, by any or all approaches, if: (a) the patient is referred by a medical practitioner; and (b) the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and | 49.00 |
| (c) the referring practitioner is not a member of a group of practitioners of which the providing practitioner is a member; and (d) the service is not performed with item 55014, 55017, 55036 or 55038 on the same patient within 24 hours (R) (NK) | ||
| 55734 | Pelvis, female, ultrasound scan of, by any or all approaches, if: (a) the patient is not referred by a medical practitioner; and (b) the service is not associated with a service to which an item in Subgroup 2 or 3 applies (NR) (NK) | 17.50 |
| 55735 | Pelvis, female, ultrasound scan of, in association with saline infusion of the endometrial cavity, by any or all approaches, if: (a) the patient is referred by a medical practitioner; and (b) the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and | 63.50 |
| (c) the referring medical practitioner is not a member of a group of medical practitioners of which the providing practitioner is a member; and | ||
| (d) a previous transvaginal ultrasound has revealed an abnormality of the uterus or fallopian tube (R) (NK) | ||
| 55737 | Pelvis, female, ultrasound scan of, in association with saline infusion of the endometrial cavity, by any or all approaches, if: (a) the patient is not referred by a medical practitioner; and (b) the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and (c) a previous transvaginal ultrasound has revealed an abnormality of the uterus or fallopian tube (NR) (NK) | 28.50 |
| 55760 | Pelvis or abdomen, pregnancy‑related or pregnancy complication, fetal development and anatomy, ultrasound scan of, by any or all approaches, with measurement of all parameters for dating purposes, if: (a) the patient is referred by a medical practitioner; and (b) ultrasound of the same pregnancy confirms a multiple pregnancy; and | 75.00 |
| (c) the dating of the pregnancy (as confirmed by ultrasound) is 17 to 22 weeks gestation; and (d) the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and (e) the referring practitioner is not a member of a group of practitioners of which the providing practitioner is a member; and | ||
| (f) the service described in item 55706, 55709, 55712, 55713, 55715, 55717, 55719, 55720, 55762 or 55763 is not performed in conjunction with the scan during the same pregnancy (R) (NK) | ||
| 55763 | Pelvis or abdomen, pregnancy‑related or pregnancy complication, fetal development and anatomy, ultrasound scan of, by any or all approaches, with measurement of all parameters for dating purposes, if: (a) the patient is not referred by a medical practitioner; and (b) ultrasound of the same pregnancy confirms a multiple pregnancy; and | 30.00 |
| (c) the dating of the pregnancy (as confirmed by ultrasound) is 17 to 22 weeks gestation; and (d) the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and | ||
| (e) the service described in item 55706, 55709, 55712, 55713, 55715, 55717, 55719, 55720, 55759 or 55760 is not performed in conjunction with the scan during the same pregnancy (NR) (NK) | ||
| 55765 | Pelvis or abdomen, pregnancy‑related or pregnancy complication, fetal development and anatomy, ultrasound scan of, by any or all approaches, with measurement of all parameters for dating purposes, if: | 80.00 |
| (a) the patient is referred by a medical practitioner who: (i) is a Member or Fellow of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists; or (ii) has a Diploma of Obstetrics; or (iii) has a qualification recognised by the Royal Australian and New Zealand College of Obstetricians and Gynaecologists as equivalent to a Diploma of Obstetrics; or | ||
| (iv) has obstetric privileges at a non‑metropolitan hospital; and (b) ultrasound of the same pregnancy confirms a multiple pregnancy; and | ||
| (c) the dating of the pregnancy (as confirmed by ultrasound) is 17 to 22 weeks gestation; and (d) the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and | ||
| (e) the referring practitioner is not a member of a group of practitioners of which the providing practitioner is a member; and (f) further examination is clinically indicated in the same pregnancy in which item 55759, 55760, 55762 or 55763 has been performed; and | ||
| (g) the service described in item 55706, 55709, 55712, 55713, 55715, 55717, 55719 or 55720 is not performed in conjunction with the scan during the same pregnancy (R) (NK) | ||
| 55767 | Pelvis or abdomen, pregnancy‑related or pregnancy complication, fetal development and anatomy, ultrasound scan of, by any or all approaches, with measurement of all parameters for dating purposes, performed by or on behalf of a medical practitioner, who is a Member or Fellow of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists, if: (a) the patient is not referred by a medical practitioner; and (b) ultrasound of the same pregnancy confirms a multiple pregnancy; and (c) the dating of the pregnancy (as confirmed by ultrasound) is 17 to 22 weeks of gestation; and | 32.50 |
| (d) the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and (e) further examination is clinically indicated in the same pregnancy in which item 55759, 55760, 55762 or 55763 has been performed; and | ||
| (f) the service described in item 55706, 55709, 55712, 55713, 55715, 55717, 55719 or 55720 is not performed in conjunction with the scan during the same pregnancy (NR) (NK) | ||
| 55769 | Pelvis or abdomen, pregnancy‑related or pregnancy complication, fetal development and anatomy, ultrasound scan of, by any or all approaches, if: (a) dating of the pregnancy (as confirmed by ultrasound) is after 22 weeks of gestation; and (b) the ultrasound confirms a multiple pregnancy; and (c) the patient is referred by a medical practitioner or participating nurse practitioner; and | 75.00 |
| (d) the service is not performed in the same pregnancy as item 55770 or 55771; and (e) the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and | ||
| (f) if the patient is referred by a medical practitioner — the referring medical practitioner is not a member of a group of practitioners of which the providing practitioner is a member; and (g) if the patient is referred by a participating nurse practitioner — the referring nurse practitioner does not have a business or financial arrangement with the providing practitioner; and | ||
| (h) the service described in item 55718, 55721, 55722, 55723, 55724, 55725, 55726 or 55727 is not performed in conjunction with the scan during the same pregnancy (R) (NK) | ||
| 55771 | Pelvis or abdomen, pregnancy‑related or pregnancy complication, fetal development and anatomy, ultrasound scan of, by any or all approaches, if: (a) dating of the pregnancy as confirmed by ultrasound is after 22 weeks of gestation; and (b) the patient is not referred by a medical practitioner or participating nurse practitioner; and | 30.00 |
| (c) the service is not performed in the same pregnancy as item 55768 or 55769; and | ||
| (d) the pregnancy as confirmed by ultrasound is a multiple pregnancy; and | ||
| (e) the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and (f) the service described in item 55718, 55721, 55722, 55723, 55724, 55725, 55726 or 55727 is not performed in conjunction with the scan during the same pregnancy (NR) (NK) | ||
| 55773 | Pelvis or abdomen, pregnancy‑related or pregnancy complication, fetal development and anatomy, ultrasound scan of, by any or all approaches, if: (a) dating of the pregnancy as confirmed by ultrasound is after 22 weeks of gestation; and | 80.00 |
| (b) the patient is referred by a medical practitioner who: (i) is a Member or Fellow of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists; or (ii) has a Diploma of Obstetrics; or | ||
| (iii) has a qualification recognised by the Royal Australian and New Zealand College of Obstetricians and Gynaecologists as equivalent to a Diploma of Obstetrics; or | ||
| (iv) has obstetric privileges at a non‑metropolitan hospital; and | ||
| (c) further examination is clinically indicated in the same pregnancy to which item 55768, 55769, 55770 or 55771 has been performed; and | ||
| (d) the pregnancy as confirmed by ultrasound is a multiple pregnancy; and (e) the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and | ||
| (f) the referring practitioner is not a member of a group of practitioners of which the providing practitioner is a member; and (g) the service described in item 55718, 55721, 55722, 55723, 55724, 55725, 55726 or 55727 is not performed in conjunction with the scan during the same pregnancy (R) (NK) | ||
| 55775 | Pelvis or abdomen, pregnancy‑related or pregnancy complication, fetal development and anatomy, ultrasound scan of, by any or all approaches, performed by or on behalf of a medical practitioner who is a Member or a Fellow of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists, if: (a) dating of the pregnancy as confirmed by ultrasound is after 22 weeks of gestation; and (b) the patient is not referred by a medical practitioner; and (c) further examination is clinically indicated in the same pregnancy to which item 55768, 55769, 55770 or 55771 has been performed; and (d) the pregnancy as confirmed by ultrasound is a multiple pregnancy; and | 32.50 |
| (e) the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and (f) the service described in item 55718, 55721, 55722, 55723, 55724, 55725, 55726 or 55727 is not performed in conjunction with the scan during the same pregnancy (NR) (NK) | ||
Subdivision D Subgroup 6 of Group I1 — Musculoskeletal ultrasound
| Group I1 — Ultrasound | |||
| Item | Health service | Fee ($) (for each State) | |
| Subgroup 6 — Musculoskeletal ultrasound | |||
| 55801 | Hand or wrist, 1 or both sides, ultrasound scan of, if: (a) the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and (b) the patient is referred by a medical practitioner or participating nurse practitioner; and (c) if the patient is referred by a medical practitioner — the referring medical practitioner is not a member of a group of practitioners of which the providing practitioner is a member; and (d) if the patient is referred by a participating nurse practitioner — the referring nurse practitioner does not have a business or financial arrangement with the providing practitioner (R) (NK) | 54.55 | |
| 55803 | Hand or wrist, 1 or both sides, ultrasound scan of, if: (a) the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and (b) the patient is not referred by a medical practitioner or participating nurse practitioner (NR) (NK) | 18.95 | |
| 55805 | Forearm or elbow, 1 or both sides, ultrasound scan of, if: (a) the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and (b) the patient is referred by a medical practitioner or participating nurse practitioner; and (c) if the patient is referred by a medical practitioner — the referring medical practitioner is not a member of a group of practitioners of which the providing practitioner is a member; and (d) if the patient is referred by a participating nurse practitioner — the referring nurse practitioner does not have a business or financial arrangement with the providing practitioner (R) (NK) | 54.55 | |
| 55807 | Forearm or elbow, 1 or both sides, ultrasound scan of, if: (a) the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and | 18.95 | |
| (b) the patient is not referred by a medical practitioner or participating nurse practitioner (NR) (NK) | |||
| 55809 | Shoulder or upper arm, 1 or both sides, ultrasound scan of, if: (a) the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and (b) the patient is referred by a medical practitioner or participating nurse practitioner; and (c) if the patient is referred by a medical practitioner — the referring medical practitioner is not a member of a group of practitioners of which the providing practitioner is a member; and (d) if the patient is referred by a participating nurse practitioner — the referring nurse practitioner does not have a business or financial arrangement with the providing practitioner; and (e) the service is used for the assessment of 1 or more of the following suspected or known conditions: (i) an injury to a muscle, tendon or muscle/tendon junction; (ii) rotator cuff tear, calcification or tendinosis (biceps, subscapular, supraspinatus, infraspinatus); | 54.55 | |
| (iii) biceps subluxation; (iv) capsulitis and bursitis; (v) a mass, including a ganglion; | |||
| (vi) an occult fracture; (vii) acromioclavicular joint pathology (R) (NK) | |||
| 55811 | Shoulder or upper arm, 1 or both sides, ultrasound scan of, if: (a) the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and (b) the patient is not referred by a medical practitioner or participating nurse practitioner; and (c) the service is used for the assessment of 1 or more of the following suspected or known conditions: (i) an injury to a muscle, tendon or muscle/tendon junction; (ii) rotator cuff tear, calcification or tendinosis (biceps, subscapular, supraspinatus, infraspinatus); (iii) biceps subluxation; | 18.95 | |
| (iv) capsulitis and bursitis; (v) a mass, including a ganglion; (vi) an occult fracture; (vii) acromioclavicular joint pathology (NR) (NK) | |||
| 55813 | Chest or abdominal wall, 1 or more areas, ultrasound scan of, if: (a) the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and (b) the patient is referred by a medical practitioner or participating nurse practitioner; and (c) if the patient is referred by a medical practitioner — the referring medical practitioner is not a member of a group of practitioners of which the providing practitioner is a member; and (d) if the patient is referred by a participating nurse practitioner — the referring nurse practitioner does not have a business or financial arrangement with the providing practitioner (R) (NK) | 54.55 | |
| 55815 | Chest or abdominal wall, 1 or more areas, ultrasound scan of, if: (a) the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and (b) the patient is not referred by a medical practitioner or participating nurse practitioner (NR) (NK) | 18.95 | |
| 55817 | Hip or groin, 1 or both sides, ultrasound scan of, if: (a) the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and (b) the patient is referred by a medical practitioner or participating nurse practitioner; and (c) if the patient is referred by a medical practitioner — the referring medical practitioner is not a member of a group of practitioners of which the providing practitioner is a member; and | 54.55 | |
| (d) if the patient is referred by a participating nurse practitioner — the referring nurse practitioner does not have a business or financial arrangement with the providing practitioner (R) (NK) | |||
| 55819 | Hip or groin, 1 or both sides, ultrasound scan of, if: (a) the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and (b) the patient is not referred by a medical practitioner or participating nurse practitioner (NR) (NK) | 18.95 | |
| 55821 | Paediatric hip examination for dysplasia, 1 or both sides, ultrasound scan of, if: (a) the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and (b) the patient is referred by a medical practitioner or participating nurse practitioner; and (c) if the patient is referred by a medical practitioner — the referring medical practitioner is not a member of a group of practitioners of which the providing practitioner is a member; and (d) if the patient is referred by a participating nurse practitioner — the referring nurse practitioner does not have a business or financial arrangement with the providing practitioner (R) (NK) | 54.55 | |
| 55823 | Paediatric hip examination for dysplasia 1 or both sides, ultrasound scan of, if: (a) the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and (b) the patient is not referred by a medical practitioner or participating nurse practitioner (NR) (NK) | 18.95 | |
| 55825 | Buttock or thigh, 1 or both sides, ultrasound scan of, if: (a) the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and (b) the patient is referred by a medical practitioner or participating nurse practitioner; and (c) if the patient is referred by a medical practitioner — the referring medical practitioner is not a member of a group of practitioners of which the providing practitioner is a member; and | 54.55 | |
| (d) if the patient is referred by a participating nurse practitioner — the referring nurse practitioner does not have a business or financial arrangement with the providing practitioner (R) (NK) | |||
| 55827 | Buttock or thigh, 1 or both sides, ultrasound scan of, if: (a) the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and (b) the patient is not referred by a medical practitioner or participating nurse practitioner (NR) (NK) | 18.95 | |
| 55829 | Knee, 1 or both sides, ultrasound scan of, if: (a) the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and (b) the patient is referred by a medical practitioner or participating nurse practitioner; and (c) if the patient is referred by a medical practitioner — the referring medical practitioner is not a member of a group of practitioners of which the providing practitioner is a member; and (d) if the patient is referred by a participating nurse practitioner — the referring nurse practitioner does not have a business or financial arrangement with the providing practitioner; and | 54.55 | |
| (e) the service is used for the assessment of 1 or more of the following suspected or known conditions: (i) abnormality of tendons or bursae about the knee; (ii) a meniscal cyst, popliteal fossa cyst, mass or pseudomass; (iii) a nerve entrapment or a nerve or nerve sheath tumour; (iv) an injury of collateral ligaments (R) (NK) | |||
| 55831 | Knee, 1 or both sides, ultrasound scan of, if: (a) the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and (b) the patient is not referred by a medical practitioner or participating nurse practitioner; and | 18.95 | |
| (c) the service is used for the assessment of 1 or more of the following suspected or known conditions: (i) abnormality of tendons or bursae about the knee; | |||
| (ii) a meniscal cyst, popliteal fossa cyst, mass or pseudomass; (iii) a nerve entrapment or a nerve or nerve sheath tumour; (iv) an injury of collateral ligaments (NR) (NK) | |||
| 55833 | Lower leg, 1 or both sides, ultrasound scan of, if: (a) the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and (b) the patient is referred by a medical practitioner or participating nurse practitioner; and (c) if the patient is referred by a medical practitioner — the referring medical practitioner is not a member of a group of practitioners of which the providing practitioner is a member; and (d) if the patient is referred by a participating nurse practitioner — the referring nurse practitioner does not have a business or financial arrangement with the providing practitioner (R) (NK) | 54.55 | |
| 55835 | Lower leg, 1 or both sides, ultrasound scan of, performed by or on behalf of a medical practitioner, if: (a) the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and (b) the patient is not referred by a medical practitioner or participating nurse practitioner (NR) (NK) | 18.95 | |
| 55837 | Ankle or hind foot, 1 or both sides, ultrasound scan of, if: (a) the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and (b) the patient is referred by a medical practitioner or participating nurse practitioner; and (c) if the patient is referred by a medical practitioner — the referring medical practitioner is not a member of a group of practitioners of which the providing practitioner is a member; and | 54.55 | |
| (d) if the patient is referred by a participating nurse practitioner — the referring nurse practitioner does not have a business or financial arrangement with the providing practitioner (R) (NK) | |||
| 55839 | Ankle or hind foot, 1 or both sides, ultrasound scan of, if: (a) the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and (b) the patient is not referred by a medical practitioner or participating nurse practitioner (NR) (NK) | 18.95 | |
| 55841 | Mid foot or fore foot, 1 or both sides, ultrasound scan of, if: (a) the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and (b) the patient is referred by a medical practitioner or participating nurse practitioner; and (c) if the patient is referred by a medical practitioner — the referring medical practitioner is not a member of a group of practitioners of which the providing practitioner is a member; and (d) if the patient is referred by a participating nurse practitioner — the referring nurse practitioner does not have a business or financial arrangement with the providing practitioner (R) (NK) | 54.55 | |
| 55843 | Mid foot or fore foot, 1 or both sides, ultrasound scan of, if: (a) the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and (b) the patient is not referred by a medical practitioner or participating nurse practitioner (NR) (NK) | 18.95 | |
| 55845 | Assessment of a mass associated with the skin or subcutaneous structures, not being a part of the musculoskeletal system, 1 or more areas, ultrasound scan of, if: (a) the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and (b) the patient is referred by a medical practitioner or participating nurse practitioner; and | 43.70 | |
| (c) if the patient is referred by a medical practitioner — the referring medical practitioner is not a member of a group of practitioners of which the providing practitioner is a member; and (d) if the patient is referred by a participating nurse practitioner — the referring nurse practitioner does not have a business or financial arrangement with the providing practitioner (R) (NK) | |||
| 55847 | Assessment of a mass associated with the skin or subcutaneous structures, not being a part of the musculoskeletal system, 1 or more areas, ultrasound scan of, if: (a) the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and (b) the patient is not referred by a medical practitioner or participating nurse practitioner (NR) (NK) | 18.95 | |
| 55849 | Musculoskeletal cross‑sectional echography, in conjunction with a surgical procedure using interventional techniques, not being a service associated with a service to which any other item in this group applies, and not performed in conjunction with item 55026 or 55054 (R) (NK) | 54.55 | |
| 55851 | Musculoskeletal cross‑sectional echography, in conjunction with a surgical procedure using interventional techniques, inclusive of a diagnostic musculoskeletal ultrasound service, if: (a) the patient is referred by a medical practitioner or participating nurse practitioner; and (b) if the patient is referred by a medical practitioner — the referring medical practitioner is not a member of a group of practitioners of which the providing practitioner is a member; and (c) if the patient is referred by a participating nurse practitioner — the referring nurse practitioner does not have a business or financial relationship with the providing practitioner; and (d) the referring medical practitioner or nurse practitioner has indicated on a referral for a musculoskeletal ultrasound that an ultrasound guided intervention be performed if clinically indicated; and | 76.45 | |
| (e) the service is not performed in conjunction with items 55026, 55054, or 55800 to 55849 (R) (NK) | |||
| 55853 | Paediatric spine, spinal cord and overlying subcutaneous tissues, ultrasound scan of, if: (a) the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and (b) the patient is referred by a medical practitioner or participating nurse practitioner; and (c) if the patient is referred by a medical practitioner — the referring medical practitioner is not a member of a group of practitioners of which the providing practitioner is a member; and (d) if the patient is referred by a participating nurse practitioner — the referring nurse practitioner does not have a business or financial arrangement with the providing practitioner (R) (NK) | 54.55 | |
| 55855 | Paediatric spine, spinal cord and overlying subcutaneous tissues, ultrasound scan of, if: (a) the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and (b) the patient is not referred by a medical practitioner or participating nurse practitioner (NR) (NK) | 18.95 | |
Division 2.2 Not used
Division 2.3 Group I3 — Diagnostic radiology
Subdivision A Subgroups 1 to 9 of Group I3
| Group I3 — Diagnostic radiology | ||||
| Item | Health service | Fee ($) (for each State) | ||
| Subgroup 1 — Radiographic examination of extremities | ||||
| 57529 | Hand, wrist, forearm, elbow or humerus (NR) (NK) | 14.90 | ||
| 57530 | Hand, wrist, forearm, elbow or humerus (R) (NK) | 19.90 | ||
| 57532 | Hand and wrist, or hand, wrist and forearm, or forearm and elbow, or elbow and humerus (NR) (NK) | 20.25 | ||
| 57533 | Hand and wrist, or hand, wrist and forearm, or forearm and elbow, or elbow and humerus (R) (NK) | 27.00 | ||
| 57535 | Foot, ankle, leg, knee or femur (NR) (NK) | 16.25 | ||
| 57536 | Foot, ankle, leg, knee or femur (R) (NK) | 21.70 | ||
| 57538 | Foot and ankle, or ankle and leg, or leg and knee, or knee and femur (NR) (NK) | 24.70 | ||
| 57539 | Foot and ankle, or ankle and leg, or leg and knee, or knee and femur (R) (NK) | 32.90 | ||
| Subgroup 2 — Radiographic examination of shoulder or pelvis | ||||
| 57702 | Shoulder or scapula (NR) (NK) | 20.25 | ||
| 57705 | Shoulder or scapula (R) (NK) | 27.00 | ||
| 57708 | Clavicle (NR) (NK) | 16.25 | ||
| 57711 | Clavicle (R) (NK) | 21.70 | ||
| 57714 | Hip joint (R) (NK) | 23.60 | ||
| 57717 | Pelvic girdle (R) (NK) | 30.45 | ||
| 57723 | Femur, internal fixation of neck or intertrochanteric (pertrochanteric) fracture (R) (NK) | 49.65 | ||
| Subgroup 3 — Radiographic examination of head | ||||
| 57911 | Skull, not in association with item 57902 or 57914 (R) (NK) | 32.25 | ||
| 57914 | Cephalometry, not in association with item 57901 or 57911 (R) (NK) | 32.25 | ||
| 57917 | Sinuses (R) (NK) | 23.65 | ||
| 57920 | Mastoids (R) (NK) | 32.25 | ||
| 57923 | Petrous temporal bones (R) (NK) | 32.25 | ||
| 57926 | Facial bones — orbit, maxilla or malar, any or all (R) (NK) | 23.60 | ||
| 57929 | Mandible, not by orthopantomography technique (R) (NK) | 23.60 | ||
| 57932 | Salivary calculus (R) (NK) | 23.60 | ||
| 57935 | Nose (R) (NK) | 23.60 | ||
| 57938 | Eye (R) (NK) | 23.60 | ||
| 57941 | Temporo‑mandibular joints (R) (NK) | 24.85 | ||
| 57944 | Teeth — single area (R) (NK) | 16.45 | ||
| 57947 | Teeth — full mouth (R) (NK) | 39.15 | ||
| 57950 | Palato‑pharyngeal studies with fluoroscopic screening (R) (NK) | 32.25 | ||
| 57953 | Palato‑pharyngeal studies without fluoroscopic screening (R) (NK) | 24.85 | ||
| 57956 | Larynx, lateral airways and soft tissues of the neck, not being a service associated with a service to which item 57939, 57942, 57950 or 57953 applies (R) (NK) | 21.70 | ||
| 57959 | Orthopantomography for diagnosis or management (or both) of trauma, infection, tumour or a congenital or surgical condition of the teeth or maxillofacial region (R) (NK) | 23.70 | ||
| 57962 | Orthopantomography for diagnosis or management (or both) of any of the following conditions, if the signs and symptoms of the condition is present: (a) impacted teeth; (b) caries; (c) periodontal pathology; (d) periapical pathology (R) (NK) | 23.70 | ||
| 57965 | Orthopantomography for diagnosis or management (or both) of missing or crowded teeth, or developmental anomalies of the teeth or jaws (R) (NK) | 23.70 | ||
| 57968 | Orthopantomography for diagnosis or management (or both) of temporo‑mandibular joint arthroses or dysfunction (R) (NK) | 23.70 | ||
| Subgroup 4 — Radiographic examination of spine | ||||
| 58102 | Spine — cervical (R) (NK) | 33.60 | ||
| 58105 | Spine — thoracic (R) (NK) | 27.55 | ||
| 58111 | Spine — lumbo‑sacral (R) (NK) | 38.50 | ||
| 58114 | Spine — 4 regions, cervical, thoracic, lumbosacral and sacrococcygeal (R) (NK) | 55.00 | ||
| 58117 | Spine — sacro‑coccygeal (R) (NK) | 23.50 | ||
| 58123 | Spine — 2 examinations of the kind mentioned in items 58100, 58102, 58103, 58105, 58106, 58109, 58111 and 58117 (R) (NK) | 48.65 | ||
| 58124 | Spine — 3 examinations of the kind mentioned in items 58100, 58102, 58103, 58105, 58106, 58109, 58111 and 58117 (R) (NK) | 55.00 | ||
| 58126 | Spine — 4 regions, cervical, thoracic, lumbosacral and sacrococcygeal (R) (NK), if the service to which item 58120, 58121, 58126 or 58127 applies has not been performed on the same patient within the same calendar year | 55.00 | ||
| 58127 | Spine — 3 examinations of the kind mentioned in items 58100, 58102, 58103, 58105, 58106, 58109, 58111 and 58117 (R) (NK), if the service to which item 58120, 58121, 58126 or 58127 applies has not been performed on the same patient within the same calendar year | 55.00 | ||
| Subgroup 5 — Bone age study and skeletal survey | ||||
| 58302 | Bone age study (R) (NK) | 20.05 | ||
| 58308 | Skeletal survey (R) (NK) | 44.70 | ||
| Subgroup 6 — Radiographic examination of thoracic region | ||||
| 58502 | Chest (lung fields) by direct radiography (NR) (NK) | 17.70 | ||
| 58505 | Chest (lung fields) by direct radiography (R) (NK) | 23.60 | ||
| 58508 | Chest (lung fields) by direct radiography with fluoroscopic screening (R) (NK) | 30.40 | ||
| 58511 | Thoracic inlet or trachea (R) (NK) | 19.90 | ||
| 58523 | Left ribs, right ribs or sternum (R) (NK) | 21.70 | ||
| 58526 | Left and right ribs, left ribs and sternum, or right ribs and sternum (R) (NK) | 28.25 | ||
| 58529 | Left ribs, right ribs and sternum (R) (NK) | 34.70 | ||
| Subgroup 7 — Radiographic examination of urinary tract | ||||
| 58702 | Plain renal only (R) (NK) | 23.05 | ||
| 58708 | Intravenous pyelography, with or without preliminary plain films and with or without tomography (R) (NK) | 78.95 | ||
| 58717 | Antegrade or retrograde pyelography with or without preliminary plain films and with preparation and contrast injection, 1 side (R) (NK) | 75.80 | ||
| 58720 | Retrograde cystography or retrograde urethrography with or without preliminary plain films and with preparation and contrast injection (R) (NK) (Anaes.) | 63.05 | ||
| 58723 | Retrograde micturating cysto‑urethrography, with preparation and contrast injection (R) (NK) (Anaes.) | 69.15 | ||
| Subgroup 8 — Radiographic examination of alimentary tract and biliary system | ||||
| 58902 | Plain abdominal only, not being a service associated with a service to which item 58909, 58911, 58912, 58914, 58915, 58917, 58924 or 58926 applies (NR) (NK) | 17.85 | ||
| 58905 | Plain abdominal only, not being a service associated with a service to which item 58909, 58911,58912, 58914, 58915, 58917, 58924 or 58926 applies (R) (NK) | 23.80 | ||
| 58911 | Barium or other opaque meal of 1 or more of pharynx, oesophagus, stomach or duodenum, with or without preliminary plain films of pharynx, chest or duodenum, not being a service associated with a service to which item 57939, 57942, 57945, 57950, 57953 or 57956 applies (R) (NK) | 45.00 | ||
| 58914 | Barium or other opaque meal of oesophagus, stomach, duodenum and follow through to colon, with or without screening of chest and with or without preliminary plain film (R) (NK) | 55.15 | ||
| 58917 | Barium or other opaque meal, small bowel series only, with or without preliminary plain film (R) (NK) | 39.50 | ||
| 58920 | Small bowel enema, barium or other opaque study of the small bowel, including duodenal intubation, with or without preliminary plain films, not being a service associated with a service to which item 30488 applies (R) (NK) (Anaes.) | 69.25 | ||
| 58923 | Opaque enema, with or without air contrast study and with or without preliminary plain films (R) (NK) | 67.65 | ||
| 58926 | Graham’s test (cholecystography), with preliminary plain films and with or without tomography (R) (NK) | 42.05 | ||
| 58929 | Cholegraphy direct, with or without preliminary plain films and with preparation and contrast injection, not being a service associated with a service to which item 30439 applies (R) (NK) | 38.25 | ||
| 58935 | Cholegraphy, percutaneous transhepatic, with or without preliminary plain films and with preparation and contrast injection (R) (NK) | 102.80 | ||
| 58938 | Cholegraphy, drip infusion, with or without preliminary plain films, with preparation and contrast injection and with or without tomography (R) (NK) | 98.00 | ||
| 58941 | Defaecogram (R) (NK) | 69.65 | ||
| Subgroup 9 — Radiographic examination for localisation of foreign bodies | ||||
| 59104 | Localisation of foreign body, if provided in conjunction with a service described in Subgroups 1 to 12 of Group I3 (R) (NK) | 10.65 | ||
Subdivision C Subgroup 20 of Group I5 — Scans of pelvis and upper abdomen — for specified conditions
| Group I5 — Magnetic resonance imaging | ||
| Item | Health service | Fee ($) (for each State) |
| Subgroup 20 — Scans of pelvis and upper abdomen — for specified conditions | ||
| 63479 | MRI — scan of the pelvis for the staging of histologically diagnosed cervical cancer at FIGO stage 1B or greater, if the request for scan identifies that: (a) a histological diagnosis of carcinoma of the cervix has been made; and (b) the patient has been diagnosed with cervical cancer at FIGO stage 1B or greater (R) (NK) (Anaes.) (Contrast) | 201.60 |
| 63481 | MRI — scan of the pelvis and upper abdomen, in a single examination, for the staging of histologically diagnosed cervical cancer at FIGO stage 1B or greater, if the request for scan identifies that: (a) a histological diagnosis of carcinoma of the cervix has been made; and (b) the patient has been diagnosed with cervical cancer at FIGO stage 1B or greater (R) (NK) (Anaes.) (Contrast) | 313.60 |
| 63484 | MRI — scan of the pelvis for the initial staging of rectal cancer, if: (a) a phased array body coil is used; and (b) the request for scan identifies that the indication is for the initial staging of rectal cancer (including cancer of the rectosigmoid and anorectum) (R) (NK) (Anaes.) (Contrast) | 201.60 |
Subdivision D Subgroups 21 and 22 of Group I5
| Group I5 — Magnetic resonance imaging | ||
| Item | Health service | Fee ($) (for each State) |
| Subgroup 21 — Scan of body — for specified conditions | ||
| 63486 | MRI — scan of pancreas and biliary tree for suspected biliary or pancreatic pathology (R) (NK) (Anaes.) | 201.60 |
Subdivision E Subgroup 33 of Group 15
| Group I5—Magnetic resonance imaging | ||||||||
| Item | Health service | Fee ($) | ||||||
| ___________________________________________________________________________ Subgroup 33 —Scan of body—for specified conditions | ||||||||
| 63508 | MRI—scan of head for a patient under 16 years if the service is for: | 201.60 | ||||||
| 63511 | MRI—scan of spine following radiographic examination for a patient under 16 years if the service is for: | 224.00 | ||||||
| 63514 | MRI—scan of knee following radiographic examination for internal joint derangement for a patient under 16 years (NK) (R) (Anaes.) (Contrast) | 201.60 | ||||||
| 63517 | MRI—scan of hip following radiographic examination for a patient under 16 years if any of the following is suspected: | 201.60 | ||||||
| 63520 | MRI—scan of elbow following radiographic examination for a patient under 16 years if a significant fracture or avulsion injury, which would change the way in which the patient is managed, is suspected (R)(NK) (Anaes.) (Contrast) | 201.60 | ||||||
| 63523 | MRI—scan of wrist following radiographic examination for a patient under 16 years if a scaphoid fracture is suspected (R)(NK) (Anaes.) (Contrast) | 224.00 | ||||||
Subdivision F Subgroup 34 of Group I5
| Group I5—Magnetic resonance imaging | ||
| Item | Health service | Fee ($) (for each State) |
| Subgroup 34 — Scan of body — for specified conditions | ||
| 63552 | Scan of head for a patient 16 years or older, after referral by a medical practitioner (other than a specialist or consultant physician), for any of the following: (a) unexplained seizure(s); (b) unexplained chronic headache with suspected intracranial pathology (R) (NK) (Contrast) (Anaes.) | 201.60 |
| 63555 | Scan of spine for a patient 16 years or older, after referral by a medical practitioner (other than a specialist or consultant physician), for suspected cervical radiculopathy (R) (NK) (Contrast) (Anaes.) | 179.20 |
| 63558 | Scan of spine for a patient 16 years or older, after referral by a medical practitioner (other than a specialist or consultant physician), for suspected cervical spinal trauma (R) (NK) (Contrast) (Anaes.) | 246.40 |
| 63561 | Scan of knee following acute knee trauma, after referral by a medical practitioner (other than a specialist or consultant physician), for a patient 16 years or older with: (a) inability to extend the knee suggesting the possibility of acute meniscal tear; or (b) clinical findings suggesting acute anterior cruciate ligament tear (R) (NK) (Contrast) (Anaes.) | 201.60 |
SCHEDULE 2 – References in regulations
(section 7)
Diagnostic imaging services table - clauses
Column 1 Column 2 Column 3 Provision of diagnostic imaging services table Existing item reference of diagnostic imaging services table Additional item reference Preliminary (a) Clause 1.1.1 and subclause 1.2.3(1) Item in Part 2 The items in Schedule 1 (b) Paragraph 1.2.3(2)(a) 55054, 55130, 55135, 55848, 55850, 57341, 57345, 59312, 59314, 60506, 60509 and 61109 55026, 55131, 55136, 55849, 55851, 59313, 59315, 60507, 60510, 61110 (c) Subclause 1.2.5(4) 61369 61671 (d) Subclause 1.2.7(10) 59103, 64990 or 64991 59104 Ultrasound (e) Clause 2.1.1 and subclause 2.1.2 (1) 55600 and 55603 55601, 55604 (f) Clause 2.1.3 55028, 55030 and 55032 55005, 55008, 55011 (g) Subclause 2.1.4(2) 55706, 55707, 55708, 55709, 55718, 55723, 55759, 55762, 55768 and 55770 55713, 55714, 55716, 55717, 55722, 55726, 55760, 55763, 55769, 55771 (h) Subclause 2.1.5 (1) 55700, 55704, 55707, 55718, 55759 and 55768 55701, 55710, 55714, 55722, 55760, 55769 (i) Subclause 2.1.5(1) 55712, 55721, 55764 and 55772 55719, 55724, 55765, 55773 (j) Subclause 2.1.5(2) 55703, 55705, 55708, 55715, 55723, 55725, 55762, 55766, 55770 and 55774 55702, 55711, 55716, 55720, 55726, 55727, 55763, 55767, 55771, 55775 (k) Clause 2.1.6 55712, 55721, 55764 and 55772 55719, 55724, 55765, 55773 Diagnostic radiology (l) Clause 2.3.1(2) 57901 to 57969 57911 to 57968 (m) Clauses 2.3.6 and 2.3.4 61109 61110 Nuclear medicine imaging (n) Clause 2.4.1 61302 to 61505 and item 61650 61651 to 61719, 61729 Magnetic resonance imaging (o) Subclause 2.5.1(1) and clause 2.5.7 63001 to 63482 63484, 63486 (p) Subclause 2.5.1(2) and clause 2.5.7 63464 to 63476 63457 to 63484 (q) Subclause 2.5.1(4) and clause 2.5.7 63507 to 63522
63523, 63552, 63555, 63558, 63561 (r) Subclause 2.5.9(2) 63040 to 63073 63074 to 63085 (s) Subclause 2.5.9(2) 63101 63104 (t) Subclause 2.5.9(2) 63125 to 63131 63134 to 63136 (u) Subclause 2.5.9(2) 63161 to 63185 63186 to 63194 (v) Subclause 2.5.9(2) 63219 to 63243 63257 to 63265 (w) Subclause 2.5.9(2) 63271 to 63280 63282 to 63285 (x) Subclause 2.5.9(2) 63322 to 63340 63341 to 63348 (y) Subclause 2.5.9(2) 63361 63364 (z) Subclause 2.5.9(2) 63385 to 63391 63392 to 63394 (aa) Subclause 2.5.9(2) 63401 and 63404 63407, 63408 (bb) Subclause 2.5.9(2) 63416 63419 (cc) Subclause 2.5.9(2) 63425 and 63428 63432, 63433 (dd) Subclause 2.5.9(2) 63461, 63464 and 63467 63455, 63457, 63458 (ee) Subclause 2.5.9(2) 63482 63486 (ff) Subclause 2.5.9(2) 63507 to 63522 63508, 63511, 63514, 63517, 63520, 63523, 63552, 63555, 63558, 63561 (gg) Subclauses 2.5.10(1) and (2) 63470 63479 (hh) Subclause 2.5.10(1) and (2) 63473 63481
Diagnostic imaging services table - items
Column 1 Column 2 Column 3 Existing DIST item Existing item reference Additional item reference Ultrasound (a) 55036 55038, 55044 or 55731 55017, 55020, 55732 (b) 55038 55036, 55044 or 55731 55014, 55020, 55732 (c) 55044 55036 or 55038 55014, 55017 (d) 55084 11917, 55036, 55038, 55044, 55600, 55603 or 55731 55014, 55017, 55020, 55601, 55604, 55732 (e) 55085 11917, 55037, 55039, 55045, 55600, 55603 or 55733 55016, 55019, 55022, 55601, 55604, 55734 (f) 55113 to 55118 55054 55026 (g) 55113 to 55117 55118 and 55130 55125, 55131 (h) 55130 55135 55136 (i) 55135 55130 55131 (j) 55238 to 55296 55054 55026 (k) 55706 55709 55717 (l) 55707(f) and 55078(d) 55704 55710 (m) 55707 and 55708 55700, 55703, 55704 or 55705 55701, 55702, 55710, 55711 (n) 55709 55706 55713 (o) 55712 and 55715 55706 or 55709 55713, 55717 (p) 55718 55723 55726 (q) 55721 and 55725 55718 or 55723 55722, 55726 (r) 55723 55718 55722 (s) 55731 55036 or 55038 55014, 55017 (t) 55759 55706, 55709, 55712, 55715 or 55762 55713, 55717, 55719, 55720, 55763 (u) 55762 55706, 55709, 55712, 55715 or 55759 55713, 55717, 55719, 55720, 55760 (v) 55764 and 55766 55759 or 55762 55760, 55763 (w) 55764 and 55766 55706, 55709, 55712 or 55715 55713, 55717, 55719, 55720 (x) 55768 55770 55771 (y) 55768, 55770, 55772 and 55774 55718, 55721, 55723 or 55725 55722, 55724, 55726, 55727 (z) 55770 55768 55769 (aa) 55772 and 55774 55768 or 55770 55769, 55771 (bb) 55848 and 55850 55054 55026 (cc) 55850 55800 to 55848 55849 Computed tomography (dd) 56219 and 56259 59724 59725 Diagnostic radiology (ee) 57901 57902 57914 (ff) 57902 57901 57911 (gg) 57945 57939 or 57942 57950, 57953 (hh) 58112, 58115 and 58121 58100, 58103, 58106 and 58109 58102, 58105, 58111, 58117 (ii) 58120 and 58121 58120 or 58121 58126, 58127 (jj) 58900 and 58903 58909, 58912, 58915 or 58924 58911, 58914, 58917, 58926 (kk) 58909 57939, 57942 or 57945 57950, 57953, 57956 (ll) 59733 57918 57932 (mm) 59903, 59912, 59925, 59971, 59972, and 59973 61109 61110 Nuclear medicine imaging (nn) 61462 61364, 61426, 61429, 61430, 61442, 61450, 61453, 61469, 61484 or 61485 61669, 61692, 61693, 61694, 61700, 61704, 61705, 61712, 61715, 61716 (oo) 61505 61302 to 61650 61651 to 61729 Magnetic resonance imaging (pp) 63467 63464 63457
Dictionary
Column 1 Column 2 Column 3 Definition Existing item reference Additional item reference (a) medical practitioner 55028, 55030 and 55032 55005, 55008, 55011 (b) scan 63001 to 63522 63523, 63552, 63555, 63558, 63561
Health Insurance Regulations 1975
Column 1 Column 2 Column 3 Provision of Health Insurance Regulations Existing item reference Additional item reference (a) Paragraph 10(1)(a) 55028, 55030, 55032, 56001 to 56220 (inclusive), 56224, 56227, 56230, 56259, 56301 to 56507 (inclusive), 56541, 56547, 56801 to 57007 (inclusive), 57041, 57047, 57341, 57345, 57703, 57709, 57712, 57715, 58103 to 58115 (inclusive), 58306, 58506, 58521 to 58527 (inclusive), 58909, 59103, 59703, 60000 to 60009 (inclusive), 60506, 60509, 61109, 61372, 61421, 61425, 61429, 61430, 61433, 61434, 61446, 61449, 61450, 61453, 61454, 61457, 61462, 63007 and 63334 55005, 55008, 55011, 57705, 57711, 57714, 57717, 58117, 58123, 58124, 58308, 58508, 58529, 58911, 59104, 59704, 60507, 60510, 61110, 61672, 61690, 61691, 61693, 61694, 61695, 61696, 61702, 61703, 61704, 61705, 61706, 61707, 61710, 63016, 63346 (b) Paragraph 10(1)(b) 55028, 56013, 56016, 56022, 56028, 56053, 56056, 56062, 56068, 58306, 61421, 61425, 61429, 61430, 61433, 61434, 61446, 61449, 61450, 61453, 61454, 61457, 61462 and 63334 55005, 58308, 61690, 61691, 61693, 61694, 61695, 61696, 61702, 61703, 61704, 61705, 61706, 61707, 61710, 63346 (c) Paragraph 10(1)(c) 56022, 56062, 58306, 61421, 61454, 61457 and 63334 58308, 61690, 61706, 61707, 63346 (d) Paragraph 10(1)(d) 55028, 55030, 55032, 56001, 56007, 56010, 56013, 56016, 56022, 56028, 56041, 56047, 56050, 56053, 56056, 56062, 56068, 56101, 56107, 56141, 56147, 56301, 56307, 56341, 56347, 56401, 56407, 56441, 56447, 57341, 57345, 58306, 58506, 58909, 59103, 59703, 60000, 60003, 60006, 60009, 60506, 60509, 61109, 61372, 61421, 61425, 61429, 61430, 61433, 61434, 61446, 61449, 61450, 61453, 61454, 61457, 61462, 63007 and 63334 55005, 55008, 55011, 58308, 58508, 58911, 59104, 59704, 60507, 60510, 61110, 61672, 61690, 61691, 61693, 61694, 61695, 61696, 61702, 61703, 61704, 61705, 61706, 61707, 61710, 63016, 63346 (e) Paragraph 10(1)(e) 57509, 57515, 57521, 57527, 57901 to 57969 (inclusive), 58100, 58300, 58503, 58903, 59733, 59739, 59751, 60100, 60500 and 60503 57530, 57533, 57536, 57539, 58102, 58302, 58505, 58905, 59734, 59740, 59752, 60101, 60501, 60504 (f) Subregulation 11(1) 57712, 57715, 58100 to 58106 (inclusive), 58109, 58112, 58120 and 58121 57714, 57717, 58111, 58117, 58123, 58126, 58127 (g) Subregulation 11(2) 55836, 55840, 55844, 57521 and 57527 55837, 55841, 55845, 57536, 57539 (h) Subregulation 11B(1) 55700, 55704, 55706, 55707, and 55718 55701, 55710, 55713, 55714, 55722 (i) Subregulation 11B(2) 55036, 55070, 55076, 55600, 55768, 55800, 55804, 55808, 55812, 55816, 55820, 55824, 55828, 55832, 55836, 55840, 55844, 55848, 55850, 55852, 57509, 57515, 57521 and 58503 to 58527 (inclusive) 55014, 55059, 55061, 55601, 55769, 55801, 55805, 55809, 55813, 55817, 55821, 55825, 55829, 55833, 55837, 55841, 55845, 55849, 55851, 55853, 57530, 57533, 57536, 58529 (j) Regulation 12 57712, 57715, 57901, 57902, 57903, 57912, 57915, 57921, 58100 to 58115 (inclusive), 58521, 58524, 58527, 58700, 58924 and 59103 57714, 57717, 57911, 57914, 57917, 57926, 57929, 57935, 58117, 58123, 58124, 58523, 58526, 58529, 58702, 58926, 59104
General Medical Services Table
Column 1 Column 2 Column 3 Existing GMST item Existing item reference Additional item reference (a) Item 11614 55280 55229
Note All legislative instruments and compilations are registered on the Federal Register of Legislative Instruments kept under the Legislative Instruments Act 2003. See 1—About the endnotes
The endnotes provide details of the history of this legislation and its provisions. The following endnotes are included in each compilation:
Endnote 1—About the endnotes
Endnote 2—Abbreviation key
Endnote 3—Legislation history
Endnote 4—Amendment history
Endnote 5—Uncommenced amendments
Endnote 6—Modifications
Endnote 7—Misdescribed amendments
Endnote 8—Miscellaneous
If there is no information under a particular endnote, the word “none” will appear in square brackets after the endnote heading.
Abbreviation key—Endnote 2
The abbreviation key in this endnote sets out abbreviations that may be used in the endnotes.
Legislation history and amendment history—Endnotes 3 and 4
Amending laws are annotated in the legislation history and amendment history.
The legislation history in endnote 3 provides information about each law that has amended the compiled law. The information includes commencement information for amending laws and details of application, saving or transitional provisions that are not included in this compilation.
The amendment history in endnote 4 provides information about amendments at the provision level. It also includes information about any provisions that have expired or otherwise ceased to have effect in accordance with a provision of the compiled law.
Uncommenced amendments—Endnote 5
The effect of uncommenced amendments is not reflected in the text of the compiled law, but the text of the amendments is included in endnote 5.
Modifications—Endnote 6
If the compiled law is affected by a modification that is in force, details of the modification are included in endnote 6.
Misdescribed amendments—Endnote 7
An amendment is a misdescribed amendment if the effect of the amendment cannot be incorporated into the text of the compilation. Any misdescribed amendment is included in endnote 7.
Miscellaneous—Endnote 8
Endnote 8 includes any additional information that may be helpful for a reader of the compilation.
Endnote 2—Abbreviation key
ad = added or inserted pres = present am = amended prev = previous c = clause(s) (prev) = previously Ch = Chapter(s) Pt = Part(s) def = definition(s) r = regulation(s)/rule(s) Dict = Dictionary Reg = Regulation/Regulations disallowed = disallowed by Parliament reloc = relocated Div = Division(s) renum = renumbered exp = expired or ceased to have effect rep = repealed hdg = heading(s) rs = repealed and substituted LI = legislative instrument s = section(s) LIA = Legislative Instruments Act 2003 Sch = Schedule(s) mod = modified/modification Sdiv = Subdivision(s) No = Number(s) SLI = Select Legislative Instrument o = order(s) SR = Statutory Rules Ord = Ordinance Sub-Ch = Sub-Chapter(s) orig = original SubPt = Subpart(s) par = paragraph(s)/subparagraph(s) /sub-subparagraph(s) Endnote 3—Legislation history
Name FRLI registration or gazettal Commencement Application, saving and transitional provisions Health Insurance (Diagnostic Imaging Capital Sensitivity) Determination 2011 9 May 2011 (see F2011L00724) 1 July 2011 — Health Insurance (Diagnostic Imaging Capital Sensitivity) Amendment Determination 2012 13 June 2012 (see F2012L01185)
1 July 2012
s 4 Health Insurance (Diagnostic Imaging Capital Sensitivity) Amendment Determination 2012 (No. 2) 29 Oct 2012 (see F2012L02097) 1 November 2012 ― Health Insurance (Diagnostic Imaging Capital Sensitivity) Amendment Determination 2012 (No. 3) 18 Dec 2012 (see F2012L02510) 1 January 2013 ― Health Insurance (Diagnostic Imaging Capital Sensitivity) Amendment and Repeal Determination 2013 31 October 2013 (see F2013L01862) Schedule 1: 1 November 2013
[see endnote 5]
― Endnote 4—Amendment history
Provision affected How affected s 3………………………. am F2012L01185 s 5………………………. am F2012L01185 s 6………………………. rs F2012L01185 s 7………………………. am F2012L01185 s 8………………………. rs F2012L01185 Sch 1 Sdiv E of Div 2.5……… ad F2012L02097 am F2012L02510 Sdiv F of Div 2.5………. ad F2013L01862 Sch 2 Item 1…………………... am F2012L01185; F2012L02097; F2013L01862 Item 2…………………... am F2012L02097 Item 3…………………... am F2012L02097; F2013L01862 Endnote 5—Uncommenced amendments
Health Insurance (Diagnostic Imaging Capital Sensitivity) Amendment and Repeal Determination 2013
Schedule 2 - Repeals
Health Insurance (Diagnostic Imaging Capital Sensitivity) Determination 2011
5 The whole of the determination
Repeal the determination.
Endnote 6—Modifications [none]
Endnote 7—Misdescribed amendments [none]
Endnote 8—Miscellaneous [none]
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