Health Insurance Legislation Amendment (2022 Measures No. 3) Regulations 2022 (Cth)
I, General the Honourable David Hurley AC DSC (Retd), Governor‑General of the Commonwealth of Australia, acting with the advice of the Federal Executive Council, make the following regulations.
Dated 18 August 2022
David Hurley
Governor‑General
By His Excellency’s Command
Mark Butler
Minister for Health and Aged Care
Contents
This instrument is the
Health Insurance Legislation Amendment (2022 Measures No. 3) Regulations 2022 .
(1) Each provision of this instrument specified in column 1 of the table commences, or is taken to have commenced, in accordance with column 2 of the table. Any other statement in column 2 has effect according to its terms.
Sections 1 to 4 and anything in this instrument not elsewhere covered by this table | 1 November 2022. | 1 November 2022 |
Schedules 1 to 4 | 1 November 2022. | 1 November 2022 |
Schedule 5 | 1 July 2022. | 1 July 2022 |
Note: This table relates only to the provisions of this instrument as originally made. It will not be amended to deal with any later amendments of this instrument.
(2) Any information in column 3 of the table is not part of this instrument. Information may be inserted in this column, or information in it may be edited, in any published version of this instrument.
This instrument is made under the
Health Insurance Act 1973 .
Each instrument that is specified in a Schedule to this instrument is amended or repealed as set out in the applicable items in the Schedule concerned, and any other item in a Schedule to this instrument has effect according to its terms.
1
Schedule 1 (item 38510, column 2, paragraph (b)) Omit “a service to which item 38502 applies”, substitute “coronary artery bypass surgery performed by any medical practitioner”.
Repeal the cell, substitute:
Creation of Y‑graft, T‑graft and graft‑to‑graft extensions, with micro‑arterial or micro‑venous anastomosis using microsurgical techniques, if:
|
Repeal the cell, substitute:
2,641.60 |
Repeal the cell, substitute:
3,251.20 |
Repeal the cell, substitute:
2,641.60 |
Omit “38603,”.
Repeal the cell, substitute:
3,282.20 |
Repeal the cell, substitute:
4,572.00 |
9
Schedule 1 (item 38572, column 2, paragraph (b)) After “38418,”, insert “38603,”.
Insert:
40863 | Deep brain stimulation (unilateral), remote electronic analysis and programming of neurostimulator pulse generator for the treatment of:
Applicable not more than 8 times in any 12 month period | 200.55 |
11
Schedule 1 (item 32520, column 2, subparagraphs (d)(iii) to (v)) Repeal the subparagraphs, substitute:
(iii) 59970 to 60021;
(iv) 60036 to 60045;
(v) 60060 to 60078;
(vi) 60500 to 60509;
(vii) 61109
12
Schedule 1 (item 32522, column 2, subparagraphs (d)(iii) to (v)) Repeal the subparagraphs, substitute:
(iii) 59970 to 60021;
(iv) 60036 to 60045;
(v) 60060 to 60078;
(vi) 60500 to 60509;
(vii) 61109
13
Schedule 1 (item 32523, column 2, subparagraphs (d)(iii) to (v)) Repeal the subparagraphs, substitute:
(iii) 59970 to 60021;
(iv) 60036 to 60045;
(v) 60060 to 60078;
(vi) 60500 to 60509;
(vii) 61109
14
Schedule 1 (item 32526, column 2, subparagraphs (d)(iii) to (v)) Repeal the subparagraphs, substitute:
(iii) 59970 to 60021;
(iv) 60036 to 60045;
(v) 60060 to 60078;
(vi) 60500 to 60509;
(vii) 61109
15
Schedule 1 (item 32528, column 2, subparagraphs (d)(iii) to (v)) Repeal the subparagraphs, substitute:
(iii) 59970 to 60021;
(iv) 60036 to 60045;
(v) 60060 to 60078;
(vi) 60500 to 60509;
(vii) 61109
16
Schedule 1 (item 32529, column 2, subparagraphs (d)(iii) to (v)) Repeal the subparagraphs, substitute:
(iii) 59970 to 60021;
(iv) 60036 to 60045;
(v) 60060 to 60078;
(vi) 60500 to 60509;
(vii) 61109
17
Schedule 1 (at the end of Subgroup 6 of Group D1) Add:
11736 | Implanted loop recording via remote monitoring (including reprogramming (if required), retrieval of stored data, analysis, interpretation and report), for the investigation of atrial fibrillation, if the service:
(b) is not a service to which item 38288 applies Applicable not more than 4 times in any 12 month period | 36.75 |
11737 | Implanted electrocardiogram loop recording via remote monitoring (including reprogramming (if required), retrieval of stored data, analysis, interpretation and report), by a medical practitioner, if the service is: (a) an investigation for a patient with:
(b) not a service to which item 38285 applies Applicable only once in any 4 week period | 36.75 |
Insert:
30661 | Minor surgical repair following a complication from the circumcision of a penis, when performed in conjunction with a service to which an item in Group T7 or Group T10 applies, other than a service associated with a service to which item 45206 applies (H) (Anaes.) | 405.50 |
30662 | Complex surgical repair following a complication from the circumcision of a penis, including single stage local flap, if indicated, to repair one defect, on genitals (other than a service associated with a service to which item 37819, 37822, 45200, 45201, 45202, 45203 or 45206 applies) (H) (Anaes.) | 810.90 |
After “operation for”, insert “(H)”.
Omit “repair”, substitute “, laparoscopic or open repair of,”.
Repeal the cell, substitute:
638.35 |
Omit “repair of”, substitute “laparoscopic or open repair of”.
After “performed”, insert “(H)”.
Repeal the cell, substitute:
716.45 |
Omit “repair”, substitute “, laparoscopic or open repair of,”.
Repeal the cell, substitute:
716.45 |
Insert:
39141 | Epidural or peripheral nerve electrodes (management, adjustment, or reprogramming of neurostimulator), with a medical practitioner attending remotely by video conference, for the management of chronic neuropathic pain or pain from refractory angina pectoris—each day | 135.15 |
28
Schedule 1 (item 45617, column 2, subparagraphs (a)(i) to (v)) Repeal the subparagraphs, substitute:
(i) history of a demonstrated visual impairment;
(ii) intertriginous inflammation of the eyelid;
(iii) herniation of orbital fat in exophthalmos;
(iv) facial nerve palsy;
(v) post‑traumatic scarring;
(vi) the restoration of symmetry of contralateral upper eyelid in respect of one of the conditions mentioned in subparagraphs (i) to (v); and
After “repair of,”, insert “including excision of the primary tumour bed,”.
After “repair of,”, insert “including excision of the primary tumour bed,”.
Omit “item 45201”, substitute “a service to which item 45201 applies”.
After “repair of,”, insert “including excision of the primary tumour bed,”.
After “repair of,”, insert “including excision of the primary tumour bed,”.
Omit “item 45201”, substitute “a service to which item 45201 applies”.
After “repair of,”, insert “including excision of the primary tumour bed,”.
Omit “item 45201”, substitute “a service to which item 45201 applies”.
After “repair of,”, insert “including excision of the primary tumour bed,”.
Insert:
31377 | Clinically suspected melanoma, surgical excision (other than by shave excision) and repair of, if:
not in association with a service to which item 45201 applies (Anaes.) | 114.10 |
31378 | Clinically suspected melanoma, surgical excision (other than by shave excision) and repair of, if:
(Anaes.) | 174.85 |
31379 | Clinically suspected melanoma, surgical excision (other than by shave excision) and repair of, if:
not in association with a service to which item 45201 applies (Anaes.) | 139.35 |
31380 | Clinically suspected melanoma, surgical excision (other than by shave excision) and repair of, if:
(Anaes.) | 174.85 |
31381 | Clinically suspected melanoma, surgical excision (other than by shave excision) and repair of, if:
not in association with a service to which item 45201 applies (Anaes.) | 99.35 |
31382 | Clinically suspected melanoma, surgical excision (other than by shave excision) and repair of, if:
not in association with a service to which item 45201 applies (Anaes.) | 130.60 |
31383 | Clinically suspected melanoma, surgical excision (other than by shave excision) and repair of, if:
(Anaes.) | 149.40 |
Insert:
47790 | Tendon, large, lengthening of, as an independent procedure (Anaes.) (Assist.) | 298.45 |
47791 | Tenosynovectomy, not being a service associated with a service to which another item in this Group applies (Anaes.) (Assist.) | 278.65 |
47792 | Joint stabilisation procedure of acromio‑clavicular joint or scapulo‑thoracic joint, including any of the following (if performed): (a) arthrotomy; (b) osteotomy, with or without fixation; (c) local tendon transfer; (d) local tendon lengthening or release; (e) ligament repair; (f) joint debridement; not being a service associated with a service to which another item in this Group applies (Anaes.) (Assist.) | 497.60 |
After “shoulder”, insert “or elbow”.
Omit “for infection,”.
Omit “by open procedure,”.
Omit “for infection,”.
Omit “173 to 338,”, substitute “177, 179, 181, 185, 187, 189, 191, 193 to 338,”.
After “14203 to 14212,”, insert “14216, 14219,”.
Repeal the clause, substitute:
For the purposes of items 193 to 199, treatment time for a medical practitioner does not include the period:
(a) commencing immediately after the practitioner has completed applying all acupuncture stimuli on or through a patient’s skin; and
(b) ending immediately before the practitioner begins to remove the acupuncture stimuli from the patient;
unless the practitioner personally attends the patient during that period for a consultation related to the condition for which the acupuncture was performed or another consultation.
Repeal the item.
Omit “Professional attendance by a general practitioner who is a qualified medical acupuncturist, at a place other than a hospital,”, substitute “Professional attendance by a medical practitioner who holds endorsement of registration for acupuncture with the Medical Board of Australia or is registered by the Chinese Medicine Board of Australia as an acupuncturist, at a place other than a hospital, for treatment”.
Omit “the qualified medical acupuncturist”, substitute “the medical practitioner”.
Omit “Professional attendance by a general practitioner who is a qualified medical acupuncturist, on one or more patients at a hospital,”, substitute “Professional attendance by a medical practitioner who holds endorsement of registration for acupuncture with the Medical Board of Australia or is registered by the Chinese Medicine Board of Australia as an acupuncturist, on one or more patients at a hospital, for treatment”.
Omit “the qualified medical acupuncturist”, substitute “the medical practitioner”.
Omit “Professional attendance by a general practitioner who is a qualified medical acupuncturist, at a place other than a hospital,”, substitute “Professional attendance by a medical practitioner who holds endorsement of registration for acupuncture with the Medical Board of Australia or is registered by the Chinese Medicine Board of Australia as an acupuncturist, at a place other than a hospital, for treatment”.
Omit “the qualified medical acupuncturist”, substitute “the medical practitioner”.
Omit “Professional attendance by a general practitioner who is a qualified medical acupuncturist, at a place other than a hospital,”, substitute “Professional attendance by a medical practitioner who holds endorsement of registration for acupuncture with the Medical Board of Australia or is registered by the Chinese Medicine Board of Australia as an acupuncturist, at a place other than a hospital, for treatment”.
Omit “the qualified medical acupuncturist”, substitute “the medical practitioner”.
Omit “55229 or”.
Repeal the Division.
Insert:
36530 | Renal cell carcinoma, not more than 4 cm in diameter, destruction of, by percutaneous, laparoscopic or open cryoablation (including any associated imaging services), if:
| 856.10 |
Omit “I5”, substitute “15”.
Omit “60010, 60072, 60073, 60075, 60076, 60078 or 60079”, substitute “60072, 60075 or 60078”.
Omit “60010, 60072, 60073, 60075, 60076, 60078 or 60079”, substitute “60072, 60075 or 60078”.
62
Schedule 1 (items 35657, 35673 and 35726, column 2) After “service”, insert “associated with a service”.
63
Clause 7.1.1 of Schedule 1 (definition of cervical screening service ) Omit “73073,”.
64
Clause 7.1.1 of Schedule 1 (definition of qualified medical acupuncturist ) Repeal the definition.
Omit “63560”, substitute “63563”.
2
Schedule 1 (item 63454, column 2, paragraph (b)) Omit “central nervous system”.
3
Schedule 1 (item 63454, column 2, paragraph (d)) After “diagnosis”, insert “of fetal abnormality as a result of the ultrasound”.
4
Schedule 1 (item 63454, column 2, paragraph (e)) Before “service”, insert “MRI”.
Insert:
63549 | MRI—scan of the pelvis or abdomen, for a patient with a multiple pregnancy, if:
(b) fetal abnormality is suspected; and
| 1,828.80 |
63563 | MRI—scan of the pelvis or abdomen, if the request for the scan identifies that the investigation is for:
Applicable not more than once in a 2 year period (R) (Anaes.) (Contrast) | 409.65 |
Omit “63560”, substitute “63563”.
After “Subdivision”, insert “(other than item 55758)”.
After “55723,”, insert “55742, 55743,”.
After “55721,”, insert “55740, 55742, 55757,”.
After “55725,”, insert “55741, 55743, 55758,”.
Repeal the cell, substitute:
Pelvis or abdomen, pregnancy‑related or pregnancy complication, ultrasound (the
|
Repeal the cell, substitute:
Pelvis or abdomen, pregnancy‑related or pregnancy complication, ultrasound (the
|
Repeal the cell, substitute:
Pelvis or abdomen, pregnancy‑related or pregnancy complication, fetal development and anatomy, ultrasound (the
|
Repeal the cell, substitute:
Pelvis or abdomen, pregnancy‑related or pregnancy complication, fetal development and anatomy, ultrasound (the
|
Omit “ultrasound scan”, substitute “ultrasound (the
current ultrasound ) scan”.
16
Schedule 1 (item 55706, column 2, paragraphs (a) and (b)) Repeal the paragraphs, substitute:
(a) the dating for the pregnancy (as confirmed by the current ultrasound) is 17 to 22 weeks of gestation; and
(b) the current ultrasound:
(i) is not performed in the same pregnancy as item 55709; and
(ii) is not performed on the same patient within 24 hours of a service mentioned in item 55757 or 55758 (R)
Omit “ultrasound scan”, substitute “ultrasound (the
current ultrasound ) scan”.
18
Schedule 1 (item 55707, column 2, paragraph (a)) Omit “ultrasound”, substitute “the current ultrasound”.
19
Schedule 1 (item 55707, column 2, paragraph (c)) Repeal the paragraph, substitute:
(c) the current ultrasound is not performed on the same patient within 24 hours of a service mentioned in another item in this Subgroup (R)
Omit “ultrasound scan”, substitute “ultrasound (the
current ultrasound ) scan”.
21
Schedule 1 (item 55708, column 2, paragraph (a)) Omit “ultrasound”, substitute “the current ultrasound”.
22
Schedule 1 (item 55708, column 2, paragraph (c)) Repeal the paragraph, substitute:
(c) the current ultrasound is not performed on the same patient within 24 hours of a service mentioned in another item in this Subgroup (NR)
Omit “ultrasound scan”, substitute “ultrasound (the
current ultrasound ) scan”.
24
Schedule 1 (item 55709, column 2, paragraph (a)) Omit “ultrasound”, substitute “the current ultrasound”.
25
Schedule 1 (item 55709, column 2, paragraph (b)) Repeal the paragraph, substitute:
(b) the current ultrasound:
(i) is not performed in the same pregnancy as item 55706; and
(ii) is not performed on the same patient within 24 hours of a service mentioned in item 55757 or 55758 (NR)
Omit “ultrasound scan”, substitute “ultrasound (the
current ultrasound ) scan”.
27
Schedule 1 (item 55712, column 2, paragraph (a)) Omit “service”, substitute “the current ultrasound”.
28
Schedule 1 (item 55712, column 2, paragraph (b)) Omit “ultrasound”, substitute “the current ultrasound”.
29
Schedule 1 (item 55712, column 2, paragraph (c)) Repeal the paragraph, substitute:
(c) further examination is clinically indicated after performance, in the same pregnancy, of a scan mentioned in item 55706 or 55709; and
(d) the current ultrasound is not performed on the same patient within 24 hours of a service mentioned in item 55757 or 55758 (R)
Omit “ultrasound scan”, substitute “ultrasound (the
current ultrasound ) scan”.
31
Schedule 1 (item 55715, column 2, paragraph (a)) Omit “ultrasound”, substitute “the current ultrasound”.
32
Schedule 1 (item 55715, column 2, paragraph (b)) Repeal the paragraph, substitute:
(b) further examination is clinically indicated after performance, in the same pregnancy, of a scan mentioned in item 55706 or 55709; and
(c) the current ultrasound is not performed on the same patient within 24 hours of a service mentioned in item 55757 or 55758 (NR)
Omit “ultrasound scan”, substitute “ultrasound (the
current ultrasound ) scan”.
34
Schedule 1 (item 55718, column 2, paragraph (a)) Omit “ultrasound”, substitute “the current ultrasound”.
35
Schedule 1 (item 55718, column 2, paragraph (b)) Repeal the paragraph, substitute:
(b) the current ultrasound:
(i) is not performed in the same pregnancy as item 55723; and
(ii) is not performed on the same patient within 24 hours of a service mentioned in item 55757 or 55758 (R)
Omit “ultrasound scan”, substitute “ultrasound (the
current ultrasound ) scan”.
37
Schedule 1 (item 55721, column 2, paragraph (a)) Omit “service”, substitute “current ultrasound”.
38
Schedule 1 (item 55721, column 2, paragraph (b)) Omit “ultrasound”, substitute “current ultrasound”.
39
Schedule 1 (item 55721, column 2, paragraph (c)) Repeal the paragraph, substitute:
(c) further examination is clinically indicated in the same pregnancy to which item 55718 or 55723 applies; and
(d) the current ultrasound is not performed on the same patient within 24 hours of a service mentioned in item 55757 or 55758 (R)
Omit “ultrasound scan”, substitute “ultrasound (the
current ultrasound ) scan”.
41
Schedule 1 (item 55723, column 2, paragraph (a)) Omit “ultrasound”, substitute “the current ultrasound”.
42
Schedule 1 (item 55723, column 2, paragraph (b)) Repeal the paragraph, substitute:
(b) the current ultrasound:
(i) is not performed in the same pregnancy as item 55718; and
(ii) is not performed on the same patient within 24 hours of a service mentioned in item 55757 or 55758 (NR)
Omit “ultrasound scan”, substitute “ultrasound (the
current ultrasound ) scan”.
44
Schedule 1 (item 55725, column 2, paragraph (a)) Omit “ultrasound”, substitute “the current ultrasound”.
45
Schedule 1 (item 55725, column 2, paragraph (b)) Repeal the paragraph, substitute:
(b) further examination is clinically indicated in the same pregnancy to which item 55718 or 55723 applies; and
(c) the current ultrasound is not performed on the same patient within 24 hours of a service mentioned in item 55757 or 55758 (NR)
Insert:
55740 | Pelvis or abdomen, pregnancy‑related or pregnancy complication, fetal development and anatomy, ultrasound (the
| 108.30 |
55741 | Pelvis or abdomen, pregnancy‑related or pregnancy complication, fetal development and anatomy, ultrasound (the
| 54.10 |
55742 | Pelvis or abdomen, pregnancy‑related or pregnancy complication, fetal development and anatomy, ultrasound (the
| 108.30 |
55743 | Pelvis or abdomen, pregnancy‑related or pregnancy complication, fetal development and anatomy, ultrasound (the
| 54.10 |
55757 | Pelvis or abdomen, ultrasound (the
(b) any of the following apply:
| 51.55 |
55758 | Pelvis or abdomen, ultrasound (the
(b) any of the following apply:
| 19.60 |
Omit “ultrasound scan”, substitute “ultrasound (the
current ultrasound ) scan”.
48
Schedule 1 (item 55759, column 2, paragraph (a)) Before “ultrasound”, insert “an”.
49
Schedule 1 (item 55759, column 2, paragraph (b)) Omit “ultrasound”, substitute “the current ultrasound”.
50
Schedule 1 (item 55759, column 2, paragraph (c)) Repeal the paragraph, substitute:
(c) the service mentioned in item 55706, 55709, 55712, 55715 or 55762 is not performed in conjunction with the current ultrasound during the same pregnancy; and
(d) the current ultrasound is not performed on the same patient within 24 hours of a service mentioned in item 55757 or 55758 (R)
Omit “ultrasound scan”, substitute “ultrasound (the
current ultrasound ) scan”.
52
Schedule 1 (item 55762, column 2, paragraph (a)) Before “ultrasound”, insert “an”.
53
Schedule 1 (item 55762, column 2, paragraph (b)) Omit “ultrasound”, substitute “the current ultrasound”.
54
Schedule 1 (item 55762, column 2, paragraph (c)) Repeal the paragraph, substitute:
(c) the service mentioned in item 55706, 55709, 55712, 55715 or 55759 is not performed in conjunction with the current ultrasound during the same pregnancy; and
(d) the current ultrasound is not performed on the same patient within 24 hours of a service mentioned in item 55757 or 55758 (NR)
Omit “ultrasound scan”, substitute “ultrasound (the
current ultrasound ) scan”.
56
Schedule 1 (item 55764, column 2, paragraph (b)) Before “ultrasound”, insert “an”.
57
Schedule 1 (item 55764, column 2, paragraph (c)) Omit “ultrasound”, substitute “the current ultrasound”.
58
Schedule 1 (item 55764, column 2, paragraph (e)) Repeal the paragraph, substitute:
(e) the service mentioned in item 55706, 55709, 55712 or 55715 is not performed in conjunction with the current ultrasound during the same pregnancy; and
(f) the current ultrasound is not performed on the same patient within 24 hours of a service mentioned in item 55757 or 55758 (R)
Omit “ultrasound scan”, substitute “ultrasound (the
current ultrasound ) scan”.
60
Schedule 1 (item 55766, column 2, paragraph (a)) Before “ultrasound”, insert “an”.
61
Schedule 1 (item 55766, column 2, paragraph (b)) Omit “ultrasound”, substitute “the current ultrasound”.
62
Schedule 1 (item 55766, column 2, paragraph (d)) Repeal the paragraph, substitute:
(d) the service mentioned in item 55706, 55709, 55712 or 55715 is not performed in conjunction with the current ultrasound during the same pregnancy; and
(e) the current ultrasound is not performed on the same patient within 24 hours of a service mentioned in item 55757 or 55758 (NR)
Omit “ultrasound scan”, substitute “ultrasound (the
current ultrasound ) scan”.
64
Schedule 1 (item 55768, column 2, paragraph (a)) Omit “ultrasound”, substitute “the current ultrasound”.
65
Schedule 1 (item 55768, column 2, paragraph (b)) Omit “the ultrasound”, substitute “an ultrasound”.
66
Schedule 1 (item 55768, column 2, paragraph (d)) Repeal the paragraph, substitute:
(d) the service mentioned in item 55718, 55721, 55723 or 55725 is not performed in conjunction with the current ultrasound during the same pregnancy; and
(e) the current ultrasound is not performed on the same patient within 24 hours of a service mentioned in item 55757 or 55758 (R)
Omit “ultrasound scan”, substitute “ultrasound (the
current ultrasound ) scan”.
68
Schedule 1 (item 55770, column 2, paragraph (a)) Omit “ultrasound”, substitute “the current ultrasound”.
69
Schedule 1 (item 55770, column 2, paragraph (b)) Omit “the ultrasound”, substitute “an ultrasound”.
70
Schedule 1 (item 55770, column 2, paragraph (d)) Repeal the paragraph, substitute:
(d) the service mentioned in item 55718, 55721, 55723 or 55725 is not performed in conjunction with the current ultrasound during the same pregnancy; and
(e) the current ultrasound is not performed on the same patient within 24 hours of a service mentioned in item 55757 or 55758 (NR)
Omit “ultrasound scan”, substitute “ultrasound (the
current ultrasound ) scan”.
72
Schedule 1 (item 55772, column 2, paragraph (a)) Omit “ultrasound”, substitute “the current ultrasound”.
73
Schedule 1 (item 55772, column 2, paragraph (d)) Before “ultrasound”, insert “an”.
74
Schedule 1 (item 55772, column 2, paragraph (e)) Repeal the paragraph, substitute:
(e) the service mentioned in item 55718, 55721, 55723 or 55725 is not performed in conjunction with the current ultrasound during the same pregnancy; and
(f) the current ultrasound is not performed on the same patient within 24 hours of a service mentioned in item 55757 or 55758 (R)
Omit “ultrasound scan”, substitute “ultrasound (the
current ultrasound ) scan”.
76
Schedule 1 (item 55774, column 2, paragraph (a)) Omit “ultrasound”, substitute “the current ultrasound”.
77
Schedule 1 (item 55774, column 2, paragraph (c)) Before “ultrasound”, insert “an”.
78
Schedule 1 (item 55774, column 2, paragraph (d)) Repeal the paragraph, substitute:
(d) the service mentioned in item 55718, 55721, 55723 or 55725 is not performed in conjunction with the current ultrasound during the same pregnancy; and
(e) the current ultrasound is not performed on the same patient within 24 hours of a service mentioned in item 55757 or 55758 (NR)
Repeal the item.
Repeal the paragraph, substitute:
(c) using equipment that is:
(i) located at the premises of a comprehensive practice; and
(ii) if the equipment is located in a Modified Monash 1 area—eligible equipment mentioned in clause 2.5.5.
Repeal the paragraph, substitute:
(c) using equipment that is:
(i) located at the premises of a comprehensive practice; and
(ii) if the equipment is located in a Modified Monash 1 area—partial eligible equipment mentioned in clause 2.5.6.
Repeal the paragraph, substitute:
(c) using equipment that is:
(i) located at the premises of a comprehensive practice; and
(ii) if the equipment is located in a Modified Monash 1 area—eligible equipment mentioned in clause 2.5.5 or partial eligible equipment mentioned in clause 2.5.6.
Repeal the paragraph, substitute:
(c) using equipment that is:
(i) located at the premises of a comprehensive practice; and
(ii) if the equipment is located in a Modified Monash 1 area—eligible equipment mentioned in clause 2.5.5 or partial eligible equipment mentioned in clause 2.5.6.
Repeal the paragraphs, substitute:
(a) it is made available to the comprehensive practice at which it is located by a person who is subject to a current deed with the Commonwealth that relates to the equipment; and
(b) it is not identified as partial eligible equipment in the deed.
Repeal the paragraphs, substitute:
(a) it is made available to the comprehensive practice at which it is located by a person who is subject to a current deed with the Commonwealth that relates to the equipment; and
(b) it is identified as partial eligible equipment in the deed.
Insert:
Modified Monash 1 area means an area that is not a Modified Monash 2 to 7 area.
Omit “61369”, substitute “61369 or 63549”.
Insert:
61612 | Whole body FDG PET study for the initial staging of eligible cancer types, for a patient who is considered suitable for active therapy, if: (a) the eligible cancer type is:
Applicable once per cancer diagnosis (R) | 953.00 |
Repeal the cell, substitute:
MRI—scan of both breasts for the detection of cancer in a patient, if:
|
Applicable not more than once in a 12 month period (R) (Anaes.) (Contrast) |
Repeal the clause.
Insert:
(1) Subject to subclauses (2), (3) and (4), if item 63491, 63494 or 63497 applies to an MRI or MRA service, the fee specified in that item applies in addition to the fee specified in the other item in Group I5 that applies to the service.
(2) If 2 or more MRI or MRA services mentioned in item 63494 are performed for a person on the same day, the fee specified in that item applies to one of those services only.
(3) If 2 or more MRI or MRA services mentioned in item 63497 are performed for a person on the same day, the fee specified in that item applies to one of those services only.
(4) If:
(a) one or more MRI or MRA services mentioned in item 63494; and
(b) one or more MRI or MRA services mentioned in item 63497;
are performed for a person on the same day, the fee specified in item 63494 or 63497, but not both those items, applies to one of those services only.
Repeal the cell, substitute:
MRI—multiphase scans of liver (including delayed imaging, if performed) with a contrast agent, for staging where surgical resection or interventional techniques are under consideration to treat any liver metastases detected, if:
Applicable not more than once in a 12 month period (R) (Anaes.) (Contrast) |
Add:
73422 | Characterisation of a gene variant or gene variants using a gene panel, in a patient presenting with clinical signs and symptoms suggestive of a genetic neuromuscular disorder (other than signs and symptoms associated with variants that are not detected by massively parallel sequencing), if the service is requested: (a) by a specialist or consultant physician; and (b) after exclusion of non‑genetic causes Applicable once per lifetime | 1,200.00 |
73423 | Detection of a single identified gene variant, in a biological relative of a person with a germline gene variant for a neuromuscular disorder identified by a service described in item 73422, 73425 or 73426, if the service is requested by a specialist or consultant physician Applicable once per variant | 500.00 |
73424 | Prenatal detection of an actionable pathogenic familial gene variant or gene variants (including maternal cell contamination assessment), requested by a specialist or consultant physician, for a genetic neuromuscular disorder previously identified in an index person in the patient’s family as a result of a service described in item 73422 Applicable once per pregnancy | 1,600.00 |
73425 | Prenatal detection of unknown gene variants (including maternal cell contamination assessment) using a gene panel, if: (a) the service is requested:
Applicable once per pregnancy | 1,800.00 |
73426 | Prenatal detection of unknown gene variants (including maternal cell contamination assessment) using a gene panel, if: (a) the service is requested:
Applicable once per pregnancy | 2,400.00 |
73427 | Single gene testing for the characterisation of a germline gene variant or germline gene variants, if requested by a specialist or consultant physician, within the same gene in which the patient’s reproductive partner has a documented pathogenic germline recessive gene variant for a neuromuscular disorder identified by a service described in item 73422, 73425 or 73426 Applicable once per gene | 1,200.00 |
73428 | Re‑analysis of whole genome or exome data obtained in performing a service described in item 73422, 73425 or 73426, for characterisation of previously unreported gene variants related to the clinical phenotype, if the re‑analysis is requested by:
Applicable twice per lifetime | 500.00 |
Omit “, performed on a liquid based cervical specimen”.
3
Schedule 1 (item 73072, column 2, paragraph (f)) Repeal the paragraph, substitute:
(f) for the follow‑up management of a patient exposed to diethylstilboestrol in utero; or
(g) for a patient previously treated for a genital tract malignancy when performed as a co‑test for both human papillomavirus (HPV) and liquid‑based cytology (LBC)
Repeal the item.
Repeal the cell, substitute:
A test, including partial genotyping, for oncogenic human papillomavirus, for the investigation of a patient following a total hysterectomy |
6
Schedule 1 (item 73410, column 2, subparagraph (a)(ii)) Omit “for beta‑thalassaemia was not conclusive”, substitute “was suggestive of thalassaemia”.
7
Schedule 1 (items 75862, 75863 and 75864, column 2) Omit “Commonwealth concession card holder”, substitute “concessional beneficiary”.
Omit “73073,” in the following provisions of Schedule 1:
(a) paragraph 1.2.9(1)(d);
(b) subparagraph 2.5.5(1)(a)(iii);
(c) item 73075, column 2, paragraph (a);
(d) item 73076, column 2, subparagraph (a)(i);
(e) item 73922, column 2;
(f) item 73923, column 2.
Repeal the item, substitute:
13 | Subgroup 9 of Group A7 | 272, 276, 277, 279, 281, 282, 283, 285, 286, 287, 941, 942 |
Repeal the item, substitute:
23 | A20 | 2700, 2701, 2712, 2713, 2715, 2717, 2721, 2723, 2725, 2727, 2733, 2735 |
Omit “or 1.2.19”.
Omit “
pedeodontists ”, substitute “paediatric dentistry specialists ”.
Omit “pedeodontist”, substitute “paediatric dentistry specialist”.
Omit “pedeodontics”, substitute “paediatric dentistry”.
Omit “
pedeodontist ”, substitute “paediatric dentistry specialist ”.
Repeal the heading, substitute:
Oral medicine, oral and maxillofacial pathology, oral surgery and special needs dentistry specialists
Omit “or oral pathology specialist”, substitute “, oral and maxillofacial pathology specialist, oral surgery specialist or special needs dentistry specialist”.
Omit “or oral pathology”, substitute “, oral and maxillofacial pathology, oral surgery or special needs dentistry”.
Omit “
or oral pathology specialist ”, substitute “, oral and maxillofacial pathology, oral surgery or special needs dentistry specialist ”.
1
Clause 2.1.1 of Schedule 1 (table item 9, column 3) Omit “27.00”, substitute “27.45”.
2
Clause 2.1.1 of Schedule 1 (table item 9, column 4) Omit “2.10”, substitute “2.15”.
Omit “$57.25”, substitute “$58.15”.
Omit “$41.60”, substitute “$42.25”.
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