Health Insurance Legislation Amendment (2023 Measures No. 1) Regulations 2023 (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 30 March 2023
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 (2023 Measures No. 1) Regulations 2023 .
(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 | The day after this instrument is registered. | 5 April 2023 |
Schedule 1 | The day after this instrument is registered. | 5 April 2023 |
Schedule 2 | 1 July 2023. | 1 July 2023 |
Schedule 3 | Immediately after the commencement of the provisions covered by table item 3. | 1 July 2023 |
Schedule 4 | Immediately after the commencement of the provisions covered by table item 3. | 1 July 2023 |
Schedule 5 | Immediately after the commencement of the provisions covered by table item 3. | 1 July 2023 |
Note: This table relates only to the provisions of this instrument as originally made.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Each instrument that is specified in a Schedule to this instrument is amended or repealed as set out in the applicable items in the Schedule concerned, and any other item in a Schedule to this instrument has effect according to its terms.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
Clause 5.9.2 of Schedule 1 (paragraph (a) of the definition of amount under clause 5.9.2 ) Omit “$103.00”, substitute “$104.75”.
Omit “247.20”, substitute “251.40”.
Omit “251.40”, substitute “104.75”.
Omit “309.00”, substitute “325.50”.
Omit “
1 July 2022 ”, substitute “1 July 2023 ”.
Repeal the subclause, substitute:
(1) At the start of 1 July 2023 (the
indexation time ), each amount covered by subclause (2) is replaced by the amount worked out using the following formula:Note: The indexed fees could in 2023 be viewed on the Department’s MBS Online website ( Insurance (General Medical Services Table) Regulations 2021
3
Paragraph 1.2.4(2)(c) of Schedule 1 Omit “$317.15”, substitute “$328.55”.
4
Clause 1.3.1 of Schedule 1 (heading) Omit “
1 July 2022 ”, substitute “1 July 2023 ”.5
Subclause 1.3.1(1) of Schedule 1 Repeal the subclause, substitute:
(1) At the start of 1 July 2023 (the
indexation time ), each amount covered by subclause (2) is replaced by the amount worked out using the following formula:Note: The indexed fees could in 2023 be viewed on the Department’s MBS Online website ( 1.3.1(2)(f) of Schedule 1
Omit “, 90277, 90281 and 90282”, substitute “and 90277”.
7
Clause 2.1.1 of Schedule 1 (table items 14 to 22) Repeal the items.
8
Schedule 1 (item 111, column 2, paragraph (d)) Omit “$317.15”, substitute “$328.55”.
9
Schedule 1 (item 115, column 2, paragraph (c)) Omit “$317.15”, substitute “$328.55”.
10
Schedule 1 (item 117, column 2, paragraph (e)) Omit “$317.15”, substitute “$328.55”.
11
Schedule 1 (item 120, column 2, paragraph (d)) Omit “$317.15”, substitute “$328.55”.
12
Subclause 2.30.1(1) of Schedule 1 Omit “$58.15”, substitute “$60.25”.
13
Subclause 2.30.1(2) of Schedule 1 Omit “$42.25”, substitute “$43.75”.
14
Subclause 5.7.1(1) of Schedule 1 (paragraph (b) of the definition of amount under clause 5.7.1 ) Omit “$20.10”, substitute “$20.80”.
15
Subclause 5.7.1(2) of Schedule 1 (paragraph (b) of the definition of amount under clause 5.7.1 ) Omit “$30.25”, substitute “$31.35”.
16
Clause 5.9.2 of Schedule 1 (paragraph (a) of the definition of amount under clause 5.9.2 ) Omit “$104.75”, substitute “$108.50”.
17
Schedule 1 (items 51300 and 51303, column 2) Omit “$590.25”, substitute “$611.50”.
18
Schedule 1 (items 51800 and 51803, column 2) Omit “$590.25”, substitute “$611.50”.
19
Amendments of listed provisions—clause 2.1.1 of Schedule 1 The items of the table in clause 2.1.1 of Schedule 1 listed in the following table are amended as set out in the table.
Amendments relating to indexation—amendments of table 2.1.1
Item
Table item
Omit
Substitute 1
Table item 1
27.85
28.85
2
Table item 1
2.20
2.30
3
Table item 2
27.85
28.85
4
Table item 2
2.20
2.30
5
Table item 3
27.85
28.85
6
Table item 3
2.20
2.30
7
Table item 4
27.85
28.85
8
Table item 4
2.20
2.30
9
Table item 9
27.45
28.45
10
Table item 9
2.15
2.25
11
Table item 10
27.35
28.35
12
Table item 10
2.15
2.25
13
Table item 11
27.35
28.35
14
Table item 11
2.15
2.25
15
Table item 12
27.35
28.35
16
Table item 12
2.15
2.25
17
Table item 13
27.35
28.35
18
Table item 13
2.15
2.25
19
Table item 23
27.45
28.45
20
Table item 23
2.15
2.25
21
Table item 24
49.40
51.20
22
Table item 24
3.50
3.65
23
Table item 25
27.45
28.45
24
Table item 25
2.15
2.25
25
Table item 26
49.40
51.20
26
Table item 26
3.50
3.65
27
Table item 27
27.45
28.45
28
Table item 27
2.15
2.25
29
Table item 28
49.40
51.20
30
Table item 28
3.50
3.65
31
Table item 29
27.45
28.45
32
Table item 29
2.15
2.25
33
Table item 30
49.40
51.20
34
Table item 30
3.50
3.65
35
Table item 39
27.45
28.45
36
Table item 39
2.15
2.25
37
Table item 40
27.45
28.45
38
Table item 40
2.15
2.25
39
Table item 41
21.95
22.75
40
Table item 41
1.75
1.80
41
Table item 42
21.95
22.75
42
Table item 42
1.75
1.80
20
Amendments of listed provisions—clause 2.20.2 of Schedule 1 The items of the table in clause 2.20.2 of Schedule 1 listed in the following table are amended as set out in the table.
Amendments relating to indexation—amendments of table 2.20.2
Item
Table item
Omit
Substitute 1
Table item 1
27.45
28.45
2
Table item 1
2.15
2.25
3
Table item 2
27.45
28.45
4
Table item 2
2.15
2.25
5
Table item 3
27.45
28.45
6
Table item 3
2.15
2.25
7
Table item 4
27.45
28.45
8
Table item 4
2.15
2.25
21
Amendments of listed provisions—clause 5.3.1 of Schedule 1 The items of the table in clause 5.3.1 of Schedule 1 listed in the following table are amended as set out in the table.
Amendments relating to indexation—amendments of table 5.3.1
Item
Table item
Omit
Substitute 1
Table item 1
18.05
18.70
2
Table item 2
19.60
20.30
3
Table item 3
19.85
20.55
4
Table item 4
24.00
24.85
5
Table item 5
50.00
51.80
6
Table item 6
33.75
34.95
7
Table item 7
40.15
41.60
8
Table item 8
40.15
41.60
9
Table item 9
40.15
41.60
10
Table item 10
40.15
41.60
11
Table item 11
40.15
41.60
12
Table item 12
40.15
41.60
13
Table item 13
40.15
41.60
14
Table item 14
40.15
41.60
15
Table item 15
40.15
41.60
16
Table item 16
40.15
41.60
22
Amendments of listed provisions—Group A36 The items of Schedule 1 listed in the following table are amended as set out in the table.
Amendments relating to indexation
Item
Item of Schedule 1
Omit
Substitute 1
Item 90254
60.65
62.85
2
Item 90255
89.30
92.50
3
Item 90256
77.00
79.75
4
Item 90257
113.45
117.50
5
Item 90265
60.65
62.85
6
Item 90275
78.45
81.30
7
Item 90277
112.25
116.30
23 Amendments of listed provisions—Group T10 The items of Schedule 1 listed in the following table are amended as set out in the table.
Amendments relating to indexation
Item
Item of Schedule 1
Omit
Substitute 1
Item 20100
104.75
108.50
2
Item 20102
125.70
130.20
3
Item 20104
83.80
86.80
4
Item 20120
104.75
108.50
5
Item 20124
83.80
86.80
6
Item 20140
104.75
108.50
7
Item 20142
104.75
108.50
8
Item 20143
125.70
130.20
9
Item 20144
146.65
151.90
10
Item 20145
146.65
151.90
11
Item 20146
104.75
108.50
12
Item 20147
125.70
130.20
13
Item 20148
83.80
86.80
14
Item 20160
125.70
130.20
15
Item 20162
146.65
151.90
16
Item 20164
83.80
86.80
17
Item 20170
125.70
130.20
18
Item 20172
146.65
151.90
19
Item 20174
188.55
195.30
20
Item 20176
209.50
217.00
21
Item 20190
104.75
108.50
22
Item 20192
209.50
217.00
23
Item 20210
314.25
325.50
24
Item 20212
104.75
108.50
25
Item 20214
188.55
195.30
26
Item 20216
419.00
434.00
27
Item 20220
209.50
217.00
28
Item 20222
125.70
130.20
29
Item 20225
251.40
260.40
30
Item 20230
251.40
260.40
31
Item 20300
104.75
108.50
32
Item 20305
314.25
325.50
33
Item 20320
125.70
130.20
34
Item 20321
209.50
217.00
35
Item 20330
167.60
173.60
36
Item 20350
209.50
217.00
37
Item 20352
104.75
108.50
38
Item 20355
251.40
260.40
39
Item 20400
62.85
65.10
40
Item 20401
83.80
86.80
41
Item 20402
104.75
108.50
42
Item 20403
104.75
108.50
43
Item 20404
125.70
130.20
44
Item 20405
167.60
173.60
45
Item 20406
272.35
282.10
46
Item 20410
83.80
86.80
47
Item 20420
104.75
108.50
48
Item 20440
83.80
86.80
49
Item 20450
104.75
108.50
50
Item 20452
125.70
130.20
51
Item 20470
125.70
130.20
52
Item 20472
209.50
217.00
53
Item 20474
272.35
282.10
54
Item 20475
209.50
217.00
55
Item 20500
314.25
325.50
56
Item 20520
125.70
130.20
57
Item 20522
83.80
86.80
58
Item 20524
83.80
86.80
59
Item 20526
209.50
217.00
60
Item 20528
167.60
173.60
61
Item 20540
272.35
282.10
62
Item 20542
314.25
325.50
63
Item 20546
314.25
325.50
64
Item 20548
314.25
325.50
65
Item 20560
419.00
434.00
66
Item 20600
209.50
217.00
67
Item 20604
272.35
282.10
68
Item 20620
209.50
217.00
69
Item 20622
272.35
282.10
70
Item 20630
167.60
173.60
71
Item 20632
146.65
151.90
72
Item 20634
209.50
217.00
73
Item 20670
272.35
282.10
74
Item 20680
62.85
65.10
75
Item 20690
104.75
108.50
76
Item 20700
62.85
65.10
77
Item 20702
83.80
86.80
78
Item 20703
83.80
86.80
79
Item 20704
209.50
217.00
80
Item 20706
146.65
151.90
81
Item 20730
104.75
108.50
82
Item 20740
104.75
108.50
83
Item 20745
146.65
151.90
84
Item 20750
104.75
108.50
85
Item 20752
125.70
130.20
86
Item 20754
146.65
151.90
87
Item 20756
188.55
195.30
88
Item 20770
314.25
325.50
89
Item 20790
167.60
173.60
90
Item 20791
209.50
217.00
91
Item 20792
272.35
282.10
92
Item 20793
314.25
325.50
93
Item 20794
251.40
260.40
94
Item 20798
209.50
217.00
95
Item 20799
125.70
130.20
96
Item 20800
62.85
65.10
97
Item 20802
104.75
108.50
98
Item 20803
83.80
86.80
99
Item 20804
209.50
217.00
100
Item 20806
146.65
151.90
101
Item 20810
83.80
86.80
102
Item 20815
125.70
130.20
103
Item 20820
104.75
108.50
104
Item 20830
83.80
86.80
105
Item 20832
125.70
130.20
106
Item 20840
125.70
130.20
107
Item 20841
167.60
173.60
108
Item 20842
83.80
86.80
109
Item 20844
209.50
217.00
110
Item 20845
209.50
217.00
111
Item 20846
209.50
217.00
112
Item 20847
209.50
217.00
113
Item 20848
209.50
217.00
114
Item 20850
251.40
260.40
115
Item 20855
314.25
325.50
116
Item 20860
125.70
130.20
117
Item 20862
146.65
151.90
118
Item 20863
209.50
217.00
119
Item 20864
209.50
217.00
120
Item 20866
209.50
217.00
121
Item 20867
209.50
217.00
122
Item 20868
209.50
217.00
123
Item 20880
314.25
325.50
124
Item 20882
209.50
217.00
125
Item 20884
104.75
108.50
126
Item 20886
125.70
130.20
127
Item 20900
62.85
65.10
128
Item 20902
83.80
86.80
129
Item 20904
146.65
151.90
130
Item 20905
209.50
217.00
131
Item 20906
83.80
86.80
132
Item 20910
83.80
86.80
133
Item 20911
104.75
108.50
134
Item 20912
104.75
108.50
135
Item 20914
146.65
151.90
136
Item 20916
146.65
151.90
137
Item 20920
83.80
86.80
138
Item 20924
83.80
86.80
139
Item 20926
83.80
86.80
140
Item 20928
125.70
130.20
141
Item 20930
83.80
86.80
142
Item 20932
83.80
86.80
143
Item 20934
125.70
130.20
144
Item 20936
167.60
173.60
145
Item 20938
83.80
86.80
146
Item 20940
83.80
86.80
147
Item 20942
104.75
108.50
148
Item 20943
83.80
86.80
149
Item 20944
125.70
130.20
150
Item 20946
167.60
173.60
151
Item 20948
83.80
86.80
152
Item 20950
104.75
108.50
153
Item 20952
83.80
86.80
154
Item 20954
209.50
217.00
155
Item 20956
83.80
86.80
156
Item 20958
104.75
108.50
157
Item 20960
146.65
151.90
158
Item 21100
62.85
65.10
159
Item 21110
104.75
108.50
160
Item 21112
83.80
86.80
161
Item 21114
104.75
108.50
162
Item 21116
125.70
130.20
163
Item 21120
125.70
130.20
164
Item 21130
62.85
65.10
165
Item 21140
314.25
325.50
166
Item 21150
209.50
217.00
167
Item 21155
209.50
217.00
168
Item 21160
83.80
86.80
169
Item 21170
167.60
173.60
170
Item 21195
62.85
65.10
171
Item 21199
83.80
86.80
172
Item 21200
83.80
86.80
173
Item 21202
83.80
86.80
174
Item 21210
125.70
130.20
175
Item 21212
209.50
217.00
176
Item 21214
209.50
217.00
177
Item 21215
314.25
325.50
178
Item 21216
293.30
303.80
179
Item 21220
83.80
86.80
180
Item 21230
125.70
130.20
181
Item 21232
104.75
108.50
182
Item 21234
167.60
173.60
183
Item 21260
83.80
86.80
184
Item 21270
167.60
173.60
185
Item 21272
83.80
86.80
186
Item 21274
125.70
130.20
187
Item 21275
209.50
217.00
188
Item 21280
314.25
325.50
189
Item 21300
62.85
65.10
190
Item 21321
83.80
86.80
191
Item 21340
83.80
86.80
192
Item 21360
104.75
108.50
193
Item 21380
62.85
65.10
194
Item 21382
83.80
86.80
195
Item 21390
62.85
65.10
196
Item 21392
83.80
86.80
197
Item 21400
83.80
86.80
198
Item 21402
146.65
151.90
199
Item 21403
209.50
217.00
200
Item 21404
104.75
108.50
201
Item 21420
62.85
65.10
202
Item 21430
83.80
86.80
203
Item 21432
104.75
108.50
204
Item 21440
167.60
173.60
205
Item 21445
209.50
217.00
206
Item 21460
62.85
65.10
207
Item 21461
83.80
86.80
208
Item 21462
62.85
65.10
209
Item 21464
83.80
86.80
210
Item 21472
104.75
108.50
211
Item 21474
104.75
108.50
212
Item 21480
83.80
86.80
213
Item 21482
104.75
108.50
214
Item 21484
104.75
108.50
215
Item 21486
146.65
151.90
216
Item 21490
62.85
65.10
217
Item 21500
167.60
173.60
218
Item 21502
125.70
130.20
219
Item 21520
83.80
86.80
220
Item 21522
104.75
108.50
221
Item 21530
314.25
325.50
222
Item 21532
167.60
173.60
223
Item 21535
209.50
217.00
224
Item 21600
62.85
65.10
225
Item 21610
104.75
108.50
226
Item 21620
83.80
86.80
227
Item 21622
104.75
108.50
228
Item 21630
104.75
108.50
229
Item 21632
125.70
130.20
230
Item 21634
188.55
195.30
231
Item 21636
314.25
325.50
232
Item 21638
209.50
217.00
233
Item 21650
167.60
173.60
234
Item 21652
209.50
217.00
235
Item 21654
167.60
173.60
236
Item 21656
209.50
217.00
237
Item 21670
83.80
86.80
238
Item 21680
62.85
65.10
239
Item 21682
83.80
86.80
240
Item 21685
209.50
217.00
241
Item 21700
62.85
65.10
242
Item 21710
83.80
86.80
243
Item 21712
104.75
108.50
244
Item 21714
104.75
108.50
245
Item 21716
104.75
108.50
246
Item 21730
62.85
65.10
247
Item 21732
83.80
86.80
248
Item 21740
104.75
108.50
249
Item 21756
125.70
130.20
250
Item 21760
146.65
151.90
251
Item 21770
167.60
173.60
252
Item 21772
125.70
130.20
253
Item 21780
83.80
86.80
254
Item 21785
209.50
217.00
255
Item 21790
314.25
325.50
256
Item 21800
62.85
65.10
257
Item 21810
83.80
86.80
258
Item 21820
62.85
65.10
259
Item 21830
83.80
86.80
260
Item 21832
146.65
151.90
261
Item 21834
83.80
86.80
262
Item 21840
167.60
173.60
263
Item 21842
125.70
130.20
264
Item 21850
83.80
86.80
265
Item 21860
62.85
65.10
266
Item 21865
209.50
217.00
267
Item 21870
314.25
325.50
268
Item 21872
167.60
173.60
269
Item 21878
62.85
65.10
270
Item 21879
104.75
108.50
271
Item 21880
146.65
151.90
272
Item 21881
188.55
195.30
273
Item 21882
230.45
238.70
274
Item 21883
272.35
282.10
275
Item 21884
314.25
325.50
276
Item 21885
356.15
368.90
277
Item 21886
398.05
412.30
278
Item 21887
439.95
455.70
279
Item 21900
62.85
65.10
280
Item 21906
104.75
108.50
281
Item 21908
125.70
130.20
282
Item 21910
188.55
195.30
283
Item 21912
104.75
108.50
284
Item 21914
125.70
130.20
285
Item 21915
104.75
108.50
286
Item 21916
104.75
108.50
287
Item 21918
104.75
108.50
288
Item 21922
125.70
130.20
289
Item 21925
83.80
86.80
290
Item 21926
83.80
86.80
291
Item 21930
125.70
130.20
292
Item 21935
104.75
108.50
293
Item 21936
104.75
108.50
294
Item 21939
62.85
65.10
295
Item 21941
146.65
151.90
296
Item 21942
209.50
217.00
297
Item 21943
104.75
108.50
298
Item 21945
104.75
108.50
299
Item 21949
104.75
108.50
300
Item 21952
83.80
86.80
301
Item 21955
104.75
108.50
302
Item 21959
104.75
108.50
303
Item 21962
104.75
108.50
304
Item 21965
104.75
108.50
305
Item 21969
167.60
173.60
306
Item 21970
314.25
325.50
307
Item 21973
104.75
108.50
308
Item 21976
104.75
108.50
309
Item 21980
104.75
108.50
310
Item 21990
62.85
65.10
311
Item 21992
83.80
86.80
312
Item 21997
83.80
86.80
313
Item 22002
83.80
86.80
314
Item 22007
83.80
86.80
315
Item 22008
83.80
86.80
316
Item 22012
62.85
65.10
317
Item 22014
62.85
65.10
318
Item 22015
125.70
130.20
319
Item 22020
83.80
86.80
320
Item 22025
83.80
86.80
321
Item 22031
104.75
108.50
322
Item 22036
62.85
65.10
323
Item 22041
41.90
43.40
324
Item 22042
20.95
21.70
325
Item 22051
188.55
195.30
326
Item 22055
251.40
260.40
327
Item 22060
628.50
651.00
328
Item 22065
104.75
108.50
329
Item 22075
314.25
325.50
330
Item 22900
125.70
130.20
331
Item 22905
125.70
130.20
332
Item 23010
20.95
21.70
333
Item 23025
41.90
43.40
334
Item 23035
62.85
65.10
335
Item 23045
83.80
86.80
336
Item 23055
104.75
108.50
337
Item 23065
125.70
130.20
338
Item 23075
146.65
151.90
339
Item 23085
167.60
173.60
340
Item 23091
188.55
195.30
341
Item 23101
209.50
217.00
342
Item 23111
230.45
238.70
343
Item 23112
251.40
260.40
344
Item 23113
272.35
282.10
345
Item 23114
293.30
303.80
346
Item 23115
314.25
325.50
347
Item 23116
335.20
347.20
348
Item 23117
356.15
368.90
349
Item 23118
377.10
390.60
350
Item 23119
398.05
412.30
351
Item 23121
419.00
434.00
352
Item 23170
439.95
455.70
353
Item 23180
460.90
477.40
354
Item 23190
481.85
499.10
355
Item 23200
502.80
520.80
356
Item 23210
523.75
542.50
357
Item 23220
544.70
564.20
358
Item 23230
565.65
585.90
359
Item 23240
586.60
607.60
360
Item 23250
607.55
629.30
361
Item 23260
628.50
651.00
362
Item 23270
649.45
672.70
363
Item 23280
670.40
694.40
364
Item 23290
691.35
716.10
365
Item 23300
712.30
737.80
366
Item 23310
733.25
759.50
367
Item 23320
754.20
781.20
368
Item 23330
775.15
802.90
369
Item 23340
796.10
824.60
370
Item 23350
817.05
846.30
371
Item 23360
838.00
868.00
372
Item 23370
858.95
889.70
373
Item 23380
879.90
911.40
374
Item 23390
900.85
933.10
375
Item 23400
921.80
954.80
376
Item 23410
942.75
976.50
377
Item 23420
963.70
998.20
378
Item 23430
984.65
1019.90
379
Item 23440
1005.60
1041.60
380
Item 23450
1026.55
1063.30
381
Item 23460
1047.50
1085.00
382
Item 23470
1068.45
1106.70
383
Item 23480
1089.40
1128.40
384
Item 23490
1110.35
1150.10
385
Item 23500
1131.30
1171.80
386
Item 23510
1152.25
1193.50
387
Item 23520
1173.20
1215.20
388
Item 23530
1194.15
1236.90
389
Item 23540
1215.10
1258.60
390
Item 23550
1236.05
1280.30
391
Item 23560
1257.00
1302.00
392
Item 23570
1277.95
1323.70
393
Item 23580
1298.90
1345.40
394
Item 23590
1319.85
1367.10
395
Item 23600
1340.80
1388.80
396
Item 23610
1361.75
1410.50
397
Item 23620
1382.70
1432.20
398
Item 23630
1403.65
1453.90
399
Item 23640
1424.60
1475.60
400
Item 23650
1445.55
1497.30
401
Item 23660
1466.50
1519.00
402
Item 23670
1487.45
1540.70
403
Item 23680
1508.40
1562.40
404
Item 23690
1529.35
1584.10
405
Item 23700
1550.30
1605.80
406
Item 23710
1571.25
1627.50
407
Item 23720
1592.20
1649.20
408
Item 23730
1613.15
1670.90
409
Item 23740
1634.10
1692.60
410
Item 23750
1655.05
1714.30
411
Item 23760
1676.00
1736.00
412
Item 23770
1696.95
1757.70
413
Item 23780
1717.90
1779.40
414
Item 23790
1738.85
1801.10
415
Item 23800
1759.80
1822.80
416
Item 23810
1780.75
1844.50
417
Item 23820
1801.70
1866.20
418
Item 23830
1822.65
1887.90
419
Item 23840
1843.60
1909.60
420
Item 23850
1864.55
1931.30
421
Item 23860
1885.50
1953.00
422
Item 23870
1906.45
1974.70
423
Item 23880
1927.40
1996.40
424
Item 23890
1948.35
2018.10
425
Item 23900
1969.30
2039.80
426
Item 23910
1990.25
2061.50
427
Item 23920
2011.20
2083.20
428
Item 23930
2032.15
2104.90
429
Item 23940
2053.10
2126.60
430
Item 23950
2074.05
2148.30
431
Item 23960
2095.00
2170.00
432
Item 23970
2115.95
2191.70
433
Item 23980
2136.90
2213.40
434
Item 23990
2157.85
2235.10
435
Item 24100
2178.80
2256.80
436
Item 24101
2199.75
2278.50
437
Item 24102
2220.70
2300.20
438
Item 24103
2241.65
2321.90
439
Item 24104
2262.60
2343.60
440
Item 24105
2283.55
2365.30
441
Item 24106
2304.50
2387.00
442
Item 24107
2325.45
2408.70
443
Item 24108
2346.40
2430.40
444
Item 24109
2367.35
2452.10
445
Item 24110
2388.30
2473.80
446
Item 24111
2409.25 | 2495.50 | ||
447 | Item 24112 | 2430.20 | 2517.20 |
448 | Item 24113 | 2451.15 | 2538.90 |
449 | Item 24114 | 2472.10 | 2560.60 |
450 | Item 24115 | 2493.05 | 2582.30 |
451 | Item 24116 | 2514.00 | 2604.00 |
452 | Item 24117 | 2534.95 | 2625.70 |
453 | Item 24118 | 2555.90 | 2647.40 |
454 | Item 24119 | 2576.85 | 2669.10 |
455 | Item 24120 | 2597.80 | 2690.80 |
456 | Item 24121 | 2618.75 | 2712.50 |
457 | Item 24122 | 2639.70 | 2734.20 |
458 | Item 24123 | 2660.65 | 2755.90 |
459 | Item 24124 | 2681.60 | 2777.60 |
460 | Item 24125 | 2702.55 | 2799.30 |
461 | Item 24126 | 2723.50 | 2821.00 |
462 | Item 24127 | 2744.45 | 2842.70 |
463 | Item 24128 | 2765.40 | 2864.40 |
464 | Item 24129 | 2786.35 | 2886.10 |
465 | Item 24130 | 2807.30 | 2907.80 |
466 | Item 24131 | 2828.25 | 2929.50 |
467 | Item 24132 | 2849.20 | 2951.20 |
468 | Item 24133 | 2870.15 | 2972.90 |
469 | Item 24134 | 2891.10 | 2994.60 |
470 | Item 24135 | 2912.05 | 3016.30 |
471 | Item 24136 | 2933.00 | 3038.00 |
472 | Item 25000 | 20.95 | 21.70 |
473 | Item 25005 | 41.90 | 43.40 |
474 | Item 25010 | 62.85 | 65.10 |
475 | Item 25013 | 20.95 | 21.70 |
476 | Item 25014 | 20.95 | 21.70 |
477 | Item 25020 | 41.90 | 43.40 |
Omit “
1 July 2022 ”, substitute “1 July 2023 ”.
Repeal the subclause, substitute:
(1) At the start of 1 July 2023 (the
indexation time ), the amount of a fee for an item in Group P12 is replaced by the amount worked out using the following formula:Note: The indexed fees could in 2023 be viewed on the Department’s MBS Online website ( level="6" section-type="Schedule">
Schedule 3 General amendments
Health Insurance (Diagnostic Imaging Services Table) Regulations (No. 2) 2020 1
Schedule 1 (after item 59300) Insert:
59302
Three dimensional tomosynthesis of both breasts, if there is reason to suspect the presence of malignancy because of:
(a) the past occurrence of breast malignancy in the patient; or
(b) significant history of breast or ovarian malignancy in the patient’s family; or
(c) symptoms or indications of breast disease found on examination of the patient by a medical practitioner;
not being a service to which item 59300 applies (R)
217.75
2
Schedule 1 (after item 59303) Insert:
59305
Three dimensional tomosynthesis of one breast, if there is reason to suspect the presence of malignancy because of:
(a) the past occurrence of breast malignancy in the patient; or
(b) significant history of breast or ovarian malignancy in the patient’s family; or
(c) symptoms or indications of breast disease found on examination of the patient by a medical practitioner;
not being a service to which item 59303 applies (R)
122.85
3
Schedule 1 (item 61409, column 2) After “study”, insert “using technetium 99m”.
4
Schedule 1 (after item 61462) Insert:
61466
Cerebro‑spinal fluid transport study using indium‑111, with imaging on 2 or more separate occasions (R)
4,690.90
5
Schedule 1 (at the end of Subgroup 22 of Group I5) Add:
63498
MRI service to which item 63501, 63502, 63504 or 63505 applies, if the service is performed on a person using intravenous or intra muscular sedation
47.15
63499
MRI service to which item 63501, 63502, 63504 or 63505 applies, if the service is performed on a person under anaesthetic in the presence of a medical practitioner who is qualified to perform an anaesthetic
165.05
Subgroup 32— Magnetic resonance imaging—PIP breast implant 63501
MRI—scan of one or both breasts for the evaluation of implant integrity, if:
(a) a dedicated breast coil is used; and
(b) the request for the scan identifies that the patient:
(i) has or is suspected of having a silicone breast implant manufactured by Poly Implant Prosthese (PIP); and
(ii) the result of the scan confirms a loss of integrity of the implant (R)
526.30
63502
MRI—scan of one or both breasts for the evaluation of implant integrity, if:
(a) a dedicated breast coil is used; and
(b) the request for the scan identifies that the patient:
(i) has or is suspected of having a silicone breast implant manufactured by Poly Implant Prosthese (PIP); and
(ii) the result of the scan does not demonstrate a loss of integrity of the implant (R)
526.30
63504
MRI—scan of one or both breasts for the evaluation of implant integrity, if:
(a) a dedicated breast coil is used; and
(b) the request for the scan identifies that the patient:
(i) has or is suspected of having a silicone breast implant manufactured by Poly Implant Prosthese (PIP); and
(ii) presents with symptoms where implant rupture is suspected; and
(iii) the result of the scan confirms a loss of integrity of the implant (R)
526.30
63505
MRI—scan of one or both breasts for the evaluation of implant integrity, if:
(a) a dedicated breast coil is used; and
(b) the request for the scan identifies that the patient:
(i) has or is suspected of having a silicone breast implant manufactured by Poly Implant Prosthese (PIP); and
(ii) presents with symptoms where implant rupture is suspected; and
(iii) the result of the scan does not demonstrate a loss of integrity of the implant (R)
526.30
6
Clause 2.5.14 of Schedule 1 (note at the end of the table) Repeal the note.
7
Schedule 1 (cell at item 63545, column 2) Repeal the cell, substitute:
MRI—multiphase scans of liver (including delayed imaging, if performed) with a contrast agent, for characterisation, or staging where surgical resection or interventional techniques are under consideration, if:
(a) the patient has a confirmed extra‑hepatic primary malignancy (other than hepatocellular carcinoma); and
(b) computed tomography is negative or inconclusive for hepatic metastatic disease; and
(c) the identification of liver metastases would change the patient’s treatment planning
Applicable not more than once in a 12 month period (R) (Anaes.) (Contrast)
Health Insurance (General Medical Services Table) Regulations 2021 8
Clause 1.1.2 of Schedule 1 Repeal the clause, substitute:
1.1.2 Meaning of eligible non‑vocationally recognised medical practitioner
(1) In this Schedule:
eligible non‑vocationally recognised medical practitioner means a medical practitioner who:
(a) as at 30 June 2023 was registered under the MedicarePlus for Other Medical Practitioners Program; and
(b) had successfully completed the requirements of that Program on or before 30 June 2023, as evidenced by written advice from the Chief Executive Medicare.
(2) In subclause (1):
MedicarePlus for Other Medical Practitioners Program means the program by that name that, before 1 July 2023, was administered by the Chief Executive Medicare.Note: The MedicarePlus for Other Medical Practitioners Program ceased on 30 June 2023.
9
After clause 2.11.2 of Schedule 1 Insert:
2.11.3 Certain services may be provided by video conference rather than at consulting rooms A service provided to a patient under item 291, 293, 296, 300, 302, 304, 306, 308, 310, 312, 314, 316, 318 or 319 may be provided by video conference rather than at consulting rooms if the service is associated with a service to which item 294 applies.
10
Schedule 1 (after item 293) Insert:
294
Professional attendance on a patient by a consultant physician practising in the consultant physician’s specialty of psychiatry if:
(a) the attendance is by video conference; and
(b) except for the requirement for the attendance to be at consulting rooms—item 291, 293, 296, 300, 302, 304, 306, 308, 310, 312, 314, 316, 318, 319, 348, 350 or 352 would otherwise apply to the attendance; and
(c) the patient is not an admitted patient; and
(d) the patient is bulk‑billed; and
(e) the patient:
(i) is located:
(A) within a Modified Monash 2, 3, 4, 5, 6 or 7 area; and
(B) at the time of the attendance—at least 15 km by road from the physician; or
(ii) is a care recipient in a residential aged care facility; or
(iii) is a patient of:
(A) an Aboriginal medical service; or
(B) an Aboriginal community controlled health service;
for which a direction made under subsection 19(2) of the Act applies
50% of the fee for the relevant item referred to in paragraph (b) of column 2
11
Clause 2.14.4 of Schedule 1 Repeal the clause, substitute:
2.14.4 Restrictions on items in Group A11—practitioners Each of items 588 and 591 apply to a service described in the item only if the service is rendered by a medical practitioner other than a general practitioner.
12
Clause 3.2.1 (definition of bulk‑billed ) Repeal the definition.
13
Schedule 1 (cell at item 16003, column 3) Repeal the cell, substitute:
1,554.25
14
Schedule 1 (cell at item 16006, column 3) Repeal the cell, substitute:
1,047.70
15
Schedule 1 (cell at item 16009, column 3) Repeal the cell, substitute:
507.55
16
Schedule 1 (cell at item 16012, column 3) Repeal the cell, substitute:
2,915.10
17
Schedule 1 (item 16015, column 2) Omit “painful bony metastases from carcinoma of the prostate, if hormone therapy has failed”, substitute “the relief of bone pain due to skeletal metastases (as indicated by a positive bone scan), if systemic antineoplastic therapy is unavailable or has failed to control the patient’s disease”.
18
Schedule 1 (item 16018, column 2) Omit “hormonal therapy or chemotherapy have failed”, substitute “systemic antineoplastic therapy is unavailable or has failed to control the patient’s disease”.
19
Schedule 1 (item 16018, column 3) Repeal the cell, substitute:
4,814.70
20
Schedule 1 (after item 30629) Insert:
30630
Insertion of testicular prosthesis, at least 6 months after orchidectomy (H) (Anaes.) (Assist.)
518.95
21
Clause 5.10.14 of Schedule 1 Repeal the clause.
22
Schedule 1 (item 32221) Repeal the item.
23
Schedule 1 (item 38680) After “applies”, insert “(H)”.
24
Schedule 1 (item 49706, column 2) Omit “for infection,”.
25
Clause 7.1.1 of Schedule 1 (definition of 2013 estimated resident population ) Repeal the definition.
26
Clause 7.1.1 of Schedule 1 Insert:
2016 estimated resident population means the preliminary estimated resident population as at 30 June 2016, as published by the Australian Bureau of Statistics.
27
Clause 7.1.1 of Schedule 1 (paragraph (b) of the definition of Modified Monash 2 area ) Omit “2013” (wherever occurring), substitute “2016”.
28
Clause 7.1.1 of Schedule 1 (paragraph (b) of the definition of Modified Monash 3 area ) Omit “2013” (wherever occurring), substitute “2016”.
29
Clause 7.1.1 of Schedule 1 (paragraph (b) of the definition of Modified Monash 4 area ) Omit “2013” (wherever occurring), substitute “2016”.
30
Clause 7.1.1 of Schedule 1 (definition of bulk‑billed ) Repeal the definition, substitute:
bulk‑billed : a medical service is bulk‑billed if:
(a) a medicare benefit is payable to a person in relation to the service; and
(b) under an agreement entered into under section 20A of the Act:
(i) the person assigns to the medical practitioner by whom, or on whose behalf, the service is provided, the person’s right to the payment of the medicare benefit; and
(ii) the medical practitioner accepts the assignment in full payment of the medical practitioner’s fee for the service provided.
Health Insurance (Pathology Services Table) Regulations 2020
31
Schedule 1 (Group P3 table, at the end of the table) Add:
69505
Sequencing and analysis of the genome of mycobacterium tuberculosis complex from an isolate or nucleic acid extract:
(a) to speciate the organism:
(i) at the time of a patient’s initial diagnosis and commencement of initial empiric therapy; or
(ii) following recurrence of a patient’s symptoms or a patient’s failure to respond to treatment within the expected timeframe; and
(b) for the purpose of:
(i) genome‑wide determination of the antimicrobial resistance markers (resistome) of the isolate; and
(ii) individualising the patient’s treatment
Applicable once at initial diagnosis and once per episode of disease recurrence
150.00
32
Schedule 1 (cell at item 73427, column 2) Repeal the cell, substitute:
Single gene testing for the characterisation of a germline gene variant or germline gene variants:
(a) if requested by a specialist or consultant physician; and
(b) 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:
(i) item 73422, 73425 or 73426; or
(ii) item 73434, if the patient has been provided a service described in item 73434 and that service has not identified a relevant variant
Applicable once per gene
33
Schedule 1 (Group P7 table, at the end of the table) Add:
73429
Genetic testing (including characterisation of single nucleotide variants, structural variants, fusions and copy number alterations) in a single gene panel, requested by a specialist or consultant physician, for a patient with clinical or laboratory evidence of a glioma, glioneuronal tumour or glioblastoma, to aid diagnosis and classification of the relevant tumour, including assessments of at least the following kinds:
(a) IDH1, IDH2—variant testing;
(b) 1p/19q—co‑deletion assessment;
(c) H3F3A—variant status;
(d) TERT—promoter variant status;
(e) EGFR—amplification;
(f) CDKN2A/B—deletion;
(g) BRAF—variants
Applicable to one test per diagnostic episode
887.90
73434
Detection of pathogenic or likely pathogenic gene variants, requested by a specialist or consultant physician, for any of the following:
(a) a patient with a suspected neuromuscular disorder;
(b) a relative of a patient with a pathogenic or likely pathogenic germline gene variant associated with a neuromuscular disorder (confirmed by laboratory findings);
(c) the reproductive partner of a patient with a recessive pathogenic or likely pathogenic germline gene variant associated with a neuromuscular disorder (confirmed by laboratory findings)
Applicable once per gene per lifetime
392.00
73435
Detection of pathogenic or likely pathogenic DUX4 gene variants, requested by a specialist or consultant physician, for:
(a) a patient with a suspected neuromuscular disorder; or
(b) a relative of a patient with a pathogenic or likely pathogenic germline gene variant associated with a neuromuscular disorder (confirmed by laboratory findings)
Applicable once per gene per lifetime
1,000.00
34
Schedule 1 (Group P9 table, at the end of the table) Add:
73812
Quantitation of glycated haemoglobin (HbA1c) performed in the management of established diabetes, if performed:
(a) as a point‑of‑care test; and
(b) by or on behalf of a medical practitioner who works in a general practice that is accredited to the Royal Australian College of General Practitioners Standards for point‑of care testing under the National General Practice Accreditation Scheme; and
(c) using a method certified by the National Glycohemoglobin Standardization Program (NGSP), if the instrumentation used has a total coefficient variation less than 3.0% at 48 mmol/mol (6.5%)
Applicable not more than 3 times per 12 months per patient
11.80
Schedule 4 Plastic and reconstructive surgery services
Health Insurance (General Medical Services Table) Regulations 2021 1
Clause 5.10.4 of Schedule 1 Repeal the clause.
2
Schedule 1 (cell at item 30003, column 2) Repeal the cell, substitute:
Burns, involving 1% or more but less than 3% of total body surface, dressing of (including redressing of any related donor site, if required), without anaesthesia, if medical practitioner is present—each attendance at which the procedure is performed
Not applicable for skin reactions secondary to radiotherapy
3
Schedule 1 (cell at item 30006, column 2) Repeal the cell, substitute:
Burns, involving 3% or more but less than 10% of total body surface, dressing of (including redressing of any related donor site, if required), without anaesthesia, if medical practitioner is present—each attendance at which the procedure is performed
Not applicable for skin reactions secondary to radiotherapy
4
Schedule 1 (after item 30006) Insert:
30007
Burns, involving 10% or more of total body surface, dressing of (including redressing of any related donor site, if required), without anaesthesia, if medical practitioner is present—each attendance at which the procedure is performed
Not applicable for skin reactions secondary to radiotherapy
170.20
5
Schedule 1 (cell at item 30010, column 2) Repeal the cell, substitute:
Burns, involving not more than 3% of total body surface, dressing of (including redressing of any related donor site, if required), in an operating theatre under general anaesthesia or intravenous sedation, if medical practitioner is present (H) (Anaes.)
6
Schedule 1 (cell at item 30014, column 2) Repeal the cell, substitute:
Burns, involving 3% or more but less than 20% of total body surface, dressing of (including redressing of any related donor site, if required), in an operating theatre under general anaesthesia or intravenous sedation, if medical practitioner is present (H) (Anaes.)
7
Schedule 1 (items 30017 and 30020) Repeal the items, substitute:
30015
Burns, involving 20% or more but less than 50% of total body surface, or burns of less than 20% of total body surface involving 1% or more of total body surface within the hands or face, dressing of (including redressing of any related donor site, if required), in an operating theatre under general anaesthesia or intravenous sedation, if medical practitioner is present (H) (Anaes.) (Assist.)
255.30
30016
Burns, involving 50% or more of total body surface, dressing of (including redressing of any related donor site, if required), in an operating theatre under general anaesthesia or intravenous sedation, if medical practitioner is present (H) (Anaes.) (Assist.)
382.95
8
Schedule 1 (items 30165 to 30172) Repeal the items, substitute:
30166
Removal of redundant abdominal skin and lipectomy, as a wedge excision, for functional problems following significant weight loss equivalent to at least 5 body mass index points and if there has been a stable weight for a period of at least 6 months prior to surgery, other than a service associated with a service to which item 30175, 30176, 30177, 45530, 45531, 45564, 45565, 45567, 46060, 46062, 46064, 46066, 46068, 46070, 46072, 46080, 46082, 46084, 46086, 46088 or 46090 applies (H) (Anaes.) (Assist.)
821.45
30169
Removal of redundant non‑abdominal skin and lipectomy for functional problems following significant weight loss equivalent to at least 5 body mass index points and if there has been a stable weight for a period of at least 6 months prior to surgery, one or 2 non‑abdominal areas, other than a service associated with a service to which item 30175, 30176, 45530, 45531, 45564, 45565, 45567, 46060, 46062, 46064, 46066, 46068, 46070, 46072, 46080, 46082, 46084, 46086, 46088 or 46090 applies (H) (Anaes.) (Assist.)
657.15
30175
Radical abdominoplasty, with repair of rectus diastasis, excision of skin and subcutaneous tissue, and transposition of umbilicus, not being a laparoscopic procedure, if:
(a) the patient has an abdominal wall defect as a consequence of pregnancy; and
(b) the patient:
(i) has a diastasis of at least 3cm measured by diagnostic imaging prior to this service; and
(ii) has either or both of the following:
(A) at least moderately severe pain or discomfort at the site of the diastasis in the abdominal wall during functional use and the pain or discomfort has been documented in the patient’s records by the practitioner providing the service;
(B) low back pain or urinary symptoms likely due to rectus diastasis and the pain or symptoms have been documented in the patient’s records by the practitioner providing the service; and
(iii) has failed to respond to non‑surgical conservative treatment, that must have included physiotherapy; and
(iv) has not been pregnant in the last 12 months; and
(c) the service is not a service associated with a service to which item 30166, 30169, 30176, 30177, 30179, 30651, 30655, 45530, 45531, 45564, 45565, 45567, 46060, 46062, 46064, 46066, 46068, 46070, 46072, 46080, 46082, 46084, 46086, 46088 or 46090 applies
Applicable once per lifetime (H) (Anaes.) (Assist.)
1,062.50
9
Schedule 1 (item 30176, column 2) Omit “Lipectomy, radical abdominoplasty (Pitanguy type or similar)”, substitute “Radical abdominoplasty”.
10
Schedule 1 (item 30176, column 2) Omit “item 30165, 30168, 30171, 30172, 30177, 30179, 45530, 45564 or 45565 applies”, substitute “item 30166, 30169, 30175, 30177, 30179, 45530, 45531, 45564, 45565, 45567, 46060, 46062, 46064, 46066, 46068, 46070 or 46072 applies”.
11
Schedule 1 (item 30177, column 2) Omit “(Pitanguy type or similar)”.
12
Schedule 1 (item 30177, column 2)
Omit “item 30165, 30168, 30171, 30172, 30176, 30179, 45530, 45564 or 45565 applies”, substitute “item 30166, 30175, 30176, 30179, 45530, 45531, 45564, 45565, 45567, 46060, 46062, 46064, 46066, 46068, 46070, 46072, 46080, 46082, 46084, 46086, 46088 or 46090 applies”.
Omit “(Pitanguy type or similar)”.
Omit “item 30165, 30168, 30171, 30172, 30176, 30177, 45530, 45564 or 45565 applies”, substitute “item 30175, 30176, 30177, 45530, 45531, 45564, 45565, 45567, 46060, 46062, 46064, 46066, 46068, 46070, 46072, 46080, 46082, 46084, 46086, 46088 or 46090 applies”.
Repeal the items, substitute:
30299 | Sentinel lymph node biopsy or biopsies for breast cancer, involving dissection in an axilla, using preoperative lymphoscintigraphy and/or lymphotropic dye injection (H) (Anaes.) (Assist.) | 777.85 |
30305 | Sentinel lymph node biopsy or biopsies for breast cancer, involving dissection along internal mammary chain (H) (Anaes.) (Assist.) | 777.90 |
Omit “lymphoscintigraphy and”, substitute “lymphoscintigraphy and/or”.
17
Schedule 1 (item 30311, column 2, paragraph (c)) Omit “30300, 30302, 30303”, substitute “30305”.
Omit “(sampling)”.
Repeal the item.
Omit “, to level II or III”.
Omit “service to which item”, substitute “service associated with a service to which item 30175,”.
After “keratoses),”, insert “lipomas,”.
23
Schedule 1 (item 31340, column 2, paragraph (b)) Omit “31375 or 31376”, substitute “31375, 31376, 31377, 31378, 31379, 31380, 31381, 31382 or 31383”.
Insert:
31344 | Lipoma, removal of, by surgical excision or liposuction, if: (a) the lesion:
(Anaes.) (Assist.) | 691.90 |
25
Schedule 1 (item 31345, column 2, subparagraph (a)(i)) After “diameter”, insert “but less than 150 mm in diameter”.
26
Schedule 1 (items 31356, 31358, 31359, 31361 and 31363, column 2) Omit “31375 or 31376”, substitute “31375, 31376, 31377, 31378, 31379, 31380, 31381, 31382 or 31383”.
Omit “31372 or 31373”, substitute “31372, 31373, 31377, 31378 or 31379”.
Omit “31375 or 31376”, substitute “31375, 31376, 31377, 31378, 31379, 31380, 31381, 31382 or 31383”.
Insert:
31386 | Malignant skin lesion (other than a malignant skin lesion covered by item 31371, 31372, 31373, 31374, 31375, 31376, 31377, 31378, 31379, 31380, 31381, 31382 or 31383), surgical excision (other than by shave excision) and repair of, if:
(f) the service is not covered by item 31387 (Anaes.) (Assist.) | 782.55 |
31387 | Malignant skin lesion (other than a malignant skin lesion covered by item 31371, 31372, 31373, 31374, 31375, 31376, 31377, 31378, 31379, 31380, 31381, 31382 or 31383), surgical excision (other than by shave excision) and repair of, if:
(e) the service is not covered by item 31386 (Anaes.) (Assist.) | 704.20 |
31388 | Malignant skin lesion (other than a malignant skin lesion covered by item 31371, 31372, 31373, 31374, 31375, 31376, 31377, 31378, 31379, 31380, 31381, 31382 or 31383), surgical excision (other than by shave excision) and repair of, if:
(Anaes.) (Assist.) | 633.75 |
Repeal the cell, substitute:
Breast, malignant tumour, complete local excision of, with or without frozen section histology, other than a service associated with a service to which:
(H) (Anaes.) (Assist.) |
Insert:
31513 | Breast, malignant tumour, complete local excision of, with simultaneous reshaping of the breast parenchyma using techniques such as round block or rotation flaps, other than a service associated with a service to which: (a) item 45523 or 45558 applies; and
(H) (Anaes.) (Assist.) | 930.95 |
31514 | Breast, malignant tumour, complete local excision of, with simultaneous ipsilateral pedicled breast reduction, including repositioning of the nipple, other than a service associated with a service to which: (a) item 45523 or 45558 applies; and
(H) (Anaes.) (Assist.) | 1,342.20 |
Omit “Breast, total mastectomy”, substitute “Total mastectomy (unilateral)”.
Repeal the item, substitute:
31520 | Total mastectomy (bilateral) (H) (Anaes.) (Assist.) | 1,410.75 |
31522 | Skin sparing mastectomy (unilateral) (H) (Anaes.) (Assist.) | 1,139.30 |
31523 | Skin sparing mastectomy (bilateral) (H) (Anaes.) (Assist.) | 1,993.85 |
Repeal the cell, substitute:
Mastectomy for gynaecomastia (unilateral), with or without liposuction (suction assisted lipolysis), if:
not being a service associated with a service to which item 45585 applies (H) (Anaes.) (Assist.) |
Insert:
31526 | Mastectomy for gynaecomastia (bilateral), with or without liposuction (suction assisted lipolysis), if:
not being a service associated with a service to which item 45585 applies (H) (Anaes.) (Assist.) | 996.65 |
31528 | Nipple sparing mastectomy (unilateral) (H) (Anaes.) (Assist.) | 1,139.30 |
31529 | Nipple sparing mastectomy (bilateral) (H) (Anaes.) (Assist.) | 1,993.85 |
Repeal the cell, substitute:
Inverted nipple, surgical eversion of, with or without flap repair, if the nipple cannot readily be everted manually (Anaes.) |
Omit “, 39327 or 39333”, substitute “or 39327”.
Repeal the item.
Repeal the clause, substitute:
Only one of items 46101, 46102, 46103, 46104, 46105, 46106, 46107, 46108, 46109, 46110 and 46111 may be claimed per provider per operation.
In items 46150 to 46158:
maxilla includes any procedure that involves the adjacent zygoma.
Omit “31376”, substitute “31383”.
Repeal the cell, substitute:
Single stage large myocutaneous flap repair to one defect (pectoralis major, latissimus dorsi, or similar large muscle), other than a service associated with a service to which any of items 45524 to 45542 apply (H) (Anaes.) (Assist.) |
Repeal the item, substitute:
45012 | Single stage large muscle flap repair to one defect (pectoralis major, gastrocnemius, gracilis or similar large muscle), other than a service associated with a service to which any of items 45524 to 45542 apply (H) (Anaes.) (Assist.) | 852.30 |
Repeal the cell, substitute:
Abrasive therapy for severely disfiguring scarring of face resulting from trauma, burns or acne, if sufficient photographic evidence demonstrating the clinical need for the service is included in patient notes—limited to one claim per patient per episode (Anaes.) |
Repeal the item.
Repeal the cell, substitute:
Vascular anomaly, cauterisation of or injection into, if undertaken in the operating theatre of a hospital (Anaes.) |
Repeal the items, substitute:
45030 | Vascular anomaly, of skin, mucous membrane and/or subcutaneous tissue, small, excision and suture of (Anaes.) | 148.65 |
45033 | Vascular anomaly, large or involving deeper tissue including facial muscle, excision and suture of (Anaes.) (Assist.) | 269.35 |
Repeal the cell, substitute:
Vascular anomaly, large, deep, and involving major neurovascular structures, excision of, including dissection of muscles, nerves or major vessels (H) (Anaes.) (Assist.) |
Repeal the cell, substitute:
Vascular anomaly, of neck, deep and involving major neurovascular structures, excision of, including dissection of cranial nerves and major vessels, (H) (Anaes.) (Assist.) |
Repeal the items.
Omit “Arteriovenous malformation”, substitute “Vascular anomaly”.
Repeal the item, substitute:
45054 | Limb or chest, decompression escharotomy of (including all incisions), for acute compartment syndrome secondary to burn (H) (Anaes.) (Assist.) | 357.10 |
Omit “31376”, substitute “31383”.
Omit “31373 or 31376”, substitute “31373, 31376, 31378, 31380 or 31383”.
54
Schedule 1 (items 45203, 45206 and 45207, column 2) Omit “31376”, substitute “31383”.
Repeal the cell, substitute:
Pedicled flap repair (forehead, cross arm, cross leg, abdominal or similar), first stage of a multistage procedure (Anaes.) (Assist.) |
Repeal the cell, substitute:
Pedicled flap repair (forehead, cross arm, cross leg, abdominal or similar), subsequent stage of a multistage procedure (Anaes.) (Assist.) |
Repeal the items.
Repeal the cell, substitute:
Direct, indirect, free or local flap, revision of, by incision and suture and/or liposuction, applicable once per flap, not being a service associated with a service to which item 45497 applies (Anaes.) |
Repeal the items.
Repeal the items, substitute:
45440 | Split thickness skin graft to a small defect that is: (a) less than 40 mm in diameter:
(Anaes.) (Assist.) | 311.45 |
45443 | Split thickness skin graft to a large defect that is: (a) 40 mm or more in diameter:
(Anaes.) (Assist.) | 642.35 |
Repeal the items.
Repeal the cell, substitute:
Full thickness skin graft to one defect, with an average diameter of 5 mm or more (Anaes.) (Assist.) |
Repeal the items.
Repeal the item, substitute:
45497 | Flap, free tissue transfer using microvascular techniques or any autologous breast reconstruction, revision of, by liposuction, other than a service associated with a service to which item 45239 applies (H) (Anaes.) | 347.20 |
Repeal the items.
Repeal the cell, substitute:
Microvascular repair using microsurgical techniques, with restoration of continuity of artery or vein of distal extremity or digit; cannot be claimed by the same provider for both artery and vein (H) (Anaes.) (Assist.) |
Repeal the cell, substitute:
Microvascular anastomosis of artery or vein using microsurgical techniques, for replantation or revascularisation of limb or digit, if the limb or digit is devitalised and the repair is critical for restoration of blood supply, other than a service associated with a service to which item 45564, 45565, 45567, 46060, 46062, 46064, 46066, 46068, 46070 or 46072 applies (H) (Anaes.) (Assist.) |
Repeal the item, substitute:
45502 | Microvascular anastomoses of artery and vein using microsurgical techniques, for replantation or revascularisation of limb or digit, if the limb or digit is devitalised and the repair is critical for restoration of blood supply, including anastomoses of all required vessels for that extremity or digit, unless a micro‑arterial or micro‑venous graft is being used, other than a service associated with a service to which item 45564, 45565, 45567, 46060, 46062, 46064, 46066, 46068, 46070 or 46072 applies (H) (Anaes.) (Assist.) | 2,915.50 |
Repeal the cell, substitute:
Micro‑arterial or micro‑venous graft using microsurgical techniques, if the graft is critical for restoration of blood supply, including harvest of graft and suturing of all related anastomoses (not to be claimed in the context of cardiac surgery) (H) (Anaes.) (Assist.) |
Repeal the cell, substitute:
Microvascular anastomosis of artery, vein or veins, using microsurgical techniques, for free transfer of tissue, including setting in of free flap, other than:
(H) (Anaes.) (Assist.) |
Repeal the items, substitute:
45505 | Microvascular anastomoses of artery and vein or veins, using microsurgical techniques, for free transfer of tissue, including setting in of free flap, other than:
(H) (Anaes.) (Assist.) | 2,943.50 |
45507 | Microvascular repair using microsurgical techniques, with restoration of continuity of artery and vein of distal extremity or digit, including anastomoses of all required vessels for that extremity or digit, other than a service associated with a service to which item 45564, 45565 or 45567 applies (H) (Anaes.) (Assist.) | 1,791.25 |
45510 | Scar, of face or neck, not more than 3 cm in length, revision of, if:
(Anaes.) | 240.85 |
Repeal the cell, substitute:
Scar, other than on face or neck, not more than 7 cm in length, revision of, if:
(Anaes.) |
Repeal the cell, substitute:
Scar, other than on face or neck, more than 7 cm in length, revision of, if:
(Anaes.) |
Repeal the item.
After “of the breast”, insert “, other than a service associated with a service to which item 31512, 31513 or 31514 applies on the same side”.
Repeal the cell, substitute:
Reduction mammaplasty (unilateral) without surgical repositioning of the nipple:
other than a service associated with a service to which item 31512, 31513 or 31514 applies on the same side (H) (Anaes.) (Assist.) |
Repeal the cell, substitute:
Reduction mammaplasty (bilateral) with surgical repositioning of the nipple:
other than a service associated with a service to which item 31512, 31513 or 31514 applies (H) (Anaes.) (Assist.) |
After “provided”, insert “, other than a service associated with a service to which item 45006 or 45012 applies”.
Repeal the item, substitute:
45527 | Breast reconstruction (unilateral), following mastectomy, using a permanent prosthesis, other than a service associated with a service to which item 45006 or 45012 applies (H) (Anaes.) (Assist.) | 1,173.25 |
80
Schedule 1 (item 45528, column 2, paragraph (b)) Omit “and/or”, substitute “or”.
Omit “(H) (Anaes.) (Assist.)”, substitute “other than a service associated with a service to which item 45006 or 45012 applies (H) (Anaes.) (Assist.)”.
Insert:
45529 | Breast reconstruction (bilateral), following mastectomy, using permanent prostheses, other than a service associated with a service to which item 45006 or 45012 applies (H) (Anaes.) (Assist.) | 2,053.10 |
Repeal the cell, substitute:
Post‑mastectomy breast reconstruction, autologous (unilateral), using a large muscle or myocutaneous flap, isolated on its vascular pedicle, excluding repair of muscular aponeurotic layer, other than a service associated with a service to which item 30166, 30169, 30175, 30176, 30177, 30179, 45006 or 45012 applies (H) (Anaes.) (Assist.) |
Repeal the item, substitute:
45531 | Post‑mastectomy breast reconstruction, autologous (bilateral), using a large muscle or myocutaneous flap, isolated on its vascular pedicle, excluding repair of muscular aponeurotic layer, other than a service associated with a service to which item 30166, 30169, 30175, 30176, 30177, 30179, 45006 or 45012 applies (H) (Anaes.) (Assist.) | 2,107.15 |
45532 | Revision of post‑mastectomy breast reconstruction, other than a service associated with a service to which item 45006 or 45012 applies (H) (Anaes.) (Assist.) | 296.65 |
After “single breast)”, insert “, other than a service associated with a service to which item 45006 or 45012 applies”.
After “4 services”, insert “, other than a service associated with a service to which item 45006 or 45012 applies”.
Repeal the items, substitute:
45537 | Perforator flap, such as a thoracodorsal artery perforator (TDAP) flap or a lateral intercostal artery perforator (LICAP) flap, or similar, raising on a named source vessel, for reconstruction of a partial mastectomy defect, other than a service associated with a service to which item 45006 or 45012 applies (H) (Anaes.) (Assist.) | 861.50 |
45538 | Perforator flap, such as a deep inferior epigastric perforator (DIEP) flap or similar, raising in preparation for microsurgical transfer of a free flap for post‑mastectomy breast reconstruction, other than a service associated with a service to which item 45006 or 45012 applies (H) (Anaes.) (Assist.) | 985.70 |
45539 | Breast reconstruction (unilateral), following mastectomy, using tissue expansion—insertion of tissue expansion unit and all attendances for subsequent expansion injections, other than a service associated with a service to which item 45006 or 45012 applies (H) (Anaes.) (Assist.) | 1,579.35 |
45540 | Breast reconstruction (bilateral), following mastectomy, using tissue expansion—insertion of tissue expansion unit and all attendances for subsequent expansion injections, other than a service associated with a service to which item 45006 or 45012 applies (H) (Anaes.) (Assist.) | 2,763.80 |
45541 | Breast reconstruction (bilateral), following mastectomy, using tissue expansion—removal of tissue expansion unit and insertion of permanent prosthesis, other than a service associated with a service to which item 45006 or 45012 applies (H) (Anaes.) (Assist.) | 1,175.65 |
After “prosthesis”, insert “, other than a service associated with a service to which item 45006 or 45012 applies”.
Insert:
45547 | Revision of breast prosthesis pocket, if:
(c) the existing prosthesis is used (H) (Anaes.) (Assist.) | 766.05 |
After “provided”, insert “, other than a service associated with a service to which item 31512, 31513 or 31514 applies on the same side”.
After “per lifetime”, insert “, other than a service associated with a service to which item 31512, 31513 or 31514 applies”.
Repeal the cell, substitute:
Microvascular anastomosis of artery and/or vein, if considered necessary to salvage a vascularly compromised pedicled or free flap, either during the primary procedure or at a subsequent return to theatre (H) (Anaes.) (Assist.) |
Repeal the cell, substitute:
Free transfer of tissue (microvascular free flap) for non‑breast defect involving raising of tissue on vascular pedicle, including direct repair of secondary cutaneous defect (if performed), other than a service associated with a service to which item 45564, 45565, 45567, 46060, 46062, 46064, 46066, 46068, 46070 or 46072 applies (Anaes.) (Assist.) |
Repeal the cell, substitute:
Neurovascular island flap for restoration of essential sensation in the digits or sole of the foot, or for genital reconstruction, including:
other than a service performed on simple V‑Y flaps or other standard flaps, such as rotation or keystone (Anaes.) (Assist.) |
Repeal the cell, substitute:
Free transfer of tissue (reconstructive surgery) for the repair of major tissue defect of the head and neck or other non‑breast defect, using microvascular techniques, all necessary elements of the operation including (but not limited to):
other than a service associated with a service to which item 30166, 30169, 30175, 30176, 30177, 30179, 45501, 45502, 45504, 45505, 45507, 45562 or 45567 applies—conjoint surgery, principal specialist surgeon (H) (Anaes.) (Assist.) |
Repeal the cell, substitute:
Free transfer of tissue (reconstructive surgery) for the repair of major tissue defect of the head and neck or other non‑breast defect, using microvascular techniques, all necessary elements of the operation including (but not limited to):
other than a service associated with a service to which item 30166, 30169, 30175, 30176, 30177, 30179, 45501, 45502, 45504, 45505, 45507, 45562 or 45567 applies—conjoint surgery, conjoint specialist surgeon (H) (Anaes.) (Assist.) |
Repeal the cell, substitute:
Insertion of a temporary prosthetic tissue expander which requires subsequent removal, including all attendances for subsequent expansion injections, other than a service for breast or post‑mastectomy tissue expansion (H) (Anaes.) (Assist.) |
Insert:
45567 | Free transfer of tissue (reconstructive surgery) for the repair of major tissue defect of the head and neck or other non‑breast defect, using microvascular techniques, all necessary elements of the operation including (but not limited to): (a) anastomoses of all required vessels; and (b) raising of tissue on a vascular pedicle; and (c) preparation of recipient vessels; and (d) transfer of tissue; and (e) insetting of tissue at recipient site; and
other than a service associated with a service to which item 30166, 30169, 30175, 30176, 30177, 30179, 45501, 45502, 45504, 45505, 45507, 45562, 45564 or 45565 applies—single surgeon (H) (Anaes.) (Assist.) | 3,216.55 |
Repeal the cell, substitute:
Tissue expander, removal of, including complete excision of fibrous capsule if performed (H) (Anaes.) (Assist.) |
Repeal the items, substitute:
45571 | Closure of abdomen with reconstruction of umbilicus, with or without lipectomy, to be used following the harvest of an autologous flap, being a service associated with a service to which item 45530, 45531, 45562, 45564, 45565 or 45567 applies, including repair of the musculoaponeurotic layer of the abdomen (including insertion of prosthetic mesh if used) (H) (Anaes.) (Assist.) | 1,133.55 |
Repeal the cell, substitute:
Intra‑operative tissue expansion using a prosthetic tissue expander, performed under general anaesthetic or intravenous sedation during an operation, if combined with a service to which another item in Group T8 applies (including expansion injections), not to be used for breast tissue expansion (Anaes.) |
Omit “palsy”, substitute “paralysis”.
After “31525”, insert “or 31526”.
Repeal the cell, substitute:
Orbital cavity, reconstruction of wall or floor, with or without bone graft, cartilage graft or foreign implant, other than a service associated with a service to which item 45594 applies on the same side (H) (Anaes.) (Assist.) |
Repeal the item, substitute:
45592 | Orbital cavity, reconstruction of wall and floor with bone graft, cartilage graft or foreign implant, other than a service associated with a service to which item 45594 applies on the same side (H) (Anaes.) (Assist.) | 932.25 |
45594 | Orbital cavity, exploration of wall or floor without bone graft, cartilage graft or foreign implant, other than a service associated with a service to which item 45590 or 45592 applies on the same side (H) (Anaes.) (Assist.) | 436.90 |
Omit “Maxilla, total resection of”, substitute “Hemimaxillectomy”.
Omit “Maxilla, total resection of both maxillae”, substitute “Total maxillectomy (bilateral)”.
Repeal the cell, substitute:
Mandible, total resection of, other than a service associated with a service to which item 45608 applies (H) (Anaes.) (Assist.) |
Repeal the cell, substitute:
Mandible, segmental mandibular or maxilla reconstruction with bone graft, not being a service associated with a service to which item 45599 applies (H) (Anaes.) (Assist.) |
Insert:
45609 | Mandible, maxilla or skull base, reconstruction of, using bony free flap, all osteotomies, shaping, inset and fixation by any means, including all necessary 3 dimensional planning, if performed in conjunction with one or more services covered by items 46060 to 46068 (H) (Anaes.) (Assist.) | 906.10 |
After “condylectomy”, insert “of”.
Repeal the item, substitute:
45614 | Eyelid, reconstruction of a defect (greater than one quarter of the length of the lid) involving all 3 layers of the eyelid, if unable to be closed by direct suture or wedge excision, including all flaps and grafts that may be required (Anaes.) (Assist.) | 913.50 |
113
Schedule 1 (item 45644, column 2, paragraph (b)) Omit “patient notes”, substitute “patient notes;”.
Omit “(H) (Anaes.) (Assist.)”, substitute “other than a service associated with a service to which item 45718 applies (H) (Anaes.) (Assist.)”.
Repeal the item.
Omit “multiple”.
Omit “full thickness”.
Repeal the item.
After “sutures”, insert “, excluding eyelid wedge when performed in conjunction with a cosmetic eyelid procedure”.
Repeal the cell, substitute:
Lip or eyelid reconstruction, single stage or first stage of a two‑stage flap reconstruction of a defect involving all 3 layers of tissue, if the flap is switched from the opposing lip or eyelid respectively (Anaes.) (Assist.) |
Repeal the cell, substitute:
Lip or eyelid reconstruction, second stage of a two‑stage flap reconstruction, division of the pedicle and inset of flap and closure of the donor (Anaes.) |
Repeal the items, substitute:
45677 | Cleft lip, unilateral—primary repair of nasolabial complex, one stage, without anterior palate repair (H) (Anaes.) (Assist.) | 625.25 |
45680 | Cleft lip, unilateral—primary repair of nasolabial complex, one stage, with anterior palate repair (H) (Anaes.) (Assist.) | 815.40 |
45683 | Cleft lip, bilateral—primary repair of nasolabial complex, one stage, without anterior palate repair (H) (Anaes.) (Assist.) | 905.85 |
45686 | Cleft lip, bilateral—primary repair of nasolabial complex, one stage, with anterior palate repair (H) (Anaes.) (Assist.) | 1,069.20 |
Repeal the cell, substitute:
Oro‑nasal fistula, repair of, including a local flap for closure (H) (Anaes.) (Assist.) |
Insert:
45717 | Alveolar cleft (congenital), unilateral, bone grafting of, including local flap closure of associated oro‑nasal fistulae and ridge augmentation, other than a service associated with a service to which item 45718 applies (H) (Anaes.) (Assist.) | 1,287.95 |
45718 | Face, contour restoration of one region, for the correction of deformity using autogenous bone or cartilage, if the deformity:
(b) has arisen from:
other than a service associated with a service to which item 45644 or 45717 (alveolar bone grafting) applies (H) (Anaes.) (Assist.) | 1,401.25 |
Repeal the items.
Repeal the cell, substitute:
Genioplasty, including transposition of nerves and vessels and bone grafts taken from the same site, if:
(H) (Anaes.) (Assist.) |
Omit “intra‑cranial”, substitute “using intracranial approach (H)”.
Repeal the item.
Repeal the cell, substitute:
Syndromic orbital dystopia, such as Treacher Collins Syndrome, bilateral facial or periorbital reconstruction, with bone grafts from a distant site (H) (Anaes.) (Assist.) |
Omit “, unilateral”, substitute “(H)”.
Repeal the cell, substitute:
Cranial vault reconstruction for single suture synostosis (H) (Anaes.) (Assist.) |
Repeal the cell, substitute:
Glenoid fossa, construction of, from bone and cartilage graft, and creation of condyle and ascending ramus of mandible, in hemifacial microsomia, not including harvesting of graft material (H) (Anaes.) (Assist.) |
Omit “hemifacial”, substitute “craniofacial”.
Repeal the cell, substitute:
Osseo‑integration procedure, first stage, implantation of fixture, following congenital absence, tumour or trauma, other than a service associated with a service to which item 41603 or 41604 applies (Anaes.) |
Repeal the cell, substitute:
Osseo‑integration procedure, second stage, fixation of transcutaneous abutment, following congenital absence, tumour or trauma, other than a service associated with a service to which item 41603 or 41604 applies (Anaes.) |
Repeal the item.
Repeal the items, substitute:
45801 | Tumour, cyst, ulcer or scar (other than a scar removed during the surgical approach at an operation), in the oral cavity, removal from mucosa or submucosal tissues, if the removal is by surgical excision and suture (Anaes.) | 147.80 |
Repeal the cell, substitute:
Operation on:
(Anaes.) (Assist.) |
Repeal the items.
Repeal the cell, substitute:
Arch bars or similar, one or more, that were inserted for dental fixation purposes to the maxilla or mandible, removal of, requiring general anaesthesia, if the service is undertaken in the operating theatre of a hospital (H) (Anaes.) |
Repeal the cell, substitute:
Papillary hyperplasia of the palate, surgical reduction of—cannot be claimed more than once per occasion of service (Anaes.) (Assist.) |
142
Schedule 1 (items 45833, 45835, 45839 and 45843) Repeal the items.
Repeal the cell, substitute:
Osseo‑integration procedure, intra‑oral implantation of titanium or similar fixture to facilitate restoration of the dentition following:
Fixture must be placed at site of the missing segment following appropriate reconstructive procedures (Anaes.) |
Repeal the cell, substitute:
Osseo‑integration procedure, fixation of transmucosal abutment to fixtures that are placed following:
Fixture must be placed at site of the missing segment following appropriate reconstructive procedures (Anaes.) |
Repeal the cell, substitute:
Maxillary sinus, allograft, bone graft or both, to floor of maxillary sinus following elevation of mucosal lining (sinus lift procedure), unilateral (Anaes.) (Assist.) |
Repeal the cell, substitute:
Temporomandibular joint, manipulation of, as an independent procedure performed in the operating theatre of a hospital, other than a service associated with a service to which any other item in this Group applies (H) (Anaes.) |
Repeal the item.
Repeal the item, substitute:
45855 | Temporomandibular joint, arthroscopy of, with or without biopsy, other than a service associated with another arthroscopic procedure of that joint (Anaes.) (Assist.) | 318.20 |
Repeal the cell, substitute:
Temporomandibular joint, arthroscopy of, removal of loose bodies, debridement, or lysis and lavage or biopsy (including repositioning of meniscus where indicated)—one or more such procedures of that joint, other than a service associated with any other arthroscopic or open procedure of the temporomandibular joint (Anaes.) (Assist.) |
150
Schedule 1 (items 45859, 45861, 45863, 45867 and 45869) Repeal the items.
Omit “45863, 45867, 45869 or”.
Insert:
45874 | Temporomandibular joint, including condylar head and glenoid fossa, total alloplastic replacement (H) (Anaes.) (Assist.) | 1,443.35 |
153
Schedule 1 (items 45875, 45877, 45879 and 45885) Repeal the items.
Repeal the cell, substitute:
Grafting (mucosa or split skin), in the oral cavity of a mucosal defect (Anaes.) |
Repeal the items.
Repeal the items, substitute:
46050 | Perforator flap, raising on a named source vessel, for pedicled transfer for head or neck or other non‑breast reconstruction (H) (Anaes.) (Assist.) | 861.50 |
46052 | Perforator Flap, such as anterolateral thigh flap or similar, raising in preparation for microsurgical transfer of a free flap for head or neck or other non‑breast reconstruction (H) (Anaes.) (Assist.) | 271.90 |
46060 | Free transfer of tissue with a vascularised bone component (including chimeric/composite flap), for the repair of major defect of the head or neck or other non‑breast defect, all necessary elements of the operation, including (but not limited to):
(c) raising of tissue on a vascular pedicle; and (d) preparation of recipient vessels; and
other than the following: |
(g) bony reshaping for purposes of reconstruction of maxilla, mandible or skull base;
(h) a service associated with a service to which item 30166, 30169, 30175, 30176, 30177, 30179, 45501, 45502, 45504, 45505 or 45562 applies
Single surgeon (H) (Anaes.) (Assist.)
2,915.50
46062
Free transfer of tissue with a vascularised bone component (including chimeric/composite flap), for the repair of major defect of the head or neck or other non‑breast defect, all necessary elements of the operation, including (but not limited to):
(a) anastomoses of all required vessels using microvascular techniques; and
(b) harvesting of flap (including osteotomies); and
(c) raising of tissue on a vascular pedicle; and
(d) preparation of recipient vessels; and
(e) transfer of tissue, including fixation of bony element and inset of tissue at recipient site; and
(f) direct repair of secondary cutaneous defect, if performed;
other than the following:
(g) bony reshaping for purposes of reconstruction of maxilla, mandible or skull base;
(h) a service associated with a service to which item 30166, 30169, 30175, 30176, 30177, 30179, 45501, 45502, 45504, 45505 or 45562 applies
Conjoint surgery, principal specialist surgeon (H) (Anaes.) (Assist.)
2,788.80
46064
Free transfer of tissue with a vascularised bone component (including chimeric/composite flap), for the repair of major defect of the head or neck or other non‑breast defect, all necessary elements of the operation, including (but not limited to):
(a) anastomoses of all required vessels using microvascular techniques; and
(b) harvesting of flap (including osteotomies); and
(c) raising of tissue on a vascular pedicle; and
(d) preparation of recipient vessels; and
(e) transfer of tissue, including fixation of bony element and inset of tissue at recipient site; and
(f) direct repair of secondary cutaneous defect, if performed;
other than the following:
(g) bony reshaping for purposes of reconstruction of maxilla, mandible or skull base;
(h) a service associated with a service to which item 30166, 30169, 30175, 30176, 30177, 30179, 45501, 45502, 45504, 45505 or 45562 applies
Conjoint surgery, conjoint specialist surgeon (H) (Anaes.) (Assist.)
2,091.70
46066
Double free flap, including one free transfer of tissue with a vascularized bone component, for the repair of major defect of the head or neck or other non‑breast defect, all necessary elements of the operation, including (but not limited to):
(a) anastomoses of all required vessels using microvascular techniques; and
(b) harvesting of flap (including osteotomies); and
(c) raising of tissue on a vascular pedicle; and
(d) preparation of recipient vessels; and
(e) transfer of tissue, including fixation of bony element and inset of tissue at recipient site; and
(f) direct repair of secondary cutaneous defect, if performed;
other than the following:
(g) bony reshaping for purposes of reconstruction of maxilla, mandible or skull base;
(h) a service associated with a service to which item 30166, 30169, 30175, 30176, 30177, 30179, 45501, 45502, 45504, 45505 or 45562 applies
Conjoint surgery, principal specialist surgeon (H) (Anaes.) (Assist.)
4,183.15
46068
Double free flap, including one free transfer of tissue with a vascularized bone component, for the repair of major defect of the head or neck or other non‑breast defect, all necessary elements of the operation, including (but not limited to):
(a) anastomoses of all required vessels using microvascular techniques; and
(b) harvesting of flap (including osteotomies); and
(c) raising of tissue on a vascular pedicle; and
(d) preparation of recipient vessels; and
(e) transfer of tissue, including fixation of bony element and inset of tissue at recipient site; and
(f) direct repair of secondary cutaneous defect, if performed;
other than the following:
(g) bony reshaping for purposes of reconstruction of maxilla, mandible or skull base;
(h) a service associated with a service to which item 30166, 30169, 30175, 30176, 30177, 30179, 45501, 45502, 45504, 45505 or 45562 applies
Conjoint surgery, conjoint specialist surgeon (H) (Anaes.) (Assist.)
3,137.55
46070
Double free flap, including 2 free transfers of tissue (reconstructive surgery) for the repair of major tissue defect, involving anastomoses of all required vessels using microvascular techniques, all necessary elements of the operation, including (but not limited to):
(a) raising each flap of tissue on a separate vascular pedicle; and
(b) preparation of recipient vessels; and
(c) transfer of tissue; and
(d) inset of tissue at recipient site; and
(e) direct repair of secondary cutaneous defect, if performed;
other than a service:
(f) performed in the context of breast reconstruction; or
(g) associated with a service to which item 30166, 30169, 30175, 30176, 30177, 30179, 45501, 45502, 45504, 45505 or 45562 applies
Conjoint surgery, principal specialist surgeon (H) (Anaes.) (Assist.)
4,183.15
46072
Double free flap, including 2 free transfers of tissue (reconstructive surgery) for the repair of major tissue defect, involving anastomoses of all required vessels using microvascular techniques, all necessary elements of the operation including (but not limited to):
(a) raising each flap of tissue on a separate vascular pedicle; and
(b) preparation of recipient vessels; and
(c) transfer of tissue; and
(d) inset of tissue at recipient site; and
(e) direct repair of secondary cutaneous defect, if performed;
other than a service:
(f) performed in the context of breast reconstruction; or
(g) associated with a service to which item 30166, 30169, 30175, 30176, 30177, 30179, 45501, 45502, 45504, 45505 or 45562 applies
Conjoint surgery, conjoint specialist surgeon (H) (Anaes.) (Assist.)
3,137.55
46080
Post‑mastectomy breast reconstruction, autologous, single surgeon (unilateral) using a myocutaneous or perforator flap, by microsurgical transfer:
(a) including anastomosis of artery and one or more veins (including repair of secondary skin defect); but
(b) excluding repair of muscular aponeurotic layer;
other than a service associated with a service to which item 30166, 30169, 30175, 30177 or 30179 applies (H) (Anaes.) (Assist.)
3,216.55
46082
Post‑mastectomy breast reconstruction, autologous, single surgeon (bilateral) using a myocutaneous or perforator flap, by microsurgical transfer:
(a) including anastomoses of arteries and veins (including repair of secondary skin defect); but
(b) excluding repair of muscular aponeurotic layer;
other than a service associated with a service to which item 30166, 30169, 30175, 30177 or 30179 applies (H) (Anaes.) (Assist.)
5,629.00
46084
Post‑mastectomy breast reconstruction, autologous, conjoint surgery (unilateral) using a myocutaneous or perforator flap, by microsurgical transfer:
(a) including anastomosis of artery and one or more veins (including repair of secondary skin defect); but
(b) excluding repair of muscular aponeurotic layer;
other than a service associated with a service to which item 30166, 30169, 30175, 30177 or 30179 applies—conjoint surgery, principal specialist surgeon (H) (Anaes.) (Assist.)
2,788.80
46086
Post‑mastectomy breast reconstruction, autologous, conjoint surgery (unilateral) using a myocutaneous or perforator flap, by microsurgical transfer:
(a) including anastomosis of artery and one or more veins (including repair of secondary skin defect); but
(b) excluding repair of muscular aponeurotic layer;
other than a service associated with a service to which item 30166, 30169, 30175, 30177 or 30179 applies—conjoint surgery, conjoint specialist surgeon (H) (Anaes.) (Assist.)
2,091.70
46088
Post‑mastectomy breast reconstruction, autologous, conjoint surgery (bilateral) using a myocutaneous or perforator flap, by microsurgical transfer:
(a) including anastomosis of artery and one or more veins (including repair of secondary skin defect); but
(b) excluding repair of muscular aponeurotic layer;
other than a service associated with a service to which item 30166, 30169, 30175, 30177 or 30179 applies—conjoint surgery, principal specialist surgeon (H) (Anaes.) (Assist.)
4,880.35
46090
Post‑mastectomy breast reconstruction, autologous, conjoint surgery (bilateral) using a myocutaneous or perforator flap, by microsurgical transfer:
(a) including anastomoses of arteries and veins (including repair of secondary skin defect); but
(b) excluding repair of muscular aponeurotic layer;
other than a service associated with a service to which item 30166, 30169, 30175, 30177 or 30179 applies—conjoint surgery, conjoint specialist surgeon (H) (Anaes.) (Assist.)
3,660.40
46092
Lower pole coverage of reconstructive breast prosthesis, following mastectomy, using muscle or fascia turnover flap or autologous dermal flaps, if the service is performed in combination with a service to which item 31522, 31523, 31528, 31529, 45527, 45539 or 45542 applies (Anaes.) (Assist.)
444.70
46094
Lower pole coverage or complete implant coverage of reconstructive breast prosthesis, following mastectomy, using allograft or synthetic products (Anaes.) (Assist.)
328.55
46100
Excision of burnt tissue, or definitive burn wound closure, if:
(a) the area of burn excised involves more than 1% of hands, face or anterior neck; and
(b) the service is performed in conjunction with a service (the
co‑claimed service ) to which any of items 46101 to 46135 (other than item 46112 or 46124) apply;
other than a service to which item 46136 applies
40% of the
fee for the
co‑claimed
service
46101
Excision of burnt tissue, if the area of burn excised involves not more than 1% of the total body surface (Anaes.) (Assist.)
369.65
46102
Excision of burnt tissue, if the area of burn excised involves more than 1% but less than 3% of the total body surface (H) (Anaes.) (Assist.)
586.80
46103
Excision of burnt tissue, if the area of burn excised involves 3% or more but less than 10% of the total body surface (H) (Anaes.) (Assist.)
643.65
46104
Excision of burnt tissue, if the area of burn excised involves 10% or more but less than 20% of the total body surface, excluding aftercare (H) (Anaes.) (Assist.)
981.95
46105
Excision of burnt tissue, if the area of burn excised involves 20% or more but less than 30% of total body surface, excluding aftercare (H) (Anaes.) (Assist.)
1,320.60
46106
Excision of burnt tissue, if the area of burn excised involves 30% or more but less than 40% of total body surface, excluding aftercare (H) (Anaes.) (Assist.)
1,659.80
46107
Excision of burnt tissue, if the area of burn excised involves 40% or more but less than 50% of total body surface, excluding aftercare (H) (Anaes.) (Assist.)
1,998.45
46108
Excision of burnt tissue, if the area of burn excised involves 50% or more but less than 60% of total body surface (H) (Anaes.) (Assist.)
2,336.50
46109
Excision of burnt tissue, if the area of burn excised involves 60% or more but less than 70% of total body surface, excluding aftercare (H) (Anaes.) (Assist.)
2,675.20
46110
Excision of burnt tissue, if the area of burn excised involves 70% or more but less than 80% of total body surface, excluding aftercare (H) (Anaes.) (Assist.)
3,048.05
46111
Excision of burnt tissue, if the area of burn excised involves 80% or more of total body surface, excluding aftercare (H) (Anaes.) (Assist.)
3,413.65
46112
Excision of burnt tissue, if the area of burn excised involves whole of face (excluding ears)—may be claimed with any one of items 46101 to 46111, based on the percentage total body surface (excluding the face), other than a service associated with a service to which item 46100 applies and excluding aftercare (H) (Anaes.) (Assist.)
1,884.50
46113
Excised burn wound closure, or closure of skin defect secondary to burns contracture release, if the defect area is not more than 1% of total body surface and if the service:
(a) is performed at the same time as the procedure for the primary burn wound excision or contracture release; and
(b) involves:
(i) autologous skin grafting for definitive closure; or
(ii) allogenic skin grafting, or biosynthetic skin substitutes, to temporize the excised wound
(Anaes.) (Assist.)
369.65
46114
Excised burn wound closure, or closure of skin defect secondary to burns contracture release, if the defect area is more than 1% but not more than 3% of total body surface and if the service:
(a) is performed at the same time as the procedure for the primary burn wound excision or contracture release; and
(b) involves:
(i) autologous skin grafting for definitive closure; or
(ii) allogenic skin grafting, or biosynthetic skin substitutes, to temporize the excised wound
(H) (Anaes.) (Assist.)
586.80
46115
Excised burn wound closure or closure of skin defect secondary to burns contracture release, if the defect area is more than 3% but not more than 10% of total body surface and if the service:
(a) is performed at the same time as the procedure for the primary burn wound excision or contracture release; and
(b) involves:
(i) autologous skin grafting for definitive closure; or
(ii) allogenic skin grafting, or biosynthetic skin substitutes, to temporize the excised wound
(H) (Anaes.) (Assist.)
643.65
46116
Excised burn wound closure or closure of skin defect secondary to burns contracture release, if the defect area is more than 10% but not more than 20% of total body surface and if the service:
(a) is performed at the same time as the procedure for the primary burn wound excision or contracture release; and
(b) involves:
(i) autologous skin grafting for definitive closure; or
(ii) allogenic skin grafting, or biosynthetic skin substitutes, to temporize the excised wound;
excluding aftercare (H) (Anaes.) (Assist.)
981.95
46117
Excised burn wound closure, if the defect area is 20% or more but less than 30% of total body surface and if the service:
(a) is performed at the same time as the procedure for the primary burn wound excision; and
(b) involves:
(i) autologous skin grafting for definitive closure; or
(ii) allogenic skin grafting, or biosynthetic skin substitutes, to temporize the excised wound;
excluding aftercare (H) (Anaes.) (Assist.)
1,320.60
46118
Excised burn wound closure, if the defect area is 30% or more but less than 40% of total body surface and if the service:
(a) is performed at the same time as the procedure for the primary burn wound excision; and
(b) involves:
(i) autologous skin grafting for definitive closure; or
(ii) allogenic skin grafting, or biosynthetic skin substitutes, to temporize the excised wound;
excluding aftercare (H) (Anaes.) (Assist.)
1,659.80
46119
Excised burn wound closure, if the defect area is 40% or more but less than 50% of total body surface and if the service:
(a) is performed at the same time as the procedure for the primary burn wound excision; and
(b) involves:
(i) autologous skin grafting for definitive closure; or
(ii) allogenic skin grafting, or biosynthetic skin substitutes, to temporize the excised wound;
excluding aftercare (H) (Anaes.) (Assist.)
1,998.45
46120
Excised burn wound closure, if the defect area is 50% or more but less than 60% of total body surface and if the service:
(a) is performed at the same time as the procedure for the primary burn wound excision or contracture release; and
(b) involves:
(i) autologous skin grafting for definitive closure; or
(ii) allogenic skin grafting, or biosynthetic skin substitutes, to temporize the excised wound;
excluding aftercare (H) (Anaes.) (Assist.)
2,336.50
46121
Excised burn wound closure, if the defect area is 60% or more but less than 70% of total body surface and if the service:
(a) is performed at the same time as the procedure for the primary burn wound excision; and
(b) involves:
(i) autologous skin grafting for definitive closure; or
(ii) allogenic skin grafting, or biosynthetic skin substitutes, to temporize the excised wound;
excluding aftercare (H) (Anaes.) (Assist.)
2,675.20
46122
Excised burn wound closure, if the defect area is 70% or more but less than 80% of total body surface and if the service:
(a) is performed at the same time as the procedure for the primary burn wound excision or contracture release; and
(b) involves:
(i) autologous skin grafting for definitive closure; or
(ii) allogenic skin grafting, or biosynthetic skin substitutes, to temporize the excised wound;
excluding aftercare (H) (Anaes.) (Assist.)
3,048.05
46123
Excised burn wound closure, if the defect area is 80% or more of total body surface and if the service:
(a) is performed at the same time as the procedure for the primary burn wound excision; and
(b) involves:
(i) autologous skin grafting for definitive closure; or
(ii) allogenic skin grafting, or biosynthetic skin substitutes, to temporize the excised wound;
excluding aftercare (H) (Anaes.) (Assist.)
3,413.65
46124
Excised burn wound closure of whole of face, if the service:
(a) is performed at the same time as the procedure for the primary burn wound excision; and
(b) involves:
(i) autologous skin grafting for definitive closure; or
(ii) allogenic skin grafting, or biosynthetic skin substitutes, to temporize the excised wound;
excluding aftercare, other than a service associated with a service to which item 46100 applies (H) (Anaes.) (Assist.)
1,884.50
46125
Non‑excisional debridement of superficial or mid‑dermal partial thickness burns, if the area of burn involves less than 1% of total body surface, and application of skin substitute (skin allograft or biosynthetic epidermal replacements) (Anaes.) (Assist.)
369.65
46126
Non‑excisional debridement of superficial or mid‑dermal partial thickness burns, if the area of burn involves 1% or more but less than 3% of total body surface, and application of skin substitute (skin allograft or biosynthetic epidermal replacements) (Anaes.) (Assist.)
586.80
46127
Non‑excisional debridement of superficial or mid‑dermal partial thickness burns, if the area of burn involves 3% or more but less than 10% of total body surface, and application of skin substitute (skin allograft or biosynthetic epidermal replacements) (H) (Anaes.) (Assist.)
812.90
46128
Non‑excisional debridement of superficial or mid‑dermal partial thickness burns, if the area of burn involves 10% or more but less than 30% of total body surface, and application of skin substitute (skin allograft or biosynthetic epidermal replacements), excluding aftercare (H) (Anaes.) (Assist.)
1,490.25
46129
Non‑excisional debridement of superficial or mid‑dermal partial thickness burns, if the area of burn involves 30% or more of total body surface, and application of skin substitute (skin allograft or biosynthetic epidermal replacements), excluding aftercare (H) (Anaes.) (Assist.)
2,727.10
46130
Definitive burn wound closure, or closure of skin defect secondary to necrotising fasciitis or secondary to release of burns scar contracture, if the defect area involves less than 1% of total body surface, using autologous tissue (split skin graft or other) following previous procedure using non‑autologous temporary wound closure or simple dressings (Anaes.) (Assist.)
369.65
46131
Definitive burn wound closure, or closure of skin defect secondary to necrotising fasciitis or secondary to release of burns scar contracture, if the defect area involves 1% or more but less than 3% of total body surface, using autologous tissue (split skin graft or other) following previous procedure using non‑autologous temporary wound closure or simple dressings (H) (Anaes.) (Assist.)
586.80
46132
Definitive burn wound closure, or closure of skin defect secondary to necrotising fasciitis or secondary to release of burns scar contracture, if the defect area involves 3% or more but less than 10% of total body surface, using autologous tissue (split skin graft or other) following previous procedure using non‑autologous temporary wound closure or simple dressings (H) (Anaes.) (Assist.)
643.65
46133
Definitive burn wound closure, or closure of skin defect secondary to necrotising fasciitis or secondary to release of burns scar contracture, if the defect area involves 10% or more but less than 20% of total body surface, using autologous tissue (split skin graft or other) following previous procedure using non‑autologous temporary wound closure or simple dressings, excluding aftercare (H) (Anaes.) (Assist.)
981.95 | ||
46134 | Definitive burn wound closure, or closure of skin defect secondary to necrotising fasciitis, if the defect area involves 20% or more but less than 30% of total body surface, using autologous tissue (split skin graft or other) following previous procedure using non‑autologous temporary wound closure, excluding aftercare (H) (Anaes.) (Assist.) | 2,173.15 |
46135 | Definitive burn wound closure, or closure of skin defect secondary to necrotising fasciitis, if the defect area involves 30% or more of total body surface, using autologous tissue (split skin graft or other) following previous procedure using non‑autologous temporary wound closure, excluding aftercare (H) (Anaes.) (Assist.) | 3,413.65 |
46136 | Definitive burn wound closure, or closure of skin defect secondary to necrotising fasciitis, of whole of face, using autologous tissue (split skin graft or other) following previous procedure using non‑autologous temporary wound closure, excluding aftercare, other than a service associated with a service to which item 46100 applies (H) (Anaes.) (Assist.) | 1,884.50 |
46140 | Burns contracture, release of, by excision or incision of scar, if the defect resulting from surgery is less than 1% of total body surface, including direct repair if performed (Anaes.) (Assist.) | 281.95 |
46141 | Burns contracture, release of, by excision or incision of scar, if the defect resulting from surgery is 1% or more but less than 3% of total body surface (H) (Anaes.) (Assist.) | 423.00 |
46142 | Burns contracture, release of, by excision or incision of scar, if the defect resulting from surgery is 3% or more but less than 10% of total body surface (H) (Anaes.) (Assist.) | 507.45 |
46143 | Burns contracture, release of, by excision or incision of scar, if the defect resulting from surgery is 10% or more but less than 20% of total body surface (H) (Anaes.) (Assist.) | 657.80 |
46150 | Mandible or maxilla, procedure for advancement, retrusion or alteration of tilt, by osteotomy in standard planes, including fixation by any means (including application of distractors if used)—one service per patient on the same occasion (H) (Anaes.) (Assist.) | 1,456.40 |
46151 | Mandible and maxilla (bimaxillary), procedure for advancement, retrusion or alteration of tilt, or combination of these, by osteotomies in standard planes, including fixation by any means (including application of distractors if used)—conjoint surgery, principal specialist surgeon, one service per patient on the same occasion (H) (Anaes.) (Assist.) | 1,588.00 |
46152 | Mandible and maxilla (bimaxillary), procedure for advancement, retrusion or alteration of tilt, or combination of these, by osteotomies in standard planes, including fixation by any means (including application of distractors if used)—conjoint surgery, conjoint specialist surgeon, one service per patient on the same occasion (H) (Anaes.) (Assist.) | 1,191.00 |
46153 | Mandible and maxilla (bimaxillary), procedure for advancement, retrusion or alteration of tilt, or combination of these, by osteotomies in standard planes, including fixation by any means (including application of distractors if used)—single surgeon, one service per patient on the same occasion (H) (Anaes.) (Assist.) | 1,984.90 |
46154 | Maxilla, procedure for reshaping arch of, by complex segmental osteotomies, including fixation by any means (including application of distractors if used), one service per patient on the same occasion (H) (Anaes.) (Assist.) | 1,662.20 |
46155 | Mandible, procedure for reshaping arch of, by complex segmental osteotomies, including genioplasty (if performed) and fixation by any means (including application of distractors if used), one service per patient on the same occasion (H) (Anaes.) (Assist.) | 1,662.20 |
46156 | Mandible and maxilla (bimaxillary), procedure for any combination of arch reshaping, advancement, retrusion or tilting of, involving complex segmental osteotomies, with or without standard osteotomies, including genioplasty (if performed) and fixation by any means (including application of distractors if used)—conjoint surgery, principal specialist surgeon, one service per patient on the same occasion (H) (Anaes.) (Assist.) | 1,897.60 |
46157 | Mandible and maxilla (bimaxillary), procedure for any combination of arch reshaping, advancement, retrusion or tilting of, involving complex segmental osteotomies, with or without standard osteotomies, including genioplasty (if performed) and fixation by any means (including application of distractors if used)—conjoint surgery, conjoint specialist surgeon, one service per patient on the same occasion (H) (Anaes.) (Assist.) | 1,423.20 |
46158 | Mandible and maxilla (bimaxillary), procedure for any combination of arch reshaping, advancement, retrusion or tilting of, involving complex segmental osteotomies, with or without standard osteotomies, including genioplasty (if performed) and fixation by any means (including application of distractors if used)—single surgeon, one service per patient on the same occasion (H) (Anaes.) (Assist.) | 2,371.95 |
46159 | Midfacial osteotomies, Le Fort II or Le Fort III—conjoint surgery, principal specialist surgeon (H) (Anaes.) (Assist.) | 2,098.55 |
46160 | Midfacial osteotomies, Le Fort II or Le Fort III—conjoint surgery, conjoint specialist surgeon (H) (Anaes.) (Assist.) | 1,573.90 |
46161 | Midfacial osteotomies, Le Fort II or Le Fort III—single surgeon (H) (Anaes.) (Assist.) | 2,623.15 |
46170 | Decompression of thoracic outlet, primary, for thoracic outlet syndrome, using any approach, including (if performed) division of scalene muscles, cervical rib and/or first rib resection (H) (Anaes.) (Assist.) | 1,095.25 |
46171 | Decompression of thoracic outlet, repeat (revision) procedure, for thoracic outlet syndrome, using any approach, including (if performed) division of scalene muscles, cervical rib and/or first rib resection (H) (Anaes.) (Assist.) | 1,861.90 |
46172 | Removal or debulking of brachial plexus tumour, involving intraneural dissection, either supraclavicular or infraclavicular dissection (H) (Anaes.) (Assist.) | 2,738.05 |
46173 | Removal or debulking of brachial plexus tumour, involving intraneural dissection, both supraclavicular and infraclavicular dissection (H) (Anaes.) (Assist.) | 3,833.30 |
46174 | Exploration of the brachial plexus, either supraclavicular or infraclavicular, including any neurolyses performed and intraoperative neurophysiological recordings, but excluding reconstruction of elements (H) (Anaes.) (Assist.) | 2,738.05 |
46175 | Exploration of the brachial plexus, both supraclavicular and infraclavicular, including any neurolyses performed and intraoperative neurophysiological recordings, but excluding reconstruction of elements (H) (Anaes.) (Assist.) | 4,380.90 |
46176 | Exploration of the brachial plexus, posterior subscapular approach, all necessary elements of the operation including (but not limited to):
(c) any neurolyses performed; and (d) intraoperative neurophysiological recordings; excluding the following: (e) reconstruction of elements of the plexus; (f) spinal instrumentation (H) (Anaes.) (Assist.) | 1,095.25 |
46177 | Reconstruction of deficit of the brachial plexus, single cord or trunk, by any appropriate method, single surgeon (H) (Anaes.) (Assist.) | 1,861.90 |
46178 | Reconstruction of deficit of the brachial plexus, single cord or trunk, by any appropriate method, conjoint surgery, principal surgeon (H) (Anaes.) (Assist.) | 1,861.90 |
46179 | Reconstruction of deficit of the brachial plexus, single cord or trunk, by any appropriate method, conjoint surgery, conjoint surgeon (H) (Anaes.) (Assist.) | 1,549.75 |
46180 | Reconstruction of deficit of the brachial plexus, more than a single cord or trunk, but less than the whole plexus, by any appropriate method, single surgeon (H) (Anaes.) (Assist.) | 2,738.05 |
46181 | Reconstruction of deficit of the brachial plexus, more than a single cord or trunk, but less than the whole plexus, by any appropriate method, conjoint surgery, principal surgeon (H) (Anaes.) (Assist.) | 2,738.05 |
46182 | Reconstruction of deficit of the brachial plexus, more than a single cord or trunk, but less than the whole plexus, by any appropriate method, conjoint surgery, conjoint surgeon (H) (Anaes.) (Assist.) | 2,283.55 |
46183 | Reconstruction of deficit of the brachial plexus, whole plexus, by any appropriate method, single surgeon (H) (Anaes.) (Assist.) | 3,285.65 |
46184 | Reconstruction of deficit of the brachial plexus, whole plexus, by any appropriate method, conjoint surgery, principal surgeon (H) (Anaes.) (Assist.) | 3,285.65 |
46185 | Reconstruction of deficit of the brachial plexus, whole plexus, by any appropriate method, conjoint surgery, conjoint surgeon (H) (Anaes.) (Assist.) | 2,738.05 |
Repeal the cell, substitute:
Mandible, treatment of dislocation of, by closed reduction, requiring general anaesthesia or intravenous sedation, if performed in the operating theatre of a hospital (H) (Anaes.) |
Repeal the cell, substitute:
Maxilla or mandible, treatment of fracture of, requiring splinting, wiring of teeth, circumosseous fixation or external fixation (H) (Anaes.) (Assist.) |
Repeal the item.
Repeal the cell, substitute:
Zygomatic arch, treatment of fracture of, requiring surgical reduction by a temporal, intra‑oral or other approach, other than a service associated with a service to which another item in this Group applies (Anaes.) |
Repeal the item, substitute:
47765 | Zygomaticomaxillary complex/malar, treatment of fracture of, requiring surgical reduction and involving internal or external fixation at one or more sites (H) (Anaes.) (Assist.) | 492.10 |
47766 | Naso‑orbital‑ethmoidal complex, treatment of fracture of, requiring surgical reduction and involving internal or external fixation at one or more sites (H) (Anaes.) (Assist.) | 658.20 |
Repeal the items.
Omit “plate”, substitute “one or more plates”.
164
Clause 7.1.1 of Schedule 1 (paragraph (a) of the definition of maxilla ) Omit “45720 to 45752”, substitute “46150 to 46158”.
After “855 to 858,”, insert “930, 933, 935, 937, 943, 945, 946, 948, 959, 961, 962, 964,”.
Omit “900 to 6015”, substitute “900, 903, 2700 to 6015”.
Insert:
(1A) Despite subclause (1), items 723 and 732 also apply to a service for a patient if:
(a) the service is provided for the purpose of coordinating the development of team care arrangements, or coordinating a review of team care arrangements, for the patient; and
(b) the patient:
(i) is referred for a service to which any of the following items apply:
(A) an item in Subgroup 2 of Group A20;
(B) an item in Subgroup 9 of Group A7;
(C) an item in Subgroup 3 or 10 of Group A40;
(D) an item in Group M6 or M7;
(E) an item in Subgroup 1, 2, 3, 4, 6, 7, 8 or 9 of Group M18; or
(ii) has an eating disorder treatment and management plan; and
(c) the patient is described in column 2 of an item in table 2.16.9.
4
Subclause 2.16.12(2) of Schedule 1 (table item 2) Repeal the item, substitute:
2 | 723 (if subclause 2.16.9(1) applies to the item) |
|
2A | 723 (if subclause 2.16.9(1A) applies to the item) |
|
5
Subclause 2.16.12(2) of Schedule 1 (table item 5) Repeal the item, substitute:
5 | 732 (if subclause 2.16.9(1) applies to the item) | Each service: (a) may be performed:
|
5A | 732 (if subclause 2.16.9(1A) applies to the item |
|
Omit “and 866”, substitute “, 866, 930, 933, 935, 946, 948 and 959”.
Omit “and 838”, substitute “, 838, 937, 943, 945, 961, 962 and 964”.
Insert:
Items 930 to 964 apply to a patient only if the patient:
(a) is referred for a service to which any of the following items apply:
(i) an item in Subgroup 2 of Group A20;
(ii) an item in Subgroup 9 of Group A7;
(iii) an item in Subgroup 3 or 10 of Group A40;
(iv) an item in Group M6 or M7;
(v) an item in Subgroup 1, 2, 3, 4, 6, 7, 8 or 9 of Group M18; or
(b) has an eating disorder treatment and management plan.
9
Schedule 1 (Group A15 table, at the end of the table) Add:
930 | Attendance by a general practitioner, as a member of a multidisciplinary case conference team, to organise and coordinate a mental health case conference, if the conference lasts for at least 15 minutes, but for less than 20 minutes | 77.45 |
933 | Attendance by a general practitioner, as a member of a multidisciplinary case conference team, to organise and coordinate a mental health case conference, if the conference lasts for at least 20 minutes, but for less than 40 minutes | 132.45 |
935 | Attendance by a general practitioner, as a member of a multidisciplinary case conference team, to organise and coordinate a mental health case conference, if the conference lasts for at least 40 minutes | 220.80 |
937 | Attendance by a general practitioner, as a member of a multidisciplinary case conference team, to participate in a mental health case conference, if the conference lasts for at least 15 minutes, but for less than 20 minutes | 56.90 |
943 | Attendance by a general practitioner, as a member of a multidisciplinary case conference team, to participate in a mental health case conference, if the conference lasts for at least 20 minutes, but for less than 40 minutes | 97.50 |
945 | Attendance by a general practitioner, as a member of a multidisciplinary case conference team, to participate in a mental health case conference, if the conference lasts for at least 40 minutes | 162.30 |
946 | Attendance by a consultant physician in the practice of the consultant physician’s specialty of psychiatry or paediatrics, as a member of multidisciplinary case conference team, to organise and coordinate a mental health case conference of at least 15 minutes but less than 30 minutes, with the multidisciplinary case conference team | 154.60 |
948 | Attendance by a consultant physician in the practice of the consultant physician’s specialty of psychiatry or paediatrics, as a member of a multidisciplinary case conference team, to organise and coordinate a mental health case conference of at least 30 minutes but less than 45 minutes, with the multidisciplinary case conference team | 232.05 |
959 | Attendance by a consultant physician in the practice of the consultant physician’s specialty of psychiatry or paediatrics, as a member of a multidisciplinary case conference team, to organise and coordinate a mental health case conference of at least 45 minutes, with the multidisciplinary case conference team | 309.15 |
961 | Attendance by a consultant physician in the practice of the consultant physician’s specialty of psychiatry or paediatrics, as a member of a multidisciplinary case conference team, to participate in a mental health case conference of at least 15 minutes but less than 30 minutes, with the multidisciplinary case conference team | 111.05 |
962 | Attendance by a consultant physician in the practice of the consultant physician’s specialty of psychiatry or paediatrics, as a member of a multidisciplinary case conference team, to participate in a mental health case conference of at least 30 minutes but less than 45 minutes, with the multidisciplinary case conference team | 177.10 |
964 | Attendance by a consultant physician in the practice of the consultant physician’s specialty of psychiatry or paediatrics, as a member of a multidisciplinary case conference team, to participate in a mental health case conference of at least 45 minutes, with the multidisciplinary case conference team | 243.20 |
Insert:
mental health case conference means a process by which a multidisciplinary case conference team carries out all of the following activities relevant to a patient’s mental health:
(a) discussing the patient’s history;
(b) identifying the patient’s multidisciplinary care needs;
(c) identifying outcomes to be achieved by members of the multidisciplinary case conference team giving mental health care and service to the patient;
(d) identifying tasks that need to be undertaken to achieve these outcomes, and allocating those tasks to members of the multidisciplinary case conference team;
(e) assessing whether previously identified outcomes (if any) have been achieved.
11
Subsection 28(1) (cell at table item 10, column 2) Repeal the cell, substitute:
229, 230, 231, 232, 233, 235, 236, 237, 238, 239, 240, 243, 244, 969, 971, 972, 973, 975, 986 |
After “758”, insert “, 930, 933, 935, 937, 943, 945”.
0
0
0