Health Insurance Legislation Amendment (2023 Measures No. 3) 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 16 October 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. 3) 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. | 17 October 2023 |
Schedule 1 | The day after this instrument is registered. | 17 October 2023 |
Schedule 2 | 1 November 2023. | 1 November 2023 |
Schedules 3 to 7 | Immediately after the commencement of the provisions covered by table item 3. | 1 November 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Note: This table relates only to the provisions of this instrument as originally made.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Each instrument that is specified in a Schedule to this instrument is amended or repealed as set out in the applicable items in the Schedule concerned, and any other item in a Schedule to this instrument has effect according to its terms.
Repeal the cell, substitute:
2,238.45 |
Repeal the cell, substitute:
2,377.80 |
Repeal the cell, substitute:
1,375.80 |
Repeal the cell, substitute:
365.00 |
Repeal the cell, substitute:
989.55 |
Repeal the cell, substitute:
702.80 |
Repeal the cell, substitute:
139.00 |
Repeal the cell, substitute:
134.15 |
Repeal the cell, substitute:
190.85 |
Repeal the cell, substitute:
309.50 |
Omit “
1 July 2023 ”, substitute “1 November 2023 ”.
Repeal the subclause, substitute:
(1) At the start of 1 November 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 “$328.55”, substitute “$330.20”.
4
Clause 1.3.1 of Schedule 1 (heading) Omit “
1 July 2023 ”, substitute “1 November 2023 ”.5
Subclauses 1.3.1(1) and (2) of Schedule 1 Repeal the subclauses, substitute:
(1) At the start of 1 November 2023 (the
indexation time ), each amount covered by subclause (2) is replaced by the amount worked out using the following formula:Note: The indexed fees could in 2023 be viewed on the Department’s MBS Online website ( amounts covered by this subclause are the fee for each item in a Group in this Schedule, other than the fee for the following:
(a) an item in Group A2;
(b) an item in Group A7 (other than items 193, 197 and 199);
(c) an item in Group A23;
(d) items 90092, 90093, 90095, 90096, 90098, 90183, 90188, 90202, 90212 and 90215 in Group A35;
(e) items 90254, 90255, 90256, 90257, 90265, 90275 and 90277 in Group A36;
(f) an item in Group T10.
6
Paragraph 1.3.1(3)(c) of Schedule 1 Repeal the paragraph, substitute:
(c) a table item of the following tables:
(i) table 2.1.1;
(ii) table 2.1.2;
(iii) table 2.20.2;
(iv) table 2.20.2A;
(v) table 5.3.1.
7
Clause 2.1.1 of Schedule 1 (table 2.1.1) Repeal the table, substitute:
Table 2.1.1—Amount under clause 2.1.1
Item
Column 1
Items of this Schedule
Column 2
Fee
Column 3
Amount if not more than 6 patients (to be divided by the number of patients) ($)
Column 4
Amount if more than 6 patients ($) 1
4
The fee for item 3
29.00
2.30
2
24
The fee for item 23
29.00
2.30
3
37
The fee for item 36
29.00
2.30
4
47
The fee for item 44
29.00
2.30
5
58
$8.50
15.50
0.70
6
59
$16.00
17.50
0.70
7
60
$35.50
15.50
0.70
8
65
$57.50
15.50
0.70
9
124
The fee for item 123
29.00
2.30
10
165
$88.20
15.50
0.70
11
195
The fee for item 193
28.60
2.25
12
414
The fee for item 410
28.50
2.25
13
415
The fee for item 411
28.50
2.25
14
416
The fee for item 412
28.50
2.25
15
417
The fee for item 413
28.50
2.25
16
5003
The fee for item 5000
28.60
2.25
17
5010
The fee for item 5000
51.45
3.65
18
5023
The fee for item 5020
28.60
2.25
19
5028
The fee for item 5020
51.45
3.65
20
5043
The fee for item 5040
28.60
2.25
21
5049
The fee for item 5040
51.45
3.65
22
5063
The fee for item 5060
28.60
2.25
23
5067
The fee for item 5060
51.45
3.65
24
5076
The fee for item 5071
28.60
2.25
25
5077
The fee for item 5071
51.45
3.65
26
5220
$18.50
15.50
0.70
27
5223
$26.00
17.50
0.70
28
5227
$45.50
15.50
0.70
29
5228
$67.50
15.50
0.70
30
5260
$18.50
27.95
1.25
31
5261
$112.20
15.50
0.70
32
5262
$112.20
27.95
1.25
33
5263
$26.00
31.55
1.25
34
5265
$45.50
27.95
1.25
35
5267
$67.50
27.95
1.25
36
90272
The fee for item 90271
28.60
2.25
37
90274
The fee for item 90273
28.60
2.25
38
90276
The fee for item 90275
22.85
1.80
39
90278
The fee for item 90277
22.85
1.80
8
Schedule 1 (item 111, column 2, paragraph (d)) Omit “$328.55”, substitute “$330.20”.
9
Schedule 1 (item 115, column 2, paragraph (c)) Omit “$328.55”, substitute “$330.20”.
10
Schedule 1 (item 117, column 2, paragraph (e)) Omit “$328.55”, substitute “$330.20”.
11
Schedule 1 (item 120, column 2, paragraph (d)) Omit “$328.55”, substitute “$330.20”.
12
Clause 2.20.2 of Schedule 1 (table 2.20.2, items 1 to 4) Omit “28.45”, substitute “28.60”.
13
Subclause 2.30.1(1) of Schedule 1 Omit “90043 or 90051 applies is the amount listed in the item plus $60.25”, substitute “90043, 90051 or 90054 applies is the amount listed in the item plus $60.55”.
14
Subclause 2.30.1(2) of Schedule 1 Omit “90095 or 90096 applies is the amount listed in the item plus $43.75”, substitute “90095, 90096, 90098, 90183, 90188, 90202, 90212 or 90215 applies is the amount listed in the item plus $43.95”.
15
Subclause 5.7.1(1) of Schedule 1 (paragraph (b) of the definition of amount under clause 5.7.1 ) Omit “$20.80”, substitute “$20.90”.
16
Subclause 5.7.1(2) of Schedule 1 (paragraph (b) of the definition of amount under clause 5.7.1 ) Omit “$31.35”, substitute “$31.50”.
17
Clause 5.9.2 of Schedule 1 (paragraph (a) of the definition of amount under clause 5.9.2 ) Omit “$108.50”, substitute “$109.05”.
18
Schedule 1 (cell at item 51300, column 2) Repeal the cell, substitute:
Assistance at any operation mentioned in an item in Group T8 that includes “(Assist.)” for which the fee does not exceed $614.55 or at a series or combination of operations mentioned in an item in Group T8 that include “(Assist.)” for which the aggregate fee does not exceed $614.55
19
Schedule 1 (cell at item 51303, column 2) Repeal the cell, substitute:
Assistance at any operation mentioned in an item in Group T8 that includes “(Assist.)” for which the fee exceeds $614.55 or at a series or combination of operations mentioned in an item in Group T8 that include “(Assist.)” for which the aggregate fee exceeds $614.55
20
Schedule 1 (cell at item 51800, column 2) Repeal the cell, substitute:
Assistance by an approved dental practitioner in the practice of oral and maxillofacial surgery at any operation mentioned in an item that includes “(Assist.)” for which the fee does not exceed $614.55 or at a series or combination of operations mentioned in an item in Groups O3 to O9 that include “(Assist.)” for which the aggregate fee does not exceed $614.55
21
Schedule 1 (cell at item 51803, column 2) Repeal the cell, substitute:
Assistance by an approved dental practitioner in the practice of oral and maxillofacial surgery at any operation mentioned in an item that includes “(Assist.)” for which the fee exceeds $614.55 or at a series or combination of operations mentioned in an item that include “(Assist.)” if the aggregate fee exceeds $614.55
22
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
18.70
18.80
2
Table item 2
20.30
20.40
3
Table item 3
20.55
20.65
4
Table item 4
24.85
24.95
5
Table item 5
51.80
52.05
6
Table item 6
34.95
35.10
7
Table item 7
41.60
41.80
8
Table item 8
41.60
41.80
9
Table item 9
41.60
41.80
10
Table item 10
41.60
41.80
11
Table item 11
41.60
41.80
12
Table item 12
41.60
41.80
13
Table item 13
41.60
41.80
14
Table item 14
41.60
41.80
15
Table item 15
41.60
41.80
16
Table item 16
41.60
41.80
23
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—amendments of Group A36
Item
Item of Schedule 1
Omit
Substitute 1
Item 90254
62.85
63.15
2
Item 90255
92.50
92.95
3
Item 90256
79.75
80.15
4
Item 90257
117.50
118.10
5
Item 90265
62.85
63.15
6
Item 90275
81.30
81.70
7
Item 90277
116.30
116.90
24 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—amendments of Group T10
Item
Item of Schedule 1
Omit
Substitute 1
Item 20100
108.50
109.00
2
Item 20102
130.20
130.80
3
Item 20104
86.80
87.20
4
Item 20120
108.50
109.00
5
Item 20124
86.80
87.20
6
Item 20140
108.50
109.00
7
Item 20142
108.50
109.00
8
Item 20143
130.20
130.80
9
Item 20144
151.90
152.60
10
Item 20145
151.90
152.60
11
Item 20146
108.50
109.00
12
Item 20147
130.20
130.80
13
Item 20148
86.80
87.20
14
Item 20160
130.20
130.80
15
Item 20162
151.90
152.60
16
Item 20164
86.80
87.20
17
Item 20170
130.20
130.80
18
Item 20172
151.90
152.60
19
Item 20174
195.30
196.20
20
Item 20176
217.00
218.00
21
Item 20190
108.50
109.00
22
Item 20192
217.00
218.00
23
Item 20210
325.50
327.00
24
Item 20212
108.50
109.00
25
Item 20214
195.30
196.20
26
Item 20216
434.00
436.00
27
Item 20220
217.00
218.00
28
Item 20222
130.20
130.80
29
Item 20225
260.40
261.60
30
Item 20230
260.40
261.60
31
Item 20300
108.50
109.00
32
Item 20305
325.50
327.00
33
Item 20320
130.20
130.80
34
Item 20321
217.00
218.00
35
Item 20330
173.60
174.40
36
Item 20350
217.00
218.00
37
Item 20352
108.50
109.00
38
Item 20355
260.40
261.60
39
Item 20400
65.10
65.40
40
Item 20401
86.80
87.20
41
Item 20402
108.50
109.00
42
Item 20403
108.50
109.00
43
Item 20404
130.20
130.80
44
Item 20405
173.60
174.40
45
Item 20406
282.10
283.40
46
Item 20410
86.80
87.20
47
Item 20420
108.50
109.00
48
Item 20440
86.80
87.20
49
Item 20450
108.50
109.00
50
Item 20452
130.20
130.80
51
Item 20470
130.20
130.80
52
Item 20472
217.00
218.00
53
Item 20474
282.10
283.40
54
Item 20475
217.00
218.00
55
Item 20500
325.50
327.00
56
Item 20520
130.20
130.80
57
Item 20522
86.80
87.20
58
Item 20524
86.80
87.20
59
Item 20526
217.00
218.00
60
Item 20528
173.60
174.40
61
Item 20540
282.10
283.40
62
Item 20542
325.50
327.00
63
Item 20546
325.50
327.00
64
Item 20548
325.50
327.00
65
Item 20560
434.00
436.00
66
Item 20600
217.00
218.00
67
Item 20604
282.10
283.40
68
Item 20620
217.00
218.00
69
Item 20622
282.10
283.40
70
Item 20630
173.60
174.40
71
Item 20632
151.90
152.60
72
Item 20634
217.00
218.00
73
Item 20670
282.10
283.40
74
Item 20680
65.10
65.40
75
Item 20690
108.50
109.00
76
Item 20700
65.10
65.40
77
Item 20702
86.80
87.20
78
Item 20703
86.80
87.20
79
Item 20704
217.00
218.00
80
Item 20706
151.90
152.60
81
Item 20730
108.50
109.00
82
Item 20740
108.50
109.00
83
Item 20745
151.90
152.60
84
Item 20750
108.50
109.00
85
Item 20752
130.20
130.80
86
Item 20754
151.90
152.60
87
Item 20756
195.30
196.20
88
Item 20770
325.50
327.00
89
Item 20790
173.60
174.40
90
Item 20791
217.00
218.00
91
Item 20792
282.10
283.40
92
Item 20793
325.50
327.00
93
Item 20794
260.40
261.60
94
Item 20798
217.00
218.00
95
Item 20799
130.20
130.80
96
Item 20800
65.10
65.40
97
Item 20802
108.50
109.00
98
Item 20803
86.80
87.20
99
Item 20804
217.00
218.00
100
Item 20806
151.90
152.60
101
Item 20810
86.80
87.20
102
Item 20815
130.20
130.80
103
Item 20820
108.50
109.00
104
Item 20830
86.80
87.20
105
Item 20832
130.20
130.80
106
Item 20840
130.20
130.80
107
Item 20841
173.60
174.40
108
Item 20842
86.80
87.20
109
Item 20844
217.00
218.00
110
Item 20845
217.00
218.00
111
Item 20846
217.00
218.00
112
Item 20847
217.00
218.00
113
Item 20848
217.00
218.00
114
Item 20850
260.40
261.60
115
Item 20855
325.50
327.00
116
Item 20860
130.20
130.80
117
Item 20862
151.90
152.60
118
Item 20863
217.00
218.00
119
Item 20864
217.00
218.00
120
Item 20866
217.00
218.00
121
Item 20867
217.00
218.00
122
Item 20868
217.00
218.00
123
Item 20880
325.50
327.00
124
Item 20882
217.00
218.00
125
Item 20884
108.50
109.00
126
Item 20886
130.20
130.80
127
Item 20900
65.10
65.40
128
Item 20902
86.80
87.20
129
Item 20904
151.90
152.60
130
Item 20905
217.00
218.00
131
Item 20906
86.80
87.20
132
Item 20910
86.80
87.20
133
Item 20911
108.50
109.00
134
Item 20912
108.50
109.00
135
Item 20914
151.90
152.60
136
Item 20916
151.90
152.60
137
Item 20920
86.80
87.20
138
Item 20924
86.80
87.20
139
Item 20926
86.80
87.20
140
Item 20928
130.20
130.80
141
Item 20930
86.80
87.20
142
Item 20932
86.80
87.20
143
Item 20934
130.20
130.80
144
Item 20936
173.60
174.40
145
Item 20938
86.80
87.20
146
Item 20940
86.80
87.20
147
Item 20942
108.50
109.00
148
Item 20943
86.80
87.20
149
Item 20944
130.20
130.80
150
Item 20946
173.60
174.40
151
Item 20948
86.80
87.20
152
Item 20950
108.50
109.00
153
Item 20952
86.80
87.20
154
Item 20954
217.00
218.00
155
Item 20956
86.80
87.20
156
Item 20958
108.50
109.00
157
Item 20960
151.90
152.60
158
Item 21100
65.10
65.40
159
Item 21110
108.50
109.00
160
Item 21112
86.80
87.20
161
Item 21114
108.50
109.00
162
Item 21116
130.20
130.80
163
Item 21120
130.20
130.80
164
Item 21130
65.10
65.40
165
Item 21140
325.50
327.00
166
Item 21150
217.00
218.00
167
Item 21155
217.00
218.00
168
Item 21160
86.80
87.20
169
Item 21170
173.60
174.40
170
Item 21195
65.10
65.40
171
Item 21199
86.80
87.20
172
Item 21200
86.80
87.20
173
Item 21202
86.80
87.20
174
Item 21210
130.20
130.80
175
Item 21212
217.00
218.00
176
Item 21214
217.00
218.00
177
Item 21215
325.50
327.00
178
Item 21216
303.80
305.20
179
Item 21220
86.80
87.20
180
Item 21230
130.20
130.80
181
Item 21232
108.50
109.00
182
Item 21234
173.60
174.40
183
Item 21260
86.80
87.20
184
Item 21270
173.60
174.40
185
Item 21272
86.80
87.20
186
Item 21274
130.20
130.80
187
Item 21275
217.00
218.00
188
Item 21280
325.50
327.00
189
Item 21300
65.10
65.40
190
Item 21321
86.80
87.20
191
Item 21340
86.80
87.20
192
Item 21360
108.50
109.00
193
Item 21380
65.10
65.40
194
Item 21382
86.80
87.20
195
Item 21390
65.10
65.40
196
Item 21392
86.80
87.20
197
Item 21400
86.80
87.20
198
Item 21402
151.90
152.60
199
Item 21403
217.00
218.00
200
Item 21404
108.50
109.00
201
Item 21420
65.10
65.40
202
Item 21430
86.80
87.20
203
Item 21432
108.50
109.00
204
Item 21440
173.60
174.40
205
Item 21445
217.00
218.00
206
Item 21460
65.10
65.40
207
Item 21461
86.80
87.20
208
Item 21462
65.10
65.40
209
Item 21464
86.80
87.20
210
Item 21472
108.50
109.00
211
Item 21474
108.50
109.00
212
Item 21480
86.80
87.20
213
Item 21482
108.50
109.00
214
Item 21484
108.50
109.00
215
Item 21486
151.90
152.60
216
Item 21490
65.10
65.40
217
Item 21500
173.60
174.40
218
Item 21502
130.20
130.80
219
Item 21520
86.80
87.20
220
Item 21522
108.50
109.00
221
Item 21530
325.50
327.00
222
Item 21532
173.60
174.40
223
Item 21535
217.00
218.00
224
Item 21600
65.10
65.40
225
Item 21610
108.50
109.00
226
Item 21620
86.80
87.20
227
Item 21622
108.50
109.00
228
Item 21630
108.50
109.00
229
Item 21632
130.20
130.80
230
Item 21634
195.30
196.20
231
Item 21636
325.50
327.00
232
Item 21638
217.00
218.00
233
Item 21650
173.60
174.40
234
Item 21652
217.00
218.00
235
Item 21654
173.60
174.40
236
Item 21656
217.00
218.00
237
Item 21670
86.80
87.20
238
Item 21680
65.10
65.40
239
Item 21682
86.80
87.20
240
Item 21685
217.00
218.00
241
Item 21700
65.10
65.40
242
Item 21710
86.80
87.20
243
Item 21712
108.50
109.00
244
Item 21714
108.50
109.00
245
Item 21716
108.50
109.00
246
Item 21730
65.10
65.40
247
Item 21732
86.80
87.20
248
Item 21740
108.50
109.00
249
Item 21756
130.20
130.80
250
Item 21760
151.90
152.60
251
Item 21770
173.60
174.40
252
Item 21772
130.20
130.80
253
Item 21780
86.80
87.20
254
Item 21785
217.00
218.00
255
Item 21790
325.50
327.00
256
Item 21800
65.10
65.40
257
Item 21810
86.80
87.20
258
Item 21820
65.10
65.40
259
Item 21830
86.80
87.20
260
Item 21832
151.90
152.60
261
Item 21834
86.80
87.20
262
Item 21840
173.60
174.40
263
Item 21842
130.20
130.80
264
Item 21850
86.80
87.20
265
Item 21860
65.10
65.40
266
Item 21865
217.00
218.00
267
Item 21870
325.50
327.00
268
Item 21872
173.60
174.40
269
Item 21878
65.10
65.40
270
Item 21879
108.50
109.00
271
Item 21880
151.90
152.60
272
Item 21881
195.30
196.20
273
Item 21882
238.70
239.80
274
Item 21883
282.10
283.40
275
Item 21884
325.50
327.00
276
Item 21885
368.90
370.60
277
Item 21886
412.30
414.20
278
Item 21887
455.70
457.80
279
Item 21900
65.10
65.40
280
Item 21906
108.50
109.00
281
Item 21908
130.20
130.80
282
Item 21910
195.30
196.20
283
Item 21912
108.50
109.00
284
Item 21914
130.20
130.80
285
Item 21915
108.50
109.00
286
Item 21916
108.50
109.00
287
Item 21918
108.50
109.00
288
Item 21922
130.20
130.80
289
Item 21925
86.80
87.20
290
Item 21926
86.80
87.20
291
Item 21930
130.20
130.80
292
Item 21935
108.50
109.00
293
Item 21936
108.50
109.00
294
Item 21939
65.10
65.40
295
Item 21941
151.90
152.60
296
Item 21942
217.00
218.00
297
Item 21943
108.50
109.00
298
Item 21945
108.50
109.00
299
Item 21949
108.50
109.00
300
Item 21952
86.80
87.20
301
Item 21955
108.50
109.00
302
Item 21959
108.50
109.00
303
Item 21962
108.50
109.00
304
Item 21965
108.50
109.00
305
Item 21969
173.60
174.40
306
Item 21970
325.50
327.00
307
Item 21973
108.50
109.00
308
Item 21976
108.50
109.00
309
Item 21980
108.50
109.00
310
Item 21990
65.10
65.40
311
Item 21992
86.80
87.20
312
Item 21997
86.80
87.20
313
Item 22002
86.80
87.20
314
Item 22007
86.80
87.20
315
Item 22008
86.80
87.20
316
Item 22012
65.10
65.40
317
Item 22014
65.10
65.40
318
Item 22015
130.20
130.80
319
Item 22020
86.80
87.20
320
Item 22025
86.80
87.20
321
Item 22031
108.50
109.00
322
Item 22036
65.10
65.40
323
Item 22041
43.40
43.60
324
Item 22042
21.70
21.80
325
Item 22051
195.30
196.20
326
Item 22055
260.40
261.60
327
Item 22060
651.00
654.00
328
Item 22065
108.50
109.00
329
Item 22075
325.50
327.00
330
Item 22900
130.20
130.80
331
Item 22905
130.20
130.80
332
Item 23010
21.70
21.80
333
Item 23025
43.40
43.60
334
Item 23035
65.10
65.40
335
Item 23045
86.80
87.20
336
Item 23055
108.50
109.00
337
Item 23065
130.20
130.80
338
Item 23075
151.90
152.60
339
Item 23085
173.60
174.40
340
Item 23091
195.30
196.20
341
Item 23101
217.00
218.00
342
Item 23111
238.70
239.80
343
Item 23112
260.40
261.60
344
Item 23113
282.10
283.40
345
Item 23114
303.80
305.20
346
Item 23115
325.50
327.00
347
Item 23116
347.20
348.80
348
Item 23117
368.90
370.60
349
Item 23118
390.60
392.40
350
Item 23119
412.30
414.20
351
Item 23121
434.00
436.00
352
Item 23170
455.70
457.80
353
Item 23180
477.40
479.60
354
Item 23190
499.10
501.40
355
Item 23200
520.80
523.20
356
Item 23210
542.50
545.00
357
Item 23220
564.20
566.80
358
Item 23230
585.90
588.60
359
Item 23240
607.60
610.40
360
Item 23250
629.30
632.20
361
Item 23260
651.00
654.00
362
Item 23270
672.70
675.80
363
Item 23280
694.40
697.60
364
Item 23290
716.10
719.40
365
Item 23300
737.80
741.20
366
Item 23310
759.50
763.00
367
Item 23320
781.20
784.80
368
Item 23330
802.90
806.60
369
Item 23340
824.60
828.40
370
Item 23350
846.30 | 850.20 | ||
371 | Item 23360 | 868.00 | 872.00 |
372 | Item 23370 | 889.70 | 893.80 |
373 | Item 23380 | 911.40 | 915.60 |
374 | Item 23390 | 933.10 | 937.40 |
375 | Item 23400 | 954.80 | 959.20 |
376 | Item 23410 | 976.50 | 981.00 |
377 | Item 23420 | 998.20 | 1002.80 |
378 | Item 23430 | 1019.90 | 1024.60 |
379 | Item 23440 | 1041.60 | 1046.40 |
380 | Item 23450 | 1063.30 | 1068.20 |
381 | Item 23460 | 1085.00 | 1090.00 |
382 | Item 23470 | 1106.70 | 1111.80 |
383 | Item 23480 | 1128.40 | 1133.60 |
384 | Item 23490 | 1150.10 | 1155.40 |
385 | Item 23500 | 1171.80 | 1177.20 |
386 | Item 23510 | 1193.50 | 1199.00 |
387 | Item 23520 | 1215.20 | 1220.80 |
388 | Item 23530 | 1236.90 | 1242.60 |
389 | Item 23540 | 1258.60 | 1264.40 |
390 | Item 23550 | 1280.30 | 1286.20 |
391 | Item 23560 | 1302.00 | 1308.00 |
392 | Item 23570 | 1323.70 | 1329.80 |
393 | Item 23580 | 1345.40 | 1351.60 |
394 | Item 23590 | 1367.10 | 1373.40 |
395 | Item 23600 | 1388.80 | 1395.20 |
396 | Item 23610 | 1410.50 | 1417.00 |
397 | Item 23620 | 1432.20 | 1438.80 |
398 | Item 23630 | 1453.90 | 1460.60 |
399 | Item 23640 | 1475.60 | 1482.40 |
400 | Item 23650 | 1497.30 | 1504.20 |
401 | Item 23660 | 1519.00 | 1526.00 |
402 | Item 23670 | 1540.70 | 1547.80 |
403 | Item 23680 | 1562.40 | 1569.60 |
404 | Item 23690 | 1584.10 | 1591.40 |
405 | Item 23700 | 1605.80 | 1613.20 |
406 | Item 23710 | 1627.50 | 1635.00 |
407 | Item 23720 | 1649.20 | 1656.80 |
408 | Item 23730 | 1670.90 | 1678.60 |
409 | Item 23740 | 1692.60 | 1700.40 |
410 | Item 23750 | 1714.30 | 1722.20 |
411 | Item 23760 | 1736.00 | 1744.00 |
412 | Item 23770 | 1757.70 | 1765.80 |
413 | Item 23780 | 1779.40 | 1787.60 |
414 | Item 23790 | 1801.10 | 1809.40 |
415 | Item 23800 | 1822.80 | 1831.20 |
416 | Item 23810 | 1844.50 | 1853.00 |
417 | Item 23820 | 1866.20 | 1874.80 |
418 | Item 23830 | 1887.90 | 1896.60 |
419 | Item 23840 | 1909.60 | 1918.40 |
420 | Item 23850 | 1931.30 | 1940.20 |
421 | Item 23860 | 1953.00 | 1962.00 |
422 | Item 23870 | 1974.70 | 1983.80 |
423 | Item 23880 | 1996.40 | 2005.60 |
424 | Item 23890 | 2018.10 | 2027.40 |
425 | Item 23900 | 2039.80 | 2049.20 |
426 | Item 23910 | 2061.50 | 2071.00 |
427 | Item 23920 | 2083.20 | 2092.80 |
428 | Item 23930 | 2104.90 | 2114.60 |
429 | Item 23940 | 2126.60 | 2136.40 |
430 | Item 23950 | 2148.30 | 2158.20 |
431 | Item 23960 | 2170.00 | 2180.00 |
432 | Item 23970 | 2191.70 | 2201.80 |
433 | Item 23980 | 2213.40 | 2223.60 |
434 | Item 23990 | 2235.10 | 2245.40 |
435 | Item 24100 | 2256.80 | 2267.20 |
436 | Item 24101 | 2278.50 | 2289.00 |
437 | Item 24102 | 2300.20 | 2310.80 |
438 | Item 24103 | 2321.90 | 2332.60 |
439 | Item 24104 | 2343.60 | 2354.40 |
440 | Item 24105 | 2365.30 | 2376.20 |
441 | Item 24106 | 2387.00 | 2398.00 |
442 | Item 24107 | 2408.70 | 2419.80 |
443 | Item 24108 | 2430.40 | 2441.60 |
444 | Item 24109 | 2452.10 | 2463.40 |
445 | Item 24110 | 2473.80 | 2485.20 |
446 | Item 24111 | 2495.50 | 2507.00 |
447 | Item 24112 | 2517.20 | 2528.80 |
448 | Item 24113 | 2538.90 | 2550.60 |
449 | Item 24114 | 2560.60 | 2572.40 |
450 | Item 24115 | 2582.30 | 2594.20 |
451 | Item 24116 | 2604.00 | 2616.00 |
452 | Item 24117 | 2625.70 | 2637.80 |
453 | Item 24118 | 2647.40 | 2659.60 |
454 | Item 24119 | 2669.10 | 2681.40 |
455 | Item 24120 | 2690.80 | 2703.20 |
456 | Item 24121 | 2712.50 | 2725.00 |
457 | Item 24122 | 2734.20 | 2746.80 |
458 | Item 24123 | 2755.90 | 2768.60 |
459 | Item 24124 | 2777.60 | 2790.40 |
460 | Item 24125 | 2799.30 | 2812.20 |
461 | Item 24126 | 2821.00 | 2834.00 |
462 | Item 24127 | 2842.70 | 2855.80 |
463 | Item 24128 | 2864.40 | 2877.60 |
464 | Item 24129 | 2886.10 | 2899.40 |
465 | Item 24130 | 2907.80 | 2921.20 |
466 | Item 24131 | 2929.50 | 2943.00 |
467 | Item 24132 | 2951.20 | 2964.80 |
468 | Item 24133 | 2972.90 | 2986.60 |
469 | Item 24134 | 2994.60 | 3008.40 |
470 | Item 24135 | 3016.30 | 3030.20 |
471 | Item 24136 | 3038.00 | 3052.00 |
472 | Item 25000 | 21.70 | 21.80 |
473 | Item 25005 | 43.40 | 43.60 |
474 | Item 25010 | 65.10 | 65.40 |
475 | Item 25013 | 21.70 | 21.80 |
476 | Item 25014 | 21.70 | 21.80 |
477 | Item 25020 | 43.40 | 43.60 |
Omit “
1 July 2023 ”, substitute “1 November 2023 ”.
Repeal the subclause, substitute:
(1) At the start of 1 November 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 Diagnostic imaging services
Health Insurance (Diagnostic Imaging Services Table) Regulations (No. 2) 2020 1
Subclause 1.2.18(3) of Schedule 1 Omit “or 63549”, substitute “, 61466 or 61485”.
2
Clause 2.1.7 of Schedule 1 Repeal the clause.
3
Schedule 1 (item 56219, column 2) Omit “or 59275”.
4
Subclause 2.4.2(1) of Schedule 1 Omit “Items 61523 to 61647 apply”, substitute “An item in Subgroup 2 of Group I4 applies”.
5
Schedule 1 (item 61321, column 2, paragraphs (d) and (e)) Omit “61332, 61345, 61380, 61398, 61406 or 61422”, substitute “61345, 61398 or 61406”.
6
Schedule 1 (item 61324, column 2, paragraph (e)) Omit “61311, 61321, 61325, 61329, 61332, 61377, 61345, 61357, 61380, 61394, 61398, 61406, 61414 or 61422”, substitute “61321, 61325, 61329, 61345, 61357, 61394, 61398, 61406 or 61414”.
7
Schedule 1 (item 61324, column 2, paragraph (f)) Omit “61311, 61329, 61332, 61345, 61357, 61377, 61380, 61394, 61398, 61406 or 61414”, substitute “61329, 61345, 61357, 61394, 61398, 61406 or 61414”.
8
Schedule 1 (item 61325, column 2, paragraph (d)) Omit “61332, 61345, 61380, 61398, 61406 or 61422”, substitute “61345, 61398 or 61406”.
9
Schedule 1 (item 61325, column 2, subparagraph (e)(i)) Omit “61332, 61345, 61380, 61398, 61406 or 61442,”, substitute “61345, 61398 or 61406”.
10
Schedule 1 (item 61329, column 2, paragraph (e)) Omit “61311, 61321, 61324, 61325, 61332, 61345, 61357, 61377, 61380, 61394, 61398, 61406, 61414 or 61422”, substitute “61321, 61324, 61325, 61345, 61357, 61394, 61398, 61406 or 61414”.
11
Schedule 1 (item 61329, column 2, paragraph (f)) Omit “61311, 61321, 61324, 61325, 61332, 61345, 61357, 61380, 61394, 61398, 61406, 61414 or 61422”, substitute “61321, 61324, 61325, 61345, 61357, 61394, 61398, 61406 or 61414”.
12
Schedule 1 (item 61345, column 2, paragraphs (e) and (f)) Omit “61311, 61321, 61324, 61325, 61329, 61332, 61357, 61377, 61380, 61394, 61398, 61406, 61414 or 61422”, substitute “61321, 61324, 61325, 61329, 61357, 61394, 61398, 61406 or 61414”.
13
Schedule 1 (item 61349, column 2, subparagraph (a)(i)) Omit “61311, 61324, 61329, 61332, 61337, 61345, 61357, 61365, 61380, 61394, 61398, 61406, 61410, 61414 or 61418”, substitute “61324, 61329, 61345, 61357, 61394, 61398, 61406, 61410 or 61414”.
14
Schedule 1 (item 61349, column 2, paragraph (e)) Omit “, 61365, 61410 or 61418”, substitute “or 61410”.
15
Schedule 1 (item 61349, column 2, paragraph (f)) Omit “61365, 61410 or 61418”, substitute “61410”.
16
Schedule 1 (item 61357, column 2, paragraph (e)) Omit “61311, 61321, 61324, 61325, 61329, 61332, 61345, 61377, 61380, 61394, 61398, 61406, 61414 or 61422”, substitute “61321, 61324, 61325, 61329, 61345, 61394, 61398, 61406 or 61414”.
17
Schedule 1 (item 61357, column 2, paragraph (f)) Omit “61311, 61324, 61329, 61332, 61345, 61377, 61380,”, substitute “61324, 61329, 61345,”.
18
Schedule 1 (item 61394, column 2, paragraph (f)) Omit “61311, 61321, 61324, 61325, 61329, 61332, 61345, 61357, 61377, 61380, 61398, 61406, 61414 or 61422”, substitute “61321, 61324, 61325, 61329, 61345, 61357, 61398, 61406 or 61414”.
19
Schedule 1 (item 61394, column 2, paragraph (g)) Omit “61311, 61324, 61329, 61332, 61345, 61357, 61377, 61380,”, substitute “61324, 61329, 61345, 61357,”.
20
Schedule 1 (item 61398, column 2, paragraphs (f) and (g)) Omit “61311, 61321, 61324, 61325, 61329, 61332, 61345, 61357, 61377, 61380, 61394, 61406, 61414 or 61422”, substitute “61321, 61324, 61325, 61329, 61345, 61357, 61394, 61406 or 61414”.
21
Schedule 1 (item 61406, column 2, paragraph (f)) Omit “61311, 61321, 61324, 61325, 61329, 61332, 61377, 61345, 61357, 61380, 61394, 61398, 61414 or 61422”, substitute “61321, 61324, 61325, 61329, 61345, 61357, 61394, 61398 or 61414”.
22
Schedule 1 (item 61406, column 2, paragraph (g)) Omit “61311, 61321, 61324, 61325, 61329, 61332, 61345, 61357, 61377, 61380, 61394, 61398, 61414 or 61422”, substitute “61321, 61324, 61325, 61329, 61345, 61357, 61394, 61398 or 61414”.
23
Schedule 1 (item 61410, column 2, subparagraph (a)(i)) Omit “61311, 61324, 61329, 61332, 61345, 61349, 61357, 61365, 61377, 61380, 61394, 61398, 61406, 61414 or 61418”, substitute “61324, 61329, 61345, 61349, 61357, 61394, 61398, 61406 or 61414”.
24
Schedule 1 (item 61410, column 2, paragraph (e)) Omit “11729, 11730 or 61418”, substitute “11729 or 11730”.
25
Schedule 1 (item 61410, column 2, paragraph (f)) Omit “, 61365 or 61418”.
26
Schedule 1 (item 61414, column 2, paragraph (f)) Omit “61311, 61321, 61324, 61325, 61329, 61332, 61345, 61357, 61377, 61380, 61394, 61398, 61406 or 61422”, substitute “61321, 61324, 61325, 61329, 61345, 61357, 61394, 61398 or 61406”.
27
Schedule 1 (item 61414, column 2, paragraph (g)) Omit “61311, 61324, 61329, 61332, 61345, 61357, 61377, 61380,”, substitute “61324, 61329, 61345, 61357,”.
28
Schedule 1 (item 61485, column 3) Omit “999.20”, substitute “3,364.00”.
Schedule 4 General medical services Part 1 General amendments
Health Insurance (General Medical Services Table) Regulations 2021 1
Subclause 1.2.3(1) of Schedule 1 Omit “and 105”, substitute “, 105 and 151”.
2
Subclause 1.2.5(1) of Schedule 1 Repeal the subclause, substitute:
(1) Use this clause for items 3 to 338, 348 to 388, 410 to 417, 585 to 600, 733, 737, 741, 745, 761, 763, 766, 769, 772, 776, 788, 789, 792, 900, 903, 969, 971, 972, 973, 975, 986, 2497 to 2840, 3005 to 3028, 5000 to 5267, 6007 to 6015, 6018 to 6024, 6051 to 6063, 13899, 16401, 16404, 16406, 16407, 16508, 16509, 16533, 16534, 17610 to 17690, 90020 to 90096, 90098, 90183, 90188, 90202, 90212, 90215 and 90250 to 90278”.
3
Paragraph 1.2.5(3)(a) of Schedule 1 Repeal the paragraph, substitute:
(a) the vaccine is supplied to the patient in connection with a professional attendance mentioned in any of items 3 to 65, 123, 124, 151, 165, 179, 181, 185, 187, 189, 191, 203, 206, 301, 303, 5000 to 5267 and 90020 to 90098; and
4
Subclause 1.2.6(1) of Schedule 1 Repeal the subclause, substitute:
(1) Use this clause for items 3 to 147, 151, 165, 177, 179, 181, 185, 187, 189, 191, 193 to 338, 348 to 417, 585 to 600, 733, 737, 741, 745, 761, 763, 766, 769, 772, 776, 788, 789, 792
, 2497 to 2840, 3005 to 3028, 35570, 35571, 35573, 35577, 35581, 35582, 35585, 4001 to 6015, 6018 to 6024, 6051 to 6058, 6062, 6063, 10801 to 10816, 11012 to 11021, 11304, 11600, 11627, 11705, 11724, 11731, 12000 to 12004, 12201, 13030 to 13104, 13106 to 13110, 13209, 13290 to 13700, 13815 to 13899, 14100 to 14124, 14203 to 14212, 14216, 14219, 14224, 14255 to 14288, 15600, 16003 to 16512, 16515 to 51318, 90020 to 90096, 90098, 90183, 90188, 90202, 90212,90215 and 90250 to 90278.5
Subclause 1.2.7(1) of Schedule 1 Repeal the subclause, substitute:
(1) Use this clause for items 3 to 230, 233, 245 to 723, 732, 733, 737, 741, 745, 761, 763, 766, 769, 772, 776, 788, 789, 792
, 900, 903, 2700 to 6015, 6018 to 6024, 6028, 6051 to 6058, 6062, 6063, 10801 to 10816, 11012 to 11021, 11304, 11600, 11627, 11705, 11724, 11728, 11731, 11820, 11823, 12000, 12003, 12004, 12201, 13030 to 13104, 13106 to 13110, 13209, 13290 to 13700, 13815 to 13899, 14100 to 14124, 14203 to 14212, 14216, 14219, 14224, 14255 to 14288, 15600, 16003 to 16512, 16515 to 51318, 90020 to 90096, 90098, 90183, 90188, 90202, 90212, 90215 and 90250 to 90278.6
Clause 1.2.8 of Schedule 1 After “90096”, insert “, 90098, 90183, 90188, 90202, 90212, 90215”.
7
Subclause 1.2.11(1) of Schedule 1 Omit “11332, 11342,”, substitute “11332, 11340, 11341, 11342, 11343,”.
8
Schedule 1 (items 23 and 24, column 2) After “lasting”, insert “at least 6 minutes and”.
9
Clause 2.3.1 of Schedule 1 (Group A2 table, headings) Repeal the headings, substitute:
Group A2—Other non‑referred attendances to which no other item applies
Column 1
Item
Column 2
Description
Column 3
Fee ($)
Subgroup 1—Other medical practitioner attendances 10
Schedule 1 (item 946, column 2) After “member of”, insert “a”.
11
Schedule 1 (item 900, column 2) After “each 12 month period,”, insert “and only if item 245 does not apply in the same 12 month period,”.
12
Schedule 1 (item 903, column 2) After “this item”, insert “or item 249”.
13
Clause 2.23.1 of Schedule 1 (Group A21 table, headings) Repeal the headings, substitute:
Group A21—Professional attendances at recognised emergency departments of private hospitals
Column 1
Item
Column 2
Description
Column 3
Fee ($)
Subgroup 1—Consultations 14
Schedule 1 (after item 5036) Insert:
Subgroup 2—Prolonged professional attendances to which no other Group applies
15
Schedule 1 (items 5020, 5023 and 5028, column 2) After “lasting”, insert “at least 6 minutes and”.
16
Schedule 1 (item 11332, column 2) Omit “cochlear”, substitute “cochlea”.
17
Schedule 1 (items 11729 and 11730, column 2, subparagraph (e)(ii)) Omit “61311, 61324, 61329, 61332, 61345, 61349, 61357, 61365, 61377, 61380, 61394, 61398, 61406, 61410, 61414 or 61418”, substitute “61324, 61329, 61345, 61349, 61357, 61394, 61398, 61406, 61410 or 61414”.
18
Schedule 1 (item 38477, column 2, paragraph (b)) Omit “to which item”, substitute “item”.
19
Schedule 1 (item 41603, column 2) Omit “applies”, substitute “applies (Anaes.)”.
20
Schedule 1 (item 41671, column 2) After “(Anaes.)”, insert “(Assist.)”.
21
Schedule 1 (item 41693, column 2) After “(Anaes.)”, insert “(Assist.)”.
22
Schedule 1 (items 41740 and 41743, column 2) After “applies”, insert “on the same side”.
23
Schedule 1 (item 41870, column 2) Omit “item 41861 or 41879 applies”, substitute “item 41879 applies or item 41861 applies on the same side”.
24
Schedule 1 (item 45571, column 2) Omit “or 45567”, substitute “, 45567, 46080, 46082, 46084, 46086, 46088 or 46090”.
25
Schedule 1 (items 45794 and 45797, column 2) Omit “or 41604”.
26
Schedule 1 (item 46108, column 2) Omit “surface”, substitute “surface, excluding aftercare”.
27
Schedule 1 (item 46116, column 2) Omit “not more”, substitute “less”.
28
Schedule 1 (items 46120 and 46122, column 2, paragraph (a)) Omit “or contracture release”.
29
Schedule 1 (item 90035, column 2) After “lasting”, insert “at least 6 minutes and”.
30
Clause 5.10.29 of Schedule 1 (Group T8 table, Subgroup 16, heading) Repeal the heading, substitute:
Subgroup 16—Tissue ablation Part 2 Bulk‑billing incentive
Health Insurance (General Medical Services Table) Regulations 2021 31
Clause 3.2.1 of Schedule 1 Insert:
general practice support service means a service to which an item specified in subclause 3.2.2A(2) applies.
MyMedicare means the registration program by that name administered by the Department.
M yMedicare service means a service to which an item specified in subclause 3.2.2B(2) applies that is provided:
(a) to a person enrolled in MyMedicare; and
(b) at the general practice at which the person is so enrolled.
32
After clause 3.2.2 of Schedule 1 Insert:
3.2.2A Application of items 7 5870, 75871, 75872 , 75873, 75874, 75875 and 75876
(1) If item 75870, 75871, 75872, 75873, 75874, 75875 or 75876 applies to a medical service, the fee mentioned in that item applies in addition to the fee mentioned in an item specified in subclause (2) that applies to the service.
(2) For the purposes of subclause (1), items 23, 24, 36, 37, 44, 47, 53, 54, 57, 59, 60, 65, 123, 124, 151, 165, 185, 187, 189, 191, 203, 206, 301, 303, 737, 741, 745, 763, 766, 769, 776, 788, 789, 2197, 2198, 2200, 5020, 5023, 5028, 5040, 5043, 5049, 5060, 5063, 5067, 5071, 5076, 5077, 5203, 5207, 5208, 5209, 5223, 5227, 5228, 5261, 5262, 5263, 5265, 5267, 90035, 90043, 90051, 90054, 90093, 90095, 90096, 90098, 90188, 90202, 90212, 90215, 91800, 91803, 91806, 91891 and 91893 are specified.
3.2.2B Application of items 75880, 75881, 75882, 75883, 75884 and 75885
(1) If item 75880, 75881, 75882, 75883, 75884 or 75885applies to a medical service, the fee mentioned in that item applies in addition to the fee mentioned in an item specified in subclause (2) that applies to the service.
(2) For the purposes of subclause (1), items 91801, 91802, 91804, 91805, 91807, 91808, 91900, 91903, 91906, 91910, 91913, 91916, 91920, 91923 and 91926 are specified.
33
Clause 3.2.3 of Schedule 1 (Group M1 table, headings) Repeal the headings, substitute:
Group M1—Management of bulk‑billed services
Column 1
Item
Column 2
Description
Column 3
Fee ($)
Subgroup 1—Management of general bulk‑billed services
34 Schedule 1 (cell at item 10990, column 2) Repeal the cell, substitute:
A medical service to which an item in this Schedule (other than this item) applies, if:
(a) the service is an unreferred service; and
(b) the service is provided to a person who is:
(i) under the age of 16; or
(ii) a concessional beneficiary; and
(c) the person is not an admitted patient of a hospital; and
(d) the service is bulk‑billed in relation to the fees for:
(i) this item; and
(ii) any other item in this Schedule applying to the service;
other than a service associated with a service:
(e) to which another item in this Group applies; or
(f) that is a general practice support service; or
(g) that is a MyMedicare service
35
Schedule 1 (cell at item 10991, column 2) Repeal the cell, substitute:
A medical service to which an item in this Schedule (other than this item) applies, if:
(a) the service is an unreferred service; and
(b) the service is provided to a person who is:
(i) under the age of 16; or
(ii) a concessional beneficiary; and
(c) the person is not an admitted patient of a hospital; and
(d) the service is bulk‑billed in relation to the fees for:
(i) this item; and
(ii) any other item in this Schedule applying to the service; and
(e) the service is provided at, or from, a practice location in a Modified Monash 2 area;
other than a service associated with a service:
(f) to which another item in this Group applies; or
(g) that is a general practice support service; or
(h) that is a MyMedicare service
36
Schedule 1 (item 10992, column 2, paragraphs (a) and (b)) Repeal the paragraphs, substitute:
(a) item 585, 588, 591, 594, 599, 600, 5003, 5010, 5220 or 5260 applies; or
(b) item 761 or 772 applies (see the
Health Insurance (Section 3C General Medical Services – Other Medical Practitioner) Determination 2018 );37
Schedule 1 (cell at item 75855, column 2) Repeal the cell, substitute:
A medical service to which an item in this Schedule (other than this item) applies, if:
(a) the service is an unreferred service; and
(b) the service is provided to a person who is:
(i) under the age of 16; or
(ii) a concessional beneficiary; and
(c) the person is not an admitted patient of a hospital; and
(d) the service is bulk‑billed in relation to the fees for:
(i) this item; and
(ii) any other item in this Schedule applying to the service; and
(e) the service is provided at, or from, a practice location in:
(i) a Modified Monash 3 area; or
(ii) a Modified Monash 4 area;
other than a service associated with a service:
(f) to which another item in this Group applies; or
(g) that is a general practice support service; or
(h) that is a MyMedicare service
38
Schedule 1 (cell at item 75856, column 2) Repeal the cell, substitute:
A medical service to which an item in this Schedule (other than this item) applies, if:
(a) the service is an unreferred service; and
(b) the service is provided to a person who is:
(i) under the age of 16; or
(ii) a concessional beneficiary; and
(c) the person is not an admitted patient of a hospital; and
(d) the service is bulk‑billed in relation to the fees for:
(i) this item; and
(ii) any other item in this Schedule applying to the service; and
(e) the service is provided at, or from, a practice location in a Modified Monash 5 area;
other than a service associated with a service:
(f) to which another item in this Group applies; or
(g) that is a general practice support service; or
(h) that is a MyMedicare service
39
Schedule 1 (cell at item 75857, column 2) Repeal the cell, substitute:
A medical service to which an item in this Schedule (other than this item) applies, if:
(a) the service is an unreferred service; and
(b) the service is provided to a person who is:
(i) under the age of 16; or
(ii) a concessional beneficiary; and
(c) the person is not an admitted patient of a hospital; and
(d) the service is bulk‑billed in relation to the fees for:
(i) this item; and
(ii) any other item in this Schedule applying to the service; and
(e) the service is provided at, or from, a practice location in a Modified Monash 6 area;
other than a service associated with a service:
(f) to which another item in this Group applies; or
(g) that is a general practice support service; or
(h) that is a MyMedicare service
40
Schedule 1 (cell at item 75858, column 2) Repeal the cell, substitute:
A medical service to which an item in this Schedule (other than this item) applies, if:
other than a service associated with a service:
|
41
Clause 3.2.3 (at the end of the Group M1 table) Add:
75870 | Professional attendance (the
other than an attendance service associated with a service to which item 10990, 10991, 10992, 75855, 75856, 75857, 75858, 75871, 75872, 75873, 75874, 75875, 75876, 75880, 75881, 75882, 75883, 75884 or 75885 applies | 24.25 |
75871 | Professional attendance (the
other than an attendance service associated with a service to which item 10990, 10991, 10992, 75855, 75856, 75857, 75858, 75870, 75872, 75873, 75874, 75875, 75876, 75880, 75881, 75882, 75883, 75884 or 75885 applies | 36.90 |
75872 | Professional attendance (the
| 36.90 |
75873 | Professional attendance (the
other than an attendance service associated with a service to which item 10990, 10991, 10992, 75855, 75856, 75857, 75858, 75870, 75871, 75872, 75874, 75875, 75876, 75880, 75881, 75882, 75883, 75884 or 75885 applies | 39.20 |
75874 | Professional attendance (the
other than an attendance service associated with a service which item 10990, 10991, 10992, 75855, 75856, 75857, 75858, 75870, 75871, 75872, 75873, 75875, 75876, 75880, 75881, 75882, 75883, 75884 or 75885 applies | 41.65 |
75875 | Professional attendance (the
(b) the patient is not an admitted patient of a hospital; and (c) the attendance service is bulk‑billed in relation to the fees for:
other than an attendance service associated with a service to which item 10990, 10991, 10992, 75855, 75856, 75857, 75858, 75870, 75871, 75872, 75873, 75874, 75876, 75880, 75881, 75882, 75883, 75884 or 75885 applies | 43.95 |
75876 | Professional attendance (the
other than an attendance service associated with a service to which item 10990, 10991, 10992, 75855, 75856, 75857, 75858, 75870, 75871, 75872, 75873, 75874, 75875, 75880, 75881, 75882, 75883, 75884 or 75885 applies | 46.65 |
75880 | Professional attendance (the
other than an attendance service associated with a service to which item 10990, 10991, 10992, 75855, 75856, 75857, 75858, 75870, 75871, 75872, 75873, 75874, 75875, 75876, 75881, 75882, 75883, 75884 or 75885 applies | 24.25 |
75881 | Professional attendance (the
other than an attendance service associated with a service to which item 10990, 10991, 10992, 75855, 75856, 75857, 75858, 75870, 75871, 75872, 75873, 75874, 75875, 75876, 75880, 75882, 75883, 75884 or 75885 applies | 36.90 |
75882 | Professional attendance (the
other than an attendance service associated with a service to which item 10990, 10991, 10992, 75855, 75856, 75857, 75858, 75870, 75871, 75872, 75873, 75874, 75875, 75876, 75880, 75881, 75883, 75884 or 75885 applies | 39.20 |
75883 | Professional attendance (the
other than an attendance service associated with a service to which item 10990, 10991, 10992, 75855, 75856, 75857, 75858, 75870, 75871, 75872, 75873, 75874, 75875, 75876, 75880, 75881, 75882, 75884 or 75885 applies | 41.65 |
75884 | Professional attendance (the
other than an attendance service associated with a service to which item 10990, 10991, 10992, 75855, 75856, 75857, 75858, 75870, 75871, 75872, 75873, 75874, 75875, 75876, 75880, 75881, 75882, 75883 or 75885 applies | 43.95 |
75885 | Professional attendance (the
other than an attendance service associated with a service to which item 10990, 10991, 10992, 75855, 75856, 75857, 75858, 75870, 75871, 75872, 75873, 75874, 75875, 75876, 75880, 75881, 75882, 75883 or 75884 applies | 46.65 |
42
Clause 2.2.1 of Schedule 1 (at the end of the Group A1 table) Add:
123 | Professional attendance by a general practitioner at consulting rooms (other than a service to which another item in this Schedule applies), lasting at least 60 minutes and including any of the following that are clinically relevant: (a) taking an extensive patient history; (b) performing a clinical examination; (c) arranging any necessary investigation; (d) implementing a management plan; (e) providing appropriate preventive health care; for one or more health related issues, with appropriate documentation | 191.20 |
124 | Professional attendance by a general practitioner (other than attendance at consulting rooms or a residential aged care facility or a service to which another item in this Schedule applies), lasting at least 60 minutes and including any of the following that are clinically relevant: (a) taking an extensive patient history; (b) performing a clinical examination; (c) arranging any necessary investigation; (d) implementing a management plan; (e) providing appropriate preventive health care; for one or more health related issues, with appropriate documentation—an attendance on one or more patients at one place on one occasion—each patient | Amount under clause 2.1.1 |
After “45 minutes”, insert “, but not more than 60 minutes”.
Insert:
151 | Professional attendance at consulting rooms lasting more than 60 minutes (other than a service to which any other item applies) by:
(b) a Group A1 disqualified general practitioner | 98.40 |
After “45 minutes”, insert “, but not more than 60 minutes”.
46
Clause 2.3.1 of Schedule 1 (at the end of the Group A2 table) Add:
165 | Professional attendance (other than an attendance at consulting rooms or a residential aged care facility or a service to which any other item in this Schedule applies) lasting more than 60 minutes—an attendance on one or more patients at one place on one occasion—each patient, by: (a) a medical practitioner who is not a general practitioner; or (b) a Group A1 disqualified general practitioner | Amount under clause 2.1.1 |
Omit “5040 and 5060”, substitute “5040, 5060 and 5071”.
Omit “5063 and 5067”, substitute “5063, 5067, 5076 and 5077”.
49
Clause 2.24.2 of Schedule 1 (at the end of the Group A22 table) Add:
5071 | Professional attendance by a general practitioner at consulting rooms (other than a service to which another item in this Schedule applies), lasting at least 60 minutes and including any of the following that are clinically relevant: (a) taking an extensive patient history; (b) performing a clinical examination; (c) arranging any necessary investigation; (d) implementing a management plan; (e) providing appropriate preventive health care; for one or more health‑related issues, with appropriate documentation | 220.25 |
5076 | Professional attendance by a general practitioner (other than attendance at consulting rooms, a hospital or a residential aged care facility or a service to which another item in this Schedule applies), lasting at least 60 minutes and including any of the following that are clinically relevant: (a) taking an extensive patient history; (b) performing a clinical examination; (c) arranging any necessary investigation; (d) implementing a management plan; (e) providing appropriate preventive health care; for one or more health‑related issues, with appropriate documentation—an attendance on one or more patients on one occasion—each patient | Amount under clause 2.1.1 |
5077 | Professional attendance by a general practitioner, on care recipients in a residential aged care facility, other than a service to which another item in this Schedule applies, lasting at least 60 minutes and including any of the following that are clinically relevant: (a) taking an extensive patient history; (b) performing a clinical examination; (c) arranging any necessary investigation; (d) implementing a management plan; (e) providing appropriate preventive health care; for one or more health‑related issues, with appropriate documentation—an attendance on one or more patients at one residential aged care facility on one occasion—each patient | Amount under clause 2.1.1 |
Omit “and 5208”, substitute “, 5208 and 5209”.
After “45 minutes”, insert “, but not more than 60 minutes,”.
Insert:
5209 | Professional attendance at consulting rooms lasting more than 60 minutes (other than a service to which another item applies) by a medical practitioner (other than a general practitioner) | 122.40 |
After “45 minutes”, insert “, but not more than 60 minutes”.
Insert:
5261 | Professional attendance by a medical practitioner who is not a general practitioner (other than attendance at consulting rooms, a hospital or a residential aged care facility or a service to which another item in this Schedule applies), lasting more than 60 minutes—an attendance on one or more patients on one occasion—each patient | Amount under clause 2.1.1 |
After “45 minutes”, insert “, but not more than 60 minutes,”.
56
Clause 2.25.2 of Schedule 1 (at the end of the Group A23 table) Add:
5262 | Professional attendance (other than a service to which another item applies) at a residential aged care facility (other than a professional attendance at a self‑contained unit) or professional attendance at consulting rooms situated within such a complex, if the patient is a care recipient at the facility and is not a resident of a self‑contained unit, lasting more than 60 minutes by a medical practitioner (other than a general practitioner)—an attendance on one or more patients at one residential aged care facility on one occasion—each patient | Amount under clause 2.1.1 |
Insert:
90054 | Professional attendance by a general practitioner, on care recipients in a residential aged care facility, other than a service to which another item applies, lasting at least 60 minutes and including any of the following that are clinically relevant: (a) taking an extensive patient history; (b) performing a clinical examination; (c) arranging any necessary investigation; (d) implementing a management plan; (e) providing appropriate preventive health care; for one or more health‑related issues, with appropriate documentation—an attendance on one or more patients at one residential aged care facility on one occasion—each patient (subject to clause 2.30.1) | 191.20 |
After “45 minutes”, insert “, but less than 60 minutes”.
59
Clause 2.30.1 of Schedule 1 (at the end of the Group A35 table) Add:
90098 | Professional attendance (other than a service to which another item applies) at a residential aged care facility (other than a professional attendance at a self‑contained unit) or professional attendance at consulting rooms within such a complex, if the patient is a care recipient in the facility who is not a resident of a self‑contained unit, lasting more than 60 minutes—an attendance on one or more patients at one residential aged care facility on one occasion by a medical practitioner who is not a general practitioner—each patient (subject to subclause 2.30.1(2)) |
88.20 | ||
90183 | Professional attendance (other than a service to which another item applies) at a residential aged care facility (other than a professional attendance at a self‑contained unit) or professional attendance at consulting rooms within such a complex, if the patient is a care recipient in the facility who is not a resident of a self‑contained unit, lasting not more than 5 minutes—an attendance on one or more patients at one residential aged care facility on one occasion by a prescribed medical practitioner in an eligible area—each patient (subject to subclause 2.30.1(2)) | 15.15 |
90188 | Professional attendance (other than a service to which another item applies) at a residential aged care facility (other than a professional attendance at a self‑contained unit) or professional attendance at consulting rooms within such a complex, if the patient is a care recipient in the facility who is not a resident of a self‑contained unit, lasting more than 5 minutes but not more than 25 minutes—an attendance on one or more patients at one residential aged care facility on one occasion by a prescribed medical practitioner in an eligible area—each patient (subject to subclause 2.30.1(2)) | 33.10 |
90202 | Professional attendance (other than a service to which another item applies) at a residential aged care facility (other than a professional attendance at a self‑contained unit) or professional attendance at consulting rooms within such a complex, if the patient is a care recipient in the facility who is not a resident of a self‑contained unit, lasting more than 25 minutes but not more than 45 minutes—an attendance on one or more patients at one residential aged care facility on one occasion by a prescribed medical practitioner in an eligible area—each patient (subject to subclause 2.30.1(2)) | 64.10 |
90212 | Professional attendance (other than a service to which another item applies) at a residential aged care facility (other than a professional attendance at a self‑contained unit) or professional attendance at consulting rooms situated within such a complex, if the patient is a care recipient in the facility who is not a resident of a self‑contained unit, lasting more than 45 minutes but not more than 60 minutes—an attendance on one or more patients at one residential aged care facility on one occasion by a prescribed medical practitioner in an eligible area—each patient (subject to subclause 2.30.1(2)) | 94.40 |
90215 | Professional attendance (other than a service to which another item applies) at a residential aged care facility (other than a professional attendance at a self‑contained unit) or professional attendance at consulting rooms situated within such a complex, if the patient is a care recipient in the facility who is not a resident of a self‑contained unit, lasting more than 60 minutes—an attendance on one or more patients at one residential aged care facility on one occasion by a prescribed medical practitioner in an eligible area—each patient (subject to subclause 2.30.1(2)) | 152.95 |
Insert:
38372 | Leadless permanent cardiac pacemaker, single‑chamber ventricular, percutaneous insertion of, for the treatment of bradycardia, including cardiac electrophysiological services (other than a service associated with a service to which item 38350 applies) (H) (Anaes.) | 830.30 |
38373 | Leadless permanent cardiac pacemaker, single‑chamber ventricular, percutaneous retrieval and replacement of, including cardiac electrophysiological services, during the same percutaneous procedure, if: (a) the service is performed:
other than a service associated with a service to which item 38350 applies (H) (Anaes.) | 830.30 |
38374 | Leadless permanent cardiac pacemaker, single‑chamber ventricular, percutaneous retrieval of, if: (a) the service is performed:
(H) (Anaes.) | 830.30 |
38375 | Leadless permanent cardiac pacemaker, single‑chamber ventricular, explantation of, by open surgical approach (H) (Anaes.) (Assist.) | 3,107.15 |
Repeal the cell, substitute:
Professional attendance by a cardiothoracic surgeon in the practice of the surgeon’s speciality, if:
(H) |
Omit “735 to 758, 825 to 828, 930, 933, 935, 937, 943, 945, 946, 948, 959, 961, 962, 964,”, substitute “235, 236, 237, 238, 239, 240,735 to 758, 825 to 828, 930, 933, 935, 937, 943, 945, 946, 948, 959, 961, 962, 964, 969, 971, 972, 973, 975, 986,”.
Add:
In an item of this Schedule mentioned in column 1 of table 2.1.2:
amount under clause 2.1.2 means the sum of:
(a) the fee mentioned in column 2 for the item; and
(b) either:
(i) if a practitioner attends not more than 6 patients in a single attendance—the amount mentioned in column 3 for the item, divided by the number of patients attended; or
(ii) if a practitioner attends more than 6 patients in a single attendance—the amount mentioned in column 4 for the item.
1 | 181 | The fee for item 179 | 23.20 | 1.85 |
2 | 187 | The fee for item 185 | 23.20 | 1.85 |
3 | 191 | The fee for item 189 | 23.20 | 1.85 |
4 | 206 | The fee for item 203 | 23.20 | 1.85 |
5 | 303 | The fee for item 301 | 23.20 | 1.85 |
Insert:
Note 1: Various restrictions, limitations and other requirements apply to items in Subgroups 5, 6, 7, 9 and 11 of Group A7. The restrictions, limitations and other requirements are set out in the following Divisions:
(a) for items in Subgroup 5—Division 2.15;
(b) for items in Subgroup 6—Division 2.16;
(c) for items in Subgroup 7—Division 2.17;
(d) for items in Subgroup 9—Division 2.20;
(e) for items in Subgroup 11—Division 2.22.
Note 2: A number of expressions used in Subgroups 6, 7 and 9 of Group A7 are defined in Divisions 2.16, 2.17 and 2.20, including the following:
(a) contribute to a multidisciplinary care plan (see clause 2.16.3);
(b) coordinating a review of team care arrangements (see clause 2.16.5);
(c) multidisciplinary care plan (see clause 2.16.6);
(d) organise and coordinate (see clause 2.16.15);
(e) participate (see clause 2.16.16);
(f) preparing a GP management plan (see clause 2.16.7);
(g) residential medication management review (see clause 2.17.2);
(h) review of a GP mental health treatment plan (see clause 2.20.4).
Insert:
(1) Items 214 to 220 apply only to a service provided in the course of a personal attendance by one or more prescribed medical practitioners on a single patient on a single occasion.
(2) If the professional attendance is provided by one or more prescribed medical practitioners concurrently, each prescribed medical practitioner may claim an attendance fee.
(3) However, if the personal attendance is not continuous, the occasion on which the service is provided is taken to be the total time of the attendance.
Repeal the note, substitute:
Note: The fees in items 193, 197 and 199 of Group A7 are indexed in accordance with clause 1.3.1.
6
Schedule 1 (Group A7 table, at the end of the table) Add:
179 | Professional attendance at consulting rooms lasting not more than 5 minutes (other than a service to which any other item applies) by a prescribed medical practitioner in an eligible area—each attendance | 15.15 | |||||
181 | Professional attendance (other than an attendance at consulting rooms or a residential aged care facility or a service to which any other item applies) lasting not more than 5 minutes—an attendance on one or more patients at one place on one occasion by a prescribed medical practitioner in an eligible area—each patient | Amount under clause 2.1.2 | |||||
185 | Professional attendance at consulting rooms lasting more than 5 minutes but not more than 25 minutes (other than a service to which any other item applies) by a prescribed medical practitioner in an eligible area—each attendance | 33.10 | |||||
187 | Professional attendance (other than an attendance at consulting rooms or a residential aged care facility or a service to which any other item applies) lasting more than 5 minutes but not more than 25 minutes—an attendance on one or more patients at one place on one occasion by a prescribed medical practitioner in an eligible area—each patient | Amount under clause 2.1.2 | |||||
189 | Professional attendance at consulting rooms lasting more than 25 minutes but not more than 45 minutes (other than a service to which any other applies) by a prescribed medical practitioner in an eligible area—each attendance | 64.10 | |||||
191 | Professional attendance (other than an attendance at consulting rooms or a residential aged care facility or a service to which any other item applies) lasting more than 25 minutes but not more than 45 minutes—an attendance on one or more patients at one place on one occasion by a prescribed medical practitioner in an eligible area—each patient | Amount under clause 2.1.2 | |||||
203 | Professional attendance at consulting rooms lasting more than 45 minutes but not more than 60 minutes (other than a service to which any other item applies) by a prescribed medical practitioner in an eligible area—each attendance | 94.40 | |||||
206 | Professional attendance (other than an attendance at consulting rooms or a residential aged care facility or a service to which any other item applies) lasting more than 45 minutes but not more than 60 minutes—an attendance on one or more patients at one place on one occasion by a prescribed medical practitioner in an eligible area—each patient | Amount under clause 2.1.2 | |||||
301 | Professional attendance at consulting rooms lasting more than 60 minutes (other than a service to which any other item in this Schedule applies) by a prescribed medical practitioner in an eligible area—each attendance | 152.95 | |||||
303 | Professional attendance (other than an attendance at consulting rooms or a residential aged care facility or a service to which any other item applies) lasting more than 60 minutes—an attendance on one or more patients at one place on one occasion by a prescribed medical practitioner in an eligible area—each patient | Amount under clause 2.1.2 | |||||
214 | Professional attendance by a prescribed medical practitioner for a period of not less than one hour but less than 2 hours (other than a service to which another item applies) on a patient in imminent danger of death | 195.10 | |||||
215 | Professional attendance by a prescribed medical practitioner for a period of not less than 2 hours but less than 3 hours (other than a service to which another item applies) on a patient in imminent danger of death | 325.10 | |||||
218 | Professional attendance by a prescribed medical practitioner for a period of not less than 3 hours but less than 4 hours (other than a service to which another item applies) on a patient in imminent danger of death | 454.90 | |||||
219 | Professional attendance by a prescribed medical practitioner for a period of not less than 4 hours but less than 5 hours (other than a service to which another item applies) on a patient in imminent danger of death | 585.20 | |||||
220 | Professional attendance by a prescribed medical practitioner for a period of 5 hours or more (other than a service to which another item applies) on a patient in imminent danger of death | 650.20 | |||||
221 | Professional attendance for the purpose of Group therapy lasting at least one hour given under the direct continuous supervision of a prescribed medical practitioner, involving members of a family and persons with close personal relationships with that family—each Group of 2 patients | 103.50 | |||||
222 | Professional attendance for the purpose of Group therapy lasting at least one hour given under the direct continuous supervision of a prescribed medical practitioner, involving members of a family and persons with close personal relationships with that family—each Group of 3 patients | 109.10 | |||||
223 | Professional attendance for the purpose of Group therapy lasting at least one hour given under the direct continuous supervision of a prescribed medical practitioner, involving members of a family and persons with close personal relationships with that family—each Group of 4 or more patients | 132.70 | |||||
224 | Professional attendance by a prescribed medical practitioner to perform a brief health assessment, lasting not more than 30 minutes and including:
(b) a basic physical examination; and
| 52.25 | |||||
225 | Professional attendance by a prescribed medical practitioner to perform a standard health assessment, lasting more than 30 minutes but less than 45 minutes, including:
(b) an extensive physical examination; and
| 121.45 | |||||
226 | Professional attendance by a prescribed medical practitioner to perform a long health assessment, lasting at least 45 minutes but less than 60 minutes, including:
| 167.55 | |||||
227 | Professional attendance by a prescribed medical practitioner to perform a prolonged health assessment, lasting at least 60 minutes, including:
| 236.70 | |||||
228 | Professional attendance by a prescribed medical practitioner at consulting rooms or in a place other than a hospital or a residential aged care facility, for a health assessment of a patient who is of Aboriginal or Torres Strait Islander descent—applicable not more than once in a 9 month period and only if the following items are not applicable within the same 9 month period: (a) item 715;
| 186.90 | |||||
229 | Attendance by a prescribed medical practitioner, for preparation of a GP management plan for a patient (other than a service associated with a service to which any of items 235 to 240 and 735 to 758 apply) | 127.05 | |||||
230 | Attendance by a prescribed medical practitioner, to coordinate the development of team care arrangements for a patient (other than a service associated with a service to which any of items 235 to 240 and 735 to 758 apply) | 100.70 | |||||
231 | Either:
by a prescribed medical practitioner, other than a service associated with a service to which any of items 235 to 240 and 735 to 758 apply | 62.00 | |||||
232 | Either:
by a prescribed medical practitioner, other than a service associated with a service to which any of items 235 to 240 and 735 to 758 apply | 62.00 | |||||
233 | Attendance by a prescribed medical practitioner:
| 63.45 | |||||
235 | Attendance by a prescribed medical practitioner, as a member of a multidisciplinary case conference team, to organise and coordinate: (a) a community case conference; or
if the conference lasts for at least 15 minutes but less than 20 minutes, other than a service associated with a service to which any of items 229 to 233 and 721 to 732 apply | 62.30 | |||||
236 | Attendance by a prescribed medical practitioner, as a member of a multidisciplinary case conference team, to organise and coordinate: (a) a community case conference; or
if the conference lasts for at least 20 minutes but less than 40 minutes, other than a service associated with a service to which any of items 229 to 233 and 721 to 732 apply | 106.50 | |||||
237 | Attendance by a prescribed medical practitioner, as a member of a multidisciplinary case conference team, to organise and coordinate: (a) a community case conference; or
if the conference lasts at least 40 minutes, other than a service associated with a service to which any of items 229 to 233 and 721 to 732 apply | 177.50 | |||||
238 | Attendance by a prescribed medical practitioner, as a member of a multidisciplinary case conference team, to participate in: (a) a community case conference; or | ||||||
After “by a general practitioner”, insert “(for item 4001) or a prescribed medical practitioner (for item 729)”.
86
Subclause 2.22.1(3) of Schedule 1 (paragraph (b) of the definition of non‑directive pregnancy support counselling ) Omit “the general” (wherever occurring), substitute “the medical”.
After “4001”, insert “or 729”.
Omit “Note 1”, substitute “Note”.
Repeal the note.
Omit “, 224 to 228, 229 to 244”.
Insert:
amount under clause 2.1.2 has the meaning given by clause 2.1.2.
amount under clause 2.20.2A has the meaning given by clause 2.20.2A.
associated medical practitioner :
(a) for item 233—has the meaning given by subclause 2.16.2(2); and
(b) for item 277—has the meaning given by subclause 2.20.5(2).
92
Clause 7.1.1 of Schedule 1 (definition of contribute to a multidisciplinary care plan ) Omit “and 731”, substitute “, 731, 231 and 232”.
93
Clause 7.1.1 of Schedule 1 (definition of coordinating a review of team care arrangements ) Omit “item 732”, substitute “items 732 and 233”.
94
Clause 7.1.1 of Schedule 1 (definition of coordinating the development of team care arrangements ) Omit “item 723”, substitute “items 723 and 230”.
Insert:
eligible area means a Modified Monash 2 area, a Modified Monash 3 area, a Modified Monash 4 area, a Modified Monash 5 area, a Modified Monash 6 area or a Modified Monash 7 area.
96
Clause 7.1.1 of Schedule 1 (definition of living in a community setting ) Omit “item 900”, substitute “items 245 and 900”.
97
Clause 7.1.1 of Schedule 1 (paragraph (a) of the definition of multidisciplinary care plan ) Omit “for items 729 and 731”, substitute “for items 231, 233, 729 and 731”.
98
Clause 7.1.1 of Schedule 1 (definition of multidisciplinary discharge case conference ) Before “735”, insert “235, 236, 237, 238, 239, 240,”.
99
Clause 7.1.1 of Schedule 1 (paragraph (a) of the definition of organise and coordinate ) Omit “735, 739, 743, 820, 822, 823, 825, 826, 828, 830, 832, 834, 835, 837, 838, 855, 857, 858, 861, 864 and 866”, substitute “235, 236, 237, 735, 739, 743, 820, 822, 823, 825, 826, 828, 830, 832, 834, 835, 837, 838, 855, 857, 858, 861, 864, 866, 969, 971 and 972”.
100
Clause 7.1.1 of Schedule 1 (paragraph (a) of the definition of participate ) Omit “747, 750, 758, 825, 826, 828, 835, 837 and 838”, substitute “238, 239, 240, 747, 750, 758, 825, 826, 828, 835, 837, 838, 973, 975 and 986”.
101
Clause 7.1.1 of Schedule 1 (definition of preparing a GP management plan ) Omit “item 721”, substitute “items 229 and 721”.
Insert:
prescribed medical practitioner means a medical practitioner:
(a) who is not a general practitioner, specialist or consultant physician; and
(b) who:
(i) is registered under section 3GA of the Act and is practising during the period, and in the location, in respect of which the medical practitioner is registered, and insofar as the circumstances specified for the purposes of paragraph 19AA(3)(b) of the Act apply; or
(ii) is covered by an exemption under subsection 19AB(3) of the Act; or
(iii) first became a medical practitioner before 1 November 1996.
103
Clause 7.1.1 of Schedule 1 (definition of residential medication management review Omit “item 903”, substitute “items 249 and 903”.
104
Clause 7.1.1 of Schedule 1 (definition of reviewing a GP management plan ) Omit “item 732”, substitute “items 233 and 732”.
Insert:
Telehealth and Telephone Determination means theHealth Insurance (Section 3C General Medical Services – Telehealth and Telephone Attendances) Determination 2021 .
Repeal the clause, substitute:
For any patient, items 66551, 73812 and 73826 cannot be claimed more than 4 times in 12 months, whether claimed individually or in any combination of the items.
Insert:
73343 | Detection of 17p chromosomal deletions by fluorescence in situ hybridisation or genome wide micro‑array, in a patient with chronic lymphocytic leukaemia or small lymphocytic lymphoma, on a peripheral blood, bone marrow or lymph node sample, requested by a specialist or consultant physician For any particular patient: (a) at initial diagnosis; or (b) at disease relapse; or (c) on disease progression;
| 589.90 |
3
Division 2.7 of Schedule 1 (Group P7 table, at the end of the table) Add:
73440 | Genomic testing and copy number variant analysis of genes known to be causative or likely causative of childhood hearing loss in a patient, if:
Applicable once per lifetime | 1,200.00 |
73441 | Genomic testing and copy number variant analysis of relevant genes known to be causative or likely causative of childhood hearing loss in a patient, if:
Applicable once per lifetime | 2,100.00 |
73442 | Re‑analysis of whole exome or genome data obtained under a service to which item 73440 or 73441 applies, for characterisation of previously unreported germline gene variants for childhood hearing loss in a patient, if:
Applicable twice per lifetime | 500.00 |
73443 | Characterisation of one or more familial germline gene variants known to be causative or likely causative of childhood hearing loss in a person, if:
| 400.00 |
73444 | Characterisation of all germline variants in one or more genes known to cause hearing loss in a person, if:
| 1,200.00 |
73445 | Characterisation of a variant or variants in a panel of at least 25 genes using DNA and RNA, requested by a specialist or consultant physician, to determine the diagnosis, prognosis and/or management of a patient presenting with a clinically suspected haematological malignancy of myeloid origin Applicable once per diagnostic episode, at diagnosis, disease progression or relapse | 1,100.00 |
73446 | Characterisation of a variant or variants in a panel of at least 25 genes using DNA and RNA, requested by a specialist or consultant physician, to determine the diagnosis, prognosis and/or management of a patient presenting with a clinically suspected haematological malignancy of lymphoid origin Applicable once per diagnostic episode, at diagnosis, disease progression or relapse | 1,100.00 |
73447 | Characterisation of a variant or variants in a panel of at least 25 genes using DNA, requested by a specialist or consultant physician, to determine the diagnosis, prognosis and/or management of a patient presenting with a clinically suspected haematological malignancy of myeloid origin Applicable once per diagnostic episode, at diagnosis, disease progression or relapse | 927.90 |
73448 | Characterisation of a variant or variants in a panel of at least 25 genes using DNA, requested by a specialist or consultant physician, to determine the diagnosis, prognosis and/or management of a patient presenting with a clinically suspected haematological malignancy of lymphoid origin Applicable once per diagnostic episode, at diagnosis, disease progression or relapse | 927.90 |
73451 | Testing of a patient who is pregnant, or planning pregnancy, to identify carrier status for pathogenic or likely pathogenic variants in the following genes, for the purpose of determining reproductive risk of cystic fibrosis, spinal muscular atrophy or fragile X syndrome: (a) CFTR; (b) SMN1; (c) FMR1 One test per lifetime | 400.00 |
73452 | Testing of the reproductive partner of a patient who has been found to be a carrier of a pathogenic or likely pathogenic variant in the CFTR or SMN1 gene identified by testing under item 73451, for the purpose of determining the couple’s reproductive risk of cystic fibrosis or spinal muscular atrophy One test per condition per lifetime | 400.00 |
73453 | Characterisation of germline pathogenic or likely pathogenic gene variants: (a) in at least the following genes:
Applicable once per lifetime | 425.00 |
73454 | Whole gene sequencing of a gene or genes described in item 73453, in a patient who is the reproductive partner of an individual who is affected by, or is a known genetic carrier of, one or more conditions described in item 73453 (other than cystic fibrosis, fragile‑X syndrome or spinal muscular atrophy), for the purpose of determining the couple’s combined reproductive risk of the conditions, if:
Applicable once per couple per lifetime | 1,200.00 |
73455 | Testing of a pregnant patient, if at least one prospective parent is known to be affected by, or is a genetic carrier of, one or more conditions described in item 73453, for the purpose of determining whether a familial variant or variants are present in the fetus, if:
| 1,600.00 |
73456 | Characterisation by whole genome sequencing, or by either or both whole exome sequencing and mitochondrial DNA sequencing, of germline variants present in nuclear DNA and in mitochondrial DNA of a patient with a strong suspicion of a mitochondrial disease, if:
Applicable only once per lifetime | 2,100.00 |
73457 | Characterisation by whole genome sequencing, or either or both whole exome sequencing and mitochondrial DNA sequencing, of germline variants present in nuclear DNA and in mitochondrial DNA, of a patient with a strong suspicion of a mitochondrial disease, if:
Applicable only once per lifetime | 3,300.00 |
73458 | Re‑analysis of whole genome or whole exome or mitochondrial DNA data obtained in performing a service to which item 73456 or 73457 applies, for characterisation of previously unreported germline variants related to the clinical phenotype, if:
Applicable twice per lifetime | 500.00 |
73459 | Testing for diagnostic purposes of a pregnant patient, for detection in the fetus of a gene variant or variants present in the parents, if: (a) the gene variant or variants are:
| 1,600.00 |
73460 | Characterisation of mitochondrial DNA deletion or variant for diagnostic purposes in a patient suspected to have mitochondrial disease, if:
Applicable 3 times per lifetime | 450.00 |
73461 | Whole gene testing of a person for the characterisation of all germline gene variants within the same gene in which the person’s reproductive partner has a pathogenic or likely pathogenic germline recessive gene variant for mitochondrial disease, if:
| 1,200.00 |
73462 | Testing of a person for the detection of a single gene variant, if:
| 400.00 |
Omit “once per variant”, substitute “once per gene”.
Omit “400.00”, substitute “1,200.00”.
Insert:
66585 | Quantification of laboratory‑based BNP or NT‑proBNP testing in a patient with systemic sclerosis (scleroderma) to assess risk of pulmonary arterial hypertension |
Maximum of 2 tests in a 12 month period | 58.50 |
Insert:
66654 | Prostate specific antigen—quantitation in the monitoring of high risk patients For any particular patient, applicable not more than once in 11 months | 20.15 |
Omit “12”, substitute “23”.
Omit “a test to which item 66655 applies”, substitute “prostate cancer, prostatitis or a premalignant condition such as atypical small acinar proliferation”.
Repeal the cell, substitute:
Prostate specific antigen (PSA), quantitation of 2 or more fractions of PSA and any derived index, including, if performed, a test described in item 66656, in the follow up of a PSA result under item 66654 or 66655 that lies at:
For any particular patient, applicable not more than once in 11 months |
Repeal the cell, substitute:
Prostate specific antigen (PSA), quantitation of 2 or more fractions of PSA and any derived index, in the monitoring of previously diagnosed prostatic disease, including, if performed, a test described in item 66656, if the current PSA level lies at:
For any particular patient, applicable not more than 4 times in 11 months |
Insert:
71202 | Measurable residual disease (MRD) testing by flow cytometry, performed on bone marrow from a patient diagnosed with acute lymphoblastic leukaemia, for the purpose of determining baseline MRD, or facilitating the determination of MRD following combination chemotherapy or after salvage therapy, requested by a specialist or consultant physician practising as a haematologist or oncologist | 550.00 |
Insert:
73310 | Measurable residual disease (MRD) testing by next‑generation sequencing, performed on bone marrow (or a peripheral blood sample if bone marrow cannot be collected) from a patient diagnosed with acute lymphoblastic leukaemia, for the purpose of determining baseline MRD, or facilitating the determination of MRD following combination chemotherapy or after salvage therapy, requested by a specialist or consultant physician practising as a haematologist or oncologist | 1,550.00 |
Insert:
73306 | Gene expression profiling testing using EndoPredict, for the purpose of profiling gene expression in formalin‑fixed, paraffin‑embedded primary breast cancer tissue from core needle biopsy or surgical tumour sample to estimate the risk of distant recurrence of breast cancer within 10 years, if:
Applicable once per new primary breast cancer diagnosis for any particular patient | 1,200.00 |
Repeal the cell, substitute:
Characterisation of germline gene variants, including copy number variation where appropriate, requested by a specialist or consultant physician:
Once per cancer diagnosis |
Repeal the cell, substitute:
Characterisation of germline gene variants, including copy number variation where appropriate, requested by a specialist or consultant physician:
Once per variant |
1
Subsection 28(1) (at the end of the cell at table item 1, column 2) Add “, 123, 124”.
2
Subsection 28(1) (at the end of the cell at table item 2, column 2) Add “, 151, 165”.
3
Subsection 28(1) (at the end of the cell at table item 6, column 2) Add “, 301, 303”.
4
Subsection 28(1) (at the end of the cell at table item 14, column 2) Add “, 2197, 2198, 2200”.
5
Subsection 28(1) (at the end of the cell at table item 24, column 2) Add “, 5071, 5076, 5077”.
6
Subsection 28(1) (cell at table item 25, column 2) Repeal the cell, substitute:
5200, 5203, 5207, 5208, 5209, 5220, 5223, 5227, 5228, 5260, 5261, 5262, 5263, 5265, 5267 |
7
Subsection 28(1) (cell at table item 28A, column 2) Repeal the cell, substitute:
90020, 90035, 90043, 90051, 90054, 90092, 90093, 90095, 90096, 90098, 90183, 90188, 90202, 90212, 90215 |
8
Subsection 28(1) (at the end of the cell at table item 28C, column 2) Add “, 91920, 91923, 91926”.
9
Subsection 28(1) (at the end of the cell at table item 28D, column 2) Add “, 91900, 91903, 91906, 91910, 91913, 91916”.
0
0
0