Health Insurance Legislation Amendment (2024 Measures No. 2) Regulations 2024 (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 23 May 2024
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 (2024 Measures No. 2) Regulations 2024 .
(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. | 24 May 2024 |
Schedule 1 | 1 July 2024. | 1 July 2024 |
Schedule 2 | Immediately after the commencement of the provisions covered by table item 2. | 1 July 2024 |
Note: This table relates only to the provisions of this instrument as originally made.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Each instrument that is specified in a Schedule to this instrument is amended or repealed as set out in the applicable items in the Schedule concerned, and any other item in a Schedule to this instrument has effect according to its terms.
Omit “
1 November 2023 ”, substitute “1 July 2024 ”.
Repeal the subclause, substitute:
(1) At the start of 1 July 2024 (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 2024 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 “$330.20”, substitute “$341.75”.
4
Clause 1.3.1 of Schedule 1 (heading) Omit “
1 November 2023 ”, substitute “1 July 2024 ”.5
Subclauses 1.3.1(1) and (2) of Schedule 1 Repeal the subclauses, substitute:
(1) At the start of 1 July 2024 (the
indexation time ), each amount covered by subclause (2) is replaced by the amount worked out using the following formula:Note: The indexed fees could in 2024 be viewed on the Department’s MBS Online website ( amounts covered by this subclause are the fee for each item in a Group in this Schedule, other than the fee for the following:
(a) an item in Group A2;
(b) an item in Group A23;
(c) items 90092, 90093, 90095, 90096 and 90098 in Group A35;
(d) an item in Group T10.
6
Clause 2.1.1 of Schedule 1 (table 2.1.1) Repeal the table, substitute:
Table 2.1.1—Amount under clause 2.1.1
Item
Column 1
Item of this Schedule
Column 2
Fee
Column 3
Amount if not more than 6 patients (to be divided by the number of patients) ($)
Column 4
Amount if more than 6 patients ($) 1
4
The fee for item 3
30.00
2.40
2
24
The fee for item 23
30.00
2.40
3
37
The fee for item 36
30.00
2.40
4
47
The fee for item 44
30.00
2.40
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
30.00
2.40
10
165
$88.20
15.50
0.70
11
195
The fee for item 193
29.60
2.35
12
414
The fee for item 410
29.50
2.35
13
415
The fee for item 411
29.50
2.35
14
416
The fee for item 412
29.50
2.35
15
417
The fee for item 413
29.50
2.35
16
5003
The fee for item 5000
29.60
2.35
17
5010
The fee for item 5000
53.25
3.80
18
5023
The fee for item 5020
29.60
2.35
19
5028
The fee for item 5020
53.25
3.80
20
5043
The fee for item 5040
29.60
2.35
21
5049
The fee for item 5040
53.25
3.80
22
5063
The fee for item 5060
29.60
2.35
23
5067
The fee for item 5060
53.25
3.80
24
5076
The fee for item 5071
29.60
2.35
25
5077
The fee for item 5071
53.25
3.80
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
$67.50
27.95
1.25
36
90272
The fee for item 90271
29.60
2.35
37
90274
The fee for item 90273
29.60
2.35
38
90276
The fee for item 90275
23.65
1.85
39
90278
The fee for item 90277
23.65
1.85
7
Clause 2.1.2 of Schedule 1 (table 2.1.2) Repeal the table, substitute:
Table 2.1.2—Amount under clause 2.1.2
Item
Column 1
Item of this Schedule
Column 2
Fee
Column 3
Amount if not more than 6 patients (to be divided by the number of patients) ($)
Column 4
Amount if more than 6 patients ($) 1
181
The fee for item 179
24.00
1.90
2
187
The fee for item 185
24.00
1.90
3
191
The fee for item 189
24.00
1.90
4
206
The fee for item 203
24.00
1.90
5
303
The fee for item 301
24.00
1.90
8
Schedule 1 (item 111, column 2, paragraph (d)) Omit “$330.20”, substitute “$341.75”.
9
Schedule 1 (item 115, column 2, paragraph (c)) Omit “$330.20”, substitute “$341.75”.
10
Schedule 1 (item 117, column 2, paragraph (e)) Omit “$330.20”, substitute “$341.75”.
11
Schedule 1 (item 120, column 2, paragraph (d)) Omit “$330.20”, substitute “$341.75”.
12
Clause 2.10.2 of Schedule 1 (note) Repeal the note, substitute:
Note: The fees in Group A7 are indexed in accordance with clause 1.3.1.
13
Clause 2.20.2 of Schedule 1 (table 2.20.2) Repeal the table, substitute:
Table 2.20.2—Amount under clause 2.20.2
Item
Column 1
Item of this Schedule
Column 2
Fee
Column 3
Amount if not more than 6 patients (to be divided by the number of patients) ($)
Column 4
Amount if more than 6 patients ($) 1
2723
The fee for item 2721
29.60
2.35
2
2727
The fee for item 2725
29.60
2.35
3
2741
The fee for item 2739
29.60
2.35
4
2745
The fee for item 2743
29.60
2.35
14
Clause 2.20.2A of Schedule 1 (table 2.20.2A) Repeal the table, substitute:
Table 2.20.2A—Amount under clause 2.20.2A
Item
Column 1
Item of this Schedule
Column 2
Fee
Column 3
Amount if not more than 6 patients (to be divided by the number of patients) ($)
Column 4
Amount if more than 6 patients ($) 1
285
The fee for item 283
23.70
1.85
2
287
The fee for item 286
23.70
1.85
3
311
The fee for item 309
23.70
1.85
4
315
The fee for item 313
23.70
1.85
15
Subclause 2.30.1(1) of Schedule 1 Omit “$60.55”, substitute “$62.65”.
16
Subclause 2.30.1(2) of Schedule 1 Omit “$43.95”, substitute “$45.50”.
17
Clause 2.30.2 of Schedule 1 (note) Repeal the note, substitute:
Note: The fees in Group A35 (other than the fees for items 90092, 90093, 90095, 90096 and 90098) are indexed in accordance with clause 1.3.1.
18
Subclause 5.7.1(1) of Schedule 1 (paragraph (b) of the definition of amount under clause 5.7.1 ) Omit “$20.90”, substitute “$21.65”.
19
Subclause 5.7.1(2) of Schedule 1 (paragraph (b) of the definition of amount under clause 5.7.1 ) Omit “$31.50”, substitute “$32.60”.
20
Clause 5.9.1A of Schedule 1 (definition of base unit ) Omit “$21.80”, substitute “$22.55”.
21
Clause 5.9.2 of Schedule 1 (paragraph (a) of the definition of amount under clause 5.9.2 ) Omit “$109.05”, substitute “$112.85”.
22
Schedule 1 (items 51300, 51303, 51800 and 51803, column 2) Omit “$614.55” (wherever occurring), substitute “$636.05”.
23
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
18.80
19.45
2
Table item 2
20.40
21.10
3
Table item 3
20.65
21.35
4
Table item 4
24.95
25.80
5
Table item 5
52.05
53.85
6
Table item 6
35.10
36.35
7
Table item 7
41.80
43.25
8
Table item 8
41.80
43.25
9
Table item 9
41.80
43.25
10
Table item 10
41.80
43.25
11
Table item 11
41.80
43.25
12
Table item 12
41.80
43.25
13
Table item 13
41.80
43.25
14
Table item 14
41.80
43.25
15
Table item 15
41.80
43.25
16
Table item 16
41.80
43.25
Health Insurance (Pathology Services Table) Regulations 2020 24
Clause 2.14.1 of Schedule 1 (heading) Omit “
1 November 2023 ”, substitute “1 July 2024 ”.25
Subclause 2.14.1(1) of Schedule 1 Repeal the subclause, substitute:
(1) At the start of 1 July 2024 (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 2024 be viewed on the Department’s MBS Online website ( level="6" section-type="Schedule">
Schedule 2 Other amendments Part 1 Diagnostic imaging services table
Health Insurance (Diagnostic Imaging Services Table) Regulations (No. 2) 2020 1
Paragraph 1.2.7(2)(c) of Schedule 1 Repeal the paragraph, substitute:
(c) set out:
(i) reasons why the proprietor is unable to replace the equipment (or upgrade the equipment, if it has not already been upgraded) before the end of the equipment’s applicable life age; and
(ii) the steps taken by the proprietor to replace the equipment (or upgrade the equipment, if it has not already been upgraded).
2
Subclauses 1.2.8(3) and (4) of Schedule 1 Repeal the subclauses, substitute:
(3) The Secretary must not grant the exemption unless the Secretary is satisfied that both of the following apply:
(a) due to circumstances beyond the control of the proprietor, the proprietor is unable to replace the equipment (or upgrade the equipment, if it has not already been upgraded) before the end of its applicable life age;
(b) the proprietor is taking reasonable steps to replace the equipment (or upgrade the equipment, if it has not already been upgraded) before the end of the period specified under paragraph (2)(a).
(4) The period specified under paragraph (2)(a) must end no later than 6 months after the end of the equipment’s applicable life age.
Note: The period specified under paragraph (2)(a) is the initial
exemption period of the exemption: see clause 3.1. The exemption period can be extended or further extended under clause 1.2.10.3
Subclause 1.2.8(6) of Schedule 1 After “extended”, insert “or further extended”.
4
Subclause 1.2.9(2) of Schedule 1 Omit “extend the exemption period of the exemption under clause 1.2.10”, substitute “extend or further extend under clause 1.2.10 the exemption period of the exemption”.
5
Paragraph 1.2.9(3)(c) of Schedule 1 Repeal the paragraph, substitute:
(c) set out:
(i) reasons why the proprietor continues to be unable to replace or upgrade the equipment; and
(ii) the steps taken by the proprietor to replace the equipment (or upgrade the equipment, if it has not already been upgraded).
6
Paragraph 1.2.9(4)(a) of Schedule 1 After “extension”, insert “or further extension”.
7
Subclause 1.2.10(1) of Schedule 1 After “extension”, insert “or further extension”.
8
Paragraph 1.2.10(2)(a) of Schedule 1 After “extend”, insert “or further extend”.
9
Paragraph 1.2.10(2)(b) of Schedule 1 After “extend”, insert “, or further extend,”.
10
Subclause 1.2.10(3) of Schedule 1 Repeal the subclause, substitute:
(3) The Secretary must not extend or further extend the exemption period unless the Secretary is satisfied that both of the following apply:
(a) due to circumstances beyond the control of the proprietor, the proprietor is unable to replace the equipment (or upgrade the equipment, if it has not already been upgraded) before the end of the current exemption period of the exemption;
(b) the proprietor is taking reasonable steps to replace the equipment (or upgrade the equipment, if it has not already been upgraded) before the end of the exemption period as extended or further extended.
11
Subclause 1.2.10(4) of Schedule 1 After “extension”, insert “or further extension”.
12
Subclause 1.2.10(6) of Schedule 1 After “extend” (wherever occurring), insert “, or further extend,”.
13
Paragraph 1.2.11(1)(b) of Schedule 1 After “extend”, insert “, or further extend,”.
14 Clause 1.2.14 of Schedule 1 Repeal the clause.
15
Clause 2.4.1 of Schedule 1 Repeal the clause, substitute:
2.4.1 Nuclear scanning services (other than PET nuclear scanning services) and adjunctive services
(1) An item in Subgroup 1 or 3 of Group I4 applies only if:
(a) the performance of the service does not involve the use of positron‑emission radio‑isotopes or a PET scanner; and
(b) the service is performed under the supervision of a nuclear medicine credentialled specialist who is available to monitor and influence the conduct and diagnostic quality of the examination; and
(c) a nuclear medicine credentialled specialist or a specialist in the specialty of diagnostic radiology is available, if necessary, to attend on the patient personally; and
(d) the service is reported by a nuclear medicine credentialled specialist.
(2) Paragraphs (1)(a) to (c) do not apply if the service is performed:
(a) in an emergency; or
(b) because of medical necessity, in a remote location.
16
Clause 2.4.3 of Schedule 1 Repeal the clause, substitute:
2.4.3 PET nuclear scanning services—performance under supervision For the purposes of paragraph 2.4.2(1)(c), the service is performed in accordance with this clause if:
(a) all of the following subparagraphs apply:
(i) the service is performed under the supervision of a PET credentialled specialist who is available to monitor and influence the conduct and diagnostic quality of the examination;
(ii) a PET credentialled specialist, a nuclear medicine credentialled specialist or a specialist in the specialty of diagnostic radiology is available, if necessary, to attend on the patient personally;
(iii) the service is reported by a PET credentialled specialist; or
(b) the service is performed:
(i) in an emergency; or
(ii) because of medical necessity, in a remote location.
17
Clause 2.4.4 of Schedule 1 Omit “For the purposes of clause 2.4.2, the service must be”, substitute “For the purposes of paragraph 2.4.2(1)(c), the service is performed in accordance with this clause if the service is”.
18
Paragraph 2.4.5(1)(a) of Schedule 1 Omit “is a credentialed specialist or a medical practitioner who satisfies the requirements mentioned in subparagraphs 2.4.3(1)(b)(i) to (iv)”, substitute “is a PET credentialled specialist”.
19
Schedule 1 (after item 63476) Insert:
63539
MRI—scan of the abdomen, requested by a specialist or consultant physician, to assess the development or growth of renal tumours in a patient with a confirmed clinical or molecular diagnosis of a genetic disorder associated with an increased risk of developing renal tumours, other than a service to which item 63540 applies
Applicable once in any 12 month period
(R) (Anaes.) (Contrast)
686.70
63540
MRI—scan of the abdomen, requested by a specialist or consultant physician, to assess a patient with one or more known renal tumours and with a confirmed clinical or molecular diagnosis of a genetic disorder associated with an increased risk of developing renal tumours, if the service is performed:
(a) to evaluate changes in clinical condition or suspected complications of the known renal tumours; or
(b) where a disease specific line of treatment has been initiated and an assessment of patient responsiveness to the treatment is required
Applicable once in any 3 month period
(R) (Anaes) (Contrast)
686.70
20
Clause 3.1 of Schedule 1 (definition of credentialled specialist ) Repeal the definition.
21
Clause 3.1 of Schedule 1 (definition of exemption period ) After “extended”, insert “or further extended”.
22
Clause 3.1 of Schedule 1 Insert:
nuclear medicine credentialled specialist means a specialist or consultant physician whose name is included in a register, given to the Chief Executive Medicare by the JNMCAC, of participants in the Joint Nuclear Medicine Specialist Credentialling Program of the JNMCAC.
PET credentialled specialist means:
(a) a specialist or consultant physician who is credentialled under the Joint Nuclear Medicine Specialist Credentialling Program for the Recognition of the Credentials of Nuclear Medicine Specialists for Positron Emission Tomography overseen by the JNMCAC; or
(b) a specialist or consultant physician who:
(i) is a Fellow of the RACP or RANZCR; and
(ii) has reported 400 or more studies forming part of PET services for which a Medicare benefit was payable; and
(iii) is authorised under State or Territory law to prescribe and administer to humans the PET radiopharmaceuticals that are to be administered to a person; and
(iv) met the requirements of subparagraphs (i), (ii) and (iii) before 1 November 2011.
23
In the appropriate position in Part 4 of Schedule 1 Insert:
Division 2 — Health Insurance Legislation Amendment (2024 Measures No. 2) Regulations 2024
4.3 Definitions In this Division:
amending instrument means the Health Insurance Legislation Amendment (2024 Measures No. 2) Regulations 2024.
4.4 Exemptions from capital sensitivity requirements
(1) The amendments of this instrument made by items 2 to 4 and 6 to 14 of Part 1 of Schedule 2 to the amending instrument apply in relation to a decision on an application made by the Secretary on or after 1 July 2024, regardless of when the application was made.
(2) The amendments of this instrument made by items 1 and 5 of Part 1 of Schedule 2 to the amending instrument apply in relation to applications made on or after 1 July 2024.
4.5 PET nuclear scanning services—statutory declaration The amendment of clause 2.4.5 of this instrument made by Part 1 of Schedule 2 to the amending instrument applies in relation to statutory declarations given on or after 1 July 2024.
Part 2 General medical services table
Health Insurance (General Medical Services Table) Regulations 2021 24
Schedule 1 (cell at item 11300, column 2) Repeal the cell, substitute:
Brain stem evoked response audiometry, if:
(a) the service is not for the purposes of programming either an auditory implant or the sound processor of an auditory implant; and
(b) a service to which item 82300 applies has not been performed on the patient on the same day
(Anaes.)
25
Schedule 1 (items 11340, 11341 and 11343, column 2) Omit “11027, 11205 or 11300”, substitute “11027 or 11205”.
26
Schedule 1 (cell at item 32222, column 2) Repeal the cell, substitute:
Endoscopic examination of the colon to the caecum by colonoscopy, for a patient:
(a) following a positive faecal occult blood test; or
(b) who has symptoms consistent with pathology of the colonic mucosa; or
(c) who has anaemia or iron deficiency; or
(d) for whom diagnostic imaging has shown an abnormality of the colon; or
(e) who is undergoing the first examination following surgery for colorectal cancer; or
(f) who is undergoing pre‑operative evaluation; or
(g) for whom a repeat colonoscopy is required due to inadequate bowel preparation for the patient’s previous colonoscopy; or
(h) for the management of inflammatory bowel disease;
other than a service associated with a service to which item 32230 applies
Applicable once on a day under a single episode of anaesthesia or other sedation (Anaes.)
27
Schedule 1 (cell at item 32223, column 2) Repeal the cell, substitute:
Endoscopic examination of the colon to the caecum by colonoscopy, for a patient:
(a) who has had a colonoscopy that revealed:
(i) one to 4 adenomas, each of which was less than 10 mm in diameter, had no villous features and had no high grade dysplasia; or
(ii) one or 2 sessile serrated lesions, each of which was less than 10 mm in diameter, and without dysplasia; or
(b) who has a moderate risk of colorectal cancer due to family history; or
(c) who has a history of colorectal cancer and has had an initial post‑operative colonoscopy that did not reveal any adenomas or colorectal cancer;
other than a service associated with a service to which item 32230 applies
Applicable once in any 5 year period (Anaes.)
28
Schedule 1 (cell at item 32224, column 2) Repeal the cell, substitute:
Endoscopic examination of the colon to the caecum by colonoscopy, for a patient who has a moderate risk of colorectal cancer due to:
(a) a history of adenomas, including an adenoma that:
(i) was 10 mm or greater in diameter; or
(ii) had villous features; or
(iii) had high grade dysplasia; or
(b) having had a previous colonoscopy that revealed:
(i) 5 to 9 adenomas, each of which was less than 10 mm in diameter, had no villous features and had no high grade dysplasia; or
other than a service associated with a service to which item 32230 applies Applicable once in any 3 year period (Anaes.) |
Repeal the cell, substitute:
Endoscopic examination of the colon to the caecum by colonoscopy, for a patient who has a high risk of colorectal cancer due to having had a previous colonoscopy that:
other than a service associated with a service to which item 32230 applies Applicable 4 times in any 12 month period (Anaes.) |
Repeal the cell, substitute:
Endoscopic examination of the colon to the caecum by colonoscopy, for a patient who has a high risk of colorectal cancer due to:
other than a service associated with a service to which item 32230 applies Applicable once in any 12 month period (Anaes.) |
Repeal the cell, substitute:
Endoscopic examination of the colon to the caecum by colonoscopy, other than:
Applicable once (Anaes.) |
Repeal the cell, substitute:
Endoscopic mucosal resection using electrocautery of a non‑invasive sessile or flat superficial colorectal neoplasm which is at least 25mm in diameter, if the service is supported by photographic evidence to confirm the size of the polyp in situ Applicable once per polyp (H) (Anaes.) |
Omit “Cytoscopy”, substitute “Cystoscopy”.
Omit “cytoscopy and with or without urethrosocopy”, substitute “cystoscopy and with or without urethroscopy”.
Insert:
41768 | Unilateral insertion of bioabsorbable implant for nasal airway obstruction due to lateral wall insufficiency confirmed by positive modified Cottle manoeuvre, if:
Applicable once per lifetime per nostril (Anaes.) | 205.90 |
41769 | Bilateral insertion of bioabsorbable implant for nasal airway obstruction due to lateral wall insufficiency confirmed by positive modified Cottle manoeuvre, if:
Applicable once per lifetime (Anaes.) | 308.90 |
After “service associated”, insert “with”.
After “of hip”, insert “under anaesthesia”.
Insert:
66586 | Quantification of BNP or NT‑proBNP testing in a patient with diagnosed pulmonary arterial hypertension to monitor for disease progression Applicable 4 times in any 12 month period | 58.50 |
Insert:
73313 | Development of a quantitative patient‑specific molecular assay for measurable residual disease (MRD) testing performed on bone marrow (or a peripheral blood sample if bone marrow cannot be collected) from a patient diagnosed with acute lymphoblastic leukaemia treated with combination chemotherapy or after salvage therapy, including the first service described in item 73316 performed on that bone marrow or peripheral blood sample, requested by a specialist or consultant physician practising as a haematologist or oncologist Applicable once per patient per episode of disease or per relapse | 3,000.00 |
Insert:
73316 | Measurable residual disease (MRD) testing by a quantitative patient‑specific molecular assay performed on bone marrow (or, in a patient with T‑cell acute lymphoblastic leukaemia, performed on a peripheral blood sample if bone marrow cannot be collected) from a patient diagnosed with acute lymphoblastic leukaemia treated with combination chemotherapy or after salvage therapy, requested by a specialist or consultant physician practising as a haematologist or oncologist, other than a service associated with a service to which item 73313 applies | 780.00 |
41
Schedule 1 (item 73410, column 2, paragraph (b)) Repeal the paragraph, substitute:
(b) the determination of carrier status in a person:
(i) who is a reproductive partner of a person with alpha thalassaemia; and
(ii) who has abnormal red cell indices; and
(iii) who does not have a concurrent iron deficiency; or
(c) the determination of carrier status in a person:
(i) who is a reproductive partner of a person with alpha thalassemia and heterozygous 2‑gene deletion; and
(ii) who has normal red cell indices
42
Schedule 1 (items 73411, 73412 and 73413, column 2, paragraph (b)) Omit “of child‑bearing potential with diagnosed alpha thalassaemia”, substitute “with alpha thalassaemia”.
0
0
0