Health Insurance (Section 3C Diagnostic Imaging Services – Computed Tomography Angiography) Determination 2020 (Cth)

Health Insurance (Section 3C Diagnostic Imaging Services – Computed Tomography Angiography) Determination 2020

I, Paul McBride, delegate of the Minister for Health, make the following determination.

Dated        6 October 2020      

Paul McBride

First Assistant Secretary

Medical Benefits Division

Health Resourcing Group

Department of Health

Contents

1.  Name....................................................................................................................................... 1

2.  Commencement....................................................................................................................... 1

3.  Authority................................................................................................................................. 1

4.  Definitions............................................................................................................................... 1

5.  Treatment of relevant services................................................................................................. 2

6.  Application of provisions of the diagnostic imaging services table......................................... 2

Schedule – relevant services  4

1.  Name

This instrument is the Health Insurance (Section 3C Diagnostic Imaging Services – Computed Tomography Angiography) Determination 2020.

2.  Commencement

(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.

Commencement information
Column 1	Column 2	Column 3
Provisions	Commencement	Date/Details
1.  The whole of this instrument	1 November 2020

Note:        This table relates only to the provisions of this instrument as originally made.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.

3.  Authority

This instrument is made under subsection 3C(1) of the Health Insurance Act 1973.

4.  Definitions

1. In this instrument:

Act means the Health Insurance Act 1973.

relevant provisions means all provisions, of the Act and regulations made under the Act, and the National Health Act 1953 and regulations made under the National Health Act 1953, relating to medical services, professional services or items.

(R) has the meaning given by clause 1.2.15 of the diagnostic imaging services table.

relevant service means a health service, as defined in subsection 3C(8) of the Act, that is specified in a Schedule.

Schedule means a Schedule to this instrument.

Note:  The following terms are defined in subsection 3(1) of the Act:

·clinically relevant service;

·diagnostic imaging services table;

·item;

·professional service.

(2)   Unless the contrary intention appears, a reference in this instrument to a provision of the Act or the National Health Act 1953 or regulations made under the Act or under the National Health Act 1953 as applied, adopted or incorporated in relation to specifying a matter is a reference to those provisions as in force from time to time and any other reference to provisions of an Act or regulations is a reference to those provisions as in force from time to time.

5.  Treatment of relevant services

For subsection 3C(1) of the Act, a relevant service, provided in accordance with this instrument and as a clinically relevant service, is to be treated, for the relevant provisions, as if:

(a)it were both a professional service and a diagnostic imaging service; and

(b)there were an item in the diagnostic imaging services table that:

i.related to the service; and

ii.specified for the service a fee in relation to each State, being the fee specified in the Schedule in relation to the service.

6.  Application of provisions of the diagnostic imaging services table

1. Clause 1.1.1 of diagnostic imaging services table shall have effect as if item 57357 of this Determination was also specified in clause 1.1.1.

1. Clause 1.2.1 of the diagnostic imaging services table shall have effect as if item 57357 of this Determination was also specified in clause 1.2.1.

1. Clause 1.2.2 of the diagnostic imaging services table shall have effect as if item 57357 of this Determination was also specified in clause 1.2.2.

1. Clause 1.2.3 of the diagnostic imaging services table shall have effect as if item 57357 of this Determination was also specified in clause 1.2.3.

1. Clause 1.2.4 of the diagnostic imaging services table shall have effect as if item 57357 of this Determination was also specified in clause 1.2.4.

1. Clause 1.2.5 of the diagnostic imaging services table shall have effect as if item 57357 of this Determination was also specified in clause 1.2.5.

1. Clause 1.2.6 of the diagnostic imaging services table shall have effect as if item 57357 of this Determination was also specified in clause 1.2.6.

1. Clause 1.2.7 of the diagnostic imaging services table shall have effect as if item 57357 of this Determination was also specified in clause 1.2.7.

1. Clause 1.2.8 of the diagnostic imaging services table shall have effect as if item 57357 of this Determination was also specified in clause 1.2.8.

1. Clause 1.2.9 of the diagnostic imaging services table shall have effect as if item 57357 of this Determination was also specified in clause 1.2.9.

1. Clause 1.2.10 of the diagnostic imaging services table shall have effect as if item 57357 of this Determination was also specified in clause 1.2.10.

1. Clause 1.2.11 of the diagnostic imaging services table shall have effect as if item 57357 of this Determination was also specified in clause 1.2.11.

1. Clause 1.2.12 of the diagnostic imaging services table shall have effect as if item 57357 of this Determination was also specified in clause 1.2.12.

1. Clause 1.2.13 of the diagnostic imaging services table shall have effect as if item 57357 of this Determination was also specified in clause 1.2.13.

1. Clause 1.2.14 of the diagnostic imaging services table shall have effect as if item 57357 of this Determination was also specified in clause 1.2.14.

1. Clause 1.2.16 of the diagnostic imaging services table shall have effect as if item 57357 of this Determination was also specified in clause 1.2.16.

1. Clause 1.2.17 of the diagnostic imaging services table shall have effect as if item 57357 of this Determination was also specified in subclause 1.2.17(1).

1. Clause 1.2.18 of the diagnostic imaging services table shall have effect as if item 57357 of this Determination was also specified in clause 1.2.18.

1. Clause 1.2.21 of the diagnostic imaging services table shall have effect as if item 57357 of this Determination was also specified in clause 1.2.21.

1. Clause 1.2.22 of the diagnostic imaging services table shall have effect as if item 57357 of this Determination was also specified in clause 1.2.22.

1. Clause 1.2.23 of the diagnostic imaging services table shall have effect as if item 57357 of this Determination was also specified in clause 1.2.23.

1. Clause 2.2.1 of the diagnostic imaging services table shall have effect as if item 57357 of this Determination was also specified in clause 2.2.1.

1. Clause 2.2.2 of the diagnostic imaging services table shall have effect as if item 57357 of this Determination was also specified in clause 2.2.2.

Schedule – relevant services

Group I2 – Computed tomography - examination
Subgroup 12 – Angiography
Column 1 Item	Column 2 Description	Column 3 Fee ($)
57357	Computed tomography—angiography with intravenous contrast medium of any or all, or any part, of the pulmonary arteries and their branches, including any scans performed before intravenous contrast injection—one or more data acquisitions, including image editing, and maximum intensity projections or 3 dimensional surface shaded display, with hardcopy or digital recording of multiple projections, if: (a)   the service is not a service to which another item in this group applies; and (b)   the service is not a study performed to image the coronary arteries; and (c)   the service is: (i)     performed for the exclusion of pulmonary arterial stenosis, occlusion, aneurysm or embolism and is requested by a specialist or consultant physician; or (ii)    performed for the exclusion of pulmonary arterial stenosis, occlusion or aneurysm and is requested by a medical practitioner (other than a specialist or consultant physician) and the request indicates that the patient’s case has been discussed with a specialist or consultant physician; or (iii)   for the exclusion of pulmonary embolism and is requested be a medical practitioner (other than a specialist or consultant physician) (R) (Anaes.)	517.65