Health Insurance (Section 3C General Medical Services – Extracorporeal Photopheresis for Chronic Graft Versus Host Disease) Determination 2022 (Cth)
Health Insurance (Section 3C General Medical Services – Extracorporeal Photopheresis for Chronic Graft Versus Host Disease) Determination 2022
made under subsection 3C(1) of the
Health Insurance Act 1973
Compilation No. 2
Compilation date: 1 July 2023
Includes amendments up to: F2023L00348
Registered: 18 July 2023
About this compilation
This compilation
This is a compilation of the Health Insurance (Section 3C General Medical Services – Extracorporeal Photopheresis for Chronic Graft Versus Host Disease) Determination 2022 that shows the text of the law as amended and in force on 1 July 2023 (the compilation date).
The notes at the end of this compilation (the endnotes) include information about amending laws and the amendment history of provisions of the compiled law.
Uncommenced amendments
The effect of uncommenced amendments is not shown in the text of the compiled law. Any uncommenced amendments affecting the law are accessible on the Register ( The details of amendments made up to, but not commenced at, the compilation date are underlined in the endnotes. For more information on any uncommenced amendments, see the Register for the compiled law.
Application, saving and transitional provisions for provisions and amendments
If the operation of a provision or amendment of the compiled law is affected by an application, saving or transitional provision that is not included in this compilation, details are included in the endnotes.
Editorial changes
For more information about any editorial changes made in this compilation, see the endnotes.
Modifications
If the compiled law is modified by another law, the compiled law operates as modified but the modification does not amend the text of the law. Accordingly, this compilation does not show the text of the compiled law as modified. For more information on any modifications, see the Register for the compiled law.
Self‑repealing provisions
If a provision of the compiled law has been repealed in accordance with a provision of the law, details are included in the endnotes.
Contents
1............ Name............................................................................................................................. 1
3............ Authority....................................................................................................................... 1
4............ Definitions..................................................................................................................... 1
5............ Treatment of relevant services....................................................................................... 2
6............ Requirements on the rendering practitioner................................................................... 2
7............ Application of treatment cycle and session.................................................................... 2
8............ Restriction on items....................................................................................................... 2
9............ Indexation...................................................................................................................... 3
Schedule – relevant services 4
Endnotes6
Endnote 1—About the endnotes 6
Endnote 2—Abbreviation key 7
Endnote 3—Legislation history 8
Endnote 4—Amendment history 9
1. Name
This instrument is the Health Insurance (Section 3C General Medical Services – Extracorporeal Photopheresis for Chronic Graft Versus Host Disease) Determination 2022.
3. Authority
This instrument is made under subsection 3C(1) of the Health Insurance Act 1973.
4. Definitions
In this instrument:
Act means the Health Insurance Act 1973.
Pharmaceutical Benefits Scheme means the scheme for the supply of pharmaceutical benefits established under Part VII of the National Health Act 1953.
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.
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;
·general medical 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 medical service; and
(b) there were an item in the general medical 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. Requirements on the rendering practitioner
(1) Clause 1.2.7 of the general medical services table shall have effect as if the items contained in the Schedule of the Determination were also specified in the clause.
(2) Clause 1.2.11 of the general medical services table shall have effect as if the items contained in the Schedule of the Determination were also specified in the clause.
7. Application of treatment cycle and session
(1) For an item in the Schedule, treatment cycle means treatment that is required to deliver extracorporeal photopheresis that:
(a) begins on the day in which the treatment begins; and
(b) ends 12 weeks after the day specified in paragraph (a).
(2) For an item in the Schedule, treatment session means a single extracorporeal photopheresis treatment in a series of sessions that make up a treatment cycle.
8. Restriction on items
Services rendered in certain circumstances or for certain purposes
(1) Clause 1.2.9 of the general medical services table shall have effect as if the items in the Schedule of the Determination were specified in the clause.
Services provided with harvesting, storage, in vitro processing, or injection of non‑haematopoietic stem cells
(2) Clause 1.2.10 of the general medical services table shall have effect as if the items in the Schedule of the Determination were specified in the clause.
Services connected with provision of pain pump for post‑surgical pain management
(3) Clause 5.1.1 of the general medical services table shall have effect as if the items in the Schedule of the Determination were specified in the clause.
Services provided on the same occasion as certain attendances
(4) An item in the Schedule does not apply to a service if it is associated with a service to which an item in Group A3 or Group A4 of the general medical service tables applies.
9. Indexation
(1) At the start of 1 July 2023 (the indexation day), 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 of Health and Aged Care’s MBS Online website ( The amounts covered by this subsection are the fee for each item in a Schedule of this Determination.
(3) An amount worked out under subsection (1) is to be rounded up or down to the nearest 5 cents (rounding down if the amount is an exact multiple of 2.5 cents).
Schedule – relevant services
Group T1—Miscellaneous Therapeutic Procedures Column 1
Item
Column 2
Description
Column 3
Fee ($)
Subgroup 8—Haematology 13761 Extracorporeal photopheresis for the treatment of chronic graft‑versus‑host disease, if:
(a) the person is:
(i) has received allogeneic haematopoietic stem cell transplantation; and
(ii) has been diagnosed with chronic‑graft‑versus host disease following the transplantation; and
(iii) steroid treatment is clinically unsuitable as the disease is steroid refractory or the person is steroid‑dependent or steroid‑intolerant; and
(b) the person has not previously received extracorporeal photopheresis treatment; and
(c) the service is delivered using an integrated, closed extracorporeal photopheresis system; and
(d) the service is provided in combination with the use of methoxsalen that is listed on the Pharmaceutical Benefits Scheme; and
(e) the service is provided by, or on behalf of, a specialist or consultant physician who:
(i) is practising in the speciality of haematology or oncology; and
(ii) has experience with allogeneic bone marrow transplantation.
Applicable once per treatment session
1,908.35 13762 Extracorporeal photopheresis for the treatment of chronic graft‑versus‑host disease, if:
(a) the person is:
(i) has received allogeneic haematopoietic stem cell transplantation; and
(ii) has been diagnosed with chronic graft versus host disease following the transplantation; and
(iii) steroid treatment is clinically unsuitable as the disease is steroid refractory or the person is steroid‑dependent or steroid‑intolerant; and
(b) the person has previously received an extracorporeal photopheresis treatment cycle and had a partial or complete response in at least one organ in response to treatment; and
(c) the person requires further extracorporeal photopheresis; and
(d) the service is delivered using an integrated, closed extracorporeal photopheresis system; and
(e) the service is provided in combination with the use of methoxsalen that is listed on the Pharmaceutical Benefits Scheme; and
(f) the service is provided by, or on behalf of, a specialist or consultant physician who:
(i) is practising in the speciality of haematology or oncology; and
(ii) has experience with allogeneic bone marrow transplantation.
Applicable once per treatment session
1,908.35 Endnotes
Endnote 1—About the endnotes
The endnotes provide information about this compilation and the compiled law.
The following endnotes are included in every compilation:
Endnote 1—About the endnotes
Endnote 2—Abbreviation key
Endnote 3—Legislation history
Endnote 4—Amendment history
Abbreviation key—Endnote 2
The abbreviation key sets out abbreviations that may be used in the endnotes.
Legislation history and amendment history—Endnotes 3 and 4
Amending laws are annotated in the legislation history and amendment history.
The legislation history in endnote 3 provides information about each law that has amended (or will amend) the compiled law. The information includes commencement details for amending laws and details of any application, saving or transitional provisions that are not included in this compilation.
The amendment history in endnote 4 provides information about amendments at the provision (generally section or equivalent) level. It also includes information about any provision of the compiled law that has been repealed in accordance with a provision of the law.
Editorial changes
The Legislation Act 2003 authorises First Parliamentary Counsel to make editorial and presentational changes to a compiled law in preparing a compilation of the law for registration. The changes must not change the effect of the law. Editorial changes take effect from the compilation registration date.
If the compilation includes editorial changes, the endnotes include a brief outline of the changes in general terms. Full details of any changes can be obtained from the Office of Parliamentary Counsel.
Misdescribed amendments
A misdescribed amendment is an amendment that does not accurately describe how an amendment is to be made. If, despite the misdescription, the amendment can be given effect as intended, then the misdescribed amendment can be incorporated through an editorial change made under section 15V of the Legislation Act 2003.
If a misdescribed amendment cannot be given effect as intended, the amendment is not incorporated and “(md not incorp)” is added to the amendment history.
Endnote 2—Abbreviation key
ad = added or inserted o = order(s) am = amended Ord = Ordinance amdt = amendment orig = original c = clause(s) par = paragraph(s)/subparagraph(s) C[x] = Compilation No. x /sub‑subparagraph(s) Ch = Chapter(s) pres = present def = definition(s) prev = previous Dict = Dictionary (prev…) = previously disallowed = disallowed by Parliament Pt = Part(s) Div = Division(s) r = regulation(s)/rule(s) ed = editorial change reloc = relocated exp = expires/expired or ceases/ceased to have renum = renumbered effect rep = repealed F = Federal Register of Legislation rs = repealed and substituted gaz = gazette s = section(s)/subsection(s) LA = Legislation Act 2003 Sch = Schedule(s) LIA = Legislative Instruments Act 2003 Sdiv = Subdivision(s) (md) = misdescribed amendment can be given SLI = Select Legislative Instrument effect SR = Statutory Rules (md not incorp) = misdescribed amendment Sub‑Ch = Sub‑Chapter(s) cannot be given effect SubPt = Subpart(s) mod = modified/modification underlining = whole or part not No. = Number(s) commenced or to be commenced Endnote 3—Legislation history
Name Registration Commencement Application, saving and transitional provisions Health Insurance (Section 3C General Medical Services – Extracorporeal Photopheresis for Chronic Graft Versus Host Disease) Determination 2022 23 Feb 2022 (F2022L00174) 1 Mar 2022 (s 2(1) item 1) Health Insurance Legislation Amendment (Indexation) Determination 2022 7 Apr 2022 (F2022L00553) Sch 1 (item 10): 1 July 2022 (s 2(1) item 1) — Health Insurance (Section 3C General Medical Services – Extracorporeal Photopheresis for Chronic Graft Versus Host Disease) Amendment Determination 2023 24 Mar 2023 (F2023L00343) 1 July 2023 (s 2(1) item 1) — Health Insurance Legislation Amendment (Indexation) Determination 2023 24 Mar 2023 (F2023L00348) Sch 1 (item 9): 1 July 2023 (s 2(1) item 1) — Endnote 4—Amendment history
Provision affected How affected s 2........................................... rep LA s 48D s 4........................................... am F2023L00343 s 7........................................... rs F2023L00343 s 9........................................... ad F2022L00553 am F2023L00348 Schedule Schedule................................. am F2023L00343
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