Statutory Rules 1985 No. 3561
Health Insurance (Variation of Fees
and Medical Services) (No. 40) Regulations
I, THE GOVERNOR-GENERAL of the Commonwealth of Australia,
acting with the advice of the Federal Executive Council, hereby make the
following Regulations under the Health Insurance Act 1973.
Dated 19 December 1985.
N. M. STEPHEN
Governor-General
By His Excellency's Command,
NEAL BLEWETT
Minister of State for Health
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Citation
1. These
Regulations may be cited as the Health Insurance (Variation of Fees and Medical
Services) (No. 40) Regulations.
Commencement
2. (1)
Regulation 3 shall come into
operation on 1 January 1986.
(2) Regulation
4 shall be deemed to have come into operation on 1 July 1985.
(3) Regulation
5 shall be deemed to have come into operation on 1 September 1985.
Amendment of Schedule to Health Insurance
(Variation of Fees and Medical Services), (No. 37) Regulations
3. The
Schedule to the Health Insurance (Variation of Fees and Medical Services) (No.
37) Regulations (being that Schedule as amended by the Health Insurance
(Variation of Fees and Medical Services) (No. 38) Regulations and the Health
Insurance (Variation of Fees and Medical Services) (No. 39) Regulations) is
amended as set out in Schedule 1 to these Regulations.
Further
amendments
4.
The
Schedule to the Health Insurance (Variation of Fees and Medical Services) (No.
37) Regulations (being that Schedule as amended by the Health Insurance
(Variation of Fees and Medical Services) (No. 38) Regulations and the Health
Insurance (Variation of Fees and Medical Services) (No. 39) Regulations) is
amended as set out in Schedule 2 to these Regulations.
Repeal
5.
Statutory
Rules 1985 No. 207 are repealed.
——————
SCHEDULE
1 Regulation 3
AMENDMENTS OF THE SCHEDULE TO THE
HEALTH INSURANCE (VARIATION OF FEES AND MEDICAL SERVICES) (NO. 37) REGULATIONS
AMENDMENTS OF THE RULES FOR THE
INTERPRETATION OF THE TABLE OF MEDICAL BENEFITS
Sub-rule 8 (2)—
(a) Omit
"841, 843".
(b) Insert
"981, 982" after "980".
AMENDMENTS OF THE TABLE OF MEDICAL
SERVICES
1. | After item 817 insert the
following item: |
"818 Brain stem evoked
response audiometry | 105.00 | 105.00 | 105.00 | 105.00 | 105.00 | 105.00" |
2. | Omit items 821 and 824, substitute
the following items:
|
"821 Supervision in hospital
by a medical specialist of—haemodialysis, haemofiltration, haemoperfusion or peritoneal
dialysis, including all professional attendances, where the total attendance
time on the patient by the supervising medical specialist exceeds 45 minutes
in the one day
| 75.00 | 75.00 | 75.00 | 75.00 | 75.00 | 75.00 |
824 Supervision in hospital by a
medical specialist of—haemodialysis, haemofiltration, haemoperfusion or peritoneal
dialysis, including all professional attendances, where the total attendance
time on the patient by the supervising medical specialist does not exceed 45
minutes in the one day
| 39.00 | 39.00 | 39.00 | 39.00 | 39.00 | 39.00" |
3. | After item 929 insert the
following item: |
"931 Intra-arterial infusion
or retrograde intravenous perfusion of a sympatholytic agent
| 48.50 | 48.50 | 48.50 | 48.50 | 48.50 | 48.50" |
4. | After item 938 insert the
following item: |
"939 Harvesting of homologous
(including allogeneic) bone marrow for the purpose of transplantation (AU 10)............................................
| 182.00 | 182.00 | 182.00 | 182.00 | 182.00 | 182.00" |
SCHEDULE 1— continued
5. | Omit item 944, substitute the
following item: |
"944 Administration of blood
or bone marrow already collected....................................
| 45.50 | 45.50 | 45.50 | 45.50 | 45.50 | 45.50" |
6. | After item 952 insert the
following items: |
"953 Right heart balloon
flotation (Swann-Ganz) catheterisation, insertion of catheter and monitoring
of right heart and pulmonary wedge pressures, cardiac output and blood
oximetry—management on the first day............................................
| 130.00 | 130.00 | 130.00 | 130.00 | 130.00 | 130.00 |
954 Right heart balloon flotation (Swann-Ganz)
catheterisation, monitoring of right heart and pulmonary wedge pressures,
cardiac output and blood oximetry—management on each day subsequent to the
first...........................................
| 32.50 | 32.50 | 32.50 | 32.50 | 32.50 | 32.50" |
7. | After item 984 insert the
following item: |
"985 Cystometrography, rectal
pressure measurement or sphincter electromyography, urinary flow and
retrograde micturating cystourethrography including all associated
radiological services
| 164.00 | 164.00 | 164.00 | 164.00 | 164.00 | 164.00" |
8. | Omit items 1747 and 1748,
substitute the following items:
|
"1747 Serological tests for
hepatitis—for each test (maximum of 2 tests) (SP).........
| 23.00 | 23.00 | 23.00 | 23.00 | 23.00 | 23.00 |
1748 Serological tests for
hepatitis—for each test (maximum of 2 tests) (OP).........
| 17.25 | 17.25 | 17.25 | 17.25 | 17.25 | 17.25" |
9. | After item 4130 insert the
following item: |
"4131 Pancreatic abscess,
drainage of, excluding after-care (AU 11)....................................
| 280.00 | 280.00 | 280.00 | 280.00 | 280.00 | 280.00" |
10. | After item 4133 insert the
following item: |
"4139 Splenorrhaphy or
partial splenectomy for trauma (AU 13)....................................
| 490.00 | 490.00 | 490.00 | 490.00 | 490.00 | 490.00" |
11. | Omit items 4744, 4749 and 4754,
substitute the following items:
|
"4744 Aorto-iliac or
aorto-femoral bifurcate graft, with or without local endarterectomy to
prepare artery for anastomosis (AU 19).................
| 730.00 | 730.00 | 730.00 | 730.00 | 730.00 | 730.00 |
4749 Axillary or subclavian to
femoral by-pass graft or other extra-abdominal arterial by-pass graft, using
a synthetic graft, with or without local endarterectomy to prepare artery for
anastomosis (AU 16)
| 705.00 | 705.00 | 705.00 | 705.00 | 705.00 | 705.00 |
4754 Arterial by-pass graft using
vein graft, including harvesting of vein, with or without local
endarterectomy to prepare artery for anastomosis (AU20).....................................
| 730.00 | 730.00 | 730.00 | 730.00 | 730.00 | 730.00" |
SCHEDULE 1— continued
12. | Omit item 4762, substitute the
following item: |
"4762 Arterial anastomosis
not associated with any other arterial operation, with or without local endarterectomy
to prepare artery for anastomosis (AU 16)
| 650.00 | 650.00 | 650.00 | 650.00 | 650.00 | 650.00" |
13. | After item 5840 insert the
following items: |
"5841 Cystoscopy and
ureteroscopy with or without pyeloscopy including, where performed, ureteric
meatotomy or dilatation of the ureter (not associated with a service covered
by Items 5842 to 5888) (AU 5)...................................................
| 235.00 | 235.00 | 235.00 | 235.00 | 235.00 | 235.00 |
5842 Cystoscopy and ureteroscopy
with or without pyeloscopy including, where performed, ureteric meatotomy or
dilatation of the ureter with one or more of the following procedures in the
ureter or renal pelvis—biopsy, diathermy, calculus extraction (not associated
with a service covered by Item 5841 and Items 5843 to 5888) (AU 6).........
| 310.00 | 310.00 | 310.00 | 310.00 | 310.00 | 310.00 |
5843 Cystoscopy and ureteroscopy
with or without pyeloscopy including, where performed, ureteric meatotomy or
dilatation of the ureter with ultrasonic or electrohydraulic pulse
disintegration of stone in the ureter or renal pelvis (not associated with
Items 5841, 5842 and 5845 to 5888) (AU 6)...
| 390.00 | 390.00 | 390.00 | 390.00 | 390.00 | 390.00" |
14. | Omit item 6824, substitute the
following item: |
"6824 Cornea, epithelial debridement
for corneal ulcer or corneal erosion (excluding aftercare) (AU 8)
| 39.50 | 39.50 | 39.50 | 39.50 | 39.50 | 39.50" |
15. | Omit item 6900, substitute the
following item: |
"6900 Detached retina,
diathermy or cryotherapy for, not associated with Item 6902 (AU 11)
| 490.00 | 490.00 | 490.00 | 490.00 | 490.00 | 490.00" |
16. | Omit items 7106, 7111, 7112, 7116
and 7117. |
17. | After item 7099 insert the
following items: |
"7118 Cutaneous nerve (including
digital nerve), primary repair of (AU 8)..........................
| 130.00 | 130.00 | 130.00 | 130.00 | 130.00 | 130.00 |
7119 Cutaneous nerve (including
digital nerve), secondary repair of (AU 9)..........................
| 168.00 | 168.00 | 168.00 | 168.00 | 168.00 | 168.00" |
18. | Omit items 7120 and 7121,
substitute the following items:
|
"7120 Cutaneous nerve (including
digital nerve), primary repair of, using the operating microscope (AU 9)...................................................
| 194.00 | 194.00 | 194.00 | 194.00 | 194.00 | 194.00 |
SCHEDULE 1— continued
7121 Cutaneous nerve (including
digital nerve), secondary repair of, using the operating microscope (AU 10)
| 255.00 | 255.00 | 255.00 | 255.00 | 255.00 | 255.00" |
19. | Omit items 7178 and 7182,
substitute the following items:
|
"7178 Neurolysis by open
operation without transposition, not associated with Item 7133 (G) (AU 7)
| 142.00 | 142.00 | 120.00 | 120.00 | 120.00 | 120.00 |
7182 Neurolysis by open operation
without transposition, not associated with Item 7133 (S) (AU 7)
| 178.00 | 178.00 | 150.00 | 150.00 | 150.00 | 150.00" |
———————
SCHEDULE 2 Regulation 4
FURTHER AMENDMENTS OF THE SCHEDULE
TO THE HEALTH INSURANCE (VARIATION OF FEES AND MEDICAL SERVICES) (NO. 37) REGULATIONS
AMENDMENTS OF THE TABLE OF MEDICAL
SERVICES
1. | Omit
item 4319, substitute the following item: |
"4319 Circumcision of a
person under six months of age (AU 6)............................................................
| 25.50 | 25.50 | 25.50 | 25.50 | 25.50 | 25.50" |
2. | After item 8551 insert the
following items: |
"8552 Orbital cavity,
reconstruction of floor or roof of (AU 12)............................................................
| 265.00 | 265.00 | 265.00 | 265.00 | 265.00 | 265.00 |
8554 Maxilla, resection of (AU 17)......... | 490.00 | 490.00 | 490.00 | 490.00 | 490.00 | 490.00 |
8556 Mandible, resection of (AU 15)...... | 385.00 | 385.00 | 385.00 | 385.00 | 385.00 | 385.00 |
8550 Mandible, resection of (D) (AU
15) | 385.00 | 385.00 | 385.00 | 385.00 | 385.00 | 385.00 |
8560 Mandible, segmental resection
of, for tumors (AU 13)
| 320.00 | 320.00 | 320.00 | 320.00 | 320.00 | 320.00 |
8562 Mandible, segmental resection
of, for tumors (D) (AU 13)............................................................
| 320.00 | 320.00 | 320.00 | 320.00 | 320.00 | 320.00 |
8568 Mandible, hemi-mandibular
reconstruction with bone graft, not associated with Item 8556 (AU 15)
| 450.00 | 450.00 | 450.00 | 450.00 | 450.00 | 450.00 |
8570 Mandible, condylectomy (AU
11)... | 260.00 | 260.00 | 260.00 | 260.00 | 260.00 | 260.00 |
8572 Mandible, condylectomy (D)
(AU 11) | 260.00 | 260.00 | 260.00 | 260.00 | 260.00 | 260.00 |
8582 Whole thickness
reconstruction of eyelid other than by direct suture only (AU 10).................
| 320.00 | 320.00 | 320.00 | 320.00 | 320.00 | 320.00 |
8584 Reduction of upper eyelid for
skin redundancy obscuring vision, herniation of orbital fat in exophthalmos,
facial nerve palsy or post-traumatic scarring, or, in respect of one of these
conditions, the restoration of symmetry of the contralateral upper eyelid (AU
7)......
| 128.00 | 128.00 | 128.00 | 128.00 | 128.00 | 128.00 |
SCHEDULE 2— continued
8585 Reduction of lower eyelid for
herniation of orbital fat in exophthalmos, facial nerve palsy or post-traumatic
scarring, or, in respect of one of these conditions, the restoration of
symmetry of the contralateral lower eyelid (AU 8)
| 178.00 | 178.00 | 178.00 | 178.00 | 178.00 | 178.00 |
8586 Correction of ptosis
(unilateral) (AU 12) | 425.00 | 380.00 | 380.00 | 380.00 | 380.00 | 380.00 |
8588 Ectropion or entropion,
correction of (unilateral) (AU 9)................................................................
| 178.00 | 178.00 | 178.00 | 178.00 | 178.00 | 178.00 |
8592 Symblepharon, grafting for (AU
8).. | 260.00 | 260.00 | 260.00 | 260.00 | 260.00 | 260.00 |
8594 Rhinoplasty, correction of lateral
or alar cartilages or both (AU 10)..................................................
| 280.00 | 280.00 | 280.00 | 280.00 | 280.00 | 280.00 |
8596 Rhinoplasty, correction of
bony vault only (AU 10)................................................................
| 320.00 | 320.00 | 320.00 | 320.00 | 320.00 | 320.00 |
8598 Rhinoplasty, total, including
correction of all bony and cartilaginous elements of the external nose (AU
12)
| 555.00 | 555.00 | 555.00 | 555.00 | 555.00 | 555.00 |
8600 Rhinoplasty or similar
contour restoration of the face, involving autogenous bone or costal
cartilage graft (AU 13)................................................................
| 700.00 | 700.00 | 700.00 | 700.00 | 700.00 | 700.00 |
8602 Rhinoplasty, secondary
revision of (AU 10) | 81.00 | 81.00 | 81.00 | 81.00 | 81.00 | 81.00 |
8604 Rhinophyma, correction of (AU
9).. | 194.00 | 194.00 | 194.00 | 194.00 | 194.00 | 194.00 |
8606 Composite graft
(chondro-cutaneous or chondro-mucosal) to nose, ear or eyelid (AU 11).............
| 275.00 | 275.00 | 275.00 | 275.00 | 275.00 | 275.00 |
8608 Lop ear, bat ear or similar
deformity, correction of (AU 8)................................................................
| 285.00 | 285.00 | 285.00 | 285.00 | 285.00 | 285.00 |
8612 Congenital atresia,
reconstruction of external auditory canal (AU 11)..................................................
| 385.00 | 385.00 | 385.00 | 385.00 | 385.00 | 385.00 |
8614 Full thickness wedge excision
of lip or eyelid, with repair by direct sutures (AU 8).......................
| 178.00 | 178.00 | 178.00 | 178.00 | 178.00 | 178.00 |
8616 Vermilionectomy (AU 8).................. | 178.00 | 178.00 | 178.00 | 178.00 | 178.00 | 178.00 |
8618 Lip or eyelid reconstruction
using full thickness flap (Abbe or similar), first stage (AU 11)............
| 455.00 | 455.00 | 455.00 | 455.00 | 455.00 | 455.00 |
8620 Lip or eyelid reconstruction
using full thickness flap (Abbe or similar), second stage (AU 4)........
| 132.00 | 132.00 | 132.00 | 132.00 | 132.00 | 132.00" |
NOTE
1. Notified in the Commonwealth of Australia Gazette