Statutory Rules 1989 No. 3291
——————
Health
Insurance (Variation of Fees and Medical Services) (No. 52) 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 29 November 1989.
BILL HAYDEN
Governor-General
By His Excellency's Command,
NEAL BLEWETT
Minister of State for Community Services and Health
–––––––––––
Citation
1. These Regulations may be cited as
the Health Insurance (Variation of Fees and Medical Services) (No. 52)
Regulations.
Commencement
2. These Regulations commence on 1
December 1989.
Amendment of the Schedule to the
Health Insurance (Variation of Fees and Medical Services) (No. 51) Regulations
3. The Schedule to the Health
Insurance (Variation of Fees and Medical Services) (No. 51) Regulations is
amended:
(a)
by inserting after Rule 47 of the rules for interpretation of the table of
medical services the following rule:
"48. A
reference in item 3, 4, 14, 23, 24, 26, 36, 37, 39, 44, 47 or 49 to a
professional attendance may include (but is not limited to) the provision in
relation to a patient of any one or more of the following services:
(a) the
evaluation of the patient's medical condition or conditions including, where
applicable, by use of the health screening services referred to in subsection
19 (5) of the Act;
(b) the
formulation of a plan for the management and, where applicable, for the
treatment of the medical condition or conditions present in the patient;
(c) the
provision:
(i) of
advice to the patient as to the medical condition or conditions present in the
patient and, where applicable, their treatment; or
(ii) where
the patient has so authorised—of advice to a person or persons other than the
patient as to the medical condition or conditions present in the patient and,
where applicable, their treatment;
(d) the
recording of the clinical details of the service or services provided to the
patient.";
(b)
by omitting from the table of medical services items 1, 2, 5, 6, 7, 8, 9, 10,
11, 12, 15, 16, 17, 18, 21, 22, 27, 28, 29, 30, 31, 32, 34, 41, 42, 45, 46, 55,
56, 61, 62, 63, 64, 67, 68 and 70 and substituting the following items:
"3 | Professional
attendance at consulting rooms (not being an attendance covered by any other
item in this Part) by a vocationally registered general practitioner for an
obvious problem characterised by the straightforward nature of the task that
requires a short patient history and, if required, limited examination and management—each
attendance
| 10.00 | 10.00 | 10.00 | 10.00 | 10.00 | 10.00 |
4 | Professional
attendance, other than an attendance covered by any other item in this Part
and not being: (a)
an attendance at consulting rooms, a hospital or a nursing home; or (b)
an attendance that is one of two or more attendances on the one occasion at
an institution;
by a vocationally registered
general practitioner for an obvious problem characterised by the
straightforward nature of the task that requires a short patient history and,
if required, limited examination and management—each attendance | 25.00 | 25.00 | 25.00 | 25.00 | 25.00 | 25.00 |
14 | Professional attendance at an
institution (not being an attendance covered by any other item in this Part)
by a vocationally registered general practitioner' for an obvious problem
characterised by the straightforward nature of the task that requires a short
patient history and, if required, limited examination and management—an
attendance on each of two or more patients at the one institution on the one
occasion—each patient................
| 13.20 | 13.20 | 13.20 | 13.20 | 13.20 | 13.20 |
23 | Professional attendance at
consulting rooms (not being an attendance covered by any other item in this
Part) by a vocationally registered general practitioner involving taking a
selective history, examination of the patient with implementation of a
management plan in relation to one or more problems, OR a professional
attendance of less than 20 minutes duration involving components of an
attendance of the type otherwise covered by Item 36 or 44—each attendance............................
| 21.00 | 21.00 | 21.00 | 21.00 | 21.00 | 21.00 |
24 | Professional attendance, other
than an attendance covered by any other item in this Part and not being: (a) an attendance at consulting
rooms, a hospital or a nursing home; or (b) an attendance that is one of
two or more attendances on the one occasion at an institution;
by a vocationally registered general practitioner
involving taking a selective history, examination of the patient with
implementation of a management plan in relation to one or more problems, OR a
professional attendance of less than 20 minutes duration involving components
of an attendance of the type otherwise covered by Item 37 or 47—each
attendance
| 36.00 | 36.00 | 36.00 | 36.00 | 36.00 | 36.00 |
26 | Professional attendance at an institution (not being an attendance
covered by any other item in this Part) by a vocationally registered general
practitioner involving taking a selective history, examination of the patient
with implementation of a management plan in relation to one or more problems,
OR a professional attendance of less than 20 minutes duration involving
components of an attendance of the type otherwise covered by Item 39 or 49—an
attendance on each of two or more patients at the one institution on the one
occasion—each patient
| 21.00 | 21.00 | 21.00 | 21.00 | 21.00 | 21.00 |
36 | Professional attendance at consulting rooms (not being an
attendance covered by any other item in this Part) by a vocationally registered
general practitioner involving taking a detailed history, an examination of
multiple systems, arranging any necessary investigations and implementing a
management plan in relation to one or more problems, and lasting at least 20
minutes, OR a professional attendance of less than 40 minutes duration
involving components of an attendance of the type otherwise covered by Item
44—each attendance
| 38.00 | 38.00 | 38.00 | 38.00 | 38.00 | 38.00 |
37 | Professional attendance, other
than an attendance covered by any other item in this Part and not being: (a) an attendance at consulting
rooms, a hospital or a nursing home; or (b) an attendance that is one of
two or more attendances on the one occasion at an institution;
by a vocationally registered general practitioner
involving taking a detailed history, an examination of multiple systems, arranging
any necessary investigations and implementing a management plan in relation
to one or more problems, and lasting at least 20 minutes, OR a professional
attendance of less than 40 minutes duration involving components of an
attendance of the type otherwise covered by Item 47—each attendance
| 53.00 | 53.00 | 53.00 | 53.00 | 53.00 | 53.00 |
39 | Professional attendance at an
institution (not being an attendance covered by any other item in this Part)
by a vocationally registered general practitioner involving taking a detailed
history, an examination of multiple systems, arranging any necessary
investigations and implementing a management plan in relation to one or more
problems, and lasting at least 20 minutes, OR a professional attendance of
less than 40 minutes duration involving components of an attendance of the
type otherwise covered by Item 49—an attendance on each of two or more
patients at the one institution on the one occasion—each patient
| 38.00 | 38.00 | 38.00 | 38.00 | 38.00 | 38.00 |
44 | Professional attendance at
consulting rooms (not being an attendance covered by any other item in this
Part) by a vocationally registered general practitioner involving taking an
exhaustive history, a comprehensive examination of multiple systems, arranging
any necessary investigations and implementing a management plan in relation
to one or more complex problems, and lasting at least 40 minutes, OR a
professional attendance of at least 40 minutes duration for implementation of
a management plan—each attendance
| 56.00 | 56.00 | 56.00 | 56.00 | 56.00 | 56.00 |
47 | Professional attendance, other
than an attendance covered by any other item in this Part and not being: (a) an attendance at consulting
rooms, a hospital or a nursing-home; or (b) an attendance that is one of two
or more attendances on the one occasion at an institution;
by a vocationally registered general practitioner
involving taking an exhaustive history, a comprehensive examination of
multiple systems, arranging any necessary investigations and implementing a
management plan in relation to one or more complex problems, and lasting at
least 40 minutes, OR a professional attendance of at least 40 minutes
duration for implementation of a management plan—each attendance
| 71.00 | 71.00 | 71.00 | 71.00 | 71.00 | 71.00 |
49 | Professional attendance at an
institution (not being an attendance covered by any other item in this Part)
by a vocationally registered general practitioner involving taking an
exhaustive history, a comprehensive examination of multiple systems,
arranging any necessary investigations and implementing a management plan in
relation to one or more complex problems, and lasting at least 40 minutes, OR
a professional attendance of at least 40 minutes duration for implementation
of a management plan—an attendance on each of 2 or more patients at the one
institution on the one occasion—each patient
| 56.00 | 56.00 | 56.00 | 56.00 | 56.00 | 56.00 |
52 | Professional attendance at
consulting rooms of not more than 5 minutes duration (not being an attendance
covered by any other item in this Part) by a medical practitioner (not being
a vocationally registered general practitioner)—each attendance.......
| 10.00 | 10.00 | 10.00 | 10.00 | 10.00 | 10.00 |
53 | Professional attendance at
consulting rooms of more than 5 minutes duration but not more than 25 minutes
duration (not being an attendance covered by any other item in this Part) by
a medical practitioner (not being a vocationally registered general
practitioner)— each attendance...........................................
| 19.60 | 19.60 | 19.60 | 19.60 | 19.60 | 19.60 |
54 | Professional attendance at
consulting rooms of more than 25 minutes duration but not more than 45
minutes duration (not being an attendance covered by any other item in this
Part) by a medical practitioner (not being a vocationally registered general
practitioner)—each attendance...........................................
| 35.00 | 35.00 | 35.00 | 35.00 | 35.00 | 35.00 |
57 | Professional attendance at
consulting rooms of more than 45 minutes duration (not being an attendance
covered by any other other item in this Part) by a medical practitioner (not being
a vocationally registered general practitioner)—each attendance......
| 56.00 | 56.00 | 56.00 | 56.00 | 56.00 | 56.00 |
58 | Professional attendance (not being
an attendance at consulting rooms, a hospital or a nursing home or an
attendance that is one of 2 or more attendances on the one occasion at an
institution) of not more than 5 minutes duration (not being an attendance covered
by any other item in this Part) by a medical practitioner (not being a
vocationally registered general practitioner)—each attendance......
| 22.00 | 22.00 | 22.00 | 22.00 | 22.00 | 22.00 |
59 | Professional attendance (not being
an attendance at consulting rooms, a hospital or a nursing home or an
attendance that is one of 2 or more attendances on the one occasion at an
institution) of more than 5 minutes duration but not more than 25 minutes duration
(not being an attendance covered by any other item in this Part) by a medical
practitioner (not being a vocationally registered general practitioner) —
each attendance
| 29.00 | 29.00 | 29.00 | 29.00 | 29.00 | 29.00 |
60 | Professional attendance (not being
an attendance at consulting rooms, a hospital or a nursing home or an
attendance that is one of 2 or more attendances on the one occasion at an
institution) of more than 25 minutes duration but not more than 45 minutes duration
(not being an attendance covered by any other item in this Part) by a medical
practitioner (not being a vocationally registered general practitioner)—each
attendance
| 47.00 | 47.00 | 47.00 | 47.00 | 47.00 | 47.00 |
65 | Professional attendance (not being
an attendance at consulting rooms, a hospital or a nursing home or an
attendance that is one of 2 or more attendances on the one occasion at an
institution) of more than 45 minutes duration (not being an attendance
covered by any other item in this Part) by a medical practitioner (not being
a vocationally registered general practitioner)—each attendance............................................
| 67.00 | 67.00 | 67.00 | 67.00 | 67.00 | 67.00 |
66 | Professional attendance at an
institution of not more than 5 minutes duration (not being an attendance
covered by any other item in this Part) by a medical practitioner (not being
a vocationally registered general practitioner)—an attendance on each of two
or more patients at the one institution on the one occasion—each patient
| 13.20 | 13.20 | 13.20 | 13.20 | 13.20 | 13.20 |
69 | Professional attendance at an
institution of more than 5 minutes duration but not more than 25 minutes duration
(not being an attendance covered by any other item in this Part) by a medical
practitioner (not being a vocationally registered general practitioner)—an
attendance on each of two or more patients at the one institution on the one
occasion—each patient
| 19.60 | 19.60 | 19.60 | 19.60 | 19.60 | 19.60 |
71 | Professional attendance at an
institution of more than 25 minutes duration but not more than 45 minutes duration
(not being an attendance covered by any other item in this Part) by a medical
practitioner (not being a vocationally registered general practitioner)—an
attendance on each of two or more patients at the one institution on the one
occasion—each patient
| 35.00 | 35.00 | 35.00 | 35.00 | 35.00 | 35.00 |
72 | Professional attendance at an
institution of more than 45 minutes duration (not being an attendance covered
by any other item in this Part) by a medical practitioner (not being a vocationally
registered general practitioner)—an attendance on each of two or more
patients at the one institution on the one occasion—each patient
| 56.00 | 56.00 | 56.00 | 56.00 | 56.00 | 56.00 |
73 | Professional attendance at a
hospital (not being an attendance covered by any other item in this Part) by
a medical practitioner—each attendance where only one in-patient is seen..................................
| 29.00 | 29.00 | 29.00 | 29.00 | 29.00 | 29.00 |
74 | Professional attendance at a
hospital (not being an attendance covered by any other item in this Part)—an
attendance on each of two or more in-patients in the one hospital on the one
occasion by a medical practitioner—each patient who is not a nursing-home
type patient................................................................
| 19.60 | 19.60 | 19.60 | 19.60 | 19.60 | 19.60 |
75 | Professional attendance at a
hospital (not being an attendance covered by any other item in this Part) by
a medical practitioner—an attendance on each of two in-patients in the one
hospital on the one occasion where at least one of those in-patients is a
nursing-home type patient—each nursing-home type patient
| 16.60 | 16 60 | 16.60 | 16.60 | 16.60 | 16.60 |
76 | Professional attendance at a
hospital (not being an attendance covered by any other item in this Part) by
a medical practitioner—an attendance on each of three or more inpatients in
the one hospital on the one occasion where at least one of those in-patients
is a nursing-home type patient—each nursing-home type patient
| 13.20 | 13.20 | 13.20 | 13.20 | 13.20 | 13.20 |
77 | Professional attendance at a nursing home, including aged
persons' accommodation attached to a nursing home or aged persons'
accommodation situated within a complex that includes a nursing home (other
than a professional attendance at a self-contained unit) or professional attendance
at consulting rooms situated within such a complex where the patient is
accommodated in the nursing home or aged persons' accommodation (not being
accommodation in a self-contained unit) by a medical practitioner— each
attendance where only one patient is seen...........
| 29.00 | 29.00 | 29.00 | 29.00 | 29.00 | 29.00 |
78 | Professional attendance at a nursing home, including aged
persons' accommodation attached to a nursing home or aged persons'
accommodation situated within a complex that includes a nursing home (other
than a professional attendance at a self-contained unit) or professional attendance
at consulting rooms situated within such a complex where the patient is
accommodated in the nursing home or aged persons' accommodation (not being
accommodation in a self-contained unit) by a medical practitioner— an
attendance on two patients in the one nursing home or aged persons'
accommodation on the one occasion—each patient....................................
| 16.60 | 16.60 | 16.60 | 16.60 | 16.60 | 16.60 |
79 | Professional attendance at a nursing home, including aged
persons' accommodation attached to a nursing home or aged persons'
accommodation situated within a complex that includes a nursing home (other
than a professional attendance at a self-contained unit) or professional attendance
at consulting rooms situated within such a complex where the patient is
accommodated in the nursing home or aged persons' accommodation (not toeing
accommodation in a self-contained unit) by a medical practitioner— an
attendance on three or more patients in the one nursing home or aged persons'
accommodation on the one occasion—each patient........
| 13.20 | 13.20 | 13.20 | 13.20 | 13.20 | 13.20 |
80 | Professional attendance, being an attendance at other than
consulting rooms, on not more than one patient on the one occasion by a medical
practitioner—each attendance on a public holiday, on a Sunday, before 8 a.m.
or after 1 p.m. on a Saturday or at any time other than between 8 a.m. and 8
p.m. on a day not being a Saturday, Sunday or public holiday, where the
attendance is initiated by or on behalf of the patient in the same unbroken
after hours period and where the patient's medical condition requires
immediate treatment
| 40.50 | 40.50 | 40.50 | 40.50 | 40.50 | 40.50"; |
(c)
by omitting from the table of medical services items 953, 954, 5700, 5847,
6162, 6228, 6231, 6234, 7001, 7002, 8775, 8776, 8805 and 8851;
(d)
by inserting in its proper numerical position in the table of medical services
each of the following items:
"953 | Right heart balloon flotation
using pulmonary artery catheter, monitoring of right heart and pulmonary
wedge pressures, cardiac output and blood oximetry—-management on the first
day.........
| 150.00 | 150.00 | 150.00 | 150.00 | 150.00 | 150.00 |
954 | Right heart balloon flotation
using pulmonary artery catheter, monitoring of right heart and pulmonary
wedge pressures, cardiac output and blood oximetry—management on each day
subsequent to the first day.......................................................
| 37.50 | 37.50 | 37.50 | 37.50 | 37.50 | 37.50 |
5700 | Extracorporeal shock wave lithotripsy
(ESWL) to urinary tract and post-treatment care for three days, including
pre-treatment consultations, unilateral (AU 12).......................................................
| 435.00 | 435.00 | 435.00 | 435.00 | 435.00 | 435.00 |
5846 | Cystoscopy, with or without
urethroscopy, for the treatment of penile warts or urethral warts, not
associated with item 3347 (AU 6).
| 150.00 | 150.00 | 150.00 | 150.00 | 150.00 | 150.00 |
5847 | Cystoscopy, with ureteric
catheterisation including fluoroscopic imaging of the upper urinary tract,
unilateral or bilateral, not associated with item 5851 or 5855 (AU 6)...................................
| 174.00 | 174.00 | 174.00 | 174.00 | 174.00 | 174.00 |
5872 | Cystoscopy with lavage of blood
clots from bladder including any associated diathermy of prostate or bladder
and not associated with item 5845 and items 5853 to 5888 and items 6005 and
6006 (AU 8)
| 205.00 | 205.00 | 205.00 | 205.00 | 205.00 | 205.00 |
6162 | Priapism, decompression by
glandular stab cavernoso-spongiosum shunt or penile aspiration with or
without lavage (AU 7)................................
| 144.00 | 144.00 | 144.00 |