Private Health Insurance Legislation Amendment Rules (No. 1) 2025 (Cth)

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Private Health Insurance Legislation Amendment Rules (No. 1) 2025

I, Paul McBride, delegate of the Minister for Health and Aged Care, make the following Rules.

Dated, 16 December 2024

Paul McBride

Assistant Secretary

Private Health Strategy Branch

Health Systems Strategy Division

Health Strategy, First Nations and Sports Group

Department of Health and Aged Care

Contents

1Name

This instrument is the Private Health Insurance Legislation Amendment Rules (No. 1) 2025.

2Commencement

(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 January 2025

1 January 2025

Note:, This table relates only to the provisions of this instrument as originally made.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

3Authority

This instrument is made under subsection 333-20(1) of the Private Health Insurance Act 2007.

4

Schedules

Each instrument that is specified in a Schedule to this instrument is amended or repealed as set out in the applicable items in the Schedule concerned, and any other item in a Schedule to this instrument has effect according to its terms.

Schedule 1Amendments—Procedure types

Private Health Insurance (Benefit Requirements) Rules 2011

1

Repeal Clause 8 of Schedule 3 (not including the heading), substitute:

A Type C procedure is a procedure specified in this clause by reference to MBS items in the following table:

Note: These procedures normally do not require hospital treatment.

Type C procedures – list of MBS items

3, 4, 23, 24, 36, 37, 44, 47, 52, 53, 54, 57, 58, 59, 60, 65, 104, 105, 106, 107, 108, 109, 110, 115, 116, 119, 122, 128, 131, 132, 133, 135, 137, 139, 141, 143, 145, 147, 160, 161, 162, 163, 164, 170, 171, 172, 193, 195, 197, 199, 230, 233, 235, 236, 237, 238, 239, 240, 285, 287, 289, 291, 293, 296, 297, 299, 300, 302, 304, 306, 308, 310, 312, 314, 316, 318, 319, 320, 322, 324, 326, 328, 330, 332, 334, 336, 338, 341, 342, 343, 344, 345, 346, 347, 349, 385, 386, 387, 388, 410, 411, 412, 413, 414, 415, 416, 417, 721, 723, 729, 731, 732, 735, 739, 743, 747, 750, 758, 820, 822, 823, 825, 826, 828, 855, 857, 858, 900, 903, 930, 933, 935, 937, 943, 945, 946, 948, 959, 961, 962, 964, 969, 971, 972, 973, 975, 986, 2713, 2721, 2723, 2725, 2727, 2801, 2806, 2814, 2824, 2832, 2840, 2946, 2949, 2954, 2958, 2972, 2974, 3005, 3010, 3014, 3018, 3023, 3028, 3032, 3040, 3044, 3051, 3055, 3062, 4001, 5000, 5001, 5003, 5004, 5010, 5011, 5012, 5013, 5014, 5016, 5017, 5019, 5020, 5021, 5022, 5023, 5027, 5028, 5030, 5031, 5032, 5033, 5035, 5036, 5039, 5040, 5041, 5042, 5043, 5044, 5049, 5060, 5063, 5067, 5200, 5203, 5207, 5208, 5220, 5223, 5227, 5228, 5260, 5263, 5265, 5267, 6007, 6009, 6011, 6013, 6015, 6018, 6019, 6023, 6024, 6028, 6029, 6031, 6032, 6034, 6035, 6037, 6038, 6042, 6051, 6052, 6057, 6058, 6062, 6063, 6064, 6065, 6067, 6068, 6071, 6072, 6074, 6075, 6080, 6081, 6082, 6084, 10801, 10802, 10803, 10804, 10805, 10806, 10807, 10808, 10809, 10816, 10988, 10989, 11000, 11003, 11012, 11015, 11018, 11024, 11027, 11200, 11204, 11205, 11210, 11211, 11215, 11218, 11219, 11220, 11221, 11224, 11235, 11237, 11240, 11241, 11242, 11243, 11244, 11300, 11302, 11306, 11309, 11312, 11315, 11318, 11324, 11332, 11340, 11341, 11343, 11503, 11505, 11506, 11507, 11508, 11512, 11602, 11604, 11605, 11607, 11610, 11611, 11612, 11614, 11615, 11705, 11713, 11719, 11720, 11721, 11724, 11725, 11726, 11727, 11728, 11729, 11730, 11731, 11732, 11736, 11737, 11800, 11810, 11820, 11823, 11830, 11833, 11900, 11912, 11917, 12000, 12001, 12002, 12003, 12004, 12005, 12012, 12017, 12021, 12022, 12024, 12200, 12201, 12306, 12312, 12315, 12320, 12321, 12322, 12325, 12326, 12500, 12524, 12527, 12533, 13104, 13200, 13203, 13207, 13209, 13221, 13260, 13290, 13312, 13839, 13842, 13899, 14050, 14100, 14106, 14115, 14118, 14124, 14201, 14202, 14203, 14206, 14216, 14217, 14219, 14220, 14221, 14227, 14245, 14255, 14256, 14257, 14258, 14259, 14260, 14263, 14264, 14265, 14266, 14270, 14272, 14277, 14278, 14280, 14283, 14285, 14288, 15902, 15904, 15906, 15908, 15910, 15912, 15914, 15916, 15918, 15920, 15922, 15924, 15926, 15928, 15930, 15932, 15934, 15936, 15938, 15940, 15942, 15944, 15946, 15948, 15950, 15952, 15954, 15956, 15958, 15960, 15962, 15964, 15966, 15968, 15970, 15972, 15974, 15976, 15978, 15980, 15982, 15984, 16003, 16006, 16009, 16012, 16015, 16018, 16400, 16407, 16408, 16500, 16501, 16502, 16505, 16508, 16509, 16511, 16514, 16600, 17610, 17615, 17620, 17625, 17640, 17645, 17650, 17655, 17680, 17690, 18213, 18350, 18351, 18353, 18354, 18360, 18361, 18362, 18365, 18366, 18368, 18369, 18370, 18372, 18374, 18377, 30003, 30006, 30007, 30026, 30032, 30038, 30061, 30062, 30064, 30071, 30072, 30097, 30191, 30192, 30196, 30202, 30207, 30216, 30219, 30278, 30406, 30628, 30654, 31206, 31211, 31216, 31220, 31221, 31357, 31362, 31365, 31366, 31368, 31370, 31537, 31587, 32072, 32135, 32500, 32520, 32522, 32523, 32526, 32528, 32529, 35503, 35554, 35608, 35614, 35620, 35626, 35703, 36671, 36672, 36673, 36800, 37041, 37300, 37303, 37388, 37415, 38800, 39141, 40707, 40862, 40863, 41500, 41501, 41647, 41659, 41662, 41668, 41698, 41704, 41755, 41764, 41768, 41769, 41828, 42587, 42588, 42614, 42615, 42617, 42620, 42644, 42650, 42667, 42668, 42676, 42677, 42744, 42782, 42785, 42788, 42791, 42794, 42806, 42807, 42808, 42809, 42811, 45021, 45025, 45026, 45546, 45801, 45807, 45829, 45882, 47471, 47735, 47904, 47916, 47924, 50310, 51700, 51703, 52034, 52036, 52039, 52055, 52056, 52133, 53000, 53004, 53052, 53458, 55028, 55029, 55030, 55031, 55032, 55033, 55036, 55037, 55038, 55039, 55048, 55049, 55054, 55065, 55066, 55068, 55070, 55071, 55073, 55076, 55079, 55126, 55127, 55128, 55129, 55132, 55133, 55134, 55137, 55141, 55143, 55145, 55146, 55238, 55244, 55246, 55248, 55252, 55274, 55276, 55278, 55280, 55282, 55284, 55292, 55294, 55296, 55700, 55703, 55704, 55705, 55706, 55707, 55708, 55709, 55712, 55715, 55718, 55721, 55723, 55725, 55729, 55736, 55739, 55740, 55741, 55742, 55743, 55757, 55758, 55812, 55814, 55844, 55846, 55852, 55854, 55856, 55857, 55858, 55859, 55860, 55861, 55862, 55863, 55864, 55865, 55866, 55867, 55868, 55869, 55870, 55871, 55872, 55873, 55874, 55875, 55876, 55877, 55878, 55879, 55880, 55881, 55882, 55883, 55884, 55885, 55886, 55887, 55888, 55889, 55890, 55891, 55892, 55893, 55894, 55895, 56001, 56007, 56010, 56013, 56016, 56022, 56028, 56030, 56036, 56101, 56107, 56220, 56221, 56223, 56224, 56225, 56226, 56233, 56234, 56237, 56238, 56301, 56307, 56401, 56407, 56409, 56412, 56501, 56507, 56553, 56620, 56622, 56623, 56626, 56627, 56628, 56629, 56630, 56801, 56807, 57001, 57007, 57201, 57341, 57352, 57353, 57354, 57357, 57360, 57364, 57506, 57509, 57512, 57515, 57518, 57521, 57522, 57523, 57524, 57527, 57700, 57703, 57706, 57709, 57712, 57715, 57721, 57901, 57902, 57905, 57907, 57915, 57918, 57921, 57924, 57927, 57930, 57933, 57939, 57942, 57945, 57960, 57963, 57966, 57969, 58100, 58103, 58106, 58108, 58109, 58112, 58115, 58300, 58306, 58500, 58503, 58506, 58509, 58521, 58524, 58527, 58700, 58706, 58715, 58718, 58721, 58900, 58903, 58909, 58912, 58915, 58916, 58921, 58927, 58933, 58936, 59103, 59300, 59302, 59303, 59305, 59312, 59314, 59318, 59700, 59703, 59712, 59715, 59718, 59724, 59733, 59739, 59751, 59754, 59763, 60500, 60503, 60918, 60927, 61310, 61313, 61314, 61321, 61324, 61325, 61328, 61329, 61333, 61336, 61340, 61341, 61345, 61348, 61349, 61353, 61356, 61357, 61360, 61361, 61364, 61368, 61372, 61373, 61376, 61381, 61383, 61384, 61386, 61387, 61389, 61390, 61393, 61394, 61397, 61398, 61402, 61406, 61409, 61410, 61413, 61414, 61421, 61425, 61426, 61429, 61430, 61433, 61434, 61438, 61441, 61442, 61445, 61446, 61449, 61450, 61453, 61454, 61457, 61462, 61466, 61469, 61473, 61480, 61485, 61495, 61499, 61505, 61524, 61527, 61541, 61553, 61560, 61563, 61564, 61565, 61612, 61644, 61647, 63001, 63004, 63007, 63010, 63019, 63020, 63040, 63043, 63046, 63049, 63052, 63055, 63058, 63061, 63064, 63067, 63070, 63073, 63101, 63111, 63114, 63125, 63128, 63131, 63151, 63154, 63161, 63164, 63167, 63170, 63173, 63176, 63179, 63182, 63185, 63201, 63204, 63219, 63222, 63225, 63228, 63231, 63234, 63237, 63240, 63243, 63271, 63274, 63277, 63280, 63301, 63304, 63307, 63322, 63325, 63328, 63331, 63334, 63337, 63340, 63361, 63385, 63388, 63390, 63391, 63395, 63397, 63401, 63404, 63416, 63425, 63428, 63440, 63443, 63446, 63454, 63461, 63464, 63467, 63470, 63473, 63476, 63482, 63487, 63489, 63491, 63494, 63496, 63497, 63507, 63510, 63513, 63516, 63519, 63522, 63531, 63533, 63539, 63540, 63541, 63543, 63545, 63546, 63547, 63549, 63551, 63554, 63557, 63560, 63563, 63564, 63740, 63741, 63743, 65060, 65066, 65070, 65072, 65075, 65078, 65079, 65081, 65082, 65084, 65087, 65090, 65093, 65096, 65099, 65102, 65105, 65108, 65109, 65110, 65111, 65114, 65117, 65120, 65123, 65126, 65129, 65137, 65142, 65144, 65147, 65150, 65153, 65156, 65157, 65158, 65159, 65162, 65165, 65166, 65171, 65175, 65176, 65177, 65178, 65179, 65180, 65181, 66500, 66503, 66506, 66509, 66512, 66517, 66518, 66519, 66522, 66523, 66536, 66539, 66542, 66545, 66548, 66551, 66554, 66557, 66560, 66563, 66566, 66569, 66572, 66575, 66578, 66581, 66584, 66585, 66586, 66587, 66590, 66593, 66596, 66605, 66606, 66607, 66623, 66626, 66629, 66632, 66635, 66638, 66639, 66641, 66642, 66644, 66647, 66650, 66651, 66652, 66653, 66654, 66655, 66656, 66659, 66660, 66662, 66663, 66665, 66666, 66667, 66671, 66674, 66677, 66680, 66683, 66686, 66695, 66696, 66697, 66698, 66701, 66704, 66707, 66711, 66712, 66714, 66715, 66716, 66719, 66722, 66723, 66724, 66725, 66728, 66731, 66734, 66743, 66749, 66750, 66751, 66752, 66755, 66756, 66757, 66758, 66761, 66764, 66767, 66770, 66773, 66776, 66779, 66780, 66782, 66783, 66785, 66788, 66789, 66790, 66791, 66792, 66800, 66803, 66804, 66805, 66806, 66812, 66815, 66816, 66817, 66819, 66820, 66821, 66822, 66825, 66826, 66827, 66828, 66830, 66831, 66832, 66833, 66834, 66835, 66836, 66837, 66838, 66839, 66840, 66841, 66900, 69300, 69303, 69306, 69309, 69312, 69316, 69317, 69318, 69319, 69321, 69324, 69325, 69327, 69328, 69330, 69331, 69333, 69336, 69339, 69345, 69354, 69357, 69360, 69363, 69379, 69383, 69384, 69387, 69390, 69393, 69396, 69400, 69401, 69405, 69408, 69411, 69413, 69415, 69421, 69422, 69445, 69451, 69471, 69472, 69474, 69475, 69478, 69481, 69482, 69483, 69484, 69488, 69489, 69491, 69492, 69494, 69495, 69496, 69497, 69498, 69499, 69500, 69505, 71057, 71058, 71059, 71060, 71062, 71064, 71066, 71068, 71069, 71071, 71072, 71073, 71074, 71075, 71076, 71077, 71079, 71081, 71083, 71085, 71087, 71089, 71090, 71091, 71092, 71093, 71095, 71096, 71097, 71099, 71101, 71103, 71106, 71119, 71121, 71123, 71125, 71127, 71129, 71131, 71133, 71134, 71135, 71137, 71139, 71141, 71143, 71145, 71146, 71147, 71148, 71149, 71151, 71153, 71154, 71155, 71156, 71157, 71159, 71163, 71164, 71165, 71166, 71167, 71168, 71169, 71170, 71175, 71180, 71183, 71186, 71189, 71192, 71195, 71198, 71200, 71203, 72813, 72814, 72816, 72817, 72818, 72823, 72824, 72825, 72826, 72827, 72828, 72830, 72836, 72838, 72844, 72846, 72847, 72848, 72849, 72850, 72851, 72852, 72855, 72856, 72857, 73043, 73045, 73047, 73049, 73051, 73059, 73060, 73061, 73062, 73063, 73064, 73065, 73070, 73071, 73072, 73074, 73075, 73076, 73287, 73289, 73290, 73291, 73292, 73293, 73294, 73295, 73296, 73297, 73298, 73299, 73300, 73304, 73305, 73306, 73308, 73309, 73311, 73312, 73314, 73315, 73317, 73318, 73320, 73321, 73323, 73324, 73332, 73333, 73334, 73335, 73336, 73337, 73338, 73339, 73340, 73341, 73342, 73343, 73344, 73345, 73346, 73347, 73348, 73349, 73350, 73351, 73352, 73353, 73354, 73355, 73356, 73357, 73358, 73359, 73360, 73361, 73362, 73363, 73364, 73365, 73366, 73367, 73368, 73369, 73370, 73371, 73372, 73373, 73374, 73375, 73376, 73377, 73378, 73379, 73380, 73381, 73382, 73383, 73384, 73385, 73386, 73387, 73388, 73389, 73391, 73392, 73393, 73394, 73395, 73396, 73397, 73398, 73399, 73401, 73402, 73403, 73404, 73405, 73406, 73410, 73411, 73412, 73413, 73416, 73417, 73418, 73419, 73420, 73421, 73422, 73423, 73424, 73427, 73428, 73429, 73430, 73431, 73432, 73433, 73434, 73435, 73436, 73437, 73438, 73439, 73440, 73441, 73442, 73443, 73444, 73445, 73446, 73447, 73448, 73451, 73452, 73453, 73454, 73455, 73456, 73457, 73458, 73459, 73460, 73461, 73462, 73521, 73523, 73525, 73527, 73529, 73801, 73802, 73803, 73804, 73805, 73806, 73807, 73808, 73809, 73810, 73811, 73812, 73826, 73920, 73922, 73923, 73924, 73925, 73926, 73927, 73928, 73929, 73930, 73931, 73932, 73933, 73934, 73935, 73936, 73937, 73938, 73939, 73940, 74992, 74993, 74994, 74995, 74996, 74997, 74998, 74999, 82100, 82105, 82110, 82115, 82116, 82130, 82135, 82140, 82226, 82227, 82228, 91868, 91869, 91870, 91871, 91872, 91873, 91874, 91875, 91876, 91877, 91878, 91879, 91880, 91881, 91882, 91883, 91884

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