Private Health Insurance (Prostheses) Rules 2016 (No. 2) (Cth)

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Private Health Insurance (Prostheses) Rules 2016 (No. 2)

made under the

Private Health Insurance Act 2007

Compilation No. 2

Compilation date: 17 June 2016

Includes amendments up to: F2016L01039

Registered: 27 June 2016

This compilation is in 5 volumes

Volume 1:Parts 1–4

Volume 2: Part A

Volume 3: Part B

Volume 4: Part C

Volume 5: Endnotes

Each volume has its own contents

About this compilation

This compilation

This is a compilation of the Private Health Insurance (Prostheses) Rules 2016 (No. 2) that shows the text of the law as amended and in force on 17 June 2016 (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 Legislation 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 series page on the Legislation 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 series page on the Legislation 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If a provision of the compiled law has been repealed in accordance with a provision of the law, details are included in the endnotes.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

Part 1Preliminary1.Name of Rules

These Rules are the Private Health Insurance (Prostheses) Rules 2016 (No. 2).

3A.Authority

These Rules are made under the Private Health Insurance Act 2007.

4.Definitions

In these Rules:

accredited podiatrist means a podiatric surgeon who holds specialist registration in the specialty of podiatric surgery under the National Law.

Note: The registration requirements for an accredited podiatrist for the purposes of these Rules are the same registration requirements for podiatric surgeons as set out in rule 8 of the Private Health Insurance (Accreditation) Rules.

Act means the Private Health Insurance Act 2007.

cardiac home/remote monitoring system includes a component of a cardiac home/remote monitoring system.

certified overnight Type C procedure has the same meaning as in rule 3 of the Private Health Insurance (Benefit Requirements) Rules.

certified Type C procedure has the same meaning as in rule 3 of the Private Health Insurance (Benefit Requirements) Rules.

consultant physician has the same meaning as in subsection 3(1) of the Health Insurance Act 1973.

gap permitted prosthesis means a prosthesis of a kind listed in the Schedule where an amount is set out for that kind of prosthesis in the column under the heading ‘Minimum Benefit’ and a different amount is set out in the column under the heading ‘Maximum Benefit’.

implantable cardiac event recorderincludes a component of an implantable cardiac event recorder.

insulin infusion pump includes a component of an insulin infusion pump.

listed prosthesis means a kind of prosthesis listed in the Schedule to these Rules.

listing application has the same meaning as in subsection 72-10(6) of the Act.

listing criteriahas the same meaning as in subsection 72-10(6) of the Act.

National Law means:

  1. (a)

    for a State or Territory other than Western Australia—the Health Practitioner Regulation National Law set out in the Schedule to the Health Practitioner Regulation National Law Act 2009 (Qld) as it applies (with or without modification) as law of the State or Territory; or

  2. (b)

    for Western Australia—the legislation enacted by the Health Practitioner Regulation National Law (WA) Act 2010 that corresponds to the Health Practitioner Regulation National Law.

    Note: The Intergovernmental Agreement for a National Registration and Accreditation Scheme for the Health Professions that was made on 26 March 2008 provides for the enactment of the State and Territory legislation mentioned in this definition.

no gap prosthesis means a prosthesis of a kind listed in the Schedule where an amount is set out for that kind of prosthesis in the column under the heading ‘Minimum Benefit’ and no amount is set out in the column under the heading ‘Maximum Benefit’.

private hospital means a hospital in respect of which there is in force a statement under subsection 121-5(8) of the Act that the hospital is a private hospital.

professional attendance has the same meaning as in clause 1.2.3 of the general medical services table being the table prescribed under section 4 of the Health Insurance Act 1973.

professional service has the same meaning as in subsection 3(1) of the Health Insurance Act 1973.

public hospital means a hospital in respect of which there is in force a statement under subsection 121-5(8) of the Act that the hospital is a public hospital.

Schedule means the Schedule in these Rules.

Note: Terms used in these Rules have the same meaning as in the Act―see section 13 of the Legislation Act 2003. These terms include:

complying health insurance policy

hospital-substitute treatment

hospital treatment

medicare benefit

Part 2Benefit requirements5.Listing of, and benefits for, prostheses

For item 4 of the table in subsection 72-1(2) of the Act:

  1. (a)

    the Schedule lists the kinds of prostheses:

    1. (i)

      in relation to which the Minister has granted an application for listing under subsection 72-10(5) of the Act; or

    2. (ii)

      which are listed in accordance with section 12 of the Private Health Insurance (Transitional Provisions and Consequential Amendments) Act 2007; and

    Note: Section 12 of the Private Health Insurance (Transitional Provisions and Consequential Amendments) Act 2007 deals with the listing of a prosthesis that was a no gap prosthesis or a gap permitted prosthesis for the purposes of the National Health Act 1953 immediately before the commencement of the Act.

  2. (aa)

    circumstances in which a listed prosthesis is provided for the purposes of paragraph (d) of item 4 of the table in subsection 72-1(2) are set out in rule 5A; and

  3. (ab)

    conditions that must be satisfied in relation to the provision of a listed prosthesis for the purposes of paragraphs (c) and (d) of item 4 of the table in subsection 72-1(2) are set out in rule 5B; and

  4. (b)

    rule 6 sets out the method for working out the minimum benefit and maximum benefit for hospital treatment, covered under a complying private health insurance policy, that is the provision of a listed prosthesis; and

  5. (c)

    rule 7 sets out the method for working out the minimum benefit and maximum benefit for hospital-substitute treatment, covered under a complying private health insurance policy, that is the provision of a listed prosthesis.

5A.Circumstances in which a prosthesis is provided other than circumstances in which a medicare benefit is payable

For the purposes of paragraph (d) of item 4 of the table in subsection 72-1(2) of the Act, the following circumstances are set out:

  1. (a)

    the provision of a listed prosthesis which is associated with podiatric treatment by an accredited podiatrist.

    Note: Paragraph (c) of Item 4 of subsection 72-1(2) deals with the provision of a listed prosthesis in circumstances in which a medicare benefit is payable.

5B.Conditions in relation to the provision of listed prostheses

For the purposes of paragraphs (c) and (d) of item 4 of the table in subsection

72-1(2) of the Act, conditions that must be satisfied in relation to the provision of a listed prosthesis in the circumstances covered by paragraph (c) or (d) of that item, as the case may be, are:

  1. (a)

    in relation to any kind of prosthesis where there is a statement of a requirement under the heading ‘Condition’ in the Schedule under the listing for that kind of prosthesis, that requirement; and

  2. (b)

    in relation to a listed prosthesis that is an insulin infusion pump, also:

    (i) the professional service associated with the provision of the insulin infusion pump must be a professional attendance by a consultant physician in the practice of his or her specialty; and

    (ii) the professional service must be provided as a certified Type C procedure or certified overnight Type C procedure; and

    (iii) the insulin infusion pump must be provided for the purpose of administering insulin.

    Note: Item 4 of the table in subsection 72-1(2) of the Act states other requirements in relation to benefits for the provision of prostheses that a policy that covers hospital treatment must meet. These requirements relate to benefits for hospital treatment and, if the policy covers hospital-substitute treatment, to the benefits of that coverage as well.

6.Benefits for prostheses provided as part of hospital treatment
  1. (1)

    For a no gap prosthesis provided as part of an episode of hospital treatment in a private hospital, the minimum benefit and the maximum benefit are each the amount for that prosthesis listed in the column in the Schedule under the heading ‘Minimum Benefit’.

  2. (2)

    For a gap permitted prosthesis provided as part of an episode of hospital treatment in a private hospital:

    1. (a)

      the minimum benefit is the amount for that prosthesis in the column in the Schedule under the heading ‘Minimum Benefit’; and

    2. (b)

      the maximum benefit is the amount for that prosthesis in the column in the Schedule under the heading ‘Maximum Benefit’.

  3. (3)

    For a no gap prosthesis provided as part of an episode of hospital treatment in a public hospital:

    1. (a)

      the minimum benefit is the lesser of the following amounts:

      (i) the amount for that prosthesis listed in the column under the heading ‘Minimum Benefit’ in the Schedule; or

      (ii) the amount of the insured person’s liability to the public hospital for that prosthesis; and

    2. (b)

      the maximum benefit is the amount for that prosthesis listed in the column under the heading ‘Minimum Benefit’ in the Schedule.

  4. (4)

    For a gap permitted prosthesis provided as part of an episode of hospital treatment in a public hospital:

    1. (a)

      the minimum benefit is the lesser of the following amounts:

      1. (i)

        the amount for that prosthesis listed in the column under the heading ‘Minimum Benefit’ in the Schedule; or

      2. (ii)

        the amount of the insured person’s liability to the public hospital for that prosthesis; and

    2. (b)

      the maximum benefit is the amount for that prosthesis listed in the column under the heading ‘Maximum Benefit’ in the Schedule.

      Note: Paragraphs (d) and (e) of subsection 72-10(5) of the Act deal with the fixing of minimum and maximum benefits when the Minister is making or varying the Private Health Insurance (Prostheses) Rules.

7.Benefits for prostheses provided as part of hospital-substitute treatment
  1. (1)

    For a no gap prosthesis provided as part of an episode of hospital-substitute treatment the minimum benefit and the maximum benefit are each the amount for that prosthesis listed in the column in the Schedule under the heading ‘Minimum Benefit’.

  2. (2)

    For a gap permitted prosthesis provided as part of an episode of hospital-substitute treatment:

    1. (a)

      the minimum benefit is the amount for that prosthesis in the column in the Schedule under the heading ‘Minimum Benefit’; and

    2. (b)

      the maximum benefit is the amount for that prosthesis in the column in the Schedule under the heading ‘Maximum Benefit’.

      Note 1: Private health insurers cannot cover, as part of hospital-substitute treatment, a service for which medicare benefit is payable unless the service is specified in the Private Health Insurance (Health Insurance Business) Rules ―see subsection 121-10(3)(a) of the Act.

      Note 2: Paragraphs (d) and (e) of subsection 72-10(5) of the Act deal with the fixing of minimum and maximum benefits when the Minister is making or varying the Private Health Insurance (Prostheses) Rules.

Part 3Other8.Timing of applications to have a prosthesis listed

As a matter of normal administrative practice, applications made under subsection 72-10(2) of the Act will be considered after they have been received and, if the Minister decides to grant the application, the kind of prosthesis will be listed in the Schedule the next time the Minister makes or varies the Rules.

Note 1: Under subsection 72-10(5) of the Act the Minister must list the kind of prosthesis, set out the minimum benefit and, if the Minister considers it appropriate, the maximum benefit for the prosthesis in these Rules on the next occasion that the Minister makes or varies the Rules after he or she grants an application and the applicant has paid to the Commonwealth any initial listing fee within 14 days of being informed of the Minister's decision to grant the application.

Note 2: Under subsection 72-15(3) of the Act, the Minister may remove a kind of prosthesis from the list in the Rules if the applicant fails to pay an ongoing listing fee.

9.Minister may have regard to recommendations and advice

In making the decision under subsection 72-10 of the Act, the Minister may have regard to a recommendation from the Prostheses List Advisory Committee.

10.Listing criteria for prostheses to be listed in Part C of the Schedule

For a listing application to be granted to list a kind of prosthesis in Part C of the Schedule, the listing criterion is that the kind of prosthesis is an:

  1. (i)

    insulin infusion pump;

  2. (ii)

    implantable cardiac event recorder; or

  3. (iii)

    cardiac home/remote monitoring system.

Note 1: The power to make listing criteria is in subsection 72-10(6) of the Act.

Note 2: Under subsection 72-10(7) of the Act the Minister must not grant a listing application if any applicable listing criteria are not satisfied in relation to the application.

Note 3: Under the Act the Minister may refuse to grant a listing application even if the listing criteria are satisfied. See Note to subsection 72-10(7) of the Act.

Private Health Insurance (Prostheses) Rules 2016 (No. 2)

made under the

Private Health Insurance Act 2007

Compilation No. 2

Compilation date: 17 June 2016

Includes amendments up to:F2016L01039

Registered:27 June 2016

This compilation is in 5 volumes

Volume 1: Parts 1–4

Volume 2:Part A

Volume 3: Part B

Volume 4: Part C

Volume 5: Endnotes

Each volume has its own contents

About this compilation

This compilation

This is a compilation of the Private Health Insurance (Prostheses) Rules 2016 (No. 2) that shows the text of the law as amended and in force on 17 June 2016 (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 Legislation 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 series page on the Legislation 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 series page on the Legislation 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.

Part A - Prostheses List February 2016

01 - OPHTHALMIC

Minimum Maximum

Billing Code Product Description Size Benefit Benefit Condition

01.01.01 - Aphakic

01.01.01.01 - Rigid

Alcon Laboratories (Aust.) Pty Ltd

AL003 MTA2UO - MTA6UO PMMA +5 to +30 D $156.00

Bausch & Lomb (Australia) Pty Ltd

BL005 Storz (Coburn) Intraocular Lens PMMA Anterior Chamber Intraocular lens 1 13.75mm length. 6.0mm optic size, diopter $156.00

121UV; L122UV PMMA Anterior piece range 3-30d. L122UV: 6.0mm optic,

Chamber Lens 13.75mm length, power range; 5.0 to 30.0

ifc

AMO Australia Pty Ltd

AO019 Verisyse AC IOL Aphakic Model 5mm Optic Diameter x 8.5 overall length $250.00

Emagin Pty Ltd

EG009 Artisan Anterior Chamber Aphakia ModelComposition: PMMA 5.00mm Optic Diameter x 8.5 in overall length $250.00

Intraocular Lens

m

AMO Australia Pty Ltd

AO001 Intraocular Lens: Model AC 51L Duralens PMMA, Anterior Chamber IOL 6.00 mm Optic Diameter x 13.0mm in overall $198.00

length

01.01.02 - Phakic

01.01.02.01 - Rigid

AMO Australia Pty Ltd

AO016 Verisyse AC IOL Phakic Intraocular Lens: Model Myopia. 5mm Optic Diameter x 8.5 overall length; $680.00

Composition: PMMA 6mm Optic Diameter x 8.5 overall length

AO017 Verisyse AC IOL Phakic Intraocular Lens: Model Hyperopia. 5mm Optic Diameter x 8.5 overall length $680.00

Composition: PMMA

Emagin Pty Ltd

EG012 Artisan Anterior Chamber IOL Phakic Intraocular Lens Myopic / Hyperopic 5.00mm Optic Diameter x 8.5 in overall $680.00

01 - OPHTHALMIC

Minimum Maximum

Billing Code Product Description Size Benefit Benefit Condition

t1

AMO Australia Pty Ltd

AO030 Verisyse Toric (Custom) Phakic intraocular lens: Model toric 5mm Optic Diameter x 7.5mm overall length $1,056.00

t1, ifc

Emagin Pty Ltd

EG019 Artisan Toric (Custom) T1 AC Iris clip IOL Toric 5.00mm Optic Diameter x 7.5 Overall $1,150.00

t2

AMO Australia Pty Ltd

AO029 Verisyse Toric (Custom) Phakic intraocular lens: Model toric 5mm Optic Diameter x 7.5mm overall length $1,358.00

t2, ifc

Emagin Pty Ltd

EG020 Artisan Toric (Custom) T2 AC Iris clip IOL Toric 5.00mm Optic Diameter x 7.5 Overall $1,452.00

01.01.02.02 - Foldable

AMO Australia Pty Ltd

AO025 VeriFlex Foldable Phakic IOL Anterior chamber foldable phakic silicone -2 to -14.5d in 0.5d increments. Overall $723.00

intraocular lens diameter 8.5mm. Optic 6.0mm

Emagin Pty Ltd

EG010 Artiflex Anterior Chamber Optic: Hydrophobic Polysiloxane. Haptic: 6mm optic diameter x 8.5 in overall length $723.00

Intraocular Lens PMMA

01.02.01 - Rigid

Alcon Laboratories (Aust.) Pty Ltd

AL002 Models MZ60BD, MC50BD, CZ70BD Other:PMMA Range of Powers:-10 to +34 D $156.00

01 - OPHTHALMIC

Minimum Maximum

Billing Code Product Description Size Benefit Benefit Condition

01.02.02 - Foldable

01.02.02.01 - Microincision

Carl Zeiss Pty Ltd

CZ040 CT SPHERIS 209M Micro incision, Spherical aberrated, foldable Diopter range :0.00 to + 32.0. Optic Size: $322.00

square-edged single-piece intraocular lens for 6mm Overall Length: 11mm

capsular bag fixation.

at

Carl Zeiss Pty Ltd

CZ016 CT ASPHINA 409M ZEISS Micro Incision Aspheric (aberration 6mm optic, 11mm overall diameter. Diopter $364.00

neutral) IOL: Foldable, square-edged, single range 0.0 to +32.0D (0.5D steps from 10.0 to

piece IOL for capsular bag fixation 30.0D, 1.0D outside this range)

CZ017 CT ASPHINA 509M ZEISS Micro Incision Aspheric (aberration 6mm Optic, 11mm overall diameter. Diopter $364.00

correcting) IOL: Foldable, square-edged, range 0.0 to +32.0D (0.5D steps from 10.0 to

single piece IOL for capsular bag fixation 30.0D, 1.0D outside this range)

at, pl

Bausch & Lomb (Australia) Pty Ltd

BL026 Akreos AO Micro Incision Lens Micro Incision, posterior chamber, foldable 6mm optic overall diameter 11.0mm(10D- $374.00

acrylic, aphakic, anterior & posterior edge 15D), 10.7mm (15.50-22D), 10.5mm (22.50-

modification, preloaded, with aberration 30D)

control, intraocular lens

Carl Zeiss Pty Ltd

CZ028 CT ASPHINA 409MP Preloaded, micro incision, aspheric Diopter range: 0.0 to 32.0D; Optic size: $374.00

(aberration neutral), foldable square-edged 6.0mm; Overall length: 11.0mm

single piece intraocular lens for capsular bag

CZ037 CT ASPHINA 509MP Preloaded, micro incision, aspheric Diopter range: 0.0 to + 32.0D; Optic Size: $374.00

(aberration correcting), foldable square-edged 6.0mm; Overall length: 11.0mm

single-piece intraocular lens for capsular bag

Designs for Vision Pty Ltd

DV263 Rayner C-flex Advance Aspheric Mini incision pre-loaded aspheric IOL Power range +8.0 - +34.0 dioptres in 0.5 $374.00

increments

Emagin Pty Ltd

EG016 ARTIS PL E Preloaded Intraocular lens 0 to 35D $374.00

EG017 LUXIOL 60 Preloaded Intraocular lens +10 to +35D $374.00

01 - OPHTHALMIC

Minimum Maximum

Billing Code Product Description Size Benefit Benefit Condition

Kevin Grundy (IBD) Pty Ltd

KG015 Rayner C-flex Advance Aspheric Mini incision pre-loaded aspheric IOL Power range +8.0 - +34.0 dioptres in 0.5 $374.00

increments

at, pl, t1

Carl Zeiss Pty Ltd

CZ031 AT TORBI 709MP (Standard Bitoric, preloaded, micro incision, aspheric Diopter range: Sph -10.0 to 32.0, Cyl +1.0 to $760.00

(aberration neutral), foldable, square-edged, 6.5

single-piece IOL for capsular bag fixation Optic size: 6.0mm, Overall length: 11.0mm

Emagin Pty Ltd

EG015 ARTIS T PL Preloaded Toric Intraocular lens +18 to +25D / C +1.50D $760.00

at, pl, t2

Carl Zeiss Pty Ltd

CZ032 AT TORBI 709MP (high cyl) Bitoric, preloaded, micro incision, aspheric Diopter range: Sph -10.0 to 32.0, Cyl +7.0 to $1,061.00

(aberration neutral), foldable, square-edged, 12.0, Optic size: 6.0mm. Overall Length

single-piece IOL for capsular bag fixation 11.0mm

at, pl, vblf

Insight Surgical Pty Ltd

IS017 Preloaded Monofocal Hydrophilic Posterior chamber IOL, 360° Special Square Optic diameter: 6.0 mm ±0.10 mm, Overall $405.00

677PY with Blue light Filter for Edge, Aspheric – Coma optimized diameter: 13.0 mm ±0.20 mm

Medjet PL-MA 2.2 single use Powers available:

injection system -10.0 - +9.0 D ±0.25 D increment: 1.0 D

+10.0 - +25.0 D ±0.25 D increment: 0.5 D

+25.5 - +30.0 D ±0.5 D increment: 0.5 D

+31.0 - +45.0 D ±0.5 increment: 1.0 D

at, t1

Carl Zeiss Pty Ltd

CZ020 AT TORBI 709M STANDARD RANGE BITORIC - ZEISS 6mm optic, 11mm overall diameter. Diopter $740.00

Micro Incision Aspheric (abberation neutral) range: Sph -10.0 to +32.0D, Cyl +1.0 to

IOL: Foldable, square-edged, single piece 6.5D (all 0.5D steps)

IOL for capsular bag fixation

t2, at

Carl Zeiss Pty Ltd

CZ027 AT TORBI 709M HIGH CYLINDER BITORIC - ZEISS Micro 6mm optic, 11mm overall diameter. Diopter $1,041.00

Incision Aspheric (aberration neutral) IOL: range: Sph -10.0 to +32.0D, +7.0 to 12.0D

Foldable square edged, single piece IOL for (all 0.5D steps)

capsular bag fixation

01 - OPHTHALMIC

Minimum Maximum

Billing Code Product Description Size Benefit Benefit Condition

01.02.02.02 - No edge modification

Ellex Australia Pty Ltd

XE002 Staar foldable silicone intraocular Polyimide haptics 6.3mm optic - low diopters 14.0mm length $281.00

lens: Model AQ 5010V

01.02.02.03 - Edge modification

Alcon Laboratories (Aust.) Pty Ltd

AL004 Acrysof Multipiece Models Foldable Acrylic Multi-piece Lens -5 D to +30 D $322.00

MA50BM, MA60AC

AL011 Acrysof Model SA60AT Foldable Acrylic Single-piece Lens, Range of Powers: +6 to +40 D $322.00

asymmetric optic/consistent edge

AMO Australia Pty Ltd

AO002 Sensar AR40 Monofocal Acrylic Soft Acrylic, Foldable, UV Absorbing, Range available from -10D to +30D. 6 mm $322.00

IOL,

Sensar OptiEdge AR40e Optic Diameter x 13mm in overall length.

Foldable Acrylic IOL

Carl Zeiss Pty Ltd

CZ029 CT 53N Foldable, 3-piece, monofocal, square-edged, Diopter range: 0.0 to 40.0, Optic size: $322.00

hydrophilic acrylic (with hydrophobic 6.0mm, Overall length: 13.0mm

surface properties) intraocular lens for

capsular bag or sulcus fixation.

Device Technologies Australia Pty Ltd

DE398 Oculentis LENTIS L-302-1 Foldable one-piece monofocal C loop acrylic Optic Size 6.0mm, Overall Length 12.00mm. $322.00

IOL. +-0.0D to +35.0D (1.0D steps) and +15.5D

to +26.5D (0.5D steps).

Ellex Australia Pty Ltd

XE003 Staar foldable silicone IOLs: Plate haptics 6.0mm; Polymide haptics 5.5 or 10.8mm 0 13.5mm length $322.00

Models AQ2010V, AQ2017V and 6.3mm optic;

Kevin Grundy (IBD) Pty Ltd

KG001 Rayner C-Flex Hydrophilic HEMA-MMA copolymer, 5.75mm dia optic, 12.00mm dia overall $322.00

foldable with injector

KG002 Superflex Hydrophilic HEMA-MMA copolymer, 6.25mm dia optic, 12.5mm dia overall $322.00

foldable with injector

01 - OPHTHALMIC

Minimum Maximum

Billing Code Product Description Size Benefit Benefit Condition

Lumos Medical Pty Ltd

LN007 Tecsoft Flex Single piece square edged foldable intraocular Diopter power range: +5.0 D to +32.0D (0.5 $322.00

lens for implantation into the capsular bag. D increments from +10.0 D to +30.0 D, 1.0 D

increments outside this range).

For powers +5.0 D to +17.5D - Optic size:

6.0mm. Overall Length 13.5mm.

For powers +18.0 D to +25.5D - Optic size:

5.9mm. Overall Length 13.0mm.

For powers +26.0 D to +32.0 D - Optic size:

5.8mm. Overall Length 12.5mm.

at

Alcon Laboratories (Aust.) Pty Ltd

AL038 Acrysof Aspheric UV-absorbing Foldable Acrylic Single-piece Lens with UV + 6.0 D to +30.0 D $364.00

Absorbing and Aspheric Correction

AMO Australia Pty Ltd

AO014 TECNIS® Intraocular Lens (Z9002 Foldable Intraocular Lenses - Ultraviolet 5-10 dioptre in 1.0 dioptre increments; 10.5 $364.00

& ZA9003) light absorbing posterior chamber intraocular - 30 dioptre in 0.5 increments

lenses, Silicone/Acrylic

AO024 Tecnis® One Piece (ZCB00) One piece intraocular lens with edge +5 to +34 diopter powers in 0.5d increments. $364.00

modification and 360 degree square edge Overall diameter 13mm, Optic size 6mm

Bausch & Lomb (Australia) Pty Ltd

BL022 SofPort Advanced Optic (AO) Posterior chamber, foldable silicone IOL with 0 D to 30.0 D $364.00

anterior optic-haptic square edge, posterior

optic-haptic square edge, 360-degree optic

square edge and asperic optic for aberration

control

BL023 Akreos Advanced Optic Posterior chamber, foldable acrylic IOL, with 0 D to 30.0 D $364.00

anterior optic-haptic square edge, posterior

optic-haptic square edge, 360 degree optic

square edge and aspheric optic for aberration

control

BL030 enVista The enVista, Model MX60, is an ultra-violet- Overall diameter 12.5mm, optic body $364.00

absorbing, posterior chamber, hydrophobic diameter 6.0mm in dioptric powers ranging

acrylic one-piece foldable intraocular lens from +0.0 to +34D

(IOL)

Has an aspheric lens optic, square 0.0D to 10.0D in 1 Diopter increments

posterior edge, modified C haptics and 11.0D to 30.0D in 0.5 Diopter increments

available in dioptric powers ranging from 31.0D to 34.0D in 1 Diopter increments

+0.0 to +34.0D.

01 - OPHTHALMIC

Minimum Maximum

Billing Code Product Description Size Benefit Benefit Condition

Carl Zeiss Pty Ltd

CZ030 CT ASPHINA 404 Small incision, foldable, single piece, Diopter range: -10.0 to 42.0, Optic size: $364.00

monofocal, aspheric (aberration neutral), 6.0mm, Overall length: 11.0mm

square-edged, hydrophilic acrylic (with

hydrophobic surface properties) intraocular

lens for capsular bag fixation. (Monofocal lens

for powers outside standard 409MP MICS

Device Technologies Australia Pty Ltd

DE399 Oculentis LENTIS L-312 Foldable one-piece monofocal acrylic C Loop Optic size 6.0mm, Overall Length 12.00mm. $364.00

IOL Central Thickness 1.02mm (+22.0D).

Available Diopters: -10.0D to35.0D (1.0D

steps). +10.5D to 29.5D (0.5D steps)

DE400 Oculentis LENTIS L-313 Foldable one-piece monofocal acrylic plate Optic size 6.0mm, Overall Length 11.00mm. $364.00

haptic

IOL Available Diopters: +-0.0D to 35.0D (1.0D

steps). +10.5D to 29.5D (0.5D steps)

DE401 Oculentis LENTIS L-402 Foldable three piece monofocal acrylic IOL. Optic Size 6.0mm, Overall Length 13.00mm. $364.00

+-0.0D to +35.0D (1.0D) + 15.5D to +26.5D

(0.5D). Minus range on demand.

Insight Surgical Pty Ltd

IS010 BiFlex 677AB Hydrophilic Acrylic Posterior chamber IOL, 360° Special Square Optic diameter: 6.0 mm ±0.10 mm, Overall $364.00

Foldable Aspheric Monofocal Lens Edge, Aspheric – Coma optimized diameter: 13.0 mm ±0.20 mm

(without Blue light Filter) Powers available:

-10.0 - +9.0 D ±0.25 D increment: 1.0 D

+10.0 - +25.0 D ±0.25 D increment: 0.5 D

+25.5 - +30.0 D ±0.5 D increment: 0.5 D

+31.0 - +45.0 D ±0. D increment: 1.0 D

IS035 BiFlex 877FAB Hydrophobic Posterior Chamber IOL, special 360° sharp Optic diameter: 6.0 mm ±0.10 mm, Overall $364.00

Acrylic Foldable Aspheric edge, Aspheric - Aberration Balanced diameter: 13.0 mm ±0.20 mm

Monofocal Lens without Blue light Powers available:

-0.0 - +9.0 D ±0.25 D increment: 1.0 D

+10.0 - +25.0 D ±0.25 D increment: 0.5 D

+25.5 - +30.0 D ±0.5 D increment: 0.5 D

+31.0 - +35.0 D ±0.5 D increment: 1.0 D

IQ Medical

IQ004 Softec Acrylic, single piece, foldable intraocular lens Available in dioptric powers from -5.0 to $364.00

with anterior and posterior optic-haptic +36.0, 1D steps: -5.0 to +10.0 and +31.0 to

square edge, 360 degree optic square edge +36.0; 0.5D steps: +10.5 to +18.0 and +25.0

design, precision power calculation and to +29.5; 0.25D steps: +18.0 to +25.0

aberration technology

01 - OPHTHALMIC

Minimum Maximum

Billing Code Product Description Size Benefit Benefit Condition

IQ013 PreciSAL 302AC Acrylic, single piece, foldable intraocular lens Available in dioptric powers from 0.0 to $364.00

with anterior and posterior optic-haptic +30.0. 1D steps: 0.0 to +10.0; 0.5D steps:

square edge, 360 degree optic square edge +10.5 to + 17.5 and +28.5 to +30.0; 0.25D

design, precision power calculation, steps: +18.0 to +28.0

aberration technology and UV light filter.

Kevin Grundy (IBD) Pty Ltd

KG012 Rayner "C-Flex" and Superflex" Aspheric Intra Ocular Lenses with Amon- C-Flex -970C + 22.5D to +34D Superflex- $364.00

Aspheric IOL Apple enhanced 360 Degree square edge, 920H - 10D to +22D

Anti-vaulting Haptics

Lumos Medical Pty Ltd

LN003 ALSAFIT Single piece aspheric foldable intraocular lens Diopter power range: 0.0 D to 32.00 D (0.50 $364.00

for implantation into the capsular bag. D increments). Optic size: 6mm. Overall

length: 11.0mm.

Spectrum Surgical

SO074 HumanOptics Aspira Posterior chamber IOL, foldable, UV absorber, -6.0 to +40.0 D $364.00

Aspheric, aberration technology, 360° LEC

barrier, HD optic

at, pl

AMO Australia Pty Ltd

AO034 TECNIS® iTec 1-Piece Pre-Loaded 1-piece IOL Posterior Chamber Intraocular +5.0 to +34.0 diopter powers in 0.5 diopter $374.00

IOL lens, incorporates a proprietary wavefront- increments. Overall diameter 13mm, Optic

designed aspheric optic with a squared size 6mm

posterior optic edge designed to provide a

360 degree barrier. The edge of the optic has a

frosted design to reduce potential edge glare

effects. Supplied pre-loaded in a screw style

disposable injector.

Ellex Australia Pty Ltd

XE004 Preloaded Aspheric Intraocular Silicone intraocular lens 6.0mm $374.00

Insight Surgical Pty Ltd

IS031 Medicontur Preloaded Monofocal Posterior chamber IOL, 360° Special Square Optic diameter: 6.0 mm ±0.10 mm, Overall $374.00

Hydrophilic 677P without Blue Edge, Aspheric – Coma optimized diameter: 13.0 mm ±0.20 mm

light Filter for Medjet PL-MA 2.2 Powers available:

single use injection system -10.0 - +9.0 D ±0.25 D increment: 1.0 D

+10.0 - +25.0 D ±0.25 D increment: 0.5 D

+25.5 - +30.0 D ±0.5 D increment: 0.5 D

+31.0 - +45.0 D ±0.5 D increment: 1.0 D

01 - OPHTHALMIC

Minimum Maximum

Billing Code Product Description Size Benefit Benefit Condition

IS032 Medicontur Preloaded Monofocal Posterior chamber IOL, 360° Special Square Optic diameter: 6.0 mm ±0.10 mm, Overall $374.00

Hydrophilic 640P without Blue Edge, Aspheric – Coma optimized diameter: 13.0 mm ±0.20 mm

light Filter for Medjet PL-MA 2.2 Powers available:

single use injection system -10.0 - +9.0 D ±0.25 D increment: 1.0 D

+10.0 - +25.0 D ±0.25 D increment: 0.5 D

+25.5 - +30.0 D ±0.5 D increment: 0.5 D

+31.0 - +45.0 D ±0.5 D increment: 1.0 D

IS036 BiFlex 877PA Preloaded Posterior Chamber IOL, special 360° sharp Optic diameter: 6.0 mm ±0.10 mm, Overall $374.00

Hydrophobic Acrylic Foldable edge, Aspheric Aberration Balanced diameter: 13.0 mm ±0.20 mm

Aspheric Monofocal Lens without Powers available:

Blue Light Filter -0.0 - +9.0 D ±0.25 D increment: 1.0 D

+10.0 - +25.0 D ±0.25 D increment: 0.5 D

+25.5 - +30.0 D ±0.5 D increment: 0.5 D

+31.0 - +35.0 D ±0.5 D increment: 1.0 D

IQ Medical

IQ014 PreciSAL P302AC Preloaded Acrylic, single piece, foldable Available in dioptric powers from 0.0 to $374.00

intraocular lens with anterior and posterior +30.0. 1D steps: 0.0 to +10.0; 0.5D steps:

optic-haptic square edge, 360 degree optic +10.5 to + 17.5 and +28.5 to +30.0; 0.25D

square edge design, precision power steps: +18.0 to +28.0

calculation, aberration technology and UV

light filter.

Spectrum Surgical

SO075 HumanOptics Aspira Preloaded Preloaded posterior chamber IOL, foldable, +10.0 to +40.0 D $374.00

UV absorber, Aspheric, aberration

technology, 360° LEC barrier, HD optic

at, pl, t1

Bausch & Lomb (Australia) Pty Ltd

BL032 enVista Toric The enVista toric (Model MX60T) is a one- Overall diameter is 12.5mm for the entire lens $760.00

piece glistening-free hydrophobic foldable power range, with spherical equivalent

IOL. The enVista Toric, model MX60T IOL powers from +6.0 to +30.0 Diopters in 0.5

has a Toric aspheric lens optic, a square Diopter steps and cylinder powers from +1D

posterior edge and modified C haptics, an to 6D Diopters (at the IOL plane).

overall diameter of 12.5mm and an optic body

of 6.0mm.

It is available in multiple spherical

and cylindrical powers.

01 - OPHTHALMIC

Minimum Maximum

Billing Code Product Description Size Benefit Benefit Condition

Insight Surgical Pty Ltd

IS026 Medicontur BiFlex 677PT Posterior chamber IOL, 360° Special Square Optic diameter: 6.0 mm ±0.05 mm, Overall $760.00

Hydrophilic Acrylic Foldable Toric Edge, diameter: 13.0 mm ±0.10 mm

Lens without Blue light Filter, Aspheric – Coma optimized – Toric Powers available:

Preloaded -10.0 - +30.0 D ±0.25 D increment: 0.5 D

+31.0

- +35.0 D ±0.5 D increment: 1.0 D

Cylinders available:+1.5 D - +7.0 D increment:

0.75 D

IQ Medical

IQ017 PreciSAL Toric T302AC Acrylic single piece, foldable intraocular lens Available in spherical dioptric powers from $760.00

with anterior and posterior optic-haptic 0.0 to +30.0. 1D steps: 0.0 to +10.0; 0.5D

square edge, 360 degree optic square edge steps: +10.5 to +17.5 and +28.5 to +30.0;

design, precision power calculation, 0.25D steps: +18.0 to +28.0; Cylinder

aberration technology, toric correction on powers from 1.0D to 6.0D

anterior surface with cylinder marks to

indicate flat meridian plus the cylinder axis to

allow alignment for astigmatic correction, and

UV filter.

IQ018 PreciSAL Toric PT302AC Pre-loaded acrylic single piece, foldable Available in spherical dioptric powers from $760.00

intraocular lens with anterior and posterior 0.0 to +30.0. 1D steps: 0.0 to +10.0; 0.5D

optic-haptic square edge, 360 degree optic steps: +10.5 to +17.5 and +28.5 to +30.0;

square edge design, precision power 0.25D steps: +18.0 to +28.0; Cylinder

calculation, aberration technology, toric powers from 1.0D to 6.0D

correction on anterior surface with cylinder

marks to indicate flat meridian plus the

cylinder axis to allow alignment for astigmatic

correction, and UV filter.

at, pl, t1, vblf

Designs for Vision Pty Ltd

DV253 HOYA AF-1 351 Toric Preloaded injector system, correct corneal IOL Power: + 10.0 to 30.0 (0.5 steps), IOL $800.00

T3/T4/T5/T6/T7/T8/T9 astigmatism micro-incision, ashperic, blue- Cylinder power: 1.50D (351T3), 2.25D

blocker, single piece hydophobic. (351T4), 3.00D (351T5), 3.75D (351T6),

4.50D (351T7), 5.25D (351T8), 6.00D

(351T9)

at, pl, vblf

Alcon Laboratories (Aust.) Pty Ltd

AL024 AcrySert model SN60WS Foldable Acrylic Single-piece Lens with Blue +6 to +30 D $405.00

light protection and aspheric correction, in

cartridge.

01 - OPHTHALMIC

Minimum Maximum

Billing Code Product Description Size Benefit Benefit Condition

AL031 AcrySert C Model SN6CWS Posterior chamber, UV absorbing, foldable, +6.0 to +30.0 D $405.00

acrylic, single piece lens with blue light

protection and aspheric correction, in cartridge

AL039 AcrySof IQ Aspheric IOL with Pre-loaded foladable Acrylic Single-piece +6.0D to +30.0D $405.00

UltraSert pre-loaded delivery Lens with Blue light protection and Aspheric

correction (SN60WF)

Bausch & Lomb (Australia) Pty Ltd

BL035 MICRO+ AY 123 Preloaded, posterior chamber, UV absorbing, An overall diameter of 10.75mm and optic $405.00

foldable, aspheric, acrylic, single piece lens diamter of 6.15mm. From 0 to +35 diopters

with blue light protection. with 0.5 diopter increments.

BL037 MicroPure 123 Preloaded, posterior chamber, UV absorbing, Overall diameter of 10D to 24.5D: 11.00mm $405.00

foldable, aspheric, acrylic, single piece

hydrophobic glistening-free Intra Ocular 25D to 30D: 10.75mm

Optic diameter of 10D to 24.5D: 6.00mm

25D to 30 D: 5.75mm

Power from 10D to 30D with 0.5 diopter

increments.

Designs for Vision Pty Ltd

DV250 Hoya-PS AF-1 (UY) PY-60AD Preloaded in cartridge, Aspheric, Blue +6.0D to +30.0D (0.5D steps) $405.00

blocker, Foldable, Single-Piece, Hydrophobic

DV252 HOYA iSert® 251 Preloaded injector system, Micro-incision, +6.0D to 30.0D (5 steps) $405.00

Aspheric, Blue-Blocker, Single Piece,

Hydrophobic

DV262 Hoya 751 Intra Ocular Lens Intra Ocular Lens Power +10 dioptres - +26 dioptres $405.00

DV264 Hoya Vivinex iSert Preloaded IOL Intra Ocular Lens Power +6 dioptres - +30 dioptres $405.00

(Model XY1)

Insight Surgical Pty Ltd

IS034 BiFlex Preloaded 877PAY Posterior Chamber IOL, special 360° sharp Optic diameter: 6.0 mm ±0.10 mm, Overall $405.00

Hydrophobic Acrylic Foldable edge, Aspheric - Aberration Balanced diameter: 13.0 mm ±0.20 mm Powers

Aspheric Monofocal Lens with Blue available: -0.0 - +9.0 D ±0.25 D increment:

light Filter 1.0 D

+10.0 -+25.0

D ±0.25 D increment: 0.5 D

+25.5- +30.0 D ±0.5 D increment: 0.5 D

+31.0 - +35.0 D ±0.5 D increment: 1

01 - OPHTHALMIC

Minimum Maximum

Billing Code Product Description Size Benefit Benefit Condition

IQ Medical

IQ016 PreciSAL P302A Preloaded Acrylic, single piece, foldable Available in dioptric powers from 0.0 to $405.00

intraocular lens with anterior and posterior +30.0. 1D steps: 0.0 to +10.0; 0.5D steps:

optic-haptic square edge, 360 degree optic +10.5 to +17.5 and +28.5 to +30.0; 0.25D

square edge design, precision power steps: +18.0 to +28.0

calculation, aberration technology and blue

light filter.

Nvision Surgical Pty Ltd

VI001 Nidek SZ-1 Pre-Loaded IOL Pre-Loaded Intra Ocular Lens Implantation Power +11 dioptres to 30+ dioptres $405.00

Injector System system

Spectrum Surgical

SO067 HumanOptics Aspira Y Preloaded Preloaded posterior chamber IOL, foldable, +10.0 to +30.0 D $405.00

UV absorber, Aspheric, aberration

technology, 360° LEC barrier, HD optic, Blue

SO071 Mediphacos Easyflex Preloaded posterior chamber IOL, foldable, +5.0 to +30.0 D $405.00

UV absorber, Aspheric, aberration

technology, double square edge, Blue light

at, t1

AMO Australia Pty Ltd

AO039 TECNIS® Toric 1-Piece IOL 1-piece IOL Posterior chamber Intraocular +5.0 to +34.0 diopter powers in 0.5 diopter $740.00

lens, incorporates a proprietary wavefront increments. Cylinder power: 1.00 diopter,

designed toric aspheric optic with a squared 1.50 diopter, 2.25 diopter, 3.00 diopter, 3.75

posterior optic edge designed to provide a diopter, 4.00 diopter, 4.50 diopter, 5.25

360 degree barrier. The edge of the optic has a diopter and 6.00 diopter (as measured at the

frosted design to reduce potential edge glare IOL plane). Overall diameter 13mm, Optic

size 6mm.

Device Technologies Australia Pty Ltd

DE390 Oculentis LENTIS Tplus LU-313T Patient Specific: Foldable one-piece Optic Size 6.0mm, overall length 11.0mm. $740.00

monofocal toric acrylic IOL Sph +/-0.0D to +35.0D (in 0.01D

increments) Cyl +0.25 to +6.99D cyl (in

DE397 Oculentis LENTIS Tplus LS-313 Foldable one-piece monofocal toric acrylic Optic Size 6.0mm, Overall Length 11.00mm. $740.00

T1-T6 Available diopters: +10.0D to +30.0D

(0.5D). Cyl: (T1 +1.5D) (T2 +2.25D) (T3

+3.0D) (T4 +3.75D) (T5 +4.5D) (T6 +5.25D)

01 - OPHTHALMIC

Minimum Maximum

Billing Code Product Description Size Benefit Benefit Condition

Insight Surgical Pty Ltd

IS024 Medicontur BiFlex 677TA Posterior chamber IOL, 360° Special Square Optic diameter: 6.0 mm ±0.05 mm, Overall $740.00

Hydrophilic Acrylic Foldable Toric Edge, diameter: 13.0 mm ±0.10 mm

Lens without Blue light Filter Aspheric – Coma optimized – Toric Powers available:

-10.0

- +30.0 D ±0.25 D increment: 0.5 D

+31.0

- +35.0 D ±0.5 D increment: 1.0 D

Cylinders available:+1.5 D - +7.0 D increment:

0.75 D

Spectrum Surgical

SO060 HumanOptics Torica Toric posterior chamber IOL, foldable, UV Sphere +10D to +30D, Cylinder 1D to 6D $740.00

absorber, Aspheric, aberration technology,

360° LEC barrier, HD optic

at, t1, pl, vblf

Insight Surgical Pty Ltd

IS028 Medicontur BiFlex 677PTY Posterior chamber IOL, 360° Special Square Optic diameter: 6.0 mm ±0.05 mm, Overall $800.00

Hydrophilic Acrylic Foldable Toric Edge, diameter: 13.0 mm ±0.10 mm

Lens with Blue light Filter Aspheric – Coma optimized – Toric Powers available:

-10.0

- +30.0 D ±0.25 D increment: 0.5 D

+31.0

- +35.0 D ±0.5 D increment: 1.0 D

Cylinders available:+1.5 D - +7.0 D increment:

0.75 D

IQ Medical

IQ020 PreciSAL Toric PT302A Pre-loaded acrylic single piece, foldable Available in spherical dioptric powers from $800.00

intraocular lens with anterior and posterior 0.0 to +30.0. 1D steps: 0.0 to +10.0; 0.5D

optic-haptic square edge, 360 degree optic steps: +10.5 to +17.5 and +28.5 to +30.0;

square edge design, precision power 0.25D steps: +18.0 to +28.0; Cylinder

calculation, aberration technology, toric powers from 1.0D to 6.0D

correction on anterior surface with cylinder

marks to indicate flat meridian plus the

cylinder axis to allow alignment for astigmatic

correction, and UV and blue light filters.

at, t1, vblf

Device Technologies Australia Pty Ltd

DE392 Oculentis LENTIS LU-313-TY Patient Specific: Foldable one-piece Optic Size: 6.0mm, overall length 11.00mm. $780.00

monofocal toric acrylic IOL. Violet Light Sph +/-0.0D to +35.0D (in 0.01D

increments) Cyl +0.25D to +6.99D cyl (in

0.01D increments)

01 - OPHTHALMIC

Minimum Maximum

Billing Code Product Description Size Benefit Benefit Condition

Insight Surgical Pty Ltd

IS022 Medicontur BiFlex 677TAY Posterior chamber IOL, 360° Special Square Optic diameter: 6.0 mm ±0.05 mm, Overall $780.00

Hydrophilic Acrylic Foldable Toric Edge, diameter: 13.0 mm ±0.10 mm

Lens with Blue light Filter Aspheric – Coma optimized – Toric Powers available:

-10.0

- +30.0 D ±0.25 D increment: 0.5 D

+31.0

- +35.0 D ±0.5 D increment: 1.0 D

Cylinders available:+1.5 D - +7.0 D increment:

0.75 D

IQ Medical

IQ019 PreciSAL Toric T302A Acrylic single piece, foldable intraocular lens Available in spherical dioptric powers from $780.00

with anterior and posterior optic-haptic 0.0 to +30.0. 1D steps: 0.0 to +10.0; 0.5D

square edge, 360 degree optic square edge steps: +10.5 to +17.5 and +28.5 to +30.0;

design, precision power calculation, 0.25D steps: +18.0 to +28.0; Cylinder

aberration technology, toric correction on powers from 1.0D to 6.0D

anterior surface with cylinder marks to

indicate flat meridian plus the cylinder axis to

allow alignment for astigmatic correction, and

UV and blue light filters.

Lumos Medical Pty Ltd

LN005 ALSAFIT TORIC VF Single piece toric aspheric foldable Diopter power range: Sphere: From 0.0 D to $780.00

intraocular lens for implantation into the +32.00 D (0.50 D increments). Cylinder:

capsular bag. Violet filter. From +0.50 D to +6.00 D (0.50 D

increments).

Spectrum Surgical

SO057 HumanOptics Torica Y Toric posterior chamber IOL, foldable, UV Sphere +10D to +30D, Cylinder 1D to 6D $780.00

absorber, Aspheric, aberration technology,

360° LEC barrier, HD optic, Blue light filter

SO072 Mediphacos Miniflex Toric Toric posterior chamber IOL, foldable, UV Sphere +5.0 to +30.0 D, Cylinder < 7D $780.00

absorber, Aspheric, aberration technology,

double square edge, Blue light filter

at, t2

AMO Australia Pty Ltd

AO040 TECNIS® Toric 1-Piece IOL 1-piece IOL Posterior chamber Intraocular +5.0 to +34.0 diopter powers in 0.5 diopter $1,042.00

lens, incorporates a proprietary wavefront increments. Cylinder power: 7.00 diopter,

designed toric aspheric optic with a squared 8.00 diopter (as measured at the IOL plane).

posterior optic edge designed to provide a Overall diameter 13mm, Optic size 6mm.

360 degree barrier. The edge of the optic has a

frosted design to reduce potential edge glare

01 - OPHTHALMIC

Minimum Maximum

Billing Code Product Description Size Benefit Benefit Condition

Device Technologies Australia Pty Ltd

DE391 Oculentis LENTIS Tplus LU-313T Patient Specific: Foldable one-piece Optic Size: 6.0mm, overall length 11.00mm. $1,042.00

monofocal toric acrylic IOL Sph +/-0.0D to +35.0D (in 0.01D

increments) Cyl +6.99D to +12.0D cyl (in

0.01D increments)

Insight Surgical Pty Ltd

IS025 Medicontur BiFlex 677TA Posterior chamber IOL, 360° Special Square Optic diameter: 6.0 mm ±0.05 mm, Overall $1,042.00

Hydrophilic Acrylic Foldable Toric Edge, diameter: 13.0 mm ±0.10 mm

Lens without Blue light Filter Aspheric – Coma optimized – Toric Powers available:

-10.0

- +30.0 D ±0.25 D increment: 0.5 D

+31.0

- +35.0 D ±0.5 D increment: 1.0 D

Cylinders available:+7.0 D - +9.0 D increment:

0.75 D

+9.0 D - +10.0 D increment:

1.0 D

Spectrum Surgical

SO059 HumanOptics Torica Toric posterior chamber IOL, foldable, UV Sphere +10D to +30D, Cylinder 7D to 12D $1,042.00

absorber, Aspheric, aberration technology,

360° LEC barrier, HD optic

at, t2, pl

Insight Surgical Pty Ltd

IS027 Medicontur BiFlex 677PT Posterior chamber IOL, 360° Special Square Optic diameter: 6.0 mm ±0.05 mm, Overall $1,052.00

Hydrophilic Acrylic Foldable Toric Edge, diameter: 13.0 mm ±0.10 mm

Lens without Blue light Filter, Aspheric – Coma optimized – Toric Powers available:

Preloaded -10.0 - +30.0 D ±0.25 D increment: 0.5 D

+31.0

- +35.0 D ±0.5 D increment: 1.0 D

Cylinders available:+7.0 D - +9.0 D increment:

0.75 D

+9.0 D - +10.0 D increment:

1.0 D

at, t2, vblf

Device Technologies Australia Pty Ltd

DE393 Oculentis LENTIS T plus LU-313-TY Patient Specific: Foldable one-piece Optic Size: 6.0mm, overall length 11.00mm. $1,084.00

monofocal toric acrylic IOL. Violet Light Available diopters: Cyl +7.00D to +12.0D

inclusive in 0.01D increments.

01 - OPHTHALMIC

Minimum Maximum

Billing Code Product Description Size Benefit Benefit Condition

Insight Surgical Pty Ltd

IS023 Medicontur BiFlex 677TAY Posterior chamber IOL, 360° Special Square Optic diameter: 6.0 mm ±0.05 mm, Overall $1,084.00

Hydrophilic Acrylic Foldable Toric Edge, diameter: 13.0 mm ±0.10 mm

Lens with Blue light Filter Aspheric – Coma optimized – Toric Powers available:

-10.0

- +30.0 D ±0.25 D increment: 0.5 D

+31.0

- +35.0 D ±0.5 D increment: 1.0 D

Cylinders available:+7.0 D - +9.0 D increment:

0.75 D

+9.0 D - +10.0 D increment:

1.0 D

IS030 Medicontur BiFlex 677TBY Posterior chamber IOL, 360° Special Square Optic diameter: 6.0 mm ±0.10 mm, $1,084.00

Hydrophilic Acrylic Foldable Toric Edge, Overall diameter: 13.0 mm ±0.20 mm

Lens with Blue light Filter Aspheric – Coma optimized – Toric Powers available:

+5.0

- +9.0 D ±0.25 D increment: 1.0 D

+10.0

- +25.0 D ±0.25 D increment: 0.5 D

+25.5

- +30.0 D ±0.5 D increment: 0.5 D

Cylinders available:+10.0 D - +24.0 D ±0.5 D increment:

1.0 D

Spectrum Surgical

SO058 HumanOptics Torica Y Toric posterior chamber IOL, foldable, UV Sphere +10D to +30D, Cylinder 7D to 12D $1,084.00

absorber, Aspheric, aberration technology,

360° LEC barrier, HD optic, Blue light filter

at, t2, vblf, pl

Insight Surgical Pty Ltd

IS029 Medicontur BiFlex 677PTY Posterior chamber IOL, 360° Special Square Optic diameter: 6.0 mm ±0.05 mm, Overall $1,094.00

Hydrophilic Acrylic Foldable Toric Edge, diameter: 13.0 mm ±0.10 mm

Lens with Blue light Filter Aspheric – Coma optimized – Toric Powers available:

-10.0

- +30.0 D ±0.25 D increment: 0.5 D

+31.0

- +35.0 D ±0.5 D increment: 1.0 D

Cylinders available:+7.0 D - +9.0 D increment:

0.75 D

+9.0 D - +10.0 D increment:

1.0 D

at, vblf

Alcon Laboratories (Aust.) Pty Ltd

AL021 Alcon AcrySof SN60WF Foldable Acrylic Single-piece Lens with Blue + 6.0 D to +30.0 D $385.00

Light Protection and Aspheric Correction

01 - OPHTHALMIC

Minimum Maximum

Billing Code Product Description Size Benefit Benefit Condition

Bausch & Lomb (Australia) Pty Ltd

BL025 SofPort Advanced Optic (AO) Posterior chamber, aphakic, foldable silicone, 6mm optic 13mm overall lengthModified C $385.00

Violet Shield anterior & posterior edge modification 5 degree angulation 0-30D, 0.5D steps

intraocular lens with aberration technology, a

violet light

Designs for Vision Pty Ltd

DV247 HOYA AF-1 iMics1 NY-60 Mini Incision, Aspheric, Blue-blocker, +6.0D to 30.0D (0.5 steps) $385.00

Single-piece, Hydrophobic

Device Technologies Australia Pty Ltd

DE402 Oculentis LENTIS LS-312Y Foldable one-piece monofocal C Loop Acrylic Optic Size 6.0mm, Overall Length 12.0mm. $385.00

IOL. Violet Light filter. Available Diopters: +-0.0D to 35.0D (1.0D

steps) +15.5D to 26.5D (0.5D steps).

DE403 Oculentis LENTIS LS-313Y Foldable one-piece monofocal acrylic plate Optic Size 6.0mm, Overall Length 11.00mm. $385.00

haptic IOL. Violet Light Filter Available Diopters: +-0.0D to 35.0D (1.0D

steps). +15.5D to 26.5D (0.5D steps).

Insight Surgical Pty Ltd

IS016 BiFlex 677ABY Hydrophilic Posterior chamber IOL, 360° Special Square Optic diameter: 6.0 mm ±0.10 mm, Overall $385.00

Acrylic Foldable Aspheric Edge, Aspheric – Coma optimized diameter: 13.0 mm ±0.20 mm

Monofocal Lens with Blue light Powers available:

-10.0 - +9.0 D ±0.25 D increment: 1.0 D

+10.0 - +25.0 D ±0.25 D increment: 0.5 D

+25.5 - +30.0 D ±0.5 D increment: 0.5 D

+31.0 - +45.0 D ±0. D increment: 1.0 D

IS033 BiFlex 877FABY Hydrophobic Posterior Chamber IOL, special 360° sharp Optic diameter: $385.00

Acrylic Foldable Aspheric edge, Aspheric - Aberration Balanced 6.0 mm ±0.10 mm, Overall diameter: 13.0 mm

Monofocal Lens with Blue light ±0.20 mm

Powers available: -0.0 - +9.0 D ±0.25 D

increment: 1.0 D +10.0 -+25.0

D ±0.25 D

increment: 0.5 D +25.5- +30.0 D ±0.5 D

increment: 0.5 D

+31.0 - +35.0 D ±0.5 D increment: 1

IQ Medical

IQ009 Softec HDY Acrylic, single piece, foldable intraocular lens Available in dioptric powers from -5.0 to + $385.00

with anterior and posterior optic-haptic 36.0, 1D steps: -5.0 to +10.0 and +31.0 to

square edge, 360 degree optic square edge +36.0; 0.5D steps: +10.5 to +18.0 and +25.0

design, precision power calculation, to 29.5; 0.25D steps: + 18.0 to +25.0

aberration technology and blue light filter

01 - OPHTHALMIC

Minimum Maximum

Billing Code Product Description Size Benefit Benefit Condition

IQ015 PreciSAL 302A Acrylic, single piece, foldable intraocular lens Available in dioptric powers from 0.0 to $385.00

with anterior and posterior optic-haptic +30.0. 1D steps: 0.0 to +10.0; 0.5D steps:

square edge, 360 degree optic square edge +10.5 to +17.5 and +28.5 to +30.0; 0.25D

design, precision power calculation, steps: +18.0 to +28.0

aberration technology and blue light filter.

Spectrum Surgical

SO055 HumanOptics Aspira Y Posterior chamber IOL, foldable, UV absorber, -6.0 to +40.0 D $385.00

Aspheric, aberration technology, 360° LEC

barrier, HD optic, Blue light filter

SO073 Mediphacos Miniflex/Mediflex Posterior chamber IOL, foldable, UV absorber, +5.0 to +30.0 D $385.00

Aspheric, aberration technology, double

square edge, Blue light filter

t1

Kevin Grundy (IBD) Pty Ltd

KG003 Rayner Standard Toric C-Flex Hydrophilic HEMA-MMA copolymer, 5.00mm dia optic, 12.00mm dia overall, cyls $698.00

foldable with injector 2.0D to 6.0D in 2D increments

t1, at, vblf

Alcon Laboratories (Aust.) Pty Ltd

AL032 AcrySof IQ Toric IOL Posterior chamber, UV absorbing, foldable, +6 to +30 D spherical; 1.00 to 6.00 D $780.00

acrylic, toric, single piece lens with blue light

protection and aspheric correction

Designs for Vision Pty Ltd

DV251 HOYA AF - 1 311 Toric T3/T4/T5 Correct Corneal Astigmatism, Micro- lOL Power: 6.0D to 30.0D (0.5 steps)lOL $780.00

incision,Aspheric, Blue-Blocker, Single Cylinder Power: 1.50D (311T3), 2.25D

Piece, Hydrophobic (311T4), 3.00D (311T5)

t1, vblf

Alcon Laboratories (Aust.) Pty Ltd

AL023 Alcon AcrySof Toric PC IOL Models Posterior chamber, UV absorbing, foldable, +6 to +34 D spherical; 1.50 to 6.00 D $740.00

acrylic, toric, single piece lens with blue light

protection

t2

Kevin Grundy (IBD) Pty Ltd

KG004 Rayner Premium Toric C-Flex HEMA-MMA copolymer, foldable with 5.75mm dia optic, 12.00mm dia overall, cyls $1,000.00

1.5D to 11.0D in 0.5D increments

01 - OPHTHALMIC

Minimum Maximum

Billing Code Product Description Size Benefit Benefit Condition

KG013 Rayner Super Premium Toric I.O.L. Acrylic foldable toric single piece I.O.L -10.0D to 0.00D Sphere: 1D to 11.00D $1,000.00

Cylinder in 0.25 steps

+31.00D to +35.00 Spit: 1D to

11.00D Cylinder in 0.25steps

vblf

Alcon Laboratories (Aust.) Pty Ltd

AL016 Alcon Acrysof Natural Model Foldable Acrylic Single-piece Lens, +6 to +40D $364.00

SN60AT asymmetric optic/consistent edge, with blue

AL025 AcrySof Multipiece Models Foldable Acrylic multi-piece Lens with Blue - 5 D to + 30 D $364.00

MN60MA, MN60AC light Protection

01.02.02.04 - Multifocal or bifocal

Emergo Asia Pacific Pty Ltd

ER281 IC-8, Hydrophobic Small Aperture A hydrophobic posterior chamber intraocular The overall diameter is 12.5 millimetres with $780.00

Intraocular Lens lens (IOL), embedded with a central circular a 6 millimetre diameter aspheric optic.

mask, which operates under the principle of

small aperture optics to reduce near vision

blur and provide seamless extended range

vision from distance to near.

at

AMO Australia Pty Ltd

AO026 TECNIS® Multifocal Intraocular Posterior chamber lens with UV light- +5 to +34 diopter powers in 0.5d increments. $822.00

Lens (ZMA00) absorbing, foldable acrylic, 3-piece with a Overall diameter 13mm, Optic size 6mm

diffractive posterior optic and a modified

anterior surface technology with edge

modification and 360 degree square edge.

AO027 TECNIS® Multifocal 1-Piece Lens, A multifocal posterior chamber lens with UV- 6.0mm Optic Diameter x 13.0mm in overall $822.00

Models ZMB00, ZKB00, ZLB00 blocking, foldable acrylic, 1-piece with a length. +5.0 Diopter to +34.0 Diopter in 0.5

diffractive posterior optic and a modified Diopter increments. ZMB00 +4.00 Diopter

anterior surface technology with edge add, ZKB00 +2.75 add,

modification and a 360 degree square edge.

AO037 TECNIS® Symfony Extended Range Extended Range of Vision Posterior Chamber +5.0 to 34.0 diopter powers in 0.5 diopter $822.00

of Vision (ZXR00) IOL increments Overall diamter 13mm, Optic size

6mm

01 - OPHTHALMIC

Minimum Maximum

Billing Code Product Description Size Benefit Benefit Condition

Carl Zeiss Pty Ltd

CZ015 AT LISA 809M ZEISS micro incision, aspheric multifocal 6mm optic, 11mm diameter. Diopter range $822.00

IOL.

Diffractive bifocal anterior surface with 0.0D to +32.0D (0.5D steps)

asymmetric light distribution (65% distance /

35% near), 3.75D addition for near focus.

Device Technologies Australia Pty Ltd

DE396 Oculentis LENTIS Mplus LS-313 Foldable one-piece multifocal plate haptic Overall Length 11.0mm and Optic Size $822.00

acrylic IOL. 6.0mm Available diopters +-0.0D to +36.0D

(0.05D steps)

IQ Medical

IQ023 PreciSAL Multifocal M302AC Acrylic single piece, foldable intraocular lens Available in spherical dioptric powers from $822.00

with anterior and posterior optic-haptic edge, 0.0D to +30.0D. 1D steps: 0.0D to+10.0D;

360 degree optic square edge design, 0.5D steps: +10.5 to +17.5 and +28.5 to

precision power calculation, abreration +30.0; 0.25D steps: +18.0 to +28.0; near

technology, pupil independent diffractive sight correction addition up to +3.5D on all

anterior surface with a near sigh correction spherical dioptric powers.

addition of up to +3.5D, and UV Filter.

Kevin Grundy (IBD) Pty Ltd

KG009 Rayner "M-Flex" Mulitfocal Acrylic, Foldable, Single piece multi-zoned 6.5mm Optic-Overall diameter 12.5mm: +3D $822.00

Foldable IOL refractive aspheric multifocal with Amon- or + 4D Addition: +14D to +25D in 1.0D

Apple 360 Degree Square edge, Anti Vaulting increments: +8.5D to +23.5D in 0.5D

increments

Spectrum Surgical

SO063 HumanOptics Diffractiva Multifocal posterior chamber IOL, foldable, Sphere: +10D to +30D, Near addition +3.5D $822.00

UV absorber, Aspheric, aberration

technology, 360° LEC barrier, HD optic

at, pl

AMO Australia Pty Ltd

AO036 TECNIS® Multifocal 1-Piece IOL Preloaded 1-Piece Multifocal posterior +5.0 to 34.0 diopter powers in 0.5 diopter $842.00

with iTec Preloaded delivery system chamger IOL increments Overall diamter 13mm, Optic size

6mm

Carl Zeiss Pty Ltd

CZ033 AT LISA 809MP Preloaded, micro incision, aspherical bifocal, Diopter range: 0.0 to 32.0 $842.00

square edged, single-piece IOL for capsular Optic size: 6.0mm. Overall length: 11.0mm

bag fixation. The anterior aspheric bifocal

surface has an asymmetric light distribution

65/35 for distance/near vision, and 3.75D add

for the near focus.

01 - OPHTHALMIC

Minimum Maximum

Billing Code Product Description Size Benefit Benefit Condition

CZ034 AT LISA tri 839MP Trifocal (aspheric) micro incision, single- Diopter range: 0.0 to +32.0D (0.5D $842.00

piece IOL for capsular bag fixation, increments). Optic size: 6.0mm. Overall

implantable with preloaded injector system.

Length: 11.0mm

The trifocal (anterior) optic provides two

diffractive focal points (+3.33D near focus and

+1.66D intermediate focus) with asymmetric

light distribution 50% distance / 20%

intermediate / 30% near vision.

IQ Medical

IQ024 PreciSAL Mulitfocal PM302AC Pre-loaded acrylic single piece, foldable Available in spherical dioptric powers from $842.00

intraocular lens with anterior and posterior 0.0 to +30.0. 1D steps: 0.0 to +10.0; 0.5D

optichaptic square edge, 360 degree optic steps: +10.5 to +17.5 and +28.5 to +30.0;

square edge design, precision power 0.25D steps: +18.0 to +28.0; near sight

calculation, aberration technology, pupil correction addition up to +3.5D on all

independent diffractive anterior surface with a spherical dioptric powers.

near sight correction addition of up to +3.5D,

and UV filter.

Spectrum Surgical

SO065 HumanOptics Diffractiva Preloaded Preloaded Multifocal posterior chamber IOL, Sphere: +10D to +30D, Near addition +3.5D $842.00

foldable, UV absorber, Aspheric, aberration

technology, 360° LEC barrier, HD optic

at, pl, t1

Carl Zeiss Pty Ltd

CZ035 AT LISA toric 909MP ZEISS pre-loaded, micro incision, multifocal 6mm optic, 11mm diameter. Diopter range: $1,218.00

toric IOL. Aspheric toric anterior surface, Sph +6.0D to 24.0D, Cyl +1.0 to 4.0D (all

diffractive bifocal posterior surface with 0.5D steps)

asymmetric light distribution (65% distance/

35% near), and 3.75D addition for near focus.

CZ036 AT LISA tri Toric 939MP Trifocal (aspheric), bitoric, micro incision, Diopter range -10.00 to +28.0 and +1 to +4.0 $1,218.00

single-piece IOL for capsular bag fixation, DC Optic size: 6..00mml; Overall length:

implantable with preloaded injector system. 11.mm

The trifocal (anterior) optic provides two

diffractive focal points (+3.33D near focus and

+ 1.66D intermediate focus) with asymmetric

light distribution 50% distance / 20%

intermediate / 30% near vision,

01 - OPHTHALMIC

Minimum Maximum

Billing Code Product Description Size Benefit Benefit Condition

at, pl, vblf

Insight Surgical Pty Ltd

IS020 Medicontur BiFlex Preloaded Posterior chamber IOL, 360° Special Square Optic diameter: 6.0 mm ±0.10 mm, Overall $884.00

677PMY Hydrophilic Acrylic Edge, Aspheric – Coma optimized diameter: 13.0 mm ±0.20 mm

Foldable Multifocal Lens with Blue Powers available:

light Filter -10.0 - +9.0 D ±0.25 D increment: 1.0 D

+10.0 - +25.0 D ±0.25 D increment:

0.5 D

+25.5 - +30.0 D ±0.5 D increment:

0.5 D

+31.0- +45.0 D ±0. D increment:

1.0 D

IS021 Medicontur QFlex 640PMY Posterior chamber IOL, 360° Special Square Optic diameter: 6.0 mm ±0.10 mm, Overall $884.00

Hydrophilic Acrylic Foldable Edge, Aspheric – Coma optimized diameter: 13.0 mm ±0.20 mm

Multifocal Lens with Blue light Powers available:

-10.0 - +9.0 D ±0.25 D increment:

1.0 D

+10.0 - +25.0 D ±0.25 D increment:

0.5 D

+25.5 - +30.0 D ±0.5 D increment:

0.5 D

+31.0- +45.0 D ±0. D increment:

1.0 D

IQ Medical

IQ025 PreciSAL Multifocal PM302A Pre-loaded acrylic single piece, foldable Available in spherical dioptric powers from $884.00

intraocular lens with anterior and posterior 0.0 to +30.0. 1D steps: 0.0 to +10.0; 0.5D

optichaptic square edge, 360 degree optic steps: +10.5 to +17.5 and +28.5 to +30.0;

square edge design, precision power 0.25D steps: +18.0 to +28.0; near sight

calculation, aberration technology, pupil correction addition up to +3.5D on all

independent diffractive anterior surface with a spherical dioptric powers.

near sight correction addition of up to +3.5D,

and UV and blue filter powers.

Spectrum Surgical

SO066 HumanOptics Diffractiva Y Preloaded Multifocal posterior chamber IOL, Sphere: +10D to +30D, Near addition +3.5D $884.00

foldable, UV absorber, Aspheric, aberration

technology, 360° LEC barrier, HD optic, Blue

light filter

at, t1

AMO Australia Pty Ltd

AO033 TECNIS® Multifocal Toric Toric Multifocal Intraocular Lens Available +5.0 Diopters to +34.0 Diopters $1,198.00

in 0.5 Diopter increments.

Cylinder powers

1.50D, 2.25D, 3.00D and 4.00D (as

measured on the IOL plane).

AO038 TECNIS Symfony Toric Extended Extended Range of Vision Toric Multifocal +6 to +30 in 0.5d steps Available Cyl $1,198.00

Range of Vision (ZXT00) Posterior Chamber IOL powers +1.0d, 1.5d, 2.25d, 3.00d, 3.50d

01 - OPHTHALMIC

Minimum Maximum

Billing Code Product Description Size Benefit Benefit Condition

Carl Zeiss Pty Ltd

CZ038 AT LISA tri toric 939M low cylinder Trifocal (aspheric), bitoric, micro incision, Diopter range: -10.00 to + 32.0 DS and +1 to $1,198.00

single-piece IOL for capsular bag fixation.

+6.5DC

The trifocal (anterior) optic provides two Optic Size: 6.0mm. Overall Length: 11.0mm

diffractive focal points (+3.33D near focus and

+1.66D intermediate focus) with asymmetric

light distribution 50% distance / 20%

intermediate / 30% near vision.

Device Technologies Australia Pty Ltd

DE388 Oculentis LENTIS Mplus Toric LU- Patient specific one-piece multifocal-toric Overall Length 11.0mm and Optic Size $1,198.00

313MFT plate haptic acrylic IOL 6.0mm + 0.0D to +36.0D inclusive in 0.01D

increments. Cyl +0.25 to +6.99D inclusive

in 0.01D increments

at, t1, vblf

Bausch & Lomb (Australia) Pty Ltd

BL036 FineVision Toric POD FT Posterior chamber, toric, trifocal diffractive An overall diameter of 11.40mm and optic $1,240.00

(aspheric), UV and blue light blocker, single diameter of 6.00mm. From 0 to +35 Diopters

piece acrylic IOL. with 0.5 diopter increments.

Device Technologies Australia Pty Ltd

DE394 Oculentis LENTIS Mplus Toric LU- Patient specific one-piece multifocal-toric Overall Length 11.0mm and Optic Size $1,240.00

313 MF30TY plate haptic acrylic IOL. 6.0mm, +-0.0D to +36.0D inclusive in 0.01D

increments. Cyl +0.25D to +6.99D inclusive

in 0.01D increments.

Lumos Medical Pty Ltd

LN006 ALSAFIT TRIFOCAL TORIC VF Single piece trifocal toric aspheric foldable Diopter power range: Sphere: From 0.0 D to $1,240.00

introcular lens for implantation into the +32.00 D (0.50 D increments). Cylinder:

capsular bag. Violet filter. From +0.50 D to +6.00 D (0.50 D

increments).

at, t2

Carl Zeiss Pty Ltd

CZ039 AT LISA tri toric 939M high Trifocal (aspheric), bitoric, micro incision, Diopter range: -10.00 to + 32.0 DS and +7 to $1,500.00

powered cylinder single-piece IOL for capsular bag fixation. The +12 DC

trifocal (anterior) optic provides two Optic Size: 6.0mm. Overall Length: 11.0mm

diffractive focal points (+3.33D near focus and

+1.66D intermediate focus) with asymmetric

light distribution 50% distance / 20%

intermediate / 30% near vision.

01 - OPHTHALMIC

Minimum Maximum

Billing Code Product Description Size Benefit Benefit Condition

Device Technologies Australia Pty Ltd

DE389 Oculentis LENTIS Mplus LU- Patient specific one-piece multifocal-toric Overall Length 11.0mm and Optic size $1,500.00

313MFT acrylic plate haptic IOL 6.0mm +-0.0D to +36.0D inclusive in 0.01D

increments. Cyl +6.99D to +12.0D inclusive

in 0.01D increments

at, t2, vblf

Device Technologies Australia Pty Ltd

DE395 Oculentis LENTIS Mplus LU-313 Patient specific one-piece multifocal toric Overall Length 11.00mm and Optic Size $1,542.00

MFTY plate haptic acrylic IOL. Violet Light Filter 6.0mm +-0.0D to +36.0D inclusive in 0.01D

increments.

Cyl +7.00D to +12.0D inclusive

in 0.01D increments.

at, vblf

Alcon Laboratories (Aust.) Pty Ltd

AL028 AcrySof IQ ReSTOR SN6AD3 Posterior Chamber, UV absorbing, foldable, +6 D to + 34 D $864.00

acrylic, single piece lens with apodised

diffractive optic and blue light protection

AL030 AcrySof IQ ReSTOR SN6AD1, Posterior Chamber, UV absorbing, foldable, +6 D to + 34 D $864.00

SV25T0 and MN6AD1 acrylic, single piece lens with apodised

diffractive optic and blue light protection

AL040 AcrySof IQ PanOptix Presbyopia Trifocal posterior chamber, UV absorbing, +13.0 to +30.0D in 0.5 Diopter increments $864.00

Correcting IOL foldable, acrylic, aspheric, single piece lens and +31.0 to +34.0D in 1.0 Diopter

with apodised diffractive trifocal optic and

blue light protection.

The apodised diffractive trifocal optic

(anterior) provides two diffractive focal points

(+3.25D near focus and 2.17D intermediate

Bausch & Lomb (Australia) Pty Ltd

BL033 FineVision POD F Posterior chamber, UV absorbing, foldable, An overall diameter of 11.40mm and optic $864.00

aspheric, acrylic, single piece lens with diameter of 6.00mm. From 0 to +35 diopters

apodised diffractive, trifocal optic and blue with 0.5 diopters with 0.5 diopter

light protection

BL034 FineVision Micro F Posterior chamber, UV absorbing, foldable, An overall diameter of 10.75mm and optic $864.00

aspheric, acrylic, single piece lens with diameter of 6.15mm. From 0 to +35 dopters

apodised diffractive, trifocal optic and blue with 0.5 diopter increments.

light protection

Designs for Vision Pty Ltd

DV248 HOYA PY-60MV Preloaded in cartridge, Multifocal, Aspheric, +14.0D to 27.0D (0.5 steps) $864.00

Blue-blocker, Single Piece, Hydrophobic

01 - OPHTHALMIC

Minimum Maximum

Billing Code Product Description Size Benefit Benefit Condition

Insight Surgical Pty Ltd

IS019 Medicontur BiFlex 677MY Posterior chamber IOL, 360° Special Square Optic diameter: 6.0 mm ±0.10 mm, Overall $864.00

Hydrophilic Acrylic Foldable Edge, Aspheric – Coma optimized diameter: 13.0 mm ±0.20 mm

Multifocal Lens with Blue light Powers available:

-10.0 - +9.0 D ±0.25 D increment:

1.0 D

+10.0 - +25.0 D ±0.25 D increment:

0.5 D

+25.5 - +30.0 D ±0.5 D increment:

0.5 D

+31.0- +45.0 D ±0. D increment:

1.0 D

IQ Medical

IQ022 PresiSAL Multifocal M302A Acrylic single piece, foldable intraocular lens Available in sperical dioptric powers from $864.00

with anterior and posterior optic-haptic 0.0D to +30.0D. 1D steps: 0.0D to +10.0D;

square edge, 360 degree optic square edge 0.5D steps: +10.5 to +17.5 and +28.5 to

design, precision power calculation. +30.0; 0.25D steps: +18.0.0 to +28.0; near

Aberration technology, pupil independent sight correction addition up to +3.5D on all

diffractive anterior surface with a near sight spherical dioptric powers.

correction addition of up to +3.5D, and UV

and blue light fliters.

Lumos Medical Pty Ltd

LN004 ALSAFIT TRIFOCAL VF Single piece trifocal aspheric foldable Diopter power range: 0.0 D to +32.00 D $864.00

intraocular lens for implantation into the (0.50 D increments).

capsular bag. Violet filter. Optic size: 6mm. Overall length: 11.0mm.

Spectrum Surgical

SO064 HumanOptics Diffractiva Y Multifocal posterior chamber IOL, foldable, Sphere: +10D to +30D, Near addition +3.5D $864.00

UV absorber, Aspheric, aberration

technology, 360° LEC barrier, HD optic, Blue

t1, at

Carl Zeiss Pty Ltd

CZ025 AT LISA toric 909M ZEISS micro incision, multifocal toric IOL 6mm optic, 11mm diameter. Diopter range: $1,198.00

(standard cyl range). Aspheric toric anterior Sph -10.0D to +32.0D, Cyl +1.0 to 6.5D (all

surface, diffractive bifocal posterior surface 0.5D steps)

with asymmetric light distribution (65%

distance / 35% near), 3.75D addition for near

focus.

Kevin Grundy (IBD) Pty Ltd

KG010 Rayner M-Flex Toric (Standard) Acrylic, Foldable, Single Piece, Multi-zoned 5.75mm / 12.0mm: 6.25mm / 12.5mm +3.00D $1,198.00

Refractive Aspheric Toric Mulitfocal with or +4.00D Addition FAR: +14.0D to

Amon-Apple enhanced 360 degree Square +32.00D in 0.5 STEPS: +2.00D +3.00D

edge, Anti Vaulting Haptics +4.00D Cylinder. NEAR: +14.0D to 27.0D

in 0.5 STEPS: +2.00D +3.00D

+4.00D

01 - OPHTHALMIC

Minimum Maximum

Billing Code Product Description Size Benefit Benefit Condition

KG011 Rayner "M-Flex" Toric (Non Acrylic, Foldable, Single Piece, Muli-Zoned 5.75/12.0mm: 6.25/12.5mm +3.00D to $1,198.00

Standard) Refractive, Toric Multifocal with Amon-Apple +4.00D Addition FAR: +14.0D to +32.0D

enhanced 360 Degree square edge, Anti- in 0.5D Increments: NEAR: +14.0D to

vaulting Haptics, Patient Specific. +27.0D in 0.50D Increments Cylinder: 1.0D

to 1.5D and 2.5D to 6.00D in 0.5 increments

t1, at, vblf

Alcon Laboratories (Aust.) Pty Ltd

AL033 AcrySof IQ ReSTOR multifocal toric Posterior chamber UV absorbing foldable, +6 to +34 D spherical; 1.00 to 3.00 D $1,240.00

IOL (SND1T2-5; SV25T2-6) acrylic, aspheric, toric single piece lens with

apodised diffractive optic and blue light

protection.

t2, at

Carl Zeiss Pty Ltd

CZ024 AT LISA toric 909M ZEISS micro incision, multifocal toric IOL 6mm optic, 11mm diameter. Diopter range: $1,500.00

(high cyl range). Aspheric toric anterior Sph -10.0D to +32.0D, Cyl +7.0 to 12.0D

surface, diffractive bifocal posterior surface (all 0.5D steps)

with asymmetric light distribution (65%

distance / 35% near), 3.75D addition for near

focus.

01.02.02.05 - Accommodative

pa

iNova Pharmaceuticals Australia Pty Ltd

IL001 Crystalens HD Accommodating lens with > 3 Dioptres of 10.0 to 33.0 Dioptres in .05 Dioptre steps $780.00

accommodation with dual mechanism of

action: (1) forward axial movement of lens and

(2) accommodative arching of optic.

Posterior

chamber, polyspheric optics, 3-piece, plate

haptic, foldable UV light filtering, bic

IQ Medical

IQ003 Tetraflex Acrylic single piece, foldable accommodating Available in dioptric powers from +5.0 to $780.00

intraocular lens with sqare edge design, +36.0, 1D steps: +31.0 to +36.0; 0.5D steps:

custom control precision and closed loop +5.0 to +18.0 and +25.0 to +30.0; 0.2D

steps; +18.0 to +25.0

01 - OPHTHALMIC

Minimum Maximum

Billing Code Product Description Size Benefit Benefit Condition

pa, at

iNova Pharmaceuticals Australia Pty Ltd

IL002 Crystalens AO Accommodating lens designed to provide > 3 10.0 to 33.0 D in 0.50 Diopter steps. 10.0 - $822.00

Diopters of accommodation with dual 16.5 Diopters (12mm length) and 17.0 - 33.0

mechanism of action: (1) forward axial Diopters (11.5mm length).

movement of lens and (2) accommodative

arching of optic.

Posterior chamber, aspheric,

aberration free optics, 3-piece, plate haptic, fol

01.02.03 - Pseudo-phakic, piggy-back

01.02.03.01 - Monofocal

Designs for Vision Pty Ltd

DV246 Rayner Sulcoflex Ashperic Pseudophakic Supplementary I.O.L.O.L. -10.0D to -5.50D in 0.5D increments. $323.00

(Premium) I.O.L. +5.50D to 10.00D in 0.5D increments

at

Kevin Grundy (IBD) Pty Ltd

KG008 Rayner "Sulcoflex" Pseudophakic Sulcoflex Aspheric Pseudophakic I.O.L -5D to +5D $365.00

I.O.L.

at, t1, vblf

Spectrum Surgical

SO061 HumanOptics Torica Add-On IOL Toric Add-On IOL for sulcus fixation in Sphere: -4.0 to +1.5 in 0.5D steps, Cylinder $740.00

pseudophakic eyes, 3-piece, foldable, UV < 7D

absorber, blue light filter, Iris protection,

safety profile technology and undulated

at, vblf

Spectrum Surgical

SO062 HumanOptics Secura Add-On IOL Add-On IOL for sulcus fixation in -6.0 to +6.0 in 0.5D steps $385.00

pseudophakic eyes, 3-piece, foldable, UV

absorber, blue light filter, Iris protection and

safety profile technology

01 - OPHTHALMIC

Minimum Maximum

Billing Code Product Description Size Benefit Benefit Condition

t1, at

Kevin Grundy (IBD) Pty Ltd

KG005 Rayner Sulcoflex Aspheric Toric Acrylic, Aspheric, Toric Pseudophakic SE -3 to +3 in 0.5 D stepsCyl +1 to +3 in $698.00

Pseudophakic Secondary I.O.L - Secondary IOL: Sulcus fixated with 1D steps

Standard undulating Haptics and Posterior Haptic

Angulation (Standard)

KG007 Rayner Sulcoflex Aspheric Toric Acrylic, Aspheric, Toric Pseudophakic SE -6.00 to +6.00 in 0.5 D steps Syl +1.00 to $698.00

Pseudophakic Secondary IOL Secondary IOL: Sulcus fixated with +6.00 in 0.5D steps

(Premium) undulating Haptics and Posterior Haptic

Angulation (Premium)

01.02.03.02 - Multi-focal

Emagin Pty Ltd

EG014 REVERSO Multifocal Intraocular lens -3 to +3 $780.00

at

Kevin Grundy (IBD) Pty Ltd

KG006 Rayner "Sulcoflex" Aspheric Multi- Acrylic, Aspheric Multi-focal Pseudophakic 6.5mm / 13.5mm - 5.00D+5.00D sphere with $822.00

focal Pseudophakic Secondary IOL Secondary IOL: Sulcus-Fixated with + 3.00 Addition

Undulating Haptics and Posterior Haptic

Angulation

at, t1

Designs for Vision Pty Ltd

DV254 Rayner Premium Sulcoflex 653Z-Premium Multifocal Toric -7D to +7D (Spherical Equivalent) Cylinder $1,198.00

Multifocal Toric Supplementary IOL Supplementary IOL 1D, 4D, 5D, 6D Addition 3.5D

DV255 Rayner Standard Sulcoflex 653Z-Standard Multifocal Toric -3D to +3D (Spherical Equivalent) $1,198.00

Multifocal Toric Supplementary IOL Supplementary IOL Cylinders 2D and 3D Addition 3.5D

at, t1, vblf

Spectrum Surgical

SO056 HumanOptics ToricaDiffractiva Toric Multifocal Add-On IOL for sulcus -2.0 to +0.5 in 0.5D steps, Cylinder < 7D, $1,240.00

Add-On IOL fixation in pseudophakic eyes, 3-piece, Near addition 3.5D

foldable, UV absorber, blue light filter, Iris

protection, safety profile technology and

undulated haptics.

01 - OPHTHALMIC

Minimum Maximum

Billing Code Product Description Size Benefit Benefit Condition

at, vblf

Spectrum Surgical

SO068 HumanOptics Diffractiva Add-On Multifocal Add-On IOL for sulcus fixation in -6.0 to +6.0 in 0.5D steps, Near addition $864.00

IOL pseudophakic eyes, 3-piece, foldable, UV

absorber, blue light filter, Iris protection and

safety profile technology.

01.03.01 - Viscoelastic

Alcon Laboratories (Aust.) Pty Ltd

AL006 PROVISC VISCOELASTIC PROVISC contains sodium hyaluronate 0.85mL pack $80.00

SOLUTION

AL007 VISCOAT Viscoelastic Fluid Chondroitin sulfate and sodium hyaluronate 0.75mL $80.00

AL015 Cellugel viscoelastic fluid Hypromellose 2%. $80.00

AL029 DisCoVisc Ophthalmic Sodium hyaluronate 17 mg/mL and 0.5 mL and 1.0 mL $80.00

Viscosurgical Device chondroitin sulfate 40mg/mL

AMO Australia Pty Ltd

AO032 Healon Endocoat Viscoelastic 0.85ml $80.00

Bausch & Lomb (Australia) Pty Ltd

BL008 Ocucoat Intraocular Fluid 20mg/mL hydroxypropylmethyl cellulose for 1ml and 2ml Sterile $80.00

intraocular use

BL015 Amvisc Plus injection 15mg/mL Sodium Hyaluronate for intraocular 0.5mL and 0.8mL $80.00

use

Carl Zeiss Pty Ltd

CZ012 Z-HYALIN Viscoelastic Cohesive Viscoelastic Solution - sodium Volume 1.0ml $80.00

hyaluronate 10mg/ml.

(previously called

Ophthalin)

CZ013 Z-HYALIN Plus Viscoelastic Cohesive Viscoelastic Solution - sodium Volume 1.0ml $80.00

hyaluronate 15mg/ml.

(previously called

Opthalin Plus)

CZ022 VISTHESIA 1.5% VISCOANAESTHETIC syringe contains 0.8ml syringe & 2x0.3ml ampoules $80.00

sodium hyaluronate (NaHA, 1.5%) and

lidocaine hydrochloride (1%). Also contains

two topical ampoules with NaHA (0.3%) and

lidocaine (2%)

01 - OPHTHALMIC

Minimum Maximum

Billing Code Product Description Size Benefit Benefit Condition

IQ Medical

IQ002 Ocuvis and Ocumax 2% 20mg/mL hydroxypropylmethyl cellulose for 2mL sterile $80.00

Hydroxypropylmethylcellulose intraocular use. Pre-loaded in a sterile syringe

with one cannula for injection, in a sterile

Tyvek pouch

hmw

AMO Australia Pty Ltd

AO009 Healon 5, Intraocular Viscoelastic HEALON5- Sodium hyaluronate 23mg/ml. 0.6ml $85.00

Fluid

AMO Australia Pty Ltd

AO008 Healon, Intraocular Viscoelastic Sodium Hyaluronate 10mg/ml Healon 0.55ml & 0.85ml $80.00

hmw

AMO Australia Pty Ltd

AO010 Healon GV Intraocular Viscoelastic Sodium Hyaluronate 14mg/mL 0.55ml and 0.85ml $85.00

Fluid

01.03.01.01 - Dual Fluids

Alcon Laboratories (Aust.) Pty Ltd

AL005 DUOVISC VISCOELASTIC SYSTEM PROVISC contains sodium hyaluronate, Small & large packs $110.00

VISCOAT contains chondroitin sulfate and

sodium hyaluronate

Carl Zeiss Pty Ltd

CZ019 TWINVISC Viscoelastic TWINVISC includes a cohesive and a Total volume 1.4 ml $110.00

dispersive viscoelastic in one syringe,

separated by a valve.

Dispersive: sodium

hyaluronate (2.2%).

Cohesive: sodium

01.03.02 - Non Viscous

Designs for Vision Pty Ltd

DV231 Vision Blue Trypan blue dye for ophthalmic applications 0.5ml syringe $48.00

01 - OPHTHALMIC

Minimum Maximum

Billing Code Product Description Size Benefit Benefit Condition

Emagin Pty Ltd

EG013 Retidyne Tissue staining in Ophthalmic Surgery 0.5ml Syringe Vial $48.00

01.04.01 - Simple

Alcon Laboratories (Aust.) Pty Ltd

AL001 Capsular Tension Rings - 10.0 - 12.0 compressed, 12.3 - 14.5 $159.00

uncompressed

AMO Australia Pty Ltd

AO021 Stabileyes Capsular Tension Ring Polymethylmethacrylate (PMMA) Implant 12mm ring, and 13mm ring $159.00

Designs for Vision Pty Ltd

DV009 Morcher Capsular Tension Ring PMMA Implant 14, 14A, 14C $159.00

Emagin Pty Ltd

EG001 Capsular Tension Rings Clear PMMA Implant 10/08, 12/10, 13/11mm $159.00

pl

Designs for Vision Pty Ltd

DV029 Eyejet CRT Capsular tension ring made of PMMA per- 14 (10mm), 14C (11mm), 14A (12mm) $243.00

load on disposable injector

pl

Emagin Pty Ltd

EG018 RINGJECT Preloaded Capsular tension ring 12/10, 13/11 $243.00

iNova Pharmaceuticals Australia Pty Ltd

IL003 Preloaded Capsular Tension Ring Capsular tension ring preloaded (acrylic) 13/11mm $243.00

Insight Surgical Pty Ltd

IS001 Preloaded Capsular Tension Ring Capsular tension ring preloaded (acrylic) 13/11mm $243.00

01 - OPHTHALMIC

Minimum Maximum

Billing Code Product Description Size Benefit Benefit Condition

IS018 Jetring Preloaded PMMA (polymethyl methacrylate) JETRING 11ACB Right $243.00

capsular tension ring. Overall diameter: 13.0 mm ±0.20 mm

Compressed diameter:

11,0 mm ±0.20 mm

Haptic:

ø0.17 mm ±0.02 mm

Haptic design: straight, open modified

C-loop

JETRING 12ACB Right

Overall diameter:

14.5 mm ±0.20 mm

Compressed diameter:

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.

PART B - Human Tissue List

Billing Code Facility Minimum Benefit Maximum Benefit

CARDIO-THORACIC

Conduit - Aortic

TBV56 Donor Tissue Bank of Victoria $1,749.00

Conduit - Aortic + Valve

QHV09 The Prince Charles Hospital - Queensland Heart Valve Bank $6,962.00

Conduit - Arterial

SHV03 Sydney Heart Valve Bank, St. Vincent's Hospital $2,581.00

Conduit - Pulmonary

TBV03 Donor Tissue Bank of Victoria $1,749.00

Conduit - Pulmonary + Valve

QHV08 The Prince Charles Hospital - Queensland Heart Valve Bank $7,294.00

Conduit - Pulmonary large

QHV07 The Prince Charles Hospital - Queensland Heart Valve Bank $2,116.00

Patch - Mitral

QHV03 The Prince Charles Hospital - Queensland Heart Valve Bank $1,926.00

Patch - Pericardium

QHV05 The Prince Charles Hospital - Queensland Heart Valve Bank $2,116.00

Patch - Tricuspid

QHV04 The Prince Charles Hospital - Queensland Heart Valve Bank $1,926.00

Pericardium

TBV50 Donor Tissue Bank of Victoria $2,139.00

Thoracic Aorta

QHV11 The Prince Charles Hospital - Queensland Heart Valve Bank $2,116.00

Valve - Aortic

QHV01 The Prince Charles Hospital - Queensland Heart Valve Bank $7,294.00

RPH01 Royal Perth Hospital T/A Heart Valve Bank $6,406.00

SHV01 Sydney Heart Valve Bank, St. Vincent's Hospital $7,752.00

TBV01 Donor Tissue Bank of Victoria $8,266.00

Valve - Mitral

Page 1 of 16

Billing Code Facility Minimum Benefit Maximum Benefit

QHV10 The Prince Charles Hospital - Queensland Heart Valve Bank $6,962.00

Valve - Pulmonary

QHV02 The Prince Charles Hospital - Queensland Heart Valve Bank $7,294.00

RPH02 Royal Perth Hospital T/A Heart Valve Bank $6,406.00

SHV02 Sydney Heart Valve Bank, St. Vincent's Hospital $7,752.00

TBV02 Donor Tissue Bank of Victoria $8,266.00

DERMATOLOGIC

Skin < 25cm² - acellular dermal matrix allograft from human origin

SYN03 Johnson & Johnson Medical Pty Ltd t/a DePuy Synthes $2,200.00

Skin > 300cm² - acellular dermal matrix allograft from human origin

SYN07 Johnson & Johnson Medical Pty Ltd t/a DePuy Synthes $27,000.00

Skin 100cm² - frozen skin graft from human origin

QBB72 The Queensland Bone Bank $527.00

Skin 121 to 300cm² - acellular dermal matrix allograft from human origin

SYN06 Johnson & Johnson Medical Pty Ltd t/a DePuy Synthes $14,000.00

Skin 200cm² - frozen skin graft from human origin

QBB73 The Queensland Bone Bank $779.00

Skin 26 to 60cm² - acellular dermal matrix allograft from human origin

SYN04 Johnson & Johnson Medical Pty Ltd t/a DePuy Synthes $3,500.00

Skin 50cm² - frozen skin graft from human origin

QBB71 The Queensland Bone Bank $274.00

Skin 61 to 120cm² - acellular dermal matrix allograft from human origin

SYN05 Johnson & Johnson Medical Pty Ltd t/a DePuy Synthes $5,700.00

OPHTHALMIC

Amniotic Membrane

LEM03 Lions Eye Donation Service $770.00

Cornea

LEM01 Lions Eye Donation Service $2,000.00

LEN01 Lions NSW Eye Bank $2,287.00

LEW01 Lions Eye Bank of Western Australia $2,500.00

QEB01 Queensland Eye Bank $2,321.00

SAE01 The Eye Bank of South Australia $1,890.00

Page 2 of 16

Billing Code Facility Minimum Benefit Maximum Benefit

Cornea for Endothelial Keratoplasty

LEN04 Lions NSW Eye Bank $2,695.00

LEW03 Lions Eye Bank of Western Australia $3,000.00

SAE03 The Eye Bank of South Australia $2,849.00

Cornea for Endothelial Lamellar Keratoplasty

LEM04 Lions Eye Donation Service $2,660.00

Cornea For Lamellar

LEN03 Lions NSW Eye Bank $1,372.00

Sclera

LEM02 Lions Eye Donation Service $150.00

LEN02 Lions NSW Eye Bank $343.00

LEW02 Lions Eye Bank of Western Australia $250.00

QEB02 Queensland Eye Bank $329.00

SAE02 The Eye Bank of South Australia $230.00

ORTHOPAEDIC

Autologous Skull Flap

MVS23 Institute of Medical & Veterinary Science T/A South Australian Tissue Bank $1,396.00

QBB60 The Queensland Bone Bank $1,733.00

RNB02 Hunter New England Bone Bank $1,470.00

Autologous Skull Flap - processed

QBB56 The Queensland Bone Bank $2,195.00

Bone - Cancellous Bone Matrix, Lyophilised 40cc

TBV52 Donor Tissue Bank of Victoria $683.00

Bone - Cancellous Bone Matrix, Lyophilised 80cc

TBV53 Donor Tissue Bank of Victoria $1,364.00

Bone - Cancellous Crunch 15cc

NBB62 New South Wales Bone Bank $1,169.00

Bone - Cancellous Crunch 30cc

NBB61 New South Wales Bone Bank $2,131.00

Bone - Cancellous Crunch 60cc

NBB60 New South Wales Bone Bank $3,232.00

Bone - Cancellous Cubes (6) Freeze Dried

Page 3 of 16

Billing Code Facility Minimum Benefit Maximum Benefit

QBB09 The Queensland Bone Bank $1,778.00

Bone - Cancellous Strips (2) Freeze Dried

QBB10 The Queensland Bone Bank $751.00

Bone - Chips/cubes 40cc

TBV09 Donor Tissue Bank of Victoria $1,394.00

Bone - Chips/cubes 80cc

TBV10 Donor Tissue Bank of Victoria $2,420.00

Bone - Cortico-Cancellous Crunch (40/60) 15cc

NBB65 New South Wales Bone Bank $1,169.00

Bone - Cortico-Cancellous Crunch (40/60) 30cc

NBB64 New South Wales Bone Bank $2,131.00

Bone - Cortico-Cancellous Crunch (40/60) 60cc

NBB63 New South Wales Bone Bank $3,232.00

Bone - Demineralised Bone Matrix, DBX Putty, 10cc

SYN02 Johnson & Johnson Medical Pty Ltd t/a DePuy Synthes $3,400.00

Bone - Demineralised Bone Matrix, DBX Putty, 5cc

SYN01 Johnson & Johnson Medical Pty Ltd t/a DePuy Synthes $2,650.00

Bone - Demineralised Bone Matrix, Lyophilised 10g

TBV55 Donor Tissue Bank of Victoria $1,157.00

Bone - Demineralised Bone Matrix, Lyophilised 5g

TBV54 Donor Tissue Bank of Victoria $578.00

Bone - Milled <30g Freeze Dried

PBT37 Perth Bone and Tissue Bank $750.00

Bone - Milled <5 gr (<10cc equivalent)

PBT62 Perth Bone and Tissue Bank $550.00

Bone - Milled >50gr (100cc equivalent)

PBT10 Perth Bone and Tissue Bank $4,050.00

Bone - Milled 10-19 gr (20-38cc equivalent)

PBT64 Perth Bone and Tissue Bank $2,050.00

Bone - Milled 20-29gr (40-58cc equivalent)

PBT08 Perth Bone and Tissue Bank $2,950.00

Bone - Milled 20g

Page 4 of 16

Billing Code Facility Minimum Benefit Maximum Benefit

QBB45 The Queensland Bone Bank $2,202.00

Bone - Milled 20g Freeze Dried

QBB03 The Queensland Bone Bank $2,789.00

Bone - Milled 30 - 50gr (60 - 100cc equivalent)

PBT09 Perth Bone and Tissue Bank $3,550.00

Bone - Milled 30-50g Freeze Dried

PBT38 Perth Bone and Tissue Bank $900.00

Bone - Milled 40cc

TBV11 Donor Tissue Bank of Victoria $1,618.00

Bone - Milled 5-9 gr (10-18cc equivalent)

PBT63 Perth Bone and Tissue Bank $1,150.00

Bone - Milled 80cc

TBV12 Donor Tissue Bank of Victoria $2,690.00

Bone - Milled Femoral Head

AUB02 Australian Biotechnologies $2,457.00

Bone - Ronguered Chips

QBB68 The Queensland Bone Bank $2,235.00

Bone - Ronguered Chips Freeze Dried

QBB67 The Queensland Bone Bank $2,789.00

Bone – Cortico-Cancellous Crunch <20g Sterile

AUB08 Australian Biotechnologies $2,215.00

Bone – Cortico-Cancellous Crunch <30g

AUB04 Australian Biotechnologies $2,070.00

Bone Plug/Dowel - Cancellous

NBB05 New South Wales Bone Bank $1,584.00

PBT03 Perth Bone and Tissue Bank $1,200.00

TBV07 Donor Tissue Bank of Victoria $1,064.00

Bone Plug/Dowel - Tricortical

TBV08 Donor Tissue Bank of Victoria $1,133.00

Bone, Cancellous Chips - 15cc

SYN10 Johnson & Johnson Medical Pty Ltd t/a DePuy Synthes $1,250.00

Bone, Cancellous Chips - 30cc

Page 5 of 16

Billing Code Facility Minimum Benefit Maximum Benefit

SYN12 Johnson & Johnson Medical Pty Ltd t/a DePuy Synthes $1,700.00

Bone, Cancellous Granules - 15cc

SYN11 Johnson & Johnson Medical Pty Ltd t/a DePuy Synthes $1,250.00

Bone, Cancellous Granules - 30cc

SYN13 Johnson & Johnson Medical Pty Ltd t/a DePuy Synthes $1,700.00

Cartilage - costal segments

PBT11 Perth Bone and Tissue Bank $300.00

QBB12 The Queensland Bone Bank $232.00

TBV17 Donor Tissue Bank of Victoria $713.00

Cortical Strut

AUB05 Australian Biotechnologies $2,451.00

QBB52 The Queensland Bone Bank $487.00

TBV14 Donor Tissue Bank of Victoria $1,149.00

Cortical Strut >15 - 20cm

PBT07 Perth Bone and Tissue Bank $2,664.00

Cortical Strut >20cm

PBT48 Perth Bone and Tissue Bank $3,032.00

Cortical Struts 10-15cm

PBT06 Perth Bone and Tissue Bank $1,981.00

DBX Putty - 1.00cc

SYN08 Johnson & Johnson Medical Pty Ltd t/a DePuy Synthes $1,450.00

DBX Putty - 2.5cc

SYN09 Johnson & Johnson Medical Pty Ltd t/a DePuy Synthes $1,800.00

Disc - Freeze Dried

QBB04 The Queensland Bone Bank $788.00

Elbow - joint

QBB14 The Queensland Bone Bank $2,437.00

TBV18 Donor Tissue Bank of Victoria $6,380.00

Fascia Lata

NBB09 New South Wales Bone Bank $1,193.00

TBV21 Donor Tissue Bank of Victoria $1,198.00

Fascia Lata - Large (15cm x 10cm)

Page 6 of 16

Billing Code Facility Minimum Benefit Maximum Benefit

PBT15 Perth Bone and Tissue Bank $1,590.00

Fascia Lata - per sq cm

QBB11 The Queensland Bone Bank $6.00

Fascia Lata - Small (10cm x 5cm)

PBT16 Perth Bone and Tissue Bank $854.00

Femoral Head

ACT01 ACT Bone Bank $2,432.00

AUB03 Australian Biotechnologies $2,354.00

CSA01 Rachel Forster Bone Bank $802.00

DHR01 Barwon Health Bone Bank $4,616.00

MVS05 Institute of Medical & Veterinary Science T/A South Australian Tissue Bank $2,370.00

NBB16 New South Wales Bone Bank $2,354.00

PBT22 Perth Bone and Tissue Bank $2,932.00

QBB27 The Queensland Bone Bank $2,390.00

RNB01 Hunter New England Bone Bank $2,500.00

TBV26 Donor Tissue Bank of Victoria $3,063.00

Femoral Head - Autologous

QBB61 The Queensland Bone Bank $2,390.00

Femoral Head - Freeze Dried

QBB28 The Queensland Bone Bank $2,390.00

Femoral Hemi-condyle

NBB59 New South Wales Bone Bank $2,939.00

PBT21 Perth Bone and Tissue Bank $2,900.00

TBV46 Donor Tissue Bank of Victoria $1,666.00

Femoral Rings

NBB17 New South Wales Bone Bank $2,078.00

PBT24 Perth Bone and Tissue Bank $1,800.00

QBB30 The Queensland Bone Bank $1,758.00

Femoral Rings - Freeze Dried

QBB31 The Queensland Bone Bank $740.00

Femoral Shaft

QBB23 The Queensland Bone Bank $2,483.00

Femoral Shaft - Freeze Dried

Page 7 of 16

Billing Code Facility Minimum Benefit Maximum Benefit

QBB66 The Queensland Bone Bank $3,106.00

Femoral Shaft - Half

NBB57 New South Wales Bone Bank $3,595.00

Femoral Shaft - Middle Third

NBB13 New South Wales Bone Bank $3,244.00

TBV24 Donor Tissue Bank of Victoria $2,751.00

Femoral Shaft - Segment

NBB56 New South Wales Bone Bank $2,183.00

Femoral Shaft - Third

NBB55 New South Wales Bone Bank $2,183.00

Femoral Shaft/Tibial Shaft - Middle third

PBT19 Perth Bone and Tissue Bank $3,200.00

Femur - Distal (Shaft & Condyles)

MVS02 Institute of Medical & Veterinary Science T/A South Australian Tissue Bank $2,290.00

PBT17 Perth Bone and Tissue Bank $4,220.00

TBV22 Donor Tissue Bank of Victoria $4,755.00

Femur - Distal Half

NBB10 New South Wales Bone Bank $3,595.00

QBB20 The Queensland Bone Bank $3,094.00

Femur - Distal third

NBB11 New South Wales Bone Bank $3,372.00

Femur - Entire

MVS03 Institute of Medical & Veterinary Science T/A South Australian Tissue Bank $2,290.00

NBB12 New South Wales Bone Bank $8,023.00

QBB22 The Queensland Bone Bank $4,717.00

TBV23 Donor Tissue Bank of Victoria $7,790.00

Femur - Entire head removed

PBT18 Perth Bone and Tissue Bank $8,000.00

Femur - Proximal (shaft, trochanter, neck)

MVS04 Institute of Medical & Veterinary Science T/A South Australian Tissue Bank $2,290.00

PBT20 Perth Bone and Tissue Bank $4,220.00

TBV25 Donor Tissue Bank of Victoria $4,722.00

Page 8 of 16

Billing Code Facility Minimum Benefit Maximum Benefit

Femur - Proximal half

NBB15 New South Wales Bone Bank $3,780.00

QBB25 The Queensland Bone Bank $3,337.00

Femur - Proximal third

NBB14 New South Wales Bone Bank $1,690.00

Femur - Proximal with femoral head

TBV51 Donor Tissue Bank of Victoria $4,590.00

Fibula - Entire

MVS07 Institute of Medical & Veterinary Science T/A South Australian Tissue Bank $2,290.00

NBB18 New South Wales Bone Bank $7,817.00

PBT25 Perth Bone and Tissue Bank $3,500.00

QBB32 The Queensland Bone Bank $2,930.00

TBV27 Donor Tissue Bank of Victoria $7,518.00

Fibula - Segment

NBB54 New South Wales Bone Bank $3,053.00

PBT28 Perth Bone and Tissue Bank $2,000.00

Fibula - Segment (12cm)

MVS14 Institute of Medical & Veterinary Science T/A South Australian Tissue Bank $2,290.00

TBV29 Donor Tissue Bank of Victoria $1,490.00

Fibula - Segment (6cm)

MVS13 Institute of Medical & Veterinary Science T/A South Australian Tissue Bank $2,290.00

TBV28 Donor Tissue Bank of Victoria $1,064.00

Fibular Shaft

TBV30 Donor Tissue Bank of Victoria $2,818.00

Grafton Demineralized Bone Matrix

MAA01 MEDTRONIC AUSTRALASIA PTY LTD $1,400.00

MAA03 MEDTRONIC AUSTRALASIA PTY LTD $1,800.00

MAA04 MEDTRONIC AUSTRALASIA PTY LTD $1,800.00

MAA05 MEDTRONIC AUSTRALASIA PTY LTD $529.00

MAA06 MEDTRONIC AUSTRALASIA PTY LTD $1,400.00

MAA07 MEDTRONIC AUSTRALASIA PTY LTD $529.00

MAA09 MEDTRONIC AUSTRALASIA PTY LTD $1,400.00

MAA10 MEDTRONIC AUSTRALASIA PTY LTD $1,800.00

Page 9 of 16

Billing Code Facility Minimum Benefit Maximum Benefit

MAA11 MEDTRONIC AUSTRALASIA PTY LTD $1,400.00

MAA12 MEDTRONIC AUSTRALASIA PTY LTD $529.00

Grafton Plus Demineralised Bone Matrix

MAA02 MEDTRONIC AUSTRALASIA PTY LTD $529.00

Grafton Plus Demineralized Bone Matrix

MAA08 MEDTRONIC AUSTRALASIA PTY LTD $1,400.00

Hemipelvis - Acetabulum

NBB21 New South Wales Bone Bank $3,759.00

PBT29 Perth Bone and Tissue Bank $2,940.00

QBB33 The Queensland Bone Bank $3,052.00

TBV31 Donor Tissue Bank of Victoria $3,749.00

Hemipelvis - Complete

MVS08 Institute of Medical & Veterinary Science T/A South Australian Tissue Bank $2,290.00

NBB24 New South Wales Bone Bank $8,411.00

PBT30 Perth Bone and Tissue Bank $7,000.00

QBB37 The Queensland Bone Bank $4,717.00

TBV32 Donor Tissue Bank of Victoria $8,178.00

Hemipelvis - iliac crest

NBB22 New South Wales Bone Bank $3,500.00

PBT31 Perth Bone and Tissue Bank $2,000.00

QBB34 The Queensland Bone Bank $2,738.00

TBV33 Donor Tissue Bank of Victoria $3,415.00

Hemipelvis - Tricortical iliac wedge

NBB23 New South Wales Bone Bank $1,546.00

PBT32 Perth Bone and Tissue Bank $1,500.00

QBB35 The Queensland Bone Bank $1,321.00

TBV34 Donor Tissue Bank of Victoria $1,473.00

Hemipelvis - Tricortical iliac wedge Freeze Dried

QBB36 The Queensland Bone Bank $812.00

Humeral Head

TBV37 Donor Tissue Bank of Victoria $2,187.00

Humeral Head Addition

NBB26 New South Wales Bone Bank $1,999.00

Page 10 of 16

Billing Code Facility Minimum Benefit Maximum Benefit

Humeral Shaft

NBB50 New South Wales Bone Bank $3,998.00

QBB39 The Queensland Bone Bank $1,781.00

Humeral Shaft - Half

NBB51 New South Wales Bone Bank $2,162.00

Humerus - Distal

MVS19 Institute of Medical & Veterinary Science T/A South Australian Tissue Bank $2,290.00

NBB25 New South Wales Bone Bank $3,053.00

TBV49 Donor Tissue Bank of Victoria $2,873.00

Humerus - Entire

MVS20 Institute of Medical & Veterinary Science T/A South Australian Tissue Bank $2,290.00

NBB29 New South Wales Bone Bank $4,066.00

QBB43 The Queensland Bone Bank $3,354.00

Humerus - Entire with rotator cuff

NBB30 New South Wales Bone Bank $4,118.00

PBT33 Perth Bone and Tissue Bank $3,343.00

Humerus - Proximal

NBB27 New South Wales Bone Bank $3,583.00

PBT35 Perth Bone and Tissue Bank $2,800.00

TBV36 Donor Tissue Bank of Victoria $3,489.00

Humerus - Proximal half with rotator cuff

NBB28 New South Wales Bone Bank $3,595.00

Humerus - Proximal with rotator cuff

MVS09 Institute of Medical & Veterinary Science T/A South Australian Tissue Bank $2,290.00

PBT34 Perth Bone and Tissue Bank $4,200.00

TBV35 Donor Tissue Bank of Victoria $3,346.00

Humerus - Ring

NBB53 New South Wales Bone Bank $1,874.00

Ligament - Medial

NBB31 New South Wales Bone Bank $2,305.00

TBV38 Donor Tissue Bank of Victoria $2,336.00

Meniscal Graft

PBT47 Perth Bone and Tissue Bank $1,921.00

Page 11 of 16

Billing Code Facility Minimum Benefit Maximum Benefit

Meniscus

QBB05 The Queensland Bone Bank $1,547.00

TBV40 Donor Tissue Bank of Victoria $1,640.00

Meniscus with Ligaments

TBV39 Donor Tissue Bank of Victoria $2,763.00

Osteotomy Wedge

PBT60 Perth Bone and Tissue Bank $2,000.00

Patella

QBB47 The Queensland Bone Bank $871.00

TBV41 Donor Tissue Bank of Victoria $1,449.00

Patellar unit whole with or without tibial block

PBT40 Perth Bone and Tissue Bank $2,954.00

Proximal Femur with Femoral Head

PBT65 Perth Bone and Tissue Bank $6,300.00

Radius

MVS18 Institute of Medical & Veterinary Science T/A South Australian Tissue Bank $2,290.00

NBB06 New South Wales Bone Bank $3,913.00

PBT13 Perth Bone and Tissue Bank $1,800.00

QBB15 The Queensland Bone Bank $2,495.00

TBV19 Donor Tissue Bank of Victoria $3,893.00

Radius - Ring

NBB49 New South Wales Bone Bank $2,399.00

Radius - Shaft

NBB47 New South Wales Bone Bank $3,850.00

Rib (5cm)

MVS21 Institute of Medical & Veterinary Science T/A South Australian Tissue Bank $382.00

PBT41 Perth Bone and Tissue Bank $300.00

TBV43 Donor Tissue Bank of Victoria $826.00

Spinal Ring

AUB07 Australian Biotechnologies $1,854.00

Tendon

AUB10 Australian Biotechnologies $2,184.00

Page 12 of 16

Billing Code Facility Minimum Benefit Maximum Benefit

Tendon - Achilles

NBB01 New South Wales Bone Bank $2,487.00

PBT61 Perth Bone and Tissue Bank $1,985.00

QBB62 The Queensland Bone Bank $2,124.00

TBV05 Donor Tissue Bank of Victoria $1,453.00

Tendon - Achilles Hemi

QBB65 The Queensland Bone Bank $1,584.00

Tendon - Achilles with bone block

NBB02 New South Wales Bone Bank $2,883.00

PBT01 Perth Bone and Tissue Bank $2,800.00

QBB01 The Queensland Bone Bank $2,124.00

TBV06 Donor Tissue Bank of Victoria $2,691.00

Tendon - Achilles with bone plug

AUB09 Australian Biotechnologies $2,228.00

Tendon - Achilles with machined conical bone block

NBB69 New South Wales Bone Bank $3,530.00

Tendon - EHL

QBB69 The Queensland Bone Bank $2,124.00

Tendon - Gracilis

QBB59 The Queensland Bone Bank $2,124.00

Tendon - Patellar

QBB48 The Queensland Bone Bank $2,271.00

Tendon - Patellar Hemi

QBB63 The Queensland Bone Bank $1,735.00

Tendon - Patellar split with bone plugs

PBT02 Perth Bone and Tissue Bank $2,500.00

Tendon - Patellar with bone plugs

NBB33 New South Wales Bone Bank $2,778.00

TBV42 Donor Tissue Bank of Victoria $2,763.00

Tendon - Patellar with machined conical bone plug

NBB68 New South Wales Bone Bank $3,425.00

Tendon - Patellar with Quads

Page 13 of 16

Billing Code Facility Minimum Benefit Maximum Benefit

NBB72 New South Wales Bone Bank $2,826.00

Tendon - Peroneus Longus

NBB73 New South Wales Bone Bank $2,826.00

Tendon - Semi tendinosis

NBB70 New South Wales Bone Bank $2,827.00

QBB70 The Queensland Bone Bank $2,124.00

Tendon - Single (ant and post tibilias, FDL, EDL, hamstring, gracilis)

PBT46 Perth Bone and Tissue Bank $2,800.00

Tendon - Tibialis Anterior

NBB67 New South Wales Bone Bank $2,826.00

QBB58 The Queensland Bone Bank $2,124.00

TBV57 Donor Tissue Bank of Victoria $2,691.00

Tendon - Tibialis Posterior

NBB71 New South Wales Bone Bank $2,826.00

QBB57 The Queensland Bone Bank $2,124.00

Tibia - Condyles only

TBV47 Donor Tissue Bank of Victoria $2,196.00

Tibia - Distal

MVS17 Institute of Medical & Veterinary Science T/A South Australian Tissue Bank $2,290.00

QBB51 The Queensland Bone Bank $2,091.00

TBV48 Donor Tissue Bank of Victoria $2,798.00

Tibia - Plateau (prox 1/3)

NBB35 New South Wales Bone Bank $3,258.00

Tibia - Proximal

NBB36 New South Wales Bone Bank $3,301.00

PBT45 Perth Bone and Tissue Bank $2,635.00

QBB54 The Queensland Bone Bank $2,614.00

Tibia - Proximal 16-25cm

TBV45 Donor Tissue Bank of Victoria $3,138.00

Tibia - Proximal 7-15cm

TBV44 Donor Tissue Bank of Victoria $3,248.00

Tibia - Proximal half

Page 14 of 16

Billing Code Facility Minimum Benefit Maximum Benefit

MVS11 Institute of Medical & Veterinary Science T/A South Australian Tissue Bank $2,290.00

Tibia - Proximal with Patella

QBB08 The Queensland Bone Bank $3,094.00

Tibia - Proximal with Patella & Tendon

PBT44 Perth Bone and Tissue Bank $5,000.00

Tibia - Proximal with Patellar Tendon

NBB46 New South Wales Bone Bank $5,158.00

Tibia - Ring

NBB45 New South Wales Bone Bank $1,874.00

Tibia - Whole

MVS16 Institute of Medical & Veterinary Science T/A South Australian Tissue Bank $2,290.00

NBB37 New South Wales Bone Bank $5,260.00

QBB55 The Queensland Bone Bank $4,694.00

Tibia - Whole with Patella

QBB64 The Queensland Bone Bank $4,717.00

Tibia - Whole with Patellar Tendon

NBB44 New South Wales Bone Bank $7,059.00

Tibia – Proximal third

AUB06 Australian Biotechnologies $2,562.00

Tibia Shaft

QBB53 The Queensland Bone Bank $1,096.00

Tibial Shaft

NBB41 New South Wales Bone Bank $4,849.00

Tibial Shaft - half

NBB43 New South Wales Bone Bank $3,170.00

Tibial Shaft - third

NBB42 New South Wales Bone Bank $3,423.00

Tibial Shaft Freeze Dried

QBB02 The Queensland Bone Bank $964.00

Tri Cortical Osteotomy

NBB66 New South Wales Bone Bank $1,563.00

Ulna

Page 15 of 16

Billing Code Facility Minimum Benefit Maximum Benefit

MVS15 Institute of Medical & Veterinary Science T/A South Australian Tissue Bank $2,290.00

NBB07 New South Wales Bone Bank $3,606.00

PBT14 Perth Bone and Tissue Bank $1,500.00

QBB16 The Queensland Bone Bank $2,495.00

TBV20 Donor Tissue Bank of Victoria $3,609.00

Ulna - Ring

NBB40 New South Wales Bone Bank $2,399.00

Ulna - Shaft

NBB38 New South Wales Bone Bank $3,170.00

Grand Total: 302 Records

Page 16 of 16

Private Health Insurance (Prostheses) Rules 2016 (No. 2)

made under the

Private Health Insurance Act 2007

Compilation No. 2

Compilation date: 17 June 2016

Includes amendments up to:F2016L01039

Registered:27 June 2016

This compilation is in 5 volumes

Volume 1: Parts 1-4

Volume 2: Part A

Volume 3: Part B

Volume 4:Part C

Volume 5: Endnotes

Each volume has its own contents

About this compilation

This compilation

This is a compilation of the Private Health Insurance (Prostheses) Rules 2016 (No. 2) that shows the text of the law as amended and in force on 17 June 2016 (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 Legislation 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 series page on the Legislation 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 series page on the Legislation 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.

Part C - Other Prostheses February 2016

03 - GENERAL MISCELLANEOUS

Minimum Maximum

Billing Code Product Description Size Benefit Benefit Notations

03.02.03 - Infusion Pumps, Battery Powered

03.02.03.02 - Insulin infusion pump (as 3.2.3.1) with integral calculator to determine boluses and active insulin

Managing Diabetes Pty Ltd

DF001 DANAIIS Insulin Pump Continuous insulin infusion pump 75mm x 45mm x 19mm $4,000.00

DE, SS

Australasian Medical & Scientific Ltd

AN011 Animas Vibe Insulin Pump Ambulatory insulin infusion pump 8.26 x 5.08 x 2.18cm $8,950.00

with real-time continuous glucose

monitoring (CGM) capability

Managing Diabetes Pty Ltd

DF002 DANAR Insulin Pump The DANAR Insulin Pump is a small 75 x 45 x 19mm, 60grams $8,950.00

device about the size of a pager. It

holds up to 300 units of insulin,

which is delivered continuously

through a small tube to the patient.

The DANAR Insulin Pump also has

an integrated blood glucose meter and

remote control via bluetooth

communication.

Roche Diagnostics Australia Pty Ltd

RO044 Accu-Chek Combo System Insulin delivery device capable of The Accu-Chek Combo $8,950.00

remotely receiving and acting on System is only available in

information about blood glucose one size.

levels, performing bolus calculation

and bolus advice on additional

parameters than what is normally

RO051 ACCU-CHEK Insight System Insulin delivery device capable of No variable sizes offered. $8,950.00

remotely receiving and acting on Only one system provided.

information about blood glucose

levels, performing bolus calculation

and bolus advice on additional

parameters than what is normally

Page 1 of 4

03 - GENERAL MISCELLANEOUS

Minimum Maximum

Billing Code Product Description Size Benefit Benefit Notations

03.02.03.03 - Device has capability to automatically adjust the insulin delivery based on continuous glucose monitoring data

DE, SS

Medtronic Australasia Pty Ltd

MC839 Medtronic MiniMed Insulin Paradigm Veo Model MMT-554. 5.1 x 7.6 x 2.0cm $9,500.00

Infusion Pump 'Smart' Insulin Pump with REAL-

Time continuous glucose monitoring

capability, incorporating a low

glucose suspend and with remote

MC840 Medtronic MiniMed Insulin Paradigm Veo Model MMT-754. 5.1 x 9.4 x 2.0cm $9,500.00

Infusion Pump 'Smart' Insulin Pump with REAL-

Time continuous glucose monitoring

capability, incorporating a low

glucose suspend and with remote

MI150 MiniMed 640G Insulin Pump MiniMed 640G Insulin Pump with 1.8ml and 3.0ml $9,500.00

SmartGuard Technology and

continuous glucose monitoring

capability, designed to automatically

suspend insulin delivery before

dangerous lows occur, and

automatically resume after levels

recover.

Page 2 of 4

08 - CARDIAC

Minimum Maximum

Billing Code Product Description Size Benefit Benefit Notations

08.14.01 - Implantable Cardiac Event Recorders

Medtronic Australasia Pty Ltd

MC763 Reveal XT Reveal XT Insertable Cardiac Monitor 61 x 19 x 8 mm with a $3,900.00

volume of 9cc

MC768 Reveal DX Insertable Cardiac Monitor 61 x 19 x 8 mm with a $3,900.00

volume of 9cc

St Jude Medical Australia Pty Ltd

SJ152 SJM Confirm Model DM2102 Implantable cardiac monitor with 6.5cc, 12g $3,900.00

atrial fibrillation monitoring.

SJ159 SJM Confirm Model DM2100 Implantable cardiac monitor 6.5cc, 12g $3,900.00

i

Biotronik Australia Pty Ltd

BT153 BioMonitor Implantable cardiac monitor for 53.3mm x 42.7mm x 7.1mm, $3,900.00

continuous remote monitoring of 26 grams

patients with Atrial Fibrillation (AF)

or unexplained syncope

Medtronic Australasia Pty Ltd

MI141 Reveal LINQ Insertable Cardiac Monitor 45 x 7 x 3.5mm, 1.18cc $3,900.00

08.16.01 - Remote Monitoring System

St Jude Medical Australia Pty Ltd

SJ369 Merlin@Home wireless Home cardiac monitor (RF) with one size $1,960.00

landline, cellular and broadband

connectivity

SJ370 Merlin@Home Inductive Home cardiac monitor (inductive) one size $1,960.00

with landline, cellular and broadband

connectivity

Page 3 of 4

08 - CARDIAC

Minimum Maximum

Billing Code Product Description Size Benefit Benefit Notations

No Suffix

Biotronik Australia Pty Ltd

BT179 Cardio Messenger II-S 3G Bedside/Remote transmitter w/ ICD Bedside Device - 203 x $1,960.00

device life network access to 136mm x 80mm, 450 grams

Biotronik standard home monitoring

data management service.

Boston Scientific Australia Pty Ltd

BS294 Latitude Communicator Remote patient management system for One size only $1,960.00

implanted cardiac devices

Medtronic Australasia Pty Ltd

MI180 MyCareLink Patient Monitor Electronic cellular patient monitor One size $1,960.00

which gathers and transmits cardiac

information from an implanted cardiac

device (CIED) to your health care

professional for assessment.

Grand Total: 19 Records

Page 4 of 4

Private Health Insurance (Prostheses) Rules 2016 (No. 2)

made under the

Private Health Insurance Act 2007

Compilation No. 2

Compilation date: 17 June 2016

Includes amendments up to: F2016L01039

Registered: 27 June 2016

This compilation is in 5 volumes

Volume 1: Parts 1-4

Volume 2: Part A

Volume 3: Part B

Volume 4: Part C

Volume 5:Endnotes

Each volume has its own contents

About this compilation

This compilation

This is a compilation of the Private Health Insurance (Prostheses) Rules 2016 (No. 2) that shows the text of the law as amended and in force on 17 June 2016 (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 Legislation 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 series page on the Legislation 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 series page on the Legislation 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

Endnotes

Endnote 1About 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 the amendment to be made. If, despite the misdescription, the amendment can be given effect as intended, the amendment is incorporated into the compiled law and the abbreviation “(md)” added to the details of the amendment included in the amendment history.

If a misdescribed amendment cannot be given effect as intended, the abbreviation “(md not incorp)” is added to the details of the amendment included in the amendment history.

Endnote 2Abbreviation 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 3Legislation history

Name

Registration

Commencement

Application, saving and transitional provisions

Private Health Insurance (Prostheses) Rules 2016 (No. 2)

24 Mar 2016 (F2016L00381)

25 Mar 2016 (s 2)

Private Health Insurance (Prostheses) Amendment Rules 2016 (No. 1)

18 May 2016 (F2016L00812)

2 June 2016 (s 2)

Private Health Insurance (Prostheses) Amendment Rules 2016 (No. 2)

16 June 2016 (F2016L01039)

17 June 2016 (s 2)

Endnote 4Amendment history

Provision affected

How affected

Part 1

s 2.........................................

rep LA s 48D

s 3.........................................

rep LA s 48C

Part A

Part A....................................

am F2016L00812; F2016L01039

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