Untitled document

Health Insurance (Section 3C General Medical Services – Optical Coherence Tomography) Determination 2018

I, MICHAEL RYAN, delegate of the Minister for Health, make the following determination. 

Dated      5 October 2018

Michael Ryan

Acting Assistant Secretary

MBS Policy and Specialist Services Branch

Medical Benefits Division

Health Financing Group

Department of Health

Contents

1.           Name

2.           Commencement

3.           Authority

4.           Definitions

5.           Treatment of relevant services

Schedule 1 – relevant services

1. Name

This Determination is the Health Insurance (Section 3C General Medical Services – Optical Coherence Tomography) Determination 2018.

1. Commencement

This Determination commences immediately after the commencement of the Health Insurance Legislation Amendment (2018 Measures No. 3) Regulations 2018.

1. Authority     

This Determination is made under subsection 3C(1) of the Health Insurance Act 1973.

1. Definitions

1. In this Determination:

Act means the Health Insurance Act 1973.

relevant provisions means all provisions, of the Act and regulations made under the Act, and the National Health Act 1953 and regulations made under the National Health Act 1953, relating to medical services, professional services or items.

relevant service means a health service, as defined in subsection 3C(8) of the Act, that is specified in a Schedule.

Schedule means a Schedule to this Determination.

Note:       The following terms are defined in subsection 3(1) of the Act:

·clinically relevant service

·general medical services table

·item

·professional service

(2)   Unless the contrary intention appears, a reference in this Determination to a provision of the Act or the National Health Act 1953 or regulations made under the Act or under the National Health Act 1953 as applied, adopted or incorporated in relation to specifying a matter is a reference to those provisions as in force from time to time and any other reference to provisions of an Act or regulations is a reference to those provisions as in force from time to time.

1. Treatment of relevant services

For subsection 3C(1) of the Act a relevant service, provided in accordance with this Determination and as a clinically relevant service, is to be treated, for the relevant provisions, as if:

(a)it were both a professional service and a medical service; and

(b)there were an item in the general medical services table that:

(i)related to the service; and

(ii)specified for the service a fee in relation to each State, being the fee specified in the Schedule in relation to the service.

Schedule 1 – relevant services

Category 2 – Diagnostic Procedures and Investigations
Group D1 – Miscellaneous diagnostic procedures and investigations
Subgroup 2 – Ophthalmology
Item	Service	Fee ($)
11219	Optical coherence tomography for diagnosis of ocular conditions for which a medication is listed on the Pharmaceutical Benefits Scheme for intraocular administration For any particular patient—applicable not more than once in each 12 month period	40.00