Health Insurance (Section 3C Diagnostic Imaging – Conjunctive Thallium-201 Nuclear Medicine Imaging Service) Determination 2023

Administered by Department of Health, Disability and Ageing

Legislation au F2023L00688 Not in force Legislative Instrument

Legislation content

Health Insurance (Section 3C Diagnostic Imaging – Conjunctive Thallium201 Nuclear Medicine Imaging Service) Determination 2023

made under subsection 3C(1) of the

Health Insurance Act 1973

Compilation No. 3

Compilation date: 1 July 2025

Includes amendments: F2025L00554

About this compilation

This compilation

This is a compilation of the Health Insurance (Section 3C Diagnostic Imaging – Conjunctive Thallium201 Nuclear Medicine Imaging Service) Determination 2023 that shows the text of the law as amended and in force on 1 July 2025 (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 Register (www.legislation.gov.au). 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 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 Register for the compiled law.

Selfrepealing 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If a provision of the compiled law has been repealed in accordance with a provision of the law, details are included in the endnotes.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

1 Name

3 Authority

4 Definitions

5 Treatment of relevant services

6 Schedules

Schedule 1—Relevant Services

Endnotes

Endnote 1—About the endnotes

Endnote 2—Abbreviation key

Endnote 3—Legislation history

Endnote 4—Amendment history

Endnote 5—Editorial changes

 

1  Name

  This instrument is the Health Insurance (Section 3C Diagnostic Imaging – Conjunctive Thallium201 Nuclear Medicine Imaging Service) Determination 2023.

3  Authority

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

4  Definitions

 (1) In this instrument:

Act means the Health Insurance Act 1973.

bulkbilled means:

 (a) a medicare benefit is payable to a person in relation to the service; and

 (b) under an agreement entered into under section 20A of the Act:

 (i) the person assigns to the practitioner, by whom the service is provided, the person’s right to the payment of the medicare benefit; and

 (ii) the practitioner accepts the assignment in full payment of the practitioner’s fee for the service provided.

PET means positron emission tomography.

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 instrument.

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

 clinically relevant service;

 diagnostic imaging services table;

 item;

 professional service.

 (2) Unless the contrary intention appears, a reference in this instrument to a provision of the Act of 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.

5  Treatment of relevant services

  For subsection 3C(1) of the Act, a relevant service, provided in accordance with this instrument 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 diagnostic imaging service; and

 (b) there were an item in the diagnostic imaging 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.

6  Schedules

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

Schedule 1—Relevant Services

 

Group I4—Nuclear medicine imaging

Column 1

Item

Column 2

Description

Column 3

Fee ($)

Subgroup 1—Non PET

61470

Whole body or localised study using thallium201, or single rest myocardial perfusion study using thallium201, if all of the following apply:

a)      the service is bulk billed; and

b)      the service is performed in conjunction with a service described in item 61438, 61461 or 61325

 

1,551.40

 

Endnotes

Endnote 1—About 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 how an amendment is to be made. If, despite the misdescription, the amendment can be given effect as intended, then the misdescribed amendment can be incorporated through an editorial change made under section 15V of the Legislation Act 2003.

If a misdescribed amendment cannot be given effect as intended, the amendment is not incorporated and “(md not incorp)” is added to the amendment history.

 

Endnote 2—Abbreviation 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

/subsubparagraph(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

SubCh = SubChapter(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 3—Legislation history

 

Name

Registration

Commencement

Application, saving and transitional provisions

Health Insurance (Section 3C Diagnostic Imaging – Conjunctive Thallium201 Nuclear Medicine Imaging Service) Determination 2023

5 June 2023 (F2023L00688)

1 July 2023 (s 2(1) item 1)

 

Health Insurance Legislation Amendment (Nuclear Medicine Imaging Services) Determination 2024

20 May 2024 (F2024L00561)

Sch 1 (item 2): 1 July 2024 (s 2(1) item 1)

Health Insurance Legislation Amendment (Nuclear Medicine Imaging Services) Determination (No. 2) 2024

18 Sept 2024 (F2024L01173)

Sch 1 (item 2): 1 Nov 2024 (s 2(1) item 1)

Health Insurance Legislation Amendment (Indexation) Determination 2025

6 May 2025 (F2025L00554)

Sch 2 (item 4): 1 July 2025 (s 2(1) item 1)

 

Endnote 4—Amendment history

 

Provision affected

How affected

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

rep LA s 48D

Schedule 1

 

Schedule 1................

am F2024L00561; F2024L01173; F2025L00554

 

ed C3

 

Endnote 5—Editorial changes

In preparing this compilation for registration, the following kinds of editorial change(s) were made under the Legislation Act 2003.

Schedule 1 (item 61470, column 3)

Kind of editorial change

Give effect to the misdescribed amendment as intended and removal of redundant text

Details of editorial change

Schedule 2 item 4 of the Health Insurance Legislation Amendment (Indexation) Determination 2025 instructs to omit “$1,515.05” and substitute “$1,551.40” in column 3 of item 61470 of Schedule 1.

The fee of “$1,515.05” does not appear in column 3 of item 61470 of Schedule 1. However, the fee of “1,515.05” does appear.

This amendment results in a redundant dollar sign, as the column 3 heading already includes the dollar sign for the fee.

This compilation was editorially changed to omit “1,515.05” and substitute “1,551.40” in column 3 of item 61470 of Schedule 1 to give effect to the misdescribed amendment as intended and to remove the redundant text.

 

Overview

The Health Insurance (Section 3C Diagnostic Imaging – Conjunctive Thallium-201 Nuclear Medicine Imaging Service) Determination 2023, enacted under subsection 3C(1) of the Health Insurance Act 1973, was introduced to address the need for clear classification and reimbursement of specific nuclear medicine imaging services, particularly those involving conjunctive thallium-201 imaging. This legislative instrument aims to ensure that these services are appropriately recognised as both professional and diagnostic imaging services, thus facilitating accurate billing and reimbursement processes within the health insurance framework. The determination was enacted by the relevant legislature to streamline the treatment of these services under the Act, ensuring they are covered under the correct provisions and are compensated at the specified rates. This helps maintain consistency and fairness in the provision of healthcare services under the Medicare scheme.

Scope and Application

The Health Insurance (Section 3C Diagnostic Imaging – Conjunctive Thallium-201 Nuclear Medicine Imaging Service) Determination 2023 applies to services that involve the use of Thallium-201 in nuclear medicine imaging, specifically when the service is provided as a bulk-billed health service and in conjunction with a specified diagnostic imaging service. This determination is made under subsection 3C(1) of the Health Insurance Act 1973 and outlines how such services are to be treated under the Act. The instrument modifies the treatment of these services to classify them as both professional services and diagnostic imaging services, and it specifies the fees associated with each service, as listed in the schedules of the determination. The fees are indexed to account for inflation, as evidenced by amendments such as the Health Insurance Legislation Amendment (Indexation) Determination 2025. The application of the determination is limited to the services specified in Schedule 1, and it is subject to further modifications through subordinate instruments. The determination is applicable nationwide in Australia, as it is a Commonwealth instrument under the Health Insurance Act 1973.

Key Provisions

The Health Insurance (Section 3C Diagnostic Imaging – Conjunctive Thallium-201 Nuclear Medicine Imaging Service) Determination 2023 (the Determination) outlines specific provisions for the treatment of conjunctive thallium-201 nuclear medicine imaging services under the Health Insurance Act 1973 (the Act). This Determination applies to services specified in Schedule 1, which lists relevant services, including their descriptions and associated fees. These services are treated as both professional services and diagnostic imaging services, and the associated fees are outlined in the Diagnostic Imaging Services Table (section 5). Under this Determination, relevant services must be provided in accordance with the Act and must meet the criteria of being clinically relevant. The services specified in Schedule 1 are subject to the fee amounts listed, which are applicable for each State and are determined by the Schedule (section 6). For example, item 61470 pertains to a whole body or localised study using thallium-201 or a single rest myocardial perfusion study using thallium-201, provided it is bulk-billed and performed in conjunction with a specified service. The fee for such a service is set at $1,551.40. The Determination imposes obligations on health service providers, insurers, and patients to ensure that services are provided and billed in compliance with the Act and the Determination. Health service providers must ensure that the services are performed in accordance with the criteria set out in the Determination, while insurers must process claims based on the fees specified in Schedule 1. Patients must be informed of the applicable fees and the conditions under which the services are bulk-billed. Failure to comply with the requirements of the Determination may result in various consequences. For example, health service providers may face penalties for incorrect billing or for providing services that do not meet the criteria outlined in the Determination. Insurers may be liable for incorrect processing of claims, and patients may be required to pay the difference if services are not appropriately billed as bulk-billed. The specific penalties and consequences for breaches of the Determination are not explicitly stated in the Determination itself but would typically be governed by the broader provisions of the Act and related regulations.

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Sourced from the Federal Register of Legislation at 26 August 2026. For the latest information on Australian Government law please go to https://www.legislation.gov.au.