Health Insurance (Section 3C Pathology Services – Point-of-Care Testing Services) Determination 2024

Administered by Department of Health, Disability and Ageing

Legislation au F2024L01221 In force Legislative Instrument

Legislation content

Health Insurance (Section 3C Pathology Services – PointofCare Testing Services) Determination 2024

made under subsection 3C(1) of the

Health Insurance Act 1973

Compilation No. 1

Compilation date: 1 November 2025

Includes amendments: F2025L01037

About this compilation

This compilation

This is a compilation of the Health Insurance (Section 3C Pathology Services – Point-of-Care Testing Services) Determination 2024 that shows the text of the law as amended and in force on 1 November 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. The details of amendments made up to, but not commenced at, the compilation date are underlined in the endnotes. Any uncommenced amendments affecting the law are accessible on the Register (www.legislation.gov.au).

Application, saving and transitional provisions

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.

Presentational changes

The Legislation Act 2003 provides for First Parliamentary Counsel to make presentational changes to a compilation. Presentational changes are applied to give a more consistent look and feel to legislation published on the Register, and enable the user to more easily navigate those documents.

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. Any modifications affecting the law are accessible on the Register.

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If a provision of the compiled law has been repealed in accordance with a provision of the law, details are included in the endnotes.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

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 Pathology Services – PointofCare Testing Services) Determination 2024.

3  Authority

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

4  Definitions

Note: A number of expressions used in this instrument are defined in definitions section of the Act, including the following:

(a) item;

(b) professional service;

(c) schedule fee.

  In this instrument:

Act means the Health Insurance Act 1973.

eligible Aboriginal and Torres Strait Islander health practitioner has the same meaning as in the Health Insurance (Section 3C General Medical Services – Allied Health and other Primary Health Care Services) Determination 2024.

eligible Aboriginal and Torres Strait Islander health worker has the same meaning as in the Health Insurance (Section 3C General Medical Services – Allied Health and other Primary Health Care Services) Determination 2024.

general medical services table means the table prescribed under subsection 4(1) of the Act.

health professional means a practice nurse, eligible Aboriginal and Torres Strait Islander health practitioner or eligible Aboriginal and Torres Strait Islander health worker.

medical practitioner has the same meaning as subsection 3(1) of the Act.

Modified Monash 6 area has the same meaning as in the general medical services table.

Modified Monash 7 area has the same meaning as in the general medical services table.

pathology service has the same meaning as subsection 3(1) of the Act.

pathology services table means the table prescribed under subsection 4A(1) of the Act.

practice nurse has the same meaning as in the general medical services table.

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 pathology 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.

(1) Unless the contrary intention appears, a reference in this instrument 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.

5  Treatment of relevant services

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

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

 (b) there were an item in Group P9 of the pathology 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 Schedule 1 in relation to the service.

Note: For this Determination, an internal Territory is deemed to form part of the State of New South Wales – see subsection 3C(7) of the Act.

6  Application of items

 (1) Item 73813 applies to a service only if:

 (a) the service is rendered at, or from, a practice location in:

 (i) a Modified Monash 6 area; or

 (ii) a Modified Monash 7 area;

 (b) the medical practitioner providing the service, or the health professional providing the service on behalf of a medical practitioner, is employed by an organisation that:

(i) delivers health services; and

  (ii) is participating in the First Nations Molecular PointofCare (PoC) Testing Program;

 (c) the service is provided in accordance with the Program referred to in subparagraph (b)(ii);

 (d) the service is conducted by a medical practitioner, or on behalf of a medical practitioner by a health professional, who has achieved competency as a PoC operator by the First Nations Molecular PoC Testing Program for the test(s) performed;

 (e) the PoC test(s) gives valid patient result(s).

Schedule 1—Relevant services

Group P9—Simple Basic Pathology Tests

Column 1

Item

Column 2

Description

Column 3

Fee ($)

73813

Detection performed by, or on behalf of, a medical practitioner of:

(a) chlamydia trachomatis (CT) and neisseria gonorrhoeae (NG) via molecular pointofcare testing for the diagnosis of CT or NG infection; and

(b) trichomonas vaginalis (TV) via molecular pointofcare testing for the diagnosis of TV infection

117.65

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

orig = original

am = amended

p = page(s)

amdt = amendment

para = paragraph(s)/subparagraph(s)

C[x] = Compilation No. x

/subsubparagraph(s)

ch = Chapter(s)

pres = present

cl = clause(s)

prev = previous

cont. = continued

(prev…) = previously

def = definition(s)

pt = Part(s)

Dict = Dictionary

r = regulation(s)/Court rule(s)

disallowed = disallowed by Parliament

reloc = relocated

div = Division(s)

renum = renumbered

ed = editorial change

rep = repealed

exp = expires/expired or ceases/ceased to have

rs = repealed and substituted

effect

s = section(s)/subsection(s)

gaz = gazette

/rule(s)/subrule(s)/order(s)/suborder(s)

LA = Legislation Act 2003

sch = Schedule(s)

LIA = Legislative Instruments Act 2003

SLI = Select Legislative Instrument

(md) = misdescribed amendment can be given

SR = Statutory Rules

effect

sub ch = SubChapter(s)

(md not incorp) = misdescribed amendment

sub div = Subdivision(s)

cannot be given effect

sub pt = Subpart(s)

mod = modified/modification

underlining = whole or part not

No. = Number(s)

commenced or to be commenced

Ord = Ordinance

 

 

Endnote 3—Legislation history

 

Name

Registration

Commencement

Application, saving and transitional provisions

Health Insurance (Section 3C Pathology Services – PointofCare Testing Services) Determination 2024

26 Sept 2024 (F2024L01221)

1 Nov 2024 (s 2(1) item 1)

 

Health Insurance Legislation Amendment (2025 Measures No. 5) Determination 2025

2 Sept 2025 (F2025L01037)

sch 1 (items 7173): 1 Nov 2025 (s 2(1) item 1)

 

Endnote 4—Amendment history

 

Provision affected

How affected

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

rep LA s 48D

s 4.....................

am F2025L01037

 

ed C1

 

Endnote 5—Editorial changes

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

Section 4 (definition of eligible Aboriginal and Torres Strait Islander health practitioner)

Kind of editorial change

Give effect to the misdescribed amendment as intended and change to typeface

Details of editorial change

Schedule 1 item 71 of the Health Insurance Legislation Amendment (2025 Measures No. 5) Determination 2025 provides as follows:

71 Section 4 (definition of eligible Aboriginal and Torres Strait Islander health practitioner)

After “Allied Health”, insert “and other Primary Health Care”.

The text “Allied Health” does not appear in the definition of eligible Aboriginal and Torres Strait Islander health practitioner in section 4. However, the text “Allied Health” does appear.

This compilation was editorially changed to insert “and other Primary Health Care” after “Allied Healthin the definition of eligible Aboriginal and Torres Strait Islander health practitioner in section 4 to give effect to the misdescribed amendment as intended and to change the typeface to bring it into line with legislative drafting practice.

 

Overview

The Health Insurance (Section 3C Pathology Services – Point-of-Care Testing Services) Determination 2024 was enacted to address the need for the regulation of point-of-care testing services under the Health Insurance Act 1973. This legislative instrument, made under subsection 3C(1) of the Health Insurance Act 1973, aims to provide a structured framework for the provision of point-of-care pathology services, ensuring they are adequately covered and compensated under the Medicare system. The determination was introduced by the Australian Government, specifically by the Minister for Health, and seeks to ensure that such services are accessible and appropriately reimbursed in areas where they are most needed, particularly in remote and rural areas. The overarching policy objective is to enhance healthcare delivery by ensuring that point-of-care testing services are efficiently managed and integrated into the broader Medicare framework.

Scope and Application

The Health Insurance (Section 3C Pathology Services – Point-of-Care Testing Services) Determination 2024 applies to the treatment of certain pathology services, specifically point-of-care testing services, under the Health Insurance Act 1973. It pertains to medical practitioners, health professionals such as practice nurses and eligible Aboriginal and Torres Strait Islander health practitioners or workers, and organisations delivering health services participating in the First Nations Molecular Point-of-Care Testing Program. This determination is applicable in Modified Monash 6 and 7 areas, which are defined in the general medical services table under the Act. The relevant services specified in Schedule 1 of the determination, such as the detection of chlamydia trachomatis, neisseria gonorrhoeae, and trichomonas vaginalis via molecular point-of-care testing, are to be treated as both professional services and pathology services for the purposes of the relevant provisions of the Act. The fee for each service is specified in the Schedule and is applicable across the states of Australia, with internal territories deemed to be part of New South Wales. The determination came into effect on 1 November 2024 and includes amendments from the Health Insurance Legislation Amendment (2025 Measures No. 5) Determination 2025, which commenced on 1 November 2025.

Key Provisions

The Health Insurance (Section 3C Pathology Services – Point-of-Care Testing Services) Determination 2024 (the Determination) sets out the treatment of specific health services under the Health Insurance Act 1973. Section 5 of the Determination provides that relevant services, as defined, are to be treated as both a professional service and a pathology service for the purposes of the Act. It also stipulates that there should be an item in Group P9 of the pathology services table related to the service, specifying a fee for each State (s 5(1)). The Determination is applied in such a way that relevant services are recognised under the Act as both professional and pathology services, with an associated fee structure outlined in Schedule 1 (s 5(1)(a)-(b)). The Determination imposes specific obligations on parties providing relevant services. These obligations include ensuring that the service is rendered at a practice location in a Modified Monash 6 or 7 area, the service provider is employed by an organisation participating in the First Nations Molecular Point-of-Care (PoC) Testing Program, and the service provider has achieved competency in PoC testing for the tests performed (s 6(1)). Additionally, the Determination requires that the PoC tests must yield valid patient results (s 6(1)(e)). Breaches of the obligations and requirements set out in the Determination can result in civil or criminal penalties. Although the Determination itself does not specify penalties, breaches of the Health Insurance Act 1973 can attract significant penalties. For example, under the Act, a person who contravenes a provision of the Act can be subject to a penalty of up to $22,200 for individuals and $111,000 for bodies corporate, with additional penalties for ongoing contraventions (s 134A). Furthermore, more severe breaches can lead to criminal charges, with potential penalties including fines and imprisonment (s 134B).

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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.