Health Insurance (Share by Default) Rules 2025

Health Insurance (Share by Default) Rules 2025

made under the

Health Insurance Act 1973

Compilation No. 1

Compilation date: 1 July 2026

Includes amendments: F2026L00804

About this compilation

This compilation

This is a compilation of the Health Insurance (Share by Default) Rules 2025 that shows the text of the law as amended and in force on 1 July 2026 (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.

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If a provision of the compiled law has been repealed in accordance with a provision of the law, details are included in the endnotes.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 1—Preliminary

1 Name

3 Authority

4 Definitions

Part 2—Sharing health information by default

Division 1—Diagnostic imaging services

5 Diagnostic imaging services—specified professional services and persons

6 Diagnostic imaging services—information to be shared with the My Health Record system

7 Diagnostic imaging services—period for sharing information with the My Health Record system

Division 2—Pathology services

8 Pathology services—specified professional services and persons

9 Pathology services—information to be shared with the My Health Record system

10 Pathology services—period for sharing information with the My Health Record system

Endnotes

Endnote 1—About the endnotes

Endnote 2—Abbreviation key

Endnote 3—Legislation history

Endnote 4—Amendment history

Part 1—Preliminary

1  Name

  This instrument is the Health Insurance (Share by Default) Rules 2025.

3  Authority

  This instrument is made under the Health Insurance Act 1973.

4  Definitions

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

(a) approved pathology practitioner;

(b) My Health Record system;

(c) pathologist‑determinable service;

(d) pathology service;

(e) R‑type diagnostic imaging service.

  In this instrument:

Act means the Health Insurance Act 1973.

compatibility testing purposes means testing conducted on samples from donors and potential recipients in relation to the donation of human organs, tissues, blood and plasma products, cells and fluids, including reproductive cells and materials, for compatibility purposes and where the results are provided in a single summary or report with information about both the donor and potential recipient.

radiologist means a medical practitioner recognised as a specialist in diagnostic radiology:

 (a) under subsection 3D(1) of the Act; or

 (b) by a determination under paragraph 3DB(4)(a) or subsection 3E(1) of the Act that is in effect.

Part 2—Sharing health information by default

Division 1—Diagnostic imaging services

5  Diagnostic imaging services—specified professional services and persons

 (1) For the purposes of subsection 19AD(1) of the Act, this section specifies professional services rendered by or on behalf of persons specified for the service.

 (2) The specified services and persons are:

 (a) an R‑type diagnostic imaging service referred to in an item of the table in Part 2 of Schedule 1 to the Health Insurance (Diagnostic Imaging Services Table) Regulations (No. 2) 2020 that is rendered by or on behalf of a radiologist; and

 (b) a medical service referred to in an item of the table in Part 4 of Schedule 1 to the Health Insurance (General Medical Services Table) Regulations 2021 that is rendered by or on behalf of a radiologist; and

 (c) a health service that:

 (i) under a determination in force under subsection 3C(1) of the Act is treated as if it were an item in a table mentioned in paragraph (a) or (b) of this subsection related to the health service; and

 (ii) is rendered by or on behalf of a radiologist.

6  Diagnostic imaging services—information to be shared with the My Health Record system

 (1) For the purposes of subsection 19AD(1) of the Act, the specified information for a professional service specified in section 5 of this instrument is information that is included in a report or other document that is:

 (a) created in respect of that professional service; and

 (b) authorised by the radiologist who rendered the service, or on whose behalf the service was rendered.

Note: The information is required to be shared with the My Health Record system for medicare benefit to be payable for the service, unless an exception applies.

 (2) Subsection (1) does not apply to images.

7  Diagnostic imaging services—period for sharing information with the My Health Record system

 (1) For the purposes of subsection 19AD(1) of the Act, this section specifies the period within which information specified in section 6 of this instrument for a professional service must be shared with the My Health Record system.

 (2) The specified period is the period of 24 hours beginning at the time the information is first provided to:

 (a) the practitioner who requested the provision of the professional service; or

 (b) if there was no such request—the practitioner who is treating the person to whom the information relates.

Division 2—Pathology services

8  Pathology services—specified professional services and persons

 (1) For the purposes of subsection 19AD(1) of the Act, this section specifies professional services rendered by or on behalf of persons specified for the service.

 (2) The specified services and persons are:

 (a) a pathology service referred to in an item of the table in Part 2 of Schedule 1 to the Health Insurance (Pathology Services Table) Regulations 2020 rendered by or on behalf of an approved pathology practitioner; and

 (b) a health service that:

 (i) under a determination in force under subsection 3C(1) of the Act is treated as if it were an item in the table mentioned in paragraph (a) of this subsection related to the health service; and

 (ii) is rendered by or on behalf of an approved pathology practitioner; and

 (c) a pathologist‑determinable service rendered by or on behalf of an approved pathology practitioner.

 (3) Subsection (2) does not apply to a service that is rendered for compatibility testing purposes.

9  Pathology services—information to be shared with the My Health Record system

  For the purposes of subsection 19AD(1) of the Act, the specified information for a professional service specified in section 8 of this instrument is information that is included in a report or other document that is:

 (a) created in respect of that professional service; and

 (b) authorised by the approved pathology practitioner who rendered the service, or on whose behalf the service was rendered.

Note: The information is required to be shared with the My Health Record system for medicare benefit to be payable for the service, unless an exception applies.

10  Pathology services—period for sharing information with the My Health Record system

 (1) For the purposes of subsection 19AD(1) of the Act, this section specifies the period within which information specified in section 9 of this instrument for a professional service must be shared with the My Health Record system.

 (2) The specified period is the period of 24 hours beginning at the time the information is first provided to:

 (a) the practitioner who requested the provision of the professional service; or

 (b) if there was no such request—the practitioner who is treating the person to whom the information relates.

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

Endnote 3—Legislation history

Endnote 4—Amendment history