Health Insurance (Diagnostic Imaging Services Table) Amendment (2014 Measures No. 1) Regulation 2014
Select Legislative Instrument No. 79, 2014
I, General the Honourable Sir Peter Cosgrove AK MC (Ret’d), Governor‑General of the Commonwealth of Australia, acting with the advice of the Federal Executive Council, make the following regulation.
Dated 12 June 2014
Peter Cosgrove
Governor‑General
By His Excellency’s Command
Peter Dutton
Minister for Health
Contents
1............ Name of regulation.............................................................................. 1
2............ Commencement................................................................................... 1
3............ Authority............................................................................................. 1
4............ Schedule(s)......................................................................................... 1
Schedule 1—Amendments 2
Health Insurance (Diagnostic Imaging Services Table) Regulation 2013 2
1 Name of regulation
This regulation is the Health Insurance (Diagnostic Imaging Services Table) Amendment (2014 Measures No. 1) Regulation 2014.
2 Commencement
This regulation commences on 1 July 2014.
3 Authority
This regulation is made under the Health Insurance Act 1973.
4 Schedule(s)
Each instrument that is specified in a Schedule to this instrument is amended or repealed as set out in the applicable items in the Schedule concerned, and any other item in a Schedule to this instrument has effect according to its terms.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—Amendments
Health Insurance (Diagnostic Imaging Services Table) Regulation 2013
1 Clause 1.2.1 of Schedule 1
Repeal the clause, substitute:
1.2.1 Application of (K) items and (NK) items
(1) Subject to clause 1.2.3, an (NK) item applies to a service that is performed on:
(a) diagnostic imaging equipment:
(i) that has not been upgraded; and
(ii) the age of which exceeds the new effective life age for the equipment; or
(b) diagnostic imaging equipment:
(i) that has been upgraded; and
(ii) the age of which exceeds the maximum extended life age for the equipment.
(2) A (K) item does not apply to a service to which an (NK) item applies.
2 Subclauses 1.2.3(1) to (3) of Schedule 1
Omit “An item that includes the symbol (NK) at the end of the item”, substitute “An (NK) item”.
3 After paragraph 1.2.3(6)(a) of Schedule 1
Insert:
(aa) all of the following subparagraphs apply:
(i) the diagnostic imaging equipment is used to perform a service to which an item in Group I2 in Division 2.2 applies;
(ii) the diagnostic imaging equipment is ordinarily located at diagnostic imaging premises;
(iii) the diagnostic imaging premises are located in RA1;
(iv) the diagnostic imaging premises are not located in RRMA4 or RRMA5;
(v) while the Health Insurance (Diagnostic Imaging Services Table) Regulation 2012 was in force, a service performed using the diagnostic imaging equipment at the diagnostic imaging premises was a service performed in a remote location; or
4 At the end of clause 1.2.3 of Schedule 1
Add:
(8) Paragraph (6)(aa) and this subclause expire at the end of 30 June 2016 as if they had been repealed by another regulation.
5 Schedule 1 (item 55014, column headed “Description”, paragraph (f))
Omit “55020, 55038, 55044, 55731 or 55732”, substitute “55038, 55065 or 55067”.
6 Schedule 1 (item 55017, column headed “Description”, paragraph (e))
Omit “55020, 55038, 55044, 55731 or 55732”, substitute “55038, 55065 or 55067”.
7 Schedule 1 (item 55036, column headed “Description”, paragraph (f))
Omit “55020, 55038, 55044, 55731 or 55732”, substitute “55038, 55065 or 55067”.
8 Schedule 1 (item 55038, column headed “Description”, paragraph (e))
Omit “55020, 55036, 55044, 55731 or 55732”, substitute “55036, 55065 or 55067”.
9 Schedule 1 (item 55063, column headed “Description”, paragraph (d))
Omit “55020, 55036, 55038, 55044, 55600, 55601, 55603, 55604, 55731 or 55732”, substitute “55036, 55038, 55065, 55067, 55600, 55601, 55603 or 55604”.
10 Schedule 1 (item 55064, column headed “Description”, paragraph (c))
Omit “55022, 55037, 55039, 55045, 55600, 55601, 55603, 55604, 55733 or 55734”, substitute “55037, 55039, 55068, 55069, 55600, 55601, 55603 or 55604”.
11 Schedule 1 (after item 55064)
Insert:
55065
Pelvis, ultrasound scan of, by any or all approaches, if:
(a) the patient is referred by a medical practitioner for ultrasonic examination; and
(b) the medical practitioner is not a member of a group of practitioners of which the providing practitioner is a member; and
(c) the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and
(d) the service is not solely a transrectal ultrasonic examination of the prostate gland, bladder base and urethra, or any of those organs; and
(e) within 24 hours of the service, a service mentioned in item 55014, 55017, 55036 or 55038 is not performed on the same patient by the providing practitioner (R) (K)
98.25
55067
Pelvis, ultrasound scan of, by any or all approaches, if:
(a) the patient is referred by a medical practitioner for ultrasonic examination; and
(b) the medical practitioner is not a member of a group of practitioners of which the providing practitioner is a member; and
(c) the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and
(d) the service is not solely a transrectal ultrasonic examination of the prostate gland, bladder base and urethra, or any of those organs; and
(e) within 24 hours of the service, a service mentioned in item 55014, 55017, 55036 or 55038 is not performed on the same patient by the providing practitioner (R) (NK)
50.25
55068
Pelvis, ultrasound scan of, by any or all approaches, if:
(a) the patient is not referred by a medical practitioner; and
(b) the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and
(c) the service is not solely a transrectal ultrasonic examination of the prostate gland, bladder base and urethra, or any of those organs (NR) (K)
35.00
55069
Pelvis, ultrasound scan of, by any or all approaches, if:
(a) the patient is not referred by a medical practitioner; and
(b) the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and
(c) the service is not solely a transrectal ultrasonic examination of the prostate gland, bladder base and urethra, or any of those organs (NR) (NK)
17.85
12 Schedule 1 (item 55084, column headed “Description”, paragraph (d))
Omit “55020, 55036, 55038, 55044, 55600, 55601, 55603, 55604, 55731 or 55732”, substitute “55036, 55038, 55065, 55067, 55600, 55601, 55603 or 55604”.
13 Schedule 1 (item 55085, column headed “Description”, paragraph (c))
Omit “55045, 55600, 55601, 55603, 55604, 55733 or 55734”, substitute “55068, 55069, 55600, 55601, 55603 or 55604”.
14 Part 3 of Schedule 1 (definition of (Anaes.))
Relocate the definition to its appropriate alphabetical position, determined on a letter‑by‑letter basis.
15 Part 3 of Schedule 1 (definitions of (K) and (NK))
Repeal the definitions.
16 Part 3 of Schedule 1 (definitions of (NR) and (R))
Relocate the definitions to their appropriate alphabetical positions, determined on a letter‑by‑letter basis.
17 Part 3 of Schedule 1
Insert:
(K) item means an item that includes the symbol (K) at the end of the item.
(NK) item means an item that includes the symbol (NK) at the end of the item.
18 Amendments of listed provisions—repeals
Repeal the following provisions:
(a) item 55020 of Schedule 1;
(b) item 55022 of Schedule 1;
(c) item 55044 of Schedule 1;
(d) item 55045 of Schedule 1;
(e) item 55731 of Schedule 1;
(f) item 55732 of Schedule 1;
(g) item 55733 of Schedule 1;
(h) item 55734 of Schedule 1.
