Health Insurance (Magnetic Resonance Imaging for Patients 16 Years and Over) Determination 2013
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I, RICHARD BARTLETT, delegate for the Minister for Health, make this Determination under subsection 3C(1) of the Health Insurance Act 1973.
Dated 30th October 2013
______________________
Richard Bartlett
First Assistant Secretary
Medical Benefits Division
Department of Health
Contents
1 Name Of Determination 3
2 Commencement 3
3 Cessation 3
4 Authority 3
5 Interpretation 3
6 Treatment Of Relevant Services 3
7 References In Diagnostic Imaging Services Table 4
Schedule – Relevant Services 5
1 Name of Determination
This Determination is the Health Insurance (Magnetic Resonance Imaging for Patients 16 Years and Over) Determination 2013.
2 Commencement
This Determination commences on 1 November 2013.
3 Cessation
This Determination ceases as if repealed on the cessation or earlier repeal of the Health Insurance (Diagnostic Imaging Services Table) Regulation 2012.
4 Authority
This Determination is made under the Health Insurance Act 1973.
5 Interpretation
(1) In this Determination:
Act means the Health Insurance Act 1973.
relevant provision means any provision relating to professional services, medical services or items, of the Act and regulations made under the Act, and the National Health Act 1953 and regulations made under that Act.
relevant service means a health service, as defined in subsection 3C(8) of the Act, that is specified in Schedule 1.
(2) Unless the contrary intention appears, a reference to a provision of the Act or regulations made under the Act or the National Health Act 1953 or regulations made under that Act is a reference to those provisions as in force from time to time.
6 Treatment of relevant services
A relevant service provided in accordance with this Determination shall be treated for a relevant provision as if:
(a) it were both a professional service and a medical service; and
(b) there were an item in Group I5 of the diagnostic imaging services table that:
(i) related to the service; and
(ii) specified a fee for the service in relation to each State, being the fee specified in the Schedule 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.
7 References in diagnostic imaging services table
The following provisions of the diagnostic imaging services table shall have effect as if items 63551, 63554, 63557 and 63560 were also specified in the provision:
(a) subclause 2.5.1(4);
(b) clause 2.5.7;
(c) item 15 of the table in subclause 2.5.9(2);
(d) Dictionary, definition of scan.
Schedule – Relevant services
Item
Service
Fee for all States ($)
63551
Scan of head for a patient 16 years or older, after referral by a medical practitioner (other than a specialist or consultant physician), for any of the following:
(a) unexplained seizure(s);
(b) unexplained chronic headache with suspected intracranial pathology (R) (K) (Contrast) (Anaes.)
403.20
63554
Scan of spine for a patient 16 years or older, after referral by a medical practitioner (other than a specialist or consultant physician), for suspected cervical radiculopathy (R) (K) (Contrast) (Anaes.)
358.40
63557
Scan of spine for a patient 16 years or older, after referral by a medical practitioner (other than a specialist or consultant physician), for suspected cervical spinal trauma (R) (K) (Contrast) (Anaes.)
492.80
63560
Scan of knee following acute knee trauma, after referral by a medical practitioner (other than a specialist or consultant physician), for a patient 16 years or older with:
(a) inability to extend the knee suggesting the possibility of acute meniscal tear; or
(b) clinical findings suggesting acute anterior cruciate ligament tear (R) (K) (Contrast) (Anaes.)
403.20
