Private Health Insurance Legislation Amendment Rules (No. 7) 2020

(F2020L01378)

30 October 2020

Private Health Insurance Act 2007

1   Name

This instrument is the Private Health Insurance Legislation Amendment Rules (No. 7) 2020.

2   Commencement

 

(1) Each provision of this instrument specified in column 1 of the table commences, or is taken to have commenced, in accordance with column 2 of the table. Any other statement in column 2 has effect according to its terms.

Commencement information

   

Column 1

Column 2

Column 3

Provisions

Commencement

Date/Details

1. The whole of this instrument

1 November 2020.

1 November 2020.

Note: This table relates only to the provisions of this instrument as originally made. It will not be amended to deal with any later amendments of this instrument.

      

(2) Any information in column 3 of the table is not part of this instrument. Information may be inserted in this column, or information in it may be edited, in any published version of this instrument.

3   Authority

This instrument is made under section 333-20 of the Private Health Insurance Act 2007.

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Each instrument that is specified in a Schedule to this instrument is amended or repealed as set out in the applicable items in the Schedule concerned, and any other item in a Schedule to this instrument has effect according to its terms.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

Private Health Insurance (Benefit Requirements) Rules 2011

1   Repeal Clause 4(3) of Schedule 1, substitute:

(3) The MBS item numbers for this clause are those set out in the following table, but only where those items have a fee in the MBS greater than $879.60:

Type A procedures: Advanced surgical patient – list of MBS items

15600 30176 30177 30179 30250 30251 30255 30275 30294 30296 30297 30315 30317 30318 30320 30323 30324 30335 30336 30379 30382 30384 30388 30396 30405 30415 30417 30418 30421 30425 30427 30428 30430 30438 30448 30449 30454 30455 30457 30458 30460 30461 30463 30464 30466 30467 30469 30472 30500 30502 30503 30506 30508 30509 30517 30518 30521 30523 30524 30526 30527 30529 30532 30533 30535 30536 30538 30539 30541 30542 30545 30547 30548 30550 30551 30553 30554 30556 30557 30560 30565 30566 30577 30578 30580 30583 30584 30589 30590 30593 30594 30596 30599 30601 30602 30603 30605 30606 30608 30640 30680 30682 30684 30686 31002 31409 31412 31429 31432 31435 31438 31464 31466 31468 31472 31516 31524 31572 31581 31584 32000 32003 32004 32005 32006 32009 32012 32015 32018 32024 32025 32026 32028 32030 32033 32036 32039 32042 32047 32051 32054 32060 32063 32069 32104 32106 32108 32117 32209 32220 32221 32514 32517 32700 32703 32708 32710 32711 32712 32715 32718 32721 32724 32730 32733 32739 32742 32745 32748 32751 32754 32763 33050 33055 33075 33080 33100 33103 33109 33112 33115 33116 33118 33119 33121 33124 33127 33130 33133 33136 33139 33142 33145 33148 33151 33154 33157 33160 33163 33166 33169 33172 33175 33178 33181 33500 33506 33509 33512 33515 33518 33521 33524 33527 33530 33533 33536 33539 33542 33800 33803 33811 33812 33815 33818 33821 33824 33827 33830 33833 33836 33839 33842 34112 34115 34118 34121 34124 34127 34136 34139 34142 34148 34151 34154 34157 34160 34163 34166 34169 34172 34175 34509 34512 34518 34533 34803 34806 34809 34812 34815 34818 34821 34833 35003 35006 35009 35307 35312 35315 35320 35412 35414 35551 35552 35561 35562 35585 35595 35597 35641 35661 35664 35667 35670 35697 35753 35754 36503 36506 36516 36519 36522 36525 36528 36529 36531 36532 36533 36543 36564 36567 36570 36573 36576 36588 36591 36594 36597 36600 36603 36606 36610 36611 36645 36656 37014 37015 37016 37018 37019 37021 37029 37040 37042 37045 37047 37048 37053 37200 37203 37207 37209 37210 37211 37213 37214 37220 37230 37245 37309 37338 37340 37344 37338 37341 37343 37372 37375 37384 37390 37405 37411 37423 37426 37432 37607 37610 37824 37825 37831 37842 37848 37851 38212 38231 38237 38240 38246 38270 38272 38273 38274 38276 38287 38290 38293 38309 38312 38315 38318 38358 38368 38384 38390 38418 38421 38424 38427 38438 38440 38441 38446 38447 38449 38450 38453 38455 38456 38457 38466 38468 38469 38470 38477 38478 38480 38481 38483 38487 38488 38489 38493 38495 38497 38498 38500 38501 38503 38504 38506 38507 38508 38509 38512 38515 38518 38550 38553 38556 38559 38562 38565 38568 38571 38572 38600 38603 38615 38618 38624 38640 38643 38647 38650 38653 38654 38656 38670 38673 38677 38680 38700 38703 38706 38709 38712 38715 38718 38721 38724 38727 38730 38733 38736 38739 38742 38745 38748 38751 38754 38757 38760 38763 38766 39109 39113 39124 39139 39315 39503 39604 39612 39615 39638 39639 39641 39651 39654 39656 39700 39703 39710 39712 39715 39718 39720 39801 39803 39815 39818 39821 39900 39903 40004 40012 40104 40106 40109 40112 40119 40600 40700 40703 40706 40709 40712 40801 40803 40850 40851 40860 41518 41521 41530 41533 41536 41539 41542 41551 41554 41557 41560 41563 41564 41566 41569 41572 41575 41576 41578 41579 41581 41584 41587 41590 41593 41596 41599 41608 41614 41615 41617 41618 41623 41635 41638 41728 41734 41782 41785 41834 41837 41840 41843 41879 42521 42539 42543 42545 42557 42569 42626 42653 42656 42662 42672 42705 42710 42716 42725 42731 42746 42749 42752 42767 42773 42776 42779 42801 42842 42851 42860 43801 43804 43807 43810 43813 43816 43819 43822 43825 43828 43831 43834 43837 43838 43840 43843 43846 43852 43855 43861 43864 43870 43873 43876 43879 43882 43900 43903 43906 43909 43912 43915 43936 43945 43951 43954 43957 43963 43966 43969 43972 43975 43978 43984 43987 43990 43993 43996 44334 44373 45006 45036 45060 45061 45062 45215 45415 45418 45460 45461 45464 45465 45466 45468 45469 45471 45472 45474 45475 45477 45478 45480 45481 45483 45484 45490 45491 45492 45494 45500 45501 45502 45503 45504 45505 45520 45523 45528 45530 45533 45539 45558 45561 45562 45563 45564 45565 45566 45570 45587 45588 45596 45597 45599 45624 45641 45644 45646 45647 45660 45661 45686 45720 45723 45726 45729 45731 45732 45735 45738 45741 45744 45747 45752 45753 45754 45767 45770 45773 45776 45779 45782 45785 45788 45791 45853 45861 45863 45869 45871 45873 45897 46315 46318 46321 46393 46477 46504 46507 47486 47489 47501 47504 47507 47510 47519 47525 47531 47534 47566 47588 47591 48203 48427 48512 48918 48921 48924 48933 48939 48942 48951 48954 48957 48960 49106 49115 49116 49117 49210 49211 49306 49312 49318 49319 49321 49324 49327 49330 49333 49339 49342 49345 49512 49517 49518 49519 49521 49524 49527 49530 49533 49536 49539 49542 49548 49551 49554 49564 49715 49716 49717 49836 49838 49842 50212 50215 50218 50221 50224 50227 50230 50233 50236 50239 50300 50303 50306 50321 50324 50327 50336 50351 50354 50366 50372 50378 50384 50394 50399 50408 50411 50414 50417 50420 50423 50450 50451 50455 50456 50460 50461 50465 50466 50470 50471 50475 50476 50604 50608 50612 50620 50624 50628 50632 50636 50640 50644 51011 51012 51013 51014 51015 51021 51022 51023 51024 51025 51026 51031 51032 51033 51034 51035 51036 51041 51042 51043 51044 51045 51051 51052 51053 51054 51055 51056 51057 51058 51059 51061 51062 51063 51064 51065 51066 51071 51072 51073 51102 51103 51130 51131 51160 51165 51170 51171 52123 52126 52129 52158 52337 52342 52345 52348 52351 52354 52357 52360 52363 52366 52369 52372 52375 52379 52380 52382 52430 52446 52821 53209 53212 53221 53224 53227 53230 53233

2   Repeal Clause 6(3) of Schedule 1, substitute:

(3) The MBS item numbers for this clause are those set out in the following table, but only where those items have a fee in the MBS within the range of $261.90 to $879.60:

Type A procedures: Surgical patient – list of MBS items

13212 13218 13251 13700 13834 13837 14234 14237 15303 15304 15307 15308 15311 15312 15315 15316 15319 15320 15323 15324 15327 15328 15331 15332 15335 15336 15345 16567 16570 16571 16573 30017 30020 30023 30024 30068 30111 30114 30165 30168 30171 30172 30190 30225 30229 30235 30241 30244 30246 30247 30253 30256 30272 30286 30287 30289 30293 30299 30300 30302 30303 30306 30310 30314 30326 30330 30332 30373 30375 30376 30378 30385 30387 30391 30392 30393 30394 30399 30400 30402 30403 30408 30414 30416 30419 30422 30431 30433 30434 30436 30437 30440 30443 30445 30446 30450 30451 30452 30475 30479 30481 30484 30485 30490 30491 30492 30494 30495 30496 30497 30499 30505 30515 30520 30530 30544 30559 30562 30563 30564 30568 30569 30571 30572 30575 30581 30586 30587 30597 30600 30609 30611 30614 30615 30618 30619 30621 30622 30623 30626 30629 30635 30637 30639 30641 30642 30643 30644 30645 30646 30672 30676 30688 30690 30692 30694 30696 30710 31000 31001 31003 31004 31005 31225 31245 31250 31340 31350 31355 31400 31403 31406 31423 31426 31450 31452 31454 31460 31462 31470 31500 31503 31506 31509 31512 31515 31519 31525 31554 31569 31575 31578 32021 32023 32029 32045 32046 32057 32066 32094 32096 32099 32102 32103 32105 32111 32112 32120 32123 32126 32129 32131 32138 32139 32150 32159 32162 32165 32180 32183 32186 32200 32203 32206 32210 32213 32214 32216 32504 32507 32508 32511 32736 32757 32760 32766 32769 33070 33545 33548 33551 33554 33806 33810 33845 33848 34100 34103 34106 34109 34130 34133 34145 34500 34503 34515 34521 34524 34527 34528 34529 34534 34538 34800 34824 34827 34830 35000 35012 35100 35202 35300 35303 35306 35309 35317 35319 35321 35324 35327 35330 35331 35360 35361 35362 35363 35404 35406 35408 35410 35508 35530 35533 35534 35536 35539 35542 35548 35560 35564 35565 35566 35568 35570 35571 35573 35577 35578 35581 35582 35596 35599 35602 35605 35612 35613 35622 35623 35634 35635 35636 35637 35638 35645 35648 35649 35653 35657 35658 35673 35677 35678 35680 35684 35688 35694 35700 35710 35713 35717 35720 35723 35726 35750 35756 35759 36502 36508 36509 36537 36546 36549 36552 36558 36579 36585 36604 36607 36608 36609 36612 36615 36618 36621 36624 36627 36633 36636 36639 36649 36652 36654 36663 36664 36666 36803 36806 36809 36811 36818 36821 36822 36823 36833 36840 36842 36845 36854 36863 37000 37004 37008 37020 37023 37026 37038 37039 37043 37044 37046 37050 37201 37202 37206 37208 37215 37221 37224 37227 37233 37306 37318 37327 37330 37333 37336 37342 37345 37348 37351 37354 37381 37387 37396 37402 37408 37417 37418 37429 37438 37601 37604 37605 37606 37613 37616 37619 37800 37801 37803 37804 37806 37807 37809 37810 37812 37813 37818 37819 37821 37822 37827 37828 37830 37833 37834 37836 37839 37845 37854 38200 38203 38206 38209 38213 38215 38218 38222 38225 38228 38234 38241 38243 38256 38275 38300 38303 38306 38350 38353 38356 38362 38365 38371 38387 38393 38415 38430 38448 38452 38458 38460 38462 38464 38473 38475 38485 38490 38496 38505 38577 38588 3860938612 38613 38621 38627 38637 39015 39018 39118 39121 39125 39126 39127 39128 39130 39134 39137 39138 39140 39300 39303 39306 39309 39312 39318 39321 39323 39324 39327 39330 39331 39333 39610 39906 40701 40704 40705 4070840852 40854 40856 40858 40905 41512 41515 41524 41527 41545 41548 41603 41611 41620 41629 41671 41672 41707 41710 41713 41716 41722 41725 41729 41731 41737 41743 41746 41749 41752 41767 41770 41773 41776 41779 41786 41787 41789 41793 41813 41825 41831 41855 41858 41861 41864 41867 41868 41870 41873 41876 41880 41881 41885 41895 41898 41901 41905 41910 42505 42506 42509 42510 42512 42515 42518 42527 42530 42533 42536 42542 42548 42551 42554 42563 42574 42584 42590 42596 42599 42602 42605 42608 42623 42629 42635 42638 42641 42665 42680 42686 42692 42695 42698 42701 42702 42703 42704 42707 42713 42719 42734 42740 42743 42758 42761 42764 42770 42782 42785 42788 42791 42802 42805 42806 42807 42808 42809 42810 42815 42818 42833 42836 42839 42848 42854 42857 42863 42866 42869 43021 43022 43506 43509 43512 43515 43518 43521 43524 43805 43832 43835 43841 43849 43858 43867 43930 43933 43939 43960 43981 43999 44101 44102 44108 44111 44114 44130 44133 44325 44328 44331 44350 44354 44359 44361 44364 44367 44370 45000 45003 45009 45012 45015 45018 45019 45024 45026 45035 45042 45045 45048 45051 45200 45201 45202 45203 45206 45207 45209 45218 45221 45227 45233 45236 45239 45240 45403 45406 45409 45412 45439 45442 45445 45448 45451 45462 45485 45486 45487 45488 45489 45493 45496 45497 45498 45512 45519 45522 45524 45527 45536 45542 45545 45548 45551 45553 45554 45556 45560 45568 45569 45572 45575 45578 45581 45584 45585 45590 45593 45602 45605 45608 45611 45614 45620 45623 45626 4562745629 45632 45635 45652 45653 45656 45659 45662 45665 45668 45669 45671 45675 45676 45677 45680 45683 45689 45692 45695 45698 45701 45704 45707 45710 45713 45714 45716 45755 45758 45761 45794 45803 45809 45811 45813 45815 45817 45819 45821 45825 45827 45831 45833 45835 45837 45839 45841 45843 45845 45849 45855 45857 45859 45865 45867 45875 45877 45879 45885 45888 45891 45939 45984 45987 45990 45993 46300 46303 46306 46307 46309 46312 46324 46325 46330 46333 46336 46339 46342 46345 46351 46354 46357 46360 46372 46375 46378 46381 46384 46387 46390 46396 46399 46402 46405 46408 46411 46414 46417 46423 46426 46429 46432 46435 46441 46442 46444 46447 46453 46462 46468 46471 46474 46480 46483 46489 46492 46500 46501 46502 46503 46510 46522 47012 47021 47027 47033 47048 47051 47054 47063 47066 47310 47313 47316 47319 47357 47364 47370 47373 47381 47384 47385 47386 47387 47390 47393 47399 47402 47408 47417 47420 47426 47429 47432 47435 47438 47441 47447 47450 47451 47453 47456 47459 47468 47480 47483 47495 47498 47513 47516 47522 47528 47537 47546 47549 47552 47555 47558 47561 47564 47565 47567 47570 47573 47582 47585 47597 47600 47603 47609 47612 47615 47618 47621 47624 47630 47648 47654 47657 47732 47741 47753 47756 47765 47768 47771 47774 47777 47780 47783 47786 47789 47920 47930 47936 47954 47957 47966 47969 47975 47982 48200 48206 48209 48212 48215 48218 48221 48224 48227 48230 48233 48236 48239 48242 48400 48403 48406 48409 48412 48415 48418 48421 48424 48500 48503 48506 48900 48903 48906 48909 48912 48915 48927 48930 48936 48945 48948 49100 49103 49109 49112 49118 49121 49200 49203 49206 49209 49215 49218 49221 49224 49227 49300 49303 49309 49315 49336 49346 49360 49363 49366 49500 49503 49506 49509 49515 49534 49545 49557 49558 49559 49560 49561 49562 49563 49566 49569 49700 49703 49706 49709 49712 49718 49724 49727 49728 49812 49815 49818 49821 49824 49827 49830 49833 49837 49839 49845 49854 49857 49860 49863 49866 50102 50103 50104 50106 50109 50112 50118 50121 50127 50130 50201 50203 50206 50209 50309 50312 50315 50318 50333 50339 50342 50345 50353 50357 50360 50363 50369 50375 50381 50387 50393 50396 50402 50405 50426 50500 50504 50508 50512 50516 50520 50524 50528 50532 50536 50540 50544 50548 50552 50556 50560 50564 50568 50572 50576 50580 50584 50588 50600 50616 50650 50654 50950 50952 51020 51110 51111 51114 51115 51140 51141 51145 51150 51900 51904 51906 52018 52035 52039 52048 52051 52054 52059 52063 52066 52078 52090 52092 52094 52095 52105 52108 52111 52114 52117 52120 52122 52130 52131 52138 52141 52144 52147 52148 52182 52184 52186 52300 52303 52306 52312 52315 52321 52324 52330 52333 52336 52339 52378 52424 52440 52442 52444 52450 52452 52456 52458 52460 52480 52482 52484 52600 52603 52609 52612 52615 52618 52621 52624 52626 52627 52633 52800 52803 52806 52809 52812 52815 52818 52824 52828 52830 52832 53006 53009 53015 53016 53017 53019 53215 53218 53220 53225 53226 53236 53239 53242 53406 53409 53412 53413 53414 53415 53416 53418 53419 53422 53423 53424 53425 53427 53429 53453 53455 53460 55135 57351

3   Repeal Clause 4(1)(a) of Schedule 3, substitute:

(1) Hospital treatment that involves a professional service of the type identified by the MBS item number specified in this subclause is Band 1 treatment for the purposes of the tables in clause 2 of this Schedule:

a) category 3¯therapeutic procedures, being the items below in the general medical services table:

Type B Band 1 - T1: Miscellaneous Therapeutic Procedures:

13100 13103 13706 13950

Type B Band 1 – T8: Surgical Operations

30210 30473 30475 30478 30679 32075 32084 32087 32095 32215 35500 35539 35545 35703 36665 39000 39100 41604 41647 41674 42575 42741 45027 50658; and

4   Repeal Clause 5(1) of Schedule 3, substitute:

(1) Hospital treatment that involves a professional service of the type identified by the MBS item number specified in the following table in this clause is a non-band specific Type B day procedure:

Non-band specific Type B day procedures – list of MBS items

111 117 120 6080 6081 11919 13110 13212 13215 13292 13318 13750 13755 13757 13815 14218 14247 14249 15338 15513 15539 16512 16603 16618 18216 18230 18242 18274 18276 18280 18284 18286 18290 18294 18296 18298 18375 18379 30042 30045 30055 30081 30084 30087 30094 30096 30099 30103 30104 30105 30107 30187 30189 30190 30223 30225 30262 30269 30281 30283 30390 30391 30409 30484 30627 30630 30658 30687 31225 31340 31345 31346 31350 31355 31356 31358 31359 31360 31361 31363 3136431367 31369 31371 31372 31373 31374 31375 3137631456 31458 31530 31551 31557 31560 31563 31566 31590 32094 32145 32147 32150 32153 32156 32168 32171 32177 32180 32217 32222 32223 32224 32225 32226 32227 32228 32229 32504 34109 34130 34500 34503 34506 34524 34539 35324 35507 35508 35509 35513 35517 35520 35523 35527 35542 35557 35569 35572 35611 35615 35616 35618 35622 35623 35626 35627 35630 35633 35637 35640 35643 35644 35645 35646 35647 35648 35688 35730 36504 36505 36507 36561 36650 36667 36668 36812 36815 36818 36821 36822 36823 36824 36827 36830 36833 36836 36840 36860 37011 37215 37216 37217 37218 37219 37226 37318 37321 37324 37339 37354 37369 37435 37623 37803 37806 37809 37812 37815 37816 37854 38285 38286 38288 39013 39118 39133 39135 39140 39331 4070241503 41506 41509 41626 41629 41632 41644 41650 41653 41668 41677 41701 41716 41764 41801 41816 41822 41825 41831 41855 41858 41861 41864 41886 41889 41892 41898 42503 42504 42572 42573 42576 42584 42593 42610 42611 42652 42673 42680 42683 42686 42689 42692 42738 42739 42812 42818 42833 42845 42869 43942 43948 44102 44104 44105 44136 44338 44376 45019 45030 45033 45039 45200 45224 45239 45506 45515 45626 45665 45668 45823 46327 46330 46336 46363 46366 46369 46396 46420 46423 46438 46441 46450 46486 46489 46494 46495 46501 46510 46525 47738 47906 47915 47918 47927 47972 48945 49218 49557 49700 49800 49803 49806 49809 50100 50115 51112 51113 51120 51902 52015 52025 52042 52045 52057 52058 52061 52062 52064 52072 52073 52075 52081 52084 52087 52097 52099 52102 52180 52321 52826 53003 53006 53009 53054 53056 53058 53060 53062 53064 53070 53206 53215 53218 53225 53410 53459 58939 59903 59912 59925 59970 59971 59972 59973 59974 60000 60001 60003 60004 60006 60007 60009 60010 60012 60013 60015 60016 60018 60019 60021 60022 60024 60025 60027 60028 60030 60031 60033 60034 60036 60037 60039 60040 60042 60043 60045 60046 60048 60049 60051 60052 60054 60055 60057 60058 60060 60061 60063 60064 60066 60067 60069 60070 60072 60073 60075 60076 60078 60079

Schedule 2   Amendments - Type C procedures

Private Health Insurance (Benefit Requirements) Rules 2011

1   Clause 8 of Schedule 3 (Category 2 – Diagnostic procedures & investigations, under the heading "D1:")

Omit "11006", "11009" and "11919".

2   Clause 8 of Schedule 3 (Category 3 – Therapeutic procedures, under the heading "T1:")

Omit "13709", "13760", "13939", "13942", and "13945".

3   Clause 8 of Schedule 3 (Category 3 – Therapeutic procedures, under the heading "T8")

Omit "37217" and "37218".

After "37303", insert "37388".

4   Clause 8 of Schedule 3 (Category 5 – Diagnostic Imaging Services, under the heading "I2")

Omit "57355", insert "57357".

Schedule 3   Amendments - Clinical categories, Common and Support Treatments

Private Health Insurance (Complying Product) Rules 2015

1   Clause 2 of Schedule 5 (table dealing with Clinical categories)

Repeal the table, substitute:

Clinical categories table

   

Clinical category

Scope of cover (see Note 1)

Treatments that must be covered (MBS Items) (see Notes 1, 2 and 3)

Rehabilitation

Hospital treatment for physical rehabilitation for a patient related to surgery or illness.

For example: inpatient and admitted day patient rehabilitation, stroke recovery, cardiac rehabilitation.

 

Hospital psychiatric services

Hospital treatment for the treatment and care of patients with psychiatric, mental, addiction or behavioural disorders.

For example: psychoses such as schizophrenia, mood disorders such as depression, eating disorders and addiction therapy.

Treatments involving the provision of the following MBS items:
170, 171, 172, 289, 297, 320, 322, 324, 326, 328, 342, 344, 346, 348, 350, 352, 364, 366, 367, 369, 370, 855, 857, 858, 861, 864, 866, 2700, 2701, 2712, 2713, 2715, 2717, 2721, 2723, 2725, 2727, 6018, 6019, 6023, 6024, 6025, 6026, 6028, 6029, 6031, 6032, 6034, 6035, 6037, 6038, 6042, 90250, 90251, 90252, 90253, 90254, 90255, 90256, 90257, 90264, 90265, 90272, 90274, 90276, 90278, 91285, 91287, 91723, 91727, 93300, 93303, 93306, 93309, 14224, 80005, 80015, 80020, 80101, 80105, 80115, 80120, 80130, 80140, 80145, 80155, 80165, 80170

Palliative care

Hospital treatment for care where the intent is primarily providing quality of life for a patient with a terminal illness, including treatment to alleviate and manage pain.

Treatments involving the provision of the following MBS items:
3005, 3010, 3014, 3015, 3018, 3023, 3028, 3032, 3040, 3044, 3051, 3055, 3062, 3069, 3074, 3078, 3083, 3088, 3093

Assisted reproductive services

Hospital treatment for fertility treatments or procedures.

For example: retrieval of eggs or sperm, In vitro Fertilisation (IVF), and Gamete Intra-fallopian Transfer (GIFT).

Treatment of the female reproductive system is listed separately under Gynaecology.

Pregnancy and birth-related services are listed separately under Pregnancy and birth.

Treatments involving the provision of the following MBS items:
13200, 13201, 13202, 13203, 13206, 13209, 13212, 13215, 13218, 13221, 13251, 13260, 13290, 13292, 14203, 14206, 37605, 37606

Back, neck and spine

Hospital treatment for the investigation and treatment of the back, neck and spinal column, including spinal fusion.

For example: sciatica, prolapsed or herniated disc, and spine curvature disorders such as scoliosis, kyphosis and lordosis.

Joint replacements are listed separately under Joint replacements.

Joint fusions are listed separately under Bone, joint and muscle.

Spinal cord conditions are listed separately under Brain and nervous system.

Management of back pain is listed separately under Pain management. Pain management that requires a device is listed separately under Pain management with device.

Chemotherapy and radiotherapy for cancer is listed separately under Chemotherapy, radiotherapy and immunotherapy for cancer.

Treatments involving the provision of the following MBS items:
30672, 44133, 50600, 50604, 50608, 50612, 50616, 50620, 50624, 50628, 50632, 50636, 50640, 50644, 51020, 51021, 51022, 51023, 51024, 51025, 51026, 51031, 51032, 51033, 51034, 51035, 51036, 51041, 51042, 51043, 51044, 51045, 51051, 51052, 51053, 51054, 51055, 51056, 51057, 51058, 51059, 51061, 51062, 51063, 51064, 51065, 51066, 51071, 51072, 51073, 51102, 51103, 51110, 51111, 51112, 51113, 51114, 51115, 51120, 51130, 51131, 51140, 51141, 51145, 51150, 51160, 51165, 51170, 51171

Blood

Hospital treatment for the investigation and treatment of blood and blood-related conditions.

For example: blood clotting disorders and bone marrow transplants.

Treatment for cancers of the blood is listed separately under Chemotherapy, radiotherapy and immunotherapy for cancer.

Treatments involving the provision of the following MBS item:
13700

Bone, joint and muscle

Hospital treatment for the investigation and treatment of diseases, disorders and injuries of the musculoskeletal system.

For example: carpal tunnel, fractures, hand surgery, joint fusion, bone spurs, osteomyelitis and bone cancer.

Chest surgery is listed separately under Lung and chest.

Spinal cord conditions are listed separately under Brain and nervous system.

Spinal column conditions are listed separately under Back, neck and spine.

Joint reconstructions are listed separately under Joint reconstructions.

Joint replacements are listed separately under Joint replacements.

Podiatric surgery performed by a registered podiatric surgeon is listed separately under Podiatric surgery (provided by a registered podiatric surgeon).

Management of back pain is listed separately under Pain management. Pain management that requires a device is listed separately under Pain management with device.

Chemotherapy and radiotherapy for cancer is listed separately under Chemotherapy, radiotherapy and immunotherapy for cancer.

Treatments involving the provision of the following MBS item:

18350, 18351, 18353, 18354, 18360, 18361, 18365, 30103, 30107, 30111, 30114, 30226, 30229, 30232, 30235, 30238, 30241, 30244, 32036, 39331, 43500, 43503, 43506, 43509, 43512, 43515, 43518, 43521, 43524, 43876, 43879, 44325, 44328, 44331, 44334, 44338, 44342, 44346, 44350, 44354, 44358, 44359, 44361, 44364, 44367, 44370, 44373, 44376, 45605, 45788, 45851, 45855, 45857, 45859, 45861, 45863, 45867, 45869, 45871, 45873, 45875, 45945, 45978, 45981, 45987, 45993, 45996, 46300, 46303, 46306, 46307, 46327, 46330, 46333, 46336, 46339, 46342, 46348, 46351, 46354, 46357, 46360, 46363, 46366, 46369, 46372, 46375, 46378, 46381, 46384, 46387, 46390, 46393, 46396, 46399, 46402, 46405, 46459, 46462, 46464, 46465, 46468, 46471, 46474, 46477, 46480, 46483, 47000, 47003, 47006, 47009, 47012, 47015, 47018, 47021, 47024, 47027, 47030, 47033, 47036, 47039, 47042, 47045, 47048, 47051, 47054, 47057, 47060, 47063, 47066, 47069, 47072, 47301, 47304, 47307, 47310, 47313, 47316, 47319, 47348, 47351, 47354, 47357, 47361, 47362, 47364, 47367, 47370, 47373, 47378, 47381, 47384, 47385, 47386, 47387, 47390, 47393, 47396, 47399, 47402, 47405, 47408, 47411, 47414, 47417, 47420, 47423, 47426, 47429, 47432, 47435, 47438, 47441, 47444, 47447, 47450, 47451, 47453, 47456, 47459, 47462, 47465, 47466, 47467, 47468, 47471, 47474, 47477, 47480, 47483, 47486, 47489, 47492, 47495, 47498, 47501, 47504, 47507, 47510, 47513, 47516, 47519, 47522, 47525, 47528, 47531, 47534, 47537, 47540, 47543, 47546, 47549, 47552, 47555, 47558, 47561, 47564, 47565, 47566, 47567, 47570, 47573, 47576, 47579, 47582, 47585, 47588, 47591, 47594, 47597, 47600, 47603, 47606, 47609, 47612, 47615, 47618, 47621, 47624, 47627, 47630, 47633, 47636, 47639, 47642, 47645, 47648, 47651, 47654, 47657, 47663, 47666, 47672, 47678, 47726, 47729, 47732, 47753, 47756, 47762, 47765, 47768, 47771, 47774, 47777, 47780, 47783, 47786, 47789, 47900, 47903, 47920, 47921, 47924, 47927, 47930, 47933, 47936, 47948, 47951, 47954, 47957, 47960, 47963, 47966, 47969, 47972, 47975, 47978, 47981, 47982, 48200, 48203, 48206, 48209, 48212, 48215, 48218, 48221, 48224, 48227, 48230, 48233, 48236, 48239, 48242, 48400, 48403, 48406, 48409, 48412, 48415, 48418, 48421, 48424, 48427, 48500, 48503, 48506, 48509, 48512, 48912, 48936, 48939, 48942, 48945, 48954, 49100, 49106, 49109, 49118, 49200, 49203, 49206, 49212, 49218, 49300, 49303, 49306, 49360, 49363, 49366, 49500, 49509, 49512, 49545, 49566, 49569, 49700, 49712, 49718, 49721, 49724, 49727, 49728, 49800, 49803, 49806, 49809, 49812, 49815, 49818, 49821, 49824, 49827, 49830, 49833, 49836, 49837, 49838, 49845, 49848, 49851, 49854, 49860, 49863, 49866, 49878, 50100, 50102, 50103, 50104, 50109, 50112, 50115, 50118, 50121, 50130, 50200, 50201, 50203, 50206, 50209, 50212, 50215, 50218, 50221, 50224, 50227, 50230, 50233, 50236, 50239, 50300, 50303, 50306, 50309, 50312, 50315, 50318, 50321, 50324, 50327, 50330, 50336, 50339, 50342, 50345, 50348, 50349, 50351, 50352, 50353, 50354, 50357, 50360, 50363, 50366, 50369, 50372, 50375, 50378, 50381, 50384, 50387, 50390, 50393, 50394, 50396, 50399, 50402, 50405, 50408, 50426, 50450, 50451, 50455, 50456, 50460, 50461, 50465, 50466, 50470, 50471, 50475, 50476, 50500, 50504, 50508, 50512, 50516, 50520, 50524, 50528, 50532, 50536, 50540, 50544, 50548, 50552, 50556, 50560, 50564, 50568, 50572, 50576, 50580, 50584, 50588, 50650, 50654, 50658, 52056, 52057, 52058, 52059, 52060, 52061, 52062, 52063, 52064, 52066, 52069, 52072, 52073, 52075, 52078, 52081, 52084, 52087, 52090, 52092, 52094, 52095, 52096, 52097, 52098, 52099, 52102, 52105, 52114, 52126, 52129, 52130, 52131, 52180, 52182, 52184, 52186, 53200, 53203, 53206, 53209, 53212, 53215, 53218, 53220, 53221, 53224, 53225, 53226, 53227, 53230, 53233, 53236, 53239, 53400, 53403, 53406, 53409, 53410, 53411, 53412, 53413, 53414, 53415, 53416, 53418, 53419, 53422, 53423, 53424, 53425, 53427, 53429, 53439

Brain and nervous system

Hospital treatment for the investigation and treatment of the brain, brain-related conditions, spinal cord and peripheral nervous system.

For example: stroke, brain or spinal cord tumours, head injuries, epilepsy and Parkinson's disease.

Treatment of spinal column (back bone) conditions is listed separately under Back, neck and spine.

Chemotherapy and radiotherapy for cancer is listed separately under Chemotherapy, radiotherapy and immunotherapy for cancer.

Treatments involving the provision of the following MBS items:
6007, 6009, 6011, 6013, 6015, 14227, 14234, 14237, 18377, 35000, 35003, 35006, 35009, 35012, 35412, 35414, 39007, 39013, 39015, 39018, 39113, 39300, 39303, 39306, 39309, 39312, 39315, 39318, 39321, 39324, 39327, 39330, 39333, 39503, 39604, 39610, 39612, 39615, 39638, 39639, 39641, 39651, 39654, 39656, 39700, 39703, 39710, 39712, 39715, 39718, 39720, 39801, 39803, 39815, 39818, 39821, 39900, 39903, 39906, 40004, 40012, 40018, 40104, 40106, 40109, 40112, 40119, 40600, 40700, 40701, 40702, 40703, 40704, 40705, 40706, 40707, 40708, 40709, 40712, 40801, 40803, 40850, 40851, 40852, 40854, 40856, 40858, 40860, 40862, 40905, 43987, 51011, 51012, 51013, 51014, 51015, 52800, 52803, 52806, 52809, 52812, 52815, 52818, 52821, 52824, 52826, 52828, 52830, 52832

Breastsurgery (medically necessary)

Hospital treatment for the investigation and treatment of breast disorders and associated lymph nodes, and reconstruction and/or reduction following breast surgery or a preventative mastectomy.

For example: breast lesions, breast tumours, asymmetry due to breast cancer surgery, and gynecomastia.

This clinical category does not require benefits to be paid for cosmetic breast surgery that is not medically necessary.

Chemotherapy and radiotherapy for cancer is listed separately under Chemotherapy, radiotherapy and immunotherapy for cancer.

Treatments involving the provision of the following MBS items:
30299, 30300, 30302, 30303, 31500, 31503, 31506, 31509, 31512, 31515, 31516, 31519, 31524, 31525, 31530, 31533, 31536, 31548, 31551, 31554, 31557, 31560, 31563, 31566, 45060, 45061, 45062, 45520, 45522, 45523, 45524, 45527, 45528, 45530, 45533, 45536, 45539, 45542, 45545, 45546, 45548, 45551, 45553, 45554, 45556, 45558

Cataracts

Hospital treatment for surgery to remove a cataract and replace with an artificial lens.

Treatments involving the provision of the following MBS items:
42698, 42701, 42702, 42703, 42704, 42705, 42707, 42710, 42713, 42716

Chemotherapy, radiotherapy and immunotherapy for cancer

Hospital treatment for chemotherapy, radiotherapy and immunotherapy for the treatment of cancer or benign tumours.

Surgical treatment of cancer is listed separately under each body system.

Treatments involving the provision of the following MBS items:
13760, 13950, 14221, 14245, 14247, 14249, 15000, 15003, 15006, 15009, 15012, 15100, 15103, 15106, 15109, 15112, 15115, 15211, 15214, 15215, 15218, 15221, 15224, 15227, 15230, 15233, 15236, 15239, 15242, 15245, 15248, 15251, 15254, 15257, 15260, 15263, 15266, 15269, 15272, 15275, 15303, 15304, 15307, 15308, 15311, 15312, 15315, 15316, 15319, 15320, 15323, 15324, 15327, 15328, 15331, 15332, 15335, 15336, 15338, 15339, 15342, 15345, 15348, 15351, 15354, 15357, 15500, 15503, 15506, 15509, 15512, 15513, 15515, 15518, 15521, 15524, 15527, 15530, 15533, 15536, 15539, 15550, 15553, 15555, 15556, 15559, 15562, 15565, 15600, 15700, 15705, 15710, 15715, 15800, 15850, 15900, 16003, 16006, 16009, 16012, 16015, 16018, 30400, 34521, 34524, 34527, 34528, 34529, 34530, 34533, 34534, 34539, 34540, 35404, 35406, 35408, 50950, 50952

Dental surgery

Hospital treatment for surgery to the teeth and gums.

For example: surgery to remove wisdom teeth, and dental implant surgery.

Treatments involving the provision of the following MBS items:
75006, 75030, 75033, 75034, 75036, 75037, 75039, 75042, 75045, 75048, 75049, 75050, 75051, 75156, 75200, 75203, 75206, 75400, 75403, 75406, 75409, 75412, 75415, 75600, 75603, 75606, 75609, 75612, 75615, 75618, 75621, 75800, 75803, 75806, 75809, 75812, 75815, 75818, 75821, 75824, 75827, 75830, 75833, 75836, 75839, 75842, 75845, 75848, 75851, 75854

Diabetes management

(excluding insulin pumps)

Hospital treatment for the investigation and management of diabetes.

For example: stabilisation of hypo- or hyper- glycaemia, contour problems due to insulin injections.

Treatment for diabetes-related conditions is listed separately under each body system affected. For example, treatment for diabetes-related eye conditions is listed separately under Eye.

Treatment for ulcers is listed separately under Skin.

Provision and replacement of insulin pumps is listed separately under Insulin pumps.

Treatments involving the provision of the following MBS items:
31346

Dialysis for chronic kidney failure

Hospital treatment for dialysis treatment for chronic kidney failure.

For example: peritoneal dialysis and haemodialysis.

Treatments involving the provision of the following MBS items:
13100, 13103, 13104, 13106, 13109, 13110

Digestive system

Hospital treatment for the investigation and treatment of the digestive system, including the oesophagus, stomach, gall bladder, pancreas, spleen, liver and bowel.

For example: oesophageal cancer, irritable bowel syndrome, gall stones and haemorrhoids.

Endoscopy is listed separately under Gastrointestinal endoscopy.

Hernia and appendicectomy procedures are listed separately under Hernia and appendix.

Bariatric surgery is listed separately under Weight loss surgery.

Chemotherapy and radiotherapy for cancer is listed separately under Chemotherapy, radiotherapy and immunotherapy for cancer.

Treatments involving the provision of the following MBS items:
11800, 11801, 11810, 13506, 14212, 30373, 30375, 30376, 30378, 30379, 30382, 30384, 30385, 30387, 30392, 30393, 30396, 30397, 30399, 30402, 30406, 30408, 30409, 30411, 30412, 30414, 30415, 30416, 30417, 30418, 30419, 30421, 30422, 30425, 30427, 30428, 30430, 30431, 30433, 30434, 30436, 30437, 30438, 30439, 30440, 30441, 30442, 30443, 30445, 30446, 30448, 30449, 30450, 30451, 30452, 30454, 30455, 30457, 30458, 30460, 30461, 30463, 30464, 30466, 30467, 30469, 30472, 30481, 30482, 30483, 30492, 30495, 30496, 30497, 30499, 30500, 30502, 30503, 30505, 30506, 30508, 30509, 30515, 30517, 30518, 30520, 30521, 30523, 30524, 30526, 30527, 30529, 30530, 30532, 30533, 30535, 30536, 30538, 30539, 30541, 30542, 30544, 30545, 30547, 30548, 30550, 30551, 30553, 30554, 30556, 30557, 30559, 30560, 30562, 30563, 30564, 30565, 30566, 30575, 30577, 30578, 30580, 30581, 30583, 30584, 30586, 30587, 30589, 30590, 30593, 30594, 30596, 30597, 30599, 30600, 30601, 30602, 30603, 30605, 30606, 30608, 30619, 30621, 30622, 30623, 30626, 30627, 30636, 30637, 30639, 31450, 31452, 31454, 31456, 31458, 31460, 31462, 31464, 31466, 31468, 31470, 31472, 32000, 32003, 32004, 32005, 32006, 32009, 32012, 32015, 32018, 32021, 32024, 32025, 32026, 32028, 32029, 32030, 32033, 32039, 32042, 32045, 32046, 32047, 32051, 32054, 32057, 32060, 32063, 32066, 32069, 32096, 32099, 32102, 32103, 32104, 32105, 32106, 32108, 32111, 32112, 32114, 32115, 32117, 32120, 32123, 32126, 32129, 32131, 32132, 32135, 32138, 32139, 32142, 32145, 32147, 32150, 32153, 32156, 32159, 32162, 32165, 32166, 32168, 32171, 32174, 32175, 32177, 32180, 32183, 32186, 32200, 32203, 32206, 32209, 32210, 32212, 32213, 32214, 32215, 32216, 32217, 32218, 32220, 32221, 41816, 41822, 41825, 41828, 41831, 41832, 43801, 43804, 43807, 43810, 43813, 43816, 43819, 43822, 43825, 43828, 43831, 43834, 43840, 43843, 43846, 43849, 43852, 43855, 43858, 43864, 43867, 43870, 43873, 43900, 43903, 43906, 43930, 43933, 43936, 43942, 43945, 43948, 43951, 43954, 43957, 43960, 43963, 43966, 43969, 43972, 43975, 43978, 43990, 43993, 43996, 43999, 44101, 44102, 44104, 44105

Ear, nose and throat

Hospital treatment for the investigation and treatment of the ear, nose, throat, middle ear, thyroid, parathyroid, larynx, lymph nodes and related areas of the head and neck.

For example: damaged ear drum, sinus surgery, removal of foreign bodies, stapedectomy and throat cancer.

Tonsils, adenoids and grommets are listed separately under Tonsils, adenoids and grommets.

The implantation of a hearing device is listed separately under Implantation of hearing devices.

Orthopaedic neck conditions are listed separately under Back, neck and spine.

Sleep studies are listed separately under Sleep studies.

Chemotherapy and radiotherapy for cancer is listed separately under Chemotherapy, radiotherapy and immunotherapy for cancer.

Treatments involving the provision of the following MBS items:
11300, 18368, 30104, 30105, 30246, 30247, 30250, 30251, 30253, 30255, 30256, 30259, 30262, 30266, 30269, 30272, 30275, 30278, 30281, 30283, 30286, 30287, 30289, 30293, 30294, 30296, 30297, 30306, 30310, 30314, 30315, 30317, 30318, 30320, 30326, 30618, 31400, 31403, 31406, 31409, 31412, 31420, 31423, 31426, 31429, 31432, 31435, 31438, 41500, 41501, 41503, 41506, 41509, 41512, 41515, 41518, 41521, 41524, 41527, 41530, 41533, 41536, 41539, 41542, 41545, 41548, 41551, 41554, 41557, 41560, 41563, 41564, 41566, 41569, 41572, 41575, 41576, 41578, 41579, 41581, 41584, 41587, 41590, 41593, 41596, 41599, 41608, 41611, 41614, 41615, 41620, 41623, 41626, 41629, 41635, 41638, 41641, 41644, 41647, 41650, 41653, 41656, 41659, 41662, 41668, 41671, 41672, 41674, 41677, 41683, 41686, 41689, 41692, 41698, 41701, 41704, 41707, 41710, 41713, 41716, 41719, 41722, 41725, 41728, 41729, 41731, 41734, 41737, 41740, 41743, 41746, 41749, 41752, 41755, 41764, 41767, 41770, 41773, 41776, 41779, 41782, 41785, 41786, 41787, 41804, 41807, 41810, 41813, 41834, 41837, 41840, 41843, 41855, 41858, 41861, 41864, 41867, 41868, 41870, 41873, 41876, 41879, 41880, 41881, 41884, 41885, 41886, 41889, 41892, 41895, 41898, 41901, 41904, 41905, 41907, 41910, 43832, 45645, 45646, 47735, 47738, 47741, 51900, 51902, 52021, 52024, 52025, 52027, 52030, 52033, 52034, 52035, 52055, 52132, 52133, 52135, 52138, 52141, 52147, 52148, 52158, 53000, 53003, 53004, 53006, 53009, 53012, 53015, 53016, 53017, 53019, 53052, 53054, 53056, 53058, 53060, 53062, 53064, 53068, 53070, 53458, 53459, 53460

Eye (not cataracts)

Hospital treatment for the investigation and treatment of the eye and the contents of the eye socket.

For example: retinal detachment, tear duct conditions, eye infections and medically managed trauma to the eye.

Cataract procedures are listed separately under Cataracts.

Eyelid procedures are listed separately under Plastic and reconstructive surgery.

Chemotherapy and radiotherapy for cancer is listed separately under Chemotherapy, radiotherapy and immunotherapy for cancer.

Treatments involving the provision of the following MBS items:
18366, 18369, 18370, 18372, 18374, 42503, 42504, 42505, 42506, 42509, 42510, 42512, 42515, 42518, 42521, 42524, 42527, 42530, 42533, 42536, 42539, 42542, 42543, 42545, 42548, 42551, 42554, 42557, 42563, 42569, 42572, 42573, 42574, 42575, 42576, 42581, 42584, 42587, 42588, 42590, 42593, 42596, 42599, 42602, 42605, 42608, 42610, 42611, 42614, 42615, 42617, 42620, 42622, 42623, 42626, 42629, 42632, 42635, 42638, 42641, 42644, 42647, 42650, 42651, 42652, 42653, 42656, 42662, 42665, 42667, 42668, 42672, 42673, 42676, 42677, 42680, 42683, 42686, 42689, 42692, 42695, 42719, 42725, 42731, 42734, 42738, 42739, 42740, 42741, 42743, 42744, 42746, 42749, 42752, 42755, 42758, 42761, 42764, 42767, 42770, 42773, 42776, 42779, 42782, 42785, 42788, 42791, 42794, 42801, 42802, 42805, 42806, 42807, 42808, 42809, 42810, 42811, 42812, 42815, 42818, 42821, 42824, 42833, 42836, 42839, 42842, 42845, 42848, 42851, 42854, 42857, 42869, 43021, 43022, 43023

Gastrointestinal endoscopy

Hospital treatment for the diagnosis, investigation and treatment of the internal parts of the gastrointestinal system using an endoscope.

For example: colonoscopy, gastroscopy, endoscopic retrograde cholangiopancreatography (ERCP).

Non-endoscopic procedures for the digestive system are listed separately under Digestive system.

Treatments involving the provision of the following MBS items:
11820, 11823, 30473, 30475, 30478, 30479, 30484, 30485, 30488, 30490, 30491, 30494, 30568, 30569, 30680, 30682, 30684, 30686, 30687, 30688, 30690, 30692, 30694, 32023, 32072, 32075, 32084, 32087, 32094, 32095, 32222, 32223, 32224, 32225, 32226, 32227, 32228, 32229

Gynaecology

Hospital treatment for the investigation and treatment of the female reproductive system.

For example: endometriosis, polycystic ovaries, female sterilisation and cervical cancer.

Fertility treatments are listed separately under Assisted reproductive services.

Pregnancy and birth-related conditions are listed separately under Pregnancy and birth.

Miscarriage or termination of pregnancy is listed separately under Miscarriage and termination of pregnancy.

Chemotherapy and radiotherapy for cancer is listed separately under Chemotherapy, radiotherapy and immunotherapy for cancer.

Treatments involving the provision of the following MBS items:
30062, 35410, 35500, 35502, 35503, 35506, 35507, 35508, 35509, 35513, 35517, 35518, 35520, 35523, 35527, 35530, 35533, 35534, 35536, 35539, 35542, 35545, 35548, 35554, 35557, 35560, 35561, 35562, 35564, 35565, 35566, 35568, 35569, 35570, 35571, 35572, 35573, 35577, 35578, 35581, 35582, 35585, 35595, 35596, 35597, 35599, 35602, 35605, 35608, 35611, 35612, 35613, 35614, 35615, 35616, 35618, 35620, 35622, 35623, 35626, 35627, 35630, 35633, 35634, 35635, 35636, 35637, 35638, 35641, 35644, 35645, 35646, 35647, 35648, 35649, 35653, 35657, 35658, 35661, 35664, 35667, 35670, 35673, 35680, 35684, 35688, 35691, 35694, 35697, 35700, 35703, 35706, 35709, 35710, 35713, 35717, 35720, 35723, 35726, 35729, 35730, 35750, 35753, 35754, 35756, 35759

Heart and vascular system

Hospital treatment for the investigation and treatment of the heart, heart-related conditions and vascular system.

For example: heart failure and heart attack, monitoring of heart conditions, varicose veins and removal of plaque from arterial walls.

Chemotherapy and radiotherapy for cancer is listed separately under Chemotherapy, radiotherapy and immunotherapy for cancer.

Treatments involving the provision of the following MBS items:
13400, 32500, 32504, 32507, 32508, 32511, 32514, 32517, 32520, 32522, 32523, 32526, 32528, 32529, 32700, 32703, 32708, 32710, 32711, 32712, 32715, 32718, 32721, 32724, 32730, 32733, 32736, 32739, 32742, 32745, 32748, 32751, 32754, 32757, 32760, 32763, 32766, 32769, 33050, 33055, 33070, 33075, 33080, 33100, 33103, 33109, 33112, 33115, 33116, 33118, 33119, 33121, 33124, 33127, 33130, 33133, 33136, 33139, 33142, 33145, 33148, 33151, 33154, 33157, 33160, 33163, 33166, 33169, 33172, 33175, 33178, 33181, 33500, 33506, 33509, 33512, 33515, 33518, 33521, 33524, 33527, 33530, 33533, 33536, 33539, 33542, 33545, 33548, 33551, 33554, 33800, 33803, 33806, 33810, 33811, 33812, 33815, 33818, 33821, 33824, 33827, 33830, 33833, 33836, 33839, 33842, 33845, 33848, 34100, 34103, 34106, 34109, 34112, 34115, 34118, 34121, 34124, 34127, 34130, 34142, 34145, 34148, 34151, 34154, 34157, 34160, 34163, 34166, 34169, 34172, 34175, 34500, 34503, 34506, 34509, 34512, 34515, 34518, 34800, 34803, 34806, 34809, 34812, 34815, 34818, 34821, 34824, 34827, 34830, 34833, 35100, 35103, 35200, 35202, 35300, 35303, 35306, 35307, 35309, 35312, 35315, 35317, 35319, 35320, 35321, 35324, 35327, 35330, 35331, 35360, 35361, 35362, 35363, 38200, 38203, 38206, 38209, 38212, 38213, 38215, 38218, 38220, 38222, 38225, 38228, 38231, 38234, 38237, 38240, 38241, 38243, 38246, 38256, 38270, 38272, 38273, 38274, 38275, 38276, 38285, 38286, 38287, 38288, 38290, 38293, 38300, 38303, 38306, 38309, 38312, 38315, 38318, 38350, 38353, 38356, 38358, 38359, 38362, 38365, 38368, 38371, 38384, 38387, 38390, 38393, 38447, 38449, 38450, 38452, 38470, 38473, 38475, 38477, 38478, 38480, 38481, 38483, 38485, 38487, 38488, 38489, 38490, 38493, 38495, 38496, 38497, 38498, 38500, 38501, 38503, 38504, 38505, 38506, 38507, 38508, 38509, 38512, 38515, 38518, 38550, 38553, 38556, 38559, 38562, 38565, 38568, 38571, 38572, 38577, 38588, 38600, 38603, 38609, 38612, 38613, 38615, 38618, 38621, 38624, 38627, 38637, 38650, 38653, 38654, 38670, 38673, 38677, 38680, 38700, 38703, 38706, 38709, 38712, 38715, 38718, 38721, 38724, 38727, 38730, 38733, 38736, 38739, 38742, 38745, 38748, 38751, 38754, 38757, 38760, 38763, 38766, 59903, 59912, 59925

Hernia and appendix

Hospital treatment for the investigation and treatment of a hernia or appendicitis.

Digestive conditions are listed separately under Digestive system.

Treatments involving the provision of the following MBS items:
30571, 30572, 30574, 30609, 30614, 30615, 30640, 30645, 30646, 43805, 43835, 43837, 43838, 43841, 43939, 44108, 44111, 44114

Implantation of hearing devices

Hospital treatment to correct hearing loss, including implantation of a prosthetic hearing device.

Stapedectomy is listed separately under Ear, nose and throat.

Treatments involving the provision of the following MBS items:
ss41603, 41604, 41617, 41618

Insulin pumps

Hospital treatment for the provision and replacement of insulin pumps for treatment of diabetes.

 

Joint reconstructions

Hospital treatment for surgery for joint reconstructions.

For example: torn tendons, rotator cuff tears and damaged ligaments.

Joint replacements are listed separately under Joint replacements.

Bone fractures arelisted separately under Bone, joint and muscle.

Procedures to the spinal column are listed separately under Back, neck and spine.

Podiatric surgery performed by a registered podiatric surgeon is listed separately under Podiatric surgery (provided by a registered podiatric surgeon).

Treatments involving the provision of the following MBS items:
46345, 46408, 46411, 46414, 46417, 46420, 46423, 46426, 46429, 46432, 46435, 46438, 46441, 46442, 46444, 46447, 46450, 46453, 46456, 46492, 46494, 46495, 46498, 46500, 46501, 46502, 46503, 46504, 46507, 46510, 46522, 48900, 48903, 48906, 48909, 48930, 48933, 48948, 48951, 48957, 48960, 49103, 49121, 49215, 49221, 49224, 49227, 49503, 49506, 49536, 49539, 49542, 49548, 49551, 49557, 49558, 49559, 49560, 49561, 49562, 49563, 49564, 49703, 49706, 49709, 50106, 50333

Joint replacements

Hospital treatment for surgery for joint replacements, including revisions, resurfacing, partial replacements and removal of prostheses.

For example: replacement of shoulder, wrist, finger, hip, knee, ankle, or toe joint, spinal disc replacement.

Joint fusions are listed separately under Bone, joint and muscle.

Spinal fusions are listed separately under Back, neck and spine.

Joint reconstructions are listed separately under Joint reconstructions.

Podiatric surgery performed by a registered podiatric surgeon is listed separately under Podiatric surgery (provided by a registered podiatric surgeon).

Treatments involving the provision of the following MBS items:
46309, 46312, 46315, 46318, 46321, 48915, 48918, 48921, 48924, 48927, 49112, 49115, 49116, 49117, 49209, 49210, 49211, 49309, 49312, 49315, 49318, 49319, 49321, 49324, 49327, 49330, 49333, 49336, 49339, 49342, 49345, 49346, 49515, 49517, 49518, 49519, 49521, 49524, 49527, 49530, 49533, 49534, 49554, 49715, 49716, 49717, 49839, 49842, 49857

Kidney and bladder

Hospital treatment for the investigation and treatment of the kidney, adrenal gland and bladder.

For example: kidney stones, adrenal gland tumour and incontinence.

Dialysis is listed separately under Dialysis for chronic kidney failure.

Chemotherapy and radiotherapy for cancer is listed separately under Chemotherapy, radiotherapy and immunotherapy for cancer.

Treatments involving the provision of the following MBS items:
11900, 11903, 11906, 11909, 11912, 11915, 11917, 11919, 11921, 12524, 12527, 18375, 18379, 30324, 36503, 36504, 36505, 36506, 36507, 36508, 36509, 36516, 36519, 36522, 36525, 36528, 36529, 36531, 36532, 36533, 36537, 36543, 36546, 36549, 36552, 36558, 36561, 36564, 36567, 36570, 36573, 36576, 36579, 36585, 36588, 36591, 36594, 36597, 36600, 36603, 36604, 36606, 36607, 36608, 36609, 36610, 36611, 36612, 36615, 36618, 36621, 36624, 36627, 36633, 36636, 36639, 36645, 36649, 36650, 36652, 36654, 36656, 36663, 36664, 36665, 36666, 36667, 36668, 36671, 36672, 36673, 36800, 36803, 36806, 36809, 36811, 36812, 36815, 36818, 36821, 36822, 36823, 36824, 36827, 36830, 36833, 36836, 36840, 36842, 36845, 36848, 36851, 36854, 36860, 36863, 37000, 37004, 37008, 37011, 37014, 37015, 37016, 37018, 37019, 37020, 37021, 37023, 37026, 37029, 37038, 37039, 37040, 37041, 37042, 37043, 37044, 37045, 37046, 37047, 37048, 37050, 37053, 37300, 37303, 37306, 37309, 37318, 37321, 37324, 37327, 37330, 37333, 37336, 37338, 37339, 37340, 37341, 37342, 37343, 37344, 37345, 37348, 37351, 37354, 37369, 37372, 37375, 37381, 37384, 37387, 37388, 37390, 37800, 37801, 37842, 37845, 37848, 37851, 37854, 43981, 43984

Lung and chest

Hospital treatment for the investigation and treatment of the lungs, lung-related conditions, mediastinum and chest.

For example: lung cancer, respiratory disorders such as asthma, pneumonia, and treatment of trauma to the chest.

Chemotherapy and radiotherapy for cancer is listed separately under Chemotherapy, radiotherapy and immunotherapy for cancer.

Treatments involving the provision of the following MBS items:

30090, 30696, 30710, 34133, 34136, 34139, 38415, 38418, 38421, 38424, 38427, 38430, 38436, 38438, 38440, 38441, 38446, 38448, 38453, 38455, 38460, 38462, 38464, 38466, 38468, 38469, 38640, 38643, 38647, 38656, 38800, 38803, 38806, 38809, 38812, 43861, 43909, 43912

Male reproductive system

Hospital treatment for the investigation and treatment of the male reproductive system including the prostate.

For example: male sterilisation, circumcision and prostate cancer.

Chemotherapy and radiotherapy for cancer is listed separately under Chemotherapy, radiotherapy and immunotherapy for cancer.

Treatments involving the provision of the following MBS items:
30628, 30629, 30630, 30631, 30635, 30641, 30642, 30643, 30644, 30649, 30654, 30658, 30663, 30666, 37200, 37201, 37202, 37203, 37206, 37207, 37208, 37209, 37210, 37211, 37213, 37214, 37215, 37216, 37217, 37218, 37219, 37220, 37221, 37223, 37224, 37226, 37227, 37230, 37233, 37245, 37393, 37396, 37402, 37405, 37408, 37411, 37415, 37417, 37418, 37423, 37426, 37429, 37432, 37435, 37438, 37601, 37604, 37607, 37610, 37613, 37616, 37619, 37623, 37803, 37804, 37806, 37807, 37809, 37810, 37812, 37813, 37815, 37816, 37818, 37819, 37821, 37822, 37824, 37825, 37827, 37828, 37830, 37831, 37833, 37834, 37836, 37839

Miscarriage and termination of pregnancy

Hospital treatment for the investigation and treatment of a miscarriage or for termination of pregnancy.

Treatments involving the provision of the following MBS items:
16530, 16531, 35640, 35643, 35674, 35677, 35678

Pain management

Hospital treatment for pain management that does not require the insertion or surgical management of a device.

For example: treatment of nerve pain and chest pain due to cancer by injection of a nerve block.

Pain management using a device (for example an infusion pump or neurostimulator) is listed separately under Pain management with device.

Treatments involving the provision of the following MBS items:
39100, 39109, 39115, 39118, 39121, 39124, 39140, 39323, 45939

Pain management with device

Hospital treatment for the implantation, replacement or other surgical management of a device required for the treatment of pain.

For example: treatment of nerve pain, back pain, and pain caused by coronary heart disease with a device (for example an infusion pump or neurostimulator).

Treatment of pain that does not require a device is listed separately under Pain management.

Treatments involving the provision of the following MBS items:
14218, 39125, 39126, 39127, 39128, 39130, 39131, 39133, 39134, 39135, 39136, 39137, 39138, 39139

Plastic and reconstructive surgery

(medically necessary)

Hospital treatment which is medically necessary for the investigation and treatment of any physical deformity, whether acquired as a result of illness or accident, or congenital.

For example: burns requiring a graft, cleft palate, club foot and angioma.

Plastic surgery that is medically necessary relating to the treatment of a skin-related condition is listed separately under Skin.

Chemotherapy and radiotherapy for cancer is listed separately under Chemotherapy, radiotherapy and immunotherapy for cancer.

Treatments involving the provision of the following MBS items:
30003, 30006, 30010, 30014, 30017, 30020, 30176, 38457, 38458, 42860, 42863, 42866, 42872, 43882, 45000, 45003, 45006, 45009, 45012, 45015, 45018, 45019, 45021, 45024, 45025, 45026, 45027, 45030, 45033, 45035, 45036, 45039, 45042, 45045, 45048, 45051, 45054, 45200, 45201, 45202, 45203, 45206, 45207, 45209, 45212, 45215, 45218, 45221, 45224, 45227, 45230, 45233, 45236, 45239, 45240, 45400, 45403, 45406, 45409, 45412, 45415, 45418, 45439, 45442, 45445, 45448, 45451, 45460, 45461, 45462, 45464, 45465, 45466, 45468, 45469, 45471, 45472, 45474, 45475, 45477, 45478, 45480, 45481, 45483, 45484, 45485, 45486, 45487, 45488, 45489, 45490, 45491, 45492, 45493, 45494, 45496, 45497, 45498, 45499, 45500, 45501, 45502, 45503, 45504, 45505, 45506, 45512, 45515, 45518, 45519, 45560, 45561, 45562, 45563, 45564, 45565, 45566, 45568, 45569, 45570, 45572, 45575, 45578, 45581, 45584, 45585, 45587, 45588, 45590, 45593, 45596, 45597, 45599, 45602, 45608, 45611, 45614, 45617, 45620, 45623, 45624, 45625, 45626, 45627, 45629, 45632, 45635, 45641, 45644, 45647, 45650, 45652, 45653, 45656, 45659, 45660, 45661, 45662, 45665, 45668, 45669, 45671, 45674, 45675, 45676, 45677, 45680, 45683, 45686, 45689, 45692, 45695, 45698, 45701, 45704, 45707, 45710, 45713, 45714, 45716, 45720, 45723, 45726, 45729, 45731, 45732, 45735, 45738, 45741, 45744, 45747, 45752, 45753, 45754, 45755, 45758, 45761, 45767, 45770, 45773, 45776, 45779, 45782, 45785, 45791, 45794, 45797, 45799, 45801, 45803, 45805, 45807, 45809, 45811, 45813, 45815, 45817, 45819, 45821, 45823, 45825, 45827, 45829, 45831, 45833, 45835, 45837, 45839, 45841, 45843, 45845, 45847, 45849, 45853, 45865, 45877, 45879, 45882, 45885, 45888, 45891, 45894, 45897, 45900, 45975, 45984, 45990, 50411, 50414, 50417, 50420, 50423, 51904, 51906, 52010, 52036, 52045, 52048, 52106, 52108, 52111, 52117, 52120, 52122, 52123, 52300, 52303, 52306, 52309, 52312, 52315, 52318, 52319, 52321, 52324, 52327, 52330, 52333, 52336, 52337, 52339, 52342, 52345, 52348, 52351, 52354, 52357, 52360, 52363, 52366, 52369, 52372, 52375, 52378, 52379, 52380, 52382, 52420, 52424, 52430, 52440, 52442, 52444, 52446, 52450, 52452, 52456, 52458, 52460, 52480, 52482, 52484, 52600, 52603, 52606, 52609, 52612, 52615, 52618, 52621, 52624, 52626, 52627, 52630, 52633, 52636, 53242, 53453, 53455, 75024, 75027

Podiatric surgery

(provided by a registered podiatric surgeon)

Hospital treatment for the investigation and treatment of conditions affecting the foot and/or ankle, provided by a registered podiatric surgeon, but limited to cover for:

accommodation; and

the cost of a prosthesis as listed in the prostheses list set out in the Private Health Insurance (Prostheses) Rules, as in force from time to time.

Note: Insurers are not required to pay for any other benefits for hospital treatment for this clinical category but may choose to do so.

 

Pregnancy and birth

Hospital treatment for investigation and treatment of conditions associated with pregnancy and child birth.

Treatment for the baby is covered under the clinical category relevant to their condition. For example, respiratory conditions are covered under Lung and chest.

Female reproductive conditions are listed separately under Gynaecology.

Fertility treatments are listed separately under Assisted reproductive services.

Miscarriage and termination of pregnancy is listed separately under Miscarriage and termination of pregnancy.

Treatments involving the provision of the following MBS items:
16400, 16401, 16404, 16406, 16407, 16408, 16500, 16501, 16502, 16505, 16508, 16509, 16511, 16512, 16514, 16515, 16518, 16519, 16520, 16522, 16527, 16528, 16533, 16534, 16564, 16567, 16570, 16571, 16573, 16590, 16591, 16600, 16603, 16606, 16609, 16612, 16615, 16618, 16621, 16624, 16627, 82100, 82105, 82110, 82115, 82120, 82125

Skin

Hospital treatment for the investigation and treatment of skin, skin-related conditions and nails. The removal of foreign bodies is also included. Plastic surgery that is medically necessary and relating to the treatment of a skin-related condition is also included.

For example: melanoma, minor wound repair and abscesses.

Removal of excess skin due to weight loss is listed separately under Weight loss surgery.

Chemotherapy and radiotherapy for cancer is listed separately under Chemotherapy, radiotherapy and immunotherapy for cancer.

Treatments involving the provision of the following MBS items:
12012, 12017, 12021, 12022, 12024, 14050, 14100, 14106, 14115, 14118, 14124, 18362, 30023, 30024, 30026, 30029, 30032, 30035, 30038, 30042, 30045, 30049, 30052, 30055, 30064, 30071, 30099, 30180, 30183, 30187, 30189, 30190, 30191, 30192, 30196, 30202, 30207, 30210, 30216, 30219, 30223, 30676, 30679, 31000, 31001, 31002, 31003, 31004, 31005, 31206, 31211, 31216, 31220, 31221, 31225, 31245, 31250, 31340, 31345, 31356, 31357, 31358, 31359, 31360, 31361, 31362, 31363, 31364, 31365, 31366, 31367, 31368, 31369, 31370, 31371, 31372, 31373, 31374, 31375, 31376, 44136, 46486, 46489, 46513, 46516, 46528, 46531, 46534, 47904, 47906, 47912, 47915, 47916, 47918, 52000, 52003, 52006, 52009, 52039, 52042, 52051, 52054

Sleep studies

Hospital treatment for the investigation of sleep patterns and anomalies.

For example: sleep apnoea and snoring.

Treatments involving the provision of the following MBS items:
12203, 12204, 12205, 12207, 12208, 12210, 12213, 12215, 12217, 12250, 12254, 12258, 12261, 12265, 12268, 12272

Tonsils, adenoids and grommets

Hospital treatment of the tonsils, adenoids and insertion or removal of grommets.

Treatments involving the provision of the following MBS items:
41632, 41789, 41793, 41797, 41801

Weight loss surgery

Hospital treatment for surgery that is designed to reduce a person's weight, remove excess skin due to weight loss and reversal of a bariatric procedure.

For example: gastric banding, gastric bypass, sleeve gastrectomy.

Treatments involving the provision of the following MBS items:
30165, 30168, 30171, 30172, 30177, 30179, 31569, 31572, 31575, 31578, 31581, 31584, 31587, 31590

2   Clause 1 of Schedule 6 (table titled "Common treatments list")

Repeal the table, substitute:

Common treatments – table of MBS items

3, 4, 23, 24, 36, 37, 44, 47, 52, 53, 54, 57, 58, 59, 60, 65, 104, 105, 106, 107, 108, 109, 110, 111, 115, 116, 117, 119, 120, 122, 128, 131, 132, 133, 135, 137, 141, 143, 145, 147, 160, 161, 162, 163, 164, 173, 193, 195, 197, 199, 214, 215, 218, 219, 220, 221, 222, 223, 224, 225, 226, 227, 228, 229, 230, 231, 232, 233, 235, 236, 237, 238, 239, 240, 243, 244, 253, 255, 257, 260, 262, 264, 266, 269, 271, 272, 276, 277, 279, 281, 282, 285, 287, 291, 293, 296, 299, 300, 302, 304, 306, 308, 310, 312, 314, 316, 318, 319, 330, 332, 334, 336, 338, 353, 355, 356, 357, 358, 359, 361, 385, 386, 387, 388, 410, 411, 412, 413, 414, 415, 416, 417, 585, 588, 591, 594, 599, 600, 701, 703, 705, 707, 715, 721, 723, 729, 731, 732, 733, 735, 737, 739, 743, 747, 750, 758, 820, 822, 823, 825, 826, 828, 830, 832, 834, 835, 837, 838, 871, 872, 880, 900, 903, 2100, 2497, 2501, 2503, 2504, 2506, 2507, 2509, 2517, 2518, 2521, 2522, 2525, 2526, 2546, 2547, 2552, 2553, 2558, 2559, 2598, 2600, 2603, 2606, 2610, 2613, 2616, 2620, 2622, 2624, 2631, 2633, 2635, 2664, 2666, 2668, 2673, 2675, 2677, 2801, 2806, 2814, 2824, 2832, 2840, 2946, 2949, 2954, 2958, 2972, 2974, 2978, 2984, 2988, 2992, 2996, 3000, 4001, 5000, 5001, 5003, 5004, 5010, 5011, 5012, 5013, 5014, 5016, 5017, 5019, 5020, 5021, 5022, 5023, 5027, 5028, 5030, 5031, 5032, 5033, 5035, 5036, 5039, 5040, 5041, 5042, 5043, 5044, 5049, 5060, 5063, 5067, 5200, 5203, 5207, 5208, 5220, 5223, 5227, 5228, 5260, 5263, 5265, 5267, 6051, 6052, 6057, 6058, 6059, 6060, 6062, 6063, 6064, 6065, 6067, 6068, 6071, 6072, 6074, 6075, 10905, 10907, 10910, 10911, 10912, 10913, 10914, 10915, 10916, 10918, 10921, 10922, 10923, 10924, 10925, 10926, 10927, 10928, 10929, 10930, 10945, 10946, 10947, 10948, 11830, 11833, 12000, 12001, 12002, 12003, 12004, 12005, 13015, 13020, 13025, 13030, 13757, 13870, 13873, 14201, 14202, 14209, 17615, 17620, 17625, 17640, 17645, 17650, 17655, 18216, 18219, 18282, 18284, 18286, 18288, 18290, 18292, 18294, 18296, 18298, 30058, 30061, 30068, 30072, 30075, 30078, 30081, 30084, 30087, 30093, 30094, 30096, 30097, 30224, 30225, 30323, 30329, 30330, 30332, 30335, 30336, 30388, 30390, 30391, 30394, 30403, 30405, 30611, 31350, 31355, 34538, 35551, 35552, 36502, 38456, 39000, 43915, 44130, 46324, 46325, 46519, 46525, 50127, 51700, 51703, 52012, 52015, 52018, 52144, 75001, 75004, 75150, 75153, 82130, 82135, 82140, 82200, 82205, 82210, 82215

3   Clause 1 of Schedule 7 (table titled "Support treatments - table of MBS items")

Repeal the table, substitute:

Support treatments – table of MBS items

6080, 6081, 10801, 10802, 10803, 10804, 10805, 10806, 10807, 10808, 10809, 10816, 10931, 10932, 10933, 10940, 10941, 10942, 10943, 10944, 11000, 11003, 11004, 11005, 11009, 11012, 11015, 11018, 11021, 11024, 11027, 11200, 11204, 11205, 11210, 11211, 11215, 11218, 11219, 11220, 11221, 11224, 11235, 11237, 11240, 11241, 11242, 11243, 11244, 11303, 11304, 11306, 11309, 11312, 11315, 11318, 11324, 11327, 11330, 11332, 11333, 11336, 11339, 11503, 11505, 11506, 11507, 11508, 11512, 11600, 11602, 11604, 11605, 11610, 11611, 11612, 11614, 11615, 11627, 11705, 11713, 11715, 11718, 11719, 11720, 11721, 11724, 11725, 11726, 11727, 11728, 11729, 11730, 11731, 12200, 12201, 12306, 12312, 12315, 12320, 12321, 12322, 12325, 12326, 12500, 12533, 13300, 13303, 13306, 13309, 13312, 13318, 13319, 13703, 13706, 13750, 13755, 13815, 13818, 13830, 13832, 13834, 13835, 13837, 13838, 13839, 13840, 13842, 13848, 13851, 13854, 13857, 13876, 13881, 13882, 13885, 13888, 13899, 14255, 14256, 14257, 14258, 14259, 14260, 14263, 14264, 14265, 14266, 14270, 14272, 14277, 14278, 14280, 14283, 14285, 14288, 17610, 17680, 17690, 18213, 18222, 18225, 18226, 18227, 18228, 18230, 18232, 18233, 18234, 18236, 18238, 18240, 18242, 18244, 18248, 18250, 18252, 18254, 18256, 18258, 18260, 18262, 18264, 18266, 18268, 18270, 18272, 18274, 18276, 18278, 18280, 18297, 20100, 20102, 20104, 20120, 20124, 20140, 20142, 20143, 20144, 20145, 20146, 20147, 20148, 20160, 20162, 20164, 20170, 20172, 20174, 20176, 20190, 20192, 20210, 20212, 20214, 20216, 20220, 20222, 20225, 20230, 20300, 20305, 20320, 20321, 20330, 20350, 20352, 20355, 20400, 20401, 20402, 20403, 20404, 20405, 20406, 20410, 20420, 20440, 20450, 20452, 20470, 20472, 20474, 20475, 20500, 20520, 20522, 20524, 20526, 20528, 20540, 20542, 20546, 20548, 20560, 20600, 20604, 20620, 20622, 20630, 20632, 20634, 20670, 20680, 20690, 20700, 20702, 20703, 20704, 20706, 20730, 20740, 20745, 20750, 20752, 20754, 20756, 20770, 20790, 20791, 20792, 20793, 20794, 20798, 20799, 20800, 20802, 20803, 20804, 20806, 20810, 20815, 20820, 20830, 20832, 20840, 20841, 20842, 20844, 20845, 20846, 20847, 20848, 20850, 20855, 20860, 20862, 20863, 20864, 20866, 20867, 20868, 20880, 20882, 20884, 20886, 20900, 20902, 20904, 20905, 20906, 20910, 20911, 20912, 20914, 20916, 20920, 20924, 20926, 20928, 20930, 20932, 20934, 20936, 20938, 20940, 20942, 20943, 20944, 20946, 20948, 20950, 20952, 20954, 20956, 20958, 20960, 21100, 21110, 21112, 21114, 21116, 21120, 21130, 21140, 21150, 21155, 21160, 21170, 21195, 21199, 21200, 21202, 21210, 21212, 21214, 21216, 21220, 21230, 21232, 21234, 21260, 21270, 21272, 21274, 21275, 21280, 21300, 21321, 21340, 21360, 21380, 21382, 21390, 21392, 21400, 21402, 21403, 21404, 21420, 21430, 21432, 21440, 21445, 21460, 21461, 21462, 21464, 21472, 21474, 21480, 21482, 21484, 21486, 21490, 21500, 21502, 21520, 21522, 21530, 21532, 21535, 21600, 21610, 21620, 21622, 21630, 21632, 21634, 21636, 21638, 21650, 21652, 21654, 21656, 21670, 21680, 21682, 21685, 21700, 21710, 21712, 21714, 21716, 21730, 21732, 21740, 21756, 21760, 21770, 21772, 21780, 21785, 21790, 21800, 21810, 21820, 21830, 21832, 21834, 21840, 21842, 21850, 21860, 21865, 21870, 21872, 21878, 21879, 21880, 21881, 21882, 21883, 21884, 21885, 21886, 21887, 21900, 21906, 21908, 21910, 21912, 21914, 21915, 21916, 21918, 21922, 21925, 21926, 21930, 21935, 21936, 21939, 21941, 21942, 21943, 21945, 21949, 21952, 21955, 21959, 21962, 21965, 21969, 21970, 21973, 21976, 21980, 21990, 21992, 21997, 22002, 22007, 22008, 22012, 22014, 22015, 22020, 22025, 22031, 22036, 22041, 22042, 22051, 22055, 22060, 22065, 22075, 22900, 22905, 23010, 23025, 23035, 23045, 23055, 23065, 23075, 23085, 23091, 23101, 23111, 23112, 23113, 23114, 23115, 23116, 23117, 23118, 23119, 23121, 23170, 23180, 23190, 23200, 23210, 23220, 23230, 23240, 23250, 23260, 23270, 23280, 23290, 23300, 23310, 23320, 23330, 23340, 23350, 23360, 23370, 23380, 23390, 23400, 23410, 23420, 23430, 23440, 23450, 23460, 23470, 23480, 23490, 23500, 23510, 23520, 23530, 23540, 23550, 23560, 23570, 23580, 23590, 23600, 23610, 23620, 23630, 23640, 23650, 23660, 23670, 23680, 23690, 23700, 23710, 23720, 23730, 23740, 23750, 23760, 23770, 23780, 23790, 23800, 23810, 23820, 23830, 23840, 23850, 23860, 23870, 23880, 23890, 23900, 23910, 23920, 23930, 23940, 23950, 23960, 23970, 23980, 23990, 24100, 24101, 24102, 24103, 24104, 24105, 24106, 24107, 24108, 24109, 24110, 24111, 24112, 24113, 24114, 24115, 24116, 24117, 24118, 24119, 24120, 24121, 24122, 24123, 24124, 24125, 24126, 24127, 24128, 24129, 24130, 24131, 24132, 24133, 24134, 24135, 24136, 25000, 25005, 25010, 25013, 25014, 25020, 25025, 25030, 25050, 25200, 25205, 30001, 51300, 51303, 51306, 51309, 51312, 51315, 51318, 51800, 51803, 53700, 53702, 53704, 53706, 75009, 75012, 75015, 75018, 75021, 75023, 10950, 10951, 10952, 10953, 10954, 10956, 10958, 10960, 10962, 10964, 10966, 10968, 10970, 10988, 10989, 81000, 81005, 81010

Schedule 4   Amendments - COVID-19 Accreditation Arrangements

Private Health Insurance (Health Insurance Business) Rules 2018

1   Subrule 7C(e)(Part 2A)

Omit:

"submit Hospital Casemix Protocol Data to health insurers electronically with every claim for second-tier default benefits.",

substitute:

"submit Hospital Casemix Protocol Data to health insurers electronically with every claim for private health insurance benefits."

2   Add Subrule 7F(Part 2A)

Covid-19 Accreditation Arrangements

(1) If the date on which a hospital's accreditation will expire falls within the 12 months following the hospital's eligibility expiry date, then the hospital is taken to be included in the second-tier eligible hospitals class until 60 calendar days after the day on which that hospital's accreditation will expire.

(2) In this rule:

eligibility expiry date means the second-tier expiry date listed on the Commonwealth's list of all declared hospitals with second tier.

Note: Further information is available in Private Health Insurance Circular 'PHI 52/20 Second-tier Update- arrangements due to suspended accreditation assessments' available online at https://www1.health.gov.au/internet/main/publishing.nsf/Content/health-phicircular2020-52 and the Australian Safety and Quality Health Care Commission at www.safetyandquality.gov.au by searching for the 'National Safety and Quality Health Service (NSQHS) Standards' or typing in this link ' https://www.safetyandquality.gov.au/standards/nsqhs-standards/implementation-nsqhs-standards/nsqhs-standards-updates-and-consultations#faq:-covid-19-pandemic-and-accreditation '.

3   Repeal Subrule 7E (including the heading)