Health Insurance (1999–2000 General Medical Services Table) Amendment Regulations 2000 (No. 1)
Statutory Rules 2000 No. 60
I, WILLIAM PATRICK DEANE, Governor-General of the Commonwealth of Australia, acting with the advice of the Federal Executive Council, make the following Regulations under the Health Insurance Act 1973.
Dated 27 April 2000
Governor-General
By His Excellency’s Command
MICHAEL WOOLDRIDGE
Health Insurance (1999–2000 General Medical Services Table) Amendment Regulations 2000 (No. 1)1
made under the
Contents
Page
1 Name of Regulations
2 Commencement
3 Amendment of Health Insurance (1999–2000 General Medical Services Table) Regulations 1999
Schedule 1 Amendments
These Regulations are the Health Insurance (1999–2000 General Medical Services Table) Amendment Regulations 2000 (No. 1).
These Regulations commence on 1 May 2000.
3 Amendment of Health Insurance (1999–2000 General Medical Services Table) Regulations 1999
Schedule 1 amends the Health Insurance (1999–2000 General Medical Services Table) Regulations 1999.
(regulation 3)
[1] Schedule 1, Part 1, rule 7
Provision | omit | insert |
subparagraph 7 (1) (b) (i) | 18.35 | 18.75 |
subparagraph 7 (1) (b) (ii) | 1.20 | 1.25 |
subparagraph 7 (2) (b) (i) | 18.35 | 18.75 |
subparagraph 7 (2) (b) (ii) | 1.20 | 1.25 |
subparagraph 7 (3) (b) (i) | 18.35 | 18.75 |
subparagraph 7 (3) (b) (ii) | 1.20 | 1.25 |
subparagraph 7 (4) (b) (i) | 18.35 | 18.75 |
subparagraph 7 (4) (b) (ii) | 1.20 | 1.25 |
subparagraph 7 (9) (b) (i) | 18.35 | 18.75 |
subparagraph 7 (9) (b) (ii) | 1.20 | 1.25 |
[2] Schedule 1, Part 1, subrule 11 (2)
after
11330,
insert
11332,
[3] Schedule 1, Part 1, paragraph 15 (2) (a)
omit
15000
insert
15100
[4] Schedule 1, Part 1, rule 48
substitute
48 Qualified sleep medicine practitioner
For items 12203 and 12207, a person is a qualified sleep medicine practitioner if:
(a) the person has been assessed:
(i) by the Credentialling Subcommittee (the Credentialling Subcommittee) of the Specialist Advisory Committee in Thoracic and Sleep Medicine of the Royal Australasian College of Physicians (the Advisory Committee); or
(ii) on appeal from an adverse assessment of the Credentialling Subcommittee, by the Appeal Committee of the Royal Australasian College of Physicians (the Appeal Committee);
as having had, before 1 March 1999, sufficient training and experience in sleep medicine to be competent in independent clinical assessment and management of patients with respiratory sleep disorders and in reporting sleep studies; or
(b) the person has been assessed:
(i) by the Credentialling Subcommittee; or
(ii) on appeal from an adverse assessment of the Credentialling Subcommittee, by the Appeal Committee;
as:
(iii) having had, before 1 March 1999, substantial training or experience in sleep medicine; but
(iv) requiring further specified training or experience in sleep medicine to be competent in independent clinical assessment and management of patients with respiratory sleep disorders and in reporting sleep studies;
and either:
(v) the period of 2 years immediately following that assessment has not expired; or
(vi) the person has been assessed by the Credentialling Subcommittee as having satisfactorily finished the further training or gained the further experience specified for that person; or
(c) the person has attained Level I or Level II of the Advanced Training Program in Sleep Medicine of the Thoracic Society of Australia and New Zealand and the Australasian Sleep Association, after having completed at least 12 months’ core training, including clinical practice in sleep medicine and in reporting sleep studies; or
(d) the Advisory Committee has recognised, in writing, the person as having training equivalent to the training mentioned in paragraph (c).
[5] Schedule 1, Part 2, items 720, 724, 726, 728, 740, 742, 744, 759, 762, 765, 30219, 30223, 30332, 30360, 30364, 49827 and 49830
substitute each of the following items in its correct numerical position
720 | Preparation by a medical practitioner (including a general practitioner, but not including a specialist or consultant physician), in consultation with a multidisciplinary care plan team, of a multidisciplinary community care plan for a patient (not being a service associated with a service to which any of items 740 to 773 apply) — payable not more than once in any 6 month period | 184.20 |
724 | Attendance by a medical practitioner (including a general practitioner, but not including a specialist or consultant physician), to review a multidisciplinary community care plan or a discharge care plan prepared by that medical practitioner for a patient and claimed for under item 720 or 722 (not being a payment for a service to which any of items 740 to 773 apply) — payable not more than once in any 3 month period, not being an attendance in relation to a patient: (a) for whom, in the preceding 3 months, a payment has been made under item 720; or (b) for whom, in the previous month, a payment has been made under item 722 | 92.10 |
726 | Attendance by a medical practitioner (including a general practitioner, but not including a specialist or consultant physician), as a member of a multidisciplinary care plan team, to contribute to a multidisciplinary community care plan or to a review of a multidisciplinary community care plan prepared by another provider (not being a payment for a service to which any of items 740 to 773 apply) — not being an attendance in relation to a patient for whom, in the previous 6 months, a payment has been made under item 720 | 25.85 |
728 | Attendance by a medical practitioner (including a general practitioner, but not including a specialist or consultant physician), as a member of a multidisciplinary care plan team, to contribute to a multidisciplinary discharge care plan or to a review of a multidisciplinary discharge care plan prepared by another provider (not being a service associated with a service to which item 722 or any of items 740 to 773 apply) | 25.85 |
740 | Attendance by a medical practitioner (including a general practitioner, but not including a specialist or consultant physician), as a member of a case conference team, to organise and coordinate a community case conference, where the conference time is at least 15 minutes, but less than 30 minutes (not being a service associated with a service to which any of items 720 to 728 apply) | 71.65 |
742 | Attendance by a medical practitioner (including a general practitioner, but not including a specialist or consultant physician), as a member of a case conference team, to organise and coordinate a community case conference, where the conference time is at least 30 minutes, but less than 45 minutes (not being a service associated with a service to which any of items 720 to 728 apply) | 107.45 |
744 | Attendance by a medical practitioner (including a general practitioner, but not including a specialist or consultant physician), as a member of a case conference team, to organise and coordinate a community case conference, where the conference time is at least 45 minutes (not being a service associated with a service to which any of items 720 to 728 apply) | 143.25 |
759 | Attendance by a medical practitioner (including a general practitioner, but not including a specialist or consultant physician), as a member of a case conference team, to participate in a community case conference (other than to organise and coordinate the conference), where the conference time is at least 15 minutes, but less than 30 minutes (not being a service associated with a service to which any of items 720 to 728 apply) | 51.15 |
762 | Attendance by a medical practitioner (including a general practitioner, but not including a specialist or consultant physician), as a member of a case conference team, to participate in a community case conference (other than to organise and coordinate the conference), where the conference time is at least 30 minutes, but less than 45 minutes (not being a service associated with a service to which any of items 720 to 728 apply) | 81.85 |
765 | Attendance by a medical practitioner (including a general practitioner, but not including a specialist or consultant physician), as a member of a case conference team, to participate in a community case conference (other than to organise and coordinate the conference), where the conference time is at least 45 minutes (not being a service associated with a service to which any of items 720 to 728 apply) | 112.55 |
30219 | Haematoma, furuncle, small abscess or similar lesion not requiring admission to a hospital or day-hospital facility, incision with drainage of, excluding aftercare | 21.00 |
30223 | Large haematoma, large abscess, carbuncle, cellulitis or similar lesion, requiring admission to a hospital or day-hospital facility, incision with drainage of, excluding aftercare (Anaes. 17706 = 4B + 2T) | 125.40 |
30332 | Lymph nodes of axilla, limited excision of (sampling) (Anaes. 17709 = 5B + 4T) (Assist.) | 266.80 |
30360 | Fine needle aspiration of an impalpable breast lesion detected by mammography or ultrasound, imaging guided — but not including imaging (Anaes. 17705 = 3B + 2T) | 106.10 |
30364 | Breast, haematoma, seroma or inflammatory condition including abscess, granulomatous mastitis or similar, exploration and drainage of when performed in the operating theatre of a hospital or day-hospital facility, excluding aftercare (Anaes. 17707 = 3B + 4T) | 166.70 |
49827 | Foot, correction of hallux valgus by transfer of adductor hallucis tendon — unilateral (Anaes. 17708 = 3B + 5T) (Assist.) | 362.10 |
49830 | Foot, correction of hallux valgus by transfer of adductor hallucis tendon — bilateral (Anaes. 17710 = 3B + 7T) (Assist.) | 633.75 |
[6] Schedule 1, Part 2, new items 11332, 16018, 30335, 30336, 30339, 30340, 30343, 30344, 30347, 30348, 30351, 30352, 30354, 30355, 45460, 45461, 45462, 45464, 45465, 45466, 45468, 45469, 45471, 45472, 45474, 45475, 45477, 45478, 45480, 45481, 45483, 45484, 45496, 45497, 45498, 45499, 49564, 49837
and 49838
insert each of the following items in its correct numerical position
11332 | Oto-acoustic emission audiometry for the detection of permanent congenital hearing impairment, performed by or on behalf of a specialist or consultant physician, on an infant or child who is at risk due to 1 or more of the following factors: (a) admission to a neonatal intensive care unit; | 45.00 |
| (b) family history of hearing impairment; (c) intra-uterine or perinatal infection (either suspected or confirmed); (d) birthweight less than 1.5 kg; (e) craniofacial deformity; (f) birth asphyxia; (g) chromosomal abnormality, including Down’s Syndrome; (h) exchange transfusion; |
|
| where: (i) the patient is referred by another medical practitioner; and (j) middle ear pathology has been excluded by specialist opinion |
|
16018 | Administration of 153 Sm-lexidronam for the relief of bone pain due to skeletal metastases (as indicated by a positive bone scan) from: (a) carcinoma of the prostate, where hormonal therapy has failed; or (b) carcinoma of the breast, where both hormonal therapy and chemotherapy have failed and: (i) the disease is poorly controlled by conventional radiotherapy; or (ii) conventional radiotherapy is inappropriate, due to the wide distribution of sites of bone pain | 1 879.00 |
30335 | Lymph nodes of axilla, complete excision of, to level I (Anaes. 17713 = 5B + 8T) (Assist.) | 666.90 |
30336 | Lymph nodes of axilla, complete excision of, to level II or III (Anaes. 17715 = 5B + 10T) (Assist.) | 800.35 |
30339 | Breast, benign lesion up to and including 50 mm in diameter, including simple cyst, fibroadenoma or fibrocystic disease, open surgical biopsy or excision of, with or without frozen section histology (Anaes. 17708 = 5B + 3T) | 200.05 |
30340 | Breast, benign lesion more than 50 mm in diameter, excision of (Anaes. 17709 = 5B + 4T) (Assist.) | 266.80 |
30343 | Breast, abnormality detected by mammography or ultrasound where guidewire or other localisation procedure is performed, excision (Anaes. 17710 = 5B + 5T) (Assist.) | 300.15 |
30344 | Breast, malignant tumour, open surgical biopsy of, with or without frozen section histology (Anaes. 17710 = 5B + 5T) | 266.80 |
30347 | Breast, malignant tumour, complete local excision of, with or without frozen section histology (Anaes. 17712 = 5B + 7T) (Assist.) | 500.20 |
30348 | Breast, tumour site, re-excision of following open biopsy or incomplete excision of malignant tumour (Anaes. 17710 = 5B + 5T) (Assist.) | 335.50 |
30351 | Breast (female), total mastectomy (Anaes. 17712 = 5B + 7T) (Assist.) | 566.45 |
30352 | Breast (male), total mastectomy (Anaes. 17711 = 5B + 6T) (Assist.) | 333.50 |
30354 | Breast (female), subcutaneous mastectomy (Anaes. 17713 = 5B + 8T) (Assist.) | 800.35 |
30355 | Breast (male), subcutaneous mastectomy (Anaes. 17711 = 5B + 6T) (Assist.) | 400.15 |
45460 | Free grafting (split skin) to burns, including excision of burnt tissue, involving 15% or more but less than 20% of total body surface — 1 surgeon (Anaes. 17719 = 5B + 14T) (Assist.) | 964.25 |
45461 | Free grafting (split skin) to burns, including excision of burnt tissue, involving 15% or more but less than 20% of total body surface — conjoint surgery, principal surgeon (Anaes. 17715 = 5B + 10T) (Assist.) | 687.15 |
45462 | Free grafting (split skin) to burns, including excision of burnt tissue, involving 15% or more but less than 20% of total body surface — conjoint surgery, co-surgeon (Assist.) | 518.65 |
45464 | Free grafting (split skin) to burns, including excision of burnt tissue, involving 20% or more but less than 30% of total body surface — 1 surgeon (Anaes. 17721 = 5B + 16T) (Assist.) | 1 471.75 |
45465 | Free grafting (split skin) to burns, including excision of burnt tissue, involving 20% or more but less than 30% of total body surface — conjoint surgery, principal surgeon (Anaes. 17717 = 5B + 12T) (Assist.) | 1 048.50 |
45466 | Free grafting (split skin) to burns, including excision of burnt tissue, involving 20% or more but less than 30% of total body surface — conjoint surgery, co-surgeon (Assist.) | 790.70 |
45468 | Free grafting (split skin) to burns, including excision of burnt tissue, involving 30% or more but less than 40% of total body surface — conjoint surgery, principal surgeon (Anaes. 17724 = 10B + 14T) (Assist.) | 1 409.85 |
45469 | Free grafting (split skin) to burns, including excision of burnt tissue, involving 30% or more but less than 40% of total body surface — conjoint surgery, co-surgeon (Assist.) | 1 063.70 |
45471 | Free grafting (split skin) to burns, including excision of burnt tissue, involving 40% or more but less than 50% of total body surface — conjoint surgery, principal surgeon (Anaes. 17728 = 12B + 16T) (Assist.) | 1 772.20 |
45472 | Free grafting (split skin) to burns, including excision of burnt tissue, involving 40% or more but less than 50% of total body surface — conjoint surgery, co-surgeon (Assist.) | 1 336.75 |
45474 | Free grafting (split skin) to burns, including excision of burnt tissue, involving 50% or more but less than 60% of total body surface — conjoint surgery, principal surgeon (Anaes. 17734 = 14B + 20T) (Assist.) | 2 133.55 |
45475 | Free grafting (split skin) to burns, including excision of burnt tissue, involving 50% or more but less than 60% of total body surface — conjoint surgery, co-surgeon (Assist.) | 1 609.80 |
45477 | Free grafting (split skin) to burns, including excision of burnt tissue, involving 60% or more but less than 70% of total body surface — conjoint surgery, principal surgeon (Anaes. 17738 = 16B + 22T) (Assist.) | 2 494.85 |
45478 | Free grafting (split skin) to burns, including excision of burnt tissue, involving 60% or more but less than 70% of total body surface — conjoint surgery, co-surgeon (Assist.) | 1 881.80 |
45480 | Free grafting (split skin) to burns, including excision of burnt tissue, involving 70% or more but less than 80% of total body surface — conjoint surgery, principal surgeon (Anaes. 17742 = 18B + 24T) (Assist.) | 2 856.20 |
45481 | Free grafting (split skin) to burns, including excision of burnt tissue, involving 70% or more but less than 80% of total body surface — conjoint surgery, co-surgeon (Assist.) | 2 154.85 |
45483 | Free grafting (split skin) to burns, including excision of burnt tissue, involving 80% or more of total body surface — conjoint surgery, principal surgeon (Anaes. 17748 = 20B + 28T) (Assist.) | 3 254.10 |
45484 | Free grafting (split skin) to burns, including excision of burnt tissue, involving 80% or more of total body surface — conjoint surgery, co-surgeon (Assist.) | 2 455.30 |
45496 | Flap, free tissue transfer using microvascular techniques — revision of, by open operation (Anaes. 17713 = 5B + 8T) | 320.00 |
45497 | Flap, free tissue transfer using microvascular techniques — complete revision of, by liposuction (Anaes. 17709 = 5B + 4T) | 250.00 |
45498 | Flap, free tissue transfer using microvascular techniques — staged revision of, by liposuction (first stage) (Anaes. 17708 = 5B + 3T) | 201.20 |
45499 | Flap, free tissue transfer using microvascular techniques — staged revision of, by liposuction (second stage) (Anaes. 17708 = 5B + 3T) | 150.00 |
49564 | Knee, patello-femoral stabilisation of, combined arthroscopic and open procedure, including lateral release, medial capsulorrhaphy and tendon transfer (Anaes. 17714 = 4B + 10T) (Assist.) | 706.95 |
49837 | Foot, correction of hallux valgus by osteotomy of first metatarsal and transfer of adductor hallicus tendon, including internal fixation if performed — unilateral (Anaes. 17710 = 3B + 7T) (Assist.) | 497.95 |
49838 | Foot, correction of hallux valgus by osteotomy of first metatarsal and transfer of adductor hallicus tendon, including internal fixation if performed — bilateral (Anaes. 17713 = 3B + 10T) (Assist.) | 860.00 |
[7] Schedule 1, Part 2, items 30222, 30333, 30337, 30338, 30341, 30342, 30345, 30346, 30349, 30350, 30353, 30356, 30359 and 45419
omit
[8] Additional amendments of Schedule 1, Part 2
Item | omit | insert |
1 | 56.95 | 58.25 |
2 | 56.95 | 58.25 |
3 | 12.30 | 12.60 |
23 | 25.85 | 26.45 |
36 | 46.70 | 47.75 |
44 | 68.80 | 70.35 |
160 | 157.15 | 160.70 |
161 | 261.90 | 267.85 |
162 | 366.70 | 375.00 |
163 | 471.45 | 482.15 |
164 | 523.90 | 535.80 |
193 | 25.85 | 26.45 |
601 | 68.10 | 69.65 |
602 | 68.10 | 69.65 |
16502 | 25.65 | 25.85 |
16504 | 25.65 | 25.85 |
16505 | 25.65 | 25.85 |
16508 | 25.65 | 25.85 |
30332 | 189.90 | 266.80 |
30360 | 145.70 | 106.10 |
30364 | 125.10 | 166.70 |
30366 | 256.95 | 333.50 |
30367 | 205.55 | 266.80 |
30369 | 205.55 | 266.80 |
30370 | 116.15 | 199.85 |
30372 | 97.25 | 100.05 |
Notes
1. These Regulations amend Statutory Rules 1999 No. 256.
2. Made by the Governor-General on 27 April 2000, and notified in the Commonwealth of Australia Gazette on 28 April 2000.