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Determinations/Health as made
This Determination introduces new services eligible for Medicare benefits to align with the 'Changes to fees for fully depreciated diagnostic imaging equipment' or Capital Sensitivity 2009-10 Budget measure.
Administered by: Health
Made 02 May 2011
Registered 09 May 2011
Tabled HR 11 May 2011
Tabled Senate 11 May 2011
Date of repeal 27 Nov 2013
Repealed by Health Insurance (Diagnostic Imaging Capital Sensitivity) Amendment and Repeal Determination 2013
Repealing Comments ceases on the cessation or earlier repeal of the Health Insurance (Diagnostic Imaging Services Table) Regulation 2012.
Table of contents.

Health Insurance (Diagnostic Imaging Capital Sensitivity) Determination 2011

 

I, RICHARD BARTLETT, delegate of the Minister for Health and Ageing, make this Determination under subsection 3C(1) of the Health Insurance Act 1973.

Dated 2 May 2011

 

 

 

 

RICHARD BARTLETT

Delegate of the Minister for Health and Ageing

 



 

 

 

 

 


Contents

1.     Name of Determination. 3

2.     Commencement 3

3.     Interpretation. 3

4.     Treatment of certain diagnostic imaging services. 7

5.     Items in the DIST Regulations. 7

6.     NK items. 7

7.     References in Regulations. 12

8.     Reconsideration of decisions. 14

9.     Delegation. 14

SCHEDULE 1 – Specified health services. 15

SCHEDULE 2 – References in regulations. 85

 


1.                           Name of Determination

                This Determination is the Health Insurance (Diagnostic Imaging Capital Sensitivity) Determination 2011.

2.                           Commencement

                This Determination commences on 1 July 2011.

3.                           Interpretation

Definitions

(1)         In this Determination, unless the contrary intention appears:

Act means the Health Insurance Act 1973.

ASGC means the Australian Standard Geographical Classification, July 2010, published by the Australian Bureau of Statistics.

DIST Regulations means the Health Insurance (Diagnostic Imaging Services Table) Regulations 2010.

DIST service means a service to which an item in the DIST Regulations relates.

maximum extended life age has the meaning given in subsection (5).

new effective life age has the meaning given in subsection (4).

relevant proprietor, for diagnostic imaging equipment, means:

(a)               if the diagnostic imaging equipment is ordinarily located at diagnostic imaging premises, the proprietor of the diagnostic imaging premises; or

(b)               if the diagnostic imaging equipment is ordinarily located at a base for mobile diagnostic imaging equipment when not in use and is not ordinarily located at diagnostic imaging premises, the proprietor of the base for mobile diagnostic imaging equipment.

relevant service means a health service, as defined in subsection 3C(8) of the Act, that is specified in Schedule 1.

Rural, Remote and Metropolitan Areas Classification has the meaning given by the general medical services table.

Schedule means a Schedule to this Determination.

Note     Unless the contrary intention appears, expressions used in this Determination have the same meanings as in the Act—see section 13 of the Legislative Instruments Act 2003.

References to legislation

(2)         Unless the contrary intention appears, in this Determination a reference to a provision of the Act or regulations made under the Act or the National Health Act 1953 or regulations made under the National Health Act 1953 as applied, adopted or incorporated in relation to specifying a matter is a reference to those provisions as in force from time to time and any other reference to provisions of an Act or regulations is a reference to those provisions as in force from time to time.

Age of equipment

(3)         The date from which the age of equipment is worked out for this Determination is:

(a)               the date that the equipment was first installed in Australia; or

(b)               if the equipment was imported as used equipment — the date of manufacture of the oldest component of the equipment.

(4)         The new effective life age for diagnostic imaging equipment is the period set out in the following table for that type of diagnostic imaging equipment:

 

Modality

New effective life age

Ultrasound

diagnostic imaging equipment used to perform a service to which an item in Group I1 in Division 2.1 in Schedule 1 applies

10 years

Mammography

diagnostic imaging equipment used to perform a service to which an item in Subgroup 10 of Group I3 in Division 2.3 in Schedule 1 applies

10 years

Rest of diagnostic radiology

diagnostic imaging equipment used to perform a service to which an item in Subgroups 1 to 9, 11, 12, 14, 15 or 17 of Group I3 in Division 2.3 in Schedule 1 applies

15 years

Nuclear medicine (excluding PET)

diagnostic imaging equipment used to perform a service to which an item in Group I4 in Division 2.4 in Schedule 1 applies

10 years

MRI

diagnostic imaging equipment used to perform a service to which an item in Group I5 in Division 2.5 in Schedule 1 applies

10 years

 

(5)         The maximum extended life age for diagnostic imaging equipment is the period set out in the following table for that type of diagnostic imaging equipment:

 

Modality

Maximum extended life age

Ultrasound

diagnostic imaging equipment used to perform a service to which an item in Group I1 in Division 2.1 in Schedule 1 applies

15 years

Mammography

diagnostic imaging equipment used to perform a service to which an item in Subgroup 10 of Group I3 in Division 2.3 in Schedule 1 applies

15 years

Rest of diagnostic radiology

diagnostic imaging equipment used to perform a service to which an item in Subgroups 1 to 9, 11, 12, 14, 15 or 17 of Group I3 in Division 2.3 in Schedule 1 applies

20 years

Nuclear medicine (excluding PET)

diagnostic imaging equipment used to perform a service to which an item in Group I4 in Division 2.4 in Schedule 1 applies

15 years

MRI

diagnostic imaging equipment used to perform a service to which an item in Group I5 in Division 2.5 in Schedule 1 applies

15 years

 

Upgrades

(6)          For this Determination, diagnostic imaging equipment has been upgraded if:

(a)               an additional reasonable investment has been made within the new effective life age for the diagnostic imaging equipment that improves the overall performance of the imaging system so that it is equivalent to new diagnostic imaging equipment supplied in Australia at the time of the improvement; or

(b)               the diagnostic imaging equipment is currently accredited under The Royal Australian and New Zealand College of Radiologists' Mammography Quality Assurance Program.

Note     Proprietors can obtain further information on what constitutes an upgrade from the Department's website:  www.health.gov.au/capitalsensitivity

4.                           Treatment of certain diagnostic imaging services

                A relevant service shall in the circumstances specified in this Determination be treated for the purposes of the provisions of the Act and of regulations made under the Act and the provisions of the National Health Act 1953 and of regulations made under the National Health Act 1953 that make provision in respect of professional services or medical services as if:

(a)               it was both a professional service and a medical service; and

(b)               there was an item in the diagnostic imaging services table that:

(i)                related to the relevant service; and

(ii)              specified in respect of the relevant service a fee in relation to a State, being the fee specified in Schedule 1 in relation to the State specified.

5.                           Items in the DIST Regulations

                This Determination does not apply to a relevant service if a medicare benefit was paid in respect of a DIST service (other than item 63491, 63494, 63497, 64990 or 64991) rendered using the same diagnostic imaging procedure.

6.                           NK items

Application of NK items

(1)         Despite clause 1.2.4 of Schedule 1 to the DIST Regulations, subject to subsections (2) to (12), an item in Schedule 1 that includes the symbol (NK) at the end of the item applies where:

(a)               the age of the diagnostic imaging equipment used to perform the service exceeds the new effective life age for the diagnostic imaging equipment and the diagnostic imaging equipment has not been upgraded; or

(b)               the age of upgraded diagnostic imaging equipment used to perform the service exceeds the maximum extended life age for the diagnostic imaging equipment.

Exemption – notice period and replacement by 30 September 2011

(2)          An item in Schedule 1 that includes the symbol (NK) at the end of the item does not apply where:

(a)               the service is performed before 1 October 2011; and

(b)               the relevant proprietor for the diagnostic imaging equipment used to perform the service intends to replace the diagnostic imaging equipment by 30 September 2011.

Exemption – intention to replace equipment

(3)         An item in Schedule 1 that includes the symbol (NK) at the end of the item does not apply where:

(a)               the Secretary has granted an extension under subsection (4) in respect of the diagnostic imaging equipment used to provide the service; and

(b)               the service is performed before the end of the extension period.

(4)         The Secretary may grant an extension in writing specifying the end of the extension period in respect of diagnostic imaging equipment where the relevant proprietor applies in writing to the Department by 29 July 2011 providing documentary evidence to satisfy the Secretary that the relevant proprietor will replace the diagnostic imaging equipment but is unable to do so by 30 September 2011.

Exemption – outer regional, remote and very remote areas

(5)         An item in Schedule 1 that includes the symbol (NK) at the end of the item does not apply where:

(a)               the diagnostic imaging equipment used to perform the service is ordinarily located at diagnostic imaging premises; and

(b)               the diagnostic imaging premises are located in any of the following Remoteness Areas as defined in the ASGC:

(i)                Outer Regional Australia (Remoteness Area 2);

(ii)              Remote Australia (Remoteness Area 3);

(iii)            Very Remote Australia (Remoteness Area 4).

Note     Proprietors can identify what Remoteness Area they fall under at the Department's DoctorConnect website:  www.doctorconnect.gov.au  Proprietors should refer to the category names, rather than category numbers as the website uses different category numbers from those specified in this Determination.

(6)         An item in Schedule 1 that includes the symbol (NK) at the end of the item does not apply where:

(a)               the diagnostic imaging equipment used to perform the service is ordinarily located at a base for mobile diagnostic imaging equipment when not in use;

(b)               the diagnostic imaging equipment used to perform the service is not ordinarily located at diagnostic imaging premises; and

(c)               the base for mobile diagnostic imaging equipment is located in any of the following Remoteness Areas as defined in the ASGC:

(i)                Outer Regional Australia (Remoteness Area 2);

(ii)              Remote Australia (Remoteness Area 3);

(iii)            Very Remote Australia (Remoteness Area 4).

Note     Proprietors can identify what Remoteness Area they fall under at the Department's DoctorConnect website:  www.doctorconnect.gov.au  Proprietors should refer to the category names, rather than category numbers as the website uses different category numbers from those specified in this Determination.

Exemption – inner regional areas

(7)         An item in Schedule 1 that includes the symbol (NK) at the end of the item does not apply where the Secretary has granted an exemption in respect of the diagnostic imaging equipment used to perform the service under subsection (8).

(8)         The Secretary may grant an exemption in writing in respect of diagnostic imaging equipment where all of the following requirements are met:

(a)               the relevant proprietor applies in writing to the Department by 29 July 2011;

(b)               either:

(i)                all of the following apply:

(A)            the diagnostic imaging equipment is ordinarily located at diagnostic imaging premises;

(B)            the diagnostic imaging premises are located in Inner Regional Australia (Remoteness Area 1) as defined in the ASGC; and

(C)            the diagnostic imaging premises are located in an area classified as RRMA 4 or 5 (small rural centres and other rural areas) under the Rural, Remote and Metropolitan Areas Classification; or

(ii)              all of the following apply:

(A)            the diagnostic imaging equipment is ordinarily located at a base for mobile diagnostic imaging equipment when not in use;

(B)            the diagnostic imaging equipment is not ordinarily located at diagnostic imaging premises;

(C)            the base for mobile diagnostic imaging equipment is located in Inner Regional Australia (Remoteness Area 1) as defined in the ASGC; and

(D)            the base for mobile diagnostic imaging equipment is located in an area classified as RRMA 4 or 5 (small rural centres and other rural areas) under the Rural, Remote and Metropolitan Areas Classification;

(c)               the Secretary is satisfied that the diagnostic imaging equipment is operated on a sporadic or rare basis and provides crucial patient access to diagnostic imaging services;

(d)              the age of the diagnostic imaging equipment exceeds the maximum extended life age for the diagnostic imaging equipment by less than three years; and

(e)               the relevant proprietor provides documentary evidence to satisfy the Secretary that the diagnostic imaging equipment has been well maintained over its working life.

Exemptions – during application processes

(9)          If a proprietor applies for an extension under subsection (4) or an exemption under subsection (8), the Secretary must notify the proprietor of his or her decision.

(10)      An item in Schedule 1 that includes the symbol (NK) at the end of the item does not apply where:

(a)              the service is performed before 29 July 2011; and

(b)              the relevant proprietor for the diagnostic imaging equipment used to perform the service intends to apply for an extension under subsection (4) or an exemption under subsection (8).

(11)      An item in Schedule 1 that includes the symbol (NK) at the end of the item does not apply where:

(a)              the relevant proprietor for the diagnostic imaging equipment used to perform the service has applied for an extension under subsection (4) or an exemption under subsection (8); and

(b)              the Secretary has not yet notified the proprietor of his or her decision under subsection (9).

(12)      An item in Schedule 1 that includes the symbol (NK) at the end of the item does not apply where:

(a)              the relevant proprietor for the diagnostic imaging equipment used to perform the service has applied for an extension under subsection (4) or an exemption under subsection (8);

(b)              the Secretary has notified the proprietor that he or she has refused to grant the extension or exemption; and

(c)              either:

(i)                if the proprietor has not yet applied for reconsideration under section 8, the period to apply for reconsideration has not yet expired; or

(ii)              if the proprietor has applied for reconsideration under section 8, the Secretary has not yet notified the proprietor of his or her reconsideration decision.

7.                           References in Regulations

(1)         Each provision of the regulations or any instrument made under or given pursuant to the Act which refers to a Division, Subdivision, Group or Subgroup in the diagnostic imaging services table shall have effect as if the reference to the Division, Subdivision, Group or Subgroup also specified the items in the corresponding Division, Subdivision, Group or Subgroup in Schedule 1, or the relevant services to which those items are related by virtue of paragraph 4(b), as the case requires.

Note     Paragraph 3C(1)(b) of the Act allows the Minister to determine that provisions of the regulations or instruments made under the Act which specify a professional service, medical service or item have effect as if they also specified a health service or item created by this Determination. Under subsection 7(1), a reference in regulations or an instrument to a Division, Subdivision, Group or Subgroup of the diagnostic imaging services table will be taken to include a reference to the items in the corresponding Division, Subdivision, Group or Subgroup in Schedule 1.

(2)         For the avoidance of doubt, a reference in Schedule 1 to a Group or Subgroup has effect as if it also referred to the corresponding Group or Subgroup in the diagnostic imaging services table.

Note     Subsection 7(2) is an interpretation provision which complements subsection 7(1).

(3)         Each of the provisions of Schedule 1 to the DIST Regulations in column 1 of the table in item 1 of Schedule 2 shall have effect as if the corresponding existing item reference in column 2 of the table in item 1 of Schedule 2 also specified the corresponding additional item reference in column 3 of the table in item 1 of Schedule 2, or the relevant service to which that item is related by virtue of paragraph 4(b), as the case requires.

(4)         Each of the items in Schedule 1 to the DIST Regulations in column 1 of the table in item 2 of Schedule 2 shall have effect as if the corresponding existing item reference in column 2 of the table in item 2 of Schedule 2 also specified the corresponding additional item reference in column 3 of the table in item 2 of Schedule 2, or the relevant service to which that item is related by virtue of paragraph 4(b), as the case requires.

(5)         Each of the definitions in the Dictionary in the DIST Regulations in column 1 of the table in item 3 of Schedule 2 shall have effect as if the corresponding existing item reference in column 2 of the table in item 3 of Schedule 2 also specified the corresponding additional item reference in column 3 of the table in item 3 of Schedule 2, or the relevant service to which that item is related by virtue of paragraph 4(b), as the case requires.

(6)         Each of the provisions of the Health Insurance Regulations 1975 in column 1 of the table in item 4 of Schedule 2 shall have effect as if the corresponding existing item reference in column 2 of the table in item 4 of Schedule 2 also specified the corresponding additional item reference in column 3 of the table in item 4 of Schedule 2, or the relevant service to which that item is related by virtue of paragraph 4(b), as the case requires.

(7)         Each of the provisions of Schedule 1 to the Health Insurance (General Medical Services Table) Regulations 2010 in column 1 of the table in item 5 of Schedule 2 shall have effect as if the corresponding existing item reference in column 2 of the table in item 5 of Schedule 2 also specified the corresponding additional item reference in column 3 of the table item 5 of Schedule 2, or the relevant service to which that item is related by virtue of paragraph 4(b), as the case requires.

Note     Paragraph 3C(1)(b) of the Act allows the Minister to determine that provisions of regulations which specify an item have effect as if they also specified an item created by this Determination. Subsections 7(3) to (7) and the tables in Schedule 2 provide that provisions of the DIST Regulations, Health Insurance Regulations 1975 and Health Insurance (General Medical Services Table) Regulations 2010 which specify items have effect as if they also specified the relevant NK items created by Schedule 1.

8.                           Reconsideration of decisions

(1)         If a delegate of the Secretary:

(a)              refuses to grant an extension under subsection 6(4); or

(b)              refuses to grant an exemption under subsection 6(8),

the proprietor who applied for the extension or exemption may apply to the Secretary for reconsideration of the decision within 28 days after the date of issue of the notice of the decision to the proprietor (or, if the Secretary is satisfied that special circumstances exist, within such further period (if any) as the Secretary allows).

(2)         In the application, the proprietor:

(a)              must identify the decision for reconsideration and set out the reasons for the application; and

(b)              may provide new material for the Secretary to consider.

(3)         The Secretary must, within 28 days after receipt of an application, reconsider the decision and:

(a)              affirm the decision;

(b)              vary the decision; or

(c)              set aside the decision and make a decision in substitution for it.

(4)         The Secretary must notify the proprietor of a reconsideration decision under subsection (3).

9.                           Delegation

(1)         The Secretary may, either generally or as otherwise provided by the instrument of delegation, by writing signed by him or her, delegate to an officer of the Department any of his or her powers under this Determination, other than this power of delegation.

(2)         A power so delegated, when exercised by the delegate, shall, for the purposes of this Determination, be deemed to have been exercised by the Secretary.

(3)         A delegation under this section does not prevent the exercise of a power by the Secretary.


SCHEDULE 1 – Specified health services

 

Division 2.1           Group I1 — Ultrasound

Subdivision A              Not used

Subdivision B              Subgroup 1 to 4 of Group I1

 

Group I1 — Ultrasound

Item

Health service

Fee ($) (for each State)

Subgroup 1 — General

55005

Head, ultrasound scan of, if:

   (a)  the patient is referred by a medical practitioner for ultrasonic examination not being a service associated with a service to which an item in Subgroup 2 or 3 applies; and

  (b)  the referring medical practitioner is not a member of a group of practitioners of which the providing practitioner is a member (R) (NK)

54.55

 

55007

Head, ultrasound scan of, if the patient is not referred by a medical practitioner, not being a service associated with a service to which an item in Subgroup 2 or 3 applies (NR) (NK)

18.95

55008

Orbital contents, ultrasound scan of, if:

   (a)  the patient is referred by a medical practitioner for ultrasonic examination not being a service associated with a service to which an item in Subgroup 2 or 3 applies; and

  (b)  the referring medical practitioner is not a member of a group of practitioners of which the providing practitioner is a member (R) (NK)

54.55

55010

Orbital contents, ultrasound scan of, if the patient is not referred by a medical practitioner, not being a service associated with a service to which an item in Subgroup 2 or 3 applies (NR) (NK)

18.95

55011

Neck, 1 or more structures of, ultrasound scan of, if:

   (a)  the patient is referred by a medical practitioner for ultrasonic examination not being a service associated with a service to which an item in Subgroup 2 or 3 applies; and

  (b)  the referring medical practitioner is not a member of a group of practitioners of which the providing practitioner is a member (R) (NK)

54.55

55013

Neck, 1 or more structures of, ultrasound scan of, if the patient is not referred by a medical practitioner, not being a service associated with a service to which an item in Subgroup 2 or 3 applies (NR) (NK)

18.95

55014

Abdomen, ultrasound scan of (including scan of urinary tract when performed), if:

   (a)  the patient is referred by a medical practitioner or participating nurse practitioner for ultrasonic examination; and

55.65

 

  (b)  if the patient is referred by a medical practitioner — the referring medical practitioner is not a member of a group of practitioners of which the providing practitioner is a member; and

   (c)  if the patient is referred by a participating nurse practitioner — the referring nurse practitioner does not have a business or financial arrangement with the providing practitioner; and

  (d)  the service is not a service associated with a service to which an item in Subgroup 2 or 3 applies; and

 

 

   (e)  the service is not solely a transrectal ultrasonic examination of the prostate gland, bladder base and urethra, or any of those organs; and

 

 

   (f)  within 24 hours of the service, a service described in item 55017, 55020, 55038, 55044, 55731 or 55732 is not performed on the same patient by the providing practitioner (R) (NK)

 

55016

Abdomen, ultrasound scan of (including scan of urinary tract when performed), if:

   (a)  the patient is not referred by a medical practitioner or participating nurse practitioner; and

18.95

 

 

  (b)  the service is not a service 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)

 

55017

Urinary tract, ultrasound scan of, if:

   (a)  the patient is referred by a medical practitioner for ultrasonic examination; and

  (b)  the referring medical practitioner is not a member of a group of practitioners of which the providing practitioner is a member; and

54.55

 

 

   (c)  the service is not a service 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 described in item 55014, 55020, 55036, 55044, 55731 or 55732 is not performed on the same patient by the providing practitioner (R) (NK)

 

55019

Urinary tract, ultrasound scan of, if:

   (a)  the patient is not referred by a medical practitioner; and

  (b)  the service is not a service 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)

18.95

 

55020

Pelvis, male, ultrasound scan of, by any or all approaches, if:

   (a)  the patient is referred by a medical practitioner for ultrasonic examination; and

  (b)  the referring 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 a service associated with a service to which an item in Subgroup 2 or 3 applies; and

55.65

 

 

  (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 described in item 55014, 55017, 55036 or 55038 is not performed on the same patient by the providing practitioner (R) (NK)

 

55022

Pelvis, male, 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 a service 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)

18.95

 

55023

Scrotum, ultrasound scan of, if:

   (a)  the patient is referred by a medical practitioner for ultrasonic examination not being a service associated with a service to which an item in Subgroup 2 or 3 applies; and

  (b)  the referring medical practitioner is not a member of a group of practitioners of which the providing practitioner is a member (R) (NK)

54.75

 

55025

Scrotum, ultrasound scan of, if the patient is not referred by a medical practitioner, not being a service associated with a service to which an item in Subgroup 2 or 3 applies (NR) (NK)

18.95

55026

Ultrasonic cross‑sectional echography, in conjunction with a surgical procedure using interventional techniques, not being a service associated with a service to which any other item in this group applies (R) (NK)

54.55

55059

Breast, one, ultrasound scan of, if:

   (a)  the patient is referred by a medical practitioner or participating nurse practitioner; and

  (b)  the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and

   (c)  if the patient is referred by a medical practitioner — the referring medical practitioner is not a member of a group of practitioners of which the providing practitioner is a member; and

  (d)  if the patient is referred by a participating nurse practitioner — the referring nurse practitioner does not have a business or financial arrangement with the providing practitioner (R) (NK)

49.15

55060

Breast, one, ultrasound scan of, if:

   (a)  the patient is not referred by a medical practitioner or participating nurse practitioner; and

  (b)  the service is not associated with a service to which an item in Subgroup 2 or 3 applies (NR) (NK)

17.05

55061

Breasts, both, ultrasound scan of, if:

   (a)  the patient is referred by a medical practitioner or participating nurse practitioner; and

  (b)  the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and

   (c)  if the patient is referred by a medical practitioner — the referring medical practitioner is not a member of a group of practitioners of which the providing practitioner is a member; and

  (d)  if the patient is referred by a participating nurse practitioner — the referring nurse practitioner does not have a business or financial arrangement with the providing practitioner (R) (NK)

54.55

 

55062

Breasts, both, ultrasound scan of, if:

   (a)  the patient is not referred by a medical practitioner or participating nurse practitioner; and

  (b)  the service is not associated with a service to which an item in Subgroup 2 or 3 applies (NR) (NK)

18.95

 

55063

Urinary bladder, ultrasound scan of, by any or all approaches, if:

   (a)  the patient is referred by a medical practitioner for ultrasonic examination; and

  (b)  the referring medical practitioner is not a member of a group of practitioners of which the providing practitioner is a member; and

49.15

 

   (c)  the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and

  (d)  within 24 hours of the service, a service described in item 11917, 55014, 55017, 55020, 55036, 55038, 55044, 55600, 55601, 55603, 55604, 55731 or 55732 is not performed on the same patient by the providing practitioner (R) (NK)

 

55064

Urinary bladder, 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

17.05

 

 

   (c)  within 24 hours of the service, a service described in item 11917, 55016, 55019, 55022, 55037, 55039, 55045, 55600, 55601, 55603, 55604, 55733 or 55734 is not performed on the same patient by the providing practitioner (NR) (NK)

 

Subgroup 2 — Cardiac

55119

M‑mode and two‑dimensional real time echocardiographic examination of the heart from at least 2 acoustic windows for the investigation of symptoms or signs of cardiac failure, or suspected or known ventricular hypertrophy or dysfunction, or chest pain:

115.35

 

   (a)  with:

         (i)   measurement of blood flow velocities across the cardiac valves using pulsed wave and continuous wave Doppler techniques; and

        (ii)   real time colour flow mapping from at least 2 acoustic windows; and

       (iii)   recordings on video tape or digital media; and

  (b)  not being a service associated with a service to which an item in Subgroup 1 (except items 55026 and 55054) or 3, or another item in this Subgroup (except items 55118, 55125, 55130 and 55131), applies (R) (NK)

 

55120

M‑mode and two‑dimensional real time echocardiographic examination of the heart from at least 2 acoustic windows for the investigation of suspected or known acquired valvular, aortic, pericardial, thrombotic or embolic disease or heart tumour:

   (a)  with:

         (i)   measurement of blood flow velocities across the cardiac valves using pulsed wave and continuous wave Doppler techniques; and

        (ii)   real time colour flow mapping from at least 2 acoustic windows; and

       (iii)   recordings on video tape or digital media; and

115.35

 

 

  (b)  not being a service associated with a service to which an item in Subgroup 1 (except items 55026 and 55054) or 3, or another item in this Subgroup (except items 55118,  55125, 55130 and 55131), applies (R) (NK)

 

55121

M‑mode and two‑dimensional real time echocardiographic examination of the heart from at least 2 acoustic windows for the investigation of symptoms or signs of congenital heart disease:

   (a)  with:

         (i)   measurement of blood flow velocities across the cardiac valves using pulsed wave and continuous wave Doppler techniques; and

115.35

 

 

        (ii)   real time colour flow mapping from at least 2 acoustic windows; and

       (iii)   recordings on video tape or digital media; and

  (b)  not being a service associated with a service to which an item in Subgroup 1 (except items 55026 and 55054) or 3, or another item in this Subgroup (except items 55118, 55125, 55130 and 55131), applies (R) (NK)

 

55122

Exercise stress echocardiography performed in conjunction with item 11712:

   (a)  with:

         (i)   two‑dimensional recordings before exercise (baseline) from at least 3 acoustic windows; and

130.85

 

 

        (ii)   matching recordings from the same windows at, or immediately after, peak exercise; and

       (iii)   recordings on digital media with equipment permitting display of baseline and matching peak images on the same screen; and

  (b)  not being a service associated with a service to which an item in Subgroup 1 (except items 55026 and 55054) or 3, or another item in this Subgroup (except items 55118, 55125, 55130 and 55131), applies (R) (NK)

 

55123

Pharmacological stress echocardiography performed in conjunction with item 11712:

   (a)  with:

         (i)   two‑dimensional recordings before drug infusion (baseline) from at least 3 acoustic windows; and

        (ii)   matching recordings from the same windows at least twice during drug infusion, including a recording at the peak drug dose; and

130.85

 

 

       (iii)   recordings on digital media with equipment permitting display of baseline and matching peak images on the same screen; and

  (b)  not being a service associated with a service to which an item in Subgroup 1 (except items 55026 and 55054) or 3, or another item in this Subgroup (except items 55118, 55125, 55130 and 55131), applies (R) (NK)

 

55125

Heart, two‑dimensional real time transoesophageal examination of, from at least 2 levels, and in more than 1 plane at each level:

   (a)  with:

         (i)   real time colour flow mapping and, if indicated, pulsed wave Doppler examination; and

        (ii)   recordings on video tape or digital medium; and

137.75

 

 

  (b)  not being an intra‑operative service or a service associated with a service to which an item in Subgroup 1 (except items 55026 and 55054) or 3 applies (R) (NK) (Anaes.)

 

55131

Intra‑operative 2 dimensional real time transoesophageal echocardiography incorporating Doppler techniques with colour flow mapping and recording onto video tape or digital medium, performed during cardiac surgery incorporating sequential assessment of cardiac function before and after the surgical procedure, not being a service associated with a service to which item 55135 or 55136 applies (R) (NK) (Anaes.)

85.00

55136

Intra‑operative 2 dimensional real time transoesophageal echocardiography incorporating Doppler techniques with colour flow mapping and recording onto video tape or digital medium, performed during cardiac valve surgery (replacement or repair) incorporating sequential assessment of cardiac function and valve competence before and after the surgical procedure, not being a service associated with a service to which item 55130 or 55131 applies (R) (NK) (Anaes.)

176.80

Subgroup 3 — Vascular

55220

Duplex scanning, unilateral, involving B mode ultrasound imaging and integrated Doppler flow measurements by spectral analysis of arteries or bypass grafts in the lower limb or of arteries and bypass grafts in the lower limb, below the inguinal ligament, not being a service associated with a service to which an item in Subgroup 1 (with the exception of items 55026 and 55054) or 4 applies (R) (NK)

84.75

55221

Duplex scanning, unilateral, involving B mode ultrasound imaging and integrated Doppler flow measurements by spectral analysis of veins in the lower limb, below the inguinal ligament, for acute venous thrombosis, not being a service associated with a service to which an item in Subgroup 1 (with the exception of items 55026 and 55054) or 4 applies (R) (NK)

84.75

55222

Duplex scanning, unilateral, involving B mode ultrasound imaging and integrated Doppler flow measurements by spectral analysis of veins in the lower limb, below the inguinal ligament, for chronic venous disease, not being a service associated with a service to which an item in Subgroup 1 (with the exception of items 55026 and 55054) or 4 applies (R) (NK)

84.75

55223

Duplex scanning, unilateral, involving B mode ultrasound imaging and integrated Doppler flow measurements by spectral analysis of arteries or bypass grafts in the upper limb or of arteries and bypass grafts in the upper limb, not being a service associated with a service to which an item in Subgroup 1 (with the exception of items 55026 and 55054) or 4 applies (R) (NK)

84.75

55224

Duplex scanning, unilateral, involving B mode ultrasound imaging and integrated Doppler flow measurements by spectral analysis of veins in the upper limb, not being a service associated with a service to which an item in Subgroup 1 (with the exception of items 55026 and 55054) or 4 applies (R) (NK)

84.75

55226

Duplex scanning, bilateral, involving B mode ultrasound imaging and integrated Doppler flow measurements by spectral analysis of extra‑cranial bilateral carotid and vertebral vessels, with or without subclavian and innominate vessels, with or without oculoplethysmography or peri‑orbital Doppler examination, not being a service associated with a service to which an item in Subgroup 1 (with the exception of items 55026 and 55054) or 4 applies (R) (NK)

84.75

55227

Duplex scanning involving B mode ultrasound imaging and integrated Doppler flow measurements by spectral analysis of intra‑abdominal, aorta and iliac arteries or inferior vena cava and iliac veins or of intra‑abdominal, aorta and iliac arteries and inferior vena cava and iliac veins, excluding pregnancy related studies, not being a service associated with a service to which an item in Subgroup 1 (with the exception of items 55026 and 55054) or 4 applies (R) (NK)

84.75

55228

Duplex scanning involving B mode ultrasound imaging and integrated Doppler flow measurements by spectral analysis of renal or visceral vessels or of renal and visceral vessels, including aorta, inferior vena cava and iliac vessels as required excluding pregnancy related studies, not being a service associated with a service to which an item in Subgroup 1 (with the exception of items 55026 and 55054) or 4 applies (R) (NK)

84.75

55229

Duplex scanning involving B mode ultrasound imaging and integrated Doppler flow measurements by spectral analysis of intra‑cranial vessels, not being a service associated with a service to which an item in Subgroup 1 (with the exception of items 55026 and 55054) or 4 applies (R) (NK)

84.75

55230

Duplex scanning involving B mode ultrasound imaging and integrated Doppler flow measurements:

   (a)  by spectral analysis of cavernosal artery of the penis following intracavernosal administration of a vasoactive agent; and

  (b)  performed during the period of pharmacological activity of the injected agent, to confirm a diagnosis of vascular aetiology for impotence; and

84.75

 

   (c)  if a specialist in diagnostic radiology, nuclear medicine, urology, general surgery (sub‑specialising in vascular surgery) or a consultant physician in nuclear medicine attends the patient in person at the practice location where the service is performed, immediately before or for a period during the performance of the service; and

 

 

  (d)  if the specialist or consultant physician interprets the results and prepares a report, not being a service associated with a service to which an item in Subgroup 1 (with the exception of items 55026 and 55054) or 4 applies (R) (NK)

 

55232

Duplex scanning involving B mode ultrasound imaging and integrated Doppler flow measurements:

   (a)  by spectral analysis of cavernosal tissue of the penis to confirm a diagnosis; and

  (b)  if indicated, assess the progress and management of:

         (i)   priapism; or

        (ii)   fibrosis of any type; or

84.75

 

 

       (iii)   fracture of the tunica; or

       (iv)   arteriovenous malformations; and

 

 

   (c)  if a specialist in diagnostic radiology, nuclear medicine, urology, general surgery (sub‑specialising in vascular surgery) or a consultant physician in nuclear medicine attends the patient in person at the practice location where the service is performed, immediately before or for a period during the performance of the service; and

 

 

  (d)  if the specialist or consultant physician interprets the results and prepares a report, not being a service associated with a service to which an item in Subgroup 1 (with the exception of items 55026 and 55054) or 4 applies (R) (NK)

 

55233

Duplex scanning, unilateral, involving B mode ultrasound imaging and integrated Doppler flow measurements by spectral analysis of surgically created arteriovenous fistula or surgically created arteriovenous access grafts in the upper or lower limbs, not being a service associated with a service to which an item in Subgroup 1 (with the exception of items 55026 and 55054) or 4 applies (R) (NK)

84.75

55235

Duplex scanning involving B mode ultrasound imaging and integrated Doppler flow measurements by spectral analysis of arteries or veins, or both, including any associated skin marking, for mapping of bypass conduit before vascular surgery, not being a service associated with a service to which an item in Subgroup 1 (with the exception of items 55026 and 55054), 3 or 4 applies (R) (NK)

84.75

55236

Duplex scanning, unilateral, involving B mode ultrasound imaging and integrated Doppler flow spectral analysis and marking of veins in the lower limbs below the inguinal ligament before varicose vein surgery, including any associated skin marking, not being a service associated with a service to which an item in Subgroup 1 (with the exception of items 55026 and 55054), 3 or 4 applies (R) (NK)

55.55

Subgroup 4 — Urological

55601

Prostate, bladder base and urethra, transrectal ultrasound scan of, if performed:

   (a)  personally by a medical practitioner (not being the medical practitioner who assessed the patient as specified in paragraph (c)) using a transducer probe that:

         (i)   has a nominal frequency of 7 to 7.5 MHz or a nominal frequency range that includes frequencies of 7 to 7.5 MHz; and

        (ii)   can obtain both axial and sagittal scans in 2 planes at right angles; and

  (b)  following a digital rectal examination of the prostate by that medical practitioner; and

54.55

 

 

   (c)  on a patient who has been assessed by a specialist in urology, radiation oncology or medical oncology, a consultant physician in medical oncology, or a participating nurse practitioner, who has:

         (i)   examined the patient in the 60 days before the scan; and

        (ii)   recommended the scan for the management of the patient’s current prostatic disease (R) (NK)

 

55604

Prostate, bladder base and urethra, transrectal ultrasound scan of, if performed:

   (a)  personally by a medical practitioner who made the assessment mentioned in paragraph (c) using a transducer probe that:

         (i)   has a nominal frequency of 7 to 7.5 MHz or a nominal frequency range that includes frequencies of 7 to 7.5 MHz; and

        (ii)   can obtain both axial and sagittal scans in 2 planes at right angles; and

  (b)  following a digital rectal examination of the prostate by that medical practitioner; and

54.55

 

 

   (c)  on a patient who has been assessed by a specialist in urology, radiation oncology or medical oncology or a consultant physician in medical oncology who has:

         (i)   examined the patient in the 60 days before the scan; and

        (ii)   recommended the scan for the management of the patient’s current prostatic disease (R) (NK)

 

 

Subdivision C              Subgroup 5 of Group I1 — Obstetric and gynaecological

Group I1 — Ultrasound

Item

Health service

Fee ($) (for each State)

Subgroup 5 — Obstetric and gynaecological

55701

Pelvis or abdomen, pregnancy‑related or pregnancy complication, ultrasound scan of, by any or all approaches, if:

   (a)  the patient is referred by a medical practitioner or participating midwife; and

  (b)  the dating of the pregnancy (as confirmed by ultrasound) is less than 12 weeks of gestation; and

   (c)  the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and

  (d)  if the patient is referred by a medical practitioner — the referring medical practitioner is not a member of a group of practitioners of which the providing practitioner is a member; and

   (e)  if the patient is referred by a participating midwife — the referring midwife does not have a business or financial arrangement with the providing practitioner; and

30.00

 

 

   (f)  1 or more of the following conditions are present:

         (i)   hyperemesis gravidarum;

        (ii)   diabetes mellitus;

       (iii)   hypertension;

       (iv)   toxaemia of pregnancy;

        (v)   liver or renal disease;

       (vi)   autoimmune disease;

      (vii)   cardiac disease;

     (viii)   alloimmunisation;

       (ix)   maternal infection;

        (x)   inflammatory bowel disease;

       (xi)   bowel stoma;

 

 

      (xii)   abdominal wall scarring;

     (xiii)   previous spinal or pelvic trauma or disease;

     (xiv)   drug dependency;

      (xv)   thrombophilia;

     (xvi)   significant maternal obesity;

    (xvii)   advanced maternal age;

   (xviii)   abdominal pain or mass;

     (xix)   uncertain dates;

      (xx)   high risk pregnancy;

     (xxi)   previous post dates delivery;

    (xxii)   previous caesarean section;

   (xxiii)   poor obstetric history;

   (xxiv)   suspicion of ectopic pregnancy;

    (xxv)   risk of miscarriage;

   (xxvi)   diminished symptoms of pregnancy;

  (xxvii)   suspected or known cervical incompetence;

(xxviii)   suspected or known uterine abnormality;

   (xxix)   pregnancy after assisted reproduction;

    (xxx)   risk of fetal abnormality (R) (NK)

 

 

55702

Pelvis or abdomen, pregnancy‑related or pregnancy complication, ultrasound scan of, by any or all approaches, if:

   (a)  the patient is not referred by a medical practitioner or participating midwife; and

  (b)  the dating of the pregnancy (as confirmed by ultrasound) is less than 12 weeks of gestation; and

   (c)  the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and

  (d)  1 or more of the following conditions are present:

         (i)   hyperemesis gravidarum;

        (ii)   diabetes mellitus;

       (iii)   hypertension;

       (iv)   toxaemia of pregnancy;

        (v)   liver or renal disease;

       (vi)   autoimmune disease;

17.50

 

 

      (vii)   cardiac disease;

     (viii)   alloimmunisation;

       (ix)   maternal infection;

 

 

        (x)   inflammatory bowel disease;

       (xi)   bowel stoma;

 

 

      (xii)   abdominal wall scarring;

     (xiii)   previous spinal or pelvic trauma or disease;

     (xiv)   drug dependency;

 

 

      (xv)   thrombophilia;

     (xvi)   significant maternal obesity;

    (xvii)   advanced maternal age;

   (xviii)   abdominal pain or mass;

 

 

     (xix)   uncertain dates;

      (xx)   high risk pregnancy;

     (xxi)   previous post dates delivery;

    (xxii)   previous caesarean section;

   (xxiii)   poor obstetric history;

 

 

   (xxiv)   suspicion of ectopic pregnancy;

    (xxv)   risk of miscarriage;

   (xxvi)   diminished symptoms of pregnancy;

  (xxvii)   suspected or known cervical incompetence;

(xxviii)   suspected or known uterine abnormality;

   (xxix)   pregnancy after assisted reproduction;

    (xxx)   risk of fetal abnormality (NR) (NK)

 

55710

Pelvis or abdomen, pregnancy‑related or pregnancy complication, fetal development and anatomy, ultrasound scan of, by any or all approaches, if:

   (a)  the patient is referred by a medical practitioner or participating midwife; and

  (b)  the dating of the pregnancy (as confirmed by ultrasound) is 12 to 16 weeks of gestation; and

   (c)  the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and

35.00

 

 

  (d)  if the patient is referred by a medical practitioner — the referring medical practitioner is not a member of a group of practitioners of which the providing practitioner is a member; and

   (e)  if the patient is referred by a participating midwife — the referring midwife does not have a business or financial arrangement with the providing practitioner; and

 

 

   (f)  1 or more of the following conditions are present:

         (i)   hyperemesis gravidarum;

        (ii)   diabetes mellitus;

       (iii)   hypertension;

       (iv)   toxaemia of pregnancy;

        (v)   liver or renal disease;

       (vi)   autoimmune disease;

      (vii)   cardiac disease;

     (viii)   alloimmunisation;

       (ix)   maternal infection;

        (x)   inflammatory bowel disease;

       (xi)   bowel stoma;

      (xii)   abdominal wall scarring;

     (xiii)   previous spinal or pelvic trauma or disease;

     (xiv)   drug dependency;

      (xv)   thrombophilia;

     (xvi)   significant maternal obesity;

 

 

    (xvii)   advanced maternal age;

   (xviii)   abdominal pain or mass;

     (xix)   uncertain dates;

      (xx)   high risk pregnancy;

     (xxi)   previous post dates delivery;

    (xxii)   previous caesarean section;

   (xxiii)   poor obstetric history;

 

 

   (xxiv)   suspicion of ectopic pregnancy;

    (xxv)   risk of miscarriage;

   (xxvi)   diminished symptoms of pregnancy;

  (xxvii)   suspected or known cervical incompetence;

(xxviii)   suspected or known uterine abnormality;

   (xxix)   pregnancy after assisted reproduction;

    (xxx)   risk of fetal abnormality (R) (NK)

 

55711

Pelvis or abdomen, pregnancy‑related or pregnancy complication, fetal development and anatomy, ultrasound scan of, by any or all approaches, if:

   (a)  the patient is not referred by a medical practitioner or participating midwife; and

  (b)  the dating of the pregnancy (as confirmed by ultrasound) is 12 to 16 weeks of gestation; and

   (c)  the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and

17.50

 

 

  (d)  1 or more of the following conditions are present:

         (i)   hyperemesis gravidarum;

        (ii)   diabetes mellitus;

       (iii)   hypertension;

       (iv)   toxaemia of pregnancy;

        (v)   liver or renal disease;

       (vi)   autoimmune disease;

 

 

      (vii)   cardiac disease;

     (viii)   alloimmunisation;

       (ix)   maternal infection;

        (x)   inflammatory bowel disease;

       (xi)   bowel stoma;

      (xii)   abdominal wall scarring;

     (xiii)   previous spinal or pelvic trauma or disease;

     (xiv)   drug dependency;

      (xv)   thrombophilia;

     (xvi)   significant maternal obesity;

    (xvii)   advanced maternal age;

   (xviii)   abdominal pain or mass;

     (xix)   uncertain dates;

      (xx)   high risk pregnancy;

 

 

     (xxi)   previous post dates delivery;

    (xxii)   previous caesarean section;

   (xxiii)   poor obstetric history;

   (xxiv)   suspicion of ectopic pregnancy;

    (xxv)   risk of miscarriage;

 

 

   (xxvi)   diminished symptoms of pregnancy;

  (xxvii)   suspected or known cervical incompetence;

(xxviii)   suspected or known uterine abnormality;

   (xxix)   pregnancy after assisted reproduction;

    (xxx)   risk of fetal abnormality (NR) (NK)

 

55713

Pelvis or abdomen, pregnancy‑related or pregnancy complication, fetal development and anatomy, ultrasound scan of, by any or all approaches, with measurement of all parameters for dating purposes, if:

   (a)  the patient is referred by a medical practitioner or participating midwife; and

  (b)  the dating for the pregnancy (as confirmed by ultrasound) is 17 to 22 weeks of gestation; and

   (c)  the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and

50.00

 

 

  (d)  if the patient is referred by a medical practitioner — the referring medical practitioner is not a member of a group of practitioners of which the providing practitioner is a member; and

   (e)  if the patient is referred by a participating midwife — the referring midwife does not have a business or financial arrangement with the providing practitioner; and

   (f)  the service is not performed in the same pregnancy as item 55709 or 55717 (R) (NK)

 

55714

Pelvis or abdomen, pregnancy‑related or pregnancy complication, fetal development and anatomy, ultrasound scan of, by any or all approaches, if:

   (a)  the patient is referred by a medical practitioner or participating midwife; and

  (b)  the pregnancy (as confirmed by ultrasound) is dated by a fetal crown rump length of 45 to 84 mm; and

35.00

 

 

   (c)  the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and

  (d)  if the patient is referred by a medical practitioner — the referring medical practitioner is not a member of a group of practitioners of which the providing practitioner is a member; and

   (e)  if the patient is referred by a participating midwife — the referring midwife does not have a business or financial arrangement with the providing practitioner; and

   (f)  at least 1 condition mentioned in paragraph (f) of item 55704 or 55710 is present; and

 

 

   (g)  nuchal translucency measurement is performed to assess the risk of fetal abnormality; and

 

 

  (h)  the service is not performed with item 55700, 55701, 55702, 55703, 55704, 55705, 55710 or 55711 on the same patient within 24 hours (R) (NK)

 

55716

Pelvis or abdomen, pregnancy‑related or pregnancy complication, fetal development and anatomy, ultrasound scan of, by any or all approaches, if:

   (a)  the patient is not referred by a medical practitioner or participating midwife; and

  (b)  the pregnancy (as confirmed by ultrasound) is dated by a crown rump length of 45 to 84 mm; and

   (c)  the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and

  (d)  at least 1 condition mentioned in paragraph (f) of item 55704 or 55710 is present; and

   (e)  nuchal translucency measurement is performed to assess the risk of fetal abnormality; and

   (f)  the service is not performed with item 55700, 55701, 55702, 55703, 55704, 55705, 55710 or 55711on the same patient within 24 hours (NR) (NK)

17.50

 

55717

Pelvis or abdomen, pregnancy‑related or pregnancy complication, fetal development and anatomy, ultrasound scan of, by any or all approaches, with measurement of all parameters for dating purposes, if:

   (a)  the patient is not referred by a medical practitioner; and

  (b)  the dating of the pregnancy (as confirmed by ultrasound) is 17 to 22 weeks of gestation; and

19.00

 

 

   (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 performed in the same pregnancy as item 55706 or 55713 (NR) (NK)

 

55719

Pelvis or abdomen, pregnancy‑related or pregnancy complication, fetal development and anatomy, ultrasound scan of, by any or all approaches, with measurement of all parameters for dating purposes, if:

   (a)  the patient is referred by a medical practitioner who:

         (i)   is a Member or a Fellow of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists; or

        (ii)   has a Diploma of Obstetrics; or

57.50

 

 

       (iii)   has a qualification recognised by the Royal Australian and New Zealand College of Obstetricians and Gynaecologists as being equivalent to a Diploma of Obstetrics; or

       (iv)   has obstetric privileges at a non‑metropolitan hospital; and

  (b)  the dating of the pregnancy (as confirmed by ultrasound) is 17 to 22 weeks of gestation; and

 

 

   (c)  the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and

 

 

  (d)  the referring practitioner is not a member of a group of practitioners of which the providing practitioner is a member; and

 

 

   (e)  further examination is clinically indicated after performance, in the same pregnancy, of a scan mentioned in item 55706, 55709, 55713 or 55717 (R) (NK)

 

55720

Pelvis or abdomen, pregnancy‑related or pregnancy complication, fetal development and anatomy, ultrasound scan of, by any or all approaches, with measurement of all parameters for dating purposes, performed by or on behalf of a medical practitioner who is a Member or a Fellow of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists, if:

20.00

 

 

   (a)  the patient is not referred by a medical practitioner; and

 

 

  (b)  the dating of the pregnancy (as confirmed by ultrasound) is 17 to 22 weeks of gestation; and

   (c)  the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and

 

 

  (d)  further examination is clinically indicated after performance, in the same pregnancy, of a scan mentioned in item 55706, 55709, 55713 or 55717 (NR) (NK)

 

55722

Pelvis or abdomen, pregnancy‑related or pregnancy complication, fetal development and anatomy, ultrasound scan of, by any or all approaches, if:

   (a)  the patient is referred by a medical practitioner or participating midwife; and

  (b)  the dating of the pregnancy (as confirmed by ultrasound) is after 22 weeks of gestation; and

   (c)  the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and

50.00

 

 

  (d)  if the patient is referred by a medical practitioner — the referring medical practitioner is not a member of a group of practitioners of which the providing practitioner is a member; and

   (e)  if the patient is referred by a participating midwife — the referring midwife does not have a business or financial arrangement with the providing practitioner; and

   (f)  the service is not performed in the same pregnancy as item 55723 or 55726; and

   (g)  1 or more of the following conditions are present:

         (i)   known or suspected fetal abnormality or fetal cardiac arrhythmia;

 

 

        (ii)   fetal anatomy (late booking or incomplete mid‑trimester scan);

       (iii)   malpresentation;

       (iv)   cervical assessment;

        (v)   clinical suspicion of amniotic fluid abnormality;

       (vi)   clinical suspicion of placental or umbilical cord abnormality;

      (vii)   previous complicated delivery;

 

 

     (viii)   uterine scar assessment;

       (ix)   uterine fibroid;

 

 

        (x)   previous fetal death in utero or neonatal death;

       (xi)   antepartum haemorrhage;

      (xii)   clinical suspicion of intrauterine growth retardation;

     (xiii)   clinical suspicion of macrosomia;

 

 

     (xiv)   reduced fetal movements;

      (xv)   suspected fetal death;

     (xvi)   abnormal cardiotocography;

    (xvii)   prolonged pregnancy;

   (xviii)   premature labour;

     (xix)   fetal infection;

      (xx)   pregnancy after assisted reproduction;

     (xxi)   trauma;

    (xxii)   diabetes mellitus;

   (xxiii)   hypertension;

   (xxiv)   toxaemia of pregnancy;

    (xxv)   liver or renal disease;

 

 

   (xxvi)   autoimmune disease;

  (xxvii)   cardiac disease;

(xxviii)   alloimmunisation;

   (xxix)   maternal infection;

    (xxx)   inflammatory bowel disease;

 


 

   (xxxi)   bowel stoma;

  (xxxii)   abdominal wall scarring;

(xxxiii)   previous spinal or pelvic trauma or disease;

(xxxiv)   drug dependency;

 

 

  (xxxv)   thrombophilia;

(xxxvi)   gross maternal obesity;

(xxxvii)  advanced maternal age;

 

 

(xxxviii) abdominal pain or mass (R) (NK)

(Item is subject to subclause 2.1.5(2) of the DIST Regulations)

 

55724

Pelvis or abdomen, pregnancy‑related or pregnancy complication, fetal development and anatomy, ultrasound scan of, by any or all approaches, if:

   (a)  the patient is referred by a medical practitioner who:

         (i)   is a Member or a Fellow of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists; or

        (ii)   has a Diploma of Obstetrics; or

       (iii)   has a qualification recognised by the Royal Australian and New Zealand College of Obstetricians and Gynaecologists as being equivalent to a Diploma of Obstetrics; or

57.50

 

 

       (iv)   has obstetric privileges at a non‑metropolitan hospital; and

 

 

  (b)  the dating of the pregnancy (as confirmed by ultrasound) is after 22 weeks of gestation; and

   (c)  the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and

 

 

  (d)  the referring practitioner is not a member of a group of practitioners of which the providing practitioner is a member; and

   (e)  further examination is clinically indicated in the same pregnancy to which item 55718, 55722, 55723 or 55726 applies (R) (NK)

 

55726

Pelvis or abdomen, pregnancy‑related or pregnancy complication, fetal development and anatomy, ultrasound scan of, by any or all approaches, if:

   (a)  the patient is not referred by a medical practitioner; and

19.00

 

 

  (b)  the dating of the pregnancy (as confirmed by ultrasound) is after 22 weeks of gestation; 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 performed in the same pregnancy as item 55718 or 55722; and

   (e)  1 or more of the following conditions are present:

         (i)   known or suspected fetal abnormality or fetal cardiac arrhythmia;

 

 

        (ii)   fetal anatomy (late booking or incomplete mid‑trimester scan);

       (iii)   malpresentation;

       (iv)   cervical assessment;

 

 

        (v)   clinical suspicion of amniotic fluid abnormality;

       (vi)   clinical suspicion of placental or umbilical cord abnormality;

      (vii)   previous complicated delivery;

     (viii)   uterine scar assessment;

       (ix)   uterine fibroid;

 

 

        (x)   previous fetal death in utero or neonatal death;

       (xi)   antepartum haemorrhage;

      (xii)   clinical suspicion of intrauterine growth retardation;

 

 

     (xiii)   clinical suspicion of macrosomia;

     (xiv)   reduced fetal movements;

      (xv)   suspected fetal death;

     (xvi)   abnormal cardiotocography;

    (xvii)   prolonged pregnancy;

   (xviii)   premature labour;

 

 

     (xix)   fetal infection;

      (xx)   pregnancy after assisted reproduction;

     (xxi)   trauma;

    (xxii)   diabetes mellitus;

   (xxiii)   hypertension;

   (xxiv)   toxaemia of pregnancy;

    (xxv)   liver or renal disease;

 

 

   (xxvi)   autoimmune disease;

  (xxvii)   cardiac disease;

(xxviii)   alloimmunisation;

 

 

   (xxix)   maternal infection;

    (xxx)   inflammatory bowel disease;

   (xxxi)   bowel stoma;

  (xxxii)   abdominal wall scarring;

(xxxiii)   previous spinal or pelvic trauma or disease;

 

 

(xxxiv)   drug dependency;

  (xxxv)   thrombophilia;

(xxxvi)   gross maternal obesity;

(xxxvii)  advanced maternal age;

(xxxviii) abdominal pain or mass (NR) (NK)

(Item is subject to subclause 2.1.5(2) of the DIST Regulations)

 

55727

Pelvis or abdomen, pregnancy‑related or pregnancy complication, fetal development and anatomy, ultrasound scan of, by any or all approaches, performed by or on behalf of a medical practitioner who is a Member or a Fellow of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists, if:

   (a)  the patient is not referred by a medical practitioner; and

  (b)  the dating of the pregnancy (as confirmed by ultrasound) is after 22 weeks of gestation; and

20.00

 

 

   (c)  the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and

  (d)  further examination is clinically indicated in the same pregnancy to which item 55718, 55722, 55723 or 55726 applies (NR) (NK)

 

55730

Duplex scanning involving B mode ultrasound imaging and integrated Doppler flow measurements by spectral analysis of the umbilical artery, and measured assessment of amniotic fluid volume after the 24th week of gestation, if the patient is referred by a medical practitioner for this procedure and if there is reason to suspect intrauterine growth retardation or a significant risk of fetal death, not being a service associated with a service to which an item in this group applies — examination and report (R) (NK)

13.65

55732

Pelvis, female, ultrasound scan of, by any or all approaches, if:

   (a)  the patient is 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

49.00

 

   (c)  the referring practitioner is not a member of a group of practitioners of which the providing practitioner is a member; and

  (d)  the service is not performed with item 55014, 55017, 55036 or 55038 on the same patient within 24 hours (R) (NK)

 

55734

Pelvis, female, 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 (NR) (NK)

17.50

 

55735

Pelvis, female, ultrasound scan of, in association with saline infusion of the endometrial cavity, by any or all approaches, if:

   (a)  the patient is 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

63.50

 

 

   (c)  the referring medical practitioner is not a member of a group of medical practitioners of which the providing practitioner is a member; and

 

 

  (d)  a previous transvaginal ultrasound has revealed an abnormality of the uterus or fallopian tube (R) (NK)

 

55737

Pelvis, female, ultrasound scan of, in association with saline infusion of the endometrial cavity, 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)  a previous transvaginal ultrasound has revealed an abnormality of the uterus or fallopian tube (NR) (NK)

28.50

55760

Pelvis or abdomen, pregnancy‑related or pregnancy complication, fetal development and anatomy, ultrasound scan of, by any or all approaches, with measurement of all parameters for dating purposes, if:

   (a)  the patient is referred by a medical practitioner; and

  (b)  ultrasound of the same pregnancy confirms a multiple pregnancy; and

75.00

 

 

   (c)  the dating of the pregnancy (as confirmed by ultrasound) is 17 to 22 weeks gestation; and

  (d)  the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and

   (e)  the referring practitioner is not a member of a group of practitioners of which the providing practitioner is a member; and

 

 

   (f)  the service described in item 55706, 55709, 55712, 55713, 55715, 55717, 55719, 55720, 55762 or 55763 is not performed in conjunction with the scan during the same pregnancy (R) (NK)

 

55763

Pelvis or abdomen, pregnancy‑related or pregnancy complication, fetal development and anatomy, ultrasound scan of, by any or all approaches, with measurement of all parameters for dating purposes, if:

   (a)  the patient is not referred by a medical practitioner; and

  (b)  ultrasound of the same pregnancy confirms a multiple pregnancy; and

30.00

 

 

   (c)  the dating of the pregnancy (as confirmed by ultrasound) is 17 to 22 weeks gestation; and

  (d)  the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and

 

 

   (e)  the service described in item 55706, 55709, 55712, 55713, 55715, 55717, 55719, 55720, 55759 or 55760 is not performed in conjunction with the scan during the same pregnancy (NR) (NK)

 

55765

Pelvis or abdomen, pregnancy‑related or pregnancy complication, fetal development and anatomy, ultrasound scan of, by any or all approaches, with measurement of all parameters for dating purposes, if:

80.00

 

 

   (a)  the patient is referred by a medical practitioner who:

         (i)   is a Member or Fellow of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists; or

        (ii)   has a Diploma of Obstetrics; or

       (iii)   has a qualification recognised by the Royal Australian and New Zealand College of Obstetricians and Gynaecologists as equivalent to a Diploma of Obstetrics; or

 

 

       (iv)   has obstetric privileges at a non‑metropolitan hospital; and

  (b)  ultrasound of the same pregnancy confirms a multiple pregnancy; and

 

 

   (c)  the dating of the pregnancy (as confirmed by ultrasound) is 17 to 22 weeks gestation; and

  (d)  the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and

 

 

   (e)  the referring practitioner is not a member of a group of practitioners of which the providing practitioner is a member; and

   (f)  further examination is clinically indicated in the same pregnancy in which item 55759, 55760, 55762 or 55763 has been performed; and

 

 

   (g)  the service described in item 55706, 55709, 55712, 55713, 55715, 55717, 55719 or 55720 is not performed in conjunction with the scan during the same pregnancy (R) (NK)

 

55767

Pelvis or abdomen, pregnancy‑related or pregnancy complication, fetal development and anatomy, ultrasound scan of, by any or all approaches, with measurement of all parameters for dating purposes, performed by or on behalf of a medical practitioner, who is a Member or Fellow of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists, if:

   (a)  the patient is not referred by a medical practitioner; and

  (b)  ultrasound of the same pregnancy confirms a multiple pregnancy; and

   (c)  the dating of the pregnancy (as confirmed by ultrasound) is 17 to 22 weeks of gestation; and

32.50

 

 

  (d)  the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and

   (e)  further examination is clinically indicated in the same pregnancy in which item 55759, 55760, 55762 or 55763 has been performed; and

 

 

   (f)  the service described in item 55706, 55709, 55712, 55713, 55715, 55717, 55719 or 55720 is not performed in conjunction with the scan during the same pregnancy (NR) (NK)

 

55769

Pelvis or abdomen, pregnancy‑related or pregnancy complication, fetal development and anatomy, ultrasound scan of, by any or all approaches, if:

   (a)  dating of the pregnancy (as confirmed by ultrasound) is after 22 weeks of gestation; and

  (b)  the ultrasound confirms a multiple pregnancy; and

   (c)  the patient is referred by a medical practitioner or participating nurse practitioner; and

75.00

 

 

  (d)  the service is not performed in the same pregnancy as item 55770 or 55771; and

   (e)  the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and

 

 

   (f)  if the patient is referred by a medical practitioner — the referring medical practitioner is not a member of a group of practitioners of which the providing practitioner is a member; and

   (g)  if the patient is referred by a participating nurse practitioner — the referring nurse practitioner does not have a business or financial arrangement with the providing practitioner; and

 

 

  (h)  the service described in item 55718, 55721, 55722, 55723, 55724, 55725, 55726 or 55727 is not performed in conjunction with the scan during the same pregnancy (R) (NK)

 

55771

Pelvis or abdomen, pregnancy‑related or pregnancy complication, fetal development and anatomy, ultrasound scan of, by any or all approaches, if:

   (a)  dating of the pregnancy as confirmed by ultrasound is after 22 weeks of gestation; and

  (b)  the patient is not referred by a medical practitioner or participating nurse practitioner; and

30.00

 

 

   (c)  the service is not performed in the same pregnancy as item 55768 or 55769; and

 

 

  (d)  the pregnancy as confirmed by ultrasound is a multiple pregnancy; and

 

 

   (e)  the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and

   (f)  the service described in item 55718, 55721, 55722, 55723, 55724, 55725, 55726 or 55727 is not performed in conjunction with the scan during the same pregnancy (NR) (NK)

 

55773

Pelvis or abdomen, pregnancy‑related or pregnancy complication, fetal development and anatomy, ultrasound scan of, by any or all approaches, if:

   (a)  dating of the pregnancy as confirmed by ultrasound is after 22 weeks of gestation; and

80.00

 

 

  (b)  the patient is referred by a medical practitioner who:

         (i)   is a Member or Fellow of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists; or

        (ii)   has a Diploma of Obstetrics; or

 

 

       (iii)   has a qualification recognised by the Royal Australian and New Zealand College of Obstetricians and Gynaecologists as equivalent to a Diploma of Obstetrics; or

 

 

       (iv)   has obstetric privileges at a non‑metropolitan hospital; and

 

 

   (c)  further examination is clinically indicated in the same pregnancy to which item 55768, 55769, 55770 or 55771 has been performed; and

 

 

  (d)  the pregnancy as confirmed by ultrasound is a multiple pregnancy; and

   (e)  the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and

 

 

   (f)  the referring practitioner is not a member of a group of practitioners of which the providing practitioner is a member; and

   (g)  the service described in item 55718, 55721, 55722, 55723, 55724, 55725, 55726 or 55727 is not performed in conjunction with the scan during the same pregnancy (R) (NK)

 

55775

Pelvis or abdomen, pregnancy‑related or pregnancy complication, fetal development and anatomy, ultrasound scan of, by any or all approaches, performed by or on behalf of a medical practitioner who is a Member or a Fellow of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists, if:

   (a)  dating of the pregnancy as confirmed by ultrasound is after 22 weeks of gestation; and

  (b)  the patient is not referred by a medical practitioner; and

   (c)  further examination is clinically indicated in the same pregnancy to which item 55768, 55769, 55770 or 55771 has been performed; and

  (d)  the pregnancy as confirmed by ultrasound is a multiple pregnancy; and

32.50

 

 

   (e)  the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and

   (f)  the service described in item 55718, 55721, 55722, 55723, 55724, 55725, 55726 or 55727 is not performed in conjunction with the scan during the same pregnancy (NR) (NK)

 

 

Subdivision D              Subgroup 6 of Group I1 — Musculoskeletal ultrasound

Group I1 — Ultrasound

Item

Health service

Fee ($) (for each State)

Subgroup 6 — Musculoskeletal ultrasound

55801

Hand or wrist, 1 or both sides, ultrasound scan of, if:

   (a)  the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and

  (b)  the patient is referred by a medical practitioner or participating nurse practitioner; and

   (c)  if the patient is referred by a medical practitioner — the referring medical practitioner is not a member of a group of practitioners of which the providing practitioner is a member; and

  (d)  if the patient is referred by a participating nurse practitioner — the referring nurse practitioner does not have a business or financial arrangement with the providing practitioner (R) (NK)

54.55

55803

Hand or wrist, 1 or both sides, ultrasound scan of, if:

   (a)  the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and

  (b)  the patient is not referred by a medical practitioner or participating nurse practitioner (NR) (NK)

18.95

55805

Forearm or elbow, 1 or both sides, ultrasound scan of, if:

   (a)  the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and

  (b)  the patient is referred by a medical practitioner or participating nurse practitioner; and

   (c)  if the patient is referred by a medical practitioner — the referring medical practitioner is not a member of a group of practitioners of which the providing practitioner is a member; and

  (d)  if the patient is referred by a participating nurse practitioner — the referring nurse practitioner does not have a business or financial arrangement with the providing practitioner (R) (NK)

54.55

55807

Forearm or elbow, 1 or both sides, ultrasound scan of, if:

   (a)  the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and

18.95

 

  (b)  the patient is not referred by a medical practitioner or participating nurse practitioner (NR) (NK)

 

55809

Shoulder or upper arm, 1 or both sides, ultrasound scan of, if:

   (a)  the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and

  (b)  the patient is referred by a medical practitioner or participating nurse practitioner; and

   (c)  if the patient is referred by a medical practitioner — the referring medical practitioner is not a member of a group of practitioners of which the providing practitioner is a member; and

  (d)  if the patient is referred by a participating nurse practitioner — the referring nurse practitioner does not have a business or financial arrangement with the providing practitioner; and

   (e)  the service is used for the assessment of 1 or more of the following suspected or known conditions:

         (i)   an injury to a muscle, tendon or muscle/tendon junction;

        (ii)   rotator cuff tear, calcification or tendinosis (biceps, subscapular, supraspinatus, infraspinatus);

54.55

 

 

       (iii)   biceps subluxation;

       (iv)   capsulitis and bursitis;

        (v)   a mass, including a ganglion;

 

 

       (vi)   an occult fracture;

      (vii)   acromioclavicular joint pathology (R) (NK)

 

55811

Shoulder or upper arm, 1 or both sides, ultrasound scan of, if:

   (a)  the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and

  (b)  the patient is not referred by a medical practitioner or participating nurse practitioner; and

   (c)  the service is used for the assessment of 1 or more of the following suspected or known conditions:

         (i)   an injury to a muscle, tendon or muscle/tendon junction;

        (ii)   rotator cuff tear, calcification or tendinosis (biceps, subscapular, supraspinatus, infraspinatus);

       (iii)   biceps subluxation;

18.95

 

 

       (iv)   capsulitis and bursitis;

        (v)   a mass, including a ganglion;

       (vi)   an occult fracture;

      (vii)   acromioclavicular joint pathology (NR) (NK)

 

55813

Chest or abdominal wall, 1 or more areas, ultrasound scan of, if:

   (a)  the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and

  (b)  the patient is referred by a medical practitioner or participating nurse practitioner; and

   (c)  if the patient is referred by a medical practitioner — the referring medical practitioner is not a member of a group of practitioners of which the providing practitioner is a member; and

  (d)  if the patient is referred by a participating nurse practitioner — the referring nurse practitioner does not have a business or financial arrangement with the providing practitioner (R) (NK)

54.55

55815

Chest or abdominal wall, 1 or more areas, ultrasound scan of, if:

   (a)  the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and

  (b)  the patient is not referred by a medical practitioner or participating nurse practitioner (NR) (NK)

18.95

55817

Hip or groin, 1 or both sides, ultrasound scan of, if:

   (a)  the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and

  (b)  the patient is referred by a medical practitioner or participating nurse practitioner; and

   (c)  if the patient is referred by a medical practitioner — the referring medical practitioner is not a member of a group of practitioners of which the providing practitioner is a member; and

54.55

 

  (d)  if the patient is referred by a participating nurse practitioner — the referring nurse practitioner does not have a business or financial arrangement with the providing practitioner (R) (NK)

 

55819

Hip or groin, 1 or both sides, ultrasound scan of, if:

   (a)  the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and

  (b)  the patient is not referred by a medical practitioner or participating nurse practitioner (NR) (NK)

18.95

55821

Paediatric hip examination for dysplasia, 1 or both sides, ultrasound scan of, if:

   (a)  the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and

  (b)  the patient is referred by a medical practitioner or participating nurse practitioner; and

   (c)  if the patient is referred by a medical practitioner — the referring medical practitioner is not a member of a group of practitioners of which the providing practitioner is a member; and

  (d)  if the patient is referred by a participating nurse practitioner — the referring nurse practitioner does not have a business or financial arrangement with the providing practitioner (R) (NK)

54.55

55823

Paediatric hip examination for dysplasia 1 or both sides, ultrasound scan of, if:

   (a)  the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and

  (b)  the patient is not referred by a medical practitioner or participating nurse practitioner (NR) (NK)

18.95

55825

Buttock or thigh, 1 or both sides, ultrasound scan of, if:

   (a)  the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and

  (b)  the patient is referred by a medical practitioner or participating nurse practitioner; and

   (c)  if the patient is referred by a medical practitioner — the referring medical practitioner is not a member of a group of practitioners of which the providing practitioner is a member; and

54.55

 

  (d)  if the patient is referred by a participating nurse practitioner — the referring nurse practitioner does not have a business or financial arrangement with the providing practitioner (R) (NK)

 

55827

Buttock or thigh, 1 or both sides, ultrasound scan of, if:

   (a)  the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and

  (b)  the patient is not referred by a medical practitioner or participating nurse practitioner (NR) (NK)

18.95

55829

Knee, 1 or both sides, ultrasound scan of, if:

   (a)  the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and

  (b)  the patient is referred by a medical practitioner or participating nurse practitioner; and

   (c)  if the patient is referred by a medical practitioner — the referring medical practitioner is not a member of a group of practitioners of which the providing practitioner is a member; and

  (d)  if the patient is referred by a participating nurse practitioner — the referring nurse practitioner does not have a business or financial arrangement with the providing practitioner; and

54.55

 

   (e)  the service is used for the assessment of 1 or more of the following suspected or known conditions:

         (i)   abnormality of tendons or bursae about the knee;

        (ii)   a meniscal cyst, popliteal fossa cyst, mass or pseudomass;

       (iii)   a nerve entrapment or a nerve or nerve sheath tumour;

       (iv)   an injury of collateral ligaments (R) (NK)

 

55831

Knee, 1 or both sides, ultrasound scan of, if:

   (a)  the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and

  (b)  the patient is not referred by a medical practitioner or participating nurse practitioner; and

18.95

 

 

   (c)  the service is used for the assessment of 1 or more of the following suspected or known conditions:

         (i)   abnormality of tendons or bursae about the knee;

 

 

        (ii)   a meniscal cyst, popliteal fossa cyst, mass or pseudomass;

       (iii)   a nerve entrapment or a nerve or nerve sheath tumour;

       (iv)   an injury of collateral ligaments (NR) (NK)

 

55833

Lower leg, 1 or both sides, ultrasound scan of, if:

   (a)  the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and

  (b)  the patient is referred by a medical practitioner or participating nurse practitioner; and

   (c)  if the patient is referred by a medical practitioner — the referring medical practitioner is not a member of a group of practitioners of which the providing practitioner is a member; and

  (d)  if the patient is referred by a participating nurse practitioner — the referring nurse practitioner does not have a business or financial arrangement with the providing practitioner (R) (NK)

54.55

55835

Lower leg, 1 or both sides, ultrasound scan of, performed by or on behalf of a medical practitioner, if:

   (a)  the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and

  (b)  the patient is not referred by a medical practitioner or participating nurse practitioner (NR) (NK)

18.95

55837

Ankle or hind foot, 1 or both sides, ultrasound scan of, if:

   (a)  the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and

  (b)  the patient is referred by a medical practitioner or participating nurse practitioner; and

   (c)  if the patient is referred by a medical practitioner — the referring medical practitioner is not a member of a group of practitioners of which the providing practitioner is a member; and

54.55

 

  (d)  if the patient is referred by a participating nurse practitioner — the referring nurse practitioner does not have a business or financial arrangement with the providing practitioner (R) (NK)

 

55839

Ankle or hind foot, 1 or both sides, ultrasound scan of, if:

   (a)  the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and

  (b)  the patient is not referred by a medical practitioner or participating nurse practitioner (NR) (NK)

18.95

55841

Mid foot or fore foot, 1 or both sides, ultrasound scan of, if:

   (a)  the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and

  (b)  the patient is referred by a medical practitioner or participating nurse practitioner; and

   (c)  if the patient is referred by a medical practitioner — the referring medical practitioner is not a member of a group of practitioners of which the providing practitioner is a member; and

  (d)  if the patient is referred by a participating nurse practitioner — the referring nurse practitioner does not have a business or financial arrangement with the providing practitioner (R) (NK)

54.55

55843

Mid foot or fore foot, 1 or both sides, ultrasound scan of, if:

   (a)  the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and

  (b)  the patient is not referred by a medical practitioner or participating nurse practitioner (NR) (NK)

18.95

55845

Assessment of a mass associated with the skin or subcutaneous structures, not being a part of the musculoskeletal system, 1 or more areas, ultrasound scan of, if:

   (a)  the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and

  (b)  the patient is referred by a medical practitioner or participating nurse practitioner; and

43.70

 

   (c)  if the patient is referred by a medical practitioner — the referring medical practitioner is not a member of a group of practitioners of which the providing practitioner is a member; and

  (d)  if the patient is referred by a participating nurse practitioner — the referring nurse practitioner does not have a business or financial arrangement with the providing practitioner (R) (NK)

 

55847

Assessment of a mass associated with the skin or subcutaneous structures, not being a part of the musculoskeletal system, 1 or more areas, ultrasound scan of, if:

   (a)  the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and

  (b)  the patient is not referred by a medical practitioner or participating nurse practitioner (NR) (NK)

18.95

55849

Musculoskeletal cross‑sectional echography, in conjunction with a surgical procedure using interventional techniques, not being a service associated with a service to which any other item in this group applies, and not performed in conjunction with item 55026 or 55054 (R) (NK)

54.55

55851

Musculoskeletal cross‑sectional echography, in conjunction with a surgical procedure using interventional techniques, inclusive of a diagnostic musculoskeletal ultrasound service, if:

   (a)  the patient is referred by a medical practitioner or participating nurse practitioner; and

  (b)  if the patient is referred by a medical practitioner — the referring medical practitioner is not a member of a group of practitioners of which the providing practitioner is a member; and

   (c)  if the patient is referred by a participating nurse practitioner — the referring nurse practitioner does not have a business or financial relationship with the providing practitioner; and

  (d)  the referring medical practitioner or nurse practitioner has indicated on a referral for a musculoskeletal ultrasound that an ultrasound guided intervention be performed if clinically indicated; and

76.45

 

   (e)  the service is not performed in conjunction with items 55026, 55054, or 55800 to 55849 (R) (NK)

 

55853

Paediatric spine, spinal cord and overlying subcutaneous tissues, ultrasound scan of, if:

   (a)  the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and

  (b)  the patient is referred by a medical practitioner or participating nurse practitioner; and

   (c)  if the patient is referred by a medical practitioner — the referring medical practitioner is not a member of a group of practitioners of which the providing practitioner is a member; and

  (d)  if the patient is referred by a participating nurse practitioner — the referring nurse practitioner does not have a business or financial arrangement with the providing practitioner (R) (NK)

54.55

55855

Paediatric spine, spinal cord and overlying subcutaneous tissues, ultrasound scan of, if:

   (a)  the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and

  (b)  the patient is not referred by a medical practitioner or participating nurse practitioner (NR) (NK)

18.95

 

Division 2.2           Not used

 

Division 2.3           Group I3 — Diagnostic radiology

Subdivision A              Subgroups 1 to 9 of Group I3

Group I3 — Diagnostic radiology

Item

Health service

Fee ($) (for each State)

Subgroup 1 — Radiographic examination of extremities

57529

Hand, wrist, forearm, elbow or humerus (NR) (NK)

14.90

57530

Hand, wrist, forearm, elbow or humerus (R) (NK)

19.90

57532

Hand and wrist, or hand, wrist and forearm, or forearm and elbow, or elbow and humerus (NR) (NK)

20.25

57533

Hand and wrist, or hand, wrist and forearm, or forearm and elbow, or elbow and humerus (R) (NK)

27.00

57535

Foot, ankle, leg, knee or femur (NR) (NK)

16.25

57536

Foot, ankle, leg, knee or femur (R) (NK)

21.70

57538

Foot and ankle, or ankle and leg, or leg and knee, or knee and femur (NR) (NK)

24.70

57539

Foot and ankle, or ankle and leg, or leg and knee, or knee and femur (R) (NK)

32.90

Subgroup 2 — Radiographic examination of shoulder or pelvis

57702

Shoulder or scapula (NR) (NK)

20.25

57705

Shoulder or scapula (R) (NK)

27.00

57708

Clavicle (NR) (NK)

16.25

57711

Clavicle (R) (NK)

21.70

57714

Hip joint (R) (NK)

23.60

57717

Pelvic girdle (R) (NK)

30.45

57723

Femur, internal fixation of neck or intertrochanteric (pertrochanteric) fracture (R) (NK)

49.65

Subgroup 3 — Radiographic examination of head

57911

Skull, not in association with item 57902 or 57914 (R) (NK)

32.25

57914

Cephalometry, not in association with item 57901 or 57911 (R) (NK)

32.25

57917

Sinuses (R) (NK)

23.65

57920

Mastoids (R) (NK)

32.25

57923

Petrous temporal bones (R) (NK)

32.25

57926

Facial bones — orbit, maxilla or malar, any or all (R) (NK)

23.60

57929

Mandible, not by orthopantomography technique (R) (NK)

23.60

57932

Salivary calculus (R) (NK)

23.60

57935

Nose (R) (NK)

23.60

57938

Eye (R) (NK)

23.60

57941

Temporo‑mandibular joints (R) (NK)

24.85

57944

Teeth — single area (R) (NK)

16.45

57947

Teeth — full mouth (R) (NK)

39.15

57950

Palato‑pharyngeal studies with fluoroscopic screening (R) (NK)

32.25

57953

Palato‑pharyngeal studies without fluoroscopic screening (R) (NK)

24.85

57956

Larynx, lateral airways and soft tissues of the neck, not being a service associated with a service to which item 57939,  57942, 57950 or 57953 applies (R) (NK)

21.70

57959

Orthopantomography for diagnosis or management (or both) of trauma, infection, tumour or a congenital or surgical condition of the teeth or maxillofacial region (R) (NK)

23.70

57962

Orthopantomography for diagnosis or management (or both) of any of the following conditions, if the signs and symptoms of the condition is present:

   (a)  impacted teeth;

  (b)  caries;

   (c)  periodontal pathology;

  (d)  periapical pathology (R) (NK)

23.70

57965

Orthopantomography for diagnosis or management (or both) of missing or crowded teeth, or developmental anomalies of the teeth or jaws (R) (NK)

23.70

57968

Orthopantomography for diagnosis or management (or both) of temporo‑mandibular joint arthroses or dysfunction (R) (NK)

23.70

Subgroup 4 — Radiographic examination of spine

58102

Spine — cervical (R) (NK)

33.60

58105

Spine — thoracic (R) (NK)

27.55

58111

Spine — lumbo‑sacral (R) (NK)

38.50

58114

Spine — 4 regions, cervical, thoracic, lumbosacral and sacrococcygeal (R) (NK)

55.00

58117

Spine — sacro‑coccygeal (R) (NK)

23.50

58123

Spine — 2 examinations of the kind mentioned in items 58100, 58102, 58103, 58105, 58106, 58109, 58111 and 58117 (R) (NK)

48.65

58124

Spine — 3 examinations of the kind mentioned in items 58100, 58102, 58103, 58105, 58106, 58109, 58111 and 58117 (R) (NK)

55.00

58126

Spine — 4 regions, cervical, thoracic, lumbosacral and sacrococcygeal (R) (NK), if the service to which item 58120, 58121, 58126 or 58127 applies has not been performed on the same patient within the same calendar year

55.00

58127

Spine — 3 examinations of the kind mentioned in items 58100, 58102, 58103, 58105, 58106, 58109, 58111 and 58117 (R) (NK), if the service to which item 58120, 58121, 58126 or 58127 applies has not been performed on the same patient within the same calendar year

55.00

Subgroup 5 — Bone age study and skeletal survey

58302

Bone age study (R) (NK)

20.05

58308

Skeletal survey (R) (NK)

44.70

Subgroup 6 — Radiographic examination of thoracic region

58502

Chest (lung fields) by direct radiography (NR) (NK)

17.70

58505

Chest (lung fields) by direct radiography (R) (NK)

23.60

58508

Chest (lung fields) by direct radiography with fluoroscopic screening (R) (NK)

30.40

58511

Thoracic inlet or trachea (R) (NK)

19.90

58523

Left ribs, right ribs or sternum (R) (NK)

21.70

58526

Left and right ribs, left ribs and sternum, or right ribs and sternum (R) (NK)

28.25

58529

Left ribs, right ribs and sternum (R) (NK)

34.70

Subgroup 7 — Radiographic examination of urinary tract

58702

Plain renal only (R) (NK)

23.05

58708

Intravenous pyelography, with or without preliminary plain films and with or without tomography (R) (NK)

78.95

58717

Antegrade or retrograde pyelography with or without preliminary plain films and with preparation and contrast injection, 1 side (R) (NK)

75.80

58720

Retrograde cystography or retrograde urethrography with or without preliminary plain films and with preparation and contrast injection (R) (NK) (Anaes.)

63.05

58723

Retrograde micturating cysto‑urethrography, with preparation and contrast injection (R) (NK) (Anaes.)

69.15

Subgroup 8 — Radiographic examination of alimentary tract and biliary system

58902

Plain abdominal only, not being a service associated with a service to which item 58909, 58911, 58912, 58914, 58915, 58917, 58924 or 58926 applies (NR) (NK)

17.85

58905

Plain abdominal only, not being a service associated with a service to which item 58909, 58911,58912, 58914, 58915, 58917, 58924 or 58926 applies (R) (NK)

23.80

58911

Barium or other opaque meal of 1 or more of pharynx, oesophagus, stomach or duodenum, with or without preliminary plain films of pharynx, chest or duodenum, not being a service associated with a service to which item 57939, 57942, 57945,  57950, 57953 or 57956 applies (R) (NK)

45.00

58914

Barium or other opaque meal of oesophagus, stomach, duodenum and follow through to colon, with or without screening of chest and with or without preliminary plain film (R) (NK)

55.15

58917

Barium or other opaque meal, small bowel series only, with or without preliminary plain film (R) (NK)

39.50

58920

Small bowel enema, barium or other opaque study of the small bowel, including duodenal intubation, with or without preliminary plain films, not being a service associated with a service to which item 30488 applies (R) (NK) (Anaes.)

69.25

58923

Opaque enema, with or without air contrast study and with or without preliminary plain films (R) (NK)

67.65

58926

Graham’s test (cholecystography), with preliminary plain films and with or without tomography (R) (NK)

42.05

58929

Cholegraphy direct, with or without preliminary plain films and with preparation and contrast injection, not being a service associated with a service to which item 30439 applies (R) (NK)

38.25

58935

Cholegraphy, percutaneous transhepatic, with or without preliminary plain films and with preparation and contrast injection (R) (NK)

102.80

58938

Cholegraphy, drip infusion, with or without preliminary plain films, with preparation and contrast injection and with or without tomography (R) (NK)

98.00

58941

Defaecogram (R) (NK)

69.65

Subgroup 9 — Radiographic examination for localisation of foreign bodies

59104

Localisation of foreign body, if provided in conjunction with a service described in Subgroups 1 to 12 of Group I3 (R) (NK)

10.65

 

 

Subdivision B              Subgroup 10 of Group I3 — Radiographic examination of breasts

Group I3 — Diagnostic radiology

Item

Health service

Fee ($) (for each State)

Subgroup 10 — Radiographic examination of breasts

59301

Mammography of both breasts if there is reason to suspect the presence of malignancy because of:

   (a)  the past occurrence of breast malignancy in the patient or members of the patient’s family; or

44.75

 

 

  (b)  symptoms or indications of malignancy found on examination of the patient by a medical practitioner (R) (NK)

 

59304

Mammography of 1 breast if:

   (a)  the patient is referred with a specific request for a unilateral mammogram; and

  (b)  there is reason to suspect the presence of malignancy because of:

         (i)   the past occurrence of breast malignancy in the patient or members of the patient’s family; or

27.00

 

 

        (ii)   symptoms or indications of malignancy found on examination of the patient by a medical practitioner (R) (NK)

 

59307

Mammary ductogram (galactography) — 1 breast (R) (NK)

50.15

59310

Mammary ductogram (galactography) — 2 breasts (R) (NK)

100.30

59313

Radiographic examination of both breasts, in conjunction with a surgical procedure on each breast, using interventional techniques (R) (NK)

43.50

59315

Radiographic examination of 1 breast, in conjunction with a surgical procedure using interventional techniques (R) (NK)

26.25

59319

Radiographic examination of excised breast tissue to confirm satisfactory excision of 1 or more lesions in 1 breast or both following pre‑operative localisation in conjunction with a service under item 31536 (R) (NK)

23.55

 

Subdivision C              Subgroups 11 to 13 of Group I3

Group I3 — Diagnostic radiology

Item

Health service

Fee ($) (for each State)

Subgroup 11 — Radiographic examination in connection with pregnancy

59504

Pelvimetry, not being a service associated with a service to which item 57201 or 57247  applies (R) (NK)

44.70

 

Subgroup 12 — Radiographic examination with opaque or contrast media

59701

Discography, each disc, with or without preliminary plain films and with preparation and contrast injection (R) (NK) (Anaes.)

48.30

59704

Dacryocystography, 1 side, with or without preliminary plain film and with preparation and contrast injection (R) (NK)

37.95

59713

Hysterosalpingography, with or without preliminary plain films and with preparation and contrast injection (R) (NK) (Anaes.)

56.85

59716

Bronchography, 1 side, with or without preliminary plain films and with preparation and contrast injection (R) (NK) (Anaes.)

71.80

59719

Phlebography, 1 side, with or without preliminary plain films and with preparation and contrast injection (R) (NK) (Anaes.)

67.35

59725

Myelography, 1 or more regions, with or without preliminary plain films and with preparation and contrast injection, not being a service associated with a service to which item 56219 or 56259  applies (R) (NK) (Anaes.)

113.25

59734

Sialography, 1 side, with preparation and contrast injection, not being a service associated with a service to which item 57918 or 57932 applies (R) (NK)

53.85

59737

Vasoepididymography, 1 side (R) (NK)

31.00

59740

Sinogram or fistulogram, 1 or more regions, with or without preliminary plain films and with preparation and contrast injection (R) (NK)

36.90

59752

Arthrography, each joint, excluding the facet (zygapophyseal) joints of the spine, single or double contrast study, with or without preliminary plain films and with preparation and contrast injection (R) (NK)

69.60

59755

Lymphangiography, 1 or both sides, with preliminary plain films and follow‑up radiography and with preparation and contrast injection (R) (NK)

109.70

59761

Peritoneogram (herniography) with or without contrast medium including preparation — performed on a person over 14 years of age (R) (NK)

57.60

59764

Air insufflation during video — fluoroscopic imaging including associated consultation (R) (NK)

66.95

Subgroup 14 — Tomography

60101

Tomography of any region (R) (NK) (Anaes.)

30.40

 

 

Subdivision D              Subgroup 15 of Group I3 — Fluoroscopic examination

Group I3 — Diagnostic radiology

Item

Health service

Fee ($) (for each State)

Subgroup 15 — Fluoroscopic examination

60501

Fluoroscopy, with general anaesthesia (not being a service associated with a radiographic examination) (R) (NK) (Anaes.)

21.70

60504

Fluoroscopy, without general anaesthesia (not being a service associated with a radiographic examination) (R) (NK)

14.90

60507

Fluoroscopy using a mobile image intensifier, in conjunction with a surgical procedure lasting less than 1 hour, not being a service associated with a service to which another item in this table applies (R) (NK)

31.90

60510

Fluoroscopy using a mobile image intensifier, in conjunction with a surgical procedure lasting 1 hour or more, not being a service associated with a service to which another item in this table applies (R) (NK)

49.45

 

 

Subdivision E              Not used

Subdivision F              Subgroup 17 of Group I3 — Interventional techniques

Group I3 — Diagnostic radiology

Item

Health service

Fee ($) (for each State)

Subgroup 17 — Interventional techniques

61110

Fluoroscopy in an angiography suite with image intensification, in conjunction with a surgical procedure using interventional techniques, not being a service associated with a service to which another item in this table applies (R) (NK)

129.45

 

 

Division 2.4           Group I4 — Nuclear medicine imaging

Group I4 — Nuclear medicine imaging

Item

Health service

Fee ($) (for each State)

61651

Single stress or rest myocardial perfusion study — planar imaging (R) (NK)

224.45

61652

Single stress or rest myocardial perfusion study — with single photon emission tomography and with planar imaging when performed (R) (NK)

282.65

61653

Combined stress and rest, stress and re‑injection or rest and redistribution myocardial perfusion study, including delayed imaging or re‑injection protocol on a subsequent occasion — planar imaging (R) (NK)

354.85

61654

Combined stress and rest, stress and re‑injection or rest and redistribution myocardial perfusion study, including delayed imaging or re‑injection protocol on a subsequent occasion — with single photon emission tomography and with planar imaging when performed (R) (NK)

417.45

61655

Myocardial infarct‑avid‑study, with planar imaging and single photon emission tomography, or planar imaging or single photon emission tomography (R) (NK)

183.65

61656

Gated cardiac blood pool study, (equilibrium), with planar imaging and single photon emission tomography, or planar imaging or single photon emission tomography (R) (NK)

151.70

61657

Gated cardiac blood pool study, and first pass blood flow or cardiac shunt study, with planar imaging and single photon emission tomography, or planar imaging, or single photon emission tomography (R) (NK)

210.00

61658

Gated cardiac blood pool study, with intervention, with planar imaging and single photon emission tomography, or planar imaging, or single photon emission tomography (R) (NK)

190.60

61659

Gated cardiac blood pool study, with intervention and first pass blood flow study or cardiac shunt study, with planar imaging and single photon emission tomography or planar imaging, or single photon emission tomography (R) (NK)

246.20

61660

Cardiac first pass blood flow study or cardiac shunt study, not being a service to which another item in this group applies (R) (NK)

114.45

61661

Lung perfusion study, with planar imaging and single photon emission tomography or planar imaging, or single photon emission tomography (R) (NK)

113.85

61662

Lung ventilation study using aerosol, technegas or xenon gas, with planar imaging and single photon emission tomography or planar imaging or single photon emission tomography (R) (NK)

126.50

61663

Lung perfusion study and lung ventilation study using aerosol, technegas or xenon gas, with planar imaging and single photon emission tomography, or planar imaging, or single photon emission tomography (R) (NK)

221.70

61664

Liver and spleen study (colloid) — planar imaging (R) (NK)

129.70

61665

Liver and spleen study (colloid), with single photon emission tomography and with planar imaging when performed (R) (NK)

193.30

61666

Red blood cell spleen or liver study, including single photon emission tomography when performed (R) (NK)

196.40

61667

Hepatobiliary study, including morphine administration or pre‑treatment with cholecystokinin (CCK) when performed (R) (NK)

201.70

61668

Hepatobiliary study with formal quantification following baseline imaging, using an infusion of cholecystokinin (CCK) (R) (NK)

230.70

61669

Bowel haemorrhage study (R) (NK)

248.50

61670

Meckel’s diverticulum study (R) (NK)

111.55

61671

Indium‑labelled octreotide study, including single photon emission tomography when undertaken, if:

   (a)  a gastro‑entero‑pancreatic endocrine tumour is suspected, based on biochemical evidence, with negative or equivocal conventional imaging; or

  (b)  a surgically amenable gastro‑entero‑pancreatic endocrine tumour has been identified based on conventional techniques, to exclude additional disease sites (R) (NK)

1,007.90

61672

Salivary study (R) (NK)

111.55

61673

Gastro‑oesophageal reflux study, including delayed imaging on a separate occasion when performed (R) (NK)

244.85

61674

Oesophageal clearance study (R) (NK)

71.70

61675

Gastric emptying study, using single tracer (R) (NK)

287.20

61676

Combined solid and liquid gastric emptying study using dual isotope technique or the same isotope on separate days (R) (NK)

312.50

61677

Radionuclide colonic transit study (R) (NK)

343.85

61678

Renal study, including perfusion and renogram images and computer analysis or cortical study with planar imaging (R) (NK)

166.25

61679

Renal cortical study, with single photon emission tomography and planar quantification (R) (NK)

215.40

61680

Single renal study with pre‑procedural administration of a diuretic or angiotensin converting enzyme (ACE) inhibitor (R) (NK)

185.30

61681

Renal study with diuretic administration following a baseline study (R) (NK)

205.00

61682

Combined examination involving a renal study following angiotensin converting enzyme (ACE) inhibitor provocation and a baseline study, in either order and related to a single referral episode (R) (NK)

302.75

61683

Cystoureterogram (R) (NK)

123.45

61684

Testicular study (R) (NK)

81.15

61685

Cerebral perfusion study, with single photon emission tomography and with planar imaging when performed (R) (NK)

302.55

61686

Brain study with blood brain barrier agent, with planar imaging and single photon emission tomography, or planar imaging, or single photon emission tomography (R) (NK)

173.00

61687

Cerebro‑spinal fluid transport study, with imaging on 2 or more separate occasions (R) (NK)

436.75

61688

Cerebro‑spinal fluid shunt patency study (R) (NK)

113.00

61689

Dynamic blood flow study or regional blood volume quantitative study, not being a service associated with a service to which another item in this group applies (R) (NK)

59.45

61690

Bone study — whole body, with, when undertaken, blood flow, blood pool and delayed imaging on a separate occasion (R) (NK)

239.90

61691

Bone study — whole body and single photon emission tomography, with, when undertaken, blood flow, blood pool and delayed imaging on a separate occasion (R) (NK)

300.35

61692

Whole body study using iodine (R) (NK)

277.40

61693

Whole body study using gallium (R) (NK)

271.50

61694

Whole body study using gallium, with single photon emission tomography (R) (NK)

329.75

61695

Whole body study using cells labelled with technetium (R) (NK)

248.50

61696

Whole body study using cells labelled with technetium, with single photon emission tomography (R) (NK)

307.70

61697

Whole body study using thallium (R) (NK)

271.40

61698

Whole body study using thallium, with single photon emission tomography (R) (NK)

336.50

61699

Bone marrow study — whole body using technetium labelled bone marrow agents (R) (NK)

244.85

61700

Whole body study, using gallium — with single photon emission tomography of 2 or more body regions acquired separately (R) (NK)

376.20

61701

Bone marrow study — localised using technetium labelled agent (R) (NK)

143.40

61702

Localised bone or joint study, including when undertaken, blood flow, blood pool and repeat imaging on a separate occasion (R) (NK)

166.80

61703

Localised bone or joint study and single photon emission tomography, including when undertaken, blood flow, blood pool and imaging on a separate occasion (R) (NK)

228.10

61704

Localised study using gallium (R) (NK)

198.80

61705

Localised study using gallium, with single photon emission tomography (R) (NK)

257.35

61706

Localised study using cells labelled with technetium (R) (NK)

174.05

61707

Localised study using cells labelled with technetium, with single photon emission tomography (R) (NK)

235.25

61708

Localised study using thallium (R) (NK)

198.50

61709

Localised study using thallium, with single photon emission tomography (R) (NK)

263.95

61710

Repeat planar and single photon emission tomography imaging, or repeat planar imaging or single photon emission tomography imaging on an occasion subsequent to the performance of item 61364, 61426, 61429, 61430, 61442, 61450, 61453, 61469, 61484, 61485, 61669, 61692, 61693, 61694, 61700, 61704, 61705, 61712, 61715 or 61716, if there is no additional administration of radiopharmaceutical and if the previous radionuclide scan was abnormal or equivocal (R) (NK)

64.50

61711

Venography (R) (NK)

132.75

61712

Lymphoscintigraphy (R) (NK)

174.05

61713

Thyroid study including uptake measurement when performed (R) (NK)

87.70

61714

Parathyroid study, planar imaging and single photon emission tomography when performed (R) (NK)

193.45

61715

Adrenal study (R) (NK)

440.45

61716

Adrenal study, with single photon emission tomography (R) (NK)

499.60

61717

Tear duct study (R) (NK)

111.55

61718

Particle perfusion study (infra‑arterial) or Le Veen shunt study (R) (NK)

126.50

61719

CT scan performed at the same time and covering the same body area as single photon emission tomography for the purpose of anatomic localisation or attenuation correction if no separate diagnostic CT report is issued and only in association with items 61302 to 61729 (R) (NK)

50.00

61729

LeukoScan study of the long bones and feet for suspected osteomyelitis, if patient does not have access to ex‑vivo white blood cell scanning (R) (NK)

Note   LeukoScan is only indicated for diagnostic imaging in a patient suspected of infection of the long bones and feet, including those with diabetic ulcers. The descriptor does not cover a patient who is being investigated for other sites of infection.

439.35

Division 2.5           Group I5 — Magnetic resonance imaging

Subdivision A              Not used

Subdivision B              Subgroups 1 to 19 of Group I5

Group I5 — Magnetic resonance imaging

Item

Health service

Fee ($) (for each State)

Subgroup 1 — Scan of head — for specified conditions

63013

MRI — scan of head (including MRA, if performed) for tumour of the brain or meninges (R) (NK) (Anaes.) (Contrast)

201.60

63014

MRI — scan of head (including MRA, if performed) for inflammation of brain or meninges (R) (NK) (Anaes.) (Contrast)

201.60

63016

MRI — scan of head (including MRA, if performed) for skull base or orbital tumour (R) (NK) (Anaes.) (Contrast)

201.60

63017

MRI — scan of head (including MRA, if performed) for stereotactic scan of brain, with fiducials in place, for the sole purpose of allowing planning for stereotactic neurosurgery (R) (NK) (Anaes.) (Contrast)

168.00

Subgroup 2 — Scan of head — for specified conditions

63074

MRI — scan of head (including MRA, if performed) for acoustic neuroma (R) (NK) (Anaes.) (Contrast)

168.00

63075

MRI — scan of head (including MRA, if performed) for pituitary tumour (R) (NK) (Anaes.) (Contrast)

179.20

63076

MRI — scan of head (including MRA, if performed) for toxic or metabolic or ischaemic encephalopathy (R) (NK) (Anaes.) (Contrast)

201.60

63077

MRI — scan of head (including MRA, if performed) for demyelinating disease of the brain (R) (NK) (Anaes.) (Contrast)

201.60

63078

MRI — scan of head (including MRA, if performed) for congenital malformation of the brain or meninges (R) (NK) (Anaes.) (Contrast)

201.60

63079

MRI — scan of head (including MRA, if performed) for venous sinus thrombosis (R) (NK) (Anaes.) (Contrast)

201.60

63080

MRI — scan of head (including MRA, if performed) for head trauma (R) (NK) (Anaes.) (Contrast)

201.60

63081

MRI — scan of head (including MRA, if performed) for epilepsy (R) (NK) (Anaes.) (Contrast)

201.60

63082

MRI — scan of head (including MRA, if performed) for stroke (R) (NK) (Anaes.) (Contrast)

201.60

63083

MRI — scan of head (including MRA, if performed) for carotid or vertebral artery dissection (R) (NK) (Anaes.) (Contrast)

201.60

63084

MRI — scan of head (including MRA, if performed) for intracranial aneurysm (R) (NK) (Anaes.) (Contrast)

201.60

63085

MRI — scan of head (including MRA, if performed) for intracranial arteriovenous malformation (R) (NK) (Anaes.) (Contrast)

201.60

Subgroup 3 — Scan of head and neck vessels — for specified conditions

63104

MRI and MRA of extracranial or intracranial circulation (or both) — scan of head and neck vessels for stroke (R) (NK) (Anaes.) (Contrast)

246.40

 

Subgroup 4 — Scan of head and cervical spine — for specified conditions

63117

MRI — scan of head and cervical spine (including MRA, if performed) for tumour of the central nervous system or meninges (R) (NK) (Anaes.) (Contrast)

246.40

63119

MRI — scan of head and cervical spine (including MRA, if performed) for inflammation of the central nervous system or meninges (R) (NK) (Anaes.) (Contrast)

246.40

Subgroup 5 — Scan of head and cervical spine — for specified conditions

63134

MRI — scan of head and cervical spine (including MRA, if performed) for demyelinating disease of the central nervous system (R) (NK) (Anaes.) (Contrast)

246.40

63135

MRI — scan of head and cervical spine (including MRA, if performed) for congenital malformation of the central nervous system or meninges (R) (NK) (Anaes.) (Contrast)

246.40

63136

MRI — scan of head and cervical spine (including MRA, if performed) for syrinx (congenital or acquired) (R) (NK) (Anaes.) (Contrast)

246.40

Subgroup 6 — Scan of spine — 1 region or 2 contiguous regions — for specified conditions

63157

MRI — scan of 1 region or 2 contiguous regions of the spine for infection (R) (NK) (Anaes.) (Contrast)

179.20

63158

MRI — scan of 1 region or 2 contiguous regions of the spine for tumour (R) (NK) (Anaes.) (Contrast)

179.20

Subgroup 7 — Scan of spine — 1 region or 2 contiguous regions — for specified conditions

63186

MRI — scan of 1 region or 2 contiguous regions of the spine for demyelinating disease (R) (NK) (Anaes.) (Contrast)

179.20

63187

MRI — scan of 1 region or 2 contiguous regions of the spine for congenital malformation of the spinal cord or the cauda equina or the meninges (R) (NK) (Anaes.) (Contrast)

179.20

63188

MRI — scan of 1 region or 2 contiguous regions of the spine for myelopathy (R) (NK) (Anaes.) (Contrast)

179.20

63189

MRI — scan of 1 region or 2 contiguous regions of the spine for syrinx (congenital or acquired) (R) (NK) (Anaes.) (Contrast)

179.20

63190

MRI — scan of 1 region or 2 contiguous regions of the spine for cervical radiculopathy (R) (NK) (Anaes.) (Contrast)

179.20

63191

MRI — scan of 1 region or 2 contiguous regions of the spine for sciatica (R) (NK) (Anaes.) (Contrast)

179.20

63192

MRI — scan of 1 region or 2 contiguous regions of the spine for spinal canal stenosis (R) (NK) (Anaes.) (Contrast)

179.20

63193

MRI — scan of 1 region or 2 contiguous regions of the spine for previous spinal surgery (R) (NK) (Anaes.) (Contrast)

179.20

63194

MRI — scan of 1 region or 2 contiguous regions of the spine for trauma (R) (NK) (Anaes.)

179.20

Subgroup 8 — Scan of spine — 3 contiguous or 2 non‑contiguous regions — for specified conditions

63207

MRI — scan of 3 contiguous or 2 non‑contiguous regions of the spine for infection (R) (NK) (Anaes.) (Contrast)

224.00

63208

MRI — scan of 3 contiguous or 2 non‑contiguous regions of the spine for tumour (R) (NK) (Anaes.) (Contrast)

224.00

Subgroup 9 — Scan of spine — 3 contiguous or 2 non‑contiguous regions — for specified conditions

63257

MRI — scan of 3 contiguous or 2 non‑contiguous regions of the spine for demyelinating disease (R) (NK) (Anaes.) (Contrast)

224.00

63258

MRI — scan of 3 contiguous or 2 non‑contiguous regions of the spine for congenital malformation of the spinal cord or the cauda equina or the meninges (R) (NK) (Anaes.) (Contrast)

224.00

63259

MRI — scan of 3 contiguous or 2 non‑contiguous regions of the spine for myelopathy (R) (NK) (Anaes.) (Contrast)

224.00

63260

MRI — scan of 3 contiguous or 2 non‑contiguous regions of the spine for syrinx (congenital or acquired) (R) (NK) (Anaes.) (Contrast)

224.00

63261

MRI — scan of 3 contiguous or 2 non‑contiguous regions of the spine for cervical radiculopathy (R) (NK) (Anaes.) (Contrast)

224.00

63262

MRI — scan of 3 contiguous or 2 non‑contiguous regions of the spine for sciatica (R) (NK) (Anaes.) (Contrast)

224.00

63263

MRI — scan of 3 contiguous or 2 non‑contiguous regions of the spine for spinal canal stenosis (R) (NK) (Anaes.) (Contrast)

224.00

63264

MRI — scan of 3 contiguous or 2 non‑contiguous regions of the spine for previous spinal surgery (R) (NK) (Anaes.) (Contrast)

224.00

63265

MRI — scan of 3 contiguous or 2 non‑contiguous regions of the spine for trauma (R) (NK) (Anaes.)

224.00

Subgroup 10 — Scan of cervical spine and brachial plexus — for specified conditions

63282

MRI — Scan of cervical spine and brachial plexus for tumour (R) (NK) (Anaes.) (Contrast)

246.40

63283

MRI — Scan of cervical spine and brachial plexus for trauma (R) (NK) (Anaes.) (Contrast)

246.40

63284

MRI — Scan of cervical spine and brachial plexus for cervical radiculopathy (R) (NK) (Anaes.) (Contrast)

246.40

63285

MRI — Scan of cervical spine and brachial plexus for previous surgery (R) (NK) (Anaes.) (Contrast)

246.40

Subgroup 11 — Scan of musculoskeletal system — for specified conditions

63310

MRI — scan of musculoskeletal system for tumour arising in bone or musculoskeletal system, excluding tumours arising in breast, prostate or rectum (R) (NK) (Anaes.) (Contrast)

190.40

63311

MRI — scan of musculoskeletal system for infection arising in bone or musculoskeletal system, excluding infection arising in breast, prostate or rectum (R) (NK) (Anaes.) (Contrast)

190.40

63313

MRI — scan of musculoskeletal system for osteonecrosis (R) (NK) (Anaes.) (Contrast)

190.40

Subgroup 12 — Scan of musculoskeletal system — for specified conditions

63341

MRI — scan of musculoskeletal system for derangement of hip or its supporting structures (R) (NK) (Anaes.) (Contrast)

201.60

63342

MRI — scan of musculoskeletal system for derangement of shoulder or its supporting structures (R) (NK) (Anaes.) (Contrast)

201.60

63343

MRI — scan of musculoskeletal system for derangement of knee or its supporting structures (R) (NK) (Anaes.) (Contrast)

201.60

63345

MRI — scan of musculoskeletal system for derangement of ankle or foot (or both) or its supporting structures (R) (NK) (Anaes.) (Contrast)

201.60

63346

MRI — scan of musculoskeletal system for derangement of 1 or both temporomandibular joints or their supporting structures (R) (NK) (Anaes.) (Contrast)

168.00

63347

MRI — scan of musculoskeletal system for derangement of wrist or hand (or both) or its supporting structures (R) (NK) (Anaes.) (Contrast)

224.00

63348

MRI — scan of musculoskeletal system for derangement of elbow or its supporting structures (R) (NK) (Anaes.) (Contrast)

201.60

Subgroup 13 — Scan of musculoskeletal system — for specified conditions

63364

MRI — scan of musculoskeletal system for Gaucher disease (R) (NK) (Anaes.)

201.60

 

Subgroup 14 — Scan of cardiovascular system — for specified conditions

63392

MRI — scan of cardiovascular system for congenital disease of the heart or a great vessel (R) (NK) (Anaes.) (Contrast)

224.00

63393

MRI — scan of cardiovascular system for tumour of the heart or a great vessel (R) (NK) (Anaes.) (Contrast)

224.00

63394

MRI — scan of cardiovascular system for abnormality of thoracic aorta (R) (NK) (Anaes.) (Contrast)

201.60

Subgroup 15 — Magnetic resonance angiography — scan of cardiovascular system — for specified conditions

63407

MRA — if the request for the scan specifically identifies the clinical indication for the scan — scan of cardiovascular system for vascular abnormality in a patient with a previous anaphylactic reaction to an iodinated contrast medium (R) (NK) (Anaes.) (Contrast)

201.60

63408

MRA — if the request for the scan specifically identifies the clinical indication for the scan — scan of cardiovascular system for obstruction of the superior vena cava, inferior vena cava or a major pelvic vein (R) (NK) (Anaes.) (Contrast)

201.60

Subgroup 16 — Magnetic resonance angiography — for specified conditions — person under the age of 16 years

63419

MRA — scan of person under the age of 16 for the vasculature of limbs prior to limb or digit transfer surgery in congenital limb deficiency syndrome (R) (NK) (Anaes.) (Contrast)

201.60

 

Subgroup 17 — Magnetic resonance imaging — for specified conditions — person under the age of 16 years

63432

MRI — scan of person under the age of 16 for post‑inflammatory or post‑traumatic physeal fusion (R) (NK) (Anaes.)

201.60

63433

MRI — scan of person under the age of 16 for Gaucher disease (R) (NK) (Anaes.)

201.60

Subgroup 18 — Magnetic resonance imaging — for specified conditions — person under the age of 16 years

63447

MRI — scan of person under the age of 16 for pelvic or abdominal mass (R) (NK) (Anaes.) (Contrast)

201.60

63448

MRI — scan of person under the age of 16 for mediastinal mass (R) (NK) (Anaes.) (Contrast)

201.60

63449

MRI — scan of person under the age of 16 for congenital uterine or anorectal abnormality (R) (NK) (Anaes.) (Contrast)

201.60

Subgroup 19 — Scan of body — for specified conditions

63455

MRI — scan of the body for adrenal mass in a patient with a malignancy that is otherwise resectable (R) (NK) (Anaes.)

179.20

63457

MRI — scan of both breasts for the detection of cancer, if a dedicated breast coil is used, the request for scan identifies that the woman is asymptomatic and is less than 50 years of age, and the request for the scan identifies:

   (a)  that the patient is at high risk of developing breast cancer, due to 1 of the following:

         (i)   3 or more first or second degree relatives on the same side of the family diagnosed with breast or ovarian cancer;

345.00

 

        (ii)   2 or more first or second degree relatives on the same side of the family diagnosed with breast or ovarian cancer, if any of the following applies to at least 1 of the relatives:

               (A)    has been diagnosed with bilateral breast cancer;

               (B)    had onset of breast cancer before the age of 40 years;

               (C)    had onset of ovarian cancer before the age of 50 years;

               (D)    has been diagnosed with breast and ovarian cancer, at the same time or at different times;

                (E)    has Ashkenazi Jewish ancestry;

                (F)    is a male relative who has been diagnosed with breast cancer;

 

 

       (iii)   1 first or second degree relative diagnosed with breast cancer at age 45 years or younger, plus another first or second degree relative on the same side of the family with bone or soft tissue sarcoma at age 45 years or younger; or

 

 

  (b)  that genetic testing has identified the presence of a high risk breast cancer gene mutation (R) (NK) (Anaes.)

 

63458

MRI — scan of both breasts for the detection of cancer, if:

   (a)  a dedicated breast coil is used; and

  (b)  the woman has had an abnormality detected as a result of a service described in item 63464 or 63457 performed in the previous 12 months (R) (NK) (Anaes.)

345.00

 

 

Subdivision C              Subgroup 20 of Group I5 — Scans of pelvis and upper abdomen — for specified conditions

Group I5 — Magnetic resonance imaging

Item

Health service

Fee ($) (for each State)

Subgroup 20 — Scans of pelvis and upper abdomen — for specified conditions

63479

MRI — scan of the pelvis for the staging of histologically diagnosed cervical cancer at FIGO stage 1B or greater, if the request for scan identifies that:

   (a)  a histological diagnosis of carcinoma of the cervix has been made; and

  (b)  the patient has been diagnosed with cervical cancer at FIGO stage 1B or greater (R) (NK) (Anaes.) (Contrast)

201.60

63481

MRI — scan of the pelvis and upper abdomen, in a single examination, for the staging of histologically diagnosed cervical cancer at FIGO stage 1B or greater, if the request for scan identifies that:

   (a)  a histological diagnosis of carcinoma of the cervix has been made; and

  (b)  the patient has been diagnosed with cervical cancer at FIGO stage 1B or greater (R) (NK) (Anaes.) (Contrast)

313.60

63484

MRI — scan of the pelvis for the initial staging of rectal cancer, if:

   (a)  a phased array body coil is used; and

  (b)  the request for scan identifies that the indication is for the initial staging of rectal cancer (including cancer of the rectosigmoid and anorectum) (R) (NK) (Anaes.) (Contrast)

201.60

 

Subdivision D           Subgroups 21 and 22 of Group I5

Group I5 — Magnetic resonance imaging

Item

Health service

Fee ($) (for each State)

Subgroup 21 — Scan of body — for specified conditions

63486

MRI — scan of pancreas and biliary tree for suspected biliary or pancreatic pathology (R) (NK) (Anaes.)

201.60

 

 


SCHEDULE 2 – References in regulations

(section 7)

 

1.             DIST Regulations

 

 

Column 1

Column 2

Column 3

 

Provision of DIST Regulations

Existing item reference of DIST Regulations

Additional item reference

Preliminary

(a)     

Clause 1.1.1 and subclause 1.2.3(1)

Item in Part 2

The items in Schedule 1

(b)    

Paragraph 1.2.3(2)(a)

55054, 55130, 55135, 55848, 55850, 57341, 57345, 59312, 59314, 60506, 60509 and 61109

55026, 55131, 55136, 55849, 55851, 59313, 59315, 60507, 60510, 61110

(c)     

Subclause 1.2.5(4)

61369

61671

(d)    

Subclause 1.2.7(10)

59103, 64990 or 64991

59104

Ultrasound

(e)     

Clause 2.1.1

55054, 55130, 55135, 55848 and 55850

55026, 55131, 55136, 55849, 55851

(f)     

Clause 2.1.2 and subclause 2.1.3(1)

55600 and 55603

55601, 55604

(g)    

Clause 2.1.4

55028, 55030 and 55032

55005, 55008, 55011

(h)    

Subclause 2.1.5(2)

55706, 55707, 55708, 55709, 55718, 55723, 55759, 55762, 55768 and 55770

55713, 55714, 55716, 55717, 55722, 55726, 55760, 55763, 55769, 55771

(i)      

Subclause 2.1.6(1)

55700, 55704, 55707, 55718, 55759 and 55768

55701, 55710, 55714, 55722, 55760, 55769

(j)      

Subclause 2.1.6(1)

55712, 55721, 55764 and 55772

55719, 55724, 55765, 55773

(k)    

Subclause 2.1.6(2)

55703, 55705, 55708, 55715, 55723, 55725, 55762, 55766, 55770 and 55774

55702, 55711, 55716, 55720, 55726, 55727, 55763, 55767, 55771, 55775

(l)      

Clause 2.1.7

55712, 55721, 55764 and 55772

55719, 55724, 55765, 55773

Diagnostic radiology

(m)  

Clause 2.3.1

59312 and 59314

59313, 59315

(n)    

Clause 2.3.3

60506 and 60509

60507, 60510

(o)    

Clauses 2.3.6 and 2.3.7

61109

61110

Nuclear medicine imaging

(p)    

Clause 2.4.1

61302 to 61505 and item 61650

61651 to 61719, 61729

Magnetic resonance imaging

(q)    

Subclause 2.5.1(1) and clauses 2.5.2 and 2.5.7

63001 to 63482 

63484, 63486

(r)      

Subclause 2.5.9(2)

63040 to 63073

63074 to 63085

(s)     

Subclause 2.5.9(2)

63101

63104

(t)      

Subclause 2.5.9(2)

63125 to 63131

63134 to 63136

(u)    

Subclause 2.5.9(2)

63161 to 63185

63186 to 63194

(v)    

Subclause 2.5.9(2)

63219 to 63243

63257 to 63265

(w)  

Subclause 2.5.9(2)

63271 to 63280

63282 to 63285

(x)    

Subclause 2.5.9(2)

63322 to 63340

63341 to 63348

(y)    

Subclause 2.5.9(2)

63361

63364

(z)     

Subclause 2.5.9(2)

63385 to 63391

63392 to 63394

(aa) 

Subclause 2.5.9(2)

63401 and 63404

63407, 63408

(bb)  

Subclause 2.5.9(2)

63416

63419

(cc) 

Subclause 2.5.9(2)

63425 and 63428

63432, 63433

(dd) 

Subclause 2.5.9(2)

63461, 63464 and 63467

63455, 63457, 63458

(ee) 

Subclause 2.5.9(2)

63482

63486

(ff)  

Subclauses 2.5.10(1) and (2)

63470

63479

(gg)  

Subclause 2.5.10(1) and (2)

63473

63481

 


2.             Diagnotic imaging services table

 

 

Column 1

Column 2

Column 3

 

Existing   DIST item

Existing item reference

Additional item reference

Ultrasound

(a)     

55036

55038, 55044 or 55731

55017, 55020, 55732

(b)    

55038

55036, 55044 or 55731

55014, 55020, 55732

(c)     

55044

55036 or 55038

55014, 55017

(d)    

55084

11917, 55036, 55038, 55044, 55600, 55603 or 55731

55014, 55017, 55020, 55601, 55604, 55732

(e)     

55085

11917, 55037, 55039, 55045, 55600, 55603 or 55733

55016, 55019, 55022, 55601, 55604, 55734

(f)     

55113 to 55118

55054

55026

(g)    

55113 to 55117

55118 and 55130

55125, 55131

(h)    

55130

55135

55136

(i)      

55135

55130

55131

(j)      

55238 to 55296

55054

55026

(k)    

55706

55709

55717

(l)      

55707(f) and 55078(d)

55704

55710

(m)  

55707 and 55708

55700, 55703, 55704 or 55705

55701, 55702, 55710, 55711

(n)    

55709

55706

55713

(o)    

55712 and 55715

55706 or 55709

55713, 55717

(p)    

55718

55723

55726

(q)    

55721 and 55725

55718 or 55723

55722, 55726

(r)      

55723

55718

55722

(s)     

55731

55036 or 55038

55014, 55017

(t)      

55759

55706, 55709, 55712, 55715 or 55762

55713, 55717, 55719, 55720, 55763

(u)    

55762

55706, 55709, 55712, 55715 or 55759

55713, 55717, 55719, 55720, 55760

(v)    

55764 and 55766

55759 or 55762

55760, 55763

(w)  

55764 and 55766

55706, 55709, 55712 or 55715

55713, 55717, 55719, 55720

(x)    

55768

55770

55771

(y)    

55768, 55770, 55772 and 55774

55718, 55721, 55723 or 55725

55722, 55724, 55726, 55727

(z)     

55770

55768

55769

(aa) 

55772 and 55774

55768 or 55770

55769, 55771

(bb)         

55848 and 55850

55054

55026

(cc) 

55850

55800 to 55848

55849

Computed tomography

(dd)        

56219 and 56259

59724

59725

Diagnostic radiology

(ee) 

57901

57902

57914

(ff)  

57902

57901

57911

(gg)         

57945

57939 or 57942

57950, 57953

(hh)         

58112, 58115 and 58121

58100, 58103, 58106 and 58109

58102, 58105, 58111, 58117

(ii)    

58120 and 58121

58120 or 58121

58126, 58127

(jj)    

58900 and 58903

58909, 58912, 58915 or 58924

58911, 58914, 58917, 58926

(kk)         

58909

57939, 57942 or 57945

57950, 57953, 57956

(ll)    

59733

57918

57932

(mm)     

59903, 59912, 59925, 59971, 59972, and 59973

61109

61110

Nuclear medicine imaging

(nn)         

61462

61364, 61426, 61429, 61430, 61442, 61450, 61453, 61469, 61484 or 61485

61669, 61692, 61693, 61694, 61700, 61704, 61705, 61712, 61715, 61716

(oo)         

61505

61302 to 61650

61651 to 61729

Magnetic resonance imaging

(pp)         

63467

63464

63457

 


3.             Dictionary

 

 

Column 1

Column 2

Column 3

 

Definition

Existing item reference

Additional item reference

(a)     

medical practitioner

55028, 55030 and 55032

55005, 55008, 55011

(b)    

scan

63001 to 63482

63484, 63486

 

4.             Health Insurance Regulations 1975

 

 

Column 1

Column 2

Column 3

 

Provision of Health Insurance Regulations

Existing item reference

Additional item reference

(a)     

Paragraph 10(1)(a)

55028, 55030, 55032, 56001 to 56220 (inclusive), 56224, 56227, 56230, 56259, 56301 to 56507 (inclusive), 56541, 56547, 56801 to 57007 (inclusive), 57041, 57047, 57341, 57345, 57703, 57709, 57712, 57715, 58103 to 58115 (inclusive), 58306, 58506, 58521 to 58527 (inclusive), 58909, 59103, 59703, 60000 to 60009 (inclusive), 60506, 60509, 61109, 61372, 61421, 61425, 61429, 61430, 61433, 61434, 61446, 61449, 61450, 61453, 61454, 61457, 61462, 63007 and 63334

55005, 55008, 55011, 57705, 57711, 57714, 57717, 58117, 58123, 58124, 58308, 58508, 58529, 58911, 59104,  59704, 60507, 60510, 61110, 61672, 61690, 61691, 61693, 61694, 61695, 61696, 61702, 61703, 61704, 61705, 61706, 61707, 61710, 63016, 63346

(b)    

Paragraph 10(1)(b)

55028, 56013, 56016, 56022, 56028, 56053, 56056, 56062, 56068, 58306, 61421, 61425, 61429, 61430, 61433, 61434, 61446, 61449, 61450, 61453, 61454, 61457, 61462 and 63334

55005, 58308, 61690, 61691, 61693, 61694, 61695, 61696, 61702, 61703, 61704, 61705, 61706, 61707, 61710, 63346

(c)     

Paragraph 10(1)(c)

56022, 56062, 58306, 61421, 61454, 61457 and 63334

58308, 61690, 61706, 61707, 63346

(d)    

Paragraph 10(1)(d)

55028, 55030, 55032, 56001, 56007, 56010, 56013, 56016, 56022, 56028, 56041, 56047, 56050, 56053, 56056, 56062, 56068, 56101, 56107, 56141, 56147, 56301, 56307, 56341, 56347, 56401, 56407, 56441, 56447, 57341, 57345, 58306, 58506, 58909, 59103, 59703, 60000, 60003, 60006, 60009, 60506, 60509, 61109, 61372, 61421, 61425, 61429, 61430, 61433, 61434, 61446, 61449, 61450, 61453, 61454, 61457, 61462, 63007 and 63334

55005, 55008, 55011, 58308, 58508, 58911, 59104, 59704, 60507, 60510, 61110, 61672, 61690, 61691, 61693, 61694, 61695, 61696, 61702, 61703, 61704, 61705, 61706, 61707, 61710, 63016, 63346

(e)     

Paragraph 10(1)(e)

57509, 57515, 57521, 57527, 57901 to 57969 (inclusive), 58100, 58300, 58503, 58903, 59733, 59739, 59751, 60100, 60500 and 60503

57530, 57533, 57536, 57539, 58102, 58302, 58505, 58905, 59734, 59740, 59752, 60101, 60501, 60504

(f)     

Subregulation 11(1)

57712, 57715, 58100 to 58106 (inclusive), 58109, 58112, 58120 and 58121

57714, 57717, 58111, 58117, 58123, 58126, 58127

(g)    

Subregulation 11(2)

55836, 55840, 55844, 57521 and 57527

55837, 55841, 55845, 57536, 57539

(h)    

Subregulation 11B(1)

55700, 55704, 55706, 55707, and 55718

55701, 55710, 55713, 55714, 55722

(i)      

Subregulation 11B(2)

55036, 55070, 55076, 55600, 55768, 55800, 55804, 55808, 55812, 55816, 55820, 55824, 55828, 55832, 55836, 55840, 55844, 55848, 55850, 55852, 57509, 57515, 57521 and 58503 to 58527 (inclusive)

55014, 55059, 55061, 55601, 55769, 55801, 55805, 55809, 55813, 55817, 55821, 55825, 55829, 55833, 55837, 55841, 55845, 55849, 55851, 55853, 57530, 57533, 57536, 58529

(j)      

Regulation 12

57712, 57715, 57901, 57902, 57903, 57912, 57915, 57921, 58100 to 58115 (inclusive), 58521, 58524, 58527, 58700, 58924 and 59103

57714, 57717, 57911, 57914, 57917, 57926, 57929, 57935, 58117, 58123, 58124, 58523, 58526, 58529, 58702, 58926, 59104

 

5.             General Medical Services Table

 

 

Column 1

Column 2

Column 3

 

Existing GMST item

Existing item reference

Additional item reference

(a)     

Item 11614

55280

55229

 

 

Note             All legislative instruments and compilations are registered on the Federal Register of Legislative Instruments kept under the Legislative Instruments Act 2003.  See http://www.frli.gov.au