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Determinations/Health as made
This instrument provides for the payment of Medicare benefits for a pathology service to test for SARS-CoV-2 under new item 69485 of the pathology services table.
Administered by: Health
Registered 12 Mar 2020
Tabling HistoryDate
Tabled HR23-Mar-2020
Tabled Senate23-Mar-2020
To be ceased 30 Sep 2020
Ceased by Self Ceasing
Table of contents.

Commonwealth Coat of Arms of Australia

 

Health Insurance (Section 3C Pathology Services – COVID-19) Determination 2020

I, DAVID WEISS, delegate of the Minister for Health, make the following Determination.

Dated   12 March 2020                                  

David Weiss

First Assistant Secretary

Medical Benefits Division

Health Financing Group

Department of Health

 

 

 


Contents

1.  Name....................................................................................................................................... 1

2.  Commencement....................................................................................................................... 1

3.  Cessation................................................................................................................................. 1

4.  Authority................................................................................................................................. 1

5.  Definitions............................................................................................................................... 1

6.  Treatment of relevant services................................................................................................. 2

7.  Application of provisions of the pathology services table....................................................... 2

Schedule 1 – relevant services                                                                                      3

 

 


1.  Name

                        This instrument is the Health Insurance (Section 3C Pathology Services – COVID-19) Determination 2020

2.  Commencement

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

 

Commencement information

Column 1

Column 2

Column 3

Provisions

Commencement

Date/Details

1.  The whole of this instrument

13 March 2020

 

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

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

3.  Cessation

Unless earlier revoked this instrument ceases on 30 September 2020.

4.  Authority

                        This instrument is made under subsection 3C(1) of the Health Insurance Act 1973.

5.  Definitions

(1)          In this instrument:

Act means the Health Insurance Act 1973.

approved collection centre has the meaning given by subsection 23DA(1) of the Act.

bulk‑billed: a pathology service is bulk‑billed if:

(a)  a medicare benefit is payable to a person in relation to the service; and

(b)  under an agreement entered into under section 20A of the Act:

   (i)  the person assigns to the practitioner by whom, or on whose behalf, the service is provided, the person’s right to the payment of the medicare benefit; and

   (ii) the practitioner accepts the assignment in full payment of the practitioner’s fee for the service provided.

relevant provisions means all provisions, of the Act and regulations made under the Act, and the National Health Act 1953 and regulations made under the National Health Act 1953, relating to pathology services, professional services or items.

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

pathology services table means the table prescribed under subsection 4A(1) of the Act.

Schedule means a Schedule to this instrument.

Note:  The following terms are defined in subsection 3(1) of the Act:

·         clinically relevant service;

·         pathology services table;

·         item;

·         professional service.

 (2)   Unless the contrary intention appears, a reference in this instrument to a provision of the Act or the National Health Act 1953 or regulations made under the Act or 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.

 

6.  Treatment of relevant services

 

For subsection 3C(1) of the Act, a relevant service, provided in accordance with this instrument and as a clinically relevant service, is to be treated, for the relevant provisions, as if:

(a)                    it were both a professional service and a pathology service; and

(b)                   there were an item in the pathology services table that:

                                                              i.      related to the service; and

                                                            ii.      specified for the service a fee in relation to each State, being the fee specified in the Schedule in relation to the service.

7.  Application of provisions of the pathology services table

(1)      Clause 1.7 of the pathology services table shall have effect as if item 69485 of this Determination was specified in paragraph 1.7(2)(a) of the pathology services table.

 

Schedule 1 – relevant services

 

Group P3 – Microbiology  

 

Column 1

Column 2

Column 3

Item

Pathology service

Fee ($)

69485

 

Detection of a SARS-CoV-2 nucleic acid 1 or more tests if the service:

(a)     is bulk-billed; and

(b)     is in a single patient episode with a service described in 69494 or 69495 or 69496 that is rendered to test for other respiratory viruses.

28.65