Federal Register of Legislation - Australian Government

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Determinations/Health as made
This instrument provides the legal basis for Medicare Benefits Schedule items 55208 and 55211 for duplex scanning services for erectile dysfunction.
Administered by: Health
Registered 29 Apr 2020
Tabling HistoryDate
Tabled HR12-May-2020
Tabled Senate12-May-2020
Table of contents.

 

 

Health Insurance (Section 3C Diagnostic Imaging Services – Duplex Scanning for
Erectile Dysfunction) Determination
2020

__________________________________________________________________

I, David Weiss, delegate of the Minister for Health, make the following determination

Dated            24 April 2020    

David Weiss

First Assistant Secretary

Medical Benefits Division

Health Financing Group

Department of Health

 

 

 

 


Contents

1............ Name. 3

2............ Commencement 3

3............ Authority. 3

4............ Definitions. 3

5............ Schedules. 4

6............ Treatment of a relevant service. 4

7............ Limitations. 4

Schedule 1   Specified health services  5

Schedule 2   Specified medical practitioner  6

Schedule 3   Repeals  7

 

 

 

 

 

 

 

 

 

 

 


 

1.                  Name

This Determination is the Health Insurance (Section 3C Diagnostic Imaging Services – Duplex Scanning for Erectile Dysfunction) 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

1 May 2020

 

Note:          This table relates only to the provisions of this instrument as originally made.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

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

3.                  Authority

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

4.                  Definitions

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

·            clinically relevant service

·            diagnostic imaging services table

·            item

·           professional service

(1)                    In this instrument:

Act means the Health Insurance Act 1973.

relevant medical practitioner means a medical practitioner, as defined in subsection 3(1) of the Act, who is specified in Schedule 2.

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

Schedule means the Schedule to this Determination.

(2)       Unless the contrary intention appears, a reference in this instrument to a provision of the Act or the National Health Act 1953 or a legislative instrument 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 instrument is a reference to those provisions as in force from time to time.

5.                  Schedules

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

6.                  Treatment of a relevant service

A health service provided in accordance with this Determination is to be treated, for the relevant provisions, as if:

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

(b)                   there were an item in the diagnostic imaging 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 item in Schedule 2 relating to the service.

7.                  Limitations

Section 7 applies to a relevant service if it is rendered by a relevant medical practitioner in the following circumstances:

(a)                    the relevant medical practitioner:

(i)                      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

(ii)                    interprets the results and prepares a report; and

(b)                   the patient is referred to the relevant medical practitioner by another medical practitioner; and

(c)                    the service is not one to which an item in Group I1 of the diagnostic imaging services table applies.


 

Schedule 1     Specified health services

 

Item

Health Service

Fee ($)

55208

DUPLEX SCANNING involving B mode ultrasound imaging and integrated Doppler flow measurement by spectral analysis of cavernosal artery of the penis following intracavernosal administration of a vasoactive agent, performed during the period of pharmacological activity of the injected agent to confirm a diagnosis of vascular aetiology for impotence (R).

 

A fee equal to the fee in item 55282 of the diagnostic imaging services table, as specified in that item from time to time.

55211

DUPLEX SCANNING involving B mode ultrasound imaging and integrated Doppler flow measurement by spectral analysis of cavernosal tissue of the penis to confirm a diagnosis and, where indicated, assess the progress and management of:

(a) priapism; or

(b) fibrosis of any type; or

(c) fracture of the tunica; or

(d) arteriovenous malformations (R).

A fee equal to the fee in item 55284 of the diagnostic imaging services table, as specified in that item from time to time.

 

Schedule 2     Specified medical practitioner

 

Number

Medical Practitioner

1

Dr Christopher McMahon, provider number 045449 of Australian Centre for Sexual Health, Berry Road Medical Centre, St Leonards NSW 2065

 


 

Schedule 3     Repeals

Health Insurance (Duplex Scanning for Erectile Dysfunction) Determination 2010 (No. 1)

1.     The whole of the instrument

Repeal the instrument