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Determinations/Health as made
This instrument introduces item 73812 onto the Medicare Benefits Schedule as of 1 November 2021 and clarifies that a service under item 73812 is considered a Prescribed Pathology Service under the Health Insurance (Prescribed Pathology Services) Determination 2021.
Administered by: Health
Registered 16 Sep 2021
Table of contents.

Commonwealth Coat of Arms of Australia

 

Health Insurance (Section 3C Pathology Services – HbA1c Point of Care Testing) Determination 2021

I, Travis Haslam, delegate of the Minister for Health and Aged Care, make the following determination.

Dated   14 September 2021    

 

 

 

 

 

Travis Haslam

Acting First Assistant Secretary

Medical Benefits Division

Health Resourcing Group

Department of Health

 

 

 

 

 

  

  


Contents

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

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

3.  Authority................................................................................................................................. 1

4.  Definitions............................................................................................................................... 1

5.  Treatment of relevant services................................................................................................. 2

6. Application of item 73812........................................................................................................ 2

7. Limitation of item 73812.......................................................................................................... 2

Schedule 1 – relevant services                                                                                      3

 

 

 

 

 

 

 

 

 

 

                                                                                                                           

                                                                                                                           


1.  Name

            This instrument is the Health Insurance (Section 3C Pathology Services – HbA1c Point of Care Testing) Determination 2021. 

2.  Commencement

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

 

Commencement information

Column 1

Column 2

Column 3

Provisions

Commencement

Date/Details

1.  The whole of this instrument

1 November 2021

 

                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

 (1)    In this instrument:

Act means the Health Insurance Act 1973.

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 medical 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.

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.

 

5.  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 a professional 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.

 

6. Application of item 73812

Section 6 of the Health Insurance (Prescribed Pathology Services) Determination 2021 shall have effect as if the service specified in item 73812 of the Schedule were also specified in that section.

 

7. Limitation of item 73812

(1)     Item 73812 does not apply to a service provided to a patient who has already been provided, in the last 12 months, 4 other services to which any of the following apply:

(a)                    item 73812;

(b)                   item 66551;

(c)                    item 73826 of the Health Insurance (Section 3C Midwife and Nurse Practitioner Services) Determination 2020.

 

Schedule 1 – relevant services

 

Group P9—Simple basic pathology tests

Column 1

Item

Column 2

Description

Column 3

Fee ($)

73812

Quantitation of glycated haemoglobin (HbA1c) performed in the management of established diabetes when performed:

(a) as a point‑of‑care test; and

(b) by or on behalf of a medical practitioner who works in a general practice that is accredited against the point of care testing accreditation module under the National General Practice Accreditation Scheme; and

(c) using a method and instrument certified by the National Glycohemoglobin Standardization Program (NGSP), if the instrument has a total coefficient variation less than 3.0% at 48 mmol/mol (6.5%)

Applicable not more than 3 times per 12 months per patient

11.80