
Health Insurance (Section 3C General Medical Services ‑ Optometric Services) Determination 2020
made under the
Health Insurance Act 1973
Compilation No. 4
Compilation date: 1 July 2023
Includes amendments up to: F2023L00535
Registered: 27 July 2023
About this compilation
This compilation
This is a compilation of the Health Insurance (Section 3C General Medical Services - Optometric Services) Determination 2020 that shows the text of the law as amended and in force on 1 July 2023 (the compilation date).
The notes at the end of this compilation (the endnotes) include information about amending laws and the amendment history of provisions of the compiled law.
Uncommenced amendments
The effect of uncommenced amendments is not shown in the text of the compiled law. Any uncommenced amendments affecting the law are accessible on the Register (www.legislation.gov.au). The details of amendments made up to, but not commenced at, the compilation date are underlined in the endnotes. For more information on any uncommenced amendments, see the Register for the compiled law.
Application, saving and transitional provisions for provisions and amendments
If the operation of a provision or amendment of the compiled law is affected by an application, saving or transitional provision that is not included in this compilation, details are included in the endnotes.
Editorial changes
For more information about any editorial changes made in this compilation, see the endnotes.
Modifications
If the compiled law is modified by another law, the compiled law operates as modified but the modification does not amend the text of the law. Accordingly, this compilation does not show the text of the compiled law as modified. For more information on any modifications, see the Register for the compiled law.
Self‑repealing provisions
If a provision of the compiled law has been repealed in accordance with a provision of the law, details are included in the endnotes.
1. Name
This instrument is the Health Insurance (Section 3C General Medical Services ‑ Optometric Services) Determination 2020.
3. Authority
This instrument is made under the Health Insurance Act 1973.
5. Definitions
(1) In this instrument:
Act means the Health Insurance Act 1973.
bulk‑billed for a relevant service, means:
(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 person by whom the service is provided, his or her right to the payment of the medicare benefit; and
(ii) the second‑mentioned person accepts the assignment in full payment of his or her fee for the service provided.
care recipient means a person receiving residential care under section 21‑2 of the Aged Care Act 1997.
old item 10900 means item 10900 of the general medical services table as in force at any time before the repeal of the item by Part 1 of Schedule 1 to the Health Insurance Legislation Amendment (Optometric Services and Other Measures) Regulation 2014.
relevant provisions means all provisions, of the Act and regulations made under the Act, and the National Health Act 1953 and regulations made under that Act, 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 the Schedule.
residential aged care facility means a facility where residential care (within the meaning given by section 41‑3 of the Aged Care Act 1997) is provided.
Schedule means the Schedule to this instrument.
telehealth eligible area has the same meaning as in the general medical services table.
Note: The following terms are defined in subsection 3(1) of the Act:
· clinically relevant
· general medical services table
· optometrist
(2) In this instrument, Group A10 refers to the group of all the relevant services specified in items the Schedule, Subgroup 1 of Group A10 refers to the group of relevant services specified in items 10905 to 10944 of the Schedule and Subgroup 2 of Group A10 refers to the group of relevant services specified in items 10945 to 10948 of the Schedule.
(3) 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) a relevant service, other than the service described in item 10944, provided in accordance with this instrument and as a clinically relevant service, is to be treated, for the relevant provisions, as if:
(i) it were both a professional service and a medical service; and
(ii) there were an item in the general medical services table that:
(A) related to the service; and
(B) specified for the service a fee in relation to each State, being the fee specified in the Schedule in relation to the service.
(b) the relevant service described in item 10944, provided in accordance with this instrument and as a clinically relevant service, is to be treated, for the relevant provisions of the Act other than subsection 3(5), as if:
(i) it were both a professional service and a medical service; and
(ii) there were an item in the general medical services table that:
(A) related to the service; and
(B) 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 item 10929
Item 10929 does not apply to a service if the patient’s requirement for contact lenses is only for any of the following reasons:
(a) because the patient does not want to wear spectacles for reasons of appearance;
(b) because the patient wants contact lenses for work or sporting purposes;
(c) because the patient has difficulty in using, or cannot use, spectacles for psychological reasons.
8. Application of items 10931, 10932 and 10933
If item 10931, 10932 or 10933 applies to a service, the fee mentioned in that item applies in addition to the fee mentioned in another item in Subgroup 1 of Group A10 that applies to the service.
9. Application of items 10940 and 10941
(1) For this section, the following are perimetry services:
(a) a service described in item 10940;
(b) a service described in item 10941.
(2) For a particular patient, a maximum of two perimetry services apply in a 12 month period.
10. Limitation on item 10943
Item 10943 does not apply to a service used to assess learning difficulties or learning disabilities.
11. Limitation on items
(1) Item 10943 may only apply to a service in respect of a particular patient once in a 12 month period.
(2) Item 10942 may only apply to a service in respect of a particular patient twice in a 12 month period.
(3) Items 10921 to 10929 may only apply to a service in respect of a particular patient once in a 36 month period.
12. Limitation on item 10944
Item 10944 does not apply to a service on the same occasion as a service mentioned in any of items 10905, 10907, 10910, 10911, 10912, 10913, 10914, 10915, 10916 and 10918.
14. Application of items 10945 and 10946
Items 10945 and 10946 only apply to a service if the video conferencing consultation in which the patient is participating is a service for which there is an item in the general medical services table, or treated as being in the table because of subsection 3C(1) of the Act.
15. Professional attendance items and services provided with non‑medicare services
(1) Clause 1.2.5 of the general medical services table has effect as if items 10905 to 10929 were also specified in subclause 1.2.5(1).
(2) Clauses 1.2.8 and 1.2.9 of the general medical services table have effect as if items 10905 to 10948 were also specified in those clauses.
16. Indexation
(1) At the start of 1 July 2023 (the indexation day), each amount covered by subsection (2) is replaced by the amount worked out using the following formula:

Note: The indexed fees could in 2023 be viewed on the Department of Health and Aged Care’s MBS Online website (http://www.health.gov.au).
(2) The amounts covered by this subsection are the fee for each item in a Schedule of this Determination.
(3) An amount worked out under subsection (1) is to be rounded up or down to the nearest 5 cents (rounding down if the amount is an exact multiple of 2.5 cents).
Endnotes
Endnote 1—About the endnotes
The endnotes provide information about this compilation and the compiled law.
The following endnotes are included in every compilation:
Endnote 1—About the endnotes
Endnote 2—Abbreviation key
Endnote 3—Legislation history
Endnote 4—Amendment history
Abbreviation key—Endnote 2
The abbreviation key sets out abbreviations that may be used in the endnotes.
Legislation history and amendment history—Endnotes 3 and 4
Amending laws are annotated in the legislation history and amendment history.
The legislation history in endnote 3 provides information about each law that has amended (or will amend) the compiled law. The information includes commencement details for amending laws and details of any application, saving or transitional provisions that are not included in this compilation.
The amendment history in endnote 4 provides information about amendments at the provision (generally section or equivalent) level. It also includes information about any provision of the compiled law that has been repealed in accordance with a provision of the law.
Editorial changes
The Legislation Act 2003 authorises First Parliamentary Counsel to make editorial and presentational changes to a compiled law in preparing a compilation of the law for registration. The changes must not change the effect of the law. Editorial changes take effect from the compilation registration date.
If the compilation includes editorial changes, the endnotes include a brief outline of the changes in general terms. Full details of any changes can be obtained from the Office of Parliamentary Counsel.
Misdescribed amendments
A misdescribed amendment is an amendment that does not accurately describe how an amendment is to be made. If, despite the misdescription, the amendment can be given effect as intended, then the misdescribed amendment can be incorporated through an editorial change made under section 15V of the Legislation Act 2003.
If a misdescribed amendment cannot be given effect as intended, the amendment is not incorporated and “(md not incorp)” is added to the amendment history.
Endnote 2—Abbreviation key
ad = added or inserted | o = order(s) |
am = amended | Ord = Ordinance |
amdt = amendment | orig = original |
c = clause(s) | par = paragraph(s)/subparagraph(s) |
C[x] = Compilation No. x | /sub‑subparagraph(s) |
Ch = Chapter(s) | pres = present |
def = definition(s) | prev = previous |
Dict = Dictionary | (prev…) = previously |
disallowed = disallowed by Parliament | Pt = Part(s) |
Div = Division(s) | r = regulation(s)/rule(s) |
ed = editorial change | reloc = relocated |
exp = expires/expired or ceases/ceased to have | renum = renumbered |
effect | rep = repealed |
F = Federal Register of Legislation | rs = repealed and substituted |
gaz = gazette | s = section(s)/subsection(s) |
LA = Legislation Act 2003 | Sch = Schedule(s) |
LIA = Legislative Instruments Act 2003 | Sdiv = Subdivision(s) |
(md) = misdescribed amendment can be given | SLI = Select Legislative Instrument |
effect | SR = Statutory Rules |
(md not incorp) = misdescribed amendment | Sub‑Ch = Sub‑Chapter(s) |
cannot be given effect | SubPt = Subpart(s) |
mod = modified/modification | underlining = whole or part not |
No. = Number(s) | commenced or to be commenced |
Endnote 3—Legislation history
Name | Registration | Commencement | Application, saving and transitional provisions |
Health Insurance (Section 3C General Medical Services ‑ Optometric Services) Determination 2020 | 17 June 2020 (F2020L00741) | 1 July 2020 (s 2(1) item 1) | |
Health Insurance Legislation Amendment (Section 3C General Medical and Diagnostic Imaging Services – Medicare Indexation) Determination 2021 | 8 Apr 2021 (F2021L00426) | Sch 1 (items 80–111): 1 July 2021 (s 2(1) item 1) | — |
Health Insurance Legislation Amendment (Telehealth Clinical Support Services) Determination 2021 | 17 Dec 2021 (F2021L01811) | Sch 1 (items 17–21): 1 Jan 2022 (s 2(1) item 1) | — |
Health Insurance Legislation Amendment (Indexation) Determination 2022 | 7 Apr 2022 (F2022L00553) | Sch 1 (item 3): 1 July 2022 (s 2(1) item 1) | — |
Health Insurance Legislation Amendment (Indexation) Determination 2023 | 24 Mar 2023 (F2023L00348) | Sch 1 (item 3): 1 July 2023 (s 2(1) item 1) | — |
Health Insurance Legislation Amendment (2023 Measures No. 1) Determination 2023 | 11 May 2023 (F2023L00535) | Sch 1 (item 7): 1 July 2023 (s 2(1) item 1) | — |
Endnote 4—Amendment history
Provision affected | How affected |
s 2............................................. | rep LA s 48D |
s 4............................................. | rep LA s 48C |
s 5............................................. | am F2023L00535 |
s 13........................................... | rep F2021L01811 |
s 14........................................... | am F2021L01811 |
s 16........................................... | ad F2022L00553 |
| am F2023L00348 |
| ed C4 |
Schedule | |
Schedule................................... | am F2021L00426; F2021L01811 |
Endnote 5—Editorial changes
In preparing this compilation for registration, the following kinds of editorial change(s) were made under the Legislation Act 2003.
Subsection 16(1)
Kind of editorial change
Update to a reference of a law or a provision
Details of editorial change
Schedule 1 item 3 of the Health Insurance Legislation Amendment (Indexation) Determination 2023 instructs to repeal and substitute subsection 16(1).
The newly substituted subsection refers to “subclause (2)” instead of “subsection (2)”.
This compilation was editorially changed to update a reference from “subclause (2)” to “subsection (2)” in subsection 16(1).