Schedule 1―Overnight accommodation: private hospitals in all States/Territories and shared ward accommodation at public hospitals in Victoria and Tasmania

Part 1 General

1. Circumstances

For rules 4 and 5 of Part 2 of these Rules, the circumstances specified for hospital treatment to which this Schedule applies are that the treatment is:

(a) provided to a patient who is not a nursing‑home type patient; and

(b) provided to a patient:

(i) at a private hospital; or

(ii) as shared ward accommodation at a public hospital in Victoria or Tasmania; and

Note: The definition of hospital treatment in section 121‑5 of the Act includes that the treatment is provided either at the hospital or provided or arranged with the direct involvement of a hospital. This Schedule sets out benefit requirements only for treatment provided at the relevant hospital ― see paragraph 121‑5 (1) (c) of the Act.

(i) a Type A procedure; and

(ii) for a period that includes part of an overnight stay.

Note: A Type A procedure is defined to include a certified Type B procedure and a certified overnight Type C procedure―see the definitions of those terms in rule 3 of Part 1 of these Rules.

2. Minimum benefit

(1) The minimum benefit for hospital treatment provided in the circumstances specified in this Schedule is the amount set out in the tables in this Schedule for that hospital treatment.

(2) When counting the days referred to in the tables in this Schedule to determine the minimum benefit in respect of any particular patient, days forming part of a continuous period of hospitalisation are to be counted.

Table 1‑Overnight accommodation for private patients at private hospitals in all States/Territories
Column 1	Column 2
Class of patient	Minimum benefit payable per night
Advanced surgical patient
‑ first 14 days	$509
‑ over 14 days	$354
Surgical patient or obstetric patient
‑ first 14 days	$472
‑ over 14 days	$354
Psychiatric patient
‑ first 42 days	$472
‑ 43 – 65 days	$410
‑ over 65 days	$354
Rehabilitation patient
‑ first 49 days	$472
‑ 50 ‑ 65 days	$410
‑ over 65 days	$354
Other patients
‑ first 14 days	$410
‑ over 14 days	$354

Table 2‑Victoria‑overnight shared ward accommodation for private patients at public hospitals
Column 1	Column 2
Class of patient	Minimum benefit payable per night
Advanced surgical patient
‑ first 14 days	$509
‑ over 14 days	$354
Surgical patient or obstetric patient
‑ first 14 days	$472
‑ over 14 days	$354
Psychiatric patient
‑ first 42 days	$472
‑ 43 – 65 days	$410
‑ over 65 days	$354
Rehabilitation patient
‑ first 49 days	$472
‑ 50 ‑ 65 days	$410
‑ over 65 days	$354
Other patients
‑ first 14 days	$410
‑ over 14 days	$354

Table 3‑Tasmania‑overnight shared ward accommodation for private patients at public hospitals
Column 1	Column 2
Class of patient	Minimum benefit payable per night
Advanced surgical patient
‑ first 14 days	$509
‑ over 14 days	$354
Surgical patient or obstetric patient
‑ first 14 days	$472
‑ over 14 days	$354
Psychiatric patient
‑ first 42 days	$472
‑ 43 – 65 days	$410
‑ over 65 days	$354
Rehabilitation patient
‑ first 49 days	$472
‑ 50 ‑ 65 days	$410
‑ over 65 days	$354
Other patients
‑ first 14 days	$410
‑ over 14 days	$354

Part 2 Type A procedures

3. Interpretation

A Type A procedure is a procedure specified in this Part provided to a patient in one of the categories of patients in clauses 4 to 9.

4. Advanced surgical patient

(1) In this Schedule, advanced surgical patient has the meaning given by this clause.

(2) A patient is taken to be an advanced surgical patient upon admission to a hospital:

(a) from and including the day before a professional service of the type identified by the item number in the MBS which is specified in subclause (3) is rendered to the patient at that hospital, unless the particular advanced surgical procedure to be rendered is recognised as requiring a longer pre‑operative period; or

(b) if a longer pre‑operative period than that referred to in paragraph (a) is required, from and including the day of admission of the patient for the purpose of providing the professional service of the type mentioned in paragraph (a); or

(c) if the advanced surgery is rendered to a patient during an admission, from the day the advanced surgery involving a professional service of the type mentioned in paragraph (a) is performed (not the day before).

Note: The effect of the reference in subclause (1) (a) to a professional service, being a service for which a Medicare benefit is payable, is that a professional service must have been provided to the patient for the minimum benefit to apply.

(3) The MBS item numbers for this clause are those set out in the following table, but only where those items have a fee in the MBS greater than $938.80:

Type A procedures: Advanced surgical patient – list of MBS items
15600, 30175, 30176, 30177, 30179, 30250, 30251, 30255, 30275, 30294, 30296, 30297, 30315, 30317, 30318, 30320, 30323, 30324, 30336, 30382, 30384, 30388, 30396, 30415, 30417, 30418, 30421, 30425, 30427, 30428, 30430, 30448, 30449, 30454, 30455, 30457, 30458, 30460, 30461, 30463, 30464, 30469, 30472, 30517, 30518, 30521, 30526, 30529, 30532, 30533, 30560, 30565, 30577, 30583, 30584, 30589, 30590, 30593, 30594, 30596, 30599, 30601, 30606, 30608, 30619, 30640, 30655, 30657, 30680, 30682, 30684, 30686, 30725, 30730, 30732, 30750, 30751, 30752, 30753, 30754, 30755, 30756, 30762, 30771, 30780, 30792, 30810, 31002, 31005, 31409, 31412, 31429, 31432, 31435, 31438, 31466, 31468, 31472, 31514, 31516, 31520, 31522, 31523, 31526, 31528, 31529, 31572, 31581, 31584, 32000, 32003, 32004, 32005, 32006, 32009, 32012, 32015, 32018, 32024, 32025, 32026, 32028, 32030, 32033, 32036, 32039, 32042, 32047, 32051, 32054, 32060, 32063, 32069, 32106, 32108, 32117, 32118, 32221, 32232, 32514, 32517, 32700, 32703, 32708, 32710, 32711, 32712, 32715, 32718, 32721, 32724, 32730, 32733, 32739, 32742, 32745, 32748, 32751, 32754, 32763, 33050, 33055, 33075, 33080, 33100, 33103, 33109, 33112, 33115, 33116, 33118, 33119, 33121, 33124, 33127, 33130, 33133, 33136, 33139, 33142, 33145, 33148, 33151, 33154, 33157, 33160, 33163, 33166, 33169, 33172, 33175, 33178, 33181, 33500, 33506, 33509, 33512, 33515, 33518, 33521, 33524, 33527, 33530, 33533, 33536, 33539, 33542, 33800, 33803, 33811, 33812, 33815, 33818, 33821, 33824, 33827, 33830, 33833, 33836, 33839, 33842, 34112, 34115, 34118, 34121, 34124, 34127, 34136, 34139, 34142, 34148, 34151, 34154, 34157, 34160, 34163, 34166, 34169, 34172, 34175, 34509, 34512, 34518, 34533, 34803, 34806, 34809, 34812, 34815, 34818, 34821, 34833, 35003, 35006, 35009, 35307, 35312, 35315, 35320, 35412, 35414, 35548, 35551, 35552, 35561, 35562, 35585, 35591, 35592, 35596, 35597, 35632, 35641, 35661, 35667, 35668, 35669, 35671, 35697, 35717, 35720, 35721, 35723, 35724, 35753, 35754, 35756, 36503, 36506, 36516, 36519, 36522, 36525, 36528, 36529, 36531, 36532, 36533, 36543, 36564, 36567, 36570, 36573, 36576, 36588, 36591, 36594, 36597, 36600, 36603, 36606, 36610, 36611, 36645, 36656, 37014, 37015, 37016, 37018, 37019, 37021, 37029, 37040, 37042, 37045, 37047, 37048, 37053, 37200, 37203, 37207, 37209, 37210, 37211, 37213, 37214, 37220, 37245, 37309, 37338, 37340, 37341, 37343, 37344, 37372, 37375, 37384, 37390, 37405, 37411, 37423, 37426, 37432, 37607, 37610, 37822, 37824, 37825, 37831, 37842, 37848, 37851, 38212, 38244, 38247, 38248, 38249, 38251, 38252, 38270, 38272, 38273, 38276, 38287, 38290, 38293, 38307, 38308, 38309, 38310, 38311, 38313, 38314, 38316, 38317, 38319, 38320, 38322, 38323, 38358, 38368, 38375, 38429, 38431, 38461, 38463, 38467, 38471, 38474, 38477, 38484, 38487, 38493, 38495, 38499, 38502, 38508, 38509, 38512, 38514, 38515, 38516, 38517, 38518, 38522, 38550, 38553, 38554, 38555, 38556, 38557, 38558, 38568, 38571, 38600, 38615, 38618, 38624, 38653, 38670, 38673, 38677, 38680, 38700, 38703, 38706, 38709, 38715, 38718, 38721, 38724, 38727, 38730, 38733, 38736, 38739, 38742, 38745, 38748, 38751, 38754, 38757, 38760, 38764, 38766, 38816, 38817, 38818, 38820, 38821, 38822, 38823, 38824, 38831, 38832, 38833, 38834, 38838, 38840, 38841, 38842, 38846, 38848, 38852, 38853, 38857, 38858, 38859, 38864, 39109, 39113, 39124, 39139, 39315, 39503, 39604, 39610, 39612, 39615, 39638, 39639, 39641, 39651, 39654, 39656, 39700, 39703, 39710, 39712, 39715, 39718, 39720, 39801, 39803, 39815, 39818, 39821, 39900, 39903, 40004, 40012, 40104, 40106, 40109, 40112, 40119, 40600, 40700, 40703, 40706, 40709, 40712, 40801, 40803, 40805, 40806, 40850, 40851, 40860, 41518, 41521, 41530, 41533, 41536, 41539, 41542, 41551, 41554, 41557, 41560, 41563, 41564, 41566, 41569, 41572, 41575, 41576, 41578, 41579, 41581, 41584, 41587, 41590, 41593, 41596, 41599, 41608, 41614, 41615, 41617, 41618, 41623, 41635, 41638, 41703, 41705, 41728, 41734, 41785, 41834, 41837, 41840, 41843, 41879, 41887, 41888, 41890, 42521, 42539, 42543, 42545, 42557, 42569, 42626, 42653, 42656, 42662, 42672, 42705, 42710, 42716, 42725, 42731, 42746, 42749, 42752, 42767, 42773, 42776, 42779, 42801, 42842, 42851, 42860, 43801, 43804, 43807, 43810, 43813, 43816, 43819, 43822, 43825, 43828, 43831, 43834, 43837, 43838, 43840, 43843, 43846, 43852, 43855, 43861, 43864, 43870, 43873, 43876, 43879, 43882, 43900, 43903, 43906, 43909, 43912, 43915, 43936, 43945, 43951, 43954, 43957, 43963, 43966, 43969, 43972, 43975, 43978, 43984, 43987, 43990, 43993, 43996, 44334, 44373, 45006, 45036, 45060, 45061, 45062, 45500, 45501, 45502, 45503, 45504, 45505, 45507, 45520, 45523, 45527, 45528, 45529, 45530, 45531, 45535, 45538, 45539, 45540, 45541, 45558, 45561, 45562, 45563, 45564, 45565, 45566, 45567, 45571, 45587, 45588, 45596, 45597, 45599, 45624, 45641, 45644, 45646, 45660, 45661, 45686, 45717, 45718, 45767, 45773, 45776, 45779, 45782, 45785, 45788, 45791, 45871, 45873, 45874, 46060, 46062, 46064, 46066, 46068, 46070, 46072, 46080, 46082, 46084, 46086, 46088, 46090, 46104, 46105, 46106, 46107, 46108, 46109, 46110, 46111, 46112, 46116, 46117, 46118, 46119, 46120, 46121, 46122, 46123, 46124, 46128, 46129, 46133, 46134, 46135, 46136, 46150, 46151, 46152, 46153, 46154, 46155, 46156, 46157, 46158, 46159, 46160, 46161, 46170, 46171, 46172, 46173, 46174, 46175, 46176, 46177, 46178, 46179, 46180, 46181, 46182, 46183, 46184, 46185, 46315, 46318, 46321, 46324, 46325, 46380, 46393, 46394, 46395, 46477, 46504, 46507, 47486, 47489, 47491, 47501, 47511, 47519, 47531, 47534, 47558, 47566, 47588, 47591, 47956, 47983, 47984, 48254, 48421, 48422, 48426, 48427, 48433, 48446, 48448, 48450, 48452, 48454, 48456, 48512, 48918, 48919, 48921, 48924, 48939, 48942, 48951, 48954, 48958, 48959, 48960, 49106, 49115, 49116, 49117, 49210, 49230, 49306, 49318, 49319, 49321, 49372, 49374, 49376, 49378, 49380, 49382, 49384, 49386, 49388, 49390, 49392, 49394, 49396, 49398, 49512, 49516, 49517, 49518, 49519, 49521, 49524, 49525, 49527, 49530, 49533, 49536, 49542, 49544, 49548, 49551, 49554, 49564, 49565, 49592, 49712, 49715, 49716, 49717, 49740, 49742, 49744, 49763, 49764, 49765, 49766, 49767, 49768, 49769, 49770, 49776, 49778, 49779, 49780, 49781, 49784, 49785, 49786, 49787, 49788, 49789, 49790, 49797, 49798, 49814, 49815, 49836, 49838, 50212, 50215, 50218, 50221, 50224, 50233, 50236, 50239, 50245, 50300, 50303, 50306, 50321, 50324, 50336, 50351, 50354, 50372, 50378, 50384, 50394, 50395, 50399, 50411, 50414, 50417, 50420, 50423, 50450, 50451, 50455, 50456, 50460, 50461, 50465, 50466, 50470, 50471, 50475, 50476, 50592, 50604, 50608, 50612, 50620, 50624, 50628, 50632, 50636, 50640, 50644, 51011, 51012, 51013, 51014, 51015, 51021, 51022, 51023, 51024, 51025, 51026, 51031, 51032, 51033, 51034, 51035, 51036, 51041, 51042, 51043, 51044, 51045, 51051, 51052, 51053, 51054, 51055, 51056, 51057, 51058, 51059, 51061, 51062, 51063, 51064, 51065, 51066, 51071, 51072, 51073, 51102, 51103, 51130, 51131, 51160, 51165, 51170, 51171, 52123, 52126, 52129, 52158, 52337, 52342, 52345, 52348, 52351, 52354, 52357, 52360, 52363, 52366, 52369, 52372, 52375, 52379, 52380, 52382, 52430, 52446, 52821, 53209, 53212, 53221, 53224, 53227, 53230, 53233

Type A procedures: Advanced surgical patient – list of MBS items

15600, 30175, 30176, 30177, 30179, 30250, 30251, 30255, 30275, 30294, 30296, 30297, 30315, 30317, 30318, 30320, 30323, 30324, 30336, 30382, 30384, 30388, 30396, 30415, 30417, 30418, 30421, 30425, 30427, 30428, 30430, 30448, 30449, 30454, 30455, 30457, 30458, 30460, 30461, 30463, 30464, 30469, 30472, 30517, 30518, 30521, 30526, 30529, 30532, 30533, 30560, 30565, 30577, 30583, 30584, 30589, 30590, 30593, 30594, 30596, 30599, 30601, 30606, 30608, 30619, 30640, 30655, 30657, 30680, 30682, 30684, 30686, 30725, 30730, 30732, 30750, 30751, 30752, 30753, 30754, 30755, 30756, 30762, 30771, 30780, 30792, 30810, 31002, 31005, 31409, 31412, 31429, 31432, 31435, 31438, 31466, 31468, 31472, 31514, 31516, 31520, 31522, 31523, 31526, 31528, 31529, 31572, 31581, 31584, 32000, 32003, 32004, 32005, 32006, 32009, 32012, 32015, 32018, 32024, 32025, 32026, 32028, 32030, 32033, 32036, 32039, 32042, 32047, 32051, 32054, 32060, 32063, 32069, 32106, 32108, 32117, 32118, 32221, 32232, 32514, 32517, 32700, 32703, 32708, 32710, 32711, 32712, 32715, 32718, 32721, 32724, 32730, 32733, 32739, 32742, 32745, 32748, 32751, 32754, 32763, 33050, 33055, 33075, 33080, 33100, 33103, 33109, 33112, 33115, 33116, 33118, 33119, 33121, 33124, 33127, 33130, 33133, 33136, 33139, 33142, 33145, 33148, 33151, 33154, 33157, 33160, 33163, 33166, 33169, 33172, 33175, 33178, 33181, 33500, 33506, 33509, 33512, 33515, 33518, 33521, 33524, 33527, 33530, 33533, 33536, 33539, 33542, 33800, 33803, 33811, 33812, 33815, 33818, 33821, 33824, 33827, 33830, 33833, 33836, 33839, 33842, 34112, 34115, 34118, 34121, 34124, 34127, 34136, 34139, 34142, 34148, 34151, 34154, 34157, 34160, 34163, 34166, 34169, 34172, 34175, 34509, 34512, 34518, 34533, 34803, 34806, 34809, 34812, 34815, 34818, 34821, 34833, 35003, 35006, 35009, 35307, 35312, 35315, 35320, 35412, 35414, 35548, 35551, 35552, 35561, 35562, 35585, 35591, 35592, 35596, 35597, 35632, 35641, 35661, 35667, 35668, 35669, 35671, 35697, 35717, 35720, 35721, 35723, 35724, 35753, 35754, 35756, 36503, 36506, 36516, 36519, 36522, 36525, 36528, 36529, 36531, 36532, 36533, 36543, 36564, 36567, 36570, 36573, 36576, 36588, 36591, 36594, 36597, 36600, 36603, 36606, 36610, 36611, 36645, 36656, 37014, 37015, 37016, 37018, 37019, 37021, 37029, 37040, 37042, 37045, 37047, 37048, 37053, 37200, 37203, 37207, 37209, 37210, 37211, 37213, 37214, 37220, 37245, 37309, 37338, 37340, 37341, 37343, 37344, 37372, 37375, 37384, 37390, 37405, 37411, 37423, 37426, 37432, 37607, 37610, 37822, 37824, 37825, 37831, 37842, 37848, 37851, 38212, 38244, 38247, 38248, 38249, 38251, 38252, 38270, 38272, 38273, 38276, 38287, 38290, 38293, 38307, 38308, 38309, 38310, 38311, 38313, 38314, 38316, 38317, 38319, 38320, 38322, 38323, 38358, 38368, 38375, 38429, 38431, 38461, 38463, 38467, 38471, 38474, 38477, 38484, 38487, 38493, 38495, 38499, 38502, 38508, 38509, 38512, 38514, 38515, 38516, 38517, 38518, 38522, 38550, 38553, 38554, 38555, 38556, 38557, 38558, 38568, 38571, 38600, 38615, 38618, 38624, 38653, 38670, 38673, 38677, 38680, 38700, 38703, 38706, 38709, 38715, 38718, 38721, 38724, 38727, 38730, 38733, 38736, 38739, 38742, 38745, 38748, 38751, 38754, 38757, 38760, 38764, 38766, 38816, 38817, 38818, 38820, 38821, 38822, 38823, 38824, 38831, 38832, 38833, 38834, 38838, 38840, 38841, 38842, 38846, 38848, 38852, 38853, 38857, 38858, 38859, 38864, 39109, 39113, 39124, 39139, 39315, 39503, 39604, 39610, 39612, 39615, 39638, 39639, 39641, 39651, 39654, 39656, 39700, 39703, 39710, 39712, 39715, 39718, 39720, 39801, 39803, 39815, 39818, 39821, 39900, 39903, 40004, 40012, 40104, 40106, 40109, 40112, 40119, 40600, 40700, 40703, 40706, 40709, 40712, 40801, 40803, 40805, 40806, 40850, 40851, 40860, 41518, 41521, 41530, 41533, 41536, 41539, 41542, 41551, 41554, 41557, 41560, 41563, 41564, 41566, 41569, 41572, 41575, 41576, 41578, 41579, 41581, 41584, 41587, 41590, 41593, 41596, 41599, 41608, 41614, 41615, 41617, 41618, 41623, 41635, 41638, 41703, 41705, 41728, 41734, 41785, 41834, 41837, 41840, 41843, 41879, 41887, 41888, 41890, 42521, 42539, 42543, 42545, 42557, 42569, 42626, 42653, 42656, 42662, 42672, 42705, 42710, 42716, 42725, 42731, 42746, 42749, 42752, 42767, 42773, 42776, 42779, 42801, 42842, 42851, 42860, 43801, 43804, 43807, 43810, 43813, 43816, 43819, 43822, 43825, 43828, 43831, 43834, 43837, 43838, 43840, 43843, 43846, 43852, 43855, 43861, 43864, 43870, 43873, 43876, 43879, 43882, 43900, 43903, 43906, 43909, 43912, 43915, 43936, 43945, 43951, 43954, 43957, 43963, 43966, 43969, 43972, 43975, 43978, 43984, 43987, 43990, 43993, 43996, 44334, 44373, 45006, 45036, 45060, 45061, 45062, 45500, 45501, 45502, 45503, 45504, 45505, 45507, 45520, 45523, 45527, 45528, 45529, 45530, 45531, 45535, 45538, 45539, 45540, 45541, 45558, 45561, 45562, 45563, 45564, 45565, 45566, 45567, 45571, 45587, 45588, 45596, 45597, 45599, 45624, 45641, 45644, 45646, 45660, 45661, 45686, 45717, 45718, 45767, 45773, 45776, 45779, 45782, 45785, 45788, 45791, 45871, 45873, 45874, 46060, 46062, 46064, 46066, 46068, 46070, 46072, 46080, 46082, 46084, 46086, 46088, 46090, 46104, 46105, 46106, 46107, 46108, 46109, 46110, 46111, 46112, 46116, 46117, 46118, 46119, 46120, 46121, 46122, 46123, 46124, 46128, 46129, 46133, 46134, 46135, 46136, 46150, 46151, 46152, 46153, 46154, 46155, 46156, 46157, 46158, 46159, 46160, 46161, 46170, 46171, 46172, 46173, 46174, 46175, 46176, 46177, 46178, 46179, 46180, 46181, 46182, 46183, 46184, 46185, 46315, 46318, 46321, 46324, 46325, 46380, 46393, 46394, 46395, 46477, 46504, 46507, 47486, 47489, 47491, 47501, 47511, 47519, 47531, 47534, 47558, 47566, 47588, 47591, 47956, 47983, 47984, 48254, 48421, 48422, 48426, 48427, 48433, 48446, 48448, 48450, 48452, 48454, 48456, 48512, 48918, 48919, 48921, 48924, 48939, 48942, 48951, 48954, 48958, 48959, 48960, 49106, 49115, 49116, 49117, 49210, 49230, 49306, 49318, 49319, 49321, 49372, 49374, 49376, 49378, 49380, 49382, 49384, 49386, 49388, 49390, 49392, 49394, 49396, 49398, 49512, 49516, 49517, 49518, 49519, 49521, 49524, 49525, 49527, 49530, 49533, 49536, 49542, 49544, 49548, 49551, 49554, 49564, 49565, 49592, 49712, 49715, 49716, 49717, 49740, 49742, 49744, 49763, 49764, 49765, 49766, 49767, 49768, 49769, 49770, 49776, 49778, 49779, 49780, 49781, 49784, 49785, 49786, 49787, 49788, 49789, 49790, 49797, 49798, 49814, 49815, 49836, 49838, 50212, 50215, 50218, 50221, 50224, 50233, 50236, 50239, 50245, 50300, 50303, 50306, 50321, 50324, 50336, 50351, 50354, 50372, 50378, 50384, 50394, 50395, 50399, 50411, 50414, 50417, 50420, 50423, 50450, 50451, 50455, 50456, 50460, 50461, 50465, 50466, 50470, 50471, 50475, 50476, 50592, 50604, 50608, 50612, 50620, 50624, 50628, 50632, 50636, 50640, 50644, 51011, 51012, 51013, 51014, 51015, 51021, 51022, 51023, 51024, 51025, 51026, 51031, 51032, 51033, 51034, 51035, 51036, 51041, 51042, 51043, 51044, 51045, 51051, 51052, 51053, 51054, 51055, 51056, 51057, 51058, 51059, 51061, 51062, 51063, 51064, 51065, 51066, 51071, 51072, 51073, 51102, 51103, 51130, 51131, 51160, 51165, 51170, 51171, 52123, 52126, 52129, 52158, 52337, 52342, 52345, 52348, 52351, 52354, 52357, 52360, 52363, 52366, 52369, 52372, 52375, 52379, 52380, 52382, 52430, 52446, 52821, 53209, 53212, 53221, 53224, 53227, 53230, 53233

5. Obstetric patient

(1) In this Schedule, obstetric patient has the meaning given by this clause.

(2) A patient shall be taken to be an obstetric patient during an admission to a hospital from and including:

(a) whichever is the earlier of:

(i) the day on which the patient commences labour leading to delivery in that hospital; or

(ii) the day on which a professional service with the item number 16406, 16515, 16518, 16519, 16522 (excluding caesarean), 16527, 16528, 16530, 16531, 16533 or 16534 is rendered to the patient in that hospital; or

(b) if the circumstances in paragraph (a) do not apply, the day before a professional service with the item number 16520 and 16522 (including caesarean) is rendered to the patient at that hospital, unless the particular obstetric procedure to be rendered is recognised as requiring a longer pre‑operative period; or

(c) the day on which a professional service with the item number 82118, 82120, 82123, 82125 or 82127 is rendered to a patient by a participating midwife.

(3) In this clause, the item numbers specified are the item numbers in the general medical services table.

6. Surgical patient

(1) In this Schedule, surgical patient has the meaning given by this clause.

(2) A patient shall be taken to be a surgical patient upon admission to a hospital from and including:

(a) the day before a professional service of the type identified by the item number in the MBS which is specified in subclause (3), is rendered to the patient at that hospital, unless the particular surgical procedure to be rendered is recognised as requiring a longer pre‑operative period; or

(b) if a longer pre‑operative period is required, from and including the day of admission of the patient for the purpose of providing the professional service of the type mentioned in paragraph (a); or

(c) if the surgery is rendered to a patient during an admission, from the day the surgery involving a professional service of the type mentioned in paragraph (a) is performed (not the day before).

Note: The effect of the reference in subclause (1) (a) to a professional service, being the service for which a Medicare benefit is payable, is that a professional service must have been provided to the patient for the minimum benefit to apply.

(3) The MBS item numbers for this clause are those set out in the following table, but only where those items have a fee in the MBS within the range of $279.55 to $938.80:

Type A procedures: Surgical patient – list of MBS items
13212, 13218, 13241, 13251, 13700, 13834, 13837, 14234, 14237, 15303, 15304, 15307, 15308, 15311, 15312, 15315, 15316, 15319, 15320, 15323, 15324, 15327, 15328, 15331, 15332, 15335, 15336, 15345, 16567, 16570, 16571, 16573, 30016, 30023, 30024, 30068, 30166, 30169, 30190, 30225, 30229, 30235, 30241, 30244, 30246, 30247, 30253, 30256, 30272, 30286, 30287, 30289, 30293, 30299, 30305, 30306, 30310, 30311, 30314, 30326, 30330, 30332, 30385, 30387, 30392, 30399, 30400, 30408, 30414, 30416, 30419, 30422, 30431, 30433, 30440, 30443, 30445, 30450, 30451, 30452, 30475, 30479, 30481, 30484, 30485, 30490, 30491, 30492, 30494, 30495, 30515, 30520, 30530, 30559, 30562, 30563, 30600, 30611, 30615, 30618, 30621, 30622, 30623, 30626, 30629, 30635, 30637, 30639, 30641, 30642, 30643, 30644, 30645, 30646, 30648, 30651, 30652, 30662, 30664, 30665, 30672, 30676, 30688, 30690, 30692, 30694, 30720, 30721, 30722, 30723, 30724, 30731, 30760, 30761, 30763, 30770, 30790, 30791, 30800, 31000, 31001, 31003, 31004, 31245, 31250, 31350, 31355, 31400, 31403, 31406, 31423, 31426, 31454, 31460, 31462, 31500, 31503, 31506, 31509, 31512, 31513, 31515, 31519, 31525, 31554, 31569, 31575, 31578, 31585, 32021, 32023, 32045, 32046, 32057, 32066, 32094, 32096, 32105, 32123, 32129, 32131, 32139, 32150, 32159, 32162, 32165, 32183, 32186, 32213, 32216, 32230, 32231, 32233, 32237, 32504, 32507, 32508, 32511, 32736, 32757, 32760, 32766, 32769, 33070, 33545, 33548, 33551, 33554, 33806, 33810, 33845, 33848, 34100, 34103, 34106, 34109, 34130, 34133, 34145, 34500, 34503, 34515, 34521, 34524, 34527, 34528, 34529, 34534, 34538, 34800, 34824, 34827, 34830, 35000, 35012, 35100, 35202, 35300, 35303, 35306, 35309, 35317, 35319, 35321, 35324, 35327, 35330, 35331, 35360, 35361, 35362, 35363, 35401, 35404, 35406, 35408, 35410, 35508, 35533, 35534, 35536, 35560, 35564, 35565, 35566, 35568, 35570, 35571, 35573, 35577, 35578, 35581, 35582, 35595, 35599, 35610, 35612, 35616, 35622, 35623, 35631, 35635, 35636, 35637, 35645, 35649, 35653, 35657, 35658, 35673, 35680, 35694, 35700, 35726, 35750, 35751, 35759, 36502, 36508, 36509, 36530, 36537, 36546, 36549, 36552, 36558, 36579, 36585, 36604, 36607, 36608, 36609, 36612, 36615, 36618, 36621, 36624, 36627, 36633, 36636, 36639, 36649, 36652, 36654, 36663, 36664, 36666, 36803, 36806, 36809, 36811, 36818, 36821, 36822, 36823, 36833, 36840, 36842, 36845, 36854, 36863, 37000, 37004, 37008, 37020, 37023, 37026, 37038, 37039, 37044, 37046, 37050, 37201, 37208, 37215, 37221, 37224, 37227, 37306, 37318, 37327, 37330, 37333, 37336, 37342, 37345, 37348, 37351, 37354, 37381, 37387, 37396, 37402, 37408, 37417, 37418, 37429, 37438, 37601, 37604, 37605, 37606, 37613, 37616, 37619, 37800, 37801, 37803, 37804, 37806, 37807, 37809, 37810, 37812, 37813, 37818, 37819, 37821, 37827, 37828, 37830, 37833, 37834, 37836, 37839, 37845, 37854, 38200, 38203, 38206, 38209, 38213, 38256, 38274, 38275, 38325, 38350, 38353, 38356, 38362, 38365, 38372, 38373, 38374, 38416, 38417, 38422, 38423, 38425, 38426, 38472, 38485, 38523, 38609, 38612, 38621, 38627, 38637, 38830, 38837, 38839, 38845, 38847, 38849, 38850, 38851, 39015, 39018, 39110, 39111, 39116, 39117, 39118, 39119, 39121, 39125, 39126, 39127, 39128, 39129, 39130, 39134, 39137, 39138, 39140, 39300, 39303, 39306, 39307, 39309, 39312, 39318, 39319, 39321, 39323, 39324, 39327, 39328, 39330, 39336, 39339, 39342, 39906, 40701, 40704, 40705, 40708, 40804, 40852, 40854, 40856, 40858, 40905, 41512, 41515, 41524, 41527, 41545, 41548, 41603, 41611, 41620, 41629, 41671, 41689, 41692, 41707, 41710, 41713, 41725, 41737, 41743, 41746, 41749, 41752, 41770, 41776, 41779, 41786, 41789, 41793, 41813, 41825, 41831, 41867, 41873, 41876, 41880, 41881, 41885, 41910, 42505, 42506, 42509, 42510, 42512, 42515, 42518, 42527, 42530, 42533, 42536, 42542, 42548, 42551, 42554, 42563, 42574, 42584, 42590, 42596, 42599, 42602, 42605, 42608, 42623, 42629, 42635, 42638, 42641, 42665, 42680, 42686, 42692, 42695, 42698, 42701, 42702, 42703, 42704, 42707, 42713, 42719, 42734, 42740, 42743, 42758, 42761, 42764, 42770, 42782, 42785, 42788, 42791, 42802, 42805, 42806, 42807, 42808, 42809, 42810, 42815, 42818, 42833, 42836, 42839, 42848, 42854, 42857, 42863, 42866, 42869, 43021, 43022, 43521, 43527, 43530, 43533, 43805, 43832, 43835, 43841, 43849, 43858, 43867, 43930, 43933, 43939, 43960, 43981, 43999, 44101, 44102, 44108, 44111, 44114, 44130, 44133, 44325, 44328, 44331, 44346, 44350, 44354, 44359, 44361, 44364, 44367, 44370, 45000, 45003, 45009, 45012, 45015, 45018, 45019, 45026, 45035, 45045, 45048, 45051, 45054, 45200, 45201, 45202, 45203, 45206, 45207, 45209, 45221, 45227, 45233, 45440, 45443, 45451, 45496, 45497, 45512, 45522, 45524, 45532, 45534, 45537, 45542, 45545, 45547, 45548, 45551, 45553, 45554, 45556, 45560, 45568, 45572, 45575, 45578, 45581, 45584, 45585, 45590, 45592, 45594, 45602, 45605, 45608, 45609, 45611, 45614, 45620, 45623, 45626, 45627, 45629, 45632, 45635, 45652, 45653, 45656, 45658, 45659, 45668, 45669, 45671, 45675, 45676, 45677, 45680, 45683, 45689, 45692, 45695, 45698, 45701, 45704, 45707, 45710, 45713, 45714, 45716, 45761, 45794, 45809, 45811, 45813, 45815, 45825, 45827, 45831, 45837, 45841, 45845, 45849, 45865, 45888, 45891, 45939, 46050, 46052, 46092, 46094, 46103, 46115, 46127, 46132, 46142, 46143, 46300, 46303, 46308, 46309, 46312, 46322, 46330, 46333, 46335, 46336, 46339, 46340, 46341, 46342, 46345, 46351, 46354, 46357, 46360, 46367, 46372, 46375, 46378, 46379, 46381, 46384, 46387, 46390, 46399, 46401, 46408, 46411, 46414, 46417, 46423, 46426, 46432, 46434, 46441, 46442, 46444, 46453, 46468, 46471, 46474, 46480, 46483, 46489, 46492, 46493, 46500, 46501, 46502, 46503, 46510, 46522, 47007, 47012, 47021, 47027, 47033, 47045, 47047, 47049, 47052, 47053, 47054, 47063, 47066, 47310, 47313, 47316, 47319, 47357, 47364, 47370, 47373, 47381, 47384, 47385, 47386, 47387, 47390, 47393, 47399, 47402, 47408, 47417, 47420, 47426, 47429, 47432, 47435, 47438, 47441, 47447, 47450, 47451, 47453, 47456, 47459, 47465, 47468, 47480, 47483, 47495, 47498, 47514, 47516, 47528, 47537, 47546, 47549, 47552, 47555, 47559, 47561, 47565, 47568, 47570, 47573, 47577, 47582, 47585, 47592, 47593, 47597, 47600, 47603, 47612, 47615, 47618, 47621, 47624, 47630, 47648, 47657, 47741, 47753, 47765, 47766, 47786, 47789, 47790, 47791, 47792, 47795, 47953, 47954, 47955, 47967, 47975, 47982, 48245, 48248, 48251, 48257, 48400, 48403, 48406, 48409, 48412, 48415, 48419, 48420, 48423, 48424, 48430, 48435, 48442, 48444, 48507, 48900, 48903, 48906, 48909, 48915, 48925, 48927, 48932, 48943, 48944, 48945, 48948, 48952, 48953, 48972, 48980, 48983, 48986, 49100, 49104, 49105, 49109, 49112, 49113, 49114, 49118, 49121, 49124, 49127, 49200, 49203, 49206, 49209, 49213, 49215, 49218, 49219, 49220, 49221, 49224, 49227, 49233, 49236, 49239, 49300, 49303, 49309, 49315, 49360, 49363, 49366, 49500, 49503, 49506, 49509, 49515, 49534, 49569, 49570, 49572, 49574, 49576, 49578, 49580, 49582, 49584, 49586, 49590, 49594, 49596, 49703, 49706, 49709, 49718, 49724, 49727, 49728, 49730, 49732, 49734, 49736, 49738, 49760, 49761, 49762, 49771, 49772, 49773, 49774, 49775, 49777, 49782, 49783, 49791, 49792, 49793, 49794, 49795, 49796, 49812, 49818, 49821, 49824, 49827, 49830, 49833, 49837, 49839, 49845, 49854, 49857, 49860, 49866, 50107, 50112, 50118, 50130, 50201, 50203, 50206, 50209, 50242, 50309, 50312, 50333, 50335, 50339, 50345, 50357, 50360, 50369, 50375, 50381, 50393, 50396, 50426, 50428, 50508, 50512, 50524, 50528, 50532, 50536, 50540, 50544, 50548, 50552, 50556, 50560, 50564, 50568, 50572, 50576, 50580, 50584, 50588, 50596, 50600, 50616, 50654, 50950, 50952, 51020, 51110, 51111, 51114, 51115, 51140, 51141, 51145, 51150, 51900, 51904, 51906, 52018, 52035, 52039, 52048, 52051, 52054, 52059, 52063, 52066, 52078, 52090, 52092, 52094, 52095, 52105, 52108, 52111, 52114, 52117, 52120, 52122, 52130, 52131, 52138, 52141, 52144, 52147, 52148, 52182, 52184, 52186, 52300, 52303, 52306, 52312, 52315, 52321, 52324, 52330, 52333, 52336, 52339, 52378, 52424, 52440, 52442, 52444, 52450, 52452, 52456, 52458, 52460, 52480, 52482, 52484, 52600, 52603, 52609, 52612, 52615, 52618, 52621, 52624, 52626, 52627, 52633, 52800, 52803, 52806, 52809, 52812, 52815, 52818, 52824, 52828, 52830, 52832, 53006, 53009, 53015, 53016, 53017, 53019, 53215, 53218, 53220, 53225, 53226, 53236, 53239, 53242, 53406, 53409, 53412, 53413, 53414, 53415, 53416, 53418, 53419, 53422, 53423, 53424, 53425, 53427, 53429, 53453, 53455, 53460

Type A procedures: Surgical patient – list of MBS items

13212, 13218, 13241, 13251, 13700, 13834, 13837, 14234, 14237, 15303, 15304, 15307, 15308, 15311, 15312, 15315, 15316, 15319, 15320, 15323, 15324, 15327, 15328, 15331, 15332, 15335, 15336, 15345, 16567, 16570, 16571, 16573, 30016, 30023, 30024, 30068, 30166, 30169, 30190, 30225, 30229, 30235, 30241, 30244, 30246, 30247, 30253, 30256, 30272, 30286, 30287, 30289, 30293, 30299, 30305, 30306, 30310, 30311, 30314, 30326, 30330, 30332, 30385, 30387, 30392, 30399, 30400, 30408, 30414, 30416, 30419, 30422, 30431, 30433, 30440, 30443, 30445, 30450, 30451, 30452, 30475, 30479, 30481, 30484, 30485, 30490, 30491, 30492, 30494, 30495, 30515, 30520, 30530, 30559, 30562, 30563, 30600, 30611, 30615, 30618, 30621, 30622, 30623, 30626, 30629, 30635, 30637, 30639, 30641, 30642, 30643, 30644, 30645, 30646, 30648, 30651, 30652, 30662, 30664, 30665, 30672, 30676, 30688, 30690, 30692, 30694, 30720, 30721, 30722, 30723, 30724, 30731, 30760, 30761, 30763, 30770, 30790, 30791, 30800, 31000, 31001, 31003, 31004, 31245, 31250, 31350, 31355, 31400, 31403, 31406, 31423, 31426, 31454, 31460, 31462, 31500, 31503, 31506, 31509, 31512, 31513, 31515, 31519, 31525, 31554, 31569, 31575, 31578, 31585, 32021, 32023, 32045, 32046, 32057, 32066, 32094, 32096, 32105, 32123, 32129, 32131, 32139, 32150, 32159, 32162, 32165, 32183, 32186, 32213, 32216, 32230, 32231, 32233, 32237, 32504, 32507, 32508, 32511, 32736, 32757, 32760, 32766, 32769, 33070, 33545, 33548, 33551, 33554, 33806, 33810, 33845, 33848, 34100, 34103, 34106, 34109, 34130, 34133, 34145, 34500, 34503, 34515, 34521, 34524, 34527, 34528, 34529, 34534, 34538, 34800, 34824, 34827, 34830, 35000, 35012, 35100, 35202, 35300, 35303, 35306, 35309, 35317, 35319, 35321, 35324, 35327, 35330, 35331, 35360, 35361, 35362, 35363, 35401, 35404, 35406, 35408, 35410, 35508, 35533, 35534, 35536, 35560, 35564, 35565, 35566, 35568, 35570, 35571, 35573, 35577, 35578, 35581, 35582, 35595, 35599, 35610, 35612, 35616, 35622, 35623, 35631, 35635, 35636, 35637, 35645, 35649, 35653, 35657, 35658, 35673, 35680, 35694, 35700, 35726, 35750, 35751, 35759, 36502, 36508, 36509, 36530, 36537, 36546, 36549, 36552, 36558, 36579, 36585, 36604, 36607, 36608, 36609, 36612, 36615, 36618, 36621, 36624, 36627, 36633, 36636, 36639, 36649, 36652, 36654, 36663, 36664, 36666, 36803, 36806, 36809, 36811, 36818, 36821, 36822, 36823, 36833, 36840, 36842, 36845, 36854, 36863, 37000, 37004, 37008, 37020, 37023, 37026, 37038, 37039, 37044, 37046, 37050, 37201, 37208, 37215, 37221, 37224, 37227, 37306, 37318, 37327, 37330, 37333, 37336, 37342, 37345, 37348, 37351, 37354, 37381, 37387, 37396, 37402, 37408, 37417, 37418, 37429, 37438, 37601, 37604, 37605, 37606, 37613, 37616, 37619, 37800, 37801, 37803, 37804, 37806, 37807, 37809, 37810, 37812, 37813, 37818, 37819, 37821, 37827, 37828, 37830, 37833, 37834, 37836, 37839, 37845, 37854, 38200, 38203, 38206, 38209, 38213, 38256, 38274, 38275, 38325, 38350, 38353, 38356, 38362, 38365, 38372, 38373, 38374, 38416, 38417, 38422, 38423, 38425, 38426, 38472, 38485, 38523, 38609, 38612, 38621, 38627, 38637, 38830, 38837, 38839, 38845, 38847, 38849, 38850, 38851, 39015, 39018, 39110, 39111, 39116, 39117, 39118, 39119, 39121, 39125, 39126, 39127, 39128, 39129, 39130, 39134, 39137, 39138, 39140, 39300, 39303, 39306, 39307, 39309, 39312, 39318, 39319, 39321, 39323, 39324, 39327, 39328, 39330, 39336, 39339, 39342, 39906, 40701, 40704, 40705, 40708, 40804, 40852, 40854, 40856, 40858, 40905, 41512, 41515, 41524, 41527, 41545, 41548, 41603, 41611, 41620, 41629, 41671, 41689, 41692, 41707, 41710, 41713, 41725, 41737, 41743, 41746, 41749, 41752, 41770, 41776, 41779, 41786, 41789, 41793, 41813, 41825, 41831, 41867, 41873, 41876, 41880, 41881, 41885, 41910, 42505, 42506, 42509, 42510, 42512, 42515, 42518, 42527, 42530, 42533, 42536, 42542, 42548, 42551, 42554, 42563, 42574, 42584, 42590, 42596, 42599, 42602, 42605, 42608, 42623, 42629, 42635, 42638, 42641, 42665, 42680, 42686, 42692, 42695, 42698, 42701, 42702, 42703, 42704, 42707, 42713, 42719, 42734, 42740, 42743, 42758, 42761, 42764, 42770, 42782, 42785, 42788, 42791, 42802, 42805, 42806, 42807, 42808, 42809, 42810, 42815, 42818, 42833, 42836, 42839, 42848, 42854, 42857, 42863, 42866, 42869, 43021, 43022, 43521, 43527, 43530, 43533, 43805, 43832, 43835, 43841, 43849, 43858, 43867, 43930, 43933, 43939, 43960, 43981, 43999, 44101, 44102, 44108, 44111, 44114, 44130, 44133, 44325, 44328, 44331, 44346, 44350, 44354, 44359, 44361, 44364, 44367, 44370, 45000, 45003, 45009, 45012, 45015, 45018, 45019, 45026, 45035, 45045, 45048, 45051, 45054, 45200, 45201, 45202, 45203, 45206, 45207, 45209, 45221, 45227, 45233, 45440, 45443, 45451, 45496, 45497, 45512, 45522, 45524, 45532, 45534, 45537, 45542, 45545, 45547, 45548, 45551, 45553, 45554, 45556, 45560, 45568, 45572, 45575, 45578, 45581, 45584, 45585, 45590, 45592, 45594, 45602, 45605, 45608, 45609, 45611, 45614, 45620, 45623, 45626, 45627, 45629, 45632, 45635, 45652, 45653, 45656, 45658, 45659, 45668, 45669, 45671, 45675, 45676, 45677, 45680, 45683, 45689, 45692, 45695, 45698, 45701, 45704, 45707, 45710, 45713, 45714, 45716, 45761, 45794, 45809, 45811, 45813, 45815, 45825, 45827, 45831, 45837, 45841, 45845, 45849, 45865, 45888, 45891, 45939, 46050, 46052, 46092, 46094, 46103, 46115, 46127, 46132, 46142, 46143, 46300, 46303, 46308, 46309, 46312, 46322, 46330, 46333, 46335, 46336, 46339, 46340, 46341, 46342, 46345, 46351, 46354, 46357, 46360, 46367, 46372, 46375, 46378, 46379, 46381, 46384, 46387, 46390, 46399, 46401, 46408, 46411, 46414, 46417, 46423, 46426, 46432, 46434, 46441, 46442, 46444, 46453, 46468, 46471, 46474, 46480, 46483, 46489, 46492, 46493, 46500, 46501, 46502, 46503, 46510, 46522, 47007, 47012, 47021, 47027, 47033, 47045, 47047, 47049, 47052, 47053, 47054, 47063, 47066, 47310, 47313, 47316, 47319, 47357, 47364, 47370, 47373, 47381, 47384, 47385, 47386, 47387, 47390, 47393, 47399, 47402, 47408, 47417, 47420, 47426, 47429, 47432, 47435, 47438, 47441, 47447, 47450, 47451, 47453, 47456, 47459, 47465, 47468, 47480, 47483, 47495, 47498, 47514, 47516, 47528, 47537, 47546, 47549, 47552, 47555, 47559, 47561, 47565, 47568, 47570, 47573, 47577, 47582, 47585, 47592, 47593, 47597, 47600, 47603, 47612, 47615, 47618, 47621, 47624, 47630, 47648, 47657, 47741, 47753, 47765, 47766, 47786, 47789, 47790, 47791, 47792, 47795, 47953, 47954, 47955, 47967, 47975, 47982, 48245, 48248, 48251, 48257, 48400, 48403, 48406, 48409, 48412, 48415, 48419, 48420, 48423, 48424, 48430, 48435, 48442, 48444, 48507, 48900, 48903, 48906, 48909, 48915, 48925, 48927, 48932, 48943, 48944, 48945, 48948, 48952, 48953, 48972, 48980, 48983, 48986, 49100, 49104, 49105, 49109, 49112, 49113, 49114, 49118, 49121, 49124, 49127, 49200, 49203, 49206, 49209, 49213, 49215, 49218, 49219, 49220, 49221, 49224, 49227, 49233, 49236, 49239, 49300, 49303, 49309, 49315, 49360, 49363, 49366, 49500, 49503, 49506, 49509, 49515, 49534, 49569, 49570, 49572, 49574, 49576, 49578, 49580, 49582, 49584, 49586, 49590, 49594, 49596, 49703, 49706, 49709, 49718, 49724, 49727, 49728, 49730, 49732, 49734, 49736, 49738, 49760, 49761, 49762, 49771, 49772, 49773, 49774, 49775, 49777, 49782, 49783, 49791, 49792, 49793, 49794, 49795, 49796, 49812, 49818, 49821, 49824, 49827, 49830, 49833, 49837, 49839, 49845, 49854, 49857, 49860, 49866, 50107, 50112, 50118, 50130, 50201, 50203, 50206, 50209, 50242, 50309, 50312, 50333, 50335, 50339, 50345, 50357, 50360, 50369, 50375, 50381, 50393, 50396, 50426, 50428, 50508, 50512, 50524, 50528, 50532, 50536, 50540, 50544, 50548, 50552, 50556, 50560, 50564, 50568, 50572, 50576, 50580, 50584, 50588, 50596, 50600, 50616, 50654, 50950, 50952, 51020, 51110, 51111, 51114, 51115, 51140, 51141, 51145, 51150, 51900, 51904, 51906, 52018, 52035, 52039, 52048, 52051, 52054, 52059, 52063, 52066, 52078, 52090, 52092, 52094, 52095, 52105, 52108, 52111, 52114, 52117, 52120, 52122, 52130, 52131, 52138, 52141, 52144, 52147, 52148, 52182, 52184, 52186, 52300, 52303, 52306, 52312, 52315, 52321, 52324, 52330, 52333, 52336, 52339, 52378, 52424, 52440, 52442, 52444, 52450, 52452, 52456, 52458, 52460, 52480, 52482, 52484, 52600, 52603, 52609, 52612, 52615, 52618, 52621, 52624, 52626, 52627, 52633, 52800, 52803, 52806, 52809, 52812, 52815, 52818, 52824, 52828, 52830, 52832, 53006, 53009, 53015, 53016, 53017, 53019, 53215, 53218, 53220, 53225, 53226, 53236, 53239, 53242, 53406, 53409, 53412, 53413, 53414, 53415, 53416, 53418, 53419, 53422, 53423, 53424, 53425, 53427, 53429, 53453, 53455, 53460

7. Psychiatric patient

In this Schedule, a psychiatric patient is a patient in a hospital who is admitted for the purposes of undertaking a specific psychiatric treatment program that is deemed by the insurer to be relevant and appropriate for the treatment of the patient’s disease, injury or condition.

Note: If a patient is receiving psychiatric treatment that is not under a specific psychiatric treatment program, the patient is taken to be in the category of 'other patient'.

8. Rehabilitation patient

In this Schedule, a rehabilitation patient is a patient in a hospital who is admitted for the purposes of undertaking a specific rehabilitation treatment program that is deemed by the insurer to be relevant and appropriate for the treatment of the patient’s disease, injury or condition.

Note: If a patient is receiving rehabilitation treatment that is not under a specific rehabilitation treatment program, the patient is taken to be in the category of 'other patient'.

9. Other patient

(1) In this Schedule, other patient is deemed to be a patient at a hospital who is receiving any treatment that involves part of an overnight stay, but who is not:

(a) an advanced surgical patient;

(b) a surgical patient;

(d) a psychiatric patient; or

(e) a rehabilitation patient.

Note: A patient receiving hospital treatment that is palliative care as described in item 1 of the table in subsection 72‑1 (2) of the Act is deemed to be in the category of 'other patient'.

Table 1‑Overnight shared ward accommodation for private patients at public hospitals in the Australian Capital Territory, New South Wales, Northern Territory, Queensland, South Australia and Western Australia
Australian Capital Territory	$421
New South Wales	$421
Northern Territory	$421
Queensland	$431
South Australia	$421
Western Australia	$421

Table 1‑Same day accommodation for private patients at public hospitals in all States/Territories
New South Wales	$305	$340	$375	$421
Australian Capital Territory	$305	$340	$375	$421
Northern Territory	$305	$350	$403	$421
Queensland	$311	$352	$385	$431
South Australia	$305	$350	$384	$421
Tasmania	$296	$353	$407	$472
Victoria	$300	$354	$411	$472
Western Australia	$347	$347	$347	$347

Part 2 Type B procedures

3. Interpretation

A Type B procedure is a procedure specified as a Band 1, 2, 3 and 4 as described in this Part.

Note: These procedures normally require hospital treatment that does not include part of an overnight stay.

4. Band 1

(1) Hospital treatment that involves a professional service of the type identified by the MBS item number specified in the following table in this clause is Band 1 treatment for the purposes of the tables in clause 2 of this Schedule:

Type B day procedures: Band 1 – list of MBS items
11801, 13100, 13103, 13706, 13950, 30210, 30475, 30679, 32075, 32084, 32087, 32095, 32215, 35500, 36665, 39000, 41674, 42575, 42741, 55118, 55600, 55603

(2) Other hospital treatment requiring day admission to a hospital that is not Band 2, 3 or 4 treatment is Band 1 treatment for the purposes of the tables in clause 2 of this Schedule.

5. Non‑band specific Type B day procedures

(1) Hospital treatment that involves a professional service of the type identified by the MBS item number specified in the following table in this clause is a non‑band specific Type B day procedure:

Non‑band specific Type B day procedures – list of MBS items

111, 117, 120, 11919, 13110, 13212, 13215, 13241, 13318, 13400, 13750, 13755, 13757, 13761, 13762, 13815, 14218, 14224, 14247, 14249, 15338, 15513, 15539, 16512, 16603, 16618, 18216, 18230, 18242, 18276, 18280, 18284, 18286, 18290, 18294, 18296, 18298, 18375, 18379, 30042, 30045, 30055, 30081, 30084, 30087, 30094, 30099, 30103, 30104, 30105, 30107, 30187, 30189, 30190, 30223, 30225, 30257, 30262, 30269, 30281, 30283, 30311, 30390, 30409, 30473, 30478, 30484, 30627, 30630, 30658, 30661, 30687, 30820, 31225, 31227, 31344, 31345, 31346, 31350, 31355, 31356, 31358, 31359, 31360, 31361, 31363, 31364, 31367, 31369, 31371, 31372, 31373, 31374, 31375, 31376, 31377, 31378, 31379, 31380, 31381, 31382, 31383, 31386, 31387, 31388, 31456, 31458, 31530, 31551, 31557, 31560, 31563, 31566, 31590, 32094, 32147, 32150, 32156, 32171, 32218, 32222, 32223, 32224, 32225, 32226, 32227, 32228, 32229, 32230, 32235, 32236, 32237, 32504, 34109, 34130, 34500, 34503, 34506, 34524, 34539, 35324, 35507, 35508, 35509, 35513, 35517, 35527, 35536, 35539, 35545, 35548, 35557, 35560, 35569, 35609, 35612, 35616, 35622, 35623, 35630, 35633, 35635, 35636, 35637, 35640, 35641, 35643, 35644, 35645, 35647, 35648, 35694, 35697, 35730, 36504, 36505, 36507, 36561, 36650, 36667, 36668, 36812, 36815, 36818, 36821, 36822, 36823, 36824, 36827, 36830, 36833, 36836, 36840, 36860, 37011, 37204, 37205, 37215, 37216, 37217, 37218, 37219, 37226, 37318, 37321, 37324, 37339, 37354, 37369, 37435, 37623, 37803, 37806, 37809, 37812, 37815, 37816, 37854, 38200, 38272, 38285, 38286, 38288, 38419, 38420, 38423, 38428, 39013, 39014, 39100, 39110, 39111, 39116, 39117, 39118, 39119, 39133, 39135, 39140, 39323, 39329, 39331, 39332, 39345, 40702, 41503, 41506, 41509, 41626, 41629, 41632, 41644, 41650, 41677, 41693, 41701, 41702, 41722, 41801, 41822, 41831, 41855, 41861, 41870, 41886, 42503, 42504, 42572, 42573, 42576, 42584, 42593, 42610, 42611, 42652, 42673, 42680, 42683, 42686, 42689, 42692, 42738, 42739, 42812, 42818, 42833, 42845, 42869, 43942, 43948, 44102, 44104, 44105, 44136, 44338, 44342, 44346, 44358, 44376, 45019, 45027, 45030, 45033, 45200, 45212, 45224, 45239, 45510, 45515, 45534, 45535, 45589, 45626, 45665, 45668, 45674, 45823, 45851, 45855, 45857, 46101, 46102, 46113, 46114, 46125, 46126, 46130, 46131, 46140, 46141, 46330, 46336, 46348, 46363, 46364, 46365, 46370, 46420, 46438, 46441, 46450, 46486, 46489, 46495, 46501, 46510, 46525, 47738, 47906, 47915, 47918, 47927, 48436, 48438, 48440, 48945, 49218, 49800, 49803, 49806, 49809, 49881, 49884, 49887, 49890, 50115, 50352, 51112, 51113, 51120, 51902, 52015, 52025, 52042, 52045, 52057, 52058, 52061, 52062, 52064, 52072, 52073, 52075, 52081, 52084, 52087, 52097, 52099, 52102, 52180, 52321, 52826, 53003, 53006, 53009, 53054, 53056, 53058, 53060, 53062, 53064, 53070, 53206, 53215, 53218, 53225, 53410, 53459, 58939, 59970, 60000, 60003, 60006, 60009, 60012, 60015, 60018, 60021, 60024, 60027, 60030, 60033, 60036, 60039, 60042, 60045, 60048, 60051, 60054, 60057, 60060, 60063, 60066, 60069, 60072, 60075, 60078, 71202, 73310, 73425, 73426

(2) A non‑band specific Type B day procedure is Band 2, 3 or 4 treatment depending on anaesthetic type and, where applicable, theatre time as specified in clause 6 of this Schedule.

(3) If a non‑band specific Type B day procedure does not involve anaesthetic or theatre times, the minimum benefit is the benefit for Band 1 treatment.

6. Other bands

(1) In this Schedule:

Band 2 treatment means procedures, other than those that are Band 1 treatment, carried out under local anaesthetic with no sedation.

Band 3 treatment means procedures, other than those that are Band 1 treatment, carried out under:

(a) general anaesthesia; or

(b) regional anaesthesia; or

where the theatre time, being the actual time in theatre, is less than one hour.

Band 4 treatment means procedures, other than those that are Band 1 treatment, carried out under:

(a) general anaesthesia; or

(b) regional anaesthesia; or

where the theatre time, being the actual time in theatre, is one hour or more.

7. Certified Type C procedure

Note: Type C procedures are procedures that do not normally require hospital treatment.

(1) Benefits for day‑only accommodation are payable for patients receiving a Type C procedure only if certification under subclause (2) is provided.

(2) Certification must be provided as follows, the medical practitioner providing the professional service must certify in writing that:

(a) because of the medical condition of the patient specified in the certificate; or

(b) because of the special circumstances specified in the certificate,

it would be contrary to accepted medical practice to provide the procedure to the patient unless the patient is given hospital treatment at the hospital for a period that does not include part of an overnight stay.

Part 3 Type C procedures

8. Interpretation

A Type C procedure is a procedure specified in this clause by reference to MBS items in the following table:

Note: These procedures normally do not require hospital treatment.

Type C procedures – list of MBS items
3, 4, 23, 24, 36, 37, 44, 47, 52, 53, 54, 57, 58, 59, 60, 65, 104, 105, 106, 107, 108, 109, 110, 115, 116, 119, 122, 128, 131, 132, 133, 135, 137, 139, 141, 143, 145, 147, 160, 161, 162, 163, 164, 170, 171, 172, 193, 195, 197, 199, 230, 233, 235, 236, 237, 238, 239, 240, 285, 287, 289, 291, 293, 296, 297, 299, 300, 302, 304, 306, 308, 310, 312, 314, 316, 318, 319, 320, 322, 324, 326, 328, 330, 332, 334, 336, 338, 341, 342, 343, 344, 345, 346, 347, 349, 385, 386, 387, 388, 410, 411, 412, 413, 414, 415, 416, 417, 721, 723, 729, 731, 732, 735, 739, 743, 747, 750, 758, 820, 822, 823, 825, 826, 828, 855, 857, 858, 900, 903, 930, 933, 935, 937, 943, 945, 946, 948, 959, 961, 962, 964, 969, 971, 972, 973, 975, 986, 2713, 2721, 2723, 2725, 2727, 2801, 2806, 2814, 2824, 2832, 2840, 2946, 2949, 2954, 2958, 2972, 2974, 3005, 3010, 3014, 3018, 3023, 3028, 3032, 3040, 3044, 3051, 3055, 3062, 4001, 5000, 5001, 5003, 5004, 5010, 5011, 5012, 5013, 5014, 5016, 5017, 5019, 5020, 5021, 5022, 5023, 5027, 5028, 5030, 5031, 5032, 5033, 5035, 5036, 5039, 5040, 5041, 5042, 5043, 5044, 5049, 5060, 5063, 5067, 5200, 5203, 5207, 5208, 5220, 5223, 5227, 5228, 5260, 5263, 5265, 5267, 6007, 6009, 6011, 6013, 6015, 6018, 6019, 6023, 6024, 6028, 6029, 6031, 6032, 6034, 6035, 6037, 6038, 6042, 6051, 6052, 6057, 6058, 6062, 6063, 6064, 6065, 6067, 6068, 6071, 6072, 6074, 6075, 6080, 6081, 6082, 6084, 10801, 10802, 10803, 10804, 10805, 10806, 10807, 10808, 10809, 10816, 10988, 10989, 11000, 11003, 11012, 11015, 11018, 11024, 11027, 11200, 11204, 11205, 11210, 11211, 11215, 11218, 11219, 11220, 11221, 11224, 11235, 11237, 11240, 11241, 11242, 11243, 11244, 11300, 11302, 11306, 11309, 11312, 11315, 11318, 11324, 11332, 11340, 11341, 11343, 11503, 11505, 11506, 11507, 11508, 11512, 11602, 11604, 11605, 11607, 11610, 11611, 11612, 11614, 11615, 11705, 11713, 11719, 11720, 11721, 11724, 11725, 11726, 11727, 11728, 11729, 11730, 11731, 11732, 11736, 11737, 11800, 11810, 11820, 11823, 11830, 11833, 11900, 11912, 11917, 12000, 12001, 12002, 12003, 12004, 12005, 12012, 12017, 12021, 12022, 12024, 12200, 12201, 12306, 12312, 12315, 12320, 12321, 12322, 12325, 12326, 12500, 12524, 12527, 12533, 13104, 13200, 13203, 13207, 13209, 13221, 13260, 13290, 13312, 13839, 13842, 13899, 14050, 14100, 14106, 14115, 14118, 14124, 14201, 14202, 14203, 14206, 14216, 14217, 14219, 14220, 14221, 14227, 14245, 14255, 14256, 14257, 14258, 14259, 14260, 14263, 14264, 14265, 14266, 14270, 14272, 14277, 14278, 14280, 14283, 14285, 14288, 15000, 15003, 15006, 15009, 15012, 15100, 15103, 15106, 15109, 15112, 15115, 15211, 15214, 15215, 15218, 15221, 15224, 15227, 15230, 15233, 15236, 15239, 15242, 15245, 15248, 15251, 15254, 15257, 15260, 15263, 15266, 15269, 15272, 15275, 15500, 15503, 15506, 15509, 15512, 15515, 15518, 15521, 15524, 15527, 15530, 15533, 15550, 15553, 15555, 15556, 15559, 15562, 15565, 15700, 15705, 15710, 15715, 15800, 15850, 16003, 16006, 16009, 16012, 16015, 16018, 16400, 16407, 16408, 16500, 16501, 16502, 16505, 16508, 16509, 16511, 16514, 16600, 17610, 17615, 17620, 17625, 17640, 17645, 17650, 17655, 17680, 17690, 18213, 18350, 18351, 18353, 18354, 18360, 18361, 18362, 18365, 18366, 18368, 18369, 18370, 18372, 18374, 18377, 30003, 30006, 30007, 30026, 30032, 30038, 30061, 30062, 30064, 30071, 30072, 30097, 30191, 30192, 30196, 30202, 30207, 30216, 30219, 30278, 30406, 30628, 30654, 31206, 31211, 31216, 31220, 31221, 31357, 31362, 31365, 31366, 31368, 31370, 31537, 31587, 32072, 32135, 32500, 32520, 32522, 32523, 32526, 32528, 32529, 35503, 35554, 35608, 35614, 35620, 35626, 35703, 36671, 36672, 36673, 36800, 37041, 37300, 37303, 37388, 37415, 38800, 39141, 40707, 40862, 40863, 41500, 41501, 41647, 41659, 41662, 41668, 41698, 41704, 41755, 41764, 41828, 42587, 42588, 42614, 42615, 42617, 42620, 42644, 42650, 42667, 42668, 42676, 42677, 42744, 42782, 42785, 42788, 42791, 42794, 42806, 42807, 42808, 42809, 42811, 45021, 45025, 45026, 45546, 45801, 45807, 45829, 45882, 47471, 47735, 47904, 47916, 47924, 50310, 51700, 51703, 52034, 52036, 52039, 52055, 52056, 52133, 53000, 53004, 53052, 53458, 55028, 55029, 55030, 55031, 55032, 55033, 55036, 55037, 55038, 55039, 55048, 55049, 55054, 55065, 55066, 55068, 55070, 55071, 55073, 55076, 55079, 55126, 55127, 55128, 55129, 55132, 55133, 55134, 55137, 55141, 55143, 55145, 55146, 55208, 55211, 55238, 55244, 55246, 55248, 55252, 55274, 55276, 55278, 55280, 55282, 55284, 55292, 55294, 55296, 55700, 55703, 55704, 55705, 55706, 55707, 55708, 55709, 55712, 55715, 55718, 55721, 55723, 55725, 55729, 55736, 55739, 55740, 55741, 55742, 55743, 55757, 55758, 55812, 55814, 55844, 55846, 55852, 55854, 55856, 55857, 55858, 55859, 55860, 55861, 55862, 55863, 55864, 55865, 55866, 55867, 55868, 55869, 55870, 55871, 55872, 55873, 55874, 55875, 55876, 55877, 55878, 55879, 55880, 55881, 55882, 55883, 55884, 55885, 55886, 55887, 55888, 55889, 55890, 55891, 55892, 55893, 55894, 55895, 56001, 56007, 56010, 56013, 56016, 56022, 56028, 56030, 56036, 56101, 56107, 56220, 56221, 56223, 56224, 56225, 56226, 56233, 56234, 56237, 56238, 56301, 56307, 56401, 56407, 56409, 56412, 56501, 56507, 56553, 56620, 56622, 56623, 56626, 56627, 56628, 56629, 56630, 56801, 56807, 57001, 57007, 57201, 57341, 57352, 57353, 57354, 57357, 57360, 57364, 57506, 57509, 57512, 57515, 57518, 57521, 57522, 57523, 57524, 57527, 57700, 57703, 57706, 57709, 57712, 57715, 57721, 57901, 57902, 57905, 57907, 57915, 57918, 57921, 57924, 57927, 57930, 57933, 57939, 57942, 57945, 57960, 57963, 57966, 57969, 58100, 58103, 58106, 58108, 58109, 58112, 58115, 58300, 58306, 58500, 58503, 58506, 58509, 58521, 58524, 58527, 58700, 58706, 58715, 58718, 58721, 58900, 58903, 58909, 58912, 58915, 58916, 58921, 58927, 58933, 58936, 59103, 59300, 59302, 59303, 59305, 59312, 59314, 59318, 59700, 59703, 59712, 59715, 59718, 59724, 59733, 59739, 59751, 59754, 59763, 60500, 60503, 60918, 60927, 61310, 61313, 61314, 61321, 61324, 61325, 61328, 61329, 61333, 61336, 61340, 61341, 61345, 61348, 61349, 61353, 61356, 61357, 61360, 61361, 61364, 61368, 61372, 61373, 61376, 61381, 61383, 61384, 61386, 61387, 61389, 61390, 61393, 61394, 61397, 61398, 61402, 61406, 61409, 61410, 61413, 61414, 61421, 61425, 61426, 61429, 61430, 61433, 61434, 61438, 61441, 61442, 61445, 61446, 61449, 61450, 61453, 61454, 61457, 61462, 61466, 61469, 61473, 61480, 61485, 61495, 61499, 61505, 61524, 61527, 61541, 61553, 61560, 61563, 61564, 61565, 61612, 61644, 61647, 63001, 63004, 63007, 63010, 63019, 63020, 63040, 63043, 63046, 63049, 63052, 63055, 63058, 63061, 63064, 63067, 63070, 63073, 63101, 63111, 63114, 63125, 63128, 63131, 63151, 63154, 63161, 63164, 63167, 63170, 63173, 63176, 63179, 63182, 63185, 63201, 63204, 63219, 63222, 63225, 63228, 63231, 63234, 63237, 63240, 63243, 63271, 63274, 63277, 63280, 63301, 63304, 63307, 63322, 63325, 63328, 63331, 63334, 63337, 63340, 63361, 63385, 63388, 63391, 63395, 63397, 63399, 63401, 63404, 63416, 63425, 63428, 63440, 63443, 63446, 63454, 63461, 63464, 63467, 63470, 63473, 63476, 63482, 63487, 63489, 63491, 63494, 63496, 63497, 63507, 63510, 63513, 63516, 63519, 63522, 63531, 63533, 63541, 63543, 63545, 63546, 63547, 63549, 63551, 63554, 63557, 63560, 63563, 63564, 63740, 63741, 63743, 65060, 65066, 65070, 65072, 65075, 65078, 65079, 65081, 65082, 65084, 65087, 65090, 65093, 65096, 65099, 65102, 65105, 65108, 65109, 65110, 65111, 65114, 65117, 65120, 65123, 65126, 65129, 65137, 65142, 65144, 65147, 65150, 65153, 65156, 65157, 65158, 65159, 65162, 65165, 65166, 65171, 65175, 65176, 65177, 65178, 65179, 65180, 65181, 66500, 66503, 66506, 66509, 66512, 66517, 66518, 66519, 66522, 66523, 66536, 66539, 66542, 66545, 66548, 66551, 66554, 66557, 66560, 66563, 66566, 66569, 66572, 66575, 66578, 66581, 66584, 66585, 66587, 66590, 66593, 66596, 66605, 66606, 66607, 66623, 66626, 66629, 66632, 66635, 66638, 66639, 66641, 66642, 66644, 66647, 66650, 66651, 66652, 66653, 66654, 66655, 66656, 66659, 66660, 66662, 66663, 66665, 66666, 66667, 66671, 66674, 66677, 66680, 66683, 66686, 66695, 66696, 66697, 66698, 66701, 66704, 66707, 66711, 66712, 66714, 66715, 66716, 66719, 66722, 66723, 66724, 66725, 66728, 66731, 66734, 66743, 66749, 66750, 66751, 66752, 66755, 66756, 66757, 66758, 66761, 66764, 66767, 66770, 66773, 66776, 66779, 66780, 66782, 66783, 66785, 66788, 66789, 66790, 66791, 66792, 66800, 66803, 66804, 66805, 66806, 66812, 66815, 66816, 66817, 66819, 66820, 66821, 66822, 66825, 66826, 66827, 66828, 66830, 66831, 66832, 66833, 66834, 66835, 66836, 66837, 66838, 66839, 66840, 66841, 66900, 69300, 69303, 69306, 69309, 69312, 69316, 69317, 69318, 69319, 69321, 69324, 69325, 69327, 69328, 69330, 69331, 69333, 69336, 69339, 69345, 69354, 69357, 69360, 69363, 69379, 69383, 69384, 69387, 69390, 69393, 69396, 69400, 69401, 69405, 69408, 69411, 69413, 69415, 69445, 69451, 69471, 69472, 69474, 69475, 69478, 69481, 69482, 69483, 69484, 69488, 69489, 69491, 69492, 69494, 69495, 69496, 69497, 69498, 69499, 69500, 69505, 69511, 69512, 69513, 69514, 69515, 71057, 71058, 71059, 71060, 71062, 71064, 71066, 71068, 71069, 71071, 71072, 71073, 71074, 71075, 71076, 71077, 71079, 71081, 71083, 71085, 71087, 71089, 71090, 71091, 71092, 71093, 71095, 71096, 71097, 71099, 71101, 71103, 71106, 71119, 71121, 71123, 71125, 71127, 71129, 71131, 71133, 71134, 71135, 71137, 71139, 71141, 71143, 71145, 71146, 71147, 71148, 71149, 71151, 71153, 71154, 71155, 71156, 71157, 71159, 71163, 71164, 71165, 71166, 71167, 71168, 71169, 71170, 71175, 71180, 71183, 71186, 71189, 71192, 71195, 71198, 71200, 71203, 72813, 72814, 72816, 72817, 72818, 72823, 72824, 72825, 72826, 72827, 72828, 72830, 72836, 72838, 72844, 72846, 72847, 72848, 72849, 72850, 72851, 72852, 72855, 72856, 72857, 73043, 73045, 73047, 73049, 73051, 73059, 73060, 73061, 73062, 73063, 73064, 73065, 73070, 73071, 73072, 73074, 73075, 73076, 73287, 73289, 73290, 73291, 73292, 73293, 73294, 73295, 73296, 73297, 73298, 73299, 73300, 73304, 73305, 73306, 73308, 73309, 73311, 73312, 73314, 73315, 73317, 73318, 73320, 73321, 73323, 73324, 73332, 73333, 73334, 73335, 73336, 73337, 73338, 73339, 73340, 73341, 73342, 73343, 73344, 73345, 73346, 73347, 73348, 73349, 73350, 73351, 73352, 73353, 73354, 73355, 73356, 73357, 73358, 73359, 73360, 73361, 73362, 73363, 73364, 73365, 73366, 73367, 73368, 73369, 73370, 73371, 73372, 73373, 73374, 73375, 73376, 73377, 73378, 73379, 73380, 73381, 73382, 73383, 73384, 73385, 73386, 73387, 73388, 73389, 73391, 73392, 73393, 73394, 73395, 73396, 73397, 73398, 73399, 73401, 73402, 73403, 73404, 73405, 73406, 73410, 73411, 73412, 73413, 73416, 73417, 73418, 73419, 73420, 73421, 73422, 73423, 73424, 73427, 73428, 73429, 73430, 73431, 73432, 73433, 73434, 73435, 73436, 73437, 73438, 73439, 73440, 73441, 73442, 73443, 73444, 73445, 73446, 73447, 73448, 73451, 73452, 73453, 73454, 73455, 73456, 73457, 73458, 73459, 73460, 73461, 73462, 73521, 73523, 73525, 73527, 73529, 73801, 73802, 73803, 73804, 73805, 73806, 73807, 73808, 73809, 73810, 73811, 73812, 73826, 73920, 73922, 73923, 73924, 73925, 73926, 73927, 73928, 73929, 73930, 73931, 73932, 73933, 73934, 73935, 73936, 73937, 73938, 73939, 73940, 74992, 74993, 74994, 74995, 74996, 74997, 74998, 74999, 82100, 82105, 82110, 82115, 82116, 82130, 82135, 82140, 82226, 82227, 82228, 91868, 91869, 91870, 91871, 91872, 91873, 91874, 91875, 91876, 91877, 91878, 91879, 91880, 91881, 91882, 91883, 91884

Type C procedures – list of MBS items

3, 4, 23, 24, 36, 37, 44, 47, 52, 53, 54, 57, 58, 59, 60, 65, 104, 105, 106, 107, 108, 109, 110, 115, 116, 119, 122, 128, 131, 132, 133, 135, 137, 139, 141, 143, 145, 147, 160, 161, 162, 163, 164, 170, 171, 172, 193, 195, 197, 199, 230, 233, 235, 236, 237, 238, 239, 240, 285, 287, 289, 291, 293, 296, 297, 299, 300, 302, 304, 306, 308, 310, 312, 314, 316, 318, 319, 320, 322, 324, 326, 328, 330, 332, 334, 336, 338, 341, 342, 343, 344, 345, 346, 347, 349, 385, 386, 387, 388, 410, 411, 412, 413, 414, 415, 416, 417, 721, 723, 729, 731, 732, 735, 739, 743, 747, 750, 758, 820, 822, 823, 825, 826, 828, 855, 857, 858, 900, 903, 930, 933, 935, 937, 943, 945, 946, 948, 959, 961, 962, 964, 969, 971, 972, 973, 975, 986, 2713, 2721, 2723, 2725, 2727, 2801, 2806, 2814, 2824, 2832, 2840, 2946, 2949, 2954, 2958, 2972, 2974, 3005, 3010, 3014, 3018, 3023, 3028, 3032, 3040, 3044, 3051, 3055, 3062, 4001, 5000, 5001, 5003, 5004, 5010, 5011, 5012, 5013, 5014, 5016, 5017, 5019, 5020, 5021, 5022, 5023, 5027, 5028, 5030, 5031, 5032, 5033, 5035, 5036, 5039, 5040, 5041, 5042, 5043, 5044, 5049, 5060, 5063, 5067, 5200, 5203, 5207, 5208, 5220, 5223, 5227, 5228, 5260, 5263, 5265, 5267, 6007, 6009, 6011, 6013, 6015, 6018, 6019, 6023, 6024, 6028, 6029, 6031, 6032, 6034, 6035, 6037, 6038, 6042, 6051, 6052, 6057, 6058, 6062, 6063, 6064, 6065, 6067, 6068, 6071, 6072, 6074, 6075, 6080, 6081, 6082, 6084, 10801, 10802, 10803, 10804, 10805, 10806, 10807, 10808, 10809, 10816, 10988, 10989, 11000, 11003, 11012, 11015, 11018, 11024, 11027, 11200, 11204, 11205, 11210, 11211, 11215, 11218, 11219, 11220, 11221, 11224, 11235, 11237, 11240, 11241, 11242, 11243, 11244, 11300, 11302, 11306, 11309, 11312, 11315, 11318, 11324, 11332, 11340, 11341, 11343, 11503, 11505, 11506, 11507, 11508, 11512, 11602, 11604, 11605, 11607, 11610, 11611, 11612, 11614, 11615, 11705, 11713, 11719, 11720, 11721, 11724, 11725, 11726, 11727, 11728, 11729, 11730, 11731, 11732, 11736, 11737, 11800, 11810, 11820, 11823, 11830, 11833, 11900, 11912, 11917, 12000, 12001, 12002, 12003, 12004, 12005, 12012, 12017, 12021, 12022, 12024, 12200, 12201, 12306, 12312, 12315, 12320, 12321, 12322, 12325, 12326, 12500, 12524, 12527, 12533, 13104, 13200, 13203, 13207, 13209, 13221, 13260, 13290, 13312, 13839, 13842, 13899, 14050, 14100, 14106, 14115, 14118, 14124, 14201, 14202, 14203, 14206, 14216, 14217, 14219, 14220, 14221, 14227, 14245, 14255, 14256, 14257, 14258, 14259, 14260, 14263, 14264, 14265, 14266, 14270, 14272, 14277, 14278, 14280, 14283, 14285, 14288, 15000, 15003, 15006, 15009, 15012, 15100, 15103, 15106, 15109, 15112, 15115, 15211, 15214, 15215, 15218, 15221, 15224, 15227, 15230, 15233, 15236, 15239, 15242, 15245, 15248, 15251, 15254, 15257, 15260, 15263, 15266, 15269, 15272, 15275, 15500, 15503, 15506, 15509, 15512, 15515, 15518, 15521, 15524, 15527, 15530, 15533, 15550, 15553, 15555, 15556, 15559, 15562, 15565, 15700, 15705, 15710, 15715, 15800, 15850, 16003, 16006, 16009, 16012, 16015, 16018, 16400, 16407, 16408, 16500, 16501, 16502, 16505, 16508, 16509, 16511, 16514, 16600, 17610, 17615, 17620, 17625, 17640, 17645, 17650, 17655, 17680, 17690, 18213, 18350, 18351, 18353, 18354, 18360, 18361, 18362, 18365, 18366, 18368, 18369, 18370, 18372, 18374, 18377, 30003, 30006, 30007, 30026, 30032, 30038, 30061, 30062, 30064, 30071, 30072, 30097, 30191, 30192, 30196, 30202, 30207, 30216, 30219, 30278, 30406, 30628, 30654, 31206, 31211, 31216, 31220, 31221, 31357, 31362, 31365, 31366, 31368, 31370, 31537, 31587, 32072, 32135, 32500, 32520, 32522, 32523, 32526, 32528, 32529, 35503, 35554, 35608, 35614, 35620, 35626, 35703, 36671, 36672, 36673, 36800, 37041, 37300, 37303, 37388, 37415, 38800, 39141, 40707, 40862, 40863, 41500, 41501, 41647, 41659, 41662, 41668, 41698, 41704, 41755, 41764, 41828, 42587, 42588, 42614, 42615, 42617, 42620, 42644, 42650, 42667, 42668, 42676, 42677, 42744, 42782, 42785, 42788, 42791, 42794, 42806, 42807, 42808, 42809, 42811, 45021, 45025, 45026, 45546, 45801, 45807, 45829, 45882, 47471, 47735, 47904, 47916, 47924, 50310, 51700, 51703, 52034, 52036, 52039, 52055, 52056, 52133, 53000, 53004, 53052, 53458, 55028, 55029, 55030, 55031, 55032, 55033, 55036, 55037, 55038, 55039, 55048, 55049, 55054, 55065, 55066, 55068, 55070, 55071, 55073, 55076, 55079, 55126, 55127, 55128, 55129, 55132, 55133, 55134, 55137, 55141, 55143, 55145, 55146, 55208, 55211, 55238, 55244, 55246, 55248, 55252, 55274, 55276, 55278, 55280, 55282, 55284, 55292, 55294, 55296, 55700, 55703, 55704, 55705, 55706, 55707, 55708, 55709, 55712, 55715, 55718, 55721, 55723, 55725, 55729, 55736, 55739, 55740, 55741, 55742, 55743, 55757, 55758, 55812, 55814, 55844, 55846, 55852, 55854, 55856, 55857, 55858, 55859, 55860, 55861, 55862, 55863, 55864, 55865, 55866, 55867, 55868, 55869, 55870, 55871, 55872, 55873, 55874, 55875, 55876, 55877, 55878, 55879, 55880, 55881, 55882, 55883, 55884, 55885, 55886, 55887, 55888, 55889, 55890, 55891, 55892, 55893, 55894, 55895, 56001, 56007, 56010, 56013, 56016, 56022, 56028, 56030, 56036, 56101, 56107, 56220, 56221, 56223, 56224, 56225, 56226, 56233, 56234, 56237, 56238, 56301, 56307, 56401, 56407, 56409, 56412, 56501, 56507, 56553, 56620, 56622, 56623, 56626, 56627, 56628, 56629, 56630, 56801, 56807, 57001, 57007, 57201, 57341, 57352, 57353, 57354, 57357, 57360, 57364, 57506, 57509, 57512, 57515, 57518, 57521, 57522, 57523, 57524, 57527, 57700, 57703, 57706, 57709, 57712, 57715, 57721, 57901, 57902, 57905, 57907, 57915, 57918, 57921, 57924, 57927, 57930, 57933, 57939, 57942, 57945, 57960, 57963, 57966, 57969, 58100, 58103, 58106, 58108, 58109, 58112, 58115, 58300, 58306, 58500, 58503, 58506, 58509, 58521, 58524, 58527, 58700, 58706, 58715, 58718, 58721, 58900, 58903, 58909, 58912, 58915, 58916, 58921, 58927, 58933, 58936, 59103, 59300, 59302, 59303, 59305, 59312, 59314, 59318, 59700, 59703, 59712, 59715, 59718, 59724, 59733, 59739, 59751, 59754, 59763, 60500, 60503, 60918, 60927, 61310, 61313, 61314, 61321, 61324, 61325, 61328, 61329, 61333, 61336, 61340, 61341, 61345, 61348, 61349, 61353, 61356, 61357, 61360, 61361, 61364, 61368, 61372, 61373, 61376, 61381, 61383, 61384, 61386, 61387, 61389, 61390, 61393, 61394, 61397, 61398, 61402, 61406, 61409, 61410, 61413, 61414, 61421, 61425, 61426, 61429, 61430, 61433, 61434, 61438, 61441, 61442, 61445, 61446, 61449, 61450, 61453, 61454, 61457, 61462, 61466, 61469, 61473, 61480, 61485, 61495, 61499, 61505, 61524, 61527, 61541, 61553, 61560, 61563, 61564, 61565, 61612, 61644, 61647, 63001, 63004, 63007, 63010, 63019, 63020, 63040, 63043, 63046, 63049, 63052, 63055, 63058, 63061, 63064, 63067, 63070, 63073, 63101, 63111, 63114, 63125, 63128, 63131, 63151, 63154, 63161, 63164, 63167, 63170, 63173, 63176, 63179, 63182, 63185, 63201, 63204, 63219, 63222, 63225, 63228, 63231, 63234, 63237, 63240, 63243, 63271, 63274, 63277, 63280, 63301, 63304, 63307, 63322, 63325, 63328, 63331, 63334, 63337, 63340, 63361, 63385, 63388, 63391, 63395, 63397, 63399, 63401, 63404, 63416, 63425, 63428, 63440, 63443, 63446, 63454, 63461, 63464, 63467, 63470, 63473, 63476, 63482, 63487, 63489, 63491, 63494, 63496, 63497, 63507, 63510, 63513, 63516, 63519, 63522, 63531, 63533, 63541, 63543, 63545, 63546, 63547, 63549, 63551, 63554, 63557, 63560, 63563, 63564, 63740, 63741, 63743, 65060, 65066, 65070, 65072, 65075, 65078, 65079, 65081, 65082, 65084, 65087, 65090, 65093, 65096, 65099, 65102, 65105, 65108, 65109, 65110, 65111, 65114, 65117, 65120, 65123, 65126, 65129, 65137, 65142, 65144, 65147, 65150, 65153, 65156, 65157, 65158, 65159, 65162, 65165, 65166, 65171, 65175, 65176, 65177, 65178, 65179, 65180, 65181, 66500, 66503, 66506, 66509, 66512, 66517, 66518, 66519, 66522, 66523, 66536, 66539, 66542, 66545, 66548, 66551, 66554, 66557, 66560, 66563, 66566, 66569, 66572, 66575, 66578, 66581, 66584, 66585, 66587, 66590, 66593, 66596, 66605, 66606, 66607, 66623, 66626, 66629, 66632, 66635, 66638, 66639, 66641, 66642, 66644, 66647, 66650, 66651, 66652, 66653, 66654, 66655, 66656, 66659, 66660, 66662, 66663, 66665, 66666, 66667, 66671, 66674, 66677, 66680, 66683, 66686, 66695, 66696, 66697, 66698, 66701, 66704, 66707, 66711, 66712, 66714, 66715, 66716, 66719, 66722, 66723, 66724, 66725, 66728, 66731, 66734, 66743, 66749, 66750, 66751, 66752, 66755, 66756, 66757, 66758, 66761, 66764, 66767, 66770, 66773, 66776, 66779, 66780, 66782, 66783, 66785, 66788, 66789, 66790, 66791, 66792, 66800, 66803, 66804, 66805, 66806, 66812, 66815, 66816, 66817, 66819, 66820, 66821, 66822, 66825, 66826, 66827, 66828, 66830, 66831, 66832, 66833, 66834, 66835, 66836, 66837, 66838, 66839, 66840, 66841, 66900, 69300, 69303, 69306, 69309, 69312, 69316, 69317, 69318, 69319, 69321, 69324, 69325, 69327, 69328, 69330, 69331, 69333, 69336, 69339, 69345, 69354, 69357, 69360, 69363, 69379, 69383, 69384, 69387, 69390, 69393, 69396, 69400, 69401, 69405, 69408, 69411, 69413, 69415, 69445, 69451, 69471, 69472, 69474, 69475, 69478, 69481, 69482, 69483, 69484, 69488, 69489, 69491, 69492, 69494, 69495, 69496, 69497, 69498, 69499, 69500, 69505, 69511, 69512, 69513, 69514, 69515, 71057, 71058, 71059, 71060, 71062, 71064, 71066, 71068, 71069, 71071, 71072, 71073, 71074, 71075, 71076, 71077, 71079, 71081, 71083, 71085, 71087, 71089, 71090, 71091, 71092, 71093, 71095, 71096, 71097, 71099, 71101, 71103, 71106, 71119, 71121, 71123, 71125, 71127, 71129, 71131, 71133, 71134, 71135, 71137, 71139, 71141, 71143, 71145, 71146, 71147, 71148, 71149, 71151, 71153, 71154, 71155, 71156, 71157, 71159, 71163, 71164, 71165, 71166, 71167, 71168, 71169, 71170, 71175, 71180, 71183, 71186, 71189, 71192, 71195, 71198, 71200, 71203, 72813, 72814, 72816, 72817, 72818, 72823, 72824, 72825, 72826, 72827, 72828, 72830, 72836, 72838, 72844, 72846, 72847, 72848, 72849, 72850, 72851, 72852, 72855, 72856, 72857, 73043, 73045, 73047, 73049, 73051, 73059, 73060, 73061, 73062, 73063, 73064, 73065, 73070, 73071, 73072, 73074, 73075, 73076, 73287, 73289, 73290, 73291, 73292, 73293, 73294, 73295, 73296, 73297, 73298, 73299, 73300, 73304, 73305, 73306, 73308, 73309, 73311, 73312, 73314, 73315, 73317, 73318, 73320, 73321, 73323, 73324, 73332, 73333, 73334, 73335, 73336, 73337, 73338, 73339, 73340, 73341, 73342, 73343, 73344, 73345, 73346, 73347, 73348, 73349, 73350, 73351, 73352, 73353, 73354, 73355, 73356, 73357, 73358, 73359, 73360, 73361, 73362, 73363, 73364, 73365, 73366, 73367, 73368, 73369, 73370, 73371, 73372, 73373, 73374, 73375, 73376, 73377, 73378, 73379, 73380, 73381, 73382, 73383, 73384, 73385, 73386, 73387, 73388, 73389, 73391, 73392, 73393, 73394, 73395, 73396, 73397, 73398, 73399, 73401, 73402, 73403, 73404, 73405, 73406, 73410, 73411, 73412, 73413, 73416, 73417, 73418, 73419, 73420, 73421, 73422, 73423, 73424, 73427, 73428, 73429, 73430, 73431, 73432, 73433, 73434, 73435, 73436, 73437, 73438, 73439, 73440, 73441, 73442, 73443, 73444, 73445, 73446, 73447, 73448, 73451, 73452, 73453, 73454, 73455, 73456, 73457, 73458, 73459, 73460, 73461, 73462, 73521, 73523, 73525, 73527, 73529, 73801, 73802, 73803, 73804, 73805, 73806, 73807, 73808, 73809, 73810, 73811, 73812, 73826, 73920, 73922, 73923, 73924, 73925, 73926, 73927, 73928, 73929, 73930, 73931, 73932, 73933, 73934, 73935, 73936, 73937, 73938, 73939, 73940, 74992, 74993, 74994, 74995, 74996, 74997, 74998, 74999, 82100, 82105, 82110, 82115, 82116, 82130, 82135, 82140, 82226, 82227, 82228, 91868, 91869, 91870, 91871, 91872, 91873, 91874, 91875, 91876, 91877, 91878, 91879, 91880, 91881, 91882, 91883, 91884

Public hospital: State/Territory	Minimum benefit per night
Australian Capital Territory	$142.45
New South Wales	$172.60
Northern Territory	$147.19
Queensland	$145.80
South Australia	$141.00
Tasmania	$181.30
Victoria	$140.00
Western Australia	$149.75

Schedule 5―Second‑tier default benefits

1. Interpretation

(1) In this Schedule:

authorised officer means a departmental officer authorised by the Secretary of the Department to make a determination under subclause 1A (2), (3) or (4) or to review a determination under subclause 1B (3).

comparable has the meaning given by subclause 1A (6).

Hospital Casemix Protocol Data has the meaning given by rule 4 of the Private Health Insurance (Health Insurance Business) Rules 2018.

second‑tier eligible hospital means a hospital in the class set out in rule 7A of the Private Health Insurance (Health Insurance Business) Rules 2018.

(2) In this Schedule, except in subclauses 1A (8) and (9), the Australian Capital Territory is taken to be part of New South Wales, and the Northern Territory is taken to be part of South Australia.

1A. Categorisation of private hospitals

(1) If, as at 1 January 2019, a departmental officer authorised by the Secretary of the Department for the purpose has, in anticipation of the commencement of this provision, caused to be published on the Department’s website a list of all the hospitals for which a declaration is in force under subsection 121‑5 (6) of the Act that places each hospital in a category set out in subclause (7), then each hospital is taken to be determined to be in that category.

(2) If such a list has not been published, then as soon as practicable an authorised officer must determine which category of hospital from the categories set out in subclause (7) each private hospital for which a declaration is in force under subsection 121‑5 (6) of the Act is to be placed in, and cause a list of the hospitals in each category to be published on the Department’s website.

Note: If a patient is admitted to a hospital between 1 January 2019 and 31 August 2019 insurers may continue to work out the average charge on the basis of the provisions of this Schedule as in force immediately before the commencement of Schedule 4 to the Private Health Insurance (Reforms) Amendment Rules 2018. However, insurers must use the Department’s published list of hospitals under subclause (1) or (2) to determine in which category a hospital claiming second‑tier default benefits is placed.

(3) If a private hospital is declared under subsection 121‑5 (6) of the Act after 1 January 2019, an authorised officer must determine which category of hospital from the categories set out in subclause (7) that private hospital is to be placed in.

(4) If a hospital has been placed in a category by a determination under this clause, an authorised officer may before 1 June of a particular year determine a different category of hospital from the categories set out in subclause (7) that the private hospital is to be placed in.

(5) A list of the hospitals in each category as of 1 August of each year must be published on the Department’s website.

(6) Private hospitals are comparable if they are placed in the same category by a determination made under subclause (1), (2), (3) or (4).

(7) For the purposes of this clause, the categories are the following:

(a) private hospitals that provide psychiatric care, including treatment of addictions, for at least 50% of the episodes of hospital treatment, and do not fall into category (g);

(b) private hospitals that provide rehabilitation care for at least 50% of the episodes of hospital treatment, and do not fall into categories (a) or (g);

(d) private hospitals that do not fall into categories (a), (b) or (g), with more than 50 licensed beds and up to and including 100 licensed beds;

(e) private hospitals that do not fall into categories (a), (b) or (g), with more than 100 licensed beds, without an accident and emergency unit or a specialised cardiac care unit or an intensive care unit;

(f) private hospitals that do not fall into categories (a), (b) or (g), with more than 100 licensed beds, with either (or any combination of) an accident and emergency unit or a specialised cardiac care unit or an intensive care unit;

(g) private hospitals that provide episodes of hospital treatment only for periods of not more than 24 hours.

(8) If State or Territory legislation in the State or Territory where the private hospital is located regulates the number of beds or patients that a private hospital is permitted—in subclause (7), a reference to licensed beds is a reference to the beds or patients that a private hospital is permitted, under State or Territory legislation in the State or Territory where the private hospital is located.

(9) If State or Territory legislation in the State or Territory where the private hospital is located does not regulate the number of beds or patients that a private hospital is permitted—in subclause (7), a reference to licensed beds is a reference to the beds and bed equivalents the private hospital operates.

(10) An authorised officer must calculate proportions for the purposes of paragraphs (7) (a) and (b):

(a) if Hospital Casemix Protocol Data is available for the private hospital—using the most recent year of Hospital Casemix Protocol Data available to the Department for the private hospital; and

(b) otherwise—on the basis of any relevant information available to the Department about the episodes of hospital treatment at the private hospital.

1B. Internal review of a categorisation determination

(1) A private hospital subject to a determination made under subclause 1A (1), (2), (3) or (4) may request internal review of its categorisation by the determination.

(2) An application for internal review under subclause (1) must be made in writing within 28 days after the day the determination is notified to the hospital.

(3) If an application for internal review is made, an authorised officer (who must not be the authorised officer who made the original determination) must:

(a) review the determination; and

(b) either confirm the determination or make a fresh one within 28 days after the day on which the application was received by the Department.

2. Circumstances

For rules 4 and 5 of Part 2 of these Rules, the circumstances for hospital treatment to which this Schedule applies are that the treatment is provided to a patient who is not a nursing‑home type patient and the treatment is provided at a second‑tier eligible hospital.

3. Minimum benefit

(1) Despite anything in Schedules 1, 2 or 3, but subject to subclause (2) of this clause, the minimum benefit for hospital treatment provided in the circumstances described in clause 2 of this Schedule is the amount worked out in accordance with this clause.

(2) Where hospital treatment is provided in the circumstances described in clause 2 of this Schedule, but:

(a) the minimum benefit worked out in accordance with this clause for the hospital treatment is below the amount determined in accordance with Schedules 1, 2 or 3 of these Rules; or

(b) an amount for the hospital treatment cannot be worked out in accordance with this clause,

the minimum benefit for that hospital treatment is the amount worked out in accordance with Schedules 1, 2 or 3 for that hospital treatment.

(3) If a hospital ceases to be a second‑tier eligible hospital for the purposes of this Schedule, the minimum benefit in relation to an episode of hospital treatment for an insured person who was an admitted patient at the hospital or booked for hospital treatment at the hospital (as opposed to merely being on the hospital’s waiting list) before the day that the hospital ceased to be a second‑tier eligible hospital is the minimum benefit that would have applied if the hospital continued to be a second‑tier eligible hospital at the time the treatment was provided.

(4) Subject to subclauses (2) and (8), the minimum benefit payable by an insurer for an episode of hospital treatment at a second‑tier eligible hospital for which the admission date was between 1 September of a particular year (the first year) and 31 August of the next year is an amount no less than 85% of the average charge for the equivalent episode of hospital treatment, under that insurer’s negotiated agreements as in force on 1 August of the first year, with all private hospitals:

(a) that:

(i) if the second‑tier eligible hospital is on the list published on the Department’s website under subclause 1A (5)—were comparable on 1 August of the first year with the second‑tier eligible hospital; and

(ii) otherwise—are in the same category as the second‑tier eligible hospital in the list published on the Department’s website under subclause 1A (5) as at 1 August of the first year; and

(b) that are in the same State as the second‑tier eligible hospital.

Note: See clause 4 for a transitional arrangement for admissions to second‑tier eligible hospitals between 1 January 2019 and 31 August 2019.

(5) The formula for calculating the average charge for the equivalent episode of hospital treatment by an insurer in each State is as follows:

A formula to work out the average charge for the equivalent episode of hospital treatment by an insurer in each State

Where: j = group of equivalent episodes of hospital treatment under the insurer's negotiated agreements;

i = group of the insurer's negotiated agreements in force on 1 August of the first year with comparable private hospitals in the State;

n= the number of the insurer's negotiated agreements in force on 1 August of the first year with comparable private hospitals in the State;

Rji = charge for episode of hospital treatment type j in the negotiated agreement i

Rj = average charge for episode of hospital treatment type j.

(6) In subclause (4), each episode of hospital treatment must be identified using the patient classification system and payment structure in the majority of the relevant insurer's negotiated agreements in force on 1 August of the first year with all comparable private hospitals in the State in which the second‑tier eligible hospital is located.

(7) In subclause (4), for the purpose of calculating the average charge for the equivalent episode of hospital treatment in a State:

(a) the charge will include the sum of the amount payable by the insurer under that insurer's negotiated agreement and any excess or co‑payment amounts payable by members, in accordance with the insurer's rules; and

Note: Policy holders’ financial obligations under such levels of cover will still apply.

(b) must not include any charges:

(i) referred to in the insurer's negotiated agreements for medical devices and human tissue products; and

(ii) that are minimum benefits for medical devices and human tissue products as specified for the purpose of item 4 of the table in subsection 72‑1 (2) of the Act, and

(iii) referred to in the insurer's negotiated agreements for hospital treatment provided to nursing‑home type patients.

(8) Subject to subclause (2), if an insurer has less than 5 negotiated agreements in force on 1 August of the first year with a particular category of comparable private hospitals in a State, then all of that insurer's negotiated agreements with all classes of private hospitals in that State are to be used to calculate the minimum benefit.

4. Transitional

(1) If a patient is admitted to a second‑tier eligible hospital between 1 January 2019 and 31 August 2019:

(a) an insurer may instead work out the average charge on the basis of the repealed provisions; and

(b) if the insurer does so, comparable has the same meaning as in the repealed provisions.

(2) For subclause (1), the repealed provisions are the provisions of this Schedule as in force immediately before the commencement of Schedule 4 to the Private Health Insurance (Reforms) Amendment Rules 2018.

Note: For the purpose of determining which category the second‑tier eligible hospital to which the patient was admitted is placed in, an insurer must use the Department’s determination in respect of that hospital under subclause 1A (1), (2), (3) or (4).

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
Private Health Insurance (Benefit Requirements) Amendment Rules 2011	31 Oct 2011 (F2011L02160)		1 November 2011
Private Health Insurance (Benefit Requirements) Amendment Rules 2011 (No. 10)	19 Dec 2011 (F2011L02731)		20 December 2011	—
Private Health Insurance (Benefit Requirements) Amendment Rules 2012 (No. 1)	20 March 2012 (F2012L00604)		20 March 2012	—
Private Health Insurance (Benefit Requirements) Amendment Rules 2012 (No. 2)	11 April 2012 (F2012L00822)		12 April 2012	—
Private Health Insurance (Benefit Requirements) Amendment Rules 2012 (No. 3)	20 April 2012 (F2012L00905)		21 April 2012	—
Private Health Insurance (Benefit Requirements) Amendment Rules 2012 (No. 4)	20 June 2012 (F2012L01264)		1 July 2012	—
Private Health Insurance (Benefit Requirements) Amendment Rules 2012 (No. 5)	18 Sept 2012 (F2012L01887)		20 September 2012	—
Private Health Insurance (Benefit Requirements) Amendment Rules 2012 (No. 6)	31 Sept 2012 (F2012L02111)		1 November 2012	—
Private Health Insurance (Benefit Requirements) Amendment Rules 2012 (No. 7)	31 Sept 2012 (F2012L02114)		1 November 2012	—
Private Health Insurance (Benefit Requirements) Amendment Rules 2012 (No. 8)	7 Nov 2012 (F2012L02151)		8 November 2012	—
Private Health Insurance (Benefit Requirements) Amendment Rules 2012 (No. 9)	17 Dec 2012 (F2012L02502)		18 December 2012	—
Private Health Insurance (Benefit Requirements) Amendment Rules 2012 (No. 10)	2 Jan 2013 (F2013L00003)		3 January 2013	—
Private Health Insurance (Benefit Requirements) Amendment Rules 2013 (No. 1)	19 March 2013 (F2013L00497)		20 March 2013	—
Private Health Insurance (Benefit Requirements) Amendment Rules 2013 (No. 2)	27 June 2013 (F2013L01190)		1 July 2013	—
Private Health Insurance (Benefit Requirements) Amendment Rules 2013 (No. 3)	4 July 2013 (F2013L01321)		5 July 2013	—
Private Health Insurance (Benefit Requirements) Amendment Rules 2013 (No. 4)	19 September 2013 (F2013L01714)		20 September 2013	—
Private Health Insurance (Benefit Requirements) Amendment Rules 2013 (No. 5)	27 September 2013 (F2013L01714)		1 October 2013	—
Private Health Insurance (Benefit Requirements) Amendment Rules 2013 (No. 6)	31 October 2013 (F2013L01866)		1 November 2013	—
Private Health Insurance (Benefit Requirements) Amendment Rules 2013 (No. 7)	16 December 2013 (F2013L02113)		1 January 2014	—
Private Health Insurance (Benefit Requirements) Amendment Rules 2014 (No. 1)	19 March 2014 (F2014L00309)		20 March 2014	—
Private Health Insurance (Benefit Requirements) Amendment Rules 2014 (No. 2)	24 June 2014 (F2014L00801)		1 July 2014	—
Private Health Insurance (Benefit Requirements) Amendment Rules 2014 (No. 3)	23 July 2014 (F2014L01016)		24 July 2014	—
Private Health Insurance (Benefit Requirements) Amendment Rules 2014 (No. 4)	17 September 2014 (F2014L01235)		20 September 2014	—
Private Health Insurance (Benefit Requirements) Amendment Rules 2014 (No. 5)	29 October 2014 (F2014L01434)		1 November 2014	—
Private Health Insurance (Benefit Requirements) Amendment Rules 2014 (No. 6)	22 December 2014 (F2014L01775)		1 January 2015	—
Private Health Insurance (Benefit Requirements) Amendment Rules 2015 (No. 1)	20 March 2015 (F2015L00324)		20 March 2015	—
Private Health Insurance (Benefit Requirements) Amendment Rules 2015 (No. 2)	24 June 2015 (F2015L00926)		1 July 2015	—
Private Health Insurance (Benefit Requirements) Amendment Rules 2015 (No.3)	28 August 2015 (F2015L01356)		1 September 2015	—
Private Health Insurance (Benefit Requirements) Amendment Rules 2015 (No.4)	17 September 2015 (F2015L01451)		20 September 2015	—
Private Health Insurance (Benefit Requirements) Amendment Rules 2015 (No.5)	29 October 2015 (F2015L01711)		1 November 2015	—
Private Health Insurance (Benefit Requirements) Amendment Rules 2015 (No.6)	23 December 2015 (F2015L02118)		1 January 2016	—
Private Health Insurance (Benefit Requirements) Amendment Rules 2016 (No.1)	18 March 2016 (F2016L00352)		20 March 2016	—
Private Health Insurance (Benefit Requirements) Amendment Rules 2016 (No. 2)	28 April 2016 (F2016L00589)		1 May 2016	—
Private Health Insurance (Benefit Requirements) Amendment Rules 2016 (No.3)	2 June 2016 (F2016L00979)		3 June 2016	—
Private Health Insurance (Benefit Requirements) Amendment Rules 2016 (No.4)	29 June 2016 (F2016L01101)		1 July 2016	—
Private Health Insurance (Benefit Requirements) Amendment Rules 2016 (No.5)	16 September 2016 (F2016L01446)		20 September 2016	—
Private Health Insurance (Benefit Requirements) Amendment Rules 2016 (No.6)	20 September 2016 (F2016L01463)		20 September 2016	—
Private Health Insurance (Benefit Requirements) Amendment Rules 2016 (No.7)	31 November 2016 (F2016L01665)		1 November 2016	—
Private Health Insurance (Benefit Requirements) Amendment Rules 2016 (No.8)	1 December 2016 (F2016L01846)		1 December 2016	—
Private Health Insurance (Benefit Requirements) Amendment Rules 2016 (No.9)	15 December 2016 (F2016L01967)		1 January 2017	—
Private Health Insurance (Benefit Requirements) Amendment Rules 2017 (No.1)	1 February 2017 (F2017L00084)		1 February 2017	—
Private Health Insurance (Benefit Requirements) Amendment Rules 2017 (No.2)	17 March 2017 (F2017L00242)		20 March 2017	—
Private Health Insurance (Benefit Requirements) Amendment Rules 2017 (No.3)	21 April 2017 (F2017L00461)		1 May 2017	—
Private Health Insurance (Benefit Requirements) Amendment Rules 2017 (No.4)	26 May 2017 (F2017L00603)		27 May 2017	—
Private Health Insurance (Benefit Requirements) Amendment Rules 2017 (No.5)	30 June 2017 (F2017L00830)		1 July 2017	—
Private Health Insurance (Benefit Requirements) Amendment Rules 2017 (No.6)	7 July 2017 (F2017L00894)		8 July 2017	—
Private Health Insurance (Benefit Requirements) Amendment Rules 2017 (No.7)	20 September 2017 (F2017L01217)		20 September 2017	—
Private Health Insurance (Benefit Requirements) Amendment Rules 2017 (No.8)	30 October 2017 (F2017L01401)		1 November 2017	—
Private Health Insurance (Benefit Requirements) Amendment Rules 2017 (No.9)	27 November 2017 F2017L01527)		1 December 2017	—
Private Health Insurance (Benefit Requirements) Amendment Rules 2017 (No.10)	8 December 2017 (F2017L01603)		1 January 2018	—
Private Health Insurance (Benefit Requirements) Amendment Rules 2018 (No.1)	20 March 2018 (F2018L00323)		20 March 2018	—
Private Health Insurance (Benefit Requirements) Amendment Rules 2018 (No.2)	30 April 2018 (F2018L00544)		1 May 2018	—
Private Health Insurance (Benefit Requirements) Amendment Rules 2018 (No.3)	28 June 2018 (F2018L00927)		1 July 2018 (s 2)	—
Private Health Insurance (Benefit Requirements) Amendment Rules 2018 (No. 4)	19 Sept 2018 (F2018L01315)		20 Sept 2018 (s 2)	—
Private Health Insurance (Reforms) Amendment Rules 2018	11 Oct 2018 (F2018L01414)		Sch 4 (items 1–7): 1 Jan 2019 (s 2(1) item 8)	—
Private Health Insurance (Benefit Requirements) Amendment Rules 2018 (No. 5)	26 Oct 2018 (F2018L01474)		1 Nov 2018 (s 2)	—
Private Health Insurance (Benefit Requirements) Amendment Rules 2018 (No. 6)	19 Dec 2018 (F2018L01797)		20 Dec 2018 (s 2(1) item 1)	—
Private Health Insurance (Benefit Requirements) Amendment Rules 2019 (No. 1)	21 Jan 2019 (F2019L00048)		1 Feb 2019 (s 2(1) item 1)	—
Private Health Insurance (Benefit Requirements) Amendment Rules (No. 2) 2019	20 Mar 2019 (F2019L00327)		Sch 1: 20 Mar 2019 (s 2(1) item 2) Sch 2: 1 July 2019 (s 2(1) item 3)	—
as amended by
Private Health Insurance Legislation Amendment Rules (No. 1) 2019	29 Apr 2019 (F2019L00639)	Sch 2: 30 Apr 2019 (s 2(1) item 3)		—
Private Health Insurance (Benefit Requirements) Amendment Rules (No. 3) 2019	1 Apr 2019 (F2019L00493)		1 Apr 2019 (s 2(1) item 1)	—
Private Health Insurance Legislation Amendment Rules (No. 1) 2019	29 Apr 2019 (F2019L00639)		Sch 1: 1 May 2019 (s 2(1) item 2)	—
Private Health Insurance Legislation Amendment (No. 2) Rules 2019	28 June 2019 (F2019L00925)		Sch 1: 1 July 2019 (s 2(1) item 1)	—
Private Health Insurance Legislation Amendment (No. 3) Rules 2019	19 Sept 2019 (F2019L01221)		Sch 1: 20 Sept 2019 (s 2(1) item 1)	—
Private Health Insurance Legislation Amendment Rules (No. 4) 2019	30 Oct 2019 (F2019L01384)		Sch 1: 1 Nov 2019 (s 2(1) item 1)	—
Private Health Insurance Legislation Amendment Rules (No. 1) 2020	28 Feb 2020 (F2020L00190)		Sch 1: 1 Mar 2020 (s 2(1) item 1)	—
Private Health Insurance Legislation Amendment Rules (No. 2) 2020	19 Mar 2020 (F2020L00272)		Sch 1: 20 Mar 2020 (s 2(1) item 1)	—
Private Health Insurance Legislation Amendment Rules (No. 3) 2020	30 Apr 2020 (F2020L00539)		Sch 1 (items 1–9): 1 May 2020 (s 2(1) item 1)	—
Private Health Insurance Legislation Amendment Rules (No. 4) 2020	30 June 2020 (F2020L00862)		Sch 1: 1 July 2020 (s 2(1) item 1)	—
Private Health Insurance Legislation Amendment Rules (No. 5) 2020	31 July 2020 (F2020L00978)		Sch 1: 1 Aug 2020 (s 2(1) item 1)	—
Private Health Insurance Legislation Amendment Rules (No. 6) 2020	29 Sept 2020 (F2020L01244)		Sch 1 and 2: 30 Sept 2020 (s 2(1) item 1)	—
Private Health Insurance Legislation Amendment Rules (No. 7) 2020	30 Oct 2020 (F2020L01378)		Sch 1 and 2: 1 Nov 2020 (s 2(1) item 1)	—
Private Health Insurance Legislation Amendment Rules (No. 1) 2021	25 Feb 2021 (F2021L00155)		Sch 1: 1 Mar 2021 (s 2(1) item 1)	—
Private Health Insurance Legislation Amendment Rules (No. 2) 2021	19 Mar 2021 (F2021L00264)		Sch 2: 20 Mar 2021 (s 2(1) item 1)	—
Private Health Insurance Legislation Amendment Rules (No. 3) 2021	25 June 2021 (F2021L00856)		Sch 1: 1 July 2021 (s 2(1) item 1)	—
Private Health Insurance Legislation Amendment Rules (No. 4) 2021	30 June 2021 (F2021L00906)		Sch 2 and 3: 1 July 2021 (s 2(1) item 1)	—
Private Health Insurance Legislation Amendment Rules (No. 5) 2021	17 Sept 2021 (F2021L01295)		Sch 2: 20 Sept 2021 (s 2(1) item 1)	—
Private Health Insurance Legislation Amendment Rules (No. 6) 2021	26 Oct 2021 (F2021L01461)		Sch 2 and 3: 1 Nov 2021 (s 2(1) item 1)	—
Private Health Insurance Legislation Amendment Rules (No. 7) 2021	22 Dec 2021 (F2021L01879)		Sch 2 and 3: 1 Jan 2022 (s 2(1) item 1)	—
Private Health Insurance Legislation Amendment Rules (No. 1) 2022	28 Jan 2022 (F2022L00080)		Sch 2 and 3: 1 Mar 2022 (s 2(1) item 1)	—
Private Health Insurance Legislation Amendment Rules (No. 2) 2022	1 Mar 2022 (F2022L00230)		Sch 2: 1 Mar 2022 (s 2(1) item 1)	—
Private Health Insurance Legislation Amendment Rules (No. 3) 2022	11 Mar 2022 (F2022L00303)		Sch 2: 20 Mar 2022 (s 2(1) item 1)	—
Private Health Insurance Legislation Amendment Rules (No. 4) 2022	31 Mar 2022 (F2022L00462)		1 Apr 2022 (s 2(1) item 1)	—
Private Health Insurance Legislation Amendment Rules (No. 5) 2022	28 Apr 2022 (F2022L00635)		Sch 2 and 3: 1 July 2022 (s 2(1) item 1)	—
Private Health Insurance Legislation Amendment Rules (No. 6) 2022	30 June 2022 (F2022L00897)		Sch 1: 1 July 2022 (s 2(1) item 1)	—
Private Health Insurance Legislation Amendment Rules (No. 7) 2022	30 June 2022 (F2022L00924)		1 July 2022 (s 2(1) item 1)	—
Private Health Insurance Legislation Amendment Rules (No. 8) 2022	5 July 2022 (F2022L00954)		Sch 2: 6 July 2022 (s 2(1) item 1)	—
Private Health Insurance Legislation Amendment Rules (No. 9) 2022	27 July 2022 (F2022L01010)		Sch 1: 1 Aug 2022 (s 2(1) item 1)	—
Private Health Insurance Legislation Amendment Rules (No. 10) 2022	7 Sept 2022 (F2022L01182)		Sch 2: 20 Sept 2022 (s 2(1) item 1)	—
Private Health Insurance Legislation Amendment Rules (No. 11) 2022	29 Sept 2022 (F2022L01279)		1 Oct 2022 (s 2(1) item 1)	—
Private Health Insurance Legislation Amendment Rules (No. 12) 2022	27 Oct 2022 (F2022L01404)		Sch 2: 1 Nov 2022 (s 2(1) item 1)	—
as repealed by
Private Health Insurance Legislation Amendment Rules (No. 13) 2022	31 Oct 2022 (F2022L01417)		Sch 3: 1 Nov 2022 (s 2(1) item 1)	—
Private Health Insurance Legislation Amendment Rules (No. 13) 2022	31 Oct 2022 (F2022L01417)		Sch 2: 1 Nov 2022 (s 2(1) item 1)	—
Private Health Insurance Legislation Amendment Rules (No. 1) 2023	28 Feb 2023 (F2023L00173)		Sch 2: 1 Mar 2023 (s 2(1) item 1)	—
Private Health Insurance Legislation Amendment Rules (No. 3) 2023	16 Mar 2023 (F2023L00232)		17 Mar 2023 (s 2(1) item 1)	—
Private Health Insurance Legislation Amendment Rules (No. 2) 2023	17 Mar 2023 (F2023L00252)		Sch 2: 20 Mar 2023 (s 2(1) item 1)	—
Private Health Insurance Legislation Amendment (Prostheses—Repeal and Consequential Amendments) Rules 2023	29 June 2023 (F2023L00891)		Sch 2 (item 1): 1 July 2023 (s 2(1) item 1)	—
Private Health Insurance Legislation Amendment Rules (No. 4) 2023	29 June 2023 (F2023L00901)		Sch 1: 1 July 2023 (s 2(1) item 1)	—
Private Health Insurance Legislation Amendment Rules (No. 5) 2023	30 June 2023 (F2023L00926)		Sch 2: 1 July 2023 (s 2(1) item 1)	—
Private Health Insurance Legislation Amendment Rules (No. 6) 2023	27 July 2023 (F2023L01036)		28 July 2023 (s 2(1) item 1)	—
Private Health Insurance Legislation Amendment Rules (No. 7) 2023	18 Sept 2023 (F2023L01257)		Sch 2: 20 Sept 2023 (s 2(1) item 1) Sch 3: 1 Nov 2023 (s 2(1) item 2)	—
Private Health Insurance Legislation Amendment Rules (No. 8) 2023	26 Oct 2023 (F2023L01411)		Sch 2: 1 Nov 2023 (s 2(1) item 1)	—
Private Health Insurance Legislation Amendment Rules (No. 1) 2024	16 Feb 2024 (F2024L00179)		Sch 2: 1 Mar 2024 (s 2(1) item 1)	—
Private Health Insurance Legislation Amendment Rules (No. 2) 2024	18 Mar 2024 (F2024L00326)		Sch 2: 20 Mar 2024 (s 2(1) item 1)	—

Endnote 4—Amendment history

Provision affected	How affected
Schedule 1
Part 1, Subclause 2(2)	am. F2012L01264; F2013L01190; F2014L00801; F2015L00926; F2016L01101; F2017L00830
Part 2, Subclause 4(3)	am. F2012L02114; F2012L02151; F2013L01190; F2013L01321; F2014L00801; F2015L01356; F2015L01711; F2015L02118; F2016L00589; F2016L01101 F2016L01665; F2016L01846; F2017L00603; F2017L01401
Part 2, Subclause 5(2)(a)	am. F2017L01401
Part 2, Subclause 6(3)	am F2012L00604; F2012L01264; F2012L02114; F2012L02502; F2013L00497; F2013L01190; F2013L01321; F2014L00801; F2014L01016; F2014L01434; F2015L01356; F2015L02118; F2016L00589; F2016L00979; F2016L01101; F2016L01846; F2017L00461; F2017L00603; F2017L00830; F2017L01401
Schedule 2 Clause 2, Table	rs. F2012L01264; F2013L01190; F2014L00801; F2015L00926; F2016L01101; F2017L00830
Schedule 3
Part 1, Subclause 2(2), Table 1	rs. F2012L01264; F2013L01190; F2014L00801; F2015L00926; F2017L00830
Part 1, Subclause 2(2), Table 2	rs. F2012L01264; F2013L01190; F2014L00801; F2015L00926; F2016L01101; F2017L00830
Part 2, Paragraph 4(1)(a)	am. F2012L00604; F2016L00979; F2016L01101; F2017L01401
Part 2, Paragraph 4 (1)(c)	ad. F2015L01356
Part 2, Subclause 5(1)	am. F2012L00604; F2012L00905; F2012L01264; F2012L02114; F2012L02502; F2013L01321; F2013L01753; F2014L01434; F2015L01356; F2016L00979; F2016L01101; F2016L01665; F2017L00461; F2017L00603; F2017L00830; F2017L01401; F2018L00544
Part 3, Clause 8	am F2012L00604; F2012L00905; F2012L01264; F2012L02114; F2013L00497; F2013L01190; F2013L01321; F2013L01866; F2014L00309; F2014L00801; F2014L01434; F2015L00926; F2015L01356; F2015L02118; F2016L01101; F2016L01665; F2016L01846; F2017L00084; F2017L00603; F2017L01217; F2017L01401; F2017L01527; F2018L00544
Schedule 4
Clause 6, Table 1	am. F2012L00604; F2012L01264; F2012L01887; F2012L02111; F2013L00497; F2013L01190; F2014L00309; F2014L00801; F2014L01235; F2015L00324; F2015L00926; F2015L01451; F2016L00352; F2016L01101; F2016L01446; F2016L01463; F2017L00242; F2017L00830; F2017L00894; F2017L01217; F2018L00323 rs. F2013L01714
Clause 6, Table 2	am. F2012L00604; F2012L01887; F2013L00497; F2013L01714; F2014L00309; F2014L01235; F2015L00324; F2015L01451: F2016L00352; F2016L01446; F2017L00242; F2017L01217; F2018L00323
Schedule 5
Subclause 1(1)	am. F2013L00003
Clause 4, Table	am. F2011L02731; F2012L00604; F2012L00822; F2012L01264; F2012L01887; F2012L02502 rs. F2013L00003
Subclause 4(1)	am. F2013L00497; F2013L01190; F2013L02113; F2014L00309; F2014L00801; F2014L01016; F2014L01235; F2014L01775; F2015L00324; F2015L00926; F2015L01451; F2015L02118; F2016L00352; F2016L01101; F2016L01446; F2016L01967; F2017L00242; F2017L00830; F2017L01217; F2017L01603; F2018L00323 rs. F2013L01753

Endnote 4—Amendment history from 1 July 2018

Provision affected	How affected
Part 1
s 2.....................	rep LIA s 48D
Schedule 1
Schedule 1................	am F2018L00927; F2018L01474; F2018L01797; F2019L00925; F2019L01384; F2020L00190; F2020L00539; F2020L00862; F2020L01244; F2020L01378; F2021L00155; F2021L00856; F2021L00906; F2021L01461; F2022L00080; F2022L00635; F2022L00897; F2022L00954; F2022L01404; F2022L01417; F2023L00901; F2023L00926; F2023L01257; F2023L01411; F2024L00179
Schedule 2
Schedule 2 heading	rs F2020L00862
Schedule 2................	am F2018L00927; F2019L00925; F2020L00862; F2021L00856; F2022L00897; F2023L00901
Schedule 3
Schedule 3................	am F2018L00927; F2018L01474; F2018L01797; F2019L00048; F2019L00493; F2019L00639; F2019L00925; F2019L01384; F2020L00190; F2020L00539; F2020L00862; F2020L00978; F2020L01244; F2020L01378; F2021L00155; F2021L00856; F2021L00906; F2021L01461; F2021L01879; F2022L00080; F2022L00230
	ed C75
	am F2022L00462; F2022L00635; F2022L00897; F2022L00924; F2022L01010; F2022L01279; F2022L01404; F2022L01417; F2023L00232; F2023L00901; F2023L00926; F2023L01036; F2023L01257; F2023L01411; F2024L00179
Schedule 4
Schedule 4................	am F2018L00927; F2018L01315; F2019L00327; F2019L00925; F2019L01221; F2020L00272; F2020L00862; F2021L00264; F2021L00856; F2021L01295; F2022L00303; F2022L00897; F2022L01182; F2023L00252; F2023L00901; F2023L01257; F2024L00326
	ed C92
Schedule 5
Schedule 5................	am F2018L00927; F2018L01315; F2018L01797
	ed C53
	am F2018L01414; F2023L00891

Endnote 5—Editorial changes

In preparing this compilation for registration, the following kinds of editorial change(s) were made under the Legislation Act 2003.

Clause 6 of Schedule 4 (Table 2)

Kind of editorial change

Give effect to the misdescribed amendment as intended

Details of editorial change

Schedule 2 item 4 of the Private Health Insurance Legislation Amendment Rules (No. 2) 2024 provides as follows:

4 Clause 6 of Schedule 4 (Table 2, table item dealing with Private hospitals, column headed “Minimum benefit per night”)

Omit “$36.90”, substitute “$35.55”.

A column headed “Minimum benefit per night” does not appear in Table 2 in clause 6 of Schedule 4, as the table does not contain table column headings. However, a table entry for Private hospitals does appear.

This compilation was editorially changed to omit “$36.90” and substitute “$35.55” in the Table 2 entry for Private hospitals in clause 6 of Schedule 4 to give effect to the misdescribed amendment as intended.

Table 2‑Same day accommodation for private patients at private hospitals in all States/Territories
Column 1	Column 2	Column 3	Column 4	Column 5
Private hospitals	Band 1	Band 2	Band 3	Band 4
All States and Territories	$264	$332	$403	$472