Private Health Insurance (Prostheses) Rules 2016 (No. 4)

made under item 4 of section 333-20 of the

Private Health Insurance Act 2007

Compilation No. 2

Compilation date:    20 February 2017

Includes amendments up to: F2017L00089

Registered:    20 February 2017

This compilation is in 6 volumes

Volume 1: Parts 1–3

Volume 2: Schedule, Part A (Categories 01–05)

Volume 3: Schedule, Part A (Category 06)

Volume 4: Schedule, Part A (Categories 07–08)

Volume 5: Schedule, Part A (Categories 09–10)

Volume 6: Schedule, Part A (Categories 11–13)

Volume 7: Schedule, Part B - Human Tissue List

Volume 8: Schedule, Part C - Other Prostheses

Volume 9: Endnotes

Each volume has its own contents

About this compilation

This compilation

This is a compilation of the Private Health Insurance (Prostheses) Rules 2016 (No. 4) that shows the text of the law as amended and in force on 20 February 2017 (the compilation date).

The notes at the end of this compilation (the endnotes) include information about amending laws and the amendment history of provisions of the compiled law.

Uncommenced amendments

The effect of uncommenced amendments is not shown in the text of the compiled law. Any uncommenced amendments affecting the law are accessible on the Legislation Register (www.legislation.gov.au). The details of amendments made up to, but not commenced at, the compilation date are underlined in the endnotes. For more information on any uncommenced amendments, see the series page on the Legislation Register for the compiled law.

Application, saving and transitional provisions for provisions and amendments

If the operation of a provision or amendment of the compiled law is affected by an application, saving or transitional provision that is not included in this compilation, details are included in the endnotes.

Editorial changes

For more information about any editorial changes made in this compilation, see the endnotes.

Modifications

If the compiled law is modified by another law, the compiled law operates as modified but the modification does not amend the text of the law. Accordingly, this compilation does not show the text of the compiled law as modified. For more information on any modifications, see the series page on the Legislation Register for the compiled law.

Self-repealing provisions

If a provision of the compiled law has been repealed in accordance with a provision of the law, details are included in the endnotes. 

PART B - Human Tissue List September 2016

Billing Code

Facility

Minimum Benefit

Maximum Benefit

CARDIO-THORACIC

Conduit - Aortic

TBV56

Donor Tissue Bank of Victoria

1749

Conduit - Aortic + Valve

QHV09

The Prince Charles Hospital - Queensland Heart Valve Bank

6962

Conduit - Arterial

SHV03

Sydney Heart Valve Bank, St. Vincent's Hospital

2581

Conduit - Pulmonary

TBV03

Donor Tissue Bank of Victoria

1749

Conduit - Pulmonary + Valve

QHV08

The Prince Charles Hospital - Queensland Heart Valve Bank

7294

Conduit - Pulmonary large

Patch - Pericardium

QHV05

The Prince Charles Hospital - Queensland Heart Valve Bank

2116

Patch - Tricuspid

QHV10

The Prince Charles Hospital - Queensland Heart Valve Bank

6962

Valve - Pulmonary

DERMATOLOGIC

Skin < 25cm² - acellular dermal matrix allograft from human origin

SYN03

Johnson & Johnson Medical Pty Ltd t/a DePuy Synthes

2200

Skin > 300cm² - acellular dermal matrix allograft from human origin

SYN07

Johnson & Johnson Medical Pty Ltd t/a DePuy Synthes

27000

Skin 100cm² - frozen skin graft from human origin

QBB72

The Queensland Bone Bank

527

Skin 121 to 300cm² - acellular dermal matrix allograft from human origin

SYN06

Johnson & Johnson Medical Pty Ltd t/a DePuy Synthes

14000

Skin 200cm² - frozen skin graft from human origin

QBB73

The Queensland Bone Bank

779

Skin 26 to 60cm² - acellular dermal matrix allograft from human origin

SYN04

Johnson & Johnson Medical Pty Ltd t/a DePuy Synthes

3500

Skin 50cm² - frozen skin graft from human origin

QBB71

The Queensland Bone Bank

274

Skin 61 to 120cm² - acellular dermal matrix allograft from human origin

SYN05

Johnson & Johnson Medical Pty Ltd t/a DePuy Synthes

5700

OPHTHALMIC

Amniotic Membrane

Cornea for Endothelial Keratoplasty

Cornea for Endothelial Lamellar Keratoplasty

LEM04

Lions Eye Donation Service

2660

Cornea For Lamellar

ORTHOPAEDIC

Autologous Skull Flap

Autologous Skull Flap - processed

QBB56

The Queensland Bone Bank

2195

Bone - Cancellous Bone Matrix, Lyophilised 40cc

TBV52

Donor Tissue Bank of Victoria

683

Bone - Cancellous Bone Matrix, Lyophilised 80cc

TBV53

Donor Tissue Bank of Victoria

1364

Bone - Cancellous Crunch 15cc

NBB62

New South Wales Bone Bank

1169

Bone - Cancellous Crunch 30cc

NBB61

New South Wales Bone Bank

2131

Bone - Cancellous Crunch 60cc

NBB60

New South Wales Bone Bank

3232

Bone - Cancellous Cubes (6) Freeze Dried

QBB09

The Queensland Bone Bank

1778

Bone - Cancellous Strips (2) Freeze Dried

QBB10

The Queensland Bone Bank

751

Bone - Chips/cubes 40cc

TBV09

Donor Tissue Bank of Victoria

1394

Bone - Chips/cubes 80cc

TBV10

Donor Tissue Bank of Victoria

2420

Bone - Cortico-Cancellous Crunch (40/60) 15cc

NBB65

New South Wales Bone Bank

1169

Bone - Cortico-Cancellous Crunch (40/60) 30cc

NBB64

New South Wales Bone Bank

2131

Bone - Cortico-Cancellous Crunch (40/60) 60cc

NBB63

New South Wales Bone Bank

3232

Bone - Demineralised Bone Matrix, DBX Putty, 10cc

SYN02

Johnson & Johnson Medical Pty Ltd t/a DePuy Synthes

3400

Bone - Demineralised Bone Matrix, DBX Putty, 5cc

SYN01

Johnson & Johnson Medical Pty Ltd t/a DePuy Synthes

2650

Bone - Demineralised Bone Matrix, Lyophilised 10g

TBV55

Donor Tissue Bank of Victoria

1157

Bone - Demineralised Bone Matrix, Lyophilised 5g

TBV54

Donor Tissue Bank of Victoria

578

Bone - Milled <30g Freeze Dried

PBT37

Perth Bone and Tissue Bank

750

Bone - Milled <5 gr (<10cc equivalent)

PBT62

Perth Bone and Tissue Bank

750

Bone - Milled >50gr (100cc equivalent)

PBT10

Perth Bone and Tissue Bank

4250

Bone - Milled 10-19 gr (20-38cc equivalent)

PBT64

Perth Bone and Tissue Bank

2250

Bone - Milled 20-29gr (40-58cc equivalent)

PBT08

Perth Bone and Tissue Bank

3150

Bone - Milled 20g

QBB45

The Queensland Bone Bank

2202

Bone - Milled 20g Freeze Dried

QBB03

The Queensland Bone Bank

2789

Bone - Milled 30 - 50gr (60 - 100cc equivalent)

PBT09

Perth Bone and Tissue Bank

3750

Bone - Milled 30-50g Freeze Dried

PBT38

Perth Bone and Tissue Bank

900

Bone - Milled 40cc

TBV11

Donor Tissue Bank of Victoria

1618

Bone - Milled 5-9 gr (10-18cc equivalent)

PBT63

Perth Bone and Tissue Bank

2000

Bone - Milled 80cc

TBV12

Donor Tissue Bank of Victoria

2690

Bone - Milled Femoral Head

AUB02

Australian Biotechnologies

2457

Bone - Ronguered Chips

QBB68

The Queensland Bone Bank

2235

Bone - Ronguered Chips Freeze Dried

QBB67

The Queensland Bone Bank

2789

Bone – Cortico-Cancellous Crunch <20g Sterile

AUB08

Australian Biotechnologies

2215

Bone – Cortico-Cancellous Crunch <30g

AUB04

Australian Biotechnologies

2070

Bone Plug/Dowel - Cancellous

Bone Plug/Dowel - Tricortical

TBV08

Donor Tissue Bank of Victoria

1133

Bone, Cancellous Chips - 15cc

SYN10

Johnson & Johnson Medical Pty Ltd t/a DePuy Synthes

1250

Bone, Cancellous Chips - 30cc

SYN12

Johnson & Johnson Medical Pty Ltd t/a DePuy Synthes

1700

Bone, Cancellous Granules - 15cc

SYN11

Johnson & Johnson Medical Pty Ltd t/a DePuy Synthes

1250

Bone, Cancellous Granules - 30cc

SYN13

Johnson & Johnson Medical Pty Ltd t/a DePuy Synthes

1700

Cartilage - costal segments

Cortical Strut >15 - 20cm

PBT07

Perth Bone and Tissue Bank

2700

Cortical Strut >20cm

PBT48

Perth Bone and Tissue Bank

3100

Cortical Struts 10-15cm

PBT06

Perth Bone and Tissue Bank

2000

DBX Putty - 1.00cc

SYN08

Johnson & Johnson Medical Pty Ltd t/a DePuy Synthes

1450

DBX Putty - 2.5cc

SYN09

Johnson & Johnson Medical Pty Ltd t/a DePuy Synthes

1800

Disc - Freeze Dried

Fascia Lata - Large (15cm x 10cm)

PBT15

Perth Bone and Tissue Bank

1590

Fascia Lata - per sq cm

QBB11

The Queensland Bone Bank 6

Fascia Lata - Small (10cm x 5cm)

Femoral Head - Autologous

QBB61

The Queensland Bone Bank

2390

Femoral Head - Freeze Dried

QBB28

The Queensland Bone Bank

2390

Femoral Hemi-condyle

QBB66

The Queensland Bone Bank

3106

Femoral Shaft - Half

NBB57

New South Wales Bone Bank

3595

Femoral Shaft - Middle Third

Femoral Shaft - Segment

NBB56

New South Wales Bone Bank

2183

Femoral Shaft - Third

NBB55

New South Wales Bone Bank

2183

Femoral Shaft/Tibial Shaft - Middle third

PBT19

Perth Bone and Tissue Bank

3200

Femur - Distal (Shaft & Condyles)

Femur - Entire head removed

PBT18

Perth Bone and Tissue Bank

8000

Femur - Proximal (shaft, trochanter, neck)

Femur - Proximal half

Femur - Proximal third

NBB14

New South Wales Bone Bank

1690

Femur - Proximal with femoral head