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If a provision of the compiled law has been repealed in accordance with a provision of the law, details are included in the endnotes.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 C - Other Prostheses September 2016
Billing Code Product Name Description Size
3.2.3 - Infusion Pumps, Battery Powered
3.2.3.2 - Insulin infusion pump (as 3.2.3.1) with integral calculator to determine boluses and ac
Minimum
Benefit
Maximum
Benefit
Condition
Managing Diabetes Pty Ltd
DF001 DANAIIS Insulin Pump Continuous insulin infusion pump 75mm x 45mm x 19mm $4,000.00
DE, SS
Australasian Medical & Scientific Ltd
AN011 Animas Vibe Insulin Pump Ambulatory insulin infusion pump with real-
time continuous glucose monitoring (CGM) capability
8.26 x 5.08 x 2.18cm $8,950.00
DF002 DANAR Insulin Pump The DANAR Insulin Pump is a small device
about the size of a pager. It holds up to 300 units of insulin, which is delivered continuously through a small tube to the patient. The DANAR Insulin Pump also has an integrated blood glucose meter and remote control via bluetooth communication.
75 x 45 x 19mm, 60grams $8,950.00
RB001 | Accu-Chek Combo System | Insulin delivery device capable of remotely receiving and acting on information about blood glucose levels, performing bolus calculation and bolus advice on additional parameters than what is normally provided. | The Accu-Chek Combo System is only available in one size. | $8,950.00 |
RB002 | ACCU-CHEK Insight System | Insulin delivery device capable of remotely receiving and acting on information about blood glucose levels, performing bolus calculation and bolus advice on additional parameters than what is normally provided. | No variable sizes offered. Only one system provided. | $8,950.00 |
| Minimum | Maximum |
| ||
illing Code Product Name | Description | Size | Benefit | Benefit | Condition |
Medtronic Australasia Pty Ltd
MC839 | Medtronic MiniMed Insulin Infusion Pump | Paradigm Veo Model MMT-554. 'Smart' Insulin Pump with REAL-Time continuous glucose monitoring capability, incorporating a low glucose suspend and with remote control. | 5.1 x 7.6 x 2.0cm | $9,500.00 |
MC840 | Medtronic MiniMed Insulin Infusion | Paradigm Veo Model MMT-754. 'Smart' | 5.1 x 9.4 x 2.0cm | $9,500.00 |
| Pump | Insulin Pump with REAL-Time continuous |
|
|
|
| glucose monitoring capability, incorporating a |
|
|
|
| low glucose suspend and with remote control. |
|
|
MI150 | MiniMed 640G Insulin Pump | MiniMed 640G Insulin Pump with SmartGuard | 1.8ml and 3.0ml | $9,500.00 |
|
| Technology and continuous glucose monitoring |
|
|
|
| capability, designed to automatically suspend |
|
|
|
| insulin delivery before dangerous lows occur, |
|
|
|
| and automatically resume after levels recover. |
|
|
Billing Code Product Name Description Size
08.14.01 - Implantable Cardiac Event Recorders
Medtronic Australasia Pty Ltd
Benefit
Benefit
Condition
MC763 | Reveal XT | Reveal XT Insertable Cardiac Monitor | 61 x 19 x 8 mm with a volume of 9cc | $3,900.00 |
MC768 | Reveal DX | Insertable Cardiac Monitor | 61 x 19 x 8 mm with a volume of 9cc | $3,900.00 |
St Jude Medical Australia Pty Ltd
SJ152 SJM Confirm Model DM2102 Implantable cardiac monitor with atrial
fibrillation monitoring.
6.5cc, 12g $3,900.00
Biotronik Australia Pty Ltd
BT153 BioMonitor Implantable cardiac monitor for continuous remote monitoring of patients with Atrial Fibrillation (AF) or unexplained syncope
53.3mm x 42.7mm x 7.1mm, 26 grams $3,900.00
BT186 BioMonitor 2-AF Implantable Cardiac Monitor
Implantable cardiac monitor for continuous remote monitoring of patients with Atrial Fibrillation (AF) or unexplained syncope
88.4 mm x 15.2 mm x 6.2 mm , 10.1g , 5cm3 $3,900.00
MI141 Reveal LINQ Insertable Cardiac Monitor 45 x 7 x 3.5mm, 1.18cc $3,900.00
BT187 CardioMessenger Smart 3G Bedside/Remote transmitter w/ pacemaker/ICD
device life network access to Biotronik standard home monitoring data management service.
Length - 130mm, Width - 65mm, Height - 13mm Weight - 75g
$1,960.00
Billing Code Product Name Description Size
Livanova Australia Pty Limited
Benefit
Benefit
Condition
SA173 Smartview Remote Monitoring
Solution
The Smartview PSTN monitor and Smartview Monitor GPRS - Pacemaker programmer is designed to allow physicians and nurses following patients with a Sorin PARADYMTM RF or INTENSIA family of ICD and CRT-D devices to access valuable cardiac data and alert messages from the device while the patient is at home.
Single Device Product $1,960.00
MI196 MyCareLink Smart Patient Reader Electronic cellular patient reader which gathers
and transmits cardiac information from an implanted cardiac device (CIED) to your health care professional for assessment.
SJ369 Merlin@Home wireless Home cardiac monitor (RF) with landline,
cellular and broadband connectivity
SJ370 Merlin@Home Inductive Home cardiac monitor (inductive) with
landline, cellular and broadband connectivity
One size only $1,960.00
one size $1,960.00
one size $1,960.00
Biotronik Australia Pty Ltd
BT179 Cardio Messenger II-S 3G Bedside/Remote transmitter w/ ICD device life
network access to Biotronik standard home monitoring data management service.
Bedside Device - 203 x 136mm x 80mm, 450 grams
$1,960.00
BS294 Latitude Communicator Remote patient management system for
implanted cardiac devices
One size only $1,960.00
MI180 MyCareLink Patient Monitor Electronic cellular patient monitor which
gathers and transmits cardiac information from an implanted cardiac device (CIED) to your health care professional for assessment.
One size $1,960.00
Grand Total: 22 Records