73295 | Detection of germline BRCA1 or BRCA2 pathogenic or likely pathogenic gene variants, requested by a specialist or consultant physician, to determine eligibility for a relevant treatment under the Pharmaceutical Benefits Scheme (PBS), in a patient with: (a) advanced (FIGO III‑IV) high‑grade serous or high‑grade epithelial ovarian, fallopian tube or primary peritoneal cancer for whom testing of tumour tissue is not feasible; or (b) breast cancer. Applicable once per lifetime | 1,200.00 |
73301 | A test of tumour tissue from a patient with advanced (FIGO III‑IV), high grade serous or high grade epithelial ovarian, fallopian tube or primary peritoneal cancer, requested by a specialist or consultant physician, to determine eligibility relating to BRCA status for access to treatment with a poly (adenosine diphosphate [ADP]‑ribose) polymerase (PARP) inhibitor under the Pharmaceutical Benefits Scheme (PBS) Applicable once per primary tumour diagnosis | 1,200.00 |
73302 | Characterisation of germline gene variants including copy number variants, in BRCA1 or BRCA2 genes, in a patient who has had a pathogenic or likely pathogenic variant identified in either gene by tumour testing and who has not previously received a service to which items 73295, 73296 or 73297 applies, requested by a specialist or consultant physician Applicable once per primary tumour diagnosis Note: Items 73296 and 73297 are in the pathology services table. | 400.00 |
73303 | A test of tumour tissue from a patient with metastatic castration‑resistant prostate cancer, including subsequent characterisation of germline gene variants should tumour tissue testing undertaken during the same service be inconclusive, requested by a specialist or consultant physician, to determine eligibility relating to BRCA status for access to a relevant treatment under the Pharmaceutical Benefits Scheme; Applicable once per primary tumour diagnosis | 1,000.00 |
73304 | Detection of germline BRCA1 or BRCA2 pathogenic or likely pathogenic gene variants, in a patient with metastatic castration‑resistant prostate cancer, for whom testing of tumour tissue is not clinically feasible, requested by a specialist or consultant physician, to determine eligibility for a relevant treatment under the Pharmaceutical Benefits Scheme; Applicable once per lifetime | 1,000.00 |
73307 | A test of tumour tissue from a patient with advanced (FIGO III‑IV), high‑grade serous or other high‑grade ovarian, fallopian tube or primary peritoneal carcinoma, requested by a specialist or consultant physician, if the test is: (a) to determine eligibility with respect to homologous recombination deficiency (HRD) status, including BRCA1 or BRCA2 status, to provide access to poly (adenosine diphosphate [ADP]‑ribose) polymerase (PARP) inhibitor therapy under the Pharmaceutical Benefits Scheme; and (b) including a service described in item 73301 Applicable once per primary tumour diagnosis | 3,000.00 |
73332 | An in situ hybridisation (ISH) test of tumour tissue from a patient with breast cancer requested by, or on the advice of, a specialist or consultant physician who manages the treatment of the patient to determine if the requirements relating to human epidermal growth factor receptor 2 (HER2) gene amplification for access to trastuzumab under the Pharmaceutical Benefits Scheme or the Herceptin Program are fulfilled. | 315.40 |
73336 | A test of tumour tissue from a patient with stage III or stage IV metastatic cutaneous melanoma, requested by, or on behalf of, a specialist or consultant physician, to determine if the requirements relating to BRAF V600 mutation status for access to dabrafenib, vemurafenib or encorafenib under the Pharmaceutical Benefits Scheme are fulfilled | 230.95 |
73337 | A test of tumour tissue from a patient with a new diagnosis of non‑small cell lung cancer, shown to have non‑squamous histology or histology not otherwise specified, requested by, or on behalf of, a specialist or consultant physician, if the test is: (a) to determine if requirements relating to epidermal growth factor receptor (EGFR) gene status for access to an immunotherapy listed under the Pharmaceutical Benefits Scheme (PBS) are fulfilled; and (b) not associated with a service to which item 73437 or 73438 applies | 397.35 |
73338 | A test of tumour tissue from a patient with metastatic colorectal cancer (stage IV), requested by a specialist or consultant physician, to determine if: (a) requirements relating to rat sarcoma oncogene (RAS) gene variant status for access to cetuximab or panitumumab under the Pharmaceutical Benefits Scheme are fulfilled, if: (i) the test is conducted for all clinically relevant mutations on KRAS exons 2, 3 and 4 and NRAS exons 2, 3, and 4; or (ii) a clinically‑relevant RAS variant is detected; and, in cases where no RAS variant is detected: (b) the requirements relating to BRAF V600 gene variant status for access to encorafenib under the Pharmaceutical Benefits Scheme are fulfilled. | 362.60 |
73341 | Fluorescence in situ hybridisation (FISH) test of tumour tissue from a patient with a new diagnosis of locally advanced or metastatic non‑small cell lung cancer, which is of non‑squamous histology or histology not otherwise specified, with documented evidence of anaplastic lymphoma kinase (ALK) immunoreactivity by immunohistochemical (IHC) examination giving a staining intensity score > 0, and with documented absence of activating mutations of the epidermal growth factor receptor (EGFR) gene, requested by a specialist or consultant physician, if the test is: (a) to determine if requirements relating to ALK gene rearrangement status for access to an immunotherapy listed under the Pharmaceutical Benefits Scheme (PBS) are fulfilled; and (b) not associated with a service to which item 73437 or 73439 applies | 400.00 |
73342 | An in situ hybridisation (ISH) test of tumour tissue from a patient with metastatic adenocarcinoma of the stomach or gastro‑oesophageal junction, with documented evidence of human epidermal growth factor receptor 2 (HER2) overexpression by immunohistochemical (IHC) examination giving a staining intensity score of 2+ or 3+ on the same tumour tissue sample, requested by, or on the advice of, a specialist or consultant physician who manages the treatment of the patient to determine if the requirements relating to HER2 gene amplification for access to trastuzumab under the Pharmaceutical Benefits Scheme are fulfilled. | 315.40 |
73344 | Fluorescence in situ hybridization (FISH) test of tumour tissue from a patient with a new diagnosis of locally advanced or metastatic non‑small cell lung cancer, which is of non‑squamous histology or histology not otherwise specified, with documented evidence of ROS proto‑oncogene 1 (ROS1) immunoreactivity by immunohistochemical (IHC) examination giving a staining intensity score of 2+ or 3+; and with documented absence of both activating mutations of the epidermal growth factor receptor (EGFR) gene and anaplastic lymphoma kinase (ALK) immunoreactivity by IHC, requested by a specialist or consultant physician, if the test is: (a) to determine if requirements relating to ROS1 gene arrangement status for access to an immunotherapy listed under the Pharmaceutical Benefits Scheme (PBS) are fulfilled: and (b) not associated with a service to which item 73437 or 73439 applies | 400.00 |
73351 | A test of tumour tissue that is derived from a new sample from a patient with locally advanced (Stage IIIb) or metastatic (Stage IV) non‑small cell lung cancer (NSCLC), who has progressed on or after treatment with an epidermal growth factor receptor tyrosine kinase inhibitor (EGFR TKI). The test is to be requested by a specialist or consultant physician, to determine if the requirements relating to EGFR T790M gene status for access to osimertinib under the Pharmaceutical Benefits Scheme are fulfilled. | 397.35 |
73430 | Fluorescence in‑situ hybridisation (FISH) test of tumour tissue from a patient with locally advanced or metastatic solid tumour, if: (a) the tumour is at risk of being caused by a neurotrophic receptor tyrosine kinase (NTRK) gene fusion as determined by either: (i) occurring in a child less than 18 years of age; or (ii) being mammary analogue secretory carcinoma of the salivary gland; or (iii) being secretory breast carcinoma; and (b) the test is requested by a specialist or consultant physician to determine if requirements relating to NTRK gene fusion status for access to a tropomyosin receptor kinase (Trk) inhibitor under the Pharmaceutical Benefits Scheme are fulfilled This item cannot be claimed if item 73433 has been claimed for the same patient during the same cancer diagnosis Applicable only once per cancer diagnosis | 400.00 |
73431 | Two tests described in item 73430 | 533.00 |
73432 | Three or more tests described in item 73430 | 667.00 |
73433 | Next generation sequencing (NGS) test for neurotrophic receptor tyrosine kinase (NTRK1, NTRK2, NTRK3) fusions by RNA or DNA in tumour tissue from a patient with locally advanced or metastatic solid tumour, if: (a) the tumour is at risk of being caused by an NTRK gene fusion as determined by either: (i) occurring in a child less than 18 years of age; or (ii) being mammary analogue secretory carcinoma of the salivary gland; or (iii) being secretory breast carcinoma; (b) the test is requested by a specialist or consultant physician to determine if requirements relating to NTRK gene fusion status for access to a tropomyosin receptor kinase (Trk) inhibitor under the Pharmaceutical Benefits Scheme are fulfilled This item cannot be claimed if item 73430 has been claimed for the same patient during the same cancer diagnosis Applicable only once per cancer diagnosis | 1,000.00 |
73436 | A test of tumour tissue from a patient with a new diagnosis of locally advanced or metastatic non‑small cell lung cancer requested by, or on behalf of, a specialist or consultant physician, if the test is: (a) to determine if the requirements relating to MET proto‑oncogene, receptor tyrosine kinase (MET) exon 14 skipping alterations (METex14sk) status for access to an immunotherapy listed under the Pharmaceutical Benefits Scheme (PBS) are fulfilled: and (b) not associated with a service to which item 73437 or 73438 applies | 397.35 |
73437 | A nucleic acid‑based multi‑gene panel test of tumour tissue from a patient with a new diagnosis of non‑small cell lung cancer requested by, or on behalf of, a specialist or consultant physician, if the test is: (a) to detect variants in at least EGFR, BRAF, KRAS and MET exon 14 to determine access to specific therapies relevant to these variants listed on the Pharmaceutical Benefits Scheme (PBS); and (b) to detect the fusion status of at least ALK, ROS1, RET, NTRK1, NTRK2 and NTRK3; and (i) to determine access to specific therapies relevant to these variants listed on the PBS; or (ii) determine if the requirements relating to EGFR, ALK and ROS1 status for access immunotherapies listed on the PBS are fulfilled; and (c) not associated with a service to which item 73438, 73439, 73337, 73341, 73344, 73436 or 73351 applies | 1,247.00 |
73438 | A DNA‑based multi‑gene panel test of tumour tissue from a patient with a new diagnosis of non‑small cell lung cancer requested by, or on behalf of, a specialist or consultant physician, if the test is: (a) to detect variants in at least EGFR, BRAF, KRAS and MET exon 14; and (b) to determine access to specific therapies relevant to these variants listed on the Pharmaceutical Benefits Scheme (PBS); or (c) to determine if the requirements relating to EGFR status for access to immunotherapies listed on the PBS are fulfilled; and (d) not associated with a service to which item 73437, 73337, 73436 or 73351 applies | 682.35 |
73439 | A nucleic acid‑based multi‑gene panel test of tumour tissue from a patient with a new diagnosis of non‑small cell lung cancer and with documented absence of activating variants of the EGFR gene, KRAS, BRAF and MET exon14, requested by, or on behalf of, a specialist or consultant physician, if the test is: (a) to determine the fusion status of at least ALK, ROS1, RET, NTRK1, NTRK2, and NTRK3 to determine access to specific therapies relevant to these variants listed on the Pharmaceutical Benefits Scheme (PBS) are fulfilled; or (b) to determine if the requirements relating to ALK and ROS1 status for access to immunotherapies listed on the PBS are fulfilled; and (c) not associated with a service to which item 73437, 73341, 73344 or 73351 applies | 682.35 |
