Commonwealth Coat of Arms of Australia

Health Insurance (Section 3C Pathology Services – COVID19) Determination 2020

made under subsection 3C(1) of the

Health Insurance Act 1973

Compilation No. 14

Compilation date: 1 January 2023

Includes amendments up to: F2022L01632

Registered: 17 January 2023

About this compilation

This compilation

This is a compilation of the Health Insurance (Section 3C Pathology Services – COVID-19) Determination 2020 that shows the text of the law as amended and in force on 1 January 2023 (the compilation date).

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

Uncommenced amendments

The effect of uncommenced amendments is not shown in the text of the compiled law. Any uncommenced amendments affecting the law are accessible on the 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.

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If a provision of the compiled law has been repealed in accordance with a provision of the law, details are included in the endnotes.

 

 

 

Contents

1. Name

3. Cessation

4. Authority

5. Definitions

6. Treatment of relevant services

7. Application of provisions of the pathology services table

Schedule 1 – relevant services

Endnotes

Endnote 1—About the endnotes

Endnote 2—Abbreviation key

Endnote 3—Legislation history

Endnote 4—Amendment history

1.  Name

 This instrument is the Health Insurance (Section 3C Pathology Services – COVID19) Determination 2020

3.  Cessation

 Unless earlier revoked this instrument ceases on 31 December 2023 at 11.59pm.

4.  Authority

 This instrument is made under subsection 3C(1) of the Health Insurance Act 1973.

5.  Definitions

(1) In this instrument:

Act means the Health Insurance Act 1973.

bulkbilled: a pathology service is bulkbilled if:

(a)  a medicare benefit is payable to a person in relation to the service; and

(b)  under an agreement entered into under section 20A of the Act:

   (i)  the person assigns to the practitioner by whom, or on whose behalf, the service is provided, the person’s right to the payment of the medicare benefit; and

   (ii) the practitioner accepts the assignment in full payment of the practitioner’s fee for the service provided.

relevant provisions means all provisions, of the Act and regulations made under the Act, and the National Health Act 1953 and regulations made under the National Health Act 1953, relating to pathology services, professional services or items.

relevant service means a health service, as defined in subsection 3C(8) of the Act, that is specified in a Schedule.

pathology services table means the table prescribed under subsection 4A(1) of the Act.

prescribed laboratory has the meaning given by clause 4.1 of the pathology services table.

Schedule means a Schedule to this instrument.

Note:  The following terms are defined in subsection 3(1) of the Act:

 clinically relevant service;

 hospital;

 item;

 private patient;

 professional service;

 recognised hospital;

 schedule fee.

(2) Unless the contrary intention appears, a reference in this instrument to a provision of the Act or the National Health Act 1953 or regulations made under the Act or under the National Health Act 1953 as applied, adopted or incorporated in relation to specifying a matter is a reference to those provisions as in force from time to time and any other reference to provisions of an Act or regulations is a reference to those provisions as in force from time to time.

6.  Treatment of relevant services

(1) For a service to which an item in Schedule 1 applies, a relevant service, provided in accordance with this instrument and as a clinically relevant service, is to be treated, for the relevant provisions, as if:

(a) it were both a professional service and a pathology service; and

(b) there were an item in the pathology services table that:

(i) related to the service; and

(ii) specified for the service a fee in relation to each State, being the fee specified in the Schedule in relation to the service.

7.  Application of provisions of the pathology services table

(1) Clause 1.2.9 of the pathology services table shall have effect as if items in Schedule 1 of this Determination were specified in paragraph 1.2.9(2)(a) of the pathology services table.

Schedule 1 – relevant services

 

Group P3 – Microbiology 

 

Column 1

Column 2

Column 3

Item

Pathology service

Fee ($)

69506

Detection of a SARSCoV2 nucleic acid if:

(a) the person is a private patient in a recognised hospital; or

(b) the person receives a bulkbilled service from a prescribed laboratory

34.90

69507

Detection of a viral, fungal, atypical pneumonia pathogen or Bordetella species nucleic acid from a nasal swab, throat swab, nasopharyngeal aspirate and/or lower respiratory tract sample, including a service described in 69506, if:

(a) the person is a private patient in a recognised hospital; or

(b) the person receives a bulkbilled service from a prescribed laboratory

2 to 4 tests

37.85

69508

5 to 8 tests described in 69507

40.85

69509

9 to 12 tests described in 69507

43.80

69510

13 or more tests described in item 69507

46.75

69511

Detection of a SARSCoV2 nucleic acid if:

(a) the person is a private patient in a hospital other than a recognised hospital; or

(b) the person receives a bulkbilled service not covered by item 69506

68.85

69512

Detection of a viral, fungal, atypical pneumonia pathogen or Bordetella species nucleic acid from a nasal swab, throat swab, nasopharyngeal aspirate and/or lower respiratory tract sample, including a service described in 69511, if:

(a) the person is a private patient in a hospital other than a recognised hospital; or

(b) the person receives a bulkbilled service not covered by item 69507

2 to 4 tests

74.75

69513

5 to 8 tests described in 69512

80.65

69514

9 to 12 tests described in 69512

86.55

69515

13 or more tests described in item 69512

92.45

 

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

/subsubparagraph(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

SubCh = SubChapter(s)

cannot be given effect

SubPt = Subpart(s)

mod = modified/modification

underlining = whole or part not

No. = Number(s)

commenced or to be commenced

 

Endnote 3—Legislation history

 

Name

Registration

Commencement

Application, saving and transitional provisions

Health Insurance (Section 3C Pathology Services – COVID19) Determination 2020

12 Mar 2020 (F2020L00250)

13 Mar 2020 (s 2(1) item 1)

 

Health Insurance (Section 3C Pathology Services – COVID19) Amendment Determination 2020

16 Mar 2020 (F2020L00258)

17 Mar 2020 (s 2(1) item 1)

Health Insurance (Section 3C Pathology Services – COVID19) Amendment (No. 2) Determination 2020

31 Mar 2020 (F2020L00373)

1 Apr 2020 (s 2(1) item 1)

Health Insurance (Section 3C Pathology Services – COVID19) Amendment (No. 3) Determination 2020

20 May 2020 (F2020L00592)

1 May 2020 (s 2(1) item 1)

Health Insurance (Section 3C Pathology Services – COVID19) Amendment (No. 4) Determination 2020

28 July 2020 (F2020L00954)

7.07 pm (A.C.T.) 28 July 2020 (s 2(1) item 1)

Health Insurance (Section 3C Pathology Services – COVID19) Amendment (No. 5) Determination 2020

3 Aug 2020 (F2020L00981)

10.59 am (A.C.T.) 3 Aug 2020 (s 2(1) item 1)

Health Insurance Legislation Amendment (Extend Cessation Date of Temporary COVID19 Items) Determination 2020

21 Sept 2020 (F2020L01190)

Sch 1 (items 4–6): 22 Sept 2020 (s 2(1) item 2)

Health Insurance Legislation Amendment (Extend Cessation Date of Temporary COVID19 Items) Determination 2021

19 Mar 2021 (F2021L00267)

Sch 1 (item 3): 3.56 pm (A.C.T.) 19 Mar 2021 (s 2(1) item 1)

Health Insurance Legislation Amendment (Extension of Cessation Dates and Pathology COVID19 Services Amendments) Determination 2021

17 Dec 2021 (F2021L01808)

Sch 1 (item 1): 10.12 am (A.C.T.) 17 Dec 2021 (s 2(1) item 1)
Sch 2: 1 Jan 2022 (s 2(1) item 4)

Health Insurance Legislation Amendment (2022 Measures No. 3) Determination 2022

7 Apr 2022 (F2022L00567)

Sch 3 (item 4): 11 Apr 2022 (s 2(1) item 1)

Health Insurance Legislation Amendment (2022 Measures No. 4) Determination 2022

28 Sept 2022 (F2022L01263)

Sch 1 (item 1): 30 Sept 2022 (s 2(1) item 2)
Sch 2: 1 Oct 2022 (s 2(1) item 3)

Health Insurance Legislation Amendment (2022 Measures No. 5) Determination 2022

12 Dec 2022 (F2022L01632)

Sch 1 (item 2): 31 Dec 2022 (s 2(1) item 1)
Sch 2: 1 Jan 2023 (s 2(1) item 2)

Endnote 4—Amendment history

 

Provision affected

How affected

s 2.....................

rep LA s 48D

s 3.....................

am F2020L01190; F2021L00267

 

rs F2021L01808; F2022L00567

 

am F2022L01263; F2022L01632

s 5.....................

am F2020L00954

 

ed C4

 

am F2020L00981

 

ed C5

 

am F2020L01190

 

ed C6

 

am F2021L01808; F2022L01263

s 6.....................

am F2020L00954; F2021L01808; F2022L01263

s 7.....................

am F2020L00373; F2020L00592; F2021L01808

 

rs F2022L01263

Schedule 1

 

Schedule 1................

am F2020L00258; F2020L00373; F2020L00592; F2020L00954; F2020L00981; F2020L01190; F2021L01808; F2022L01263; F2022L01632