This instrument is the Health Insurance (Section 3C Diagnostic Imaging – Cardiac MRI for Myocarditis) Determination 2021.

(1) Each provision of this instrument specified in column 1 of the table commences, or is taken to have commenced, in accordance with column 2 of the table. Any other statement in column 2 has effect according to its terms.

Commencement information
Column 1	Column 2	Column 3
Provisions	Commencement	Date/Details
1. The whole of this instrument	1 January 2022

Note: This table relates only to the provisions of this instrument as originally made. It will not be amended to deal with any later amendments of this instrument.

(2) Any information in column 3 of the table is not part of this instrument. Information may be inserted in this column, or information in it may be edited, in any published version of this instrument.

3. Authority

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

4. Definitions

(1) In this instrument:

Act means the Health Insurance Act 1973.

(Anaes.) has the meaning given by subclause 5.9.4(1) of the general medical services table.

MRI has the meaning given by the term in the diagnostic imaging services table.

(R) has the meaning given by subclause 1.2.15(1) of the diagnostic imaging services table.

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 medical 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.

Schedule means a Schedule to this instrument.

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

clinically relevant service;
diagnostic imaging services table;
general medical services table;
item;
professional service.

(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.

5. Treatment of relevant services

For subsection 3C(1) of the Act, 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 diagnostic imaging service; and

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

related to the service; and
specified for the service a fee in relation to each State, being the fee specified in the Schedule in relation to the service.

6. Application of provisions from the diagnostic imaging services table

(1) The item in the Schedule applies to an MRI service if all of the following apply:

(a) it is performed in a permissible circumstance, as described in clause 2.5.3 of the diagnostic imaging services table;

(b) it is performed by an eligible provider, as described in clause 2.5.4 of the diagnostic imaging services table;

eligible equipment, as described in clause 2.5.5 of the diagnostic imaging services table; or
partial eligible equipment, as described in clause 2.5.6 of the diagnostic imaging services table.

(2) Subject to paragraph (1)(b), clause 2.5.4 of the diagnostic imaging services table shall have effect as if the item in the Schedule were also specified in column 1 of item 1 and 2 of table 2.5.4.

7. Application of contrast

(1) If a service to which an item in the Schedule applies is performed using a contrast agent, the fee specified in that item applies in addition to the schedule fee in item 63491 of the diagnostic imaging services table.

Note: Clause 2.5.12 of the diagnostic imaging services table sets out the application of modifying items in subgroup 22 of Group I5 to other items in Group I5.

Schedule – relevant services

Group I5 – Magnetic Resonance Imaging
Column 1 Item	Column 2 Description	Column 3 Fee ($)
Subgroup 14 - Scan of cardiovascular system—for specified conditions
63399	MRI–scan of cardiovascular system for the assessment of myocardial structure and function, if the service is requested by a consultant physician who has assessed the patient, and the request for the scan indicates: (a) the patient has suspected myocarditis after receiving a mRNA COVID-19 vaccine; and (b) the patient had symptom onset within 21 days of a mRNA COVID-19 vaccine administration; and (c) the results from the following examinations are inconclusive to form a diagnosis of myocarditis: (i) echocardiogram; and (ii) troponin; and (iii) chest X-ray. Applicable not more than once in a patient’s lifetime (R) (Anaes.) (Contrast)	855.20