Commonwealth Coat of Arms of Australia

 

Health Insurance (Section 3C General Medical Services – Transcatheter Aortic Valve Implantation) Amendment (Limit to Intermediate and High Risk Surgical Patients) Determination 2021

I, Nigel Murray, delegate of the Minister for Health and Aged Care, make the following Determination.

Dated 17th December 2021

Nigel Murray

Assistant Secretary

MBS Policy and Specialist Services Branch

Medical Benefits Division
Health Resourcing Group

Department of Health

 

 

 

Contents

1  Name

2  Commencement

3  Authority

4  Schedules

Schedule 1— Amendments

 

1  Name

 This instrument is the Health Insurance (Section 3C General Medical Services – Transcatheter Aortic Valve Implantation) Amendment (Limit to Intermediate and High Risk Surgical Patients) Determination 2021.

2  Commencement

(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 March 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 Note: This table relates only to the provisions of this instrument as originally made.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  Schedules

  Each instrument that is specified in a Schedule to this instrument is amended or repealed as set out in the applicable items in the Schedule concerned, and any other item in a Schedule to this instrument has effect according to its terms.


Schedule 1— Amendments

Health Insurance (Section 3C General Medical Services – Transcatheter Aortic Valve Implantation) Determination 2018

  1. Section 5 (definition of TAVI Case Conference and TAVI Hospital)

Omit “item 38495” wherever occurring, substitute “items 38945 and 38514”.

2.     Section 5 (definition of TAVI Patient)

Repeal the definition, substitute:

TAVI Patient means a patient who, as a result of a TAVI Case Conference, has been assessed as having a high or an intermediate risk for open surgical aortic valve replacement and is recommended as being suitable to receive the service described in items 38495 or 38514.

3.     Section 7 (heading)

Repeal the heading, substitute:

7.         Application of items 38495 and 38514

4.     Section 7 (body)

Omit “item 38495”, substitute “items 38495 and 38514”.

5.     After Section 7

Insert:

8. Meaning of symbol (H)

An item in this Schedule including the symbol (H) applies only to a service performed or provided in a hospital.

6.     Schedule 1 (item 38495)

Repeal the item, substitute:

 

38495

TAVI, for the treatment of symptomatic severe aortic stenosis, performed via transfemoral delivery, unless transfemoral delivery is contraindicated or not feasible, if:

(a)     the TAVI Patient is at high risk for surgery; and

(b)    the service:

(i)        is performed by a TAVI Practitioner in a TAVI Hospital; and

(ii)      includes all intraoperative diagnostic imaging that the TAVI Practitioner performs upon the TAVI Patient;

not being a service which has been rendered within 5 years of a service to which this item or 38514 applies (H) (Anaes.) (Assist.)

1,490.25

38514

TAVI, for the treatment of symptomatic severe aortic stenosis, performed via transfemoral delivery, unless transfemoral delivery is contraindicated or not feasible, if:

(a)     the TAVI Patient is at intermediate risk for surgery; and

(b)    the service:

(i)        is performed by a TAVI Practitioner in a TAVI Hospital; and

(ii)      includes all intraoperative diagnostic imaging that the TAVI Practitioner performs upon the TAVI Patient;

not being a service which has been rendered within 5 years of a service to which this item or 38495 applies (H) (Anaes.) (Assist.)

1,490.25