Commonwealth Coat of Arms of Australia

 

Health Insurance Legislation Amendment (Indexation) Regulations 2025

I, the Honourable Sam Mostyn AC, GovernorGeneral of the Commonwealth of Australia, acting with the advice of the Federal Executive Council, make the following regulations.

Dated   20   February 2025

Sam Mostyn AC

GovernorGeneral

By Her Excellency’s Command

Mark Butler

Minister for Health and Aged Care

 

 

 

 

 

1 Name

2 Commencement

3 Authority

4 Schedules

Schedule 1—Amendments

Health Insurance (Diagnostic Imaging Services Table) Regulations (No. 2) 2020

Health Insurance (General Medical Services Table) Regulations 2021

Health Insurance (Pathology Services Table) Regulations 2020

 

  This instrument is the Health Insurance Legislation Amendment (Indexation) Regulations 2025.

 (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 July 2025.

1 July 2025

Note: This table relates only to the provisions of this instrument as originally made.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

  This instrument is made under the Health Insurance Act 1973.

  Each instrument that is specified in a Schedule to this instrument is amended or repealed as set out in the applicable items in the Schedule concerned, and any other item in a Schedule to this instrument has effect according to its terms.

 

1  Clause 2.4.6 of Schedule 1 (before the table)

Insert:

Note: The fees in Subgroup 1 of Group I4 are indexed in accordance with clause 2.7.1.

2  Clause 2.7.1 of Schedule 1 (heading)

Omit “1 July 2024”, substitute “1 July 2025”.

3  Subclause 2.7.1(1) of Schedule 1

Repeal the subclause, substitute:

 (1) At the start of 1 July 2025 (the indexation time), each amount covered by subclause (2) is replaced by the amount worked out using the following formula:

Start formula 1.024 times the amount immediately before the indexation time end formula

Note: The indexed fees could in 2025 be viewed on the Department’s MBS Online website (http://www.health.gov.au).

4  After subparagraph 2.7.1(2)(a)(iii) of Schedule 1

Insert:

 (iiia) Subgroup 1 of Group I4 (nuclear medicine imaging services—non PET);

5  Paragraph 1.2.4(2)(c) of Schedule 1

Omit “$341.75”, substitute “$349.95”.

6  Clause 1.3.1 of Schedule 1 (heading)

Omit “1 July 2024”, substitute “1 July 2025”.

7  Subclause 1.3.1(1) of Schedule 1

Repeal the subclause, substitute:

 (1) At the start of 1 July 2025 (the indexation time), each amount covered by subclause (2) is replaced by the amount worked out using the following formula:

Start formula 1.024 times the amount of the fee immediately before the indexation time end formula

Note: The indexed fees could in 2025 be viewed on the Department’s MBS Online website (http://www.health.gov.au).

8  Clause 2.1.1 of Schedule 1 (table 2.1.1)

Repeal the table, substitute:

 

Table 2.1.1—Amount under clause 2.1.1

 

Item

Column 1

Item of this Schedule

Column 2

Fee

Column 3

Amount if not more than 6 patients (to be divided by the number of patients) ($)

Column 4

Amount if more than 6 patients ($)

1

4

The fee for item 3

30.70

2.45

2

24

The fee for item 23

30.70

2.45

3

37

The fee for item 36

30.70

2.45

4

47

The fee for item 44

30.70

2.45

5

58

$8.50

15.50

0.70

6

59

$16.00

17.50

0.70

7

60

$35.50

15.50

0.70

8

65

$57.50

15.50

0.70

9

124

The fee for item 123

30.70

2.45

10

165

$88.20

15.50

0.70

11

195

The fee for item 193

30.30

2.40

12

414

The fee for item 410

30.20

2.40

13

415

The fee for item 411

30.20

2.40

14

416

The fee for item 412

30.20

2.40

15

417

The fee for item 413

30.20

2.40

16

5003

The fee for item 5000

30.30

2.40

17

5010

The fee for item 5000

54.55

3.90

18

5023

The fee for item 5020

30.30

2.40

19

5028

The fee for item 5020

54.55

3.90

20

5043

The fee for item 5040

30.30

2.40

21

5049

The fee for item 5040

54.55

3.90

22

5063

The fee for item 5060

30.30

2.40

23

5067

The fee for item 5060

54.55

3.90

24

5076

The fee for item 5071

30.30

2.40

25

5077

The fee for item 5071

54.55

3.90

26

5220

$18.50

15.50

0.70

27

5223

$26.00

17.50

0.70

28

5227

$45.50

15.50

0.70

29

5228

$67.50

15.50

0.70

30

5260

$18.50

27.95

1.25

31

5261

$112.20

15.50

0.70

32

5262

$112.20

27.95

1.25

33

5263

$26.00

31.55

1.25

34

5265

$45.50

27.95

1.25

35

5267

$67.50

27.95

1.25

36

90272

The fee for item 90271

30.30

2.40

37

90274

The fee for item 90273

30.30

2.40

38

90276

The fee for item 90275

24.20

1.90

39

90278

The fee for item 90277

24.20

1.90

9  Clause 2.1.2 of Schedule 1 (table 2.1.2)

Repeal the table, substitute:

 

Table 2.1.2—Amount under clause 2.1.2

 

Item

Column 1

Item of this Schedule

Column 2

Fee

Column 3

Amount if not more than 6 patients (to be divided by the number of patients) ($)

Column 4

Amount if more than 6 patients ($)

1

181

The fee for item 179

24.60

1.95

2

187

The fee for item 185

24.60

1.95

3

191

The fee for item 189

24.60

1.95

4

206

The fee for item 203

24.60

1.95

5

303

The fee for item 301

24.60

1.95

10  Schedule 1 (item 111, column 2, paragraph (d))

Omit “$341.75”, substitute “$349.95”.

11  Schedule 1 (item 115, column 2, paragraph (c))

Omit “$341.75”, substitute “$349.95”.

12  Schedule 1 (item 117, column 2, paragraph (e))

Omit “$341.75”, substitute “$349.95”.

13  Schedule 1 (item 120, column 2, paragraph (d))

Omit “$341.75”, substitute “$349.95”.

14  Subclause 2.20.2(1) of Schedule 1 (table 2.20.2)

Repeal the table, substitute:

 

Table 2.20.2—Amount under clause 2.20.2

 

Item

Column 1

Item of this Schedule

Column 2

Fee

Column 3

Amount if not more than 6 patients (to be divided by the number of patients) ($)

Column 4

Amount if more than 6 patients ($)

1

2723

The fee for item 2721

30.30

2.40

2

2727

The fee for item 2725

30.30

2.40

3

2741

The fee for item 2739

30.30

2.40

4

2745

The fee for item 2743

30.30

2.40

15  Subclause 2.20.2A(1) of Schedule 1 (table 2.20.2A)

Repeal the table, substitute:

 

Table 2.20.2A—Amount under clause 2.20.2A

 

Item

Column 1

Item of this Schedule

Column 2

Fee

Column 3

Amount if not more than 6 patients (to be divided by the number of patients) ($)

Column 4

Amount if more than 6 patients ($)

1

285

The fee for item 283

24.25

1.90

2

287

The fee for item 286

24.25

1.90

3

311

The fee for item 309

24.25

1.90

4

315

The fee for item 313

24.25

1.90

16  Subclause 2.30.1(1) of Schedule 1

Omit “$62.65”, substitute “$64.15”.

17  Subclause 2.30.1(2) of Schedule 1

Omit “$45.50”, substitute “$46.60”.

18  Subclause 5.7.1(1) of Schedule 1 (paragraph (b) of the definition of amount under clause 5.7.1)

Omit “$21.65”, substitute “$22.15”.

19  Subclause 5.7.1(2) of Schedule 1 (paragraph (b) of the definition of amount under clause 5.7.1)

Omit “$32.60”, substitute “$33.40”.

20  Clause 5.9.1A of Schedule 1

Omit “an item in Group T10”, substitute “this Division”.

21  Clause 5.9.1A of Schedule 1 (definition of base unit)

Omit “$22.55”, substitute “$23.10”.

22  Clause 5.9.2 of Schedule 1 (paragraph (a) of the definition of amount under clause 5.9.2)

Omit “$112.85”, substitute “5 base units”.

23  Schedule 1 (items 51300, 51303, 51800 and 51803, column 2)

Omit “$636.05” (wherever occurring), substitute “$651.30”.

24  Clause 2.1.2 of Schedule 1 (before the table)

Insert:

Note: The fees in Group P1 are indexed in accordance with clause 2.14.1.

25  Clause 2.4.2 of Schedule 1 (before the table)

Insert:

Note: The fees in Group P4 are indexed in accordance with clause 2.14.1.

26  Clause 2.5.6 of Schedule 1 (before the table)

Insert:

Note: The fees in Group P5 are indexed in accordance with clause 2.14.1.

27  Clause 2.6.2 of Schedule 1 (note)

Repeal the note, substitute:

Note 1: The fees in Group P6 are indexed in accordance with clause 2.14.1.

Note 2: See clause 2.5.4 in relation to the restriction that applies if certain services in Groups P5 and P6 are performed in a single patient episode.

28  Clause 2.8.1 of Schedule 1 (before the table)

Insert:

Note: The fees in Group P8 are indexed in accordance with clause 2.14.1.

29  Clause 2.14.1 of Schedule 1 (heading)

Omit “1 July 2024”, substitute “1 July 2025”.

30  Subclause 2.14.1(1) of Schedule 1

Repeal the subclause, substitute:

 (1) At the start of 1 July 2025 (the indexation time), each amount covered by subclause (1A) is replaced by the amount worked out using the following formula:

Start formula 1.024 times the amount of the fee immediately before the indexation time end formula

Note: The indexed fees could in 2025 be viewed on the Department’s MBS Online website (http://www.health.gov.au).

 (1A) The amounts covered by this subclause are the fee for each item in the following:

 (a) Group P1 (haematology services);

 (b) Group P4 (immunology services);

 (c) Group P5 (tissue pathology services);

 (d) Group P6 (cytology services);

 (e) Group P8 (infertility and pregnancy test services);

 (f) Group P12 (management of bulk‑billed services).