Health Insurance (Section 3C Diagnostic Imaging Services – National Lung Cancer Screening Program) Determination 2025

I, Mary Warner, delegate for the Minister for Health and Aged Care, make the following Determination.

Dated 7 May 2025

Mary Warner

Assistant Secretary

Diagnostic Imagining and Pathology Branch

Medicare Benefits and Digital Health Division

Health Resourcing Group

Department of Health and Aged Care

Contents

1  Name...................................................1

2  Commencement............................................1

3  Authority................................................1

4  Definitions...............................................1

5  Treatment of relevant services....................................2

6  Eligibility for services.........................................2

7  Limitation on services.........................................3

Schedule 1 — Relevant services 4

1  Items in Subgroup 14 of Group I2..................................4

1  Name

  This instrument is the Health Insurance (Section 3C Diagnostic Imaging Services – National Lung Cancer Screening Program) Determination 2025.

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.

Note:  This table relates only to the provisions of this instrument as originally made.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

1.     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.

bulk‑billed has the meaning given by the Health Insurance (Diagnostic Imaging Services Table) Regulations (No. 2) 2020.

computed tomography or CT has the meaning given by the Health Insurance (Diagnostic Imaging Services Table) Regulations (No. 2) 2020.

pack-years means the number of cigarettes a person smoked per day multiplied by the number of years the person has smoked.

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 to this instrument.

remote location has the meaning given by the Health Insurance (Diagnostic Imaging Services Table) Regulations (No. 2) 2020.

smoke or smoking means the action of inhaling and exhaling cigarette tobacco and  includes packaged cigarettes and roll-your-own cigarettes (rollies). It does not include other forms of tobacco or nicotine smoking or consumption, such as vaping.

1.    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.

Note: A number of expressions used in this instrument are defined in the Act, including the following:

• clinically relevant service;
• diagnostic imaging services table;
• item;
• professional service.

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:

1.     it were both a professional service and a general medical service; and
2.     there were an item in the diagnostic imaging services table that:
   1.       related to the service; and
   2.       specified for the service a fee in relation to each State, being the fee specified in the Schedule 1 in relation to the service.

6  Eligibility for services

1.    A patient is eligible to receive a service specified in Schedule 1 to this instrument if they:

1.     receive a request for the service as part of the National Lung Cancer Screening Program when they are aged between 50 years and 70 years and 364 days; and
2.    are asymptomatic (show no signs or symptoms of lung cancer); and
3.     currently smoke or have quit smoking in the past ten years; and
4.    have a history of cigarette tobacco smoking of at least 30 pack-years.

1.    If a patient has been assessed as eligible to receive a service described in items 57410 and 57413, the patient remains eligible to receive these services until they turn 71 years and 364 days.

7  Limitation on services

For the purposes of MBS items 57410 and 57413, clause 2.2.1(1)(a) of the diagnostic imaging services table does not apply if the services are provided as part of a mobile screening service provided more than 30 kilometres from a hospital that provides computed tomography radiology service or fixed radiology infrastructure.

Schedule 1 — Relevant services

1  Items in Subgroup 14 of Group I2