{"id":"C1949L00092","name":"National Health (Medical Expenses) Regulations","slug":"national-health-medical-expenses-regulations","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"repealed","isInForce":false,"actNumber":"92 of 1949","makingDate":null,"administeringDepartment":null,"currentVersion":{"id":23293,"registerId":"commonwealth-C1949L00092-current","compilationNumber":null,"startDate":"2026-04-01","status":"Repealed","reasons":null,"registeredAt":null},"sections":[{"sectionNumber":"1","sectionType":"section","heading":"National Health (Medical Expenses) Regulations","content":"STATUTORY RULES.\n\n1949\\. No. 92.\n\n![](image.001.png)REGULATIONS UNDER THE NATIONAL HEALTH SERVICE\n\nACT 1948-1949.\\*\n\nI, THE GOVERNOR-GENERAL in and over the Commonwealth of Australia, acting with the advice of the Federal Executive Council, hereby make the following Regulations under the National Health Service Act 1948-1949.\n\nDated this twenty-third day of November, 1949.\n\nW. J. McKELL\n\nGovernor-General.\n\nBy His Excellency's Command,\n\nN. E. McKENNA\n\nMinister of State for Health.\n\n![](image.002.png)National Health (Medical Expenses) Regulations.\n\nCitation.\n\n1. These Regulations may be cited as the National Health (Medical Expenses) Regulations.\n\nDefinition.\n\n2. In these Regulations, \" the Scheme \" means the Medical Expenses Scheme established by these Regulations.\n\nEstablishment of Scheme.\n\n3. The Medical Expenses Scheme set out in the Schedule to these Regulations is hereby established, and shall apply in relation to professional services (as defined in the Scheme) rendered after a date to be fixed by the Minister by notice published in the Gazette.\n\nApplication of Scheme.\n\n4.—(1.) The Minister may, by notice published in the Gazette, declare that the Scheme shall not apply in relation to professional services rendered on or after a date specified in the notice—\n\n(a) in a part of Australia specified in the notice, being a part of Australia in which the Commonwealth provides, or will, after that date, provide, otherwise than under the Scheme, benefits or services which, in the opinion of the Minister, render the application of the Scheme unnecessary in that part of Australia ; or\n\n(b) by a medical practitioner in accordance with the terms of an agreement between the medical practitioner and the Commonwealth, a State or any other body or person.\n\n![](image.003.png)(2.) On and after the date specified in a notice under this regulation, and until the notice is revoked, the Scheme shall not apply in relation to the services to which the notice relates.\n\n\\* Notified in the Commonwealth Gazette on 25th November, 1949.\n\n5224.—Price 8d.\n\n \n\nJurisdiction to hear appeals against suspension.\n\n5.—(1.) The Supreme Court of each State is hereby invested with federal jurisdiction, and jurisdiction is hereby conferred on the Supreme Court of each Territory of the Commonwealth, to hear and determine appeals under clause 13 of the Scheme.\n\n(2.) The Director-General shall be the respondent in any such appeal.\n\n(3.) Upon the hearing of any such appeal, the Supreme Court may—\n\n(a) admit further evidence, either orally or upon affidavit or otherwise ;\n\n(b) permit the examination and cross-examination of witnesses ;\n\n(c) affirm, reverse or modify the decision of the Director-General ; and\n\n(d) order any party to pay costs to any other party.\n\n(4.) If the Supreme Court is satisfied that there has been undue delay by the medical practitioner in prosecuting his appeal, the Court may dismiss the appeal without hearing it.\n\nScheme to have effect.\n\n6.—(1.) The provisions of the Scheme shall, by force of these Regulations, have effect according to their tenor.\n\n(2.) The provisions of the Acts Interpretation Act 1901-1948 shall apply as if the clauses of the Scheme were regulations contained in these Regulations.\n\n![](image.004.png)THE SCHEDULE. Reg. 3.\n\nMEDICAL EXPENSES SCHEME\n\nCitation.\n\n1\\. This Scheme may be cited as the Medical Expenses Scheme.\n\nInterpretation.\n\n2.—(1.) In this Scheme, unless the contrary intention appears-\n\n\" medical practitioner \" means a person registered or licensed as a medical practitioner under a law of a State or of the Australian Capital Territory providing for the registration or licensing of medical practitioners ;\n\n\" participating medical practitioner \" means a medical practitioner whose name is recorded in the list of participating medical practitioners maintained in accordance with this Scheme ;\n\n\" professional service \" means a service rendered by a participating medical practitioner in his capacity as a medical practitioner, being a service to which this Scheme applies, and includes any travelling incidental to the performance of any such service, but does not include the supply of materials or appliances;\n\n\" the Act \"' means the National Health Service Act 1948-1949 ;\n\n\" the Minister \" means the Minister of State for Health ;\n\n\" the prescribed fee \", in respect of a professional service, means the fee in respect of that service ascertained in accordance with clause 16 of this Scheme.\n\n(2.) For the purposes of this Scheme, two or more professional services rendered by a medical practitioner in respect of one person on the same occasion shall be deemed to be one professional service.\n\n \n\n(3.) For the purposes of this Scheme, a participating medical practitioner shall be deemed to render a service where the service is rendered by another medical practitioner in circumstances in which the fee for the service is payable directly to that participating medical practitioner.\n\n(4.) In this Scheme any reference to a form shall be read as a reference to a form in the Appendix of Forms annexed to this Scheme.\n\nDelegation.\n\n3.—(1.) The Director-General may, in relation to any particular matter or class of matters, or to any particular part of the Commonwealth, by writing under his hand, delegate to any person all or any of his powers or functions under this Scheme (except this power of delegation) so that the delegated powers or functions may be exercised by the delegate with respect to the matter or class of matters, or the part of the Commonwealth, specified in the instrument of delegation as fully and effectually as by the Director-General.\n\n(2.) Every delegation under this clause shall be revocable at will and no delegation shall prevent the exercise of any power or function by the Director-General.\n\nServices to which Scheme applies.\n\n4\\. Except as otherwise provided in this Scheme or in the Act or in regulations made under the Act, this Scheme shall apply to every service rendered by a participating medical practitioner, in his capacity as a medical practitioner, for which the medical practitioner is entitled to charge a fee.\n\nPayments by Commonwealth.\n\n5\\. Where a participating medical practitioner renders a professional service, the Commonwealth shall, subject to this Scheme, be liable to pay to the medical practitioner, on behalf of the person liable to pay the fee for that service, so much of that fee as does not exceed one-half of the prescribed fee, and the person so liable shall, to the extent of the liability of the Commonwealth under this clause, be discharged from his liability.\n\nFriendly societies, &c.\n\n6\\. Where—\n\n(a) a participating medical practitioner renders professional services for which he does not charge specific fees but for which he is) remunerated under arrangements between himself and a society or body which, or person who, conducts a scheme of medical benefits; and\n\n(b) the Director-General declares, by notice published in the Gazette or given to the medical practitioner, that he is satisfied that the arrangements between the medical practitioner and that society, body or person are such that while this Scheme applies in relation to those services, the persons entitled to the benefits of the scheme so conducted will directly or indirectly receive the benefit of payments made under this Scheme in respect of those services,\n\nthis Scheme shall, on and after a date specified in the notice and while the notice is unrevoked, apply in respect of those services as if there were payable to the medical practitioner for each such service a fee equal to the prescribed fee.\n\nCases where workers' compensation or damages payable\n\n7.—(1.) Where a person has received, or is entitled to receive or to have made for his benefit, in respect of the expenses of a professional service, a payment (in this clause referred to as “ the indemnity \")—\n\n(a) by way of compensation or damages (including settlement of a claim for damages) ; or\n\n \n\n(b) otherwise under any law, but not including a payment resulting wholly or partly from contributions made by that person,\n\nthe amount payable by the Commonwealth under this Scheme in respect of that service shall be reduced by the amount by which the indemnity exceeds half the prescribed fee.\n\n(2.) Where, in respect of an injury for which a person has received or receives a professional service, there is or has been awarded or paid, or agreed to be paid, an amount by way of damages or in settlement of a claim for damages, so much of that amount as does not exceed the prescribed fee shall, for the purposes of this clause, be deemed to be awarded, paid or agreed to be paid (as the case may be) in respect of the injured person's expenses of that professional service.\n\n(3.) Where a participating medical practitioner is not aware that sub-clause (1.) of this clause is applicable in relation to a professional service rendered, by him, or is in doubt as to whether, or to what extent, that sub-clause is so applicable, he shall be entitled to claim and receive payment from the Commonwealth under this Scheme as if that sub-clause did not apply.\n\n(4.) Where the Commonwealth has made a payment to a medical practitioner in respect of a professional service in relation to which sub-clause (1.) of this clause is applicable—\n\n(a) the medical practitioner shall be liable to repay that amount to the Commonwealth to the extent of so much of any amount of the indemnity paid directly to him as exceeds the balance of the fee charged by him remaining after deducting the payment made by the Commonwealth; and\n\n(b) the person on whose behalf the Commonwealth made the payment shall be liable to pay to the Commonwealth so much of any amount of the indemnity received or receivable by him as exceeds so much of the fee charged by the medical practitioner as is in excess of half the prescribed fee and does not exceed the payment made by the Commonwealth.\n\n(5.) Where a person or authority who or which is liable or proposes to pay the indemnity or part thereof is aware that the professional service to which the payment relates was, or is likely to be, rendered by a participating medical practitioner, that person or authority shall, before making the payment, inform the Director-General in writing of the facts relating to the proposed payment, and shall not make the payment before the expiration of fourteen days after he or it has so informed the Director-General.\n\n(6.) Where—\n\n(a) the Commonwealth has made a payment to a medical practitioner in respect of a professional service to which sub-clause (1.) of this clause is applicable ; and\n\n(b) a person or authority is liable to make a payment referred to in sub-clause (1.) of this clause in relation to the expenses of that professional service,\n\nthe Director-General may serve on that person or authority, by post or otherwise, a notice requiring that person or authority to pay to the Director-General an amount specified in the notice, being an amount\n\n \n\nnot exceeding the amount which that person or authority is so liable to pay or the amount which the person liable to pay the fee for the professional service would, under this clause, be liable to pay to the Commonwealth if the 'payment were made to him (whichever is the less).\n\n(7.) Where a notice is served on a person or authority in accordance with the last preceding sub-clause—\n\n(a) that person or authority shall be liable to pay to the Commonwealth the amount specified in the notice ; and\n\n(b) payment of any amount to the Commonwealth in pursuance of the notice shall, to the extent of that payment, and not-withstanding any defect in the notice, be a good discharge of the obligation of that person or authority to make the payment referred to in sub-clause (1.) of this clause.\n\nMedical practitioners entitled to become participating medical practitioners.\n\n8.—(1.) Subject to the next succeeding sub-clause, every medical practitioner shall be entitled to become a participating medical practitioners.\n\n(2.) A medical practitioner who has been suspended from participation in the Scheme shall not, during the period of his suspension, be entitled to become a participating medical practitioner.\n\nNotice of desire to participate.\n\n9\\. A medical practitioner who desires to participate in the Scheme shall forward a notice in writing to that effect to the Director-General and shall specify in the notice the address or addresses of the premises at which he conducts or will conduct his practice.\n\nList of participating medical practitioners.\n\n10.—(1.) Upon receipt of a notice in accordance with the last preceding clause, the Director-General shall cause the name of the medical practitioner to be recorded in a list of participating medical practitioners maintained for that purpose.\n\n(2.) The Director-General shall forthwith notify the medical practitioner in writing of the date on which the medical practitioner became a participating medical practitioner.\n\nTermination of participation.\n\n11.—(1.) The Director-General shall, at the request of a participating medical practitioner, forthwith remove the name of the medical practitioner from the list of participating medical practitioners and the medical practitioner shall thereupon cease to be a participating medical practitioner.\n\n(2.) The Director-General shall forthwith notify the medical practitioner in writing of the date on which he ceased to be a participating medical practitioner.\n\n(3.) The fact that a participating medical practitioner has ceased to be a participating medical practitioner shall not affect his rights, obligations and liabilities arising out of or in connexion with professional services rendered by him while he was a participating medical practitioner, and, for the purposes of those rights, obligations and liabilities, he shall be deemed to be a participating medical practitioner.\n\n(4.) Without prejudice to the right of a participating medical practitioner to withdraw at any time from participation in this Scheme, the operation of this Scheme in relation to participating medical practitioners shall be subject to amendments made from time to time to this Scheme, or to the regulations by which this Scheme is established.\n\n \n\nSuspension of participating medical practitioners.\n\n12.—(1.) Where a participating medical practitioner—\n\n(a) repeatedly fails to comply with the provisions of this Scheme ; or\n\n(b) defrauds or attempts to defraud the Commonwealth in connexion with the operation of this Scheme,\n\nthe Director-General may suspend the medical practitioner from participation in the Scheme for a period not exceeding six months.\n\n(2.) The Director-General may at any time remove any such suspension subject to such conditions (if any) as the Director-General thinks fit to impose.\n\n(3.) Before deciding to suspend a participating medical practitioner under this clause, the Director-General shall—\n\n(a) serve on the participating medical practitioner a notice specifying the grounds on which his suspension is being considered ;\n\n(b) refer the matter to a committee established in pursuance of section 16 of the Act for inquiry and report to the Director-General ; and\n\n(c) take into consideration the report of the committee.\n\n(4.) An inquiry under this clause shall be conducted by the committee in such manner as the Director-General directs.\n\n(5.) The participating medical practitioner shall be entitled to attend the inquiry and be heard by the committee.\n\n(6.) Where the Director-General, after an inquiry by a committee, decides to suspend the participating medical practitioner from participation in this Scheme, the Director-General shall serve notice of the proposed suspension on the medical practitioner.\n\nAppeals.\n\n13\\. The medical practitioner may, within fourteen days after service of the notice under the last preceding sub-clause, appeal against the proposed suspension to the Supreme Court of a State or Territory of the Commonwealth by—\n\n(a) filing a notice of appeal with the proper officer of the Court ; and\n\n(b) serving a copy of the notice on the Director-General.\n\nRemoval of name from list.\n\n14.—(1.) The Director-General may remove the name of a medical practitioner from the list of participating medical practitioners where a notice of proposed suspension has been served on the medical practitioner under clause 12 of this Scheme and—\n\n(a) the medical practitioner has not, within the time and in the manner prescribed by the last preceding clause, appealed against the proposed suspension ; or\n\n(b) upon an appeal against the proposed suspension, the Court has confirmed the proposed suspension (whether or not the period of the proposed suspension has been varied),\n\nand the suspension shall thereupon take effect.\n\n(2.) Upon the expiration of the period of suspension, the Director-General shall, upon application by the medical practitioner, restore his name to the list of participating medical practitioners.\n\n \n\nParticipating medical practitioner not to exceed prescribed fees.\n\n15.—(1.) A participating medical practitioner shall not demand or receive, from a person other than the Commonwealth, payment in respect of his fee for a professional service of an amount in excess of one-half of the prescribed fee.\n\n(2.) The last preceding sub-clause shall not operate so as to prevent a medical practitioner from demanding or receiving any amount in respect of any travel, outside a radius of three miles from his place of residence, which is not taken into account for the purpose of ascertaining mileage allowance under clause 17 of this Scheme.\n\n(3.) Where the prescribed fee in respect of a professional service rendered by a participating medical practitioner is not provided for in the table of fees annexed to this Scheme, the medical practitioner shall not, without the consent of the Director-General, demand or receive an amount in respect of his fee for that service before the prescribed fee has been agreed on or determined under this Scheme.\n\n(4.) Where the person liable to pay the fee for a professional service rendered or to be rendered by a participating medical practitioner informs that practitioner that he does not desire to benefit under this Scheme in respect of that professional service, the medical practitioner may accept from that person payment of more than one-half of the prescribed fee, but upon acceptance of any such payment—\n\n(a) no amount shall be payable to, or claimed by, the medical practitioner under this Scheme in respect of the service ; and\n\n(b) if the medical practitioner has already received or claimed any payment under this Scheme in respect of the service—\n\n(i) he shall forthwith inform the Director-General of the acceptance of the payment from the person liable to pay the fee ; and\n\n(ii) the amount of any such payment received from the Commonwealth may be deducted from any further amount becoming payable by the Commonwealth to the medical practitioner under this Scheme.\n\nPrescribed fees.\n\n16.—(1.) Subject to the succeeding provisions of this clause, the prescribed fee for a professional service specified in the table of fees annexed to this Scheme shall be the fee specified in column 3 of that table opposite to that professional service or otherwise provided by that table.\n\n(2.) Where the professional service is not specified in the table of fees annexed to this Scheme or the professional service consists of two or more services specified in that table, the prescribed fee shall, subject to the next succeeding sub-clause, be the fee determined in the following manner :—\n\n(a) the prescribed fee shall be fixed by agreement between the participating medical practitioner and the Director-General ; or\n\n(b) where the Director General is satisfied that agreement cannot be reached, the prescribed fee shall be determined by the Minister after taking into consideration the advice of a committee established in pursuance of section 16 of the Act for the purpose of advising on such matters.\n\n \n\n(3.) Where the professional service consists of two or more services specified in the table of fees annexed to this Scheme, the prescribed fee shall not be less than the highest fee ascertained under that table in respect of any one of those services and not more than the aggregate of the fees ascertained under that table in respect of all of those services.\n\n(4.) A professional service specified in the table of fees annexed to this Scheme shall, for all purposes of this Scheme, be deemed to include any consultation or visit rendered by the participating medical practitioner rendering the professional service which is necessary or incidental to, or is rendered in connexion with, that service.\n\n(5.) Subject to the next succeeding sub-clause, a professional service consisting of a visit or consultation specified in Part I. of the table of fees annexed to this Scheme shall be deemed to include any professional service rendered on the occasion of the visit or consultation which is not otherwise specified in that table.\n\n(6.) Where a participating medical practitioner notifies the Director-General that he considers that the nature of a professional service rendered on the occasion of a visit or consultation specified in Part I. of the table of fees annexed to this Scheme justifies a higher fee than the prescribed fee for the consultation or visit, the visit or consultation (including the professional services rendered on the occasion of the visit or consultation) shall be deemed to be a professional service not specified in that table.\n\nMileage allowance.\n\n17.—(1.) Where a participating medical practitioner travels for the purpose of rendering a professional service, the prescribed fee otherwise applicable to that service shall, subject to this clause, be increased by a mileage allowance ascertained in accordance with this clause.\n\n(2.) Where any travel of a participating medical practitioner is undertaken for the purpose of rendering two or more professional services, the prescribed fee in respect of each of those services shall, subject to the next succeeding sub-clause, be deemed to be increased by an amount determined by the medical practitioner as mileage in respect of that service.\n\n(3.) The last preceding sub-clause shall apply only if the total of the amounts determined as mileage in respect of all the services does not exceed the amount which would be deemed to be added to the prescribed fee as a mileage allowance if the whole of the travel involved was for the purpose of rendering one professional service.\n\n(4.) Where the participating medical practitioner who renders the service is the medical practitioner whose place of residence is nearest to the place where the service is rendered, the mileage allowance shall be calculated in respect of that portion of the distance travelled for the purpose of rendering the service (including distance so travelled after rendering the service) which is outside a radius of three miles from his place of residence.\n\n(5.) Where the participating medical practitioner who renders the service is not the medical practitioner whose place of residence is nearest to the place where the service is rendered, the mileage allowance shall be calculated in respect of the distance in respect of which the mileage allowance would have been calculated if the last-mentioned medical practitioner had rendered the service and that medical practitioner had been a participating medical practitioner.\n\n \n\n(6.) The rate of the mileage allowance shall be One shilling and eight pence per mile.\n\n(7.) Nothwithstanding the preceding provisions of this clause, the Director-General may enter into an arrangement with a participating medical practitioner in lieu of the provisions of this clause in connexion with the charges of the medical practitioner in respect of travel for the purpose of rendering professional services, and where such an arrangement is in force the provisions of the arrangement shall apply in lieu of the provisions of this clause.\n\nDaily records.\n\n18.—(1.) A participating medical practitioner shall keep, or cause to be kept, a daily record in accordance with this clause.\n\n(2.) The daily record shall, in respect of each professional service rendered by the medical practitioner, specify—\n\n(a) the date on which the service was rendered ;\n\n(b) the name and address of the patient ;\n\n(c) the general nature of the service ;\n\n(d) where practicable, the prescribed fee ; and\n\n(e) where applicable, the number of miles in respect of which mileage allowance will be claimed.\n\n(3.) The daily record may be in accordance with Form A.\n\n(4.) A person shall not destroy a daily record unless authorized so to do by the Director-General or until a period of two years has elapsed since the date of the last entry in the daily record.\n\n(5.) For the purposes of paragraph (c) of sub-clause (2.) of this clause the general nature of a professional service shall be sufficiently specified by the use of the appropriate symbol set out in the following table :—\n\n| Class of Service. | Symbol. |\n| --------------------------------------------------------- | ------- |\n| | |\n| Surgery consultation ............................... | S |\n| After hours surgery consultation ....................... | SE |\n| Home or hospital visit .............................. | H |\n| After hours home or hospital visit ...................... | HH |\n| Anaesthetic..................................... | A |\n| Any other service ................................. | O |\n\n(6.) For the purposes of the last preceding sub-clause, \" after hours \" means—\n\n(a) between the hours of nine o'clock in the afternoon and eight o'clock in the forenoon on any day from Monday to Friday (inclusive) ;\n\n(b) between the hours of twelve o'clock midday on Saturday and eight o'clock in the forenoon on the following Monday ; and\n\n(c) on a public holiday.\n\nAccounts.\n\n19\\. A participating medical practitioner who renders a professional service shall indicate on the account (if any) sent to the person liable to pay the fee for the service, the amount (if any) charged for mileage and the amount payable by the Commonwealth under this Scheme.\n\n \n\nClaims.\n\n20.—(1.) A claim by a participating medical practitioner for payment in accordance with this Scheme shall be in accordance with Form B and shall be forwarded—\n\n(a) in the case of a medical practitioner practising in a State—to the Deputy Director of Health, Commonwealth Department of Health, in the capital city of that State; and\n\n(b) in any other case to the Director-General.\n\n(2.) A claim shall be accompanied by—\n\n(a) the relevant daily records, bearing the initials of the medical practitioner on each page; or\n\n(b) a statement of services in accordance with Form C.\n\n(3.) A medical practitioner shall not knowingly claim payment from the Commonwealth under this Scheme of an amount which is not so payable.\n\n(4.) For the purposes of Form C, the nature of a professional service shall be sufficiently specified by the use of the appropriate symbol set out in sub-clause (5.) of clause 18 of this Scheme.\n\nReceipts.\n\n21\\. A participating medical practitioner shall issue a receipt for all moneys received by him (otherwise than from the Commonwealth) for professional services.\n\nInspection.\n\n22\\. The Director-General may, at all reasonable times, inspect any daily record required to be kept in accordance with this Scheme.\n\nExhibition of notice.\n\n23.—(1.) A participating medical practitioner shall display, at each of the premises at which he carries on practice, a notice indicating that he is a participating medical practitioner.\n\n(2.) The notice shall be affixed in some conspicuous place in or on the premises in such manner as to be readily visible to persons entering the premises.\n\nServices of notices, &c.\n\n![](image.005.png)24\\. A notice under this Scheme may be served by post on a participating medical practitioner at the address specified in his application to participate in this Scheme or at his place of practice last known to the Director-General.\n\nAPPENDIX OF FORMS.\n\nClause 18. Form A.\n\nDaily Record.\n\nName of Medical Practitioner\n\nAddress\n\n| Date. | Patient's name. | Patient's address. | General nature of service (appropriate symbol to be used). | Prescribed fee (exclusive of mileage) | Number of miles in respect of which mileage allowance payable. | Remarks. |\n| ----- | --------------- | ------------------ | ---------------------------------------------------------- | ------------------------------------- | -------------------------------------------------------------- | -------- |\n| | | | | | | |\n\n \n\nAppendix of Forms—continued.\n\nClause 20. Form B.\n\nAddress 19\n\nThe Director-General of Health\\*\n\nThe Deputy Director of Health\\*\n\nIn pursuance of the Medical Expenses Scheme, I hereby claim payment of the amount of in respect of professional services rendered during the period to (both inclusive) as per daily records\\*\n\nstatement of services\\* attached hereto, and I declare that the particulars set out therein are, to the best of my knowledge and belief, true and correct.\n\n( Signature of Medical Practitioner.)\n\nPaying instructions :—\n\n\\*Credit cheque to\n\n\\*Post cheque to me at the above address.\n\n\\* Strike out whichever is not applicable.\n\n![](image.006.png)Clause 20. Form C.\n\nStatement of Services Rendered.\n\nName of Medical Practitioner\n\nAddress\n\nStatement of services rendered during the period.\n\nto both inclusive) .\n\n```html\n

Patient's name

Patient's address

Services.

Total of prescribed fees (exclusive of mileage).

Number of miles in respect of which mileage allowance payable.

Mileage allowance at prescribed rate

Remarks.

Number of times service rendered.

symbol

Totals

Amounts payable by Commonwealth

£

£

\n```\n\nTABLE OF FEES.\n\n```html\n

Column 1.

Column 2.

Column 3.

Item Number.

Professional Service.

Fee.

£

s.

d.

Part 1.—Consultations and Visits.

NOTE.—In this Part, \" after hours\" means—

(a) between the hours of 9 p.m. and 8 a.m. Mondays to Fridays ;

(b) between the hours of 12 noon Saturday and 8 a.m. Monday ; and

(c) on a public holiday....................

1

Surgery consultation ..............................

0

10

6

2

After hours surgery consultation.......................

1

1

0

3

Home visit .....................................

0

12

6

4

After hours home visit..............................

1

1

0

5

Hospital visit to a patient other than a patient in a public ward of a public hospital

0

12

6

6

After hours hospital visit to a patient other than a patient in a public ward of a public hospital

1

1

0

\n```\n\n \n\n```html\n

Column 1.

Column 2.

Column 3.

Item Number.

Professional Service.

Fee.

£

s.

d.

Part 2.—Administration of Anaesthetics.

Administration of—

1

General anaesthetic (not otherwise provided for in this Part) for major operation

3

3

0

2

General anaesthetic (not otherwise provided for in this Part) for minor operation lasting less than half an hour

1

1

0

3

General anaesthetic for minor operation lasting half an hour or more

2

2

0

4

Intravenous anaesthetic for major operation .............

4

4

0

5

Intravenous anaesthetic for minor operation .............

3

3

0

6

Local anaesthetic for major operation .................

3

3

0

7

Local anaesthetic for minor operation .................

0

10

6

8

Spinal anaesthetic ..............................

4

4

0

9

Nitrous oxide anaesthetic .........................

4

4

0

10

Cyclopropane anaesthetic..........................

4

4

0

Part 3.—Operations.

Division 1.—Ear, Nose and Throat.

1

Removal of tonsils (persons under twelve years) ............

5

5

0

2

Removal of tonsils and adenoids (persons under twelve years

6

6

0

3

Removal of adenoids ..............................

2

2

0

4

Removal of tonsils (persons twelve years and over)...........

8

8

0

5

Paracentesis tympani ..............................

2

2

0

6

Maxillary antrum proof puncture.......................

2

2

0

7

Removal of nasal polypus...........................

2

2

0

8

Radical maxillary antrostomy (single)....................

10

10

0

9

Radical maxillary antrostomy (double) ...................

5

15

0

10

Mastoidectomy ..................................

21

0

0

11

Resection of nasal septum ...........................

15

15

0

12

Cauterization of septum.............................

2

2

0

Division 2.—Abdominal.

1

Cholecystostomy ................................

15

15

0

2

Cholecystectomy.................................

26

5

0

3

Gastro-enterostomy ...............................

26

5

0

4

Gastrectomy....................................

26

5

0

5

Suture of perforated gastric ulcer ......................

26

5

0

6

Appendicectomy .................................

15

15

0

7

Splenectomy ....................................

26

5

0

8

Repair of umbilical hernia (infants) .....................

5

5

0

9

Repair of umbilical hernia (persons over one year) ...........

15

15

0

10

Repair of incisional hernia ...........................

21

0

0

11

Repair of femoral or inguinal hernia ....................

15

5

0

12

Repair of double hernia .............................

21

0

0

13

Repair of strangulated hernia .........................

21

0

0

14

Removal of varicocele .............................

10

10

0

15

Orchidectomy...................................

10

10

0

16

Transplantation of undescended testicle ..................

15

15

0

17

Laparotomy exploratory ............................

12

12

0

18

Laparotomy (involving operations on abdominal viscera not otherwise specified in this Division)

21

0

0

19

Tapping of hydrocoele .............................

2

2

0

20

Removal of hydrocoele.............................

10

10

0

\n```\n\n \n\n```html\n

Column 1.

Column 2.

Column 3.

Item Number.

Professional Service.

Fee.

£

s.

d.

Division 3.—Urological.

1

Catherization of urethra.............................

1

1

3

2

Cystoscopic examination ............................

3

3

0

3

Cystoscopic examination and renal functional test............

4

4

0

4

Passage of urethral sounds...........................

1

1

0

5

Suprapubic cystostomy .............................

12

12

0

6

Nephrectomy....................................

26

5

0

Division 4.—Gynaecological.

1

Perineal repair ...................................

12

12

0

2

Repair of cystocoele...............................

15

15

0

3

Perineal repair and repair of cystocoele...................

18

0

0

4

Amputation or repair of cervix........................

10

10

0

5

Perineal repair, repair of cystocoele and amputation or repair of cervix

21

0

0

6

Excision of Bartholinian cyst.........................

5

5

0

7

Hysterectomy and plastic repair operations ................

26

5

0

8

Cauterization or diathermy of cervix....................

5

5

0

9

Curettage ......................................

5

5

0

10

Drainage of pelvic abscess...........................

15

15

0

11

Hysterectomy ...................................

21

0

0

12

Removal of Fallopian tubes with or without removal of ovaries...

15

15

0

13

Removal of ruptured ectopic gestation...................

21

0

0

14

Suspension or fixation of uterus .......................

15

15

0

Division 5.—Special Operations and Procedure.

1

Enucleation of eye................................

15

15

0

2

Craniotomy ....................................

21

0

0

3

Tracheotomy....................................

10

10

0

4

Intubation .....................................

5

5

0

5

Pterygium (removal of) .............................

10

10

0

6

Tarsal cyst (extirpation of) ...........................

2

2

0

7

Paracentesis thoracic ..............................

2

2

0

8

Aspiration of pleural cavity ..........................

3

3

0

9

Radical treatment of empyaema (involving resection of rib)

10

10

0

10

Section of breast for biopsy ..........................

3

3

0

11

Amputation of breast (simple).........................

15

15

0

12

Removal of cyst or simple tumor of breast (minor operation)....

3

3

0

13

Excision of exostosis...............................

5

5

0

14

Removal of meniscus of knee joint .....................

15

15

0

15

Assisting at operation—

First hour....................................

2

2

0

Each hour or part of an hour after first hour ..............

1

1

0

16

Blood transfusion ................................

5

5

0

17

Collection of blood for purposes of transfusion .............

2

2

0

18

Typing blood and determining compatibility for transfusion purpose

2

2

0

19

Collection intravenously of blood specimen for pathological test

1

1

0

20

Injection intravenously of saline and glucose ...............

2

2

0

21

Removal of haemorrhoids ...........................

12

12

0

22

Injection of haemorrhoids, per injection ..................

1

1

0

23

Excision of fistula in ano ............................

15

15

0

24

Incision of ischio-rectal abscess........................

5

5

0

25

Primary suture of flexor tendons of hand..................

7

7

0

26

Secondary suture of flexor tendons of hand ................

10

10

0

27

Primary suture of extensor tendons of hand................

5

5

0

28

Secondary suture of extensor tendons of hand ..............

7

7

0

\n```\n\n \n\n```html\n

Column 1.

Column 2.

Column 3.

Item Number.

Professional Service.

Fee.

£

s.

d.

Division 5.—Special Operations and Procedure—continued

29

Suture of tendo Achilles ............................

10

10

0

30

Suture of one nerve trunk ...........................

7

7

0

31

Suture of two or more nerve trunks.....................

12

12

0

32

Circumcision (infants) .............................

2

2

0

33

Circumcision (persons over one year) ...................

5

5

0

34

Spinal puncture (other than for anaesthetic purposes) .........

1

11

6

Division 6.—Amputations and Disarticulations of Limbs.

Amputation or disarticulation—

1

Of finger.....................................

4

4

0

2

Of fingers (two or more) ..........................

5

5

0

3

Through metacarpals.............................

10

10

0

4

Of hand .....................................

15

15

0

5

Of forearm ...................................

15

15

0

6

Through arm..................................

15

15

0

7

At shoulder ...................................

21

0

0

8

Of toe ......................................

5

5

0

9

Of toes (two or more) ............................

6

6

0

10

Of foot......................................

15

15

0

11

Through leg ..................................

15

15

0

12

At knee .....................................

15

15

0

13

Through thigh .................................

21

0

0

14

At hip ......................................

25

0

0

Part 4.—Midwifery.

1

Antenatal care, each consultation, where consultations do not exceed six

0

10

6

2

Antenatal care, where consultations exceed six .............

3

3

0

3

Confinement (including post-natal care for nine days) .........

5

5

0

4

Antenatal care and confinement (including postnatal care for nine days)

8

8

0

5

Caesarian section (including antenatal care)................

21

0

0

6

Caesarian section (excluding antenatal care) ...............

17

17

0

Additional fees for special services......................

7

Toxaemia of pregnancy other than eclampsia, each consultation, where consultations do not exceed ten

0

10

6

8

Toxaemia of pregnancy other than eclampsia, where consultations exceed ten

5

5

0

9

Eclampsia....................................

5

5

0

10

Antepartum haemorrhage involving surgical intervention and blood transfusion

4

4

0

11

Postpartum haemorrhage involving blood transfusion .......

4

4

0

12

Surgical induction of labour........................

2

2

0

Part 5.—Injections and Vaccinations

1

Injection of varicose veins, per injection..................

1

1

0

2

Diphtheria immunization ............................

2

2

0

3

Whooping cough immunization .......................

2

2

0

4

Tetanus immunization or injection of anti-tetanic serum .......

1

1

0

5

Vaccination against smallpox.........................

1

1

0

6

Inoculation against cholera ..........................

1

1

0

7

Inoculation against typhoid and paratyphoid fevers...........

1

1

0

8

Inoculation against plague ...........................

1

1

0

9

Inoculation against typhus...........................

1

1

0

\n```\n\n \n\n```html\n

Column 1.

Column 2.

Column 3.

Item Number.

Professional Service.

Fee.

£

s.

d.

Part 6.—Treatment of Dislocations.

Division 1.—Not Necessitating Open Operation.

Treatment of dislocation of—

1

Mandible.....................................

2

2

0

2

Clavicle .....................................

6

6

0

3

Shoulder .....................................

5

5

0

4

Elbow ......................................

6

6

0

5

Wrist .......................................

4

4

0

6

Finger ......................................

2

2

0

7

Metacarpo-phalangeal joint of thumb ..................

5

5

0

8

Hip ........................................

12

12

0

9

Knee .......................................

10

10

0

10

Patella ......................................

4

4

0

11

Ankle ......................................

7

7

0

12

Toe ........................................

2

2

0

13

Tarsus......................................

4

4

0

\n```\n\nDivision 2.—Necessitating Open Operation.\n\nThe prescribed fee for treatment of a dislocation necessitating an open operation shall be the fee which would be the prescribed fee for treatment of that dislocation under Division 1 of this Part if the dislocation did not necessitate an open operation, plus one-half of that fee.\n\nPart 7.—Treatment of Fractures.\n\nDivision 1.— Simple and Uncomplicated Fractures Not Requiring Open Operation and Not\n\nInvolving Joints.\n\n| | Treatment of fracture of- | | . | |\n| --- | ---------------------------------------------------------------------------- | --- | --- | --- |\n| 1 | Terminal phalanx of finger or thumb................... | 2 | 2 | 0 |\n| 2 | Terminal phalanx of more than one finger or of thumb and one or more fingers | 3 | 3 | 0 |\n| 3 | Proximal phalanx of finger or thumb................... | 5 | 5 | 0 |\n| 4 | Proximal phalanx of more than one finger or of thumb and one or more fingers | 6 | 6 | 0 |\n| 5 | Middle phalanx of finger.......................... | 3 | 3 | 0 |\n| 6 | Middle phalanx of more than one finger ................ | 4 | 4 | 0 |\n| 7 | One or more metacarpals but not including Bennett's fracture | 4 | 4 | 0 |\n| 8 | Metacarpal (Bennett's fracture)...................... | 7 | 7 | 0 |\n| 9 | Carpal bone (not including navicular) .................. | 4 | 4 | 0 |\n| 10 | Navicular .................................... | 8 | 8 | 0 |\n| 11 | Radius...................................... | 6 | 6 | 0 |\n| 12 | Ulna ....................................... | 5 | 5 | 0 |\n| 13 | Both shafts of forearm ............................ | 11 | 11 | 0 |\n| 14 | Wrist (Colles's fracture) ........................... | 7 | 7 | 0 |\n| 15 | Humerus .................................... | 12 | 12 | 0 |\n| 16 | Clavicle ..................................... | 5 | 5 | 0 |\n| 17 | Scapula ..................................... | 7 | 7 | 0 |\n| 18 | Sternum ..................................... | 5 | 5 | 0 |\n| 19 | One or more ribs ............................... | 3 | 13 | 6 |\n| 20 | One or more nasal bones .......................... | 5 | 5 | 0 |\n| 21 | Maxilla...................................... | 10 | 10 | 0 |\n| 22 | Mandible..................................... | 12 | 12 | 0 |\n| 23 | Zygoma..................................... | 5 | 5 | 0 |\n| 24 | Pelvis, excluding symphysis pubis .................... | 12 | 12 | 0 |\n| 25 | Symphysis pubis ............................... | 8 | 8 | 0 |\n| 26 | Femur ...................................... | 21 | 0 | 0 |\n| 27 | Patella ...................................... | 5 | 5 | 0 |\n\n \n\n```html\n

Column 1.

Column 2.

Column 3.

Item Number.

Professional Service.

Fee.

£

s.

d.

Part 7.—Treatment of Fractures—continued.

Division 1—continued.

28

Tibia.........................................

10

10

0

29

Fibula ........................................

5

5

0

30

Both shafts of leg .................................

14

14

0

31

Ankle (Pott's fracture)..............................

14

14

0

32

Tarsal bone (excepting os calcis or os talus) ...............

5

5

0

33

Os calcis.......................................

10

10

0

34

Os talus .......................................

10

10

0

35

One or more metatarsals ............................

4

14

6

36

Phalanx of toe (other than great toe) ....................

2

2

0

37

More than one phalanx of toe (other than great toe) ..........

3

3

0

38

Distal phalanx of great toe ..........................

4

4

0

39

Proximal phalanx of great toe .........................

4

4

0

40

Skull .........................................

15

15

0

\n```\n\nDivision 2.—Treatment of Simple and Uncomplicated Fractures Requiring Open Operation.\n\n| 1 | Excision of coccyx................................ | 10 | 10 | 0 |\n| --- | -------------------------------------------------------- | --- | --- | --- |\n| 2 | Treatment of fracture of patella ....................... | 15 | 15 | 0 |\n| | | | | |\n\nThe prescribed fee for treatment of any other simple and uncomplicated fracture requiring an open operation but not involving joints shall be the fee which would be the prescribed fee for treatment of that fracture if the fracture did not require open operation, plus one-third of that fee.\n\nDivision 3.—Treatment of Simple Fractures Involving Joints.\n\nThe prescribed fee for treatment of a simple fracture involving a joint (whether requiring an open operation or not) shall be the fee which would be the prescribed fee for treatment of that fracture if the fracture were simple and uncomplicated, did not require an open operation and did not involve joints, plus one-third of that fee.\n\nDivision 4.—Treatment of Compound Fractures Not Requiring Open Operation.\n\nThe prescribed fee for treatment of a compound fracture not requiring an open operation shall be the fee which would be the prescribed fee for treatment of that fracture if the fracture were simple and uncomplicated, did not require an open operation and did not involve joints, plus one-quarter of that fee.\n\nDivision 5.—Treatment of Compound Fractures Requiring Open Operation.\n\nThe prescribed fee for treatment of a compound fracture requiring an open operation shall be the fee which would be the prescribed fee for treatment of that fracture if the fracture were simple and uncomplicated, did not require an open operation and did not involve joints, plus one-half of that fee.\n\nDivision 6.—Treatment of Complicated Fractures Involving Visceral or Nerve Operations and Necessitating Open Operation.\n\nThe prescribed fee for treatment of a complicated fracture involving a visceral or nerve injury and necessitating an open operation shall be the fee which would be the prescribed fee for treatment of that fracture if the fracture were simple and uncomplicated, did not require an open operation and did not involve joints, plus three-quarters of that fee.\n\n![](image.007.png)By Authority : L. F. Johnston, Commonwealth Government Printer, Canberra.","sortOrder":0}],"analysis":{"kimi_summary":{"_metrics":{"model":"kimi-k2.5","source":"moonshot-realtime","completionTokens":1915},"content_quality":"ok","complexity_score":7,"scope_assessment":{"changed":false,"description":"This is the original 1949 instrument establishing the Medical Expenses Scheme. The scope remains consistent with the original intent—to create a subsidized medical benefits system—with no evidence of significant expansion beyond the initial purpose."},"complexity_factors":["Extensive fee schedule with 7 parts and multiple divisions specifying exact fees for over 200 distinct medical procedures","Mathematical conditional logic for fee adjustments (e.g., 'plus one-third of that fee' for open operations, 'plus one-half' for compound fractures)","Multiple overlapping conditions for service eligibility (after-hours definitions, mileage calculations, workers' compensation offsets)","Cross-referencing structure between the Regulations proper and the Scheme in the Schedule","Procedural requirements for administrative actions (suspension inquiries, Supreme Court appeals, record-keeping specifications)","Special provisions for friendly societies, blood transfusions, and multi-procedure billing"],"plain_english_summary":"The Regulations establish the Medical Expenses Scheme, Australia’s first national medical insurance: doctors may opt in as “participating” practitioners and, when they treat patients, the Commonwealth pays up to half a government‑set “prescribed fee” directly to the doctor, reducing patients’ bills. An extensive fee schedule sets rates (varying by time, complexity and travel). The scheme requires detailed record‑keeping, allows patient opt‑out, adjusts subsidies for compensation recoveries, and empowers the Director‑General to discipline non‑compliant doctors."}},"importantCases":[],"_links":{"self":"/api/acts/national-health-medical-expenses-regulations","history":"/api/acts/national-health-medical-expenses-regulations/history","analysis":"/api/acts/national-health-medical-expenses-regulations/analysis","conflicts":"/api/acts/national-health-medical-expenses-regulations/conflicts","importantCases":"/api/acts/national-health-medical-expenses-regulations/important-cases","documents":"/api/acts/national-health-medical-expenses-regulations/documents"}}