Commonwealth legislation

Health Insurance (1994-1995 Diagnostic Imaging Services Table) Regulations

RepealedCTH

This Act has been repealed and is no longer in force. It is retained for historical reference.

Jurisdiction

Commonwealth

Act Number

363 of 1994

Collection

legislative instrument

Plain English Summary

8/10 complexity

These Regulations set the Medicare rebate schedule for diagnostic imaging (ultrasound, CT, X‑ray, nuclear medicine) for the 1994–95 financial year, replacing the prior year’s table. They determine what patients can claim back and how referring doctors and imaging providers are paid, establishing who may perform services and the technical/billing standards that affect rebate levels. The rules ensure consistent subsidy amounts and prevent duplicate claims across Australia.

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Current sections

Direct links to the current provisions in Health Insurance (1994-1995 Diagnostic Imaging Services Table) Regulations.

Sch 2

SCHEDULE 2

Table of Diagnostic Imaging Services

Part

Rules of Interpretation 2

1 Rules of Interpretation 2

Services and Fees 7

2 Services and Fees 7

Group or Subgroup

I1	Ultrasound	7
1	General	7
2	Cardiac	19
3	Vascular	22
4	Urological	24

TABLE OF PROVISIONS—continued

Group or Subgroup Page

I2	Computerised Tomography (excluding Magnetic Resonance Imaging)	26
1	Computerised Tomography on a Body Scanner and Report	26
2	Computerised Tomography on a Brain Scanner and Report	36
I3	Diagnostic Radiology	36
1	Radiographic Examination of Extremities and Report	36
2	Radiographic Examination of Shoulder or Pelvis and Report	37
3	Radiographic Examination of Head and Report	38
4	Radiographic Examination of Spine and Report	39
5	Bone Age Study and Skeletal Surveys and Report	40
6	Radiographic Examination of Thoracic Region and Report	40
7	Radiographic Examination of Urinary Tract and Report	41
8	Radiographic Examination of Alimentary Tract and Biliary System and Report	42
9	Radiographic Examination for Localisation of Foreign Bodies and Report	43
10	Radiographic Examination of Breasts and Report	44
11	Radiographic Examination in connection with Pregnancy and Report	45
12	Radiographic Examination with Opaque or Contrast Media and Report	45
13	Angiography and Report	47
14	Tomography and Report	51
15	Stereoscopic Examination and Report	51
16	Fluoroscopic Examination and Report	51
17	Examination and Report to which no other Item Applies	52
18	Preparation for Radiological Procedure	52

TABLE OF PROVISIONS—continued

Group or Subgroup Page

19	Interventional Techniques	54
I4	Nuclear Medicine Imaging	55

Statutory Rules 1994 No. 3631

_______________

Health Insurance (1994-1995 Diagnostic Imaging Services Table) Regulations

I, The Governor-General of the Commonwealth of Australia, acting with the advice of the Federal Executive Council, make the following Regulations under the Health Insurance Act 1973.

Dated 25 October 1994.

BILL HAYDEN

Governor-General

By His Excellency’s Command,

CARMEN LAWRENCE

Minister for Human Services and Health

____________

Citation

These Regulations may be cited as the Health Insurance (1994-1995 Diagnostic Imaging Services Table) Regulations.

Commencement

These Regulations commence on 1 November 1994.

Repeal of Health Insurance (1993-1994 Diagnostic Imaging Services Table) Regulations

Statutory Rules 1993 No. 271 are repealed.

Diagnostic imaging services table

The table of diagnostic imaging services set out in the Schedule is prescribed for the purposes of subsection 4AA (1) of the Health Insurance Act 1973.

________________

SCHEDULE Regulation 4

TABLE OF DIAGNOSTIC IMAGING SERVICES

Part 1

RULES OF INTERPRETATION

PART 1—RULES OF INTERPRETATION

General

In this table, unless the contrary intention appears:

“the Act” means the Health Insurance Act 1973.

References to items in the general medical services table

A reference by number to an item in the series 11603 to 11612 (inclusive) is a reference to the item so numbered in the general medical services table.

Meaning of “(C)” and (“NC)”

(1) An item including the symbol “(C)” applies only to a service provided using a radioisotope imaging scanner at a nuclear medicine unit that has computerised processing facilities capable of being used for the service.

(2) An item including the symbol “(NC)” applies only to a service provided using a radioisotope imaging scanner at a nuclear medicine unit that does not have computerised processing facilities capable of being used for the service.

Meaning of “(R)” and “(NR)”

(1) An item including the symbol “(R)” is an R-type diagnostic imaging service.

(2) An item including the symbol “(NR)” is an NR-type diagnostic imaging service.

Meaning of “(S)”

An item including the symbol “(S)” applies only to a service provided by a specialist in the practice of diagnostic radiology.

Who may provide a diagnostic imaging service

A diagnostic imaging service set out in this table is a diagnostic imaging service for the purposes of the Act, whether the service is provided by:

(a) a medical practitioner; or

(b) a person, other than a medical practitioner, who:

(i) is employed by a medical practitioner; or

(ii) provides the service under the supervision of a medical practitioner in accordance with accepted medical practice.

Meaning of “report” in certain items

In items 55028 to 61109 (inclusive), “report” means a report prepared by a medical practitioner.

Administration of anaesthetics in connection with certain services

If a general anaesthetic is administered in connection with a service specified in an item that includes the formula:

Anaes. n = n1 B + n2 T

in which:

(a) n is a number; and

(b) n1 and n2 are other numbers;

the service that is provided by the medical practitioner who administers the anaesthetic is the service described in item n in the general medical services table.

Meaning of “group of practitioners”

In this table, “group of practitioners” has the same meaning as in subsection 16A (10) of the Act.

Meaning of “Amount under rule 10” in item 57303

In item 57303, “Amount under rule 10” means an amount equal to the sum of:

(a) the fee set out in the item in items 56000 to 57406 (inclusive) in conjunction with which a service referred to in item 57303 is provided; and

(b) $113.10.

Meaning of “Amount under rule 11” in certain items

In items 59103, 59739 and 60300, “Amount under rule 11” means an amount equal to the sum of:

(a) the fee set out in another item for the radiographic examination in conjunction with which a service referred to in item 59103, 59739 or 60300 is provided; and

(b) 1 of the following amounts:

(i) in the case of item 59103—$20.75;

(ii) in the case of item 59739—$22.00;

(iii) in the case of item 60300—$13.20.

Preparation of patients for radiological procedures

Items 60900 to 60981 (inclusive) apply only to the preparation of a patient for a radiological procedure by:

(a) injecting opaque or contrast media; or

(b) removing fluid and replacing it by air, oxygen or other contrast media; or

Meaning of “angiography suite” in item 61109

In item 61109, “angiography suite” means a room that contains only equipment designed for angiography that is able to perform digital subtraction or rapid sequence film angiography.

Nuclear scanning services

Items 61300 to 61502 (inclusive) apply to a nuclear scanning service only if:

(a) the performance of the scan is undertaken:

(i) by a medical practitioner; or

(ii) by a person acting on behalf of a medical practitioner in the presence of the practitioner; and

(b) the compilation of the final report is undertaken by the medical practitioner who undertook the preliminary examination of the patient and the estimation and administration of the dosage.

Meaning of “Amount under rule 15” in certain items

In items 61322 and 61323, “Amount under rule 15” means an amount equal to the sum of:

(a) the fee set out in the item in items 61300 to 61502 (inclusive) in conjunction with which a service referred to in item 61322 or 61323 is provided and:

(b) 1 of the following amounts:

(i) in the case of item 61322—$91.15;

(ii) in the case of item 61323—$68.10.

Meaning of “Amount under rule 16” in item 61490

In item 61490, “Amount under rule 16” means an amount equal to the sum of:

(a) the fee set out in the item in items 61300 to 61502 (inclusive) in conjunction with which a service referred to in item 61490 is provided; and

(b) $182.25.

More sections below

Source text: opening excerpt

Sourced from the Federal Register of Legislation (legislation.gov.au), CC BY 4.0.

1 Health Insurance (1994-1995 Diagnostic Imaging Services Table) Regulations

Statutory Rules 1994 No. 363

_______________

Health Insurance (1994-1995 Diagnostic Imaging Services Table) Regulations

TABLE OF PROVISIONS

Regulation Page

1 Citation 1

2 Commencement 1

3 Repeal of Health Insurance (1993-1994 Diagnostic Imaging Services Table) Regulations 2

Diagnostic imaging services table 2

SCHEDULE 2

Table of Diagnostic Imaging Services

Part

1 Rules of Interpretation 2

2 Services and Fees 7

Group or Subgroup

I1	Ultrasound	7
1	General	7
2	Cardiac	19
3	Vascular	22
4	Urological	24

TABLE OF PROVISIONS—continued

Group or Subgroup Page

I2	Computerised Tomography (excluding Magnetic Resonance Imaging)	26
1	Computerised Tomography on a Body Scanner and Report	26
2	Computerised Tomography on a Brain Scanner and Report	36
I3	Diagnostic Radiology	36
1	Radiographic Examination of Extremities and Report	36
2	Radiographic Examination of Shoulder or Pelvis and Report	37
3	Radiographic Examination of Head and Report	38
4	Radiographic Examination of Spine and Report	39
5	Bone Age Study and Skeletal Surveys and Report	40
6	Radiographic Examination of Thoracic Region and Report

Item	Diagnostic imaging service	Fee
55028	Head, ultrasound scan of, performed by, or on behalf of, a medical practitioner, if:(a) the patient is referred by a medical practitioner for ultrasonic examination, not being a service associated with a service to which item 55055 or an item in Subgroup 2 or 3 of this Group applies; and	$97.00
	(b) the referring medical practitioner is not a member of a group of practitioners of which the first-mentioned practitioner is a member (R)
55029	Head, ultrasound scan of, if the patient is not referred by a medical practitioner, not being a service associated with a service to which item 55055, or an item in Subgroup 2 or 3 of this Group, applies (NR)	$33.65
55030	Orbital contents, ultrasound scan of, performed by, or on behalf of, a medical practitioner, if:(a) the patient is referred by a medical practitioner for ultrasonic examination, not being a service associated with a service to which item 55055, or an item in Subgroup 2 or 3 of this Group, applies; and(b) the referring medical practitioner is not a member of a group of practitioners of which the first-mentioned practitioner is a member (R)	$97.00
55031	Orbital contents, ultrasound scan of, if the patient is not referred by a medical practitioner, not being a service associated with a service to which item 55055, or an item in Subgroup 2 or 3 of this Group, applies (NR)	$33.65
55032	Neck, 1 or more structures of, ultrasound scan of, performed by, or on behalf of, a medical practitioner, if:(a) the patient is referred by a medical practitioner for ultrasonic examination, not being a service associated with a service to which item 55055, or an item in Subgroup 2 or 3 of this Group, applies; and(b) the referring medical practitioner is not a member of a group of practitioners of which the first-mentioned practitioner is a member (R)	$97.00
55033	Neck, 1 or more structures of, ultrasound scan of, if the patient is not referred by a medical practitioner, not being a service associated with a service to which item 55055, or an item in Subgroup 2 or 3 of this Group, applies (NR)	$33.65
55034	Breast, 1 or both, ultrasound scan of, performed by, or on behalf of, a medical practitioner if:(a) the patient is referred by a medical practitioner for ultrasonic examination, not being a service associated with a service to which item 55055, or an item in Subgroup 2 or 3 of this Group, applies; and(b) the referring medical practitioner is not a member of a group of practitioners of which the first-mentioned practitioner is a member (R)	$97.00
55035	Breast, 1 or both, ultrasound scan of, if the patient is not referred by a medical practitioner, not being a service associated with a service to which item 55055, or an item in Subgroup 2 or 3 of this Group, applies (NR)	$33.65
55036	Abdomen, ultrasound scan of, including scan of urinary tract when undertaken, performed by, or on behalf of, a medical practitioner, if:(a) the patient is referred by a medical practitioner for ultrasonic examination, not bein