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This is the Health Insurance (Diagnostic Imaging Services Table) Regulation 2015.
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Direct links to the current provisions in Health Insurance (Diagnostic Imaging Services Table) Regulation 2015.
This is the Health Insurance (Diagnostic Imaging Services Table) Regulation 2015.
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Each instrument that is specified in a Schedule to this instrument is amended or repealed as set out in the applicable items in the Schedule concerned, and any other item in a Schedule to this instrument has effect according to its terms.
For subsection 4AA(1) of the Act, Schedule 1 prescribes a table of diagnostic imaging services.
The Dictionary in Part 3 of Schedule 1 defines certain words and expressions that are used in this instrument, and includes references to certain words and expressions that are defined elsewhere in this instrument.
Sourced from the Federal Register of Legislation (legislation.gov.au), CC BY 4.0.
This is the Health Insurance (Diagnostic Imaging Services Table) Regulation 2015.
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Each instrument that is specified in a Schedule to this instrument is amended or repealed as set out in the applicable items in the Schedule concerned, and any other item in a Schedule to this instrument has effect according to its terms.
For subsection 4AA(1) of the Act, Schedule 1 prescribes a table of diagnostic imaging services.
The Dictionary in Part 3 of Schedule 1 defines certain words and expressions that are used in this instrument, and includes references to certain words and expressions that are defined elsewhere in this instrument.
Schedule 1—Diagnostic imaging services table
Note: See section 5.
A reference to a diagnostic imaging service in an item in Part 2 includes a reference to the undertaking of the diagnostic imaging procedure used for rendering the service.
(1) Subject to clause 1.2.3, an (NK) item applies to a service that is performed on: (a) diagnostic imaging equipment: (i) that has not been upgraded; and (ii) the age of which exceeds the new effective life age for the equipment; or (b) diagnostic imaging equipment: (i) that has been upgraded; and (ii) the age of which exceeds the maximum extended life age for the equipment. (2) A (K) item does not apply to a service to which an (NK) item applies.
Age of equipment (1) The date from which the age of equipment is worked out for this instrument is: (a) the date that the diagnostic imaging equipment was first installed in Australia; or (b) if the diagnostic imaging equipment was imported as used equipment—the date of manufacture of the oldest component of the equipment. Life ages (2) The new effective life age and maximum extended life age for equipment are the periods set out in the following table for that type of equipment:
<table cellspacing="0" cellpadding="0" style="width:100%; border-collapse:collapse"><thead><tr><td colspan="5" style="border-top:1.5pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p class="TableHeading"><span>Life ages</span></p></td></tr><tr><td style="width:8.56%; border-top:0.75pt solid #000000; border-bottom:1.5pt solid #000000; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p class="TableHeading"><span>Item</span></p></td><td style="width:23.08%; border-top:0.75pt solid #000000; border-bottom:1.5pt solid #000000; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p class="TableHeading"><span>Column 1</span></p><p class="TableHeading"><span>Topic</span></p></td><td style="width:34.6%; border-top:0.75pt solid #000000; border-bottom:1.5pt solid #000000; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p class="TableHeading"><span>Column 2</span></p><p class="TableHeading"><span>Modality</span></p></td><td style="width:16.14%; border-top:0.75pt solid #000000; border-bottom:1.5pt solid #000000; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p class="TableHeading" style="text-align:right"><span>Column 3</span></p><p class="TableHeading" style="text-align:right"><span>New effective life age (years)</span></p></td><td style="width:17.62%; border-top:0.75pt solid #000000; border-bottom:1.5pt solid #000000; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p class="TableHeading" style="text-align:right"><span>Column 4</span></p><p class="TableHeading" style="text-align:right"><span>Maximum extended life age (years)</span></p></td></tr></thead><tbody><tr><td style="width:8.56%; border-top:1.5pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p class="Tabletext"><span>1</span></p></td><td style="width:23.08%; border-top:1.5pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p class="Tabletext"><span>Ultrasound</span></p></td><td style="width:34.6%; border-top:1.5pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p class="Tabletext"><span>Equipment used to perform a service to which an item in Group I1 in Division</span><span> </span><span>2.1 applies</span></p></td><td style="width:16.14%; border-top:1.5pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p class="Tabletext" style="text-align:right"><span>10</span></p></td><td style="width:17.62%; border-top:1.5pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p class="Tabletext" style="text-align:right"><span>15</span></p></td></tr><tr><td style="width:8.56%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p class="Tabletext"><span>2</span></p></td><td style="width:23.08%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p class="Tabletext"><span>CT</span></p></td><td style="width:34.6%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p class="Tabletext"><span>Equipment used to perform a service to which an item in Group I2 in Division</span><span> </span><span>2.2 applies</span></p></td><td style="width:16.14%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p class="Tabletext" style="text-align:right"><span>10</span></p></td><td style="width:17.62%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p class="Tabletext" style="text-align:right"><span>15</span></p></td></tr><tr><td style="width:8.56%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p class="Tabletext"><span>3</span></p></td><td style="width:23.08%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p class="Tabletext"><span>Mammography</span></p></td><td style="width:34.6%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p class="Tabletext"><span>Equipment used to perform a service to which an item in Group I3 (other than Subgroup 10) in Division</span><span> </span><span>2.3 applies</span></p></td><td style="width:16.14%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p class="Tabletext" style="text-align:right"><span>10</span></p></td><td style="width:17.62%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p class="Tabletext" style="text-align:right"><span>15</span></p></td></tr><tr><td style="width:8.56%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p class="Tabletext"><span>4</span></p></td><td style="width:23.08%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p class="Tabletext"><span>Angiography</span></p></td><td style="width:34.6%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p class="Tabletext"><span>Equipment used to perform a service to which an item in Subgroup 13 of Group I3 in Division</span><span> </span><span>2.3 applies</span></p></td><td style="width:16.14%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p class="Tabletext" style="text-align:right"><span>10</span></p></td><td style="width:17.62%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p class="Tabletext" style="text-align:right"><span>15</span></p></td></tr><tr><td style="width:8.56%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p class="Tabletext"><span>5</span></p></td><td style="width:23.08%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p class="Tabletext"><span>Rest of diagnostic radiology</span></p></td><td style="width:34.6%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p class="Tabletext"><span>Equipment used to perform a service to which an item in Subgroups 1 to 9, 12, 14, 15 or 17 of Group I3 in Division</span><span> </span><span>2.3 applies</span></p></td><td style="width:16.14%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p class="Tabletext" style="text-align:right"><span>15</span></p></td><td style="width:17.62%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p class="Tabletext" style="text-align:right"><span>20</span></p></td></tr><tr><td style="width:8.56%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p class="Tabletext"><span>6</span></p></td><td style="width:23.08%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p class="Tabletext"><span>Nuclear medicine (excluding PET)</span></p></td><td style="width:34.6%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p class="Tabletext"><span>Equipment used to perform a service to which an item in Group I4 in Division</span><span> </span><span>2.4 applies</span></p></td><td style="width:16.14%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p class="Tabletext" style="text-align:right"><span>10</span></p></td><td style="width:17.62%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p class="Tabletext" style="text-align:right"><span>15</span></p></td></tr><tr><td style="width:8.56%; border-top:0.75pt solid #000000; border-bottom:1.5pt solid #000000; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p class="Tabletext"><span>7</span></p></td><td style="width:23.08%; border-top:0.75pt solid #000000; border-bottom:1.5pt solid #000000; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p class="Tabletext"><span>MRI</span></p></td><td style="width:34.6%; border-top:0.75pt solid #000000; border-bottom:1.5pt solid #000000; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p class="Tabletext"><span>Equipment used to perform a service to which an item in Group I5 in Division</span><span> </span><span>2.5 applies</span></p></td><td style="width:16.14%; border-top:0.75pt solid #000000; border-bottom:1.5pt solid #000000; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p class="Tabletext" style="text-align:right"><span>10</span></p></td><td style="width:17.62%; border-top:0.75pt solid #000000; border-bottom:1.5pt solid #000000; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p class="Tabletext" style="text-align:right"><span>20</span></p></td></tr></tbody></table>
Upgrades (3) Diagnostic imaging equipment has been upgraded if: (a) an additional reasonable investment has been made within the new effective life age for the equipment that improves the overall performance of the imaging system so that it is equivalent to new equipment supplied in Australia at the time of the improvement; or (aa) in the case of CT or angiography equipment that was not more than 15 years old on 1 January 2015—an additional reasonable investment has been made before 1 January 2016 that improves the overall performance of the imaging system so that it is equivalent to new equipment supplied in Australia at the time of the improvement; or (b) the equipment is currently accredited under The Royal Australian and New Zealand College of Radiologists’ Mammography Quality Assurance Program.
Note: Proprietors can obtain further information on what constitutes an upgrade from the Department’s website (http://www.health.gov.au/capitalsensitivity).
Outer regional, remote and very remote areas (1) An (NK) item does not apply if: (a) the diagnostic imaging equipment used to perform the service is ordinarily located at diagnostic imaging premises; and (b) the diagnostic imaging premises are located in RA2, RA3 or RA4.
Note: Proprietors can identify what Remoteness Area they fall under at the Department’s DoctorConnect website (http://www.doctorconnect.gov.au). Proprietors should refer to the category names, rather than category numbers as the website uses different category numbers from those specified in this instrument.
(2) An (NK) item does not apply if: (a) the diagnostic imaging equipment used to perform the service is not ordinarily located at diagnostic imaging premises; and (b) the diagnostic imaging equipment used to perform the service is ordinarily located, when not in use, at a base for mobile diagnostic imaging equipment; and (c) the base for mobile diagnostic imaging equipment is located in RA2, RA3 or RA4.
Note: Proprietors can identify what Remoteness Area they fall under at the Department’s DoctorConnect website (http://www.doctorconnect.gov.au). Proprietors should refer to the category names, rather than category numbers as the website uses different category numbers from those specified in this instrument.
Inner regional areas (3) An (NK) item does not apply if: (a) both of the following subparagraphs apply: (i) the Department has notified the relevant proprietor of the receipt of a valid application for an exemption under subclause (4); (ii) the Secretary has not made a decision under subclause (4); or (b) the Secretary has granted an exemption under subclause (4); or (c) the Secretary has notified the relevant proprietor that the Secretary has refused to grant an exemption under subclause (4), and: (i) if the proprietor has not yet applied for reconsideration under clause 1.2.4—the period to apply for reconsideration has not yet expired; or (ii) if the proprietor has applied for reconsideration under clause 1.2.4—the Secretary has not yet notified the proprietor of the Secretary’s reconsideration decision. (4) The Secretary may grant an exemption in writing in respect of diagnostic imaging equipment if the Secretary is satisfied that the diagnostic imaging equipment: (a) is operated on a rare and sporadic basis; and (b) provides crucial patient access to diagnostic
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