Health Insurance (Pathology Services Table) Regulations 2004
14Items in Groups P10 (Patient episode initiation) and P11 (Specimen referred) not to apply in certain circumstances
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14 Items in Groups P10 (Patient episode initiation) and P11 (Specimen referred) not to apply in certain circumstances
(1) For this rule and items in Groups P10 (Patient episode initiation) and P11 (Specimen referred):
approved collection centre has the same meaning as in Part IIA of the Act.
institution means a place at which residential accommodation or day care is, or both residential accommodation and day care are, made available to:
(a) disadvantaged children; or
(b) juvenile offenders; or
(c) aged persons; or
(d) chronically ill psychiatric patients; or
(e) homeless persons; or
(f) unemployed persons; or
(g) persons suffering from alcoholism; or
(h) persons addicted to drugs; or
(i) physically or mentally handicapped persons;
but does not include:
(j) a hospital; or
(k) a residential care facility; or
(l) accommodation for aged persons that is attached to a residential care facility or situated within a residential care facility complex.
prescribed laboratory means a laboratory operated by:
(a) the Commonwealth; or
(b) an authority of the Commonwealth; or
(c) a State or internal Territory; or
(d) an authority of a State or internal Territory; or
(e) an Australian tertiary education institution.
residential care facility means a facility in which residential care, within the meaning of section 41-3 of the Aged Care Act 1997, is provided.
specimen collection centre has the same meaning as in Part IIA of the Act.
treating practitioner has the same meaning as in paragraph 16A (1) (a) of the Act.
(2) If a service described in an item in Group P10 is rendered by, or on behalf of, an approved pathology practitioner who is a recognised pathologist, the relevant one of those items does not apply to the service if:
(a) the service is rendered upon a request made in the course of an out-patient service at a recognised hospital; or
(b) the service is rendered upon a request made for a patient who is a private patient in a recognised hospital when the request is made; or
(c) the pathology equipment of a recognised hospital, or a prescribed laboratory, is used rendering the service; or
(d) a member of the staff of a recognised hospital, or a prescribed laboratory, participates in the service in the course of the member’s employment with the hospital or laboratory.