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This instrument is the Health Insurance (Section 3C Diagnostic Imaging – Conjunctive Thallium‑201 Nuclear Medicine Imaging Service) Determination 2023.
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Commonwealth legislation
This instrument specifies that a particular thallium‑201 conjunctive nuclear medicine imaging service is to be treated for Medicare purposes as both a professional service and a diagnostic imaging service, and that an item with state‑specific fees is to apply (s5). It affects medical practitioners who provide and bill the service and the Medicare payment rules (including bulk‑billing mechanics); it matters because it fixes how the service is classified, billed and paid under the Health Insurance Act.
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Direct links to the current provisions in Health Insurance (Section 3C Diagnostic Imaging – Conjunctive Thallium-201 Nuclear Medicine Imaging Service) Determination 2023.
This instrument is the Health Insurance (Section 3C Diagnostic Imaging – Conjunctive Thallium‑201 Nuclear Medicine Imaging Service) Determination 2023.
This instrument is made under subsection 3C(1) of the Health Insurance Act 1973.
(1) In this instrument:
Act means the Health Insurance Act 1973.
bulk‑billed means:
(a) a medicare benefit is payable to a person in relation to the service; and
(b) under an agreement entered into under section 20A of the Act:
(i) the person assigns to the practitioner, by whom the service is provided, the person’s right to the payment of the medicare benefit; and
(ii) the practitioner accepts the assignment in full payment of the practitioner’s fee for the service provided.
PET means positron emission tomography.
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.
Schedule means a Schedule to this instrument.
Note: The following terms are defined in subsection 3(1) of the Act:
clinically relevant service;
diagnostic imaging services table;
item;
professional service.
(2) Unless the contrary intention appears, a reference in this instrument to a provision of the Act of 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.
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: (a) it were both a professional service and a diagnostic imaging service; and (b) there were an item in the diagnostic imaging services table that: i. related to the service; and ii. specified for the service a fee in relation to each State, being the fee specified in the Schedule in relation to the service.
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.
Sourced from the Federal Register of Legislation (legislation.gov.au), CC BY 4.0.
This instrument is the Health Insurance (Section 3C Diagnostic Imaging – Conjunctive Thallium‑201 Nuclear Medicine Imaging Service) Determination 2023.
This instrument is made under subsection 3C(1) of the Health Insurance Act 1973.
(1) In this instrument:
Act means the Health Insurance Act 1973.
bulk‑billed means:
(a) a medicare benefit is payable to a person in relation to the service; and
(b) under an agreement entered into under section 20A of the Act:
(i) the person assigns to the practitioner, by whom the service is provided, the person’s right to the payment of the medicare benefit; and
(ii) the practitioner accepts the assignment in full payment of the practitioner’s fee for the service provided.
PET means positron emission tomography.
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.
Schedule means a Schedule to this instrument.
Note: The following terms are defined in subsection 3(1) of the Act:
clinically relevant service;
diagnostic imaging services table;
item;
professional service.
(2) Unless the contrary intention appears, a reference in this instrument to a provision of the Act of 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.
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: (a) it were both a professional service and a diagnostic imaging service; and (b) there were an item in the diagnostic imaging services table that: i. related to the service; and ii. specified for the service a fee in relation to each State, being the fee specified in the Schedule in relation to the service.
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.