Health Insurance (Section 3C Diagnostic Imaging Services – Complex gynaecological ultrasound) Determination 2025
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Commonwealth Coat of Arms of Australia
Health Insurance (Section 3C Diagnostic Imaging Services – Complex gynaecological ultrasound) Determination 2025
I, Mary Warner, delegate of the Minister for Health and Ageing, make the following determination.
Dated 26 August 2025
Mary Warner
Assistant Secretary
Diagnostic Imaging and Pathology Branch
Medicare Benefits and Digital Health Division
Health Resourcing Group
Department of Health, Disability and Ageing
Contents
1. Name
2. Commencement
3. Authority
4. Definitions
5. Treatment of relevant services
6. Application of provisions of the diagnostic imaging services table
Schedule 1 – Relevant services
1. Name
This instrument is the Health Insurance (Section 3C Diagnostic Imaging Services – Complex gynaecological ultrasound) Determination 2025.
2. Commencement
(1) Each provision of this instrument specified in column 1 of the table commences, or is taken to have commenced, in accordance with column 2 of the table. Any other statement in column 2 has effect according to its terms.
- Commencement information
- Column 1 Column 2 Column 3
- Provisions Commencement Date/Details
-
- The whole of this instrument 1 November 2025. 1 November 2025
Note: This table relates only to the provisions of this instrument as originally made. It will not be amended to deal with any later amendments of this instrument.
(2) Any information in column 3 of the table is not part of this instrument. Information may be inserted in this column, or information in it may be edited, in any published version of this instrument.
3. Authority
This instrument is made under subsection 3C(1) of the Health Insurance Act 1973.
4. Definitions
Note: The following terms are defined in subsection 3(1) of the Act:
clinically relevant service;
diagnostic imaging services table;
item;
professional service.
(1) In this instrument:
Act means the Health Insurance Act 1973.
(R) has the meaning given by subsection 1.2.15(1) of the diagnostic imaging services table.
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 10AC(1) of the Act, that is specified in a Schedule.
Schedule means a Schedule to this instrument.
- Treatment of relevant services
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 is:
(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.
- Application of provisions of the diagnostic imaging services table
Clause 2.1.2 of the diagnostic imaging services table shall have effect as if item 55080 of Schedule 1 of this Determination was also specified in clause 2.1.2 of the diagnostic imaging services table.
Schedule 1 – Relevant services
- Group I1—Ultrasound
- Column 1Item Column 2Description Column 3Fee ($)
- Subgroup 1—General
- 55080 Pelvis, ultrasound scan of, by any or all approaches (including transvaginal), if:(a) the patient is known to have, or the requesting practitioner suspects, a complex gynaecological condition; and (b) the service is considered a complex investigation requiring a minimum of 30 minutes scanning time; and(c) within 24 hours of the service, a service mentioned in item 55038, 55065, 55700, 55704, 55736, or 55739 is not performed on the same patient. (R) 255.00