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This instrument is the Health Insurance (Section 3C General Medical Services – Botox, Dysport or Xeomin Injection) Determination 2020.
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Commonwealth legislation
This instrument adds Botox, Dysport and Xeomin injections as "relevant services" under subsection 3C(1) of the Health Insurance Act and treats those injections as both medical and professional services for Medicare billing, creating MBS item 18365 with state-by-state fees set in the Schedule. It applies existing general medical services rules to that item and fixes an indexation step from 1 July 2025 (multiplier 1.024) with specified rounding. It affects clinicians who bill Medicare, patients claiming rebates, and Medicare administrators.
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Direct links to the current provisions in Health Insurance (Section 3C General Medical Services – Botox, Dysport or Xeomin Injection) Determination 2020.
This instrument is the Health Insurance (Section 3C General Medical Services – Botox, Dysport or Xeomin Injection) Determination 2020.
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.
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;
general medical services table;
item;
professional service.
(2) Unless the contrary intention appears, a reference in this instrument to a provision of the Act or 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 medical service; and
(b) there were an item in the general medical 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.
(1) Clause 5.8.1 of the general medical services table shall have effect as if item 18365 of this Determination was specified in the clause. (2) Clause 5.8.2 of the general medical services table shall have effect as if item 18365 of this Determination was specified in subclause 5.8.2(2) and 5.8.2(3).
(1) At the start of 1 July 2025 (the indexation time), each amount covered by subsection (2) is replaced by the amount worked out using the following formula: 1.024 multiplied by the amount immediately before the indexation time
Note: The indexed fees could in 2025 be viewed on the Department of Health and Aged Care’s MBS Online website (https://www.mbsonline.gov.au).
(2) The amounts covered by this subsection are the fee for each item in a Schedule of this Determination. (3) An amount worked out under subsection (1) is to be rounded up or down to the nearest 5 cents (rounding down if the amount is an exact multiple of 2.5 cents).
Sourced from the Federal Register of Legislation (legislation.gov.au), CC BY 4.0.
This instrument is the Health Insurance (Section 3C General Medical Services – Botox, Dysport or Xeomin Injection) Determination 2020.
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.
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;
general medical services table;
item;
professional service.
(2) Unless the contrary intention appears, a reference in this instrument to a provision of the Act or 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 medical service; and
(b) there were an item in the general medical 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.
(1) Clause 5.8.1 of the general medical services table shall have effect as if item 18365 of this Determination was specified in the clause. (2) Clause 5.8.2 of the general medical services table shall have effect as if item 18365 of this Determination was specified in subclause 5.8.2(2) and 5.8.2(3).
(1) At the start of 1 July 2025 (the indexation time), each amount covered by subsection (2) is replaced by the amount worked out using the following formula:
Note: The indexed fees could in 2025 be viewed on the Department of Health and Aged Care’s MBS Online website (https://www.mbsonline.gov.au).
(2) The amounts covered by this subsection are the fee for each item in a Schedule of this Determination. (3) An amount worked out under subsection (1) is to be rounded up or down to the nearest 5 cents (rounding down if the amount is an exact multiple of 2.5 cents).