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Commonwealth legislation
This Act has been repealed and is no longer in force. It is retained for historical reference.
This determination adds vigilance testing (daytime sleepiness and wakefulness assessments used to diagnose hypersomnolence/narcolepsy and confirm fitness for safety‑critical work) to the Medicare Benefits Schedule, making them rebated professional services.
It affects patients needing these tests, sleep medicine clinicians and technicians, and reduces out‑of‑pocket costs for otherwise expensive, specialist‑run, monitored sleep studies that are important for diagnosis and workplace safety.
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Direct links to the current provisions in Health Insurance (Section 3C General Medical Services – Vigilance Testing) Determination 2018.
Name 1
Commencement 1
Authority 1
Definitions 1
Treatment of relevant services 1
Application of provisions of the general medical services table 2
Schedule 1 – relevant services 3
Endnotes
Endnote 1—About the endnotes 9
Endnote 2—Abbreviation key 10
Endnote 3—Legislation history 11
Endnote 4—Amendment history 12
This Determination is the Health Insurance (Section 3C General Medical Services – Vigilance Testing) Determination 2018.
This Determination is made under subsection 3C(1) of the Health Insurance Act 1973.
(1) In this Determination:
Act means the Health Insurance Act 1973.
Pharmaceutical Benefits Scheme means the scheme for the supply of pharmaceutical benefits established under Part VII of the National Health Act 1953.
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 Determination.
Note: The following terms are defined in subsection 3(1) of the Act:
(2) Unless the contrary intention appears, a reference in this Determination 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 Determination 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 1.2.10 of the general medical services table shall have effect as if item 12254, 12258, 12261, 12265, 12268 and 12272 were also specified in the clause.
(2) Clause 2.36.2 of the general medical services table shall have effect as if item 12261 and 12265 were also specified in subclause 2.36.2(1).
(3) Clause 2.36.2 of the general medical services table shall have effect as if item 12268 and 12272 were also specified in subclause 2.36.2(2).
(4) Clause 2.36.2 of the general medical services table shall have effect as if item 12254 and 12258 were also specified in subclause 2.36.2(3).
Schedule 1 – relevant services
<table cellspacing="0" cellpadding="0" style="width:467pt; border-collapse:collapse"><thead><tr><td colspan="6" style="width:456.3pt; border-top:1.5pt solid #000000; border-bottom:1.5pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top; background-color:#ffffff"><p style="margin-top:3pt; page-break-after:avoid; line-height:12pt"><span style="font-size:10pt; font-weight:bold">Category </span><span style="font-size:10pt; font-weight:bold">2</span><span style="font-size:10pt; font-weight:bold"> – </span><span style="font-size:10pt; font-weight:bold">Diagnostic</span><span style="font-size:10pt; font-weight:bold"> Procedures </span><span style="font-size:10pt; font-weight:bold">and Investigations</span></p></td></tr><tr><td colspan="6" style="width:456.3pt; border-top:1.5pt solid #000000; border-bottom:1.5pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top; background-color:#ffffff"><p style="margin-top:3pt; page-break-after:avoid; line-height:12pt"><span style="font-size:10pt; font-weight:bold">Group </span><span style="font-size:10pt; font-weight:bold">D1</span><span style="font-size:10pt; font-weight:bold"> – </span><span style="font-size:10pt; font-weight:bold">Miscellaneous Diagnostic Procedures And Investigations</span></p></td></tr><tr><td colspan="6" style="width:456.3pt; border-top:1.5pt solid #000000; border-bottom:1.5pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top; background-color:#ffffff"><p style="margin-top:3pt; page-break-after:avoid; line-height:12pt"><span style="font-size:10pt; font-weight:bold">Subgroup </span><span style="font-size:10pt; font-weight:bold">10</span><span style="font-size:10pt; font-weight:bold"> </span><span style="font-size:10pt; font-weight:bold">–</span><span style="font-size:10pt; font-weight:bold"> </span><span style="font-size:10pt; font-weight:bold">Other Diagnostic Procedures and Investigations</span></p></td></tr><tr><td style="border-top:1.5pt solid #000000; border-bottom:1.5pt solid #000000; vertical-align:top"></td><td colspan="2" style="width:59.4pt; border-top:1.5pt solid #000000; border-bottom:1.5pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top; background-color:#ffffff"><p style="margin-top:3pt; page-break-after:avoid; line-height:12pt"><span style="font-size:10pt; font-weight:bold">Item</span></p></td><td colspan="2" style="width:301.15pt; border-top:1.5pt solid #000000; border-bottom:1.5pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top; background-color:#ffffff"><p style="margin-top:3pt; page-break-after:avoid; line-height:12pt"><span style="font-size:10pt; font-weight:bold">Service</span></p></td><td style="width:73.4pt; border-top:1.5pt solid #000000; border-bottom:1.5pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top; background-color:#ffffff"><p style="margin-top:3pt; margin-left:29.7pt; page-break-after:avoid; line-height:12pt"><span style="font-size:10pt; font-weight:bold">Fee ($)</span></p></td></tr></thead><tbody><tr><td colspan="2" style="width:59.4pt; border-top:1.5pt solid #000000; border-bottom:1.5pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top; background-color:#ffffff"><p style="margin-top:3pt; margin-bottom:3pt; line-height:115%; font-size:10pt"><a id="CU_54742"></a><span>12254</span></p></td><td colspan="2" style="width:301.15pt; border-top:1.5pt solid #000000; border-bottom:1.5pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top; background-color:#ffffff"><p class="tabletext" style="margin-top:0pt; margin-bottom:6pt; font-size:10pt; background-color:#ffffff"><span>Multiple </span><span>s</span><span>leep </span><span>l</span><span>atency </span><span>t</span><span>est</span><span> </span><span>for the</span><span> assessment of unexplained hypersomnolence in a patient aged 18 years or more</span><span>,</span><span> if:</span></p><div style="margin-left:18pt; margin-bottom:6pt; background-color:#ffffff"><p class="tabletext" style="margin-top:0pt; margin-left:18pt; margin-bottom:0pt; text-indent:-18pt; font-size:10pt"><span><span>(a)</span></span><span style="font:7pt 'Times New Roman'"> </span><span>a qualified sleep medicine practitioner or neurologist determines that testing is necessary to confirm the diagnosis of a central disorder of hypersomnolence or to determine whether the eligibility criteria for drugs relevant to treat that condition under the Pharmaceutical Benefits Scheme are fulfilled;</span><span> and</span></p></div><div style="margin-left:18pt; margin-bottom:6pt; background-color:#ffffff"><p class="tabletext" style="margin-top:0pt; margin-left:18pt; margin-bottom:0pt; text-indent:-18pt; font-size:10pt"><span><span>(b)</span></span><span style="font:7pt 'Times New Roman'"> </span><span>an overnight diagnostic assessment of sleep, for a period of at least 8 hours duration</span><span> </span><span>is performed, with</span><span> </span><span>continuous monitoring and recording, in accordance with current professional guidelines, of the following measures:</span></p></div><p class="ListParagraph" style="margin-left:35.8pt; font-size:10pt"><span>(i) airflow;</span></p><p class="ListParagraph" style="margin-left:35.8pt; font-size:10pt"><span>(ii) continuous EMG;</span><span style="width:76.6pt; display:inline-block"></span></p><p class="ListParagraph" style="margin-left:35.8pt; font-size:10pt"><span>(iii) anterior tibial EMG;</span></p><p class="ListParagraph" style="margin-left:35.8pt; font-size:10pt"><span>(iv) continuous ECG;</span></p><p class="ListParagraph" style="margin-left:35.8pt; font-size:10pt"><span>(v) continuous EEG;</span></p><p class="ListParagraph" style="margin-left:35.8pt; font-size:10pt"><span>(vi) EOG;</span></p><p class="ListParagraph" style="margin-left:35.8pt; font-size:10pt"><span>(vii) oxygen saturation;</span></p><p class="ListParagraph" style="margin-left:35.8pt; font-size:10pt"><span>(viii) respiratory movement (chest and abdomen);</span></p><p class="ListParagraph" style="margin-left:35.8pt; font-size:10pt"><span>(ix)</span><span> position;</span><span> and</span></p><div style="margin-left:18pt; margin-bottom:6pt; background-color:#ffffff"><p class="tabletext" style="margin-top:0pt; margin-left:18pt; margin-bottom:0pt; text-indent:-18pt; font-size:10pt"><span><span>(c)</span></span><span style="font:7pt 'Times New Roman'"> </span><span>immediately following the overnight investigation </span><span>a daytime investigation is performed where at least 4 nap periods are conducted, during which there is continuous recording of EEG, EMG, EOG and ECG;</span><span> and</span></p></div><div style="margin-left:18.15pt; margin-bottom:6pt; background-color:#ffffff"><p class="tabletext" style="margin-top:0pt; margin-left:17.85pt; margin-bottom:0pt; text-indent:-17.85pt; font-size:10pt"><span><span>(d)</span></span><span style="font:7pt 'Times New Roman'"> </span><span>a sleep technician is in continuous attendance under the supervision of a qualified sleep medicine practitioner;</span><span> and</span></p></div><div style="margin-left:18.15pt; background-color:#ffffff"><p class="tabletext" style="margin-top:0pt; margin-left:17.85pt; margin-bottom:0pt; text-indent:-17.85pt; font-size:10pt"><span><span>(e)</span></span><span style="font:7pt 'Times New Roman'"> </span><span>p</span><span>olygraphic records are:</span></p></div><div style="margin-left:40.6pt; background-color:#ffffff"><p class="tabletext" style="margin-top:0pt; margin-left:17.85pt; margin-bottom:0pt; text-indent:-17.85pt; font-size:10pt"><span><span>(i)</span></span><span style="font:7pt 'Times New Roman'"> </span><span>analysed (for assessment of sleep stage, arousals, respiratory events, cardiac abnormalities and limb movements) with manual scoring, or manual correction of computerised scoring in epochs of not more than 1 minute; and</span></p></div><div style="margin-left:40.6pt; margin-bottom:6pt; background-color:#ffffff"><p class="tabletext" style="margin-top:0pt; margin-left:17.85pt; margin-bottom:0pt; text-indent:-17.85pt; font-size:10pt"><span><span>(ii)</span></span><span style="font:7pt 'Times New Roman'"> </span><span>stored for interpretation and preparation of report; and</span></p></div><div style="margin-left:18.15pt; margin-bottom:6pt; background-color:#ffffff"><p class="tabletext" style="margin-top:0pt; margin-left:17.85pt; margin-bottom:0pt; text-indent:-17.85pt; font-size:10pt"><span><span>(f)</span></span><span style="font:7pt 'Times New Roman'"> </span><span>interpretation and preparation of a permanent report is provided by a qualified sleep medicine practitioner with personal direct review of raw data from the original recording of polygraphic data from the patient; and</span></p></div><div style="margin-left:18pt; margin-bottom:14pt; background-color:#ffffff"><p class="tabletext" style="margin-top:0pt; margin-left:18pt; margin-bottom:0pt; text-indent:-18pt; font-size:10pt"><span><span>(g)</span></span><span style="font:7pt 'Times New Roman'"> </span><span>the diagnostic assessment is not provided to the patient on the same occasion that a service mentioned in any of items</span><span> </span><span>11003, </span><span>12203, 12204, 12205, 12208</span><span>,</span><span> 12250 </span><span>or 12258</span><span> </span><span>is provided to the patient</span></p></div><p class="tabletext" style="margin-top:0pt; margin-bottom:6pt; font-size:10pt; background-color:#ffffff"><span>Applicable only once in a 12 month period</span></p></td><td colspan="2" style="width:74.35pt; border-top:1.5pt solid #000000; border-bottom:1.5pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top; background-color:#ffffff"><p style="margin-top:3pt; margin-left:29.7pt; margin-bottom:3pt; page-break-after:avoid; line-height:115%; font-size:10pt"><span>928.30</span></p></td></tr><tr><td colspan="2" style="width:59.4pt; border-top:1.5pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top; background-color:#ffffff"><p style="margin-top:3pt; margin-bottom:3pt; line-height:115%; font-size:10pt"><a id="CU_66703"></a><span>12258</span></p></td><td colspan="2" style="width:301.15pt; border-top:1.5pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top; background-color:#ffffff"><p class="tabletext" style="margin-top:0pt; margin-bottom:6pt; font-size:10pt; background-color:#ffffff"><span>Maintenance of </span><span>w</span><span>akefulness </span><span>t</span><span>est</span><span> for the </span><span>assessment of the ability to maintain wakefulness in a patient aged 18 years or more</span><span>,</span><span> if</span><span>:</span></p><div style="margin-left:18pt; margin-bottom:6pt; background-color:#ffffff"><p class="tabletext" style="margin-top:0pt; margin-left:18pt; margin-bottom:0pt; text-indent:-18pt; font-size:10pt"><span><span>(a)</span></span><span style="font:7pt 'Times New Roman'"> </span><span>a qualified sleep medicine practitioner or neurologist determines that testing</span><span> is necessary </span><span>to objectively confirm the ability to maintain wakefulness</span><span>;</span><span> and</span></p></div><div style="margin-left:18.15pt; background-color:#ffffff"><p class="tabletext" style="margin-top:0pt; margin-left:17.85pt; margin-bottom:0pt; text-indent:-17.85pt; font-size:10pt"><span><span>(b)</span></span><span style="font:7pt 'Times New Roman'"> </span><span>an overnight diagnostic assessment of sleep, for a period of at least 8 hours duration</span><span> is performed, with</span><span> </span><span>continuous monitoring and recording, in accordance with current professional guidelines, of the following measures:</span></p></div><p class="ListParagraph" style="margin-left:35.8pt; font-size:10pt"><span>(i) airflow;</span></p><p class="ListParagraph" style="margin-left:35.8pt; font-size:10pt"><span>(ii) continuous EMG;</span><span style="width:76.6pt; display:inline-block"></span></p><p class="ListParagraph" style="margin-left:35.8pt; font-size:10pt"><span>(iii) anterior tibial EMG;</span></p><p class="ListParagraph" style="margin-left:35.8pt; font-size:10pt"><span>(iv) continuous ECG;</span></p><p class="ListParagraph" style="margin-left:35.8pt; font-size:10pt"><span>(v) continuous EEG;</span></p><p class="ListParagraph" style="margin-left:35.8pt; font-size:10pt"><span>(vi) EOG;</span></p><p class="ListParagraph" style="margin-left:35.8pt; font-size:10pt"><span>(vii) oxygen saturation;</span></p><p class="ListParagraph" style="margin-left:35.8pt; font-size:10pt"><span>(viii) respiratory movement (chest and abdomen);</span></p><p class="ListParagraph" style="margin-left:35.8pt; font-size:10pt"><span>(ix)</span><span> position</span><span>; and</span></p><div style="margin-left:18.15pt; background-color:#ffffff"><p class="tabletext" style="margin-top:0pt; margin-left:17.85pt; margin-bottom:0pt; text-indent:-17.85pt; font-size:10pt"><span><span>(c)</span></span><span style="font:7pt 'Times New Roman'"> </span><span>immediately following the overnight investigation</span><span>, </span><span>a daytime investigation is performed</span><span> </span><span>where at least 4 </span><span>wakefulness trials</span><span> are conducted, during which there is continuous recording of EEG, EMG, EOG and ECG;</span><span> and</span><span></span></p></div><div style="margin-left:18.15pt; margin-bottom:6pt; background-color:#ffffff"><p class="tabletext" style="margin-top:0pt; margin-left:17.85pt; margin-bottom:0pt; text-indent:-17.85pt; font-size:10pt"><span><span>(d)</span></span><span style="font:7pt 'Times New Roman'"> </span><span>a sleep technician is in continuous attendance under the supervision of a qualified sleep medicine practitioner;</span><span> and</span></p></div><div style="margin-left:18.15pt; background-color:#ffffff"><p class="tabletext" style="margin-top:0pt; margin-left:17.85pt; margin-bottom:0pt; text-indent:-17.85pt; font-size:10pt"><span><span>(e)</span></span><span style="font:7pt 'Times New Roman'"> </span><span>p</span><span>olygraphic records are:</span></p></div><div style="margin-left:40.45pt; background-color:#ffffff"><p class="tabletext" style="margin-top:0pt; margin-left:18pt; margin-bottom:0pt; text-indent:-18pt; font-size:10pt"><span><span>(i)</span></span><span style="font:7pt 'Times New Roman'"> </span><span>analysed (</span><span>for assessment of sleep stage, arousals, respiratory events, cardiac abnormalities and limb movements</span><span>) with manual scoring, or manual correction of computerised scoring in epochs of not more than 1 minute; and</span></p></div><div style="margin-left:40.45pt; margin-bottom:6pt; background-color:#ffffff"><p class="tabletext" style="margin-top:0pt; margin-left:18pt; margin-bottom:0pt; text-indent:-18pt; font-size:10pt"><span><span>(ii)</span></span><span style="font:7pt 'Times New Roman'"> </span><span>stored for interpretation and preparation of report; and</span></p></div><div style="margin-left:18.15pt; margin-bottom:6pt; background-color:#ffffff"><p class="tabletext" style="margin-top:0pt; margin-left:17.85pt; margin-bottom:0pt; text-indent:-17.85pt; font-size:10pt"><span><span>(f)</span></span><span style="font:7pt 'Times New Roman'"> </span><span>interpretation and preparation of a permanent report is provided by a qualified sleep medicine practitioner with personal direct review of raw data from the original recording of polygraphic data from the patient; and</span></p></div><div style="margin-left:18pt; margin-bottom:14pt; background-color:#ffffff"><p class="tabletext" style="margin-top:0pt; margin-left:18pt; margin-bottom:0pt; text-indent:-18pt; font-size:10pt"><span><span>(g)</span></span><span style="font:7pt 'Times New Roman'"> </span><span>the diagnostic assessment is not provided to the patient on the same occasion that a ser</span><span>vice mentioned in any of items </span><span>1</span><span>1003,</span><span> </span><span>12203, 12204, 12205, 12208</span><span>, </span><span>12250 </span><span>or 12254 </span><span>is provided to the patient</span></p></div><p class="tabletext" style="margin-top:0pt; margin-bottom:0pt; font-size:10pt; background-color:#ffffff"><span>Applicable only once in a 12 month period</span></p></td><td colspan="2" style="width:74.35pt; border-top:1.5pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top; background-color:#ffffff"><p style="margin-top:3pt; margin-left:29.7pt; margin-bottom:3pt; page-break-after:avoid; line-height:115%; font-size:10pt"><span>928.30</span></p></td></tr><tr><td colspan="2" style="width:59.4pt; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top; background-color:#ffffff"><p style="margin-top:3pt; margin-bottom:3pt; line-height:115%; font-size:10pt"><a id="CU_78530"></a><span>12261</span></p></td><td colspan="2" style="width:301.15pt; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top; background-color:#ffffff"><p class="tabletext" style="margin-top:0pt; margin-bottom:6pt; font-size:10pt; background-color:#ffffff"><span>Multiple </span><span>s</span><span>leep </span><span>l</span><span>atency </span><span>t</span><span>est</span><span> for the </span><span>assessment of unexplained hypersomnolence in a patient aged </span><span>at least </span><span>12</span><span> years but less than</span><span> 18 years</span><span>,</span><span> if:</span></p><div style="margin-left:18pt; margin-bottom:6pt; background-color:#ffffff"><p class="tabletext" style="margin-top:0pt; margin-left:18pt; margin-bottom:0pt; text-indent:-18pt; font-size:10pt"><span><span>(a)</span></span><span style="font:7pt 'Times New Roman'"> </span><span>a qualified sleep medicine practitioner determines that testing is necessary to confirm the diagnosis of a central disorder of hypersomnolence or to determine whether the eligibility criteria for drugs relevant to treat that condition under the Pharmaceutical Benefits Scheme are fulfilled;</span><span> and</span></p></div><div style="margin-left:17.85pt; background-color:#ffffff"><p class="tabletext" style="margin-top:0pt; margin-left:17.85pt; margin-bottom:0pt; text-indent:-17.85pt; font-size:10pt"><span style="font-size:12pt"><span>(b)</span></span><span style="font:7pt 'Times New Roman'"> </span><span>an overnight diagnostic assessment of sleep, for a period of at least 8 hours duration</span><span> </span><span>where </span><span>continuous monitoring of oxygen saturation and breathing using a multi</span><span>‑</span><span>channel polygraph, and recordings of the following are made, in accordance with current professional guidelines:</span></p></div><p class="ListParagraph" style="margin-left:51.35pt; text-indent:-15.55pt; font-size:10pt"><span>(i) airflow;</span></p><p class="ListParagraph" style="margin-left:51.35pt; text-indent:-15.55pt; font-size:10pt"><span>(ii) continuous EMG;</span></p><p class="ListParagraph" style="margin-left:51.35pt; text-indent:-15.55pt; font-size:10pt"><span>(iii) ECG;</span></p><p class="ListParagraph" style="margin-left:51.35pt; text-indent:-15.55pt; font-size:10pt"><span>(iv) EEG (with a minimum of 4 EEG leads or, in selected investigations, a minimum of 6 EEG leads);</span></p><p class="ListParagraph" style="margin-left:51.35pt; text-indent:-15.55pt; font-size:10pt"><span>(v) EOG;</span></p><p class="ListParagraph" style="margin-left:51.35pt; text-indent:-15.55pt; font-size:10pt"><span>(vi) oxygen saturation;</span></p><p class="ListParagraph" style="margin-left:51.35pt; text-indent:-15.55pt; font-size:10pt"><span>(vii) respiratory movement of rib and abdomen (whether movement of rib is recorded separately from, or together with, movement of abdomen);</span></p><p class="ListParagraph" style="margin-left:51.35pt; text-indent:-15.55pt; font-size:10pt"><span>(viii) measurement of carbon dioxide (either end</span><span>‑</span><span>tidal or transcutaneous); and</span></p><div style="margin-left:17.85pt; background-color:#ffffff"><p class="tabletext" style="margin-top:0pt; margin-left:17.85pt; margin-bottom:0pt; text-indent:-17.85pt; font-size:10pt"><span><span>(c)</span></span><span style="font:7pt 'Times New Roman'"> </span><span>immediately following the overnight investigation</span><span>, </span><span>a daytime investigation is performed where at least 4 nap periods are conducted, during which there is continuous recording of EEG, EMG, EOG and ECG;</span><span> and</span></p></div><div style="margin-left:18.15pt; margin-bottom:6pt; background-color:#ffffff"><p class="tabletext" style="margin-top:0pt; margin-left:17.85pt; margin-bottom:0pt; text-indent:-17.85pt; font-size:10pt"><span><span>(d)</span></span><span style="font:7pt 'Times New Roman'"> </span><span>a sleep technician is in continuous attendance under the supervision of a qualified sleep medicine practitioner;</span><span> and</span></p></div><div style="margin-left:18.15pt; background-color:#ffffff"><p class="tabletext" style="margin-top:0pt; margin-left:17.85pt; margin-bottom:0pt; text-indent:-17.85pt; font-size:10pt"><span><span>(e)</span></span><span style="font:7pt 'Times New Roman'"> </span><span>p</span><span>olygraphic records are:</span></p></div><div style="margin-left:40.45pt; background-color:#ffffff"><p class="tabletext" style="margin-top:0pt; margin-left:18pt; margin-bottom:0pt; text-indent:-18pt; font-size:10pt"><span><span>(i)</span></span><span style="font:7pt 'Times New Roman'"> </span><span>analysed (</span><span>for assessment of sleep stage, and maturation of sleep indices, arousals, respiratory events and assessment of clinically significant alterations in heart rate and body movement</span><span>) with manual scoring, or manual correction of computerised scoring in epochs of not more than 1 minute; and</span></p></div><div style="margin-left:40.6pt; margin-bottom:6pt; background-color:#ffffff"><p class="tabletext" style="margin-top:0pt; margin-left:17.85pt; margin-bottom:0pt; text-indent:-17.85pt; font-size:10pt"><span><span>(ii)</span></span><span style="font:7pt 'Times New Roman'"> </span><span>stored for interpretation and preparation of report; and</span></p></div><div style="margin-left:18.15pt; margin-bottom:6pt; background-color:#ffffff"><p class="tabletext" style="margin-top:0pt; margin-left:17.85pt; margin-bottom:0pt; text-indent:-17.85pt; font-size:10pt"><span><span>(f)</span></span><span style="font:7pt 'Times New Roman'"> </span><span>interpretation and preparation of a permanent report is provided by a qualified sleep medicine practitioner with personal direct review of raw data from the original recording of polygraphic data from the patient; and</span></p></div><div style="margin-left:18pt; margin-bottom:14pt; background-color:#ffffff"><p class="tabletext" style="margin-top:0pt; margin-left:18pt; margin-bottom:0pt; text-indent:-18pt; font-size:10pt"><span><span>(g)</span></span><span style="font:7pt 'Times New Roman'"> </span><span>the diagnostic assessment is not provided to the patient on the same occasion that a service mentioned in any of items </span><span>11003,</span><span> </span><span></span><span>122</span><span>1</span><span>3</span><span>,</span><span> </span><span>122</span><span>17 </span><span>or 12265 </span><span>is provided to the patient</span></p></div><p class="tabletext" style="margin-top:0pt; margin-bottom:0pt; font-size:10pt; background-color:#ffffff"><span>Applicable only once in a 12 month period</span></p></td><td colspan="2" style="width:74.35pt; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top; background-color:#ffffff"><p style="margin-top:3pt; margin-left:29.7pt; margin-bottom:3pt; page-break-after:avoid; line-height:115%; font-size:10pt"><span>973.35</span></p></td></tr><tr><td colspan="2" style="width:59.4pt; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top; background-color:#ffffff"><p style="margin-top:3pt; margin-bottom:3pt; line-height:115%; font-size:10pt"><a id="CU_810790"></a><span>12265</span></p></td><td colspan="2" style="width:301.15pt; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top; background-color:#ffffff"><p class="tabletext" style="margin-top:0pt; margin-bottom:6pt; font-size:10pt; background-color:#ffffff"><span>Maintenance of </span><span>w</span><span>akefulness </span><span>t</span><span>est </span><span>for the </span><span>assessment of the ability to maintain wakefulness in a patient aged </span><span>at least </span><span>12 </span><span>years but less than</span><span> 18 years</span><span>,</span><span> if</span><span>:</span></p><div style="margin-left:18pt; margin-bottom:6pt; background-color:#ffffff"><p class="tabletext" style="margin-top:0pt; margin-left:18pt; margin-bottom:0pt; text-indent:-18pt; font-size:10pt"><span><span>(a)</span></span><span style="font:7pt 'Times New Roman'"> </span><span>a qualified sleep medicine practitioner determines that testing </span><span>to objectively confirm the ability to maintain wakefulness is necessary</span><span>;</span><span> and</span></p></div><div style="margin-left:18pt; margin-bottom:6pt; background-color:#ffffff"><p class="tabletext" style="margin-top:0pt; margin-left:18pt; margin-bottom:0pt; text-indent:-18pt; font-size:10pt"><span><span>(b)</span></span><span style="font:7pt 'Times New Roman'"> </span><span>an overnight diagnostic assessment of sleep, for a period of at least 8 hours duration</span><span> where </span><span>continuous monitoring of oxygen saturation and breathing using a multi</span><span>‑</span><span>channel polygraph, and recordings of the following are made, in accordance with current professional guidelines:</span></p></div><p class="ListParagraph" style="margin-left:51.35pt; text-indent:-15.55pt; font-size:10pt"><span>(i) airflow;</span></p><p class="ListParagraph" style="margin-left:51.35pt; text-indent:-15.55pt; font-size:10pt"><span>(ii) continuous EMG;</span></p><p class="ListParagraph" style="margin-left:51.35pt; text-indent:-15.55pt; font-size:10pt"><span>(iii) ECG;</span></p><p class="ListParagraph" style="margin-left:51.35pt; text-indent:-15.55pt; font-size:10pt"><span>(iv) EEG (with a minimum of 4 EEG leads or, in selected investigations, a minimum of 6 EEG leads);</span></p><p class="ListParagraph" style="margin-left:51.35pt; text-indent:-15.55pt; font-size:10pt"><span>(v) EOG;</span></p><p class="ListParagraph" style="margin-left:51.35pt; text-indent:-15.55pt; font-size:10pt"><span>(vi) oxygen saturation;</span></p><p class="ListParagraph" style="margin-left:51.35pt; text-indent:-15.55pt; font-size:10pt"><span>(vii) respiratory movement of rib and abdomen (whether movement of rib is recorded separately from, or together with, movement of abdomen);</span></p><p class="ListParagraph" style="margin-left:51.35pt; text-indent:-15.55pt; font-size:10pt"><span>(viii) measurement of carbon dioxide (either end</span><span>‑</span><span>tidal or transcutaneous)</span><span>; and</span></p><div style="margin-left:18pt; margin-bottom:6pt; background-color:#ffffff"><p class="tabletext" style="margin-top:0pt; margin-left:18pt; margin-bottom:0pt; text-indent:-18pt; font-size:10pt"><span><span>(c)</span></span><span style="font:7pt 'Times New Roman'"> </span><span>immediately following the overnight investigation</span><span>, </span><span>a daytime investigation is performed where at least 4 </span><span>wakefulness trials</span><span> are conducted, during which there is continuous recording of EEG, EMG, EOG and ECG;</span><span> </span><span>and</span></p></div><div style="margin-left:18.15pt; margin-bottom:6pt; background-color:#ffffff"><p class="tabletext" style="margin-top:0pt; margin-left:17.85pt; margin-bottom:0pt; text-indent:-17.85pt; font-size:10pt"><span><span>(d)</span></span><span style="font:7pt 'Times New Roman'"> </span><span>a sleep technician is in continuous attendance under the supervision of a qualified sleep medicine practitioner;</span><span> and</span></p></div><div style="margin-left:18.15pt; background-color:#ffffff"><p class="tabletext" style="margin-top:0pt; margin-left:17.85pt; margin-bottom:0pt; text-indent:-17.85pt; font-size:10pt"><span><span>(e)</span></span><span style="font:7pt 'Times New Roman'"> </span><span>p</span><span>olygraphic records are:</span></p></div><div style="margin-left:33.35pt; background-color:#ffffff"><p class="tabletext" style="margin-top:0pt; margin-left:18pt; margin-bottom:0pt; text-indent:-18pt; font-size:10pt"><span><span>(i)</span></span><span style="font:7pt 'Times New Roman'"> </span><span>analysed (for assessment of sleep stage, arousals, respiratory events, cardiac abnormalities and limb movements) with manual scoring, or manual correction of computerised scoring in epochs of not more than 1 minute; and</span></p></div><div style="margin-left:33.5pt; margin-bottom:6pt; background-color:#ffffff"><p class="tabletext" style="margin-top:0pt; margin-left:17.85pt; margin-bottom:0pt; text-indent:-17.85pt; font-size:10pt"><span><span>(ii)</span></span><span style="font:7pt 'Times New Roman'"> </span><span>stored for interpretation and preparation of report; and</span></p></div><div style="margin-left:18.15pt; margin-bottom:6pt; background-color:#ffffff"><p class="tabletext" style="margin-top:0pt; margin-left:17.85pt; margin-bottom:0pt; text-indent:-17.85pt; font-size:10pt"><span><span>(f)</span></span><span style="font:7pt 'Times New Roman'"> </span><span>interpretation and preparation of a permanent report is provided by a qualified sleep medicine practitioner with personal direct review of raw data from the original recording of polygraphic data from the patient; and</span></p></div><div style="margin-left:18pt; margin-bottom:14pt; background-color:#ffffff"><p class="tabletext" style="margin-top:0pt; margin-left:18pt; margin-bottom:0pt; text-indent:-18pt; font-size:10pt"><span><span>(g)</span></span><span style="font:7pt 'Times New Roman'"> </span><span>the diagnostic assessment is not provided to the patient on the same occasion that a service mentioned in any of items </span><span>1</span><span>1003,</span><span> </span><span>122</span><span>13</span><span>,</span><span> </span><span>122</span><span>17</span><span> or 1</span><span>22</span><span>61</span><span> </span><span>or is provided to the patient</span></p></div><p class="tabletext" style="margin-top:0pt; margin-bottom:6pt; font-size:10pt; background-color:#ffffff"><span>Applicable only once in a </span><span>12 month period</span></p></td><td colspan="2" style="width:74.35pt; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top; background-color:#ffffff"><p style="margin-top:3pt; margin-left:29.7pt; margin-bottom:3pt; page-break-after:avoid; line-height:115%; font-size:10pt"><span>973.35</span></p></td></tr><tr><td colspan="2" style="width:59.4pt; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top; background-color:#ffffff"><p style="margin-top:3pt; margin-bottom:3pt; line-height:115%; font-size:10pt"><a id="CU_912841"></a><span>12268</span></p></td><td colspan="2" style="width:301.15pt; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top; background-color:#ffffff"><p class="tabletext" style="margin-top:0pt; margin-bottom:6pt; font-size:10pt; background-color:#ffffff"><span>Multiple </span><span>s</span><span>leep </span><span>l</span><span>atency </span><span>t</span><span>est</span><span> for the </span><span>assessment of unexplained hypersomnolence </span><span>for a patient less than 12 years of age,</span><span> if:</span></p><div style="margin-left:18pt; margin-bottom:6pt; background-color:#ffffff"><p class="tabletext" style="margin-top:0pt; margin-left:18pt; margin-bottom:0pt; text-indent:-18pt; font-size:10pt"><span><span>(a)</span></span><span style="font:7pt 'Times New Roman'"> </span><span>a qualified sleep medicine practitioner determines that testing is necessary to confirm the diagnosis of a central disorder of hypersomnolence or to determine whether the eligibility criteria for drugs relevant to treat that condition under the Pharmaceutical Benefits Scheme are fulfilled;</span><span> and</span></p></div><div style="margin-left:18pt; margin-bottom:6pt; background-color:#ffffff"><p class="tabletext" style="margin-top:0pt; margin-left:18pt; margin-bottom:0pt; text-indent:-18pt; font-size:10pt"><span style="font-size:12pt"><span>(b)</span></span><span style="font:7pt 'Times New Roman'"> </span><span>an overnight diagnostic assessment of sleep, for a period of at least 8 hours duration</span><span> </span><span>where </span><span>there is continuous monitoring of oxygen saturation and breathing using a multi</span><span>‑</span><span>channel polygraph, and recordings of the following are made, in accordance with current professional guidelines:</span></p></div><p class="ListParagraph" style="margin-left:51.35pt; text-indent:-15.55pt; font-size:10pt"><span>(i) airflow;</span></p><p class="ListParagraph" style="margin-left:51.35pt; text-indent:-15.55pt; font-size:10pt"><span>(ii) continuous EMG;</span></p><p class="ListParagraph" style="margin-left:51.35pt; text-indent:-15.55pt; font-size:10pt"><span>(iii) ECG;</span></p><p class="ListParagraph" style="margin-left:51.35pt; text-indent:-15.55pt; font-size:10pt"><span>(iv) EEG (with a minimum of 4 EEG leads or, in selected investigations, a minimum of 6 EEG leads);</span></p><p class="ListParagraph" style="margin-left:51.35pt; text-indent:-15.55pt; font-size:10pt"><span>(v) EOG;</span></p><p class="ListParagraph" style="margin-left:51.35pt; text-indent:-15.55pt; font-size:10pt"><span>(vi) oxygen saturation;</span></p><p class="ListParagraph" style="margin-left:51.35pt; text-indent:-15.55pt; font-size:10pt"><span>(vii) respiratory movement of rib and abdomen (whether movement of rib is recorded separately from, or together with, movement of abdomen);</span></p><p class="ListParagraph" style="margin-left:51.35pt; text-indent:-15.55pt; font-size:10pt"><span>(viii) measurement of carbon dioxide (either end</span><span>‑</span><span>tidal or transcutaneous);</span><span> </span><span>and</span></p><div style="margin-left:18pt; margin-bottom:6pt; background-color:#ffffff"><p class="tabletext" style="margin-top:0pt; margin-left:18pt; margin-bottom:0pt; text-indent:-18pt; font-size:10pt"><span><span>(c)</span></span><span style="font:7pt 'Times New Roman'"> </span><span>immediately following the overnight investigation</span><span>,</span><span> </span><span>a daytime investigation is performed</span><span> </span><span>where at least 4 nap periods are conducted, during which there is continuous recording of EEG, EMG, EOG and ECG;</span><span> and</span></p></div><div style="margin-left:18.15pt; margin-bottom:6pt; background-color:#ffffff"><p class="tabletext" style="margin-top:0pt; margin-left:17.85pt; margin-bottom:0pt; text-indent:-17.85pt; font-size:10pt"><span><span>(d)</span></span><span style="font:7pt 'Times New Roman'"> </span><span>a sleep technician is in continuous attendance under the supervision of a qualified sleep medicine practitioner;</span><span> and</span></p></div><div style="margin-left:18.15pt; background-color:#ffffff"><p class="tabletext" style="margin-top:0pt; margin-left:17.85pt; margin-bottom:0pt; text-indent:-17.85pt; font-size:10pt"><span><span>(e)</span></span><span style="font:7pt 'Times New Roman'"> </span><span>p</span><span>olygraphic records are:</span></p></div><div style="margin-left:40.45pt; background-color:#ffffff"><p class="tabletext" style="margin-top:0pt; margin-left:18pt; margin-bottom:0pt; text-indent:-18pt; font-size:10pt"><span><span>(i)</span></span><span style="font:7pt 'Times New Roman'"> </span><span>analysed (for assessment of sleep stage, arousals, respiratory events, cardiac abnormalities and limb movements) with manual scoring, or manual correction of computerised scoring in epochs of not more than 1 minute; and</span></p></div><div style="margin-left:40.6pt; margin-bottom:6pt; background-color:#ffffff"><p class="tabletext" style="margin-top:0pt; margin-left:17.85pt; margin-bottom:0pt; text-indent:-17.85pt; font-size:10pt"><span><span>(ii)</span></span><span style="font:7pt 'Times New Roman'"> </span><span>stored for interpretation and preparation of report; and</span></p></div><div style="margin-left:18.15pt; margin-bottom:6pt; background-color:#ffffff"><p class="tabletext" style="margin-top:0pt; margin-left:17.85pt; margin-bottom:0pt; text-indent:-17.85pt; font-size:10pt"><span><span>(f)</span></span><span style="font:7pt 'Times New Roman'"> </span><span>interpretation and preparation of a permanent report is provided by a qualified sleep medicine practitioner with personal direct review of raw data from the original recording of polygraphic data from the patient; and</span></p></div><div style="margin-left:18pt; margin-bottom:14pt; background-color:#ffffff"><p class="tabletext" style="margin-top:0pt; margin-left:18pt; margin-bottom:0pt; text-indent:-18pt; font-size:10pt"><span><span>(g)</span></span><span style="font:7pt 'Times New Roman'"> </span><span>the diagnostic assessment is not provided to the patient on the same occasion that a service mentioned in any of items </span><span>1</span><span>1003,</span><span> </span><span>122</span><span>10</span><span>,</span><span> </span><span>122</span><span>15</span><span> or 12272</span><span> is provided to the patient</span></p></div><p class="tabletext" style="margin-top:0pt; margin-bottom:6pt; font-size:10pt; background-color:#ffffff"><span>Applicable only once in a 12 month period</span></p></td><td colspan="2" style="width:74.35pt; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top; background-color:#ffffff"><p style="margin-top:3pt; margin-left:29.7pt; margin-bottom:3pt; page-break-after:avoid; line-height:115%; font-size:10pt"><span>1,044.00</span></p></td></tr><tr><td colspan="2" style="width:59.4pt; border-top:0.75pt solid #000000; border-bottom:1.5pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top; background-color:#ffffff"><p style="margin-top:3pt; margin-bottom:3pt; line-height:115%; font-size:10pt"><span>12272</span></p></td><td colspan="2" style="width:301.15pt; border-top:0.75pt solid #000000; border-bottom:1.5pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top; background-color:#ffffff"><p class="tabletext" style="margin-top:0pt; margin-bottom:6pt; font-size:10pt; background-color:#ffffff"><span>Maintenance of </span><span>w</span><span>akefulness </span><span>t</span><span>est</span><span> for the</span><span> assessment of the ability to maintain wakefulness </span><span>for a patient less than 12 years of age, if</span><span>:</span></p><div style="margin-left:18pt; margin-bottom:6pt; background-color:#ffffff"><p class="tabletext" style="margin-top:0pt; margin-left:18pt; margin-bottom:0pt; text-indent:-18pt; font-size:10pt"><span><span>(a)</span></span><span style="font:7pt 'Times New Roman'"> </span><span>a qualified sleep medicine practitioner determines that testing </span><span>to objectively confirm the ability to maintain wakefulness is necessary</span><span>;</span><span> and</span></p></div><div style="margin-left:18pt; margin-bottom:6pt; background-color:#ffffff"><p class="tabletext" style="margin-top:0pt; margin-left:18pt; margin-bottom:0pt; text-indent:-18pt; font-size:10pt"><span><span>(b)</span></span><span style="font:7pt 'Times New Roman'"> </span><span>an overnight diagnostic assessment of sleep, for a period of at least 8 hours duration</span><span> where </span><span>there is continuous monitoring of oxygen saturation and breathing using a multi</span><span>‑</span><span>channel polygraph, and recordings of the following are made, in accordance with current professional guidelines:</span></p></div><p class="ListParagraph" style="margin-left:51.35pt; text-indent:-15.55pt; font-size:10pt"><span>(i) airflow;</span></p><p class="ListParagraph" style="margin-left:51.35pt; text-indent:-15.55pt; font-size:10pt"><span>(ii) continuous EMG;</span></p><p class="ListParagraph" style="margin-left:51.35pt; text-indent:-15.55pt; font-size:10pt"><span>(iii) ECG;</span></p><p class="ListParagraph" style="margin-left:51.35pt; text-indent:-15.55pt; font-size:10pt"><span>(iv) EEG (with a minimum of 4 EEG leads or, in selected investigations, a minimum of 6 EEG leads);</span></p><p class="ListParagraph" style="margin-left:51.35pt; text-indent:-15.55pt; font-size:10pt"><span>(v) EOG;</span></p><p class="ListParagraph" style="margin-left:51.35pt; text-indent:-15.55pt; font-size:10pt"><span>(vi) oxygen saturation;</span></p><p class="ListParagraph" style="margin-left:51.35pt; text-indent:-15.55pt; font-size:10pt"><span>(vii) respiratory movement of rib and abdomen (whether movement of rib is recorded separately from, or together with, movement of abdomen);</span></p><p class="ListParagraph" style="margin-left:51.35pt; text-indent:-15.55pt; font-size:10pt"><span>(viii) measurement of carbon dioxide (either end</span><span>‑</span><span>tidal or transcutaneous);</span><span> and</span></p><div style="margin-left:18pt; margin-bottom:6pt; background-color:#ffffff"><p class="tabletext" style="margin-top:0pt; margin-left:18pt; margin-bottom:0pt; text-indent:-18pt; font-size:10pt"><span><span>(c)</span></span><span style="font:7pt 'Times New Roman'"> </span><span>immediately following the overnight investigation</span><span>, </span><span>a daytime investigation is performed</span><span> </span><span>where at least 4 </span><span>wakefulness trials</span><span> are conducted, during which there is continuous recording of EEG, EMG, EOG and ECG;</span><span> </span><span>and</span></p></div><div style="margin-left:18.15pt; margin-bottom:6pt; background-color:#ffffff"><p class="tabletext" style="margin-top:0pt; margin-left:17.85pt; margin-bottom:0pt; text-indent:-17.85pt; font-size:10pt"><span><span>(d)</span></span><span style="font:7pt 'Times New Roman'"> </span><span>a sleep technician is in continuous attendance under the supervision of a qualified sleep medicine practitioner;</span><span> and</span></p></div><div style="margin-left:18.15pt; background-color:#ffffff"><p class="tabletext" style="margin-top:0pt; margin-left:17.85pt; margin-bottom:0pt; text-indent:-17.85pt; font-size:10pt"><span><span>(e)</span></span><span style="font:7pt 'Times New Roman'"> </span><span>p</span><span>olygraphic records are:</span></p></div><div style="margin-left:40.45pt; background-color:#ffffff"><p class="tabletext" style="margin-top:0pt; margin-left:18pt; margin-bottom:0pt; text-indent:-18pt; font-size:10pt"><span><span>(i)</span></span><span style="font:7pt 'Times New Roman'"> </span><span>analysed (for assessment of sleep stage, arousals, respiratory events, cardiac abnormalities and limb movements) with manual scoring, or manual correction of computerised scoring in epochs of not more than 1 minute; and</span></p></div><div style="margin-left:40.45pt; margin-bottom:6pt; background-color:#ffffff"><p class="tabletext" style="margin-top:0pt; margin-left:18pt; margin-bottom:0pt; text-indent:-18pt; font-size:10pt"><span><span>(ii)</span></span><span style="font:7pt 'Times New Roman'"> </span><span>stored for interpretation and preparation of report; and</span></p></div><div style="margin-left:18.15pt; margin-bottom:6pt; background-color:#ffffff"><p class="tabletext" style="margin-top:0pt; margin-left:17.85pt; margin-bottom:0pt; text-indent:-17.85pt; font-size:10pt"><span><span>(f)</span></span><span style="font:7pt 'Times New Roman'"> </span><span>interpretation and preparation of a permanent report is provided by a qualified sleep medicine practitioner with personal direct review of raw data from the original recording of polygraphic data from the patient; and</span></p></div><div style="margin-left:18pt; margin-bottom:14pt; background-color:#ffffff"><p class="tabletext" style="margin-top:0pt; margin-left:18pt; margin-bottom:0pt; text-indent:-18pt; font-size:10pt"><span><span>(g)</span></span><span style="font:7pt 'Times New Roman'"> </span><span>the diagnostic assessment is not provided to the patient on the same occasion that a service mentioned in any of items </span><span>1</span><span>1003, </span><span></span><span>122</span><span>10</span><span>,</span><span> </span><span>122</span><span>15</span><span> </span><span>or 12268 </span><span>is provided to the patient</span></p></div><p class="tabletext" style="margin-top:0pt; margin-bottom:0pt; font-size:10pt; background-color:#ffffff"><span>Applicable only once in a </span><span>12 month period</span></p></td><td colspan="2" style="width:74.35pt; border-top:0.75pt solid #000000; border-bottom:1.5pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top; background-color:#ffffff"><p style="margin-top:3pt; margin-left:29.7pt; margin-bottom:3pt; page-break-after:avoid; line-height:115%; font-size:10pt"><span>1,044.00</span><span></span></p></td></tr></tbody><tbody><tr style="height:0pt"><td style="width:0.95pt"></td><td style="width:69.15pt"></td><td style="width:0.95pt"></td><td style="width:310.9pt"></td><td style="width:0.95pt"></td><td style="width:84.1pt"></td></tr></tbody></table>
Sourced from the Federal Register of Legislation (legislation.gov.au), CC BY 4.0.
Name 1
Commencement 1
Authority 1
Definitions 1
Treatment of relevant services 1
Application of provisions of the general medical services table 2
Schedule 1 – relevant services 3
Endnotes
Endnote 1—About the endnotes 9
Endnote 2—Abbreviation key 10
Endnote 3—Legislation history 11
Endnote 4—Amendment history 12
This Determination is the Health Insurance (Section 3C General Medical Services – Vigilance Testing) Determination 2018.
This Determination is made under subsection 3C(1) of the Health Insurance Act 1973.
(1) In this Determination:
Act means the Health Insurance Act 1973.
Pharmaceutical Benefits Scheme means the scheme for the supply of pharmaceutical benefits established under Part VII of the National Health Act 1953.
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 Determination.
Note: The following terms are defined in subsection 3(1) of the Act:
(2) Unless the contrary intention appears, a reference in this Determination 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 Determination 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 1.2.10 of the general medical services table shall have effect as if item 12254, 12258, 12261, 12265, 12268 and 12272 were also specified in the clause.
(2) Clause 2.36.2 of the general medical services table shall have effect as if item 12261 and 12265 were also specified in subclause 2.36.2(1).
(3) Clause 2.36.2 of the general medical services table shall have effect as if item 12268 and 12272 were also specified in subclause 2.36.2(2).
(4) Clause 2.36.2 of the general medical services table shall have effect as if item 12254 and 12258 were also specified in subclause 2.36.2(3).
Schedule 1 – relevant services
<table cellspacing="0" cellpadding="0" style="width:467pt; border-collapse:collapse"><thead><tr><td colspan="6" style="width:456.3pt; border-top:1.5pt solid #000000; border-bottom:1.5pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top; background-color:#ffffff"><p style="margin-top:3pt; page-break-after:avoid; line-height:12pt"><span style="font-size:10pt; font-weight:bold">Category </span><span style="font-size:10pt; font-weight:bold">2</span><span style="font-size:10pt; font-weight:bold"> – </span><span style="font-size:10pt; font-weight:bold">Diagnostic</span><span style="font-size:10pt; font-weight:bold"> Procedures </span><span style="font-size:10pt; font-weight:bold">and Investigations</span></p></td></tr><tr><td colspan="6" style="width:456.3pt; border-top:1.5pt solid #000000; border-bottom:1.5pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top; background-color:#ffffff"><p style="margin-top:3pt; page-break-after:avoid; line-height:12pt"><span style="font-size:10pt; font-weight:bold">Group </span><span style="font-size:10pt; font-weight:bold">D1</span><span style="font-size:10pt; font-weight:bold"> – </span><span style="font-size:10pt; font-weight:bold">Miscellaneous Diagnostic Procedures And Investigations</span></p></td></tr><tr><td colspan="6" style="width:456.3pt; border-top:1.5pt solid #000000; border-bottom:1.5pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top; background-color:#ffffff"><p style="margin-top:3pt; page-break-after:avoid; line-height:12pt"><span style="font-size:10pt; font-weight:bold">Subgroup </span><span style="font-size:10pt; font-weight:bold">10</span><span style="font-size:10pt; font-weight:bold"> </span><span style="font-size:10pt; font-weight:bold">–</span><span style="font-size:10pt; font-weight:bold"> </span><span style="font-size:10pt; font-weight:bold">Other Diagnostic Procedures and Investigations</span></p></td></tr><tr><td style="border-top:1.5pt solid #000000; border-bottom:1.5pt solid #000000; vertical-align:top"></td><td colspan="2" style="width:59.4pt; border-top:1.5pt solid #000000; border-bottom:1.5pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top; background-color:#ffffff"><p style="margin-top:3pt; page-break-after:avoid; line-height:12pt"><span style="font-size:10pt; font-weight:bold">Item</span></p></td><td colspan="2" style="width:301.15pt; border-top:1.5pt solid #000000; border-bottom:1.5pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top; background-color:#ffffff"><p style="margin-top:3pt; page-break-after:avoid; line-height:12pt"><span style="font-size:10pt; font-weight:bold">Service</span></p></td><td style="width:73.4pt; border-top:1.5pt solid #000000; border-bottom:1.5pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top; background-color:#ffffff"><p style="margin-top:3pt; margin-left:29.7pt; page-break-after:avoid; line-height:12pt"><span style="font-size:10pt; font-weight:bold">Fee ($)</span></p></td></tr></thead><tbody><tr><td colspan="2" style="width:59.4pt; border-top:1.5pt solid #000000; border-bottom:1.5pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top; background-color:#ffffff"><p style="margin-top:3pt; margin-bottom:3pt; line-height:115%; font-size:10pt"><a id="CU_54742"></a><span>12254</span></p></td><td colspan="2" style="width:301.15pt; border-top:1.5pt solid #000000; border-bottom:1.5pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top; background-color:#ffffff"><p class="tabletext" style="margin-top:0pt; margin-bottom:6pt; font-size:10pt; background-color:#ffffff"><span>Multiple </span><span>s</span><span>leep </span><span>l</span><span>atency </span><span>t</span><span>est</span><span> </span><span>for the</span><span> assessment of unexplained hypersomnolence in a patient aged 18 years or more</span><span>,</span><span> if:</span></p><div style="margin-left:18pt; margin-bottom:6pt; background-color:#ffffff"><p class="tabletext" style="margin-top:0pt; margin-left:18pt; margin-bottom:0pt; text-indent:-18pt; font-size:10pt"><span><span>(a)</span></span><span style="font:7pt 'Times New Roman'"> </span><span>a qualified sleep medicine practitioner or neurologist determines that testing is necessary to confirm the diagnosis of a central disorder of hypersomnolence or to determine whether the eligibility criteria for drugs relevant to treat that condition under the Pharmaceutical Benefits Scheme are fulfilled;</span><span> and</span></p></div><div style="margin-left:18pt; margin-bottom:6pt; background-color:#ffffff"><p class="tabletext" style="margin-top:0pt; margin-left:18pt; margin-bottom:0pt; text-indent:-18pt; font-size:10pt"><span><span>(b)</span></span><span style="font:7pt 'Times New Roman'"> </span><span>an overnight diagnostic assessment of sleep, for a period of at least 8 hours duration</span><span> </span><span>is performed, with</span><span> </span><span>continuous monitoring and recording, in accordance with current professional guidelines, of the following measures:</span></p></div><p class="ListParagraph" style="margin-left:35.8pt; font-size:10pt"><span>(i) airflow;</span></p><p class="ListParagraph" style="margin-left:35.8pt; font-size:10pt"><span>(ii) continuous EMG;</span><span style="width:76.6pt; display:inline-block"></span></p><p class="ListParagraph" style="margin-left:35.8pt; font-size:10pt"><span>(iii) anterior tibial EMG;</span></p><p class="ListParagraph" style="margin-left:35.8pt; font-size:10pt"><span>(iv) continuous ECG;</span></p><p class="ListParagraph" style="margin-left:35.8pt; font-size:10pt"><span>(v) continuous EEG;</span></p><p class="ListParagraph" style="margin-left:35.8pt; font-size:10pt"><span>(vi) EOG;</span></p><p class="ListParagraph" style="margin-left:35.8pt; font-size:10pt"><span>(vii) oxygen saturation;</span></p><p class="ListParagraph" style="margin-left:35.8pt; font-size:10pt"><span>(viii) respiratory movement (chest and abdomen);</span></p><p class="ListParagraph" style="margin-left:35.8pt; font-size:10pt"><span>(ix)</span><span> position;</span><span> and</span></p><div style="margin-left:18pt; margin-bottom:6pt; background-color:#ffffff"><p class="tabletext" style="margin-top:0pt; margin-left:18pt; margin-bottom:0pt; text-indent:-18pt; font-size:10pt"><span><span>(c)</span></span><span style="font:7pt 'Times New Roman'"> </span><span>immediately following the overnight investigation </span><span>a daytime investigation is performed where at least 4 nap periods are conducted, during which there is continuous recording of EEG, EMG, EOG and ECG;</span><span> and</span></p></div><div style="margin-left:18.15pt; margin-bottom:6pt; background-color:#ffffff"><p class="tabletext" style="margin-top:0pt; margin-left:17.85pt; margin-bottom:0pt; text-indent:-17.85pt; font-size:10pt"><span><span>(d)</span></span><span style="font:7pt 'Times New Roman'"> </span><span>a sleep technician is in continuous attendance under the supervision of a qualified sleep medicine practitioner;</span><span> and</span></p></div><div style="margin-left:18.15pt; background-color:#ffffff"><p class="tabletext" style="margin-top:0pt; margin-left:17.85pt; margin-bottom:0pt; text-indent:-17.85pt; font-size:10pt"><span><span>(e)</span></span><span style="font:7pt 'Times New Roman'"> </span><span>p</span><span>olygraphic records are:</span></p></div><div style="margin-left:40.6pt; background-color:#ffffff"><p class="tabletext" style="margin-top:0pt; margin-left:17.85pt; margin-bottom:0pt; text-indent:-17.85pt; font-size:10pt"><span><span>(i)</span></span><span style="font:7pt 'Times New Roman'"> </span><span>analysed (for assessment of sleep stage, arousals, respiratory events, cardiac abnormalities and limb movements) with manual scoring, or manual correction of computerised scoring in epochs of not more than 1 minute; and</span></p></div><div style="margin-left:40.6pt; margin-bottom:6pt; background-color:#ffffff"><p class="tabletext" style="margin-top:0pt; margin-left:17.85pt; margin-bottom:0pt; text-indent:-17.85pt; font-size:10pt"><span><span>(ii)</span></span><span style="font:7pt 'Times New Roman'"> </span><span>stored for interpretation and preparation of report; and</span></p></div><div style="margin-left:18.15pt; margin-bottom:6pt; background-color:#ffffff"><p class="tabletext" style="margin-top:0pt; margin-left:17.85pt; margin-bottom:0pt; text-indent:-17.85pt; font-size:10pt"><span><span>(f)</span></span><span style="font:7pt 'Times New Roman'"> </span><span>interpretation and preparation of a permanent report is provided by a qualified sleep medicine practitioner with personal direct review of raw data from the original recording of polygraphic data from the patient; and</span></p></div><div style="margin-left:18pt; margin-bottom:14pt; background-color:#ffffff"><p class="tabletext" style="margin-top:0pt; margin-left:18pt; margin-bottom:0pt; text-indent:-18pt; font-size:10pt"><span><span>(g)</span></span><span style="font:7pt 'Times New Roman'"> </span><span>the diagnostic assessment is not provided to the patient on the same occasion that a service mentioned in any of items</span><span> </span><span>11003, </span><span>12203, 12204, 12205, 12208</span><span>,</span><span> 12250 </span><span>or 12258</span><span> </span><span>is provided to the patient</span></p></div><p class="tabletext" style="margin-top:0pt; margin-bottom:6pt; font-size:10pt; background-color:#ffffff"><span>Applicable only once in a 12 month period</span></p></td><td colspan="2" style="width:74.35pt; border-top:1.5pt solid #000000; border-bottom:1.5pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top; background-color:#ffffff"><p style="margin-top:3pt; margin-left:29.7pt; margin-bottom:3pt; page-break-after:avoid; line-height:115%; font-size:10pt"><span>928.30</span></p></td></tr><tr><td colspan="2" style="width:59.4pt; border-top:1.5pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top; background-color:#ffffff"><p style="margin-top:3pt; margin-bottom:3pt; line-height:115%; font-size:10pt"><a id="CU_66703"></a><span>12258</span></p></td><td colspan="2" style="width:301.15pt; border-top:1.5pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top; background-color:#ffffff"><p class="tabletext" style="margin-top:0pt; margin-bottom:6pt; font-size:10pt; background-color:#ffffff"><span>Maintenance of </span><span>w</span><span>akefulness </span><span>t</span><span>est</span><span> for the </span><span>assessment of the ability to maintain wakefulness in a patient aged 18 years or more</span><span>,</span><span> if</span><span>:</span></p><div style="margin-left:18pt; margin-bottom:6pt; background-color:#ffffff"><p class="tabletext" style="margin-top:0pt; margin-left:18pt; margin-bottom:0pt; text-indent:-18pt; font-size:10pt"><span><span>(a)</span></span><span style="font:7pt 'Times New Roman'"> </span><span>a qualified sleep medicine practitioner or neurologist determines that testing</span><span> is necessary </span><span>to objectively confirm the ability to maintain wakefulness</span><span>;</span><span> and</span></p></div><div style="margin-left:18.15pt; background-color:#ffffff"><p class="tabletext" style="margin-top:0pt; margin-left:17.85pt; margin-bottom:0pt; text-indent:-17.85pt; font-size:10pt"><span><span>(b)</span></span><span style="font:7pt 'Times New Roman'"> </span><span>an overnight diagnostic assessment of sleep, for a period of at least 8 hours duration</span><span> is performed, with</span><span> </span><span>continuous monitoring and recording, in accordance with current professional guidelines, of the following measures:</span></p></div><p class="ListParagraph" style="margin-left:35.8pt; font-size:10pt"><span>(i) airflow;</span></p><p class="ListParagraph" style="margin-left:35.8pt; font-size:10pt"><span>(ii) continuous EMG;</span><span style="width:76.6pt; display:inline-block"></span></p><p class="ListParagraph" style="margin-left:35.8pt; font-size:10pt"><span>(iii) anterior tibial EMG;</span></p><p class="ListParagraph" style="margin-left:35.8pt; font-size:10pt"><span>(iv) continuous ECG;</span></p><p class="ListParagraph" style="margin-left:35.8pt; font-size:10pt"><span>(v) continuous EEG;</span></p><p class="ListParagraph" style="margin-left:35.8pt; fo
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