Health Insurance (Section 3C – Lutetium Therapeutic Nuclear Medicine Treatments) Determination 2025
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4 Definitions
(1) In this instrument:
Act means the Health Insurance Act 1973.
disease progression means, for items 16050 and 16055 only, either or both:
(a) a rise in PSA of >2ng/mL confirmed by two tests a minimum of two weeks apart, or
(b) evidence of new soft tissue or bone metastases on diagnostic imaging computed tomography as per established guidelines (such as the Response Evaluation Criteria in Solid Tumours criteria, as published by the European Organisation for Research and Treatment of Cancer, or the Response Evaluation Criteria in PSMA-Imaging Criteria.
formally convened neuroendocrine multidisciplinary board means a formal board of relevant practitioners, including specialists in medical oncology and nuclear medicine with experience in managing neuroendocrine neoplasms, endocrinology and surgery specialists, as well as medical practitioners from different areas of medical practice. The board must include at least one oncologist and one surgeon.
peptide receptor radionuclide therapy means a targeted form of radiation treatment that can be used to treat neuroendocrine neoplasms.
PET means positron emission tomography.
PSA means prostate‑specific antigen
PSMA means prostate specific membrane antigen
nuclear medicine credentialled specialist means a specialist or consultant physician whose name is included in a register, given to the Chief Executive Medicare by the JNMCAC, of participants in the Joint Nuclear Medicine Specialist Credentialling Program of the JNMCAC.
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.
report means a report prepared by a medical practitioner.
(R) has the meaning given by clause 1.2.15 of the diagnostic imaging services table.
Schedule means a Schedule to this instrument.