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Health Insurance (Section 3C Midwife and Nurse Practitioner Services) Determination 2020
4Items in Subgroup 1 of Group M33—nurse practitioner providing assistance at operations
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4 Items in Subgroup 1 of Group M33—nurse practitioner providing assistance at operations
This clause sets out items in Subgroup 1 of Group M33.
<table cellspacing="0" cellpadding="0" style="width:100%; border-collapse:collapse"><thead><tr><td colspan="3" style="border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top"><p style="margin-top:3pt; margin-bottom:3pt; page-break-after:avoid; line-height:10pt"><span style="font-weight:bold">Group M33 – Non</span><span style="font-weight:bold">‑</span><span style="font-weight:bold">medical assistance at operations</span></p></td></tr><tr><td colspan="3" style="border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top"><p style="margin-top:3pt; margin-bottom:3pt; page-break-after:avoid; line-height:10pt"><span style="font-weight:bold">Subgroup 1 – Assistance at operations provided by a nurse practitioner</span></p></td></tr><tr><td style="width:12.9%; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top"><p style="margin-top:3pt; line-height:12pt"><span style="font-size:10pt; font-weight:bold">Column 1</span></p><p style="margin-top:3pt; margin-bottom:3pt; page-break-after:avoid; line-height:10pt"><span style="font-size:10pt; font-weight:bold">Item</span></p></td><td style="width:73.1%; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top"><p style="margin-top:3pt; line-height:12pt"><span style="font-size:10pt; font-weight:bold">Column 2</span></p><p style="margin-top:3pt; margin-bottom:3pt; page-break-after:avoid; line-height:10pt"><span style="font-size:10pt; font-weight:bold">Service</span></p></td><td style="width:14%; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top"><p style="margin-top:3pt; text-align:right; line-height:12pt"><span style="font-size:10pt; font-weight:bold">Column 3</span></p><p style="margin-top:3pt; margin-left:23.05pt; margin-bottom:3pt; page-break-after:avoid; line-height:10pt"><span style="font-size:10pt; font-weight:bold">Fee ($)</span></p></td></tr></thead><tbody><tr style="height:62.35pt"><td style="width:12.9%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top"><p style="margin-top:3pt; margin-bottom:3pt; line-height:12pt"><span style="font-size:10pt">93718</span></p></td><td style="width:73.1%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top"><p class="Tabletext"><span>Assistance by a participating nurse practitioner at any operation mentioned in an item in Group T8 that includes “(Assist.)” for which the fee does not exceed $651.30 or at a series or combination of operations mentioned in an item in Group T8 that include “(Assist.)” for which the aggregate fee does not exceed $651.30</span></p></td><td style="width:14%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top"><p style="margin-top:3pt; margin-bottom:3pt; text-align:right; line-height:12pt"><span style="font-size:10pt">100.65</span></p></td></tr><tr style="height:54.25pt"><td style="width:12.9%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top"><p style="margin-top:3pt; margin-bottom:3pt; line-height:12pt"><span style="font-size:10pt">93719</span></p></td><td style="width:73.1%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top"><p class="Tabletext"><span>Assistance by a participating nurse practitioner at any operation mentioned in an item in Group T8 that includes “(Assist.)” for which the fee exceeds $651.30 or at a series or combination of operations mentioned in an item in Group T8 that include “(Assist.)” for which the aggregate fee exceeds $651.30</span></p></td><td style="width:14%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top"><p style="margin-top:3pt; margin-bottom:3pt; line-height:12pt"><span style="font-size:10pt">Amount under clause</span><span style="font-size:10pt"> </span><span style="font-size:10pt">3.1</span></p></td></tr><tr style="height:18.65pt"><td style="width:12.9%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top"><p style="margin-top:3pt; margin-bottom:3pt; line-height:12pt"><span style="font-size:10pt">93720</span></p></td><td style="width:73.1%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top"><p class="Tabletext"><span>Assistance by a participating nurse practitioner at a birth involving Caesarean section (H)</span></p></td><td style="width:14%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top"><p style="margin-top:3pt; margin-bottom:3pt; text-align:right; line-height:12pt"><span style="font-size:10pt">145.45</span></p></td></tr><tr style="height:42.35pt"><td style="width:12.9%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top"><p style="margin-top:3pt; margin-bottom:3pt; line-height:12pt"><span style="font-size:10pt">93721</span></p></td><td style="width:73.1%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top"><p class="Tabletext"><span>Assistance by a participating nurse practitioner at a series or combination of operations that include “(Assist.)” and assistance by a participating nurse practitioner at a birth involving Caesarean section (H)</span></p></td><td style="width:14%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top"><p style="margin-top:3pt; margin-bottom:3pt; line-height:12pt"><span style="font-size:10pt">Amount under clause</span><span style="font-size:10pt"> </span><span style="font-size:10pt">3.2</span></p></td></tr><tr style="height:42.2pt"><td style="width:12.9%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top"><p style="margin-top:3pt; margin-bottom:3pt; line-height:12pt"><span style="font-size:10pt">93722</span></p></td><td style="width:73.1%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top"><p class="Tabletext"><span>Assistance by a participating nurse practitioner at any interventional obstetric procedure covered by items 16606, 16609, 16612, 16615 and 16627 (H)</span></p></td><td style="width:14%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top"><p style="margin-top:3pt; margin-bottom:3pt; line-height:12pt"><span style="font-size:10pt">Amount under clause</span><span style="font-size:10pt"> </span><span style="font-size:10pt">3.3</span></p></td></tr><tr style="height:56.3pt"><td style="width:12.9%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top"><p style="margin-top:3pt; margin-bottom:3pt; line-height:12pt"><span style="font-size:10pt">93723</span></p></td><td style="width:73.1%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top"><p class="Tabletext"><span>Assistance by a participating nurse practitioner at cataract and intraocular lens surgery covered by item 42698, 42701, 42702, 42704, 42705 or 42707, when performed in association with services covered by item 42551 to 42569, 42653, 42656, 42725, 42746, 42749, 42752, 42776 or 42779 (H)</span></p></td><td style="width:14%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top"><p style="margin-top:3pt; margin-bottom:3pt; text-align:right; line-height:12pt"><span style="font-size:10pt">317.80</span></p></td></tr><tr style="height:141.3pt"><td style="width:12.9%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top"><p style="margin-top:3pt; margin-bottom:3pt; line-height:12pt"><span style="font-size:10pt">93724</span></p></td><td style="width:73.1%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top"><p class="Tabletext"><span>Assistance at cataract and intraocular lens surgery by a participating nurse practitioner, if patient has:</span></p><p class="Tablea"><span>(a) total loss of vision, including no potential for central vision, in the fellow eye; or</span></p><p class="Tablea"><span>(b) one of the following in the fellow eye:</span></p><p class="Tablei"><span>(i) vitreous loss;</span></p><p class="Tablei"><span>(ii) rupture of posterior capsule;</span></p><p class="Tablei"><span>(iii) loss of nuclear material into the vitreous;</span></p><p class="Tablei"><span>(iv) intraocular haemorrhage;</span></p><p class="Tablei"><span>(v) intraocular infection (endophthalmitis);</span></p><p class="Tablei"><span>(vi) cystoid macular oedema;</span></p><p class="Tablei"><span>(vii) corneal decompensation;</span></p><p class="Tablei"><span>(viii) retinal detachment; or</span></p><p class="Tablea"><span>(c) pseudo exfoliation, subluxed lens, iridodonesis, phacodonesis, retinal detachment, corneal scarring, pre</span><span>‑</span><span>existing uveitis, bound down miosed pupil, nanophthalmos, spherophakia, Marfan’s syndrome, homocysteinuria or previous blunt trauma causing intraocular damage</span></p><p class="Tablea"><span>(H)</span></p></td><td style="width:14%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top"><p style="margin-top:3pt; margin-bottom:3pt; text-align:right; line-height:12pt"><span style="font-size:10pt">209.75</span></p></td></tr></tbody></table>