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Commonwealth legislation
This Act has been repealed and is no longer in force. It is retained for historical reference.
This instrument updates the Medicare Benefits Schedule for pathology: it adds and revises hundreds of test items and descriptions, establishes two fee tiers (Specialist and Other Pathologists), removes a few obsolete items, refreshes ordering abbreviations, and repeals two older statutory instruments.
It matters to patients (which tests get Medicare rebates and how much), pathologists and laboratories (their fees), and GPs/specialists (the billing codes they must use).
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Zoe can write the in-depth analysis on top of the summary above: how it works, who it affects and what each part actually does.
Direct links to the current provisions in Health Insurance (Variation of Pathology Services Table) (No. 2) Regulations.
Sourced from the Federal Register of Legislation (legislation.gov.au), CC BY 4.0.
Statutory Rules 1990 No. 3121
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Health Insurance (Variation of Pathology Services Table) (No. 2) Regulations
I, THE GOVERNOR-GENERAL of the Commonwealth of Australia, acting with the advice of the Federal Executive Council, hereby make the following Regulations under the Health Insurance Act 1973.
Dated 11 October 1990.
BILL HAYDEN
Governor-General
By His Excellency’s Command,
B. HOWE
Minister of State for Community Services and Health
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Citation
Commencement
2. These Regulations commence on 15 October 1990.
Variation of the pathology services table
(a) by inserting after rule 16 of the rules for interpretation the following heading:
“PATHOLOGY SERVICES TABLE—SCHEDULE OF SERVICES AND FEES”;
(b) by omitting items 1396, 1397 and 2400;
(c) as the case requires:
(i) by substituting for the like-numbered item; or
(ii) inserting in the proper numerical position (in the case of item 2387, in Division 8);
each of the items set out in Schedule 1 to these Regulations;
(d) by omitting the lists of abbreviations and substituting the lists of abbreviations set out in Schedule 2 to these Regulations.
Repeal
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SCHEDULE 1 Paragraph 4 (c)
ITEMS TO BE SUBSTITUTED FOR EXISTING ITEMS, OR INSERTED, IN THE PATHOLOGY SERVICES TABLE
| Item No. | Pathology Service | Fees—All States |
|---|---|---|
| $ | ||
| 1170 | Examination of blood film, with or without differential cell count, or differential cell count with or without examination of blood film, and if performed, any of these additional services—Direct Coombs test, tests for heterophile antibodies, cold agglutinins, examination of blood film by special stains to demonstrate Heinz bodies, parasites or iron, or examination of a blood film with alpha-naphthyl acetate esterase, chloroacetate esterase, neutrophil alkaline phosphotase, nitro blue tetrazolium, periodic acid Schiff, Sudan Black stains, or Kleihauer test for HbF on blood film, including any services specified in item 1419. SP |
| 13.20 |
| 1171 | Examination of blood film, with or without differential cell count, or differential cell count with or without examination of blood film, and if performed, any of these additional services—Direct Coombs test, tests for heterophile antibodies, cold agglutinins, examination of blood film by special stains to demonstrate Heinz bodies, parasites or iron, or examination of a blood film with alpha-naphthyl acetate esterase, chloroacetate esterase, neutrophil alkaline phosphotase, nitro blue tetrazolium, periodic acid Schiff, Sudan Black stains, or Kleihauer test for HbF on blood film, including any services specified in item 1420. OP | 9.90 |
| 1419 | Direct Coombs test, qualitative or quantitative test for cold agglutinins, or heterophile antibodies, qualitative spectroscopic examinations of blood for abnormal haemoglobins, qualitative test for red cell porphyrins and detection of metalbumin (Schumm’s test) including those services specified in items 1170 and 1172—one or more tests. SP | 11.60 |
| 1420 | Direct Coombs test, qualitative or quantitative test for cold agglutinins, or heterophile antibodies, qualitative spectroscopic examinations of blood for abnormal haemoglobins, qualitative test for red cell porphyrins and detection of metalbumin (Schumm’s test) including those services specified in items 1171 and 1173—one or more tests. OP | 8.70 |
| 1575 | Qualitative estimation by any method, except by reagent strip or dipstick of the following urine constituents—bilirubin, cystine (cysteine), haemoglobin, melanin (melanogen), myoglobin, porphobilinogen, porphyrins, urobilinogen or pH measurement of body fluids other than urine (excepting urine acidification test), or cryoglobulins or cryofibrinogen in plasma—one or more estimations. SP | 12.60 |
SCHEDULE 1—continued
| Item No. | Pathology Service | Fees—All States |
|---|---|---|
| $ | ||
| 1576 | Qualitative estimation by any method, except by reagent strip or dipstick of the following urine constituents—bilirubin, cystine (cysteine), haemoglobin, melanin (melanogen), myoglobin, porphobilinogen, porphyrins, urobilinogen or pH measurement of body fluids other than urine (excepting urine acidification test), or cryoglobulins or cryofibrinogen in plasma—one or more estimations. OP | 9.45 |
| 1712 | Drug assay—quantitative estimation on blood or other body fluid by any method or methods of a drug being used therapeutically for the patient from whom the specimen was taken—one estimation not elsewhere specified in the Schedule. SP | 26.50 |
| 1713 | Drug assay—quantitative estimation on blood or other body fluid by any method or methods of a drug being used therapeutically for the patient from whom the specimen was taken—one estimation not elsewhere specified in the Schedule. OP | 19.90 |
| 1726 | Amniotic fluid, spectrophotometric examination of, estimation of lecithin/sphingomyelin ratio, palmitic acid, phosphatidylglycerol or lamellar body phospholipid—one or more examinations or estimations. SP | 42.00 |
| 1727 | Amniotic fluid, spectrophotometric examination of, estimation of lecithin/sphingomyelin ratio, palmitic acid, phosphatidylglycerol or lamellar body phospholipid—one or more examinations or estimations. OP | 31.50 |
| 1738 | Alpha-feto protein, Alpha-1 antitrypsin, Alpha-2 macroglobulin, beta-2 microglobulin, C-l esterase inhibitor, Caeruloplasmin, Ferritin (unless specified in item 1752), Haptoglobins, Microalbumin (in proven diabetes mellitus), Mucin-like carcinoma associated antigen (one or more fractions), Prostate specific antigen, Prostatic Acid Phosphatase (one or more fractions), Transferrin (unless specified in item 1752), and, in the follow-up of proven malignancy, CA-125 antigen, CA-19.9 antigen, CA-15.3 antigen, Carcinoembryonic antigen, Mammary serum antigen, Neuron specific enolase, SCC Related antigen, Thyroglobulin,—quantitative estimation in serum, urine or other body fluid—one estimation. SP | 25.50 |
SCHEDULE 1—continued
| Item No. | Pathology Service | Fees—All States |
|---|---|---|
| $ | ||
| 1739 | Alpha-feto protein, Alpha-1 antitrypsin, Alpha-2 macroglobulin, beta-2 microglobulin, C-l esterase inhibit |
This is an opening excerpt, not the complete document.