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National Health (Botulinum Toxin Program) Special Arrangement 2025
8Definition of eligible patient
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#### 8 Definition of eligible patient
A person is an eligible patient in relation to a botulinum toxin pharmaceutical benefit if:
(a) the person is entitled to receive pharmaceutical benefits as mentioned in section 86 of the Act; and
(b) if, under paragraph 85(7)(b) of the Act, a prescription for the supply of the botulinum toxin pharmaceutical benefit may be written in circumstances that include one or more sets of circumstances relating to a patient—at least one of those sets of circumstances exists in relation to the person; and
(c) in any case—the person is being treated:
(i) in or at a private hospital; or
(ii) in or at a public hospital as a non‑admitted patient, a day‑admitted patient, or an in‑patient admitted for less than 24 hours; or
(iii) by an eligible medical practitioner for the person and the benefit at a business at an address for which the eligible medical practitioner has a provider number (within the meaning of the Health Insurance Regulations 2018).
> Note: In the Listing Instrument, as in force on 1 October 2025, a set of circumstances (in which a prescription for the supply of a pharmaceutical benefit may be written) is the set of circumstances mentioned in the table in Part 1 of Schedule 4 to that instrument in relation to a particular circumstances code that is mentioned in the table in Part 1 of Schedule 1 to that instrument in relation to the pharmaceutical benefit.