CTHRepealedLegislation

Private Health Insurance (Benefit Requirements) Rules 2007

1Private Health Insurance (Benefit Requirements) Rules 2007

Start here

Get a plain-English read of 1

Turn the raw legal text into a practical explanation grounded in Private Health Insurance (Benefit Requirements) Rules 2007.

Ask Zoe about this section View in full context

meta-content-style-type: text/css meta-content-type: application/xhtml+xml; charset=utf-8 meta-generator: Aspose.Words for .NET 20.2

?xml version="1.0" encoding="utf-8" standalone="no"?>

View image in the official source

Private Health Insurance (Benefit Requirements) Rules 2007

I, ANTHONY JOHN ABBOTT, Minister for Health and Ageing, make these Rules under item 3A of the table in section 333-20 of the Private Health Insurance Act 2007.

Dated 30 March 2007

TONY ABBOTT

Minister for Health and Ageing

Part 1 Preliminary

1. Name of Rules

2. Commencement

3. Definitions

Part 2 Minimum benefit requirements

4. Psychiatric care, rehabilitation and palliative care

5. Other hospital treatments

Schedule 1―Overnight accommodation: private hospitals in all States/Territories and shared ward accommodation at public hospitals in Victoria and Tasmania

Schedule 2―Overnight accommodation: shared ward accommodation at public hospitals in the ACT, NSW, Northern Territory, Queensland, South Australia and Western Australia

Schedule 3―Same-day accommodation: hospitals in all States/Territories

Schedule 4―Nursing-home type patient accommodation: hospitals in all States/Territories

Schedule 5―Second-tier default benefits

Schedule 6―Outreach services

Part 1 Preliminary

1. Name of Rules

These Rules are the Private Health Insurance (Benefit Requirements) Rules 2007.

2. Commencement

These Rules commence:

(a) if the Rules are registered before the Act commences―at the same time as the Act commences; or

(b) if the Rules are registered on or after the day on which the Act commences―on the date on which the Rules are registered,

whichever occurs first.

3. Definitions

In these Rules:

Act means the Private Health Insurance Act 2007.

ACT means the Australian Capital Territory.

certified Type B procedure means a Type B procedure certified in accordance with clause 10 of Schedule 1.

Section 1 - Private Health Insurance (Benefit Requirements) Rules 2007 - Private Health Insurance (Benefit Requirements) Rules 2007 | Zoe

Class of patient	Minimum benefit payable per night
Advanced surgical patient
- first 14 days	$325
- over 14 days	$226
Surgical patient or obstetric patient
- first 14 days	$301
- over 14 days	$226
Psychiatric patient
- first 42 days	$301
- 43 – 65 days	$262
- over 65 days	$226
Rehabilitation patient
- first 49 days	$301
- 50 - 65 days	$262
- over 65 days	$226
Other patients
- first 14 days	$262
- over 14 days	$226

Class of patient	Minimum benefit payable per night
Advanced surgical patient
- first 14 days	$325
- over 14 days	$226
Surgical patient or obstetric patient
- first 14 days	$301
- over 14 days	$226
Psychiatric
- first 42 days	$301
- 43 – 65 days	$262
- over 65 days	$226
Rehabilitation patient
- first 49 days	$301
- 50 – 65 days	$262
- over 65 days	$226
Other patients
- first 14 days	$262
- over 14 days	$226

Class of patient	Minimum benefit payable per night
Advanced surgical patient
- first 14 days	$325
- over 14 days	$226
Surgical patient or obstetric patient
- first 14 days	$301
- over 14 days	$226
Psychiatric patient
- first 42 days	$301
- 43 – 65 days	$262
- over 65 days	$226
Rehabilitation patient
- first 49 days	$301
- 50 – 65 days	$262
- over 65 days	$226
Other patients
- first 14 days	$262
- over 14 days	$226

13218 15600 30177 30250 30251 30255 30275 30294 30296 30297 30309 30315 30317 30318 30320 30321 30323 30324 30335 30336 30379 30382 30384 30388 30396 30405 30415 30417 30418 30421 30425 30427 30428 30430 30438 30448 30449 30454 30455 30457 30458 30460 30461 30463 30464 30466 30467 30469 30472 30500 30502 30503 30506 30508 30509 30512 30514 30517 30518 30521 30523 30524 30526 30527 30529 30532 30533 30535 30536 30538 30539 30541 30542 30545 30547 30548 30550 30551 30553 30554 30556 30557 30560 30565 30566 30577 30578 30580 30583 30584 30589 30590 30593 30594 30596 30599 30601 30602 30603 30605 30606 31002 31409 31412 31429 31432 31435 31438 31464 31466 31468 31472 31524 32000 32003 32004 32005 32006 32009 32012 32015 32018 32024 32025 32026 32028 32030 32033 32036 32039 32042 32047 32051 32054 32060 32063 32069 32104 32106 32108 32117 32209 32514 32517 32700 32703 32708 32710 32711 32712 32715 32718 32721 32724 32730 32733 32739 32742 32745 32748 32751 32754 32763 33050 33055 33075 33080 33100 33103 33109 33112 33115 33116 33118 33119 33121 33124 33127 33130 33133 33136 33139 33142 33145 33148 33151 33154 33157 33160 33163 33166 33169 33172 33175 33178 33181 33500 33506 33509 33512 33515 33518 33521 33524 33527 33530 33533 33536 33539 33542 33800 33803 33811 33812 33815 33818 33821 33824 33827 33830 33833 33836 33839 33842 34112 34115 34118 34121 34124 34127 34136 34139 34142 34148 34151 34154 34157 34160 34163 34166 34169 34172 34175 34509 34512 34518 34533 34803 34806 34809 34812 34815 34818 34821 34833 35003 35006 35307 35009 35312 35315 35320 35412 35561 35562 35595 35597 35641 35661 35664 35667 35670 35697 35753 35754 36500 36503 36506 36516 36519 36522 36525 36526 36527 36528 36529 36531 36532 36533 36540 36543 36564 36567 36570 36573 36576 36588 36591 36594 36597 36600 36603 36606 36645 36648 36656 37014 37029 37042 37045 37047 37053 37200 37203 37207 37209 37210 37211 37220 37230 37309 37341 37343 37375 37384 37390 37405 37411 37423 37426 37432 37444 37607 37610 37824 37842 37848 37851 38212 38228 38231 38234 38237 38240 38246 38270 38272 38287 38290 38293 38309 38312 38315 38318 38324 38327 38330 38358 38368 38384 38390 38418 38421 38424 38427 38438 38440 38441 38446 38447 38449 38450 38453 38455 38456 38457 38466 38468 38469 38470 38477 38478 38480 38481 38483 38487 38488 38489 38493 38497 38498 38500 38501 38503 38504 38506 38507 38508 38509 38512 38515 38518 38550 38553 38556 38559 38562 38565 38568 38571 38572 38600 38603 38615 38618 38624 38640 38643 38647 38650 38653 38654 38656 38670 38673 38677 38680 38700 38703 38706 38709 38712 38715 38718 38721 38724 38727 38730 38733 38736 38739 38742 38745 38748 38751 38754 38757 38760 38763 38766 39106 39112 39124 39139 39315 39500 39503 39603 39609 39612 39615 39640 39642 39646 39650 39653 39654 39656 39658 39660 39662 39706 39709 39712 39715 39718 39800 39803 39806 39815 39818 39821 39903 40000 40003 40012 40103 40106 40109 40112 40118 40300 40301 40303 40306 40309 40312 40315 40316 40318 40321 40330 40331 40332 40334 40335 40339 40342 40345 40348 40351 40600 40700 40703 40706 40712 40801 40803 40850 40851 40860 41518 41521 41530 41533 41536 41539 41542 41551 41554 41557 41560 41563 41564 41566 41569 41572 41575 41576 41578 41579 41581 41584 41587 41590 41593 41596 41599 41608 41614 41615 41617 41623 41635 41638 41728 41734 41782 41785 41834 41837 41840 41843 41879 42521 42539 42543 42545 42557 42569 42626 42653 42656 42659 42662 42672 42702 42710 42716 42725 42731 42746 42749 42752 42767 42773 42776 42779 42801 42842 42851 42860 43801 43804 43807 43810 43813 43816 43819 43822 43825 43828 43831 43834 43837 43840 43843 43846 43852 43855 43861 43864 43870 43873 43876 43879 43882 43900 43903 43906 43909 43912 43915 43936 43945 43951 43954 43957 43963 43966 43969 43972 43975 43978 43984 43987 43990 43993 43996 44334 44373 45006 45036 45215 45415 45418 45460 45461 45464 45465 45466 45468 45469 45471 45472 45474 45475 45477 45478 45480 45481 45483 45484 45490 45491 45492 45494 45500 45501 45502 45503 45504 45505 45520 45528 45530 45533 45539 45558 45559 45562 45563 45564 45565 45566 45570 45587 45588 45596 45597 45599 45624 45638 45639 45641 45644 45646 45647 45660 45661 45686 45720 45723 45726 45729 45731 45732 45735 45738 45741 45744 45747 45752 45753 45754 45767 45770 45773 45776 45779 45782 45785 45788 45791 45853 45861 45863 45869 45871 45873 46315 46318 46321 46393 46477 46504 46507 47486 47489 47501 47504 47507 47510 47519 47525 47531 47534 47566 47588 47591 47687 47690 47693 47699 47702 48203 48427 48512 48606 48612 48613 48618 48621 48624 48627 48630 48632 48639 48640 48645 48648 48651 48654 48657 48660 48669 48672 48681 48684 48687 48690 48691 48692 48918 48921 48924 48933 48939 48942 48951 48954 48957 48960 49106 49115 49116 49117 49210 49211 49306 49312 49318 49319 49321 49324 49327 49330 49333 49339 49342 49345 49512 49517 49518 49519 49521 49524 49527 49530 49533 49536 49539 49542 49548 49551 49554 49564 49715 49716 49717 49836 49838 49842 50212 50215 50218 50221 50224 50227 50230 50233 50236 50239 50300 50303 50306 50321 50324 50327 50336 50351 50354 50366 50372 50378 50384 50394 50399 50408 50411 50414 50417 50420 50423 50450 50451 50455 50456 50460 50461 50465 50466 50470 50471 50475 50476 50604 50608 50612 50620 50624 50628 50632 50636 50640 50644 52123 52126 52129 52158 52337 52342 52345 52348 52351 52354 52357 52360 52363 52366 52369 52372 52375 52379 52380 52382 52430 52446 52821 53209 53212 53221 53224 53227 53230 53233

13212 13700 14230 14233 14236 14242 15303 15304 15307 15308 15311 15312 15315 15316 15319 15320 15323 15324 15327 15328 15331 15332 15335 15336 15345 15360 15363 15541 16567 16570 16571 16573 30017 30020 30023 30024 30068 30110 30111 30114 30165 30168 30171 30174 30190 30197 30225 30229 30235 30241 30244 30246 30247 30253 30256 30272 30286 30289 30293 30299 30300 30302 30303 30306 30308 30310 30313 30314 30330 30332 30373 30375 30376 30378 30385 30387 30391 30392 30393 30394 30399 30400 30402 30403 30408 30414 30416 30419 30422 30431 30433 30434 30436 30437 30440 30443 30445 30446 30450 30451 30452 30475 30479 30481 30484 30485 30490 30491 30492 30493 30494 30495 30496 30497 30499 30505 30511 30515 30520 30530 30544 30559 30562 30563 30564 30568 30569 30571 30572 30575 30581 30586 30587 30597 30600 30609 30612 30614 30615 30616 30617 30620 30621 30635 30638 30641 30644 30672 30675 30676 31000 31001 31225 31245 31250 31260 31270 31275 31295 31300 31305 31310 31315 31320 31325 31330 31335 31340 31350 31355 31400 31403 31406 31423 31426 31450 31452 31454 31460 31462 31470 31500 31503 31506 31509 31512 31515 31518 31521 31527 31539 31545 31554 32021 32029 32045 32046 32057 32066 32090 32093 32094 32096 32099 32102 32103 32105 32111 32112 32120 32123 32126 32129 32131 32138 32139 32150 32159 32162 32165 32180 32183 32186 32200 32203 32206 32210 32213 32214 32216 32504 32507 32508 32511 32736 32757 32760 32766 32769 33070 33545 33548 33551 33554 33806 33810 33845 33848 34100 34103 34106 34109 34130 34133 34145 34500 34503 34515 34521 34524 34527 34528 34538 34800 34824 34827 34830 35000 35012 35100 35202 35300 35303 35306 35309 35317 35319 35321 35324 35327 35330 35331 35360 35361 35362 35363 35400 35402 35404 35406 35408 35410 35508 35530 35533 35536 35539 35542 35548 35551 35560 35564 35565 35566 35568 35570 35571 35573 35577 35578 35596 35599 35602 35605 35612 35613 35622 35623 35634 35635 35636 35637 35638 35645 35648 35649 35653 35657 35658 35673 35676 35677 35678 35680 35683 35684 35687 35688 35694 35700 35710 35712 35713 35716 35717 35720 35723 35726 35750 35756 35759 36502 36509 36537 36546 36549 36552 36558 36579 36585 36604 36605 36607 36608 36609 36612 36615 36618 36621 36624 36627 36630 36633 36636 36639 36642 36649 36650 36652 36654 36803 36806 36809 36811 36818 36821 36825 36833 36840 36842 36845 36854 36857 36863 37000 37004 37008 37020 37023 37026 37038 37043 37044 37050 37201 37202 37206 37208 37212 37215 37219 37221 37224 37227 37233 37306 37318 37327 37330 37333 37336 37340 37342 37345 37348 37351 37354 37372 37381 37387 37396 37402 37408 37417 37418 37420 37429 37438 37601 37604 37613 37616 37619 37800 37803 37806 37809 37812 37818 37821 37827 37830 37833 37836 37839 37845 37854 38200 38203 38206 38209 38213 38215 38218 38222 38225 38241 38243 38256 38275 38300 38303 38306 38321 38350 38353 38356 38362 38365 38371 38387 38393 38415 38430 38448 38452 38458 38460 38462 38464 38473 38475 38485 38490 38496 38505 38577 38588 38609 38612 38613 38621 38627 38637 39015 39018 39109 39118 39121 39125 39126 39127 39128 39130 39133 39134 39137 39138 39140 39300 39303 39306 39309 39312 39318 39321 39323 39324 39327 39330 39331 39333 39600 39606 39700 39703 39721 39812 39900 39906 40006 40009 40015 40100 40115 40324 40327 40333 40336 40709 40800 40852 40854 40856 40858 40903 40905 41512 41515 41524 41527 41545 41548 41603 41611 41620 41629 41671 41672 41707 41710 41713 41716 41722 41725 41729 41731 41737 41743 41746 41749 41752 41767 41770 41773 41776 41779 41786 41787 41789 41792 41793 41813 41819 41820 41825 41831 41849 41852 41855 41858 41861 41864 41867 41868 41870 41873 41876 41880 41881 41885 41895 41898 41901 41905 41910 42506 42509 42510 42512 42515 42518 42527 42530 42533 42536 42542 42548 42551 42554 42560 42563 42566 42574 42584 42590 42596 42599 42602 42605 42608 42623 42629 42635 42638 42641 42665 42680 42686 42692 42695 42698 42701 42703 42704 42707 42713 42719 42722 42734 42737 42740 42743 42758 42761 42764 42770 42771 42782 42783 42785 42786 42788 42789 42791 42792 42802 42805 42806 42807 42808 42809 42810 42815 42818 42833 42836 42839 42848 42854 42857 42863 42866 42869 43506 43509 43512 43515 43518 43521 43524 43849 43858 43867 43930 43933 43939 43960 43981 43999 44102 44108 44111 44114 44130 44133 44325 44328 44331 44350 44354 44359 44361 44364 44367 44370 45000 45003 45009 45012 45015 45018 45019 45020 45024 45026 45035 45042 45045 45048 45051 45200 45203 45206 45207 45209 45218 45221 45227 45233 45236 45239 45240 45403 45406 45409 45412 45439 45442 45445 45448 45451 45462 45485 45486 45487 45488 45489 45493 45496 45497 45498 45512 45519 45522 45524 45527 45536 45542 45545 45548 45551 45552 45553 45554 45555 45556 45557 45560 45568 45569 45572 45575 45578 45581 45584 45585 45586 45590 45593 45602 45605 45608 45611 45614 45620 45623 45626 45629 45632 45635 45652 45653 45656 45659 45662 45665 45668 45669 45671 45675 45676 45677 45680 45683 45689 45692 45695 45698 45701 45704 45707 45710 45713 45714 45716 45755 45758 45761 45794 45803 45809 45811 45813 45815 45817 45819 45821 45825 45827 45831 45833 45835 45837 45839 45841 45843 45845 45849 45855 45857 45859 45865 45867 45875 45877 45879 46300 46303 46306 46307 46309 46312 46324 46325 46330 46333 46336 46339 46342 46345 46351 46354 46357 46360 46372 46375 46378 46381 46384 46387 46390 46396 46399 46402 46405 46408 46411 46414 46417 46423 46426 46429 46432 46435 46441 46442 46444 46447 46453 46462 46468 46471 46474 46480 46483 46489 46492 46500 46501 46502 46503 46510 46522 47012 47021 47027 47033 47048 47051 47054 47063 47066 47333 47345 47357 47366 47372 47375 47381 47384 47385 47386 47387 47390 47393 47399 47402 47408 47417 47420 47426 47429 47432 47435 47438 47441 47447 47450 47451 47453 47456 47459 47468 47480 47483 47495 47498 47513 47516 47522 47528 47537 47546 47549 47552 47555 47558 47561 47564 47565 47567 47570 47573 47582 47585 47597 47600 47603 47609 47612 47615 47618 47621 47624 47630 47648 47654 47657 47684 47696 47705 47711 47717 47720 47723 47732 47741 47753 47756 47765 47768 47771 47774 47777 47780 47783 47786 47789 47920 47930 47936 47954 47957 47966 47969 47975 47982 48200 48206 48209 48212 48215 48218 48221 48224 48227 48230 48233 48236 48239 48242 48400 48403 48406 48409 48412 48415 48418 48421 48424 48500 48503 48506 48615 48636 48642 48663 48666 48675 48678 48693 48900 48903 48906 48909 48912 48915 48927 48930 48936 48945 48948 49100 49103 49109 49112 49118 49121 49200 49203 49206 49209 49215 49218 49221 49224 49227 49300 49303 49309 49315 49336 49346 49360 49363 49366 49500 49503 49506 49509 49515 49534 49545 49557 49558 49559 49560 49561 49562 49563 49566 49569 49700 49703 49706 49709 49712 49718 49724 49727 49728 49812 49815 49818 49821 49824 49827 49830 49833 49837 49839 49845 49854 49857 49860 49863 49866 50100 50102 50103 50104 50106 50109 50112 50118 50121 50127 50130 50201 50203 50206 50209 50309 50312 50315 50318 50333 50339 50342 50345 50353 50357 50360 50363 50369 50375 50381 50387 50393 50396 50402 50405 50426 50500 50504 50508 50512 50516 50520 50524 50528 50532 50536 50540 50544 50548 50552 50556 50560 50564 50568 50572 50576 50580 50584 50588 50600 50616 50650 50654 50952 51900 51904 51906 52018 52035 52039 52048 52051 52054 52059 52063 52066 52078 52090 52092 52094 52095 52105 52108 52111 52114 52117 52120 52122 52130 52131 52138 52141 52144 52147 52148 52182 52184 52186 52300 52303 52306 52312 52315 52321 52324 52330 52333 52336 52339 52378 52424 52440 52442 52444 52450 52452 52456 52458 52460 52480 52482 52484 52600 52603 52609 52612 52615 52618 52621 52624 52626 52627 52633 52800 52803 52806 52809 52812 52815 52818 52824 52828 52830 52832 53006 53009 53015 53016 53017 53019 53215 53218 53220 53225 53226 53236 53239 53242 53406 53409 53412 53413 53414 53415 53416 53418 53419 53422 53423 53424 53425 53427 53429 53453 53455 53460 55135 57351 57356

State/Territory	Minimum benefit payable per night
ACT	$269
NSW	$269
Northern Territory	$269
Queensland	$269
South Australia	$269
Western Australia	$269

Public hospitals	Band 1	Band 2	Band 3	Band 4

NSW	$194	$218	$240	$269
ACT	$195	$219	$240	$269
Northern Territory	$195	$222	$258	$269
Queensland	$196.50	$219.50	$241.50	$269
South Australia	$195	$222	$244	$269
Tasmania	$188	$225	$261	$301
Victoria	$190	$226	$262	$301
Western Australia	$212	$212	$212	$212

13110 13212 13215 13292 13750 13755 13757 13948 14218 15338 15513 15539 16512 16603 16618 18216 18230 18242 18274 18276 18280 18284 18286 18290 18294 18296 18298 30041 30042 30045 30055 30081 30084 30087 30094 30096 30099 30102 30103 30104 30106 30107 30187 30189 30190 30223 30225 30262 30269 30281 30282 30283 30390 30391 30409 30484 30493 30653 30656 30659 30660 31225 31230 31235 31240 31255 31256 31257 31258 31260 31261 31262 31263 31265 31266 31267 31268 31270 31271 31272 31273 31275 31276 31277 31278 31280 31281 31282 31283 31285 31286 31287 31288 31290 31291 31292 31293 31295 31300 31305 31310 31315 31320 31325 31330 31335 31340 31345 31346 31350 31355 31441 31456 31458 31530 31551 31557 31560 31563 31566 32093 32094 32145 32147 32150 32153 32156 32168 32171 32177 32180 32504 34109 34130 34500 34503 34506 34524 34539 35324 35507 35508 35509 35512 35513 35516 35517 35520 35523 35526 35527 35542 35557 35569 35572 35611 35615 35616 35617 35618 35622 35623 35626 35627 35630 35633 35637 35639 35640 35643 35644 35645 35646 35647 35648 35687 35688 36812 36815 36818 36821 36824 36827 36830 36833 36836 36860 37219 37315 37318 37321 37354 37369 37435 37622 37623 37803 37806 37809 37812 37815 37854 38285 38286 39013 39118 39135 39140 39331 41503 41506 41509 41626 41629 41632 41644 41650 41653 41665 41668 41677 41695 41701 41716 41761 41764 41800 41801 41816 41819 41822 41825 41831 41849 41852 41855 41858 41861 41864 41886 41889 41892 41898 42503 42572 42573 42584 42593 42610 42611 42673 42680 42683 42686 42689 42692 42812 42818 42833 42845 42869 43942 43948 44102 44105 44136 44338 45019 45020 45030 45033 45039 45200 45224 45239 45506 45515 45626 45665 45668 45823 46327 46330 46336 46363 46366 46369 46396 46420 46423 46438 46441 46450 46486 46489 46494 46495 46501 46510 46525 47738 47906 47915 47918 47927 47972 48600 48603 48945 49218 49557 49700 49800 49803 49806 49809 50100 50115 51902 52015 52025 52042 52045 52057 52058 52061 52062 52064 52072 52073 52075 52081 52084 52087 52097 52099 52102 52144 52180 52300 52303 52321 52826 53003 53006 53009 53054 53056 53058 53060 53062 53064 53070 53206 53215 53218 53225 53410 53459 58939 59903 59912 59925 59970 59971 59972 59973 59974 60000 60003 60006 60009 60012 60015 60018 60021 60024 60027 60030 60033 60036 60039 60042 60045 60048 60051 60054 60057 60060 60063 60066 60069 60072 60075 60078

Public hospital: State/Territory	Minimum benefit per night
NSW	$95.30
Northern Territory	$56.85
Queensland	$85.50
South Australia	$91.50
Tasmania	$91.68
Victoria	$92.15
ACT	$82.85
Western Australia	$91.60

Item	Facility Name	Address
1	(Alpha) Westmead Private Hospital	Corner of Mons and Darcy Roads, WESTMEAD NSW 2145
2	Aesthetic Day Surgery	14 Kensington Street, KOGARAH NSW 2217
3	Albury-Wodonga Private Hospital	1125 Pemberton Street, ALBURY NSW 2640
4	Armidale Private Hospital	Rusden St, ARMIDALE NSW 2350
5	Attadale Private Hospital	21 Hislop Road, ATTADALE WA 6156
6	Ballina Day Surgery	46 Tamar Street, BALLINA NSW 2478
7	Bankstown Primary Health Care Day Surgery	67 Rickard Road, BANKSTOWN NSW 2200
8	Baringa Private Hospital	Mackay’s Road, COFFS HARBOUR NSW 2450
9	Bethesda Hospital	25 Queenslea Drive, CLAREMONT WA 6010
10	Bega Valley Private Hospital	31 Parker Street, BEGA NSW 2550
11	Beleura Private Hospital	925 Nepean Highway, MORNINGTON VIC 3931
12	Berkeley Vale Private Hospital	8 Lorraine Avenue, BERKELEY VALE NSW 2261
13	Blackwood Hospital Group	13 Laffers Road, BELAIR SA 5052
14	Bondi Junction Private Hospital	21 Spring St, BONDI JUNCTION NSW 2022
15	Brisbane Private Hospital	259 Wickham Tce, BRISBANE QLD 4000
16	Broadmeadow Day Surgery	1st Floor (Suite 1), 18 Lambton Road, BROADMEADOW NSW 2292
17	Buderim Gastroenterology Centre<br>(Maroochydore)	Suite 5, 102 Wises Road, MAROOCHYDORE QLD 4558
18	Caboolture Private Hospital	McKean Street, CABOOLTURE QLD 4510
19	Cabrini Brighton	243 New Street, BRIGHTON VIC 3186
20	Cairns Private Hospital	1 Upward Street, CAIRNS QLD 4870
21	Caloundra Private Hospital	96 Beerburrum Street, CALOUNDRA QLD 4566
22	Calvary Day Procedure Centre	329, 331, 333 Edward Street, WAGGA WAGGA NSW 2650
23	Calvary Health Care ACT	Calvary Public and Private Hospital, Haydon Drive, BRUCE ACT 2617
24	Calvary Health Care Sydney – Hurtstville Community	37 Gloucester Road, HURSTVILLE NSW 2220
25	Calvary Health Care Tasmania – Hobart (Lenah Valley Campus)	49 Augusta Road, LENAH VALLEY TAS 5333
26	Calvary Health Care Tasmania – Hobart (St John’s Campus)	30 Cascade Road, SOUTH HOBART TAS 7004
27	Calvary Health Care Tasmania – Launceston (St Luke’s Campus)	24 Lyttleton Street, LAUNCESTON TAS 7250
28	Calvary Health Care Tasmania – Launceston (St Vincent’s Campus)	5 Frederick Street, LAUNCESTON TAS 7250
29	Calvary Hospital Adelaide	89 Strangways Terrace, NORTH ADELAIDE SA 5006
30	Calvary Private Hospital (Riverina)	Hardy Ave, WAGGA WAGGA NSW 2650
31	Canada Bay Private Hospital	55-57 Burwood Road, CONCORD NSW 2137
32	Capital Day Surgery Centre	Calvary Clinic, Mary Potter Circuit, BRUCE ACT 2617
33	Caringbah Day Surgery	42 President Avenue, CARINGBAH NSW 2229
34	Castle Hill Hospital	72-74 Cecil Avenue, CASTLE HILL NSW 2154
35	Castlecrag Private Hospital	150 Edinburgh Road, CASTLECRAG NSW 2068
36	Cedar Court Healthsouth Rehabilitation Hospital	888 Toorak Road, CAMBERWELL VIC 3124
37	Central Districts Private Hospital	25-37 Jarvis Road, ELIZABETH VALE SA 5112
38	Chasely Day Surgery	Wesley Medical Centre, 40 Chasely Street, AUCHENFLOWER QLD 4066
39	Chesterville Day Hospital	26-28 Chesterville Road, CHELTENHAM VIC 3192
40	Coastal Private Hospital	221 Willmott Drive, WAIKIKI WA 6169
41	Coffs Harbour Day Surgery Centre	69 Albany Street, COFFS HARBOUR NSW 2450
42	Colin Street Day Surgery	51 Colin Street, WEST PERTH WA 6005
43	College Grove Rehabilitation Hospital	18 North East Road, WALKERVILLE SA 5081
44	Coolenberg Clinic	60 Lake Rd, PORT MACQUARIE NSW 2444
45	Dalcross Private Hospital	28 Stanhope Road, KILLARA NSW 2071
46	Dandenong Eye Clinic & Day Surgery Centre	1-3 Falkiner Crescent, DANDENONG VIC 3175
47	Delmar Private Hospital	58 Quirk Street, DEE WHY NSW 2099
48	Delmont Private Hospital	298 Warrigal Road, GLEN IRIS VIC 3146
49	Donvale Rehabilitation Hospital	1119-1121 Doncaster Road, DONVALE VIC 3111
50	Dudley Private Hospital	261 March Street, ORANGE NSW 2800
51	Eastern Suburbs Private Hospital	8 Chapel Street, RANDWICK NSW 2031
52	Epping Surgery Centre	Suite 3, 44 Oxford Street, EPPING NSW 2121
53	Eye-Tech Day Surgeries	Level 3, St Andrew's Place, North Street, SPRING HILL QLD 4000
54	Eye-Tech Day Surgeries Southside	22-26 Sanders Street, UPPER MOUNT GRAVATT QLD 4122
55	Figtree Private Hospital	1 Suttor Place, FIGTREE NSW 2525
56	Frances Perry Private Hospital	285 Cardigan Street, CARLTON 3053
57	Friendly Society Private Hospital	19-23 Bingera Street, BUNDABERG QLD 4670
58	Fullarton Private Hospital	293-295 Fullarton Road, PARKSIDE SA 5063
59	Glenferrie Private Hospital	25 Linda Crescent, HAWTHORN 3122
60	Glengarry Private Hospital	53 Arnisdale Road, DUNCRAIG WA 6023
61	Greenslopes Private Hospital	Newdegate Street, GREENSLOPES QLD 4120
62	Griffiths Road Day Procedure Centre	182 Christo Road, WARATAH NSW 2298
63	Harley Place Day Surgery	Suite 605, 251 Oxford Street, BONDI JUNCTION NSW 2022
64	Hawkesbury District Health Service	Level 2, 16-18 Bridge Street, EPPING NSW 2121
65	Healthwoods Specialist Centre<br>	53 Cowper Street, GRANVILLE NSW 2142
66	Hervey Bay Surgical Centre	Cnr O’Rourke Street & Boat Harbour Drive, PIALBA QLD 4655
67	Hillcrest-Rockhampton Private Hospital	4 Talford Street, ROCKHAMPTON QLD 4700
68	Hollywood Private Hospital	Monash Avenue, NEDLANDS WA 6009
69	Holroyd Private Hospital	123-129 Chetwynd Road, GUILDFORD NSW 2161
70	Holy Spirit Northside	627 Rode Road, CHERMSIDE QLD 4032
71	Hopetoun Rehabilitation Hospital	2-6 Hopetoun Street, ELSTERNWICK VIC 3185
72	Hopewell Hospice	11 Dunkirk Close, ARUNDEL QLD 4212
73	Hunters Hill Private Hospital	9 Mount Street, HUNTERS HILL NSW 2110
74	Inner West Endoscopy Centre	311 Marrickville Road, MARRICKVILLE NSW 2204
75	John Flynn Private Hospital	42 Inland Drive, TUGUN QLD 4224
76	Joondalup Private Hospital	Corner Grand Boulevard and Shenton Avenue, JOONDALUP WA 6027
77	Kahlyn Private Hospital	40 Briant Road, MAGILL SA 5072
78	Kareena Private Hospital	86 Kareena Road, CARINGTON NSW 2229
79	Kawana Private Hospital	Suite 14, Level 1, Innovation Parkway, BIRTINYA QLD 4575
80	Lake Macquarie Private Hospital	3 Sydney Street, GATESHEAD NSW 2290
81	Lawrence Hargrave Private Hospital	72 Phillip Street, THIRROUL NSW 2515
82	Linacre Private Hospital	12 Linacre Road, HAMPTON VIC 3188
83	Liverpool Day Surgery	105-119 Longstaff Avenue, MOOREBANK NSW 2170
84	Logan Endoscopy Services	Unit 2/32 76 Beaudesert Road, BROWN PLAINS QLD 4118
85	Logan Surgery Centre	Unit 12, 13-21 Mayes Avenue, LOGAN CENTRAL QLD 4114
86	Macarthur Private Hospital	92-96 Dumaresq Street, CAMPBELLTOWN NSW 2560
87	Maitland Private Hospital	173 Chisholm Road, EAST MAITLAND NSW 2323
88	Manly Waters Private Hospital	17 Cove Avenue, MANLY NSW 2095
89	Maryvale Private Hospital	McDonald Street, MORWELL VIC 3840
90	Masada Private Hospital	26 Balaclava Road, EAST ST KILDA VIC 3183
91	Mater Hospital Yeppoon	55 Cliff Street, YEPPOON QLD 4703
92	Mater Misericordiae Day Unit (Mackay)	1 Wellington Street, MACKAY QLD 4740
93	Mater Misericordiae Hospital Bundaberg	313 Bourbong Street, BUNDABERG QLD 4670
94	Mater Misericordiae Hospital Gladstone	Rossella Street, GLADSTONE QLD 4680
95	Mater Misericordiae Hospital Mackay	76 Willetts Road, NORTH MACKAY QLD 4740
96	Mater Misericordiae Hospital Rockhampton	cnr Ward & Jessie Streets, ROCKHAMPTON QLD 4700
97	Mater Misericordiae Private Hospital<br>	35 Rocklands Road, CROWS NEST NSW 2065
98	Mater Misericordiae Private Hospital (South Brisbane)	301 Vulture Street, SOUTH BRISBANE QLD 4101
99	Mater Misericordiae Private Hospital Townsville	21 Fulham Road, PIMLICO QLD 4810
100	Mater Misericordiae Women’s & Children’s Private Health Service (Children’s Campus)	Cnr Raymond Terrace & Stanley Street, SOUTH BRISBANE QLD 4101
101	Mater Misericordiae Women’s & Children’s Private Health Service (Women’s Campus)	Raymond Terrace, SOUTH BRISBANE QLD 4101
102	Mater Private Hospital Redland	Weippin Street, CLEVELAND QLD 4163
103	Mayo Private Hospital	Lot 1, Potoroo Drive, Kolodong, VIA TAREE NSW 2430
104	Melbourne Oral & Facial Surgery	Level 12, 63 Exhibition Street, Scala House, MELBOURNE VIC 3000
105	Minchinbury Community Private Hospital	Rupertswood Road, MOUNT DRUITT NSW 2770
106	Mitcham Private Hospital	27 Doncaster East Road, MITCHAM VIC 3132
107	Montserrat Day Hospital (Gaythorne)	383 – 391 Samford Road, GAYTHORNE QLD 4051
108	Montserrat Day Hospital (Indooroopilly)	12 Riverview Tce, INDOOROOPILLY QLD 4068
109	Montserrat Day Hospital (Spring Hill)	Level 2, 35 Astor Tce, BRISBANE QLD 4000
110	Mosman Private Hospital	1 Ellamatta Avenue, MOSMAN NSW 2088
111	Mount Olivet Hospital	411 Main Street, KANGAROO POINT QLD 4169
112	Mt Lawley Private Hospital	14 Alvan Street, MOUNT LAWLEY WA 6050
113	Mt Wilga Private Hospital	2 Manor Road, HORNSBY NSW 2077
114	Murdoch Surgicentre	100 Murdoch Drive, MURDOCH WA 6150
115	Murray Valley Private Hospital	Nordsvan Drive, WODONGA VIC 3690
116	Nambour Selangor Private Hospital	62 Netherton Street, NAMBOUR QLD 4560
117	New Farm Private Hospital	22 Sargent Street, NEW FARM QLD 4005
118	Ngala Family Resource Centre	9 George Street, KENSINGTON WA 6151
119	Noosa Private Hospital	111 Goodchap Street, NOOSAVILLE QLD 4566
120	North Eastern Private Hospital	580 Lower North East Road, CAMPBELLTOWN SA 5074
121	North Shore Private Hospital	Westbourne Street, ST LEONARDS NSW 2065
122	North West Private Hospital	137 Flockton Street, EVERTON PARK QLD 4053
123	Northside Clinic Private Hospital	2 Greenwich Road, GREENWICH NSW 2065
124	Northside Cremorne Clinic	3 Harrison Street, CREMORNE NSW 2090
125	Northside West Clinic	23-27 Lytton Street, WENTWORTHVILLE NSW 2145
126	Nowra Private Hospital	Weeroona Place, NOWRA NSW 2541
127	Ophthalmic Surgery Centre	Suite 6, 12-14 Malvern Avenue, CHATSWOOD NSW 2067
128	Orange Day Surgery Centre	60 McNamara Street, ORANGE NSW 2800
129	Pacific Day Surgery	38 Misterton Street, FORTITUDE VALLEY QLD 4006
130	Pendlebury Clinic Private Hospital	Suite 3, 52 Pendlebury Road, CARDIFF NSW 2285
131	Peninsula Eye Centre	47 Redcliffe Parade, REDCLIFFE QLD 4020
132	Peninsula Private Hospital (Frankston)	Cnr Cranbourne & McClelland Drive, FRANKSTON VIC 3199
133	Peninsula Private Hospital (Kippa-Ring)	cnr George and Florence Streets, KIPPA-RING QLD 4020
134	Perfect Vision Eye Surgery	Suite 3, 25 –29 Hunter Street, HORNSBY NSW 2077
135	Perth Clinic	29 Havelock St, WEST PERTH WA 6005
136	Pindara Day Procedure Centre	13 Carrara Street, BENOWA QLD 4217
137	Pindara Gold Coast Private Hospital	Allchurch Avenue, BENOWA QLD 4217
138	Pinelodge Clinic Private Hospital Dandenong	1480 Heatherton Road, DANDENONG VIC 3175
139	Poplars Private Hospital	66 Norfolk Road, EPPING NSW 2121
140	Port Macquarie Private Hospital	Lake Road, PORT MACQUARIE NSW 2444
141	QFG Day Theatres	1st & 4th Floor, St Andrew’s Place, North Street, SPRING HILL QLD 4000
142	Randwick Day Surgery	2 Eurimble Avenue, RANDWICK NSW 2031
143	Rivercity Private Hospital	401 Milton Road, AUCHENFLOWER QLD 4066
144	Roderick Street Day Surgery	23 Roderick Street, IPSWICH QLD 4305
145	Rosebud SurgiCentre	1537 Point Nepean Road, ROSEBUD WEST VIC 3940
146	Saint Frances Xavier Cabrini Hospital (Malvern)	181-183 Wattletree Road, MALVERN VIC 3144
147	Saint Frances Xavier Cabrini Hospital (Prahran)	646 High Street, PRAHRAN EAST VIC 3181
148	Shellharbour Private Hospital	27 Captain Cook Drive, BARRACK HEIGHTS NSW 2528
149	Shepparton Private Hospital	Fitzgerald Street, SHEPPARTON VIC 3630
150	Short Street Day Surgery	2 Short Street, SOUTHPORT QLD 4215
151	Solander Day Surgery	182 Grafton St, CAIRNS QLD 4870
152	South Coast Digestive Diseases Centre	86 Ashmore Road, BUNDALL QLD 4217
153	South Pacific Private Hospital	18 Beach Street, HARBORD NSW 2096
154	South Perth Hospital	76 South Terrace, COMO WA 6152
155	South Western Day Surgery Centre	20-22 Bigge Street, LIVERPOOL NSW 2170
156	Southern Highlands Private Hospital	99 Bowral Street, BOWRAL NSW 2576
157	Spendelove House Private Hospital	24 Spendelove Avenue, SOUTHPORT QLD 4215
158	Sportsmed.SA Hospital	32 Payneham Road, STEPNEY SA 5069
159	St Andrew’s Ipswich Private Hospital	Corner Roderick and Pring Streets, IPSWICH QLD 4305
160	St Andrew’s Toowoomba Hospital	280 North Street, TOOWOOMBA QLD 4350
161	St George Private Hospital	1 South Street, KOGARAH NSW 2217
162	St John of God Health Care (Ballarat)<br>	101 Drummond Street North, BALLARAT VIC 3350
163	St John of God Health Care (Warrnambool)	136 Botanic Road, WARRNAMBOOL VIC 3280
164	St John of God Health Care Berwick	Gibb Street, BERWICK VIC 3806
165	St John of God Healthcare Nepean Rehabilitation Hospital	255 Cranbourne Road, FRANKSTON VIC 3199
166	St John of God Hospital Bendigo	Lily Street, BENDIGO VIC 3552
167	St John of God Hospital Bunbury	Cnr Robertson Drive & Bussell Highway, BUNBURY WA 6230
168	St John of God Hospital Geelong	80 Myers Street, GEELONG VIC 3220
169	St John of God Hospital Geraldton	12 Hermitage Street, GERALDTON WA 6530
170	St John of God Hospital Murdoch	100 Murdoch Drive, MURDOCH WA 6150
171	St John of God Hospital Subiaco	12 Salvado Road, SUBIACO WA 6008
172	St Kilda Day Hospital	26A Dickens Street, ELWOOD VIC 3184
173	St Luke’s Hospital Complex	18 Rosalyn Street, POTTS POINT NSW 2011
174	St Vincent’s & Mercy Private Hospital, Mercy Campus	159 Grey Street, MELBOURNE EAST VIC 3002
175	St Vincent’s Hospital (Toowoomba)	Scott Street, TOOWOOMBA QLD 4350
176	St Vincent’s Private Hospital (Bathurst)	Gorman’s Hill Road, BATHURST NSW 2795
177	St Vincent’s Private Hospital (Fitzroy)	59 Victoria Parade, FITZROY VIC 3065
178	Stirling District Hospital	20 Milan Terrace, STIRLING SA 5152
179	Sydney Adventist Private Hospital	185 Fox Valley Road, WAHROONGA NSW 2076
180	Sydney Day Surgery	213-219 Darlinghurst Road, DARLINGHURST NSW 2010
181	Sydney Eastern Eye Centre	11a Fullerton Street, WOOLLAHRA NSW 2025
182	Sydney Eye Specialist Centre	2 Middle Street, KINGSFORD NSW 2032
183	Sydney Haematology and Oncology Clinics	Unit 13/49 Palmerston Road, HORNSBY NSW 2077
184	Sydney IVF – Liverpool	173-175 Biggs Street, LIVERPOOL NSW 2170
185	Sydney IVF Clinic	4 O’Connell Street, SYDNEY NSW 2000
186	Sydney Oculoplastic Surgery	229 Macquarie St, SYDNEY NSW 2000
187	Sydney Retina Clinic & Day Surgery	Level 13, 187 Macquarie Street, SYDNEY NSW 2000
188	Tamara Private Hospital	2-6 Dean Street, TAMWORTH NSW 2340
189	Terrace West Endoscopy Centre	18 Limestone Street, IPSWICH QLD 4305
190	The Adelaide Clinic	33 Park Terrace, GILBERTON SA 5081
191	The Albert Road Clinic	31-33 Albert Road, SOUTH MELBOURNE SA 3004
192	The Avenue Private Hospital	40 The Avenue, WINDSOR VIC 3128
193	The Bays Hospital – Mornington	262-268 Main Street, MORNINGTON VIC 3931
194	The Burnside War Memorial Hospital	120 Kensington Road, TOORAK GARDENS SA 5065
195	The CAPS Clinic<br>	Strickland Crescent, DEAKIN ACT 2600
196	The Double Bay Day Surgery	20 Manning Road, DOUBLE BAY NSW 2028
197	The Eye Institute	Level 4, 270 Victoria Avenue, CHATSWOOD NSW 2057
198	The Hills Parenting Centre	103-108 Showground Road, CASTLE HILL NSW 2154
199	The Hornsby Sleep Disorder and Diagnostic Centre	104 Balmoral Street, WAITARA NSW 2077
200	The Marian Centre	187 Cambridge Street, WEMBLEY WA 6014
201	The San Day Surgery	1a Northcote Road, HORNSBY NSW 2077
202	The Sydney Private Hospital	63 Victoria Street, ASHFIELD NSW 2131
203	The Valley Private Hospital	Corner Police and Gladstone Roads, MULGRAVE VIC 3170
204	Toowong Private Hospital	496 Milton Rd, TOOWONG QLD 4066
205	Toronto Private Hospital	Cary Street, TORONTO NSW 2283
206	Townsville Day Surgery	1 Martinez Avenue, West End, TOWNSVILLE QLD 4810
207	Vaucluse Private Hospital	82 Moreland Road, BRUNSWICK VIC 3056
208	Vista Laser Eye Clinics NSW	1 McClaren St, NORTH SYDNEY NSW 2060
209	Wakefield Hospital	300 Wakefield Street, ADELAIDE SA 5000
210	Wandene Private Hospital	7 Blake Street, KOGARAH NSW 2217
211	Wangaratta Private Hospital	134-150 Templeton Street, WANGARATTA VIC 3677
212	Warners Bay Private Hospital	Fairfax Road, WARNERS BAY NSW 2282
213	Warringal Private Hospital	216 Burgundy Street, HEIDELBERG VIC 3084
214	Waverly Private Hospital	343-357 Blackburn Road, MOUNT WAVERLY VIC 3149
215	Wesley Private Hospital	91 Milton Street, ASHFIELD NSW 2131
216	West Lakes Day Surgery	151 Brebner Drive, WEST LAKES SA 5021
217	Western Plains Day Surgery	62 Windsor Parade, DUBBO NSW 2850
218	Western Private Hospital	Corner Eleanor and Marion Streets, FOOTSCRAY VIC 3012
219	Westmead Rehabilitation Centre	7 Coleman Street, MERRYLANDS NSW 2160
220	Wolper Jewish Private Hospital	8 Trelawney Street, WOOLLAHRA NSW 2025

1Private Health Insurance (Benefit Requirements) Rules 2007

Get a plain-English read of 1

meta-content-style-type: text/css meta-content-type: application/xhtml+xml; charset=utf-8 meta-generator: Aspose.Words for .NET 20.2

Contents

1. Name of Rules

2. Commencement

3. Definitions

4. Psychiatric care, rehabilitation and palliative care

5. Other hospital treatments

Category 1 – attendances

Category 2 – diagnostic procedures & investigations

Category 3 – therapeutic procedures

Category 4 – oral and maxillofacial

Category 5

Magnetic resonance imaging

Where: j = group of equivalent episodes of hospital treatment under the insurer's negotiated agreements;

Public hospital: State/Territory	Minimum benefit payable per day
NSW	$162
Victoria	$162
Queensland	$162
South Australia	$162
Western Australia	$162
Tasmania	$162
ACT	$162
Northern Territory	$157