Commonwealth Consolidated Regulations Commonwealth Consolidated Regulationsmade under the
Compilation No. 16
Compilation date: 1 July 2024
Includes amendments: F2024L00573
Registered: 5 July 2024
About this compilation
This compilation
This is a compilation of the Health Insurance (Diagnostic Imaging Services Table) Regulations (No. 2) 2020 that shows the text of the law as amended and in force on 1 July 2024 (the compilation date).
The notes at the end of this compilation (the endnotes) include information about amending laws and the amendment history of provisions of the compiled law.
Uncommenced amendments
The effect of uncommenced amendments is not shown in the text of the compiled law. Any uncommenced amendments affecting the law are accessible on the Register (www.legislation.gov.au). The details of amendments made up to, but not commenced at, the compilation date are underlined in the endnotes. For more information on any uncommenced amendments, see the Register for the compiled law.
Application, saving and transitional provisions for provisions and amendments
If the operation of a provision or amendment of the compiled law is affected by an application, saving or transitional provision that is not included in this compilation, details are included in the endnotes.
Editorial changes
For more information about any editorial changes made in this compilation, see the endnotes.
Modifications
If the compiled law is modified by another law, the compiled law operates as modified but the modification does not amend the text of the law. Accordingly, this compilation does not show the text of the compiled law as modified. For more information on any modifications, see the Register for the compiled law.
Self-repealing provisions
If a provision of the compiled law has been repealed in accordance with a provision of the law, details are included in the endnotes.
Contents
1 Name
3 Authority
4 Diagnostic imaging services table
Schedule 1--Diagnostic imaging services table
Part 1--Preliminary
Division 1.1--Interpretation
1.1.1 References to diagnostic imaging services
1.1.2 References in this Schedule to items include items determined under section 3C of the Act
1.1.3 Dictionary
Division 1.2--General application provisions
Subdivision A--Capital sensitivity requirements
1.2.1 Restriction on items--services performed on aged equipment
1.2.2 Age of equipment
Subdivision B--Exemptions from capital sensitivity requirements
1.2.4 Meaning of relevant proprietor
1.2.7 Equipment unable to be replaced etc. before end of applicable life age--applying for exemptions
1.2.8 Equipment unable to be replaced etc. before end of applicable life age--granting exemptions
1.2.9 Equipment unable to be replaced etc. before end of applicable life age--applying for extensions of exemption periods
1.2.10 Equipment unable to be replaced etc. before end of applicable life age--extending exemption periods
1.2.11 Reconsideration by Secretary--applying for reconsideration
1.2.12 Reconsideration by Secretary--reconsidering decisions
1.2.13 Review by AAT
Subdivision C--Other provisions
1.2.15 Meaning of symbols (R) and (NR)
1.2.16 Who may provide a diagnostic imaging service
1.2.17 Restriction on items--report requirements for R-type diagnostic imaging services
1.2.18 Bulk-billing incentive
1.2.21 Reduction in fees--multiple services on same day--general
1.2.22 Restriction on items--services provided with autologous injections of blood or blood products
1.2.23 Restriction on items--services provided with harvesting, storage, in vitro processing or injection of non -haematopoietic stem cells
Part 2--Services and fees
Division 2.1--Group I1: ultrasound
Subdivision A--General
2.1.1 Restriction on items--ultrasound services
2.1.2 Restriction on items--R-type ultrasound services
Subdivision B--Subgroups 1 to 4 of Group I1
2.1.2A Reduction in fees--multiple services on same day--vascular ultrasounds
2.1.3 Items in Subgroups 1 to 4 of Group I1
Subdivision C--Subgroup 5 of Group I1: obstetric and gynaecological
2.1.4 Obstetric and gynaecological ultrasound services--limits
2.1.5 Obstetric and gynaecological services--referrals and clinical notes
2.1.6 Items in Subgroup 5 of Group I1
Subdivision D--Subgroup 6 of Group I1: musculoskeletal ultrasound
2.1.8 Unilateral item cannot be claimed twice if bilateral item could have been claimed
2.1.9 Musculoskeletal ultrasound services--comparison ultra-sonography
2.1.10 Items in Subgroup 6 of Group I1
Subdivision E--Subgroup 7 of Group I1: Transthoracic and stress echocardiograms
2.1.11 Restrictions on items for transthoracic echocardiograms--assessments
2.1.12 Restriction on item 55126--timing
2.1.13 Restriction on items for stress echocardiograms--patients, requests and requirements
2.1.14 Stress echocardiograms--patients
2.1.15 Stress echocardiograms--requirements
2.1.16 Restrictions on items for stress echocardiograms--timing
2.1.17 Reduction in fees--multiple services on same day--transthoracic and stress echocardiograms
2.1.18 Items in Subgroup 7 of Group I1
Division 2.2--Group I2: computed tomography (examination)
Subdivision A--General
2.2.1 CT services--eligible services
2.2.2 Restriction on items--attenuation correction and anatomical correlation
2.2.3 Application of items 56001 and 56007 if axial scan performed for exclusion of acoustic neuroma
2.2.4 CT services--assessment of headache
2.2.5 CT services--number of services
2.2.5A Restriction on item 57360--patients
Subdivision B--Subgroups 1 to 13 of Group I2
2.2.6 Items in Subgroups 1 to 13 of Group I2
Division 2.3--Group I3: diagnostic radiology
Subdivision A--General
2.3.1 Application of items in Subdivision B, D, E or G to services rendered using diagnostic imaging procedures carried out in metropolitan areas and certain inner regional areas
2.3.2 Restriction on items--certain services requested by chiropractors, osteopaths and physiotherapists
2.3.3 Increased fees for certain diagnostic radiology services carried out at residential aged care facilities
Subdivision B--Subgroups 1 to 9 of Group I3
2.3.4 Items in Subgroups 1 to 9 of Group I3
Subdivision C--Subgroup 10 of Group I3: radiographic examination of breasts
2.3.5 Mammography services--eligible services
2.3.6 Items in Subgroup 10 of Group I3
Subdivision D--Subgroups 12 and 13 of Group I3
2.3.7 Items in Subgroups 12 and 13 of Group I3
Subdivision E--Subgroup 15 of Group I3: fluoroscopic examination
2.3.8 Items in Subgroup 15 of Group I3
Subdivision F--Subgroup 16 of Group I3: preparation for radiological procedure
2.3.9 Preparation of patients for radiological procedures
2.3.10 Items in Subgroup 16 of Group I3
Subdivision G--Subgroup 17 of Group I3: interventional techniques
2.3.11 Meaning of angiography suite
2.3.12 Items in Subgroup 17 of Group I3
Division 2.4--Group I4: nuclear medicine imaging
Subdivision A--General
2.4.1 Nuclear scanning services (other than PET nuclear scanning services) and adjunctive services
2.4.1A Restriction on items for stress myocardial perfusion studies--patients, requests and requirements
2.4.1B Stress myocardial perfusion studies--patients
2.4.1C Stress myocardial perfusion studies--requirements
2.4.2 PET nuclear scanning services
2.4.3 PET nuclear scanning services--performance under supervision
2.4.4 PET nuclear scanning services--equipment
2.4.5 PET nuclear scanning services--statutory declaration
Subdivision B--Subgroups 1, 2 and 3 of Group I4
2.4.6 Items in Subgroups 1, 2 and 3 of Group I4
Division 2.5--Group I5: magnetic resonance imaging
Subdivision A--General
2.5.1 Application of items to certain MRI and MRA services
2.5.2 MRI and MRA services--request
2.5.3 MRI and MRA services--permissible circumstances for performance
2.5.4 MRI and MRA services--eligible provider
2.5.5 MRI and MRA services--eligible equipment
2.5.6 MRI and MRA services--partial eligible equipment
2.5.7 MRI and MRA services--meaning of scan
2.5.8 Restriction on items--multiple services in certain subgroups on a day
2.5.8A Restriction on items--multiple services in certain subgroups in an attendance
2.5.8B Reduction in fees--multiple services on same day--Subgroups 12 and 13
2.5.9 Restriction on items--related MRI or MRA services
2.5.9A Circumstances for suspecting prostate cancer for item 63541
2.5.9B Restriction on item 63543--timing and purpose
Subdivision B--Subgroups 1 to 19 of Group I5
2.5.10 Items in Subgroups 1 to 19 of Group I5
Subdivision C--Subgroup 20 of Group I5: scans of pelvis and upper abdomen for specified conditions
2.5.11 Restriction on items 63470, 63473, 63740 and 63743
2.5.13 Items in Subgroup 20 of Group I5
Subdivision D--Subgroups 21 and 22 of Group I5
2.5.13A MRI and MRA services--modifying items
2.5.14 Items in Subgroups 21 and 22 of Group I5
Subdivision E--Subgroup 33 of Group I5
2.5.15 Items in Subgroup 33 of Group I5
Subdivision F--Subgroup 34 of Group I5
2.5.16 Items in Subgroup 34 of Group I5
Division 2.6--Group I6: management of bulk-billed services
2.6.1 Application of items 64990, 64991, 64992, 64993, 64994 and 64995
2.6.2 Items in Group I6
Division 2.7--Indexation of fees
2.7.1 Indexation--1 July 2024
Part 3--Dictionary
3.1 Dictionary
Part 4--Application, saving and transitional provisions
Division 1--Health Insurance (Diagnostic Imaging Services Table) Amendment (Equipment Capital Sensitivity) Regulations 2022
4.1 Definitions
4.2 Application of amendments
Division 2--Health Insurance Legislation Amendment (2024 Measures No. 2) Regulations 2024
4.3 Definitions
4.4 Exemptions from capital sensitivity requirements
4.5 PET nuclear scanning services--statutory declaration
Endnotes
Endnote 1--About the endnotes
Endnote 2--Abbreviation key
Endnote 3--Legislation history
Endnote 4--Amendment history
The endnotes provide information about this compilation and the compiled law.
The following endnotes are included in every compilation:
Endnote 1--About the endnotes
Endnote 2--Abbreviation key
Endnote 3--Legislation history
Endnote 4--Amendment history
Abbreviation key--Endnote 2
The abbreviation key sets out abbreviations that may be used in the endnotes.
Legislation history and amendment history--Endnotes 3 and 4
Amending laws are annotated in the legislation history and amendment history.
The legislation history in endnote 3 provides information about each law that has amended (or will amend) the compiled law. The information includes commencement details for amending laws and details of any application, saving or transitional provisions that are not included in this compilation.
The amendment history in endnote 4 provides information about amendments at the provision (generally section or equivalent) level. It also includes information about any provision of the compiled law that has been repealed in accordance with a provision of the law.
Editorial changes
The Legislation Act 2003 authorises First Parliamentary Counsel to make editorial and presentational changes to a compiled law in preparing a compilation of the law for registration. The changes must not change the effect of the law. Editorial changes take effect from the compilation registration date.
If the compilation includes editorial changes, the endnotes include a brief outline of the changes in general terms. Full details of any changes can be obtained from the Office of Parliamentary Counsel.
Misdescribed amendments
A misdescribed amendment is an amendment that does not accurately describe how an amendment is to be made. If, despite the misdescription, the amendment can be given effect as intended, then the misdescribed amendment can be incorporated through an editorial change made under section 15V of the Legislation Act 2003.
If a misdescribed amendment cannot be given effect as intended, the amendment is not incorporated and "(md not incorp)" is added to the amendment history.
ad = added or inserted | o = order(s) |
am = amended | Ord = Ordinance |
amdt = amendment | orig = original |
c = clause(s) | par = paragraph(s)/subparagraph(s) |
C[x] = Compilation No. x | /sub-subparagraph(s) |
Ch = Chapter(s) | pres = present |
def = definition(s) | prev = previous |
Dict = Dictionary | (prev ... ) = previously |
disallowed = disallowed by Parliament | Pt = Part(s) |
Div = Division(s) | r = regulation(s)/rule(s) |
ed = editorial change | reloc = relocated |
exp = expires/expired or ceases/ceased to have | renum = renumbered |
effect | rep = repealed |
F = Federal Register of Legislation | rs = repealed and substituted |
gaz = gazette | s = section(s)/subsection(s) |
LA = Legislation Act 2003 | Sch = Schedule(s) |
Sdiv = Subdivision(s) | |
(md) = misdescribed amendment can be given | SLI = Select Legislative Instrument |
effect | SR = Statutory Rules |
(md not incorp) = misdescribed amendment | Sub-Ch = Sub-Chapter(s) |
cannot be given effect | SubPt = Subpart(s) |
mod = modified/modification | underlining = whole or part not |
No. = Number(s) | commenced or to be commenced |
Endnote 3--Legislation history
Name | Registration | Commencement | Application, saving and transitional provisions |
Health Insurance (Diagnostic Imaging Services Table) Regulations (No. 2) 2020 | 15 June 2020 (F2020L00713) | 1 July 2020 (s 2(1) item 1) |
|
Health Insurance Legislation Amendment (2020 Measures No. 1) Regulations 2020 | 6 July 2020 (F2020L00882) | Sch 1 (items 1-4): 1 Aug 2020 (s 2(1) item 1) | -- |
Health Insurance Legislation Amendment (Bulk-billing Incentive (No. 2)) Regulations 2020 | 23 Sept 2020 (F2020L01203) | Sch 1 (items 1, 2): 1 Oct 2020 (s 2(1) item 1) | -- |
Health Insurance Legislation Amendment (2020 Measures No. 2) Regulations 2020 | 20 Oct 2020 (F2020L01330) | Sch 1 (items 150-152): 1 Nov 2020 (s 2(1) item 1) | -- |
Health Legislation Amendment (Administration) Regulations 2020 | 14 Dec 2020 (F2020L01602) | Sch 1 (item 1): 15 Dec 2020 (s 2(1) item 1) | -- |
Health Insurance Legislation Amendment (2020 Measures No. 3) Regulations 2020 | 14 Dec 2020 (F2020L01608) | Sch 1 (items 10-24, 67, 69-80): 1 Mar 2021 (s 2(1) items 2, 4) | -- |
Health Insurance Legislation Amendment (2021 Measures No. 1) Regulations 2021 | 2 June 2021 (F2021L00681) | Sch 1 (items 1-5, 8-33, 40-42, 96-100): 1 July 2021 (s 2(1) items 2-4) | -- |
Health Insurance Legislation Amendment (2021 Measures No. 2) Regulations 2021 | 17 Sept 2021 (F2021L01281) | Sch 2: 1 Nov 2021 (s 2(1) item 1) | -- |
Health Insurance Legislation Amendment (Rural Bulk-billing Incentive) Regulations 2021 | 9 Dec 2021 (F2021L01748) | Sch 1 (items 1-8): 1 Jan 2022 (s 2(1) item 1) | -- |
Health Insurance (Diagnostic Imaging Services Table) Amendment (Equipment Capital Sensitivity) Regulations 2021 | 9 Dec 2021 (F2021L01749) | 1 May 2022 (s 2(1) item 1) | -- |
Health Insurance Legislation Amendment (2021 Measures No. 3) Regulations 2021 | 17 Dec 2021 (F2021L01814) | Sch 1 (items 1-5): 1 Jan 2022 (s 2(1) item 1) | -- |
Health Insurance Legislation Amendment (2022 Measures No. 1) Regulations 2022 | 22 Mar 2022 (F2022L00367) | Sch 1 (items 1-3, 38, 39, 44-48): 1 July 2022 (s 2(1) items 2, 3) | -- |
Health Insurance Legislation Amendment (2022 Measures No. 3) Regulations 2022 | 22 Aug 2022 (F2022L01099) | Sch 2: 1 Nov 2022 (s 2(1) item 2) | -- |
Health Insurance (Diagnostic Imaging Services Table) Amendment (Equipment Capital Sensitivity) Regulations 2022 | 16 Sept 2022 (F2022L01220) | 17 Sept 2022 (s 2(1) item 1) | -- |
Health Insurance Legislation Amendment (2023 Measures No. 1) Regulations 2023 | 4 Apr 2023 (F2023L00416) | Sch 2 (items 1, 2) and Sch 3 (items 1-7): 1 July 2023 (s 2(1) items 3, 4) | -- |
Health Insurance Legislation Amendment (2023 Measures No. 2) Regulations 2023 | 8 June 2023 (F2023L00744) | Sch 1 (items 1-4): 1 July 2023 (s 2(1) item 1) | -- |
Health Insurance Legislation Amendment (2023 Measures No. 3) Regulations 2023 | 16 Oct 2023 (F2023L01386) | Sch 2 (items 1, 2) and Sch 3: 1 Nov 2023 (s 2(1) items 3, 4) | -- |
Health Insurance Legislation Amendment (2024 Measures No. 1) Regulations 2024 | 2 Feb 2024 (F2024L00134) | Sch 1 (items 50, 51): 1 Mar 2024 (s 2(1) item 1) | -- |
Health Insurance Legislation Amendment (2024 Measures No. 2) Regulations 2024 | 23 May 2024 (F2024L00573) | Sch 1 (items 1, 2) and Sch 2 (items 1-23): 1 July 2024 (s 2(1) items 2, 3) | -- |
Provision affected | How affected |
s 2..................... | rep LA s 48D |
s 4..................... | am F2020L01602 |
s 5..................... | rep LA s 48C |
Schedule 1 |
|
Part 1 |
|
Division 1.2 |
|
Subdivision B |
|
c 1.2.3................... | rep F2021L01749 |
c 1.2.5................... | rep F2021L01749 |
c 1.2.6................... | rep F2021L01749 |
c 1.2.7................... | am F2024L00573 |
c 1.2.8................... | am F2022L01220; F2024L00573 |
c 1.2.9................... | am F2024L00573 |
c 1.2.10.................. | am F2022L01220; F2024L00573 |
c 1.2.11.................. | am F2021L01749; F2024L00573 |
c 1.2.14.................. | rep F2024L00573 |
Subdivision C |
|
c 1.2.18.................. | am F2022L00367; F2022L01099; F2023L01386 |
c 1.2.19.................. | rep F2022L00367 |
c 1.2.20.................. | rep F2021L01281 |
| am F2021L01748 (amdt never applied (Sch 1 item 1)) |
c 1.2.21.................. | am F2020L01608; F2021L01281; F2021L01748 |
| ed C8 |
Part 2 |
|
Division 2.1 |
|
Subdivision B |
|
c 2.1.2A................. | ad F2021L01281 |
c 2.1.3................... | am F2021L00681; F2021L01814 |
Group I1 Table............. | am F2020L00882; F2020L01330; F2020L01608; F2021L00681; F2021L01281; F2024L00134 |
Subdivision C |
|
c 2.1.4................... | am F2022L01099 |
c 2.1.5................... | am F2022L01099 |
c 2.1.6................... | am F2021L00681; F2021L01814 |
Group I1 Table............. | am F2022L01099 |
| ed C12 |
Subdivision D |
|
c 2.1.7................... | rep F2023L01386 |
c 2.1.10.................. | am F2021L00681; F2021L01814 |
Subdivision E |
|
Subdivision E.............. | ad F2020L01608 |
c 2.1.11.................. | ad F2020L01608 |
c 2.1.12.................. | ad F2020L01608 |
c 2.1.13.................. | ad F2020L01608 |
c 2.1.14.................. | ad F2020L01608 |
c 2.1.15.................. | ad F2020L01608 |
c 2.1.16.................. | ad F2020L01608 |
c 2.1.17.................. | ad F2020L01608 |
| am F2021L01281 |
c 2.1.18.................. | ad F2020L01608 |
| am F2022L00367 |
Group I1 Table............. | am F2021L00681 |
Division 2.2 |
|
Subdivision A |
|
c 2.2.1................... | am F2021L00681 |
c 2.2.5A................. | ad F2021L01281 |
Subdivision B |
|
c 2.2.6................... | am F2021L00681; F2021L01814 |
Group I2 Table............. | am F2020L01608; F2021L00681; F2021L01281; F2023L01386 |
Division 2.3 |
|
Subdivision A |
|
c 2.3.3................... | rs F2020L01608 |
Subdivision B |
|
c 2.3.4................... | am F2021L00681; F2021L01814 |
Subdivision C |
|
c 2.3.6................... | am F2021L00681; F2021L01814 |
Group I3 Table............. | am F2023L00416 |
Subdivision D |
|
c 2.3.7................... | am F2021L00681; F2021L01814 |
Group I3 Table............. | am F2021L00681 |
Subdivision E |
|
c 2.3.8................... | am F2021L00681; F2021L01814 |
Subdivision F |
|
c 2.3.9................... | am F2021L00681 |
c 2.3.10.................. | am F2021L00681; F2021L01814 |
Group I3 Table............. | am F2021L00681 |
Subdivision G |
|
c 2.3.12.................. | am F2021L00681; F2021L01814 |
Division 2.4 |
|
Subdivision A |
|
c 2.4.1................... | am F2020L00882; F2020L01608 |
| rs: F2024L00573 |
c 2.4.1A................. | ad F2020L01608 |
c 2.4.1B................. | ad F2020L01608 |
c 2.4.1C................. | ad F2020L01608 |
c 2.4.1D................. | ad F2020L01608 |
| rep F2021L00681 |
c 2.4.2................... | am F2023L01386 |
c 2.4.3................... | rs F2024L00573 |
c 2.4.4................... | am F2024L00573 |
c 2.4.5................... | am F2024L00573 |
Subdivision B |
|
Subdivision B heading........ | am F2020L01608 |
c 2.4.6................... | am F2020L01608 |
Group I4 Table............. | am F2020L00882; F2020L01608; F2021L00681 |
| ed C6 |
| am F2021L01281; F2021L01814; F2022L00367; F2022L01099; F2023L00416; F2023L01386 |
Division 2.5 |
|
Subdivision A |
|
c 2.5.1................... | am F2022L01099; F2023L00744 |
c 2.5.5................... | am F2022L01099 |
c 2.5.6................... | am F2022L01099 |
c 2.5.7................... | am F2022L01099 |
c 2.5.8................... | rs F2021L01281 |
c 2.5.8A................. | ad F2021L01281 |
c 2.5.8B................. | ad F2021L01281 |
c 2.5.9................... | am F2021L00681; F2021L01281; F2022L01099; F2023L00744 |
c 2.5.9A................. | ad F2021L01281 |
| am F2022L00367 |
c 2.5.9B................. | ad F2021L01281 |
| ed C7 |
Subdivision B |
|
c 2.5.10.................. | am F2022L00367 |
Group I5 Table............. | am F2021L00681; F2021L01281; F2022L01099; F2024L00134 |
Subdivision C |
|
c 2.5.12.................. | rep F2022L01099 |
c 2.5.13.................. | am F2022L00367 |
Group I5 Table............. | am F2021L00681; F2022L01099; F2024L00573 |
Subdivision D |
|
c 2.5.13A................. | ad F2022L01099 |
| am F2023L00744 |
c 2.5.14.................. | am F2022L00367; F2023L00416 |
Group I5 Table............. | am F2022L01099; F2023L00416 |
Subdivision E |
|
c 2.5.15.................. | am F2022L00367 |
Subdivision F |
|
c 2.5.16.................. | am F2022L00367 |
Division 2.6 |
|
c 2.6.1................... | am F2021L01748 |
c 2.6.2................... | am F2021L00681; F2021L01814 |
Group I6 table............. | am F2020L01203; F2021L01748 |
Division 2.7 |
|
Division 2.7............... | ad F2021L00681 |
c 2.7.1................... | ad F2021L00681 |
| ed C6 |
| am F2022L00367; F2023L00416; F2023L01386; F2024L00573 |
Part 3 |
|
c 3.1.................... | am F2020L01608; F2021L01281; F2021L01749; F2022L01099; F2024L00573 |
Part 4 |
|
Part 4................... | rep F2021L01749 |
| ad F2022L01220 |
Division 1 |
|
c 4.1.................... | rep F2021L01749 |
| ad F2022L01220 |
c 4.2.................... | rep F2021L01749 |
| ad F2022L01220 |
Division 2 |
|
Division 2................ | ad F2024L00573 |
c 4.3.................... | ad F2024L00573 |
c 4.4.................... | ad F2024L00573 |
c 4.5.................... | ad F2024L00573 |
Schedule 2................ | rep LA s 48C |