Commonwealth Consolidated Regulations Commonwealth Consolidated Regulationsmade under the
Compilation No. 15
Compilation date: 1 November 2024
Includes amendments: F2024L01219
About this compilation
This compilation
This is a compilation of the Health Insurance (Pathology Services Table) Regulations 2020 that shows the text of the law as amended and in force on 1 November 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If a provision of the compiled law has been repealed in accordance with a provision of the law, details are included in the endnotes.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 Pathology services table
Schedule 1--Pathology services table
Part 1--Preliminary
Division 1.1--Interpretation
1.1.1 Dictionary
1.1.2 Methodology for services
1.1.3 References in this Schedule to items include items determined under section 3C of the Act
Division 1.2--General application provisions
1.2.1 Restriction on items--precedence
1.2.2 When services rendered following multiple requests are taken to have been rendered following a single request
1.2.3 Services to which clause 1.2.2 does not apply--general
1.2.4 Services to which clause 1.2.2 does not apply--haematology
1.2.5 Services to which clause 1.2.2 does not apply--chemical
1.2.6 Referral of designated tests by one pathology practitioner to another
1.2.7 Items not to be split except as stated in clause 1.2.6
1.2.8 Services in certain sets of services to be treated as individual services
1.2.9 Sets of services for the purposes of clause 1.2.8
1.2.10 Satisfying requirements in descriptions of services
1.2.11 Restriction on items--services rendered with autologous injections of blood or blood products
1.2.12 Restriction on items--services rendered with harvesting, storage, in vitro processing or injection of non -haematopoietic stem cells
1.2.13 Restriction on items 66551, 73812 and 73826--timing
Division 1.3--Patient episodes
1.3.1 Meaning of patient episode
1.3.2 When later services are taken to be part of an earlier patient episode
Part 2--Services and fees
Division 2.1--Group P1: haematology
2.1.1 Restriction on items 65090 and 65093--services for patients in hospital
2.1.2 Items in Group P1
Division 2.2--Group P2: chemical
2.2.1 Inclusion of measurement of creatinine in services
2.2.2 Restriction on vitamins testing items--timing
2.2.3 Restriction on metals testing items--timing
2.2.4 Items in Group P2
Division 2.3--Group P3: microbiology
2.3.1 Restriction on certain items--antigen detection services rendered as pathologist-determinable services
2.3.2 Fee for certain items in a single patient episode--investigation for hepatitis serology
2.3.3 Restriction on certain items--timing
2.3.4 Items in Group P3
Division 2.4--Group P4: immunology
2.4.1 Restriction on item 71148--HLA-B27 typing services rendered as pathologist -determinable services
2.4.2 Items in Group P4
Division 2.5--Group P5: tissue pathology
2.5.1 Restrictions on items--services performed using material submitted for a Group P6 service
2.5.2 Restrictions on items--certain biopsy examinations performed in a single patient episode
2.5.3 Restrictions on items--certain histopathological examinations performed on specimens from a single patient episode
2.5.4 Restriction on items--certain services in Groups P5 and P6 performed in a single patient episode
2.5.5 Restrictions on items 72858 and 72859
2.5.5A Application of item 72860
2.5.6 Items in Group P5
Division 2.6--Group P6: cytology
2.6.1 Restriction on items in Group P6--fee for services performed in a single patient episode
2.6.2 Items in Group P6
Division 2.7--Group P7: genetics
2.7.1A Restriction on item 73287--conjunction with item 73388
2.7.1B Restriction on item 73290--conjunction with item 73391
2.7.1 Restriction on items 73320 and 73321 (HLA-B27 detection)--services rendered as pathologist -determinable services
2.7.2 Restriction on items 73339 and 73340 (relating to RET gene mutations)
2.7.3 Restriction on items 73345 to 73350 (relating to cystic fibrosis)--testing methodology
2.7.3A Items 73384 to 73387 (relating to pre-implantation genetic testing)--patient eligibility
2.7.4 Items in Group P7
Division 2.8--Group P8: infertility and pregnancy tests
2.8.1 Items in Group P8
Division 2.9--Group P9: simple basic pathology tests
2.9.1 Items in Group P9
Division 2.10--Group P10: patient episode initiation
2.10.1 Restrictions on items in Group P10--circumstances
2.10.2 Items in Group P10
Division 2.11--Group P11: specimen referred
2.11.1 Restriction on items in Group P11--circumstances
2.11.2 Restriction on items in Group P10--patient episodes including a service to which item 73940 applies
2.11.3 Restrictions on items in Group P11--referrals
2.11.4 Items in Group P11
Division 2.12--Group P12: management of bulk-billed services
2.12.1 Application of items 74990, 74991, 75861, 75862, 75863 and 75864
2.12.2 Items in Group P12
Division 2.13--Group P13: bulk-billing incentive
2.13.1 Items in Group P13
Division 2.14--Indexation of fees
2.14.1 Indexation--1 July 2024
Part 3--Complexity levels for tissue pathology items
3.1 Complexity levels
Part 4--Dictionary
4.1 Dictionary
Endnotes
Endnote 1--About the endnotes
Endnote 2--Abbreviation key
Endnote 3--Legislation history
Endnote 4--Amendment history
Endnote 5--Editorial changes
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 (Pathology Services Table) Regulations 2020 | 23 Apr 2020 (F2020L00460) | 1 May 2020 (s 2(1) item 1) |
|
Health Insurance Legislation Amendment (Bulk-billing Incentive) Regulations 2020 | 29 Mar 2020 (F2020L00341) | Sch 1 (items 11, 12): 1 May 2020 (s 2(1) item 3) | -- |
Health Insurance (Pathology Services Table) Amendment (Indexation) Regulations 2020 | 16 June 2020 (F2020L00728) | 1 July 2020 (s 2(1) item 1) | -- |
Health Insurance Legislation Amendment (Bulk-billing Incentive (No. 2)) Regulations 2020 | 23 Sept 2020 (F2020L01203) | Sch 1 (items 5, 6): 1 Oct 2020 (s 2(1) item 1) | -- |
Health Insurance Legislation Amendment (2020 Measures No. 2) Regulations 2020 | 20 Oct 2020 (F2020L01330) | Sch 1 (item 159): 1 Nov 2020 (s 2(1) item 1) | -- |
Health Legislation Amendment (Administration) Regulations 2020 | 14 Dec 2020 (F2020L01602) | Sch 1 (item 2): 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 65, 66, 94-96): 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 6, 7): 1 July 2021 (s 2(1) item 2) | -- |
Health Insurance Legislation Amendment (2021 Measures No. 2) Regulations 2021 | 17 Sept 2021 (F2021L01281) | Sch 3: 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 24-29): 1 Jan 2022 (s 2(1) item 1) | -- |
Health Insurance Legislation Amendment (2021 Measures No. 3) Regulations 2021 | 17 Dec 2021 (F2021L01814) | Sch 1 (items 25-27): 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 4-10, 122, 123): 1 July 2022 (s 2(1) items 2, 3) | -- |
Health Insurance Legislation Amendment (2022 Measures No. 3) Regulations 2022 | 22 Aug 2022 (F2022L01099) | Sch 3: 1 Nov 2022 (s 2(1) item 2) | -- |
Health Insurance Legislation Amendment (2023 Measures No. 1) Regulations 2023 | 4 Apr 2023 (F2023L00416) | Sch 2 (items 24, 25) and Sch 3 (items 31-34): 1 July 2023 (s 2(1) items 3, 4) | -- |
Health Insurance Legislation Amendment (2023 Measures No. 3) Regulations 2023 | 16 Oct 2023 (F2023L01386) | Sch 2 (items 25, 26) and Sch 6: 1 Nov 2023 (s 2(1) items 3, 4) | -- |
Health Insurance Legislation Amendment (2024 Measures No. 2) Regulations 2024 | 23 May 2024 (F2024L00573) | Sch 1 (items 24, 25) and Sch 2 (items 38-42): 1 July 2024 (s 2(1) items 2, 3) | -- |
Health Insurance Legislation Amendment (2024 Measures No. 4) Regulations 2024 | 26 Sept 2024 (F2024L01219) | Sch 3: 1 Nov 2024 (s 2(1) item 1) | -- |
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 |
|
c 1.2.2................... | am F2021L01748 |
c 1.2.9................... | am F2022L01099 |
c 1.2.13.................. | ad F2021L01814 |
| rs F2023L01386 |
Part 2 |
|
Division 2.2 |
|
Group P2 Table............ | am F2021L01281; F2021L01814; F2023L01386; F2024L00573; F2024L01219 |
Division 2.3 |
|
Group P3 Table............ | am F2020L00728; F2023L00416 |
Division 2.4 |
|
Group P4 Table............ | am F2021L01281; F2023L01386 |
Division 2.5 |
|
c 2.5.5................... | am F2022L01099 |
c 2.5.5A................. | ad F2020L01608 |
Group P5 Table............ | am F2020L01608 |
Division 2.6 |
|
Group P6 Table............ | am F2022L00367; F2022L01099 |
Division 2.7 |
|
c 2.7.1A................. | ad F2021L01281 |
c 2.7.1B................. | ad F2021L01281 |
c 2.7.3A................. | ad F2021L01281 |
Group P7 Table............ | am F2020L01330; F2020L01608; F2021L01281; F2022L00367; F2022L01099; F2023L00416; F2023L01386; F2024L00573; F2024L01219 |
| ed C15 |
Division 2.9 |
|
Group P9 Table............ | am F2023L00416 |
Division 2.10 |
|
Group P10 Table............ | am F2022L01099 |
Division 2.12 |
|
c 2.12.1.................. | rs F2021L01748 |
c 2.12.2.................. | am F2021L00681; F2021L01814 |
Group P12 Table............ | am F2020L00341; F2020L00728; F2020L01203; F2021L01748; F2022L01099 |
Division 2.14 |
|
Division 2.14.............. | ad F2021L00681 |
c 2.14.1.................. | ad F2021L00681 |
| ed C7 |
| am F2022L00367; F2023L00416; F2023L01386; F2024L00573 |
Part 4 |
|
c 4.1.................... | am F2021L01281 |
Schedule 2................ | rep LA s 48C |
In preparing this compilation for registration, the following kinds of editorial change(s) were made under the Legislation Act 2003.
Schedule 1 (cell at item 73451, column 2, paragraph (c))
Kind of editorial change
Update to a reference to a person, body or other entity, or an office, position, place, document or thing
Details of editorial change
Paragraph (c) contains an outdated reference to the FMR1 gene.
This compilation was editorially changed to update a reference in paragraph (c) to the international best practice terminology for the FMR1 gene, determined by the HUGO Gene Nomenclature Committee.