Commonwealth Numbered Regulations Commonwealth Numbered RegulationsSussan Ley
Minister for Health and Aged Care
Contents
1............ Name............................................................................................................................. 1
2............ Commencement............................................................................................................. 1
3............ Authority....................................................................................................................... 1
4............ Schedules...................................................................................................................... 1
5............ Diagnostic imaging services table.................................................................................. 1
6............ Dictionary...................................................................................................................... 1
Schedule 1--Diagnostic imaging services table 2
Part 1--Preliminary 2
Division 1.1--Interpretation 2
1.1.1...... References to diagnostic imaging services..................................................................... 2
Division 1.2--General application provisions 2
Subdivision A--Capital sensitivity 2
1.2.1...... Application of (K) items and (NK) items....................................................................... 2
1.2.2...... Age of equipment.......................................................................................................... 2
1.2.3...... Exemptions from capital sensitivity............................................................................... 4
1.2.4...... Reconsideration of exemption decisions........................................................................ 5
1.2.5...... Delegation..................................................................................................................... 5
Subdivision B--Other provisions 6
1.2.6...... Meaning of symbols (R) and (NR) in the table............................................................. 6
1.2.7...... Who may provide a diagnostic imaging service............................................................. 6
1.2.8...... Report requirements for certain services........................................................................ 6
1.2.9...... Bulk-billing incentive.................................................................................................... 6
1.2.10.... Bulk-billing--magnetic resonance imaging................................................................... 6
1.2.11.... Multiple services--vascular ultrasound......................................................................... 7
1.2.12.... Multiple services........................................................................................................... 7
1.2.13.... Application of items--services provided with autologous injections of blood or blood products 8
Part 2--Services and fees 9
Division 2.1--Group I1: ultrasound 9
Subdivision A--General 9
2.1.1...... Ultrasound services--eligible services.......................................................................... 9
2.1.2...... Ultrasound services--R-type eligible services.............................................................. 9
Subdivision B--Subgroups 1 to 4 of Group I1 10
2.1.3...... Certain items taken to include referred by dental practitioner or referring dental practitioner 10
Subdivision C--Subgroup 5 of Group I1: obstetric and gynaecological 24
2.1.4...... Obstetric and gynaecological ultrasound services--limits........................................... 24
2.1.5...... Obstetric and gynaecological services--referrals and clinical notes............................ 25
2.1.6...... Obstetric and gynaecological services--conditions..................................................... 25
Subdivision D--Subgroup 6 of Group I1: musculoskeletal ultrasound 41
2.1.7...... Musculoskeletal ultrasound services--personal attendance......................................... 41
2.1.8...... Musculoskeletal ultrasound services--comparison ultra-sonography......................... 42
2.1.9...... Musculoskeletal ultrasound services--equipment....................................................... 42
Division 2.2--Group I2: computed tomography (examination) 53
2.2.1...... CT services--eligible services..................................................................................... 53
2.2.2...... CT services--exclusion of attenuation correction and anatomical correlation.............. 53
2.2.3...... CT services--exclusion of acoustic neuroma.............................................................. 54
2.2.4...... CT services--assessment of headache........................................................................ 54
2.2.5...... CT services--number of services................................................................................ 54
2.2.6...... Cone bean computed tomography--items 57362 and 57363...................................... 54
Division 2.3--Group I3: diagnostic radiology 62
Subdivision A--General 62
2.3.1...... Who must perform diagnostic imaging procedure....................................................... 62
Subdivision B--Subgroups 1 to 9 of Group I3 63
Subdivision C--Subgroup 10 of Group I3: radiographic examination of breasts 68
2.3.2...... Mammography services--eligible services................................................................. 68
Subdivision D--Subgroups 12 to 14 of Group I3 69
Subdivision E--Subgroup 15 of Group I3: fluoroscopic examination 73
Subdivision F--Subgroup 16 of Group I3: preparation for radiological procedure 74
2.3.3...... Preparation of patients for radiological procedures...................................................... 74
Subdivision G--Subgroup 17 of Group I3: interventional techniques 75
2.3.4...... Meaning of angiography suite..................................................................................... 75
Division 2.4--Group I4: nuclear medicine imaging 75
2.4.1...... Nuclear scanning services--other than PET................................................................ 75
2.4.2...... PET nuclear scanning services.................................................................................... 75
2.4.3...... PET nuclear scanning services--performance under personal supervision................. 76
2.4.4...... PET nuclear scanning services--equipment................................................................ 76
2.4.5...... PET nuclear scanning services--statutory declaration................................................. 76
Division 2.5--Group I5: magnetic resonance imaging 84
Subdivision A--General 84
2.5.1...... MRI and MRA services--eligible services................................................................. 84
2.5.2...... MRI and MRA services--request............................................................................... 85
2.5.3...... MRI and MRA services--permissible circumstances for performance....................... 85
2.5.4...... MRI and MRA services--eligible provider................................................................ 85
2.5.5...... MRI and MRA services--eligible equipment............................................................. 85
2.5.6...... MRI and MRA services--partial eligible equipment................................................... 86
2.5.7...... MRI and MRA services--meaning of scan................................................................ 86
2.5.8...... MRI and MRA services--multiple services................................................................ 86
2.5.9...... MRI or MRA services--related services that can be claimed in a 12 month period.... 86
Subdivision B--Subgroups 1 to 19 of Group I5 87
Subdivision C--Subgroup 20 of Group I5: scans of pelvis and upper abdomen for specified conditions 95
2.5.10.... MRI services--limits for certain items........................................................................ 95
2.5.11.... MRI and MRA services--modifying items................................................................ 96
Subdivision D--Subgroups 21 and 22 of Group I5 97
Subdivision E--Subgroup 33 of Group I5 98
Subdivision F--Subgroup 34 of Group I5 99
Division 2.6--Group I6: management of bulk-billed services 100
2.6.1...... Application of items 64990 and 64991...................................................................... 100
Part 3--Dictionary 103
Schedule 2--Repeals 107
Health Insurance (Diagnostic Imaging Services Table) Regulation 2015 107