Health Insurance (General Medical Services Table) Amendment Regulation 2012 (No. )

Schedule 1 Amendments

(section 3)

[1] Schedule 1, subclause 1.2.8 (1)

after

12530,

insert

13015,

[2] Schedule 1, clause 1.2.9, heading

substitute

1.2.9 Meaning of participating in a video conferencing consultation

[3] Schedule 1, clause 1.2.9

omit

participates in a consultation with a specialist or consultant physician by video conference

insert

is participating in a video conferencing consultation

[4] Schedule 1, Division 2.4, heading

substitute

Division 2.4 Group A3—Specialist attendances to which no other item applies

2.4.1 Limitation of item 99

Item 99 does not apply if the patient or the specialist travels to a place to satisfy the requirement in sub‑subparagraph (d) (i) (B) of the item.

[5] Schedule 1, item 99, column 2

substitute

Professional attendance on a patient by a specialist practising in his or her specialty if:

(a) the attendance is by video conference; and

(b) item 104 or 105 applies to the attendance; and

(d) the patient:

(i) is located both:

(A) outside an inner metropolitan area; and

(B) at the time of the attendance—at least 15 kms by road from the specialist; or

(ii) is a care recipient in a residential care service; or

(iii) is a patient of:

(A) an Aboriginal Medical Service; or

(B) an Aboriginal Community Controlled Health Service for which a direction made under subsection 19 (2) of the Act applies

[6] Schedule 1, Division 2.5, heading

Division 2.5 Group A4—Consultant physician (other than psychiatry) attendances to which no other item applies

2.5.1 Limitation of item 112

Item 112 does not apply if the patient or the physician travels to a place to satisfy the requirement in sub‑subparagraph (d) (i) (B) of the item.

[7] Schedule 1, item 112, column 2

substitute

Professional attendance on a patient by a consultant physician practising in his or her specialty if:

(a) the attendance is by video conference; and

(b) item 110, 116, 119, 132 or 133 applies to the attendance; and

(d) the patient:

(i) is located both:

(A) outside an inner metropolitan area; and

(B) at the time of the attendance—at least 15 kms by road from the physician; or

(ii) is a care recipient in a residential care service; or

(iii) is a patient of:

(A) an Aboriginal Medical Service; or

(B) an Aboriginal Community Controlled Health Service for which a direction made under subsection 19 (2) of the Act applies

[8] Schedule 1, Division 2.6, heading

Division 2.6 Group A28—Geriatric medicine

2.6.1 Limitation of item 149

Item 149 does not apply if the patient, physician or specialist travels to a place to satisfy the requirement in sub‑subparagraph (d) (i) (B) of the item.

[9] Schedule 1, item 149, column 2

substitute

Professional attendance on a patient by a consultant physician or specialist practising in his or her specialty of geriatric medicine if:

(a) the attendance is by video conference; and

(b) item 141 or 143 applies to the attendance; and

(d) the patient:

(i) is located both:

(A) outside an inner metropolitan area; and

(B) at the time of the attendance—at least 15 kms by road from the physician or specialist; or

(ii) is a care recipient in a residential care service; or

(iii) is a patient of:

(A) an Aboriginal Medical Service; or

(B) an Aboriginal Community Controlled Health Service for which a direction made under subsection 19 (2) of the Act applies

[10] After clause 2.10.3

insert

2.10.4 Limitation of item 288

Item 288 does not apply if the patient or physician travels to a place to satisfy the requirement in sub‑subparagraph (d) (i) (B) of the item.

[11] Schedule 1, item 288, column 2

substitute

Professional attendance on a patient by a consultant physician practising in his or her specialty of psychiatry if:

(a) the attendance is by video conference; and

(b) item 291, 293, 296, 300, 302, 304, 306, 308, 310, 312, 314, 316, 318, 319, 348, 350 or 352 applies to the attendance; and

(d) the patient:

(i) is located both:

(A) outside an inner metropolitan area; and

(B) at the time of the attendance—at least 15 kms by road from the physician; or

(ii) is a care recipient in a residential care service; or

(iii) is a patient of:

(A) an Aboriginal Medical Service; or

(B) an Aboriginal Community Controlled Health Service for which a direction made under subsection 19 (2) of the Act applies

[12] Schedule 1, Division 2.11, heading

substitute

Division 2.11 Group A12—Consultant occupational physician attendances to which no other item applies

2.11.1 Limitation of item 389

Item 389 does not apply if the patient or physician travels to a place to satisfy the requirement in sub‑subparagraph (d) (i) (B) of the item.

[13] Schedule 1, item 389, column 2

substitute

Professional attendance on a patient by a consultant occupational physician practising in his or her specialty of occupational medicine if:

(a) the attendance is by video conference; and

(b) item 385 or 386 applies to the attendance; and

(d) the patient:

(i) is located both:

(A) outside an inner metropolitan area; and

(B) at the time of the attendance—at least 15 kms by road from the physician; or

(ii) is a care recipient in a residential care service; or

(iii) is a patient of:

(A) an Aboriginal Medical Service; or

(B) an Aboriginal Community Controlled Health Service for which a direction made under subsection 19 (2) of the Act applies

[14] Paragraph 2.18A.1 (1) (b)

omit

[15] Clause 2.18A.3, after table

insert

2.18A.4 Limitation of items

Items 2100, 2122, 2126, 2137, 2143, 2147, 2195 and 2199 do not apply if the patient or the specialist, physician or psychiatrist mentioned in paragraph (a) of the item travels to a place to satisfy the requirement:

(a) for items 2100, 2126, 2143 and 2195—in sub‑subparagraph (c) (i) (B) of the item; and

(b) for items 2122, 2137, 2147 and 2199—in subparagraph (d) (ii) of the item.

[16] Schedule 1, item 2100, column 2

substitute

Professional attendance at consulting rooms of at least 5 minutes in duration (whether or not continuous) by a medical practitioner providing clinical support to a patient who:

(a) is participating in a video conferencing consultation with a specialist, consultant physician or psychiatrist; and

(b) is not an admitted patient; and

(i) is located both:

(A) outside an inner metropolitan area; and

(B) at the time of the attendance—at least 15 kms by road from the specialist, physician or psychiatrist mentioned in paragraph (a); or

(ii) is a patient of:

(A) an Aboriginal Medical Service; or

(B) an Aboriginal Community Controlled Health Service for which a direction made under subsection 19 (2) of the Act applies

[17] Schedule 1, item 2122, column 2

substitute

Professional attendance not in consulting rooms of at least 5 minutes in duration (whether or not continuous) by a medical practitioner providing clinical support to a patient who:

(a) is participating in a video conferencing consultation with a specialist, consultant physician or psychiatrist; and

(b) is not an admitted patient; and

(d) is located both:

(i) outside an inner metropolitan area; and

(ii) at the time of the attendance—at least 15 kms by road from the specialist, physician or psychiatrist mentioned in paragraph (a);

for an attendance on one or more patients at one place on one occasion—each patient

[18] Schedule 1, item 2126, paragraph (a)

omit

consultation; and

insert

consultation with a specialist, consultant physician or psychiatrist; and

[19] Schedule 1, item 2126, paragraph (c)

substitute

(i) is located both:

(A) outside an inner metropolitan area; and

(B) at the time of the attendance—at least 15 kms by road from the specialist, physician or psychiatrist mentioned in paragraph (a); or

(ii) is a patient of:

(A) an Aboriginal Medical Service; or

(B) an Aboriginal Community Controlled Health Service for which a direction made under subsection 19 (2) of the Act applies

[20] Schedule 1, item 2137, column 2

substitute

Professional attendance not in consulting rooms of less than 20 minutes in duration (whether or not continuous) by a medical practitioner providing clinical support to a patient who:

(a) is participating in a video conferencing consultation with a specialist, consultant physician or psychiatrist; and

(b) is not an admitted patient; and

(d) is located both:

(i) outside an inner metropolitan area; and

(ii) at the time of the attendance—at least 15 kms by road from the specialist, physician or psychiatrist mentioned in paragraph (a);

for an attendance on one or more patients at one place on one occasion—each patient

[21] Schedule 1, item 2143, paragraph (a)

omit

consultation; and

insert

consultation with a specialist, consultant physician or psychiatrist; and

[22] Schedule 1, item 2143, paragraph (c)

substitute

(i) is located both:

(A) outside an inner metropolitan area; and

(B) at the time of the attendance—at least 15 kms by road from the specialist, physician or psychiatrist mentioned in paragraph (a); or

(ii) is a patient of:

(A) an Aboriginal Medical Service; or

(B) an Aboriginal Community Controlled Health Service for which a direction made under subsection 19 (2) of the Act applies

[23] Schedule 1, item 2147, column 2

substitute

Professional attendance not in consulting rooms of at least 20 minutes in duration (whether or not continuous) by a medical practitioner providing clinical support to a patient who:

(a) is participating in a video conferencing consultation with a specialist, consultant physician or psychiatrist; and

(b) is not an admitted patient; and

(d) is located both:

(i) outside an inner metropolitan area; and

(ii) at the time of the attendance—at least 15 kms by road from the specialist, physician or psychiatrist mentioned in paragraph (a);

for an attendance on one or more patients at one place on one occasion—each patient

[24] Schedule 1, item 2195, paragraph (a)

omit

consultation; and

insert

consultation with a specialist, consultant physician or psychiatrist; and

[25] Schedule 1, item 2195, paragraph (c)

substitute

(i) is located both:

(A) outside an inner metropolitan area; and

(B) at the time of the attendance—at least 15 kms by road from the specialist, physician or psychiatrist mentioned in paragraph (a); or

(ii) is a patient of:

(A) an Aboriginal Medical Service; or

(B) an Aboriginal Community Controlled Health Service for which a direction made under subsection 19 (2) of the Act applies

[26] Schedule 1, item 2199, column 2

substitute

Professional attendance not in consulting rooms of at least 40 minutes in duration (whether or not continuous) by a medical practitioner providing clinical support to a patient who:

(a) is participating in a video conferencing consultation with a specialist, consultant physician or psychiatrist; and

(b) is not an admitted patient; and

(d) is located both:

(i) outside an inner metropolitan area; and

(ii) at the time of the attendance—at least 15 kms by road from the specialist, physician or psychiatrist mentioned in paragraph (a);

for an attendance on one or more patients at one place on one occasion—each patient

[27] Schedule 1, item 2125, column 2

substitute

Professional attendance of at least 5 minutes in duration (whether or not continuous) by a medical practitioner providing clinical support to a patient who:

(a) is participating in a video conferencing consultation with a specialist, consultant physician or psychiatrist; and

(b) is a care recipient in a residential care service; and

for an attendance on one or more patients at one place on one occasion—each patient

[28] Schedule 1, item 2138, column 2

substitute

Professional attendance of less than 20 minutes in duration (whether or not continuous) by a medical practitioner providing clinical support to a patient who:

(a) is participating in a video conferencing consultation with a specialist, consultant physician or psychiatrist; and

(b) is a care recipient in a residential care service; and

for an attendance on one or more patients at one place on one occasion—each patient

[29] Schedule 1, item 2179, column 2

substitute

Professional attendance of at least 20 minutes in duration (whether or not continuous) by a medical practitioner providing clinical support to a patient who:

(a) is participating in a video conferencing consultation with a specialist, consultant physician or psychiatrist; and

(b) is a care recipient in a residential care service; and

for an attendance on one or more patients at one place on one occasion—each patient

[30] Schedule 1, item 2220, column 2

substitute

Professional attendance of at least 40 minutes in duration (whether or not continuous) by a medical practitioner providing clinical support to a patient who:

(a) is participating in a video conferencing consultation with a specialist, consultant physician or psychiatrist; and

(b) is a care recipient in a residential care service; and

for an attendance on one or more patients at one place on one occasion—each patient

[31] After clause 2.21.4

insert

2.21.5 Limitation of items

Items 2820 and 3015 do not apply if the patient, specialist or physician travels to a place to satisfy the requirement in sub‑subparagraph (d) (i) (B) of the item.

[32] Schedule 1, item 2820, column 2

substitute

Professional attendance on a patient by a specialist or consultant physician practising in his or her specialty of pain medicine if:

(a) the attendance is by video conference; and

(b) item 2801, 2806 or 2814 applies to the attendance; and

(d) the patient:

(i) is located both:

(A) outside an inner metropolitan area; and

(B) at the time of the attendance—at least 15 kms by road from the specialist or physician; or

(ii) is a care recipient in a residential care service; or

(iii) is a patient of:

(A) an Aboriginal Medical Service; or

(B) an Aboriginal Community Controlled Health Service for which a direction made under subsection 19 (2) of the Act applies

[33] Schedule 1, item 3015, column 2

substitute

Professional attendance on a patient by a specialist or consultant physician practising in his or her specialty of palliative medicine if:

(a) the attendance is by video conference; and

(b) item 3005, 3010 or 3014 applies to the attendance; and

(d) the patient:

(i) is located both:

(A) outside an inner metropolitan area; and

(B) at the time of the attendance—at least 15 kms by road from the specialist or physician; or

(ii) is a care recipient in a residential care service; or

(iii) is a patient of:

(A) an Aboriginal Medical Service; or

(B) an Aboriginal Community Controlled Health Service for which a direction made under subsection 19 (2) of the Act applies

[34] Schedule 1, after Division 2.26 heading

insert

2.26.1 Limitation of item 6016

Item 6016 does not apply if the patient or specialist travels to a place to satisfy the requirement in sub‑subparagraph (d) (i) (B) of the item.

[35] Schedule 1, item 6016, column 2

substitute

Professional attendance on a patient by a specialist practising in his or her specialty of neurosurgery if:

(a) the attendance is by video conference; and

(b) item 6007, 6009, 6011, 6013 or 6015 applies to the attendance; and

(d) the patient:

(i) is located both:

(A) outside an inner metropolitan area; and

(B) at the time of the attendance—at least 15 kms by road from the specialist; or

(ii) is a care recipient in a residential care service; or

(iii) is a patient of:

(A) an Aboriginal Medical Service; or

(B) an Aboriginal Community Controlled Health Service for which a direction made under subsection 19 (2) of the Act applies

[36] After clause 2.30.5

insert

2.30.6 Limitation of item 10983

Item 10983 does not apply if the patient or the specialist, physician or psychiatrist mentioned in paragraph (a) of the item travels to a place to satisfy the requirement in sub‑subparagraph (c) (i) (B) of the item.

[37] Schedule 1, item 10983, column 2

substitute

Attendance by a practice nurse, an Aboriginal health worker or an Aboriginal and Torres Strait Islander health practitioner on behalf of, and under the supervision of, a medical practitioner, to provide clinical support to a patient who:

(a) is participating in a video conferencing consultation with a specialist, consultant physician or psychiatrist; and

(b) is not an admitted patient; and

(i) is located both:

(A) outside an inner metropolitan area; and

(B) at the time of the attendance—at least 15 kms by road from the specialist, physician or psychiatrist mentioned in paragraph (a); or

(ii) is a patient of:

(A) an Aboriginal Medical Service; or

(B) an Aboriginal Community Controlled Health Service for which a direction made under subsection 19 (2) of the Act applies

[38] Schedule 1, item 10984, column 2

substitute

(a) is participating in a video conferencing consultation with a specialist, consultant physician or psychiatrist; and

(b) is a care recipient in a residential care service; and

[39] Schedule 1, item 11200

after

for

insert

open angle

[40] Schedule 1, item 11203

omit

[41] Schedule 1, item 11212

omit

[42] After clause 2.37.9

insert

2.37.10 Limitation of item 13210

Item 13210 does not apply if the patient or specialist travels to a place to satisfy the requirement in sub‑subparagraph (d) (i) (B) of the item.

[43] Schedule 1, item 13015

omit

soft tissue radionecrosis or chronic or recurring wounds, if hypoxia can be demonstrated,

insert

localised non‑neurological soft tissue radiation injuries excluding radiation‑induced soft tissue lymphoedema of the arm after treatment for breast cancer,

[44] Schedule 1, item 13210, column 2

substitute

Professional attendance on a patient by a specialist practising in his or her specialty if:

(a) the attendance is by video conference; and

(b) item 13209 applies to the attendance; and

(d) the patient:

(i) is located both:

(A) outside an inner metropolitan area; and

(B) at the time of the attendance—at least 15 kms by road from the specialist; or

(ii) is a care recipient in a residential care service; or

(iii) is a patient of:

(A) an Aboriginal Medical Service; or

(B) an Aboriginal Community Controlled Health Service for which a direction made under subsection 19 (2) of the Act applies

[45] After clause 2.40.5

insert

2.40.5A Limitation of item 16399

Item 16399 does not apply if the patient or specialist travels to a place to satisfy the requirement in sub‑subparagraph (d) (i) (B) of the item.

[46] Schedule 1, item 16399, column 2

substitute

Professional attendance on a patient by a specialist practising in his or her specialty of obstetrics if:

(a) the attendance is by video conference; and

(b) item 16401, 16404, 16406, 16500, 16590 or 16591 applies to the attendance; and

(d) the patient:

(i) is located both:

(A) outside an inner metropolitan area; and

(B) at the time of the attendance—at least 15 kms by road from the specialist; or

(ii) is a care recipient in a residential care service; or

(iii) is a patient of:

(A) an Aboriginal Medical Service; or

(B) an Aboriginal Community Controlled Health Service for which a direction made under subsection 19 (2) of the Act applies

[47] After clause 2.41.1

insert

2.41.2 Limitation of item 17609

Item 17609 does not apply if the patient or specialist travels to a place to satisfy the requirement in sub‑subparagraph (d) (i) (B) of the item.

[48] Schedule 1, item 17609, column 2

substitute

Professional attendance on a patient by a specialist practising in his or her specialty of anaesthesia if:

(a) the attendance is by video conference; and

(b) item 17610, 17615, 17620, 17625, 17640, 17645, 17650, 17655 or 17690 applies to the attendance; and

(d) the patient:

(i) is located both:

(A) outside an inner metropolitan area; and

(B) at the time of the attendance—at least 15 kms by road from the specialist; or

(ii) is a care recipient in a residential care service; or

(iii) is a patient of:

(A) an Aboriginal Medical Service; or

(B) an Aboriginal Community Controlled Health Service for which a direction made under subsection 19 (2) of the Act applies

[49] Schedule 1, after subclause 2.43.5 (3)

insert

(4) An item in Group T10 does not apply to a service mentioned in the item if the service is claimed in association with a service to which item 55054 of the diagnostic imaging services table applies.

[50] Schedule 1, after item 30686

insert

30687

Endoscopy with radiofrequency ablation of mucosal metaplasia for the treatment of Barrett’s Oesophagus in a single course of treatment, following diagnosis of high grade dysplasia confirmed by histological examination (Anaes.)

$476.10

[51] Schedule 1, item 31527

after

mastectomy,

insert

with or without liposuction (suction assisted lipolysis),

[52] Schedule 1, item 32103

omit

stereoscopic rectoscopy (incorporating stereoscopic and optic systems),

insert

rectoscopy incorporating either 2 dimensional or 3 dimensional optic viewing systems,

[53] Schedule 1, item 32104

omit

stereoscopic rectoscopy (incorporating stereoscopic and optic systems),

insert

rectoscopy incorporating either 2 dimensional or 3 dimensional optic viewing systems,

[54] Schedule 1, item 32106

omit

stereoscopic rectoscopy (incorporating stereoscopic and optic systems),

insert

rectoscopy incorporating either 2 dimensional or 3 dimensional optic viewing systems,

[55] Schedule 1, item 42551

omit

Eyeball, perforating wound

insert

Eye, penetrating wound or rupture

[56] Schedule 1, item 42554

omit

Eyeball, perforating wound

insert

Eye, penetrating wound or rupture

[57] Schedule 1, item 42557

omit

Eyeball, perforating wound

insert

Eye, penetrating wound or rupture

[58] Schedule 1, item 42560

omit

[59] Schedule 1, item 42563

omit

nonmagnetic

[60] Schedule 1, item 42566

omit

[61] Schedule 1, item 42569

omit

nonmagnetic

[62] Schedule 1, item 42644

after

sclera,

insert

complete

[63] Schedule 1, item 42701

omit

Artificial

insert

Intraocular

[64] Schedule 1, item 42702

omit

artificial

insert

intraocular

[65] Schedule 1, item 42703, column 2

substitute

Intraocular lens or iris prosthethis, insertion of, into the posterior chamber with fixation to the iris or sclera (Anaes.) (Assist.)

[66] Schedule 1, item 42704

omit

Artificial

insert

Intraocular

[67] Schedule 1, item 42707

omit

Artificial

insert

Intraocular

[68] Schedule 1, item 42710, column 2

substitute

Intraocular lens, removal of, and replacement with a lens inserted into the posterior chamber and fixated to the iris or sclera (Anaes.) (Assist.)

[69] Schedule 1, item 42713, column 2

substitute

Iris suturing, McCannell technique or similar, for fixation of intraocular lens or repair of iris defect (Anaes.) (Assist.)

[70] Schedule 1, item 42719, column 2

substitute

Either or both of the following, via a limbal approach by any method:

(a) removal of capsular or lens material;

(b) removal of vitreous;

other than a service associated with a service to which item 42698, 42702, 42716, 42725 or 42731 applies (Anaes.) (Assist.)

[71] Schedule 1, item 42722

omit

[72] Schedule 1, item 42725, column 2

substitute

Vitrectomy via pars plana sclerotomy, including one or more of the following:

(a) removal of vitreous;

(b) division of vitreous bands;

(H) (Anaes.) (Assist.)

[73] Schedule 1, item 42728

omit

[74] Schedule 1, item 42731, column 2

substitute

Limbal or pars plana lensectomy combined with vitrectomy, other than a service associated with item 42698, 42702, 42719 or 42725 (H) (Anaes.) (Assist.)

[75] Schedule 1, item 42746

after

for

insert

, if conservative therapies have failed, are likely to fail, or are contraindicated

[76] Schedule 1, item 42752, column 2

substitute

Glaucoma, insertion of drainage device incorporating an extraocular reservoir for, such as a Molteno device (H) (Anaes.) (Assist.)

[77] Schedule 1, item 42755, column 2

substitute

Glaucoma, removal of drainage device incorporating an extraocular reservoir for, such as a Molteno device (H) (Anaes.) (Assist.)

[78] Schedule 1, item 42771

omit

[79] Schedule 1, item 42773

omit

diathermy or cryotherapy

insert

pneumatic retinopexy

[80] Schedule 1, item 42779

after

revision

insert

of scleral buckling

[81] Schedule 1, item 42782

after

trabeculoplasty

insert

, for the treatment of glaucoma

[82] Schedule 1, item 42783

after

trabeculoplasty

insert

, for the treatment of glaucoma

[83] Schedule 1, item 42812, column 2

substitute

Removal of sclera buckling material, from an eye having undergone previous scleral buckling surgery (Anaes.)

[84] Schedule 1, item 42815, column 2

substitute

Vitreous cavity, removal of silicone oil or other liquid vitreous substitutes from, during a procedure other than that in which the vitreous substitute is inserted (H) (Anaes.) (Assist.)

[85] Schedule 1, item 42818

omit

with external probe

insert

or when performed in association with item 42770 or 42809

[86] Schedule 1, item 45585

omit

pathological lipodystrophy of hips, buttocks, thighs, knees or lower legs (Barraquer‑Simon’s syndrome), gynaecomastia,

insert

Barraquer‑Simon’s syndrome (pathological lipodystrophy of hips, buttocks, thighs, knees or lower legs),

[87] Schedule 1, after item 48693

insert

48694

Cervical artificial intervertebral total disc replacement, at one level only, including removal of disc, for a patient who:

(a) has not had prior spinal surgery at the same cervical level; and

(b) is skeletally mature; and

(d) does not have vertebral osteoporosis; and

(e) has failed conservative therapy;

other than a service associated with item 40300 or 40301 (H) (Anaes.) (Assist.)

1 082.70

[88] Schedule 1, item 51315

after

42656,

insert

42725,

[89] Schedule 1, Divisions 2.58 to 2.61

omit

[90] Dictionary, definition of (AD)

omit

[91] Dictionary, definition of (AO)

omit

[92] Dictionary, definition of (AOS)

omit

[93] Dictionary, definition of accredited orthodontist

omit

[94] Dictionary, definition of participating in a video conferencing consultation

omit

clause 1.2.10.

insert

clause 1.2.9.