This instrument is the Health Insurance Legislation Amendment (2021 Measures No. 4) Regulations 2021.

(1) Each provision of this instrument specified in column 1 of the table commences, or is taken to have commenced, in accordance with column 2 of the table. Any other statement in column 2 has effect according to its terms.

Commencement information
Column 1	Column 2	Column 3
Provisions	Commencement	Date/Details
1. The whole of this instrument	1 March 2022.	1 March 2022

Note: This table relates only to the provisions of this instrument as originally made. It will not be amended to deal with any later amendments of this instrument.

(2) Any information in column 3 of the table is not part of this instrument. Information may be inserted in this column, or information in it may be edited, in any published version of this instrument.

3 Authority

This instrument is made under the Health Insurance Act 1973.

4 Schedules

Each instrument that is specified in a Schedule to this instrument is amended or repealed as set out in the applicable items in the Schedule concerned, and any other item in a Schedule to this instrument has effect according to its terms.

Schedule 1—Amendments

Part 1—General medical services

Health Insurance (General Medical Services Table) Regulations 2021

1 Schedule 1 (item 14209)

Repeal the item.

2 Schedule 1 (cell at item 14218, column 2)

Repeal the cell, substitute:

Implanted infusion pump, refilling of reservoir with a therapeutic agent or agents for infusion to the subarachnoid space or accessing the side port to assess catheter patency, with or without pump reprogramming, for the management of chronic pain, including cancer pain

3 Schedule 1 (item 18213, column 2)

After “perfusion”, insert “of local anaesthetic agent”.

4 Schedule 1 (items 18222 and 18225, column 2)

Omit “Infusion of a therapeutic substance”, substitute “Continuous infusion, or injection by catheter, of a therapeutic substance (not contrast agent)”.

5 Schedule 1 (item 18228, column 2)

After “substance”, insert “, not in association with a service to which an item in Group T8 applies, unless the nerve block is performed using a targeted percutaneous approach”.

6 Schedule 1 (item 18230, column 2)

After “substance”, insert “(not contrast agent) by any route, including transforaminal route”.

7 Schedule 1 (cell at item 18232, column 2)

Repeal the cell, substitute:

Intrathecal or epidural injection (including translaminar and transforaminal approaches) of therapeutic substance or substances (anaesthetic, steroid or chemotherapeutic agents):

(a) other than a service to which another item in this Group applies; and

(b) not in association with a service to which an item in Group T8 applies, unless the nerve block is performed using a targeted percutaneous approach (Anaes.)

8 Schedule 1 (cell at item 18234, column 2)

Repeal the cell, substitute:

Trigeminal nerve, primary branch (ophthalmic, maxillary or mandibular branches, excluding infraorbital nerve), injection of an anaesthetic agent or steroid, but not in association with a service to which an item in Group T8 applies, unless a targeted percutaneous technique is used (Anaes.)

9 Schedule 1 (cell at item 18236, column 2)

Repeal the cell, substitute:

Trigeminal nerve, peripheral branch (including infraorbital nerve), injection of an anaesthetic agent, but not in association with a service to which an item in Group T8 applies, unless a targeted percutaneous technique is used (Anaes.)

10 Schedule 1 (item 18238, column 2)

After “applies”, insert “, not in association with a service to which an item in Group T8 applies, unless the nerve block is performed using a targeted percutaneous approach”.

11 Schedule 1 (items 18244, 18252, 18254, 18262 and 18264, column 2)

After “agent”, insert “, not in association with a service to which an item in Group T8 applies, unless the nerve block is performed using a targeted percutaneous approach”.

12 Schedule 1 (item 18266, column 2)

After “block”, insert “, not in association with a service to which an item in Group T8 applies, unless the nerve block is performed using a targeted percutaneous approach”.

13 Schedule 1 (item 18274)

Repeal the item.

14 Schedule 1 (items 18278 and 18280, column 2)

After “agent”, insert “, not in association with a service to which an item in Group T8 applies, unless the nerve block is performed using a targeted percutaneous approach”.

15 Schedule 1 (cell at item 18284, column 2)

Repeal the cell, substitute:

Cervical or thoracic sympathetic chain, injection of an anaesthetic agent (Anaes.)

16 Schedule 1 (cell at item 18286, column 2)

Repeal the cell, substitute:

Lumbar or pelvic sympathetic chain, injection of an anaesthetic agent (Anaes.)

17 Schedule 1 (item 18288, column 2)

After “agent”, insert “, not in association with a service to which an item in Group T8 applies, unless the nerve block is performed using a targeted percutaneous approach”.

18 Schedule 1 (items 18290, 18292 and 18294, column 2)

After “agent”, insert “under image guidance”.

19 Schedule 1 (cell at item 18296, column 2)

Repeal the cell, substitute:

Lumbar or pelvic sympathetic chain, destruction by a neurolytic agent under image guidance (Anaes.)

20 At the end of clause 5.9.5 of Schedule 1

Add:

(3) Items 23010 to 24136 apply to a service provided to a patient under anaesthesia, but only if the anaesthesia start and end times are recorded in writing.

21 Schedule 1 (item 20402, column 2)

After “breast”, insert “, including implant reconstruction and exchange”.

22 Schedule 1 (item 20403, column 2)

Omit “removal of breast lump or for breast segmentectomy, if axillary node dissection is performed”, substitute “axillary dissection or sentinel node biopsy”.

23 Schedule 1 (cell at item 20745, column 2)

Repeal the cell, substitute:

Initiation of the management of anaesthesia for any of the following:

(a) upper gastrointestinal endoscopic procedures in association with acute gastrointestinal haemorrhage;

(b) endoscopic retrograde cholangiopancreatography;

(d) percutaneous endoscopic gastrostomy;

(e) upper gastrointestinal endoscopic mucosal resection of tumour

24 Schedule 1 (item 21214, column 2)

Omit “total hip replacement or revision”, substitute “primary total hip replacement”.

25 Schedule 1 (after item 21214)

Insert:

21215

Initiation of management of anaesthesia for revision total hip replacement

309.00

26 Schedule 1 (cell at item 38276, column 2)

Repeal the cell, substitute:

Transcatheter occlusion of left atrial appendage, and cardiac catheterisation performed by the same practitioner, for stroke prevention in a patient who has non‑valvular atrial fibrillation, if:

(a) the patient is at increased risk of thromboembolism demonstrated by:

(i) a prior stroke (whether of an ischaemic or unknown type), transient ischaemic attack or non‑central nervous system systemic embolism; or

(ii) at least 2 of the following risk factors:

(A) an age of 65 years or more;

(B) hypertension;

(D) heart failure or left ventricular ejection fraction of 35% or less (or both);

(E) vascular disease (prior myocardial infarction, peripheral artery disease or aortic plaque); and

(b) the patient has an absolute and permanent contraindication to oral anticoagulation (confirmed by written documentation that is provided by a medical practitioner, independent of the practitioner rendering the service); and

(c) the service is not associated with a service to which item 38200, 38203, 38206 or 38254 applies (H) (Anaes.) (Assist.)

27 Schedule 1 (cell at item 39013, column 2)

Repeal the cell, substitute:

Injection of one or more zygo‑apophyseal or costo‑transverse joints with one or more of contrast media, local anaesthetic or corticosteroid under image guidance (Anaes.)

28 Schedule 1 (after item 39013)

Insert:

39014

Medial branch block of one or more primary posterior rami, injection of an anaesthetic agent under image guidance (Anaes.)

129.90

29 Schedule 1 (cell at item 39100, column 2)

Repeal the cell, substitute:

Injection of primary branch of trigeminal nerve (ophthalmic, maxillary or mandibular branches) with alcohol, cortisone, phenol, or similar neurolytic substance, under image guidance (Anaes.)

30 Schedule 1 (after item 39109)

Insert:

	39110	Left lumbar percutaneous zygapophyseal joint denervation by radio‑frequency probe, or cryoprobe, using radiological imaging control, applicable not more than 3 times in a 12 month period (Anaes.)	278.90
39111		Right lumbar percutaneous zygapophyseal joint denervation by radio‑frequency probe, or cryoprobe, using radiological imaging control, applicable not more than 3 times in a 12 month period (Anaes.)	278.90

31 Schedule 1 (item 39115)

Repeal the item, substitute:

39116	Left thoracic percutaneous zygapophyseal joint denervation by radio‑frequency probe, or cryoprobe, using radiological imaging control, applicable not more than 3 times in a 12 month period (Anaes.)	309.90
39117	Right thoracic percutaneous zygapophyseal joint denervation by radio‑frequency probe or cryoprobe using radiological imaging control, applicable not more than 3 times in a 12 month period (Anaes.)	309.90

32 Schedule 1 (item 39118)

Repeal the item, substitute:

39118	Left cervical percutaneous zygapophyseal joint denervation by radio‑frequency probe, or cryoprobe, using radiological imaging control, applicable not more than 3 times in a 12 month period (Anaes.)	340.90
39119	Right cervical percutaneous zygapophyseal joint denervation by radio‑frequency probe, or cryoprobe, using radiological imaging control, applicable not more than 3 times in a 12 month period (Anaes.)	340.90

33 Schedule 1 (cell at item 39125,column 2)

Repeal the cell, substitute:

Spinal catheter, insertion or replacement of, and connection to a subcutaneous implanted infusion pump, for the management of chronic pain, including cancer pain (H) (Anaes.) (Assist.)

34 Schedule 1 (cell at item 39126,column 2)

Repeal the cell, substitute:

All of the following:

(a) infusion pump, subcutaneous implantation or replacement of;

(b) connection of the pump to a spinal catheter;

with or without programming the pump, for the management of chronic pain, including cancer pain (H) (Anaes.) (Assist.)

35 Schedule 1 (cell at item 39127,column 2)

Repeal the cell, substitute:

Subcutaneous reservoir and spinal catheter, insertion of, for the management of chronic pain, including cancer pain (H) (Anaes.)

36 Schedule 1 (cell at item 39128, column 2)

Repeal the cell, substitute:

All of the following:

(a) infusion pump, subcutaneous implantation of;

(b) spinal catheter, insertion of;

(d) filling of reservoir with a therapeutic agent or agents;

with or without programming the pump, for the management of chronic pain, including cancer pain (H) (Anaes.) (Assist.)

37 Schedule 1 (after item 39128)

Insert:

39129

Peripheral lead or leads, percutaneous placement of, including intraoperative test stimulation, for the management of chronic neuropathic pain (H) (Anaes.) (Assist.)

631.30

38 Schedule 1 (cell at item 39130,column 2)

Repeal the cell, substitute:

Epidural lead or leads, percutaneous placement of, including intraoperative test stimulation, for the management of chronic neuropathic pain or pain from refractory angina pectoris (H) (Anaes.) (Assist.)

39 Schedule 1 (cell at item 39131,column 2)

Repeal the cell, substitute:

Epidural or peripheral nerve electrodes (management, adjustment or reprogramming, of neurostimulator), with a medical practitioner attending, for the management of chronic neuropathic pain or pain from refractory angina pectoris—each day

40 Schedule 1 (cell at item 39133,column 2)

Repeal the cell, substitute:

Either:

(a) subcutaneously implanted infusion pump, removal of; or

(b) spinal catheter, removal or repositioning of;

for the management of chronic pain, including cancer pain (H) (Anaes.)

41 Schedule 1 (item 39134,column 2)

Omit “intractable”.

42 Schedule 1 (cell at item 39135,column 2)

Repeal the cell, substitute:

Neurostimulator or receiver that was inserted for the management of chronic neuropathic pain or pain from refractory angina pectoris, open surgical removal of, performed in the operating theatre of a hospital (H) (Anaes.) (Assist.)

43 Schedule 1 (cell at item 39136,column 2)

Repeal the cell, substitute:

Epidural or peripheral nerve lead that was implanted for the management of chronic neuropathic pain or pain from refractory angina pectoris, open surgical removal of, performed in the operating theatre of a hospital (H) (Anaes.) (Assist.)

44 Schedule 1 (cell at item 39137,column 2)

Repeal the cell, substitute:

Epidural or peripheral nerve lead that was implanted for the management of chronic neuropathic pain or pain from refractory angina pectoris, open surgical repositioning of, to correct displacement or unsatisfactory positioning, including intraoperative test stimulation, other than a service to which item 39130, 39138 or 39139 applies (H) (Anaes.) (Assist.)

45 Schedule 1 (cell at item 39138,column 2)

Repeal the cell, substitute:

Peripheral nerve lead or leads, surgical placement of, including intraoperative test stimulation, for the management of chronic neuropathic pain where the leads are intended to remain in situ long term (H) (Anaes.) (Assist.)

46 Schedule 1 (cell at item 39139,column 2)

Repeal the cell, substitute:

Epidural lead, surgical placement of one or more of by partial or total laminectomy, including intraoperative test stimulation, for the management of chronic neuropathic pain or pain from refractory angina pectoris (H) (Anaes.) (Assist.)

47 Schedule 1 (cell at item 39323,column 2)

Repeal the cell, substitute:

Percutaneous denervation (excluding medial branch nerve) by cryotherapy or radiofrequency probe, other than a service to which another item applies, applicable not more than 6 times for a given nerve in a 12 month period (Anaes.)

Part 2—Gynaecological services

Health Insurance (General Medical Services Table) Regulations 2021

48 Schedule 1 (cell at item 11900, column 2)

Repeal the cell, substitute:

Urine flow study, including peak urine flow measurement, not being a service associated with a service to which item 11912, 11917 or 11919 applies

49 Schedule 1 (item 11912)

Repeal the item, substitute :

11912

Cystometrography:

(a) with measurement of any one or more of the following:

(i) urine flow rate;

(ii) urethral pressure profile;

(iii) urethral sphincter electromyography; and

(b) with simultaneous measurement of:

(i) rectal pressure; or

(ii) stomal or vaginal pressure if rectal pressure is not possible;

not being a service associated with a service to which any of items 11012 to 11027, 11900, 11917, 11919 and 36800 or an item in Group I3 of the diagnostic imaging services table applies (Anaes.)

205.50

50 Schedule 1 (cell at item 11917, column 2)

Repeal the cell, substitute:

Cystometrography, in conjunction with real time ultrasound of one or more components of the urinary tract:

(a) with measurement of any one or more of the following:

(i) urine flow rate;

(ii) urethral pressure profile;

(iii) urethral sphincter electromyography; and

(b) with simultaneous measurement of:

(i) rectal pressure; or

(ii) stomal or vaginal pressure if rectal pressure is not possible;

including all imaging associated with cystometrography, not being a service associated with a service to which any of items 11012 to 11027, 11900, 11912, 11919 and 36800 or an item in Group I3 of the diagnostic imaging services table applies (Anaes.)

51 Schedule 1 (cell at item 13203, column 2)

Repeal the cell, substitute:

Ovulation monitoring services for artificial insemination or gonadotrophin, stimulated ovulation induction, including quantitative estimation of hormones and ultrasound examinations, being services rendered during one treatment cycle but excluding a service to which item 13200, 13201, 13202, 13212, 13215 or 13218 applies

52 Schedule 1 (after item 13221)

Insert:

13241

Open surgical testicular sperm retrieval, unilateral, using operating microscope, including the exploration of scrotal contents, with biopsy, for the purposes of intracytoplasmic sperm injection, for male factor infertility, not being a service associated with a service to which item 13218 or 37604 applies (H) (Anaes.)

884.45

53 Schedule 1 (item 35503)

Repeal the item, substitute:

35503

Introduction of an intra‑uterine device for abnormal uterine bleeding or contraception or for endometrial protection during oestrogen replacement therapy, if the service is not associated with a service to which another item in this Group applies (other than a service described in item 30062, 35506 or 35620) (Anaes.)

83.40

54 Schedule 1 (cell at item 35506, column 2)

Repeal the cell, substitute:

Intra‑uterine device, removal of under general anaesthesia, for a retained or embedded device, not being a service associated with a service to which another item in this Group applies (other than a service described in item 35503) (Anaes.)

55 Schedule 1 (item 35513, column 2)

Omit “cyst”, substitute “abscess, cyst or gland”.

56 Schedule 1 (item 35517, column 2)

Omit “cyst”, substitute “abscess, cyst”.

57 Schedule 1 (item 35518, column 2)

After “reproductive techniques”, insert “, and not in cases of suspected or possible malignancy”.

58 Schedule 1 (cell at item 35527, column 2)

Repeal the cell, substitute:

Urethral caruncle, symptomatic excision of, if:

(a) conservative management has failed; or

(b) there is a suspicion of malignancy

(Anaes.)

59 Schedule 1 (cell at item 35536, column 2)

Repeal the cell, substitute:

Vulva, wide local excision or hemivulvectomy, one or both procedures, for suspected malignancy or vulval lesions with a high risk of malignancy (Anaes.) (Assist.)

60 Schedule 1 (cell at item 35539, column 2)

Repeal the cell, substitute:

Colposcopically directed laser therapy for histologically confirmed high grade intraepithelial neoplastic changes of the vagina, vulva, urethra or anal canal, including any associated biopsies—one anatomical site (Anaes.)

61 Schedule 1 (item 35545, column 2)

Omit “CO2”.

62 Schedule 1 (item 35548, column 3)

Omit “867.85”, substitute “1,301.75”.

63 Schedule 1 (item 35552, column 2)

After “unilateral,”, insert “or sentinel node dissection”.

64 Schedule 1 (cell at item 35557, column 2)

Repeal the cell, substitute:

Vagina, complete excision of benign tumour (including Gartner duct cyst), with histological documentation (Anaes.)

65 Schedule 1 (cell at item 35560, column 2)

Repeal the cell, substitute:

Partial or complete vaginectomy, for either or both of the following:

(a) deeply infiltrating vaginal endometriosis, if accompanied by histological confirmation from excised tissue;

(b) pre‑invasive or invasive lesions

Not being a service associated with hysterectomy for non‑invasive indications (H) (Anaes.) (Assist.)

66 Schedule 1 (item 35561, column 3)

Omit “1,435.35”, substitute “1,597.25”.

67 Schedule 1 (item 35562, column 3)

Omit “1,178.45”, substitute “1,345.55”.

68 Schedule 1 (item 35564, column 3)

Omit “544.00”, substitute “672.80”.

69 Schedule 1 (cell at item 35568, column 2)

Repeal the cell, substitute:

Procedures for the management of symptomatic upper vaginal (vault or cervical) prolapse by sacrospinous or ilococcygeus fixation (H) (Anaes.) (Assist.)

70 Schedule 1 (cell at item 35578, column 2)

Repeal the cell, substitute:

Colpocleisis for pelvic organ prolapse, not being a service associated with a service to which another item (other than item 35599) in this Subgroup applies (H) (Anaes.) (Assist.)

71 Schedule 1 (after item 35585)

Insert:

35591	Rectovaginal fistula repair of, by vaginal route approach, not being a service associated with a service to which item 35592, 35596, 37029, 37333 or 37336 applies (H) (Anaes.) (Assist.)	962.20
35592	Vesicovaginal fistula closure of, by vaginal approach, not being a service associated with a service to which item 35591, 35596, 37029, 37333 or 37336 applies (H) (Anaes.) (Assist.)	962.20

72 Schedule 1 (items 35595 and 35596

Repeal the items, substitute:

35595	Procedure for the management of symptomatic vaginal vault or cervical prolapse, by uterosacral ligament suspension, by any approach, without graft, if the uterosacral ligaments are separately identified, transfixed and then incorporated into rectovaginal and pubocervical fascia of the vaginal vault, including cystoscopy to check ureteric integrity (H) (Anaes.) (Assist.)	649.90
35596	Fistula between genital and urinary or alimentary tracts, repair of, other than a service to which item 35591, 35592, 37029, 37333 or 37336 applies (H) (Anaes.) (Assist.)	962.20

73 Schedule 1 (cell at item 35597, column 2)

Repeal the cell, substitute:

Sacral colpopexy, by any approach where graft or mesh is secured to vault, anterior and posterior compartments and to sacrum for correction of symptomatic upper vaginal vault prolapse (H) (Anaes.) (Assist.)

74 Schedule 1 (cell at item 35608, column 2)

Repeal the cell, substitute:

Cervix, one or more biopsies, cauterisation (other than by chemical means), ionisation, diathermy or endocervical curettage of, with or without dilatation of cervix (Anaes.)

75 Schedule 1 (after item 35608)

Insert:

35609	Cervix, cone biopsy or amputation (Anaes.)	226.80
35610	Cervix, cone biopsy for histologically proven malignancy (Anaes.)	396.95

76 Schedule 1 (cell at item 35611, column 2)

Repeal the cell, substitute:

Removal of cervical or vaginal polyp or polypi, with or without dilatation of cervix, not being a service associated with a service to which item 35608 applies (Anaes.)

77 Schedule 1 (item 35612, column 2)

After “approach”, insert “for non‑malignant lesions”.

78 Schedule 1 (cell at item 35614, column 2)

Repeal the cell, substitute:

Examination of the lower genital tract using a colposcope in a patient who:

(a) has a human papilloma virus related gynaecology indication; or

(b) has symptoms or signs suspicious of lower genital tract malignancy; or

(d) is undergoing assessment or surveillance of a vulvovaginal pre‑malignant or malignant disease; or

(e) is undergoing assessment or surveillance as part of an identified at risk population

79 Schedule 1 (item 35615)

Repeal the item, substitute:

35615

Vulva or vagina, biopsy of, when performed in conjunction with a service to which item 35614 applies

73.25

80 Schedule 1 (cell at item 35616, column 2)

Repeal the cell, substitute:

Endometrial ablation by thermal balloon or radiofrequency electrosurgery, for abnormal uterine bleeding, with or without endometrial sampling, including any hysteroscopy performed on the same day (H) (Anaes.)

81 Schedule 1 (cell at item 35620, column 2)

Repeal the cell, substitute:

Endometrial biopsy for pathological assessment in women with abnormal uterine bleeding or post‑menopausal bleeding (Anaes.)

82 Schedule 1 (cell at item 35622, column 2)

Repeal the cell, substitute:

Endometrial ablation, using hysteroscopically guided electrosurgery or laser energy for abnormal uterine bleeding, with or without endometrial sampling, not being a service associated with a service to which item 30390 applies (H) (Anaes.)

83 Schedule 1 (cell at item 35623, column 2)

Repeal the cell, substitute:

Endometrial ablation and resection of myoma or uterine septum (or both), using hysteroscopic guided electrosurgery or laser energy, for abnormal uterine bleeding, with or without endometrial sampling (H) (Anaes.)

84 Schedule 1 (item 35626)

Repeal the item, substitute:

35626

Hysteroscopy for investigation of suspected intrauterine pathology, with or without local anaesthesia, including any associated endometrial biopsy, not being a service associated with a service to which item 35630 applies

233.10

85 Schedule 1 (cell at item 35630, column 2)

Repeal the cell, substitute:

Hysteroscopy for investigation of suspected intrauterine pathology if performed under general anaesthesia, including any associated endometrial biopsy, not being a service associated with a service to which item 35626 applies (H) (Anaes.)

86 Schedule 1 (after item 35630)

Insert:

35631

Operative laparoscopy, including any of the following:

(a) unilateral or bilateral ovarian cystectomy;

(b) salpingo‑oophorectomy;

(c) salpingectomy for tubal pathology (including ectopic pregnancy by tubal removal or salpingostomy, but excluding sterilisation);

(d) excision of stage II (mild) endometriosis;

not being a service associated with a service to which any other intraperitoneal or retroperitoneal procedure item (other than item 30724 or 30725) applies (H) (Anaes.) (Assist.)

740.35

35632

Complicated operative laparoscopy, including either or both of the following:

(a) excision of stage III endometriosis;

(b) laparoscopic myomectomy for a myoma of at least 4cm, including incision and repair of the uterus;

not being a service associated with a service to which any other intraperitoneal or retroperitoneal procedure item (other than item 30724 or 30725 or 35658) applies (H) (Anaes.) (Assist.)

925.40

87 Schedule 1 (cell at item 35633, column 2)

Repeal the cell, substitute:

Hysteroscopy, under visual guidance, including any of the following:

(a) removal of an intra‑uterine device;

(b) removal of polyps by any method;

(Anaes.)

88 Schedule 1 (cell at item 35635, column 2)

Repeal the cell, substitute:

Hysteroscopy involving division of:

(a) a uterine septum; or

(b) intrauterine adhesions ESH Grade 2 or higher (H) (Anaes.)

89 Schedule 1 (item 35636, column 2)

Omit “involving resection of myoma, or resection of”, substitute “resection of myoma or”.

90 Schedule 1 (cell at item 35637, column 2)

Repeal the cell, substitute:

Operative laparoscopy, including any of the following:

(a) excision or ablation of stage l (minor) endometriosis;

(b) division of pathological adhesions;

not being a service associated with a service to which any other item in this Group applies (H) (Anaes.) (Assist.)

91 Schedule 1 (cell at item 35640, column 2)

Repeal the cell, substitute:

Uterus, curettage of, with or without dilation (including curettage for incomplete miscarriage), if performed under:

(a) general anaesthesia; or

(b) epidural or spinal (intrathecal) nerve block; or

including procedures (if performed) to which item 35626 or 35630 applies (Anaes.)

92 Schedule 1 (item 35641, column 2)

Omit “level 4 or 5, laparoscopic resection of, involving any”, substitute “rAFS stage IV, laparoscopic resection of, involving”.

93 Schedule 1 (item 35641, column 2)

Omit “if the operating time exceeds 90 minutes”.

94 Schedule 1 (cell at item 35643, column 2)

Repeal the cell, substitute:

Evacuation of the contents of the gravid uterus by curettage or suction curettage, if performed under:

(a) local anaesthesia; or

(b) general anaesthesia; or

(d) sedation;

including procedures (if performed) to which item 35626 or 35630 applies (Anaes.)

95 Schedule 1 (cell at item 35644, column 2)

Repeal the cell, substitute:

Cervix, ablation by electrocoagulation diathermy, laser or cryotherapy, with colposcopy, including any local anaesthesia and biopsies, for previously biopsy confirmed HSIL (CIN 2/3) in a patient with a Type 1 or 2 (completely visible) transformation zone, if there is:

(a) no evidence of invasive or glandular disease; and

(b) no discordance between cytology and previous histology;

not being a service associated with a service to which item 35647 or 35648 applies (Anaes.)

96 Schedule 1 (cell at item 35645, column 2)

Repeal the cell, substitute:

Cervix, ablation by electrocoagulation diathermy, laser or cryotherapy, with colposcopy, including any local anaesthesia or biopsies, in conjunction with ablative therapy of additional areas of biopsy proven high grade intraepithelial lesions of one or more sites of the vagina, vulva, urethra or anus, for previously biopsy confirmed HSIL (CIN2/3) in a patient with a Type 1 of 2 (completely visible) transformation zone, if there is:

(a) no evidence of invasive or glandular disease; and

(b) no discordance between cytology and previous histology;

not being a service associated with a service to which item 35647 or 35648 applies (Anaes.)

97 Schedule 1 (cell at item 35647, column 2)

Repeal the cell, substitute:

Cervix, complete excision of the endocervical transformation zone, using large loop or laser therapy, including any local anaesthesia and biopsies (Anaes.)

98 Schedule 1 (cell at item 35648, column 2)

Repeal the cell, substitute:

Cervix, complete excision of the endocervical transformation zone, using large loop or laser therapy, including any local anaesthesia and biopsies, in conjunction with ablative treatment of additional areas of biopsy‑proven high grade intraepithelial lesions of one or more sites of the vagina, vulva, urethra or anus (Anaes.)

99 Schedule 1 (cell at item 35649, column 2)

Repeal the cell, substitute:

Myomectomy, one or more myomas, when undertaken by an open abdominal approach (H) (Anaes.) (Assist.)

100 Schedule 1 (cell at item 35653, column 2)

Repeal the cell, substitute:

Hysterectomy, abdominal, with or without removal of fallopian tubes and ovaries (H) (Anaes.) (Assist.)

101 Schedule 1 (cell at item 35657, column 2)

Repeal the cell, substitute:

Hysterectomy, vaginal, with or without uterine curettage, inclusive of posterior culdoplasty, not being a service to which item 35673 applies (H) (Anaes.) (Assist.)

102 Schedule 1 (cell at item 35658, column 2)

Repeal the cell, substitute:

Uterus (at least equivalent in size to a 10 week gravid uterus), debulking of, prior to vaginal or laparoscopic removal at hysterectomy or myoma of at least 4 cm removed by laparoscopy when retrieved from the abdomen (H) (Anaes.) (Assist.)

103 Schedule 1 (item 35661)

Repeal the item, substitute:

35661

Hysterectomy, abdominal, that concurrently requires extensive retroperitoneal dissection with exposure of one or both ureters and complex side wall dissection, including when performed with one or more of the following procedures:

(a) salpingectomy;

(b) oophorectomy;

(H) (Anaes.) (Assist.)

1,755.35

104 Schedule 1 (item 35667)

Repeal the item, substitute:

35667

Radical hysterectomy or radical trachelectomy (with or without excision of uterine adnexae) for proven malignancy, including excision of any one or more of the following:

(a) parametrium;

(b) paracolpos;

(d) contiguous pelvic peritoneum;

utilising nerve sparing techniques and involving ureterolysis, if performed (H) (Anaes.) (Assist.)

1,658

35668

Hysterectomy, radical (with or without excision of uterine adnexae) including excision of any one or more of the following:

(a) parametrium;

(b) paracolpos;

(d) contiguous pelvic peritoneum;

utilising nerve sparing techniques and involving ureterolysis, if performed in a patient with malignancy and previous pelvic radiation or chemotherapy treatment (H) (Anaes.) (Assist.)

1,926.35

35669

Hysterectomy, peripartum, performed for histologically proven placenta increta or percreta, or placenta accreta, if the patient has been referred to another practitioner for the management of severe intractable peripartum haemorrhage (H) (Anaes.)(Assist.)

1,926.35

105 Schedule 1 (after item 35670)

Insert:

35671

Hysterectomy, peripartum, for ongoing intractable haemorrhage where other haemorrhage control techniques have failed, for the purpose of providing lifesaving emergency treatment, not being a service associated with a service to which item 35667, 35668 or 35669 applies (H) (Anaes.) (Assist.)

1,511.10

106 Schedule 1 (cell at item 35673, column 2)

Repeal the cell, substitute:

Hysterectomy, vaginal, with or without uterine curettage, with salpingectomy, oophorectomy or excision of ovarian cyst, one or more, one or both sides, inclusive of a posterior culdoplasty, not being a service to which item 35657 applies (H) (Anaes.) (Assist.)

107 Schedule 1 (cell at item 35694, column 2)

Repeal the cell, substitute:

Tuboplasty (salpingostomy or salpingolysis), unilateral or bilateral, one or more procedures (H) (Anaes.) (Assist.)

108 Schedule 1 (item 35697, column 2)

After “Microsurgical”, insert “or laparoscopic”.

109 Schedule 1 (item 35700, column 2)

Omit “anastomosis of, using operating microscope”, substitute “or laparoscopic anastomosis of”.

110 Schedule 1 (item 35703, column 2)

Omit “, other than a service associated with a service to which another item in this Subgroup applies”.

111 Schedule 1 (items 35717, 35720 and 35723)

Repeal the items, substitute:

35717	Laparotomy, involving oophorectomy, salpingectomy, salpingo‑oophorectomy, removal of ovarian, parovarian, fimbrial or broad ligament cyst—one or more such procedures, unilateral or bilateral, including adhesiolysis, for benign disease (including ectopic pregnancy by tubal removal or salpingostomy), not being a service associated with hysterectomy (H) (Anaes.) (Assist.)	887.75
35720	Radical debulking, involving the radical excision of a macroscopically disseminated gynaecological malignancy from the pelvic cavity, including resection of peritoneum from the following: (a) the pelvic side wall; (b) the pouch of Douglas; (c) the bladder; for macroscopic disease confined to the pelvis, not being a service associated with a service to which item 35721 applies (H) (Anaes.) (Assist.)	1659.55
35721	Radical debulking, involving the radical excision of a macroscopically disseminated gynaecological malignancy from the abdominal and pelvic cavity, where cancer has extended beyond the pelvis, including any of the following: (a) resection of peritoneum over any of the following: (i) the diaphragm; (ii) the paracolic gutters; (iii) the greater or lesser omentum; (iv) the porta hepatis; (b) cytoreduction of recurrent gynaecological malignancy from the abdominal cavity following previous abdominal surgery, radiation or chemotherapy; (c) cytoreduction of recurrent gynaecological malignancy from the pelvic cavity following previous pelvic surgery, radiation or chemotherapy; not being a service to which a service associated with a service to which item 35720 or 35726 applies (H) (Anaes.) (Assist.)	3,319.15
35723	Para‑aortic lymph node dissection from above the level of the aortic bifurcation (unilateral), for staging or restaging of gynaecological malignancy (H) (Anaes.) (Assist.)	1,143.25
35724	Para‑aortic lymph node dissection (pelvic or above the aortic bifurcation) after prior similar dissection, radiotherapy or chemotherapy for malignancy (H) (Anaes.) (Assist.)	2,171.30

112 Schedule 1 (cell at item 35726 column 2)

Repeal the cell, substitute:

Infra‑colic omentectomy, with or without multiple peritoneal biopsies, for staging or restaging of gynaecological malignancy, not being a service to which item 35721 applies (H) (Anaes.) (Assist.)

113 Schedule 1 (cell at item 35750 column 2)

Repeal the cell, substitute:

Hysterectomy, laparoscopic assisted vaginal, by any approach, including any endometrial sampling, with or without removal of the tubes or ovarian cystectomy or removal of the ovaries and tubes due to other pathology, not being a service associated with a service to which item 35595 or 35673 applies. (Anaes.) (Assist.)

114 Schedule 1 (after item 35750)

Insert:

35751

Hysterectomy, laparoscopic, by any approach, including any endometrial sampling, with or without removal of the tubes, not being a service associated with a service to which item 35595 applies (H) (Anaes.) (Assist.)

816.40

115 Schedule 1 (cell at item 35753 column 2)

Repeal the cell, substitute:

Hysterectomy, complex laparoscopic, by any approach, including endometrial sampling, with either or both of the following procedures:

(a) unilateral or bilateral salpingo‑oophorectomy (excluding salpingectomy);

(b) excision of moderate endometriosis or ovarian cyst;

including any associated laparoscopy, not being a service associated with a service to which item 35595 applies (H) (Anaes.) (Assist.)

116 Schedule 1 (items 35754 and 35756)

Repeal the items, substitute:

35754

Hysterectomy, laparoscopic, by any approach, including any of the following procedures:

(a) salpingectomy;

(b) oophorectomy;

(d) any endometrial sampling that concurrently requires complex side wall dissection;

(e) any associated laparoscopy;

other than a service to which item 35595 or 35641 applies (H) (Anaes.) (Assist.)

1,744.35

35756

Hysterectomy, laparoscopic, by any approach, if the procedure is completed by open hysterectomy for control of bleeding or extensive pathology, including any associated laparoscopy, not being a service associated with a service to which item 35595 or 35641 applies (H) (Anaes.) (Assist.)

1,488.90

117 Schedule 1 (item 35759, column 2)

Omit “or abdominal and vaginal approach if”, substitute “, abdominal or laparoscopic approach if”.

118 Schedule 1 (item 37044)

Repeal the item, substitute:

37044

Bladder stress incontinence, suprapubic operation for (such as Burch colposuspension), open or laparoscopic route, using native tissue without graft, with diagnostic cystoscopy to assess the integrity of the lower urinary tract, not being a service associated with a service to which item 35599 or 36812 applies (H) (Anaes.) (Assist.)

806.50

Part 3——Miscellaneous amendments

Division 1—Repeals of table items

Health Insurance (General Medical Services Table) Regulations 2021

119 Amendments of listed provisions—repeals

Repeal the following table items in Schedule 1:

(a) item 11903;

(b) item 11906;

(d) item 11915;

(e) item 11921;

(f) item 13206;

(g) item 13292;

(h item 35502;

(i) item 35520;

(j) item 35523;

(k) item 35530;

(l) item 35542;

(m) item 35572;

(n) item 35602;

(o) item 35605;

(p) item 35613;

(q) item 35618;

(r) item 35627;

(s) item 35634;

(t) item 35638;

(u) item 35646;

(v) item 35664;

(w) item 35670;

(x) item 35677;

(y) item 35678;

(z) item 35684;

(za) item 35688;

(zb) item 35706;

(zc) item 35709;

(zd) item 35710;

(ze) item 35713;

(zf) item 37043.

Division 2—Consequential amendments

Health Insurance (General Medical Services Table) Regulations 2021

120 Subclause 1.2.6(1) of Schedule 1

Omit “11921 to 12004”, substitute “12000 to 12004”.

121 Subclause 1.2.7(1) of Schedule 1

Omit “11921”.

122 Subclause 1.2.11(1) of Schedule 1

Omit “11903, 11906, 11909, 11912, 11915, 11919, 12012, 12017, 12021, 12022, 12024, 12200, 12203, 12204, 12205, 12207, 12208, 12210, 12213, 12215, 12217, 12250 to 12272, 12500 to 12527, 13015, 13020, 13025, 13200 to 13203, 13206”, substitute “11912, 11919, 12012, 12017, 12021, 12022, 12024, 12200, 12203, 12204, 12205, 12207, 12208, 12210, 12213, 12215, 12217, 12250 to 12272, 12500 to 12527, 13015, 13020, 13025, 13200 to 13203”.

123 Schedule 1 (item 11919, column 2)

Omit “, 11921”.

124 Clause 5.2.2 of Schedule 1

Omit “, 13201 and 13206”, substitute “and 13201”.

125 Schedule 1 (items 13200, 13201 and 13202, column 2)

Omit “, 13206”.

126 Schedule 1 (item 13212)

Omit “, 13201 or 13206”, substitute “or 13201”.

127 Schedule 1 (items 13215 and 13218)

Omit “, 13206”.

Part 4—Medicare benefits

Health Insurance Regulations 2018

128 Subsection 28(1) (after table item 28B)

Insert:

28C	Subgroup 1 of Group A40	91790, 91800, 91801, 91802, 91792, 91803, 91804, 91805, 91794, 91806, 91807, 91808
28D	Subgroup 2 of Group A40	91890, 91891, 91892, 91893, 91894, 91895
28E	Subgroup 3 of Group A40	91818, 91819, 91820, 91821
28F	Subgroup 10 of Group A40	91842, 91843, 91844, 91845
28G	Subgroup 11 of Group A40	92004, 92011
28H	Subgroup 13 of Group A40	92024, 92025, 92026, 92027, 92028, 92055, 92056, 92057, 92058, 92059
28I	Subgroup 15 of Group A40	92136, 92137
28J	Subgroup 16 of Group A40	92138, 92139
28K	Subgroup 17 of Group A40	92142
28L	Subgroup 19 of Group A40	92112, 92113, 92114, 92115, 92116, 92117, 92118, 92119, 92120, 92121, 92122, 92123
28M	Subgroup 20 of Group A40	92126, 92127, 92132, 92133
28N	Subgroup 21 of Group A40	92146, 92147, 92148, 92149, 92150, 92151, 92152, 92153
28O	Subgroup 25 of Group A40	92170, 92171
28P	Subgroup 26 of Group A40	92176, 92177
28Q	Subgroup 27 of Group A40	92182, 92184, 92186, 92188
28R	Subgroup 28 of Group A40	92194, 92196, 92198, 92200
28S	Subgroup 29 of Group A40	92210, 92211
28T	Subgroup 39 of Group A40	92715, 92716, 92717, 92718, 92719, 92720, 92721, 92722, 92723, 92724, 92725, 92726
28U	Subgroup 40 of Group A40	92731, 92732, 92733, 92734, 92735, 92736, 92737, 92738, 92739, 92740, 92741, 92742
28V	Subgroup 41 of Group A40	92746, 92747
28W	Subgroup 1 of Group A41	93287, 93288, 93300, 93301, 93302, 93303, 93304, 93305
28X	Subgroup 2 of Group A41	93291, 93292, 93306, 93307, 93308, 93309, 93310, 93311
28Y	Subgroup 1 of Group A42	93400, 93401, 93402, 93403, 93404, 93405, 93406, 93407
28Z	Subgroup 2 of Group A42	93421, 93422, 93424
28ZA	Subgroup 3 of Group A42	93431, 93432, 93433, 93434, 93435, 93436, 93437, 93438
28ZB	Subgroup 4 of Group A42	93451, 93452, 93453
28ZC	Subgroup 1 of Group A43	93469, 93470
28ZD	Subgroup 2 of Group A43	93475, 93479
28ZE	Subgroup 1 of Group A45	93680, 93681, 93682, 93683, 93684, 93685
28ZF	Subgroup 2 of Group A45	93690, 93691, 93692, 93693, 93694, 93695
28ZG	Subgroup 3 of Group A45	93700, 93701, 93702, 93703, 93704, 93705