Health Insurance (Section 3C General Medical Services – Transcatheter Aortic Valve Implantation) Amendment (Low Risk Surgical Patients and CEP Device) Determination 2022
I, Travis Haslam, delegate of the Minister for Health and Aged Care, make the following Determination.
Dated 8 April 2022
Travis Haslam
Acting First Assistant Secretary
Medical Benefits Division
Health Resourcing Group
Department of Health
Contents
1 Name
2 Commencement
3 Authority
4 Schedules
Schedule 1— TAVI Amendments
This instrument is the Health Insurance (Section 3C General Medical Services – Transcatheter Aortic Valve Implantation) Amendment (Low Risk Surgical Patients and CEP Device) Determination 2022.
(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 July 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Note: This table relates only to the provisions of this instrument as originally made.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.
This instrument is made under subsection 3C(1) of the Health Insurance Act 1973.
Each instrument that is specified in a Schedule to this instrument is amended or repealed as set out in the applicable items in the Schedule concerned, and any other item in a Schedule to this instrument has effect according to its terms.
1. Subsection 5(1) (definition of TAVI Case Conference and TAVI Hospital)
Omit “items 38495 and 38514” wherever occurring, substitute “item 38495, 38514 or 38522”.
2. Subsection 5(1) (definition of TAVI Patient)
Repeal the definition, substitute:
TAVI Patient means a patient who, as a result of a TAVI Case Conference, has been assessed as having a high, intermediate or low risk for open surgical aortic valve replacement and is recommended as being suitable to receive the service described in item 38495, 38514 or 38522.
3. Section 7 (heading)
Repeal the heading, substitute:
4. Section 7 (body)
Omit “items 38495 and 38514”, substitute “item 38495, 38514 or 38522”.
5. Schedule 1 (item 6080, column 3)
Omit “52.95”, substitute “53.80”.
6. Schedule 1 (item 6081, column 3)
Omit “39.50”, substitute “40.15”.
7. Schedule 1 (items 38495 and 38514)
Repeal the items, substitute:
38495 | TAVI, for the treatment of symptomatic severe aortic stenosis, performed via transfemoral delivery, unless transfemoral delivery is contraindicated or not feasible, if: (a) the TAVI Patient is at high risk for surgery; and (b) the service: (i) is performed by a TAVI Practitioner in a TAVI Hospital; and (ii) includes all intraoperative diagnostic imaging that the TAVI Practitioner performs upon the TAVI Patient; not being a service which has been rendered within 5 years of a service to which this item or item 38514 or 38522 applies (H) (Anaes.) (Assist.) | 1,514.10 |
38514 | TAVI, for the treatment of symptomatic severe aortic stenosis, performed via transfemoral delivery, unless transfemoral delivery is contraindicated or not feasible, if: (a) the TAVI Patient is at intermediate risk for surgery; and (b) the service: (i) is performed by a TAVI Practitioner in a TAVI Hospital; and (ii) includes all intraoperative diagnostic imaging that the TAVI Practitioner performs upon the TAVI Patient; not being a service which has been rendered within 5 years of a service to which this item or item 38495 or 38522 applies (H) (Anaes.) (Assist.) | 1,514.10 |
38522 | TAVI, for the treatment of symptomatic severe native calcific aortic stenosis, performed via transfemoral delivery, unless transfemoral delivery is contraindicated or not feasible, if: (a) the TAVI Patient is at low risk for surgery; and (b) the service: (i) is performed by a TAVI Practitioner in a TAVI Hospital; and (ii) includes all intraoperative diagnostic imaging that the TAVI Practitioner performs upon the TAVI Patient; not being a service which has been rendered within 5 years of a service to which this item or item 38495 or 38514 applies (H) (Anaes.) (Assist.) | 1,514.10 |
38523 | Percutaneous transcatheter delivery of dual-filter cerebral embolic protection system during a TAVI procedure, for the reduction of postoperative embolic ischaemic strokes, if: (a) the service is performed upon a TAVI Patient in a TAVI Hospital; and (b) where the service is performed by the practitioner performing the TAVI procedure, the service includes all intraoperative diagnostic imaging that the TAVI Practitioner performs upon the TAVI Patient (H) (Anaes.) (Assist.) | 275.20 |