Acting First Assistant Secretary

Medical Benefits Division

Health Resourcing Group

Department of Health and Aged Care

Health Insurance (Section 3C Diagnostic Imaging – Nuclear Medicine

Services) Determination 2019  

1.     Section 4(1)

2.     Section 4(1)

3.     Section 6 (below the heading)

(1)              Clause 1.2.17 of the diagnostic imaging services table shall have effect as if the items in Schedule 1 of this instrument were specified for the purpose of that clause.

(2)              Clause 2.4.2 of the diagnostic imaging services table does not apply to the items in Schedule 1 of this instrument.

4.     Section 7

(1)               Items 61333, 61336 and 61341 only apply to a service described in the item, if:

(a)    the patient’s clinical condition requires the service to be performed before the resumption of normal technetium-99m supply is anticipated by the practitioner who provides the service; and

(b)    the report of the service performed includes a justification for the substitute service, which describes the unavailability of a service to which item 61348, 61402, 61421 or 61425 applies.

8.      PET nuclear scanning services

(1)              Items 61333, 61336 and 61341 apply only if the service is performed on a person:

(a)   in a comprehensive facility; and

(b)   in accordance with sections 9 and 10.

(2)                Also, the items apply only if the owner or operator of the equipment used to perform the service is not in breach of section 11.

9.      PET nuclear scanning services—performance under personal supervision

(1)              For the purposes of section 8, the service must be performed on a person by or under the personal supervision of:

(a)   a credentialled specialist; or

(b)   a medical practitioner other than the requesting practitioner if the medical practitioner:

(i)                 is a Fellow of the RACP or RANZCR; and

(ii)               has reported 400 or more studies forming part of PET services for which a medicare benefit was payable; and

(iii)            is authorised under State or Territory law to prescribe and administer to humans the PET radiopharmaceuticals that are to be administered to the person; and

(iv)             met the requirements of subparagraphs (i), (ii) and (iii) before 1 November 2011.

10.      PET nuclear scanning services—equipment

(1)              For the purposes of section 8, the service must be performed on a person using equipment that meets the requirements set out in Requirements for PET Accreditation (Instrumentation & Radiation Safety) 3rd Edition (2017), issued by the Australian and New Zealand Society of Nuclear Medicine Inc, as existing on 1 July 2020.

Note:          The Requirements for PET Accreditation (Instrumentation & Radiation Safety) 3rd Edition (2017) could in 2020 be viewed on the website of the Society (https://www.anzsnm.org.au).

11.      PET nuclear scanning services—statutory declaration

(1)              The owner or operator mentioned in subsection 8(2) must have given a statutory declaration to the Chief Executive Medicare that includes the following information:

(a)   whether the owner or operator is a credentialed specialist or a medical practitioner who satisfies the requirements mentioned in subparagraphs 9(1)(b)(i) to (iv);

(b)   whether the place where the owner or operator provides the service in a comprehensive facility;

(c)   whether the equipment meets the requirements mentioned in section 10;

(d)   the facility’s address;

(e)   the provider number for the facility given by the Chief Executive Medicare;

(f)    the location specific practice number for the facility given by the Minister;

(g)   the models, serial numbers and manufacturers of the equipment.

(2)              If the matters declared in the statutory declaration change, the owner or operator must give the Chief Executive Medicare written notice of the change as soon as the owner or operator knows about the change.

5.     Schedule 1

6.     Schedule 2