Australian Government - Department of Health

Health Technology Assessment

Prostheses List

How to apply for listing on the Prostheses List
Human Tissue Review
Prostheses List Advisory Committee
Contact details

Under the Private Health Insurance Act 2007, private health insurers are required to pay benefits for a range of prostheses that are provided as part of an episode of hospital treatment or hospital substitute treatment for which a patient has cover and for which a Medicare benefit is payable for the associated professional service.

The type of products on the Prostheses List include cardiac pacemakers and defibrillators, cardiac stents, hip and knee replacements and intraocular lenses, as well as human tissues such as human heart valves, corneas, bones (part and whole) and muscle tissue. The list does not include external legs, external breast prostheses, wigs and other such devices.

The Prostheses List contains prostheses and human tissue prostheses and the benefit to be paid by the private health insurers. The Prostheses List is published bi-annually.

How to apply for listing on the Prostheses List

The Guide to listing and setting benefits for prostheses has been developed to provide information about the arrangements under which private health insurers provide benefits for surgically implanted prostheses for their insured persons and explains the process by which applications are assessed. The guide is divided into two parts

Part 1 provides information on the prostheses arrangements.

Part 2 sets out the requirements for making an application to have products included in the Prostheses List, or to have existing product details amended.

Access the Prostheses Guide

Further information on the Prostheses List.

Human Tissue Review

The Human Tissue Review commenced in 2009 and includes the consideration of the appropriateness of autologous products as well as appropriate processes for the assessment of complex human tissues and new technologies for listing on the Prostheses List. This Review is the first step to address the recommendations of the Doyle Report that relate to human tissue products. This review is expected to be completed mid 2010.

Further information on the Human Tissue Review.

Prostheses List Advisory Committee

On 4 October 2010, the Minister for Health and Ageing approved the establishment of the Prostheses List Advisory Committee (PLAC) (to replace the Prostheses and Devices Committee (PDC)) with revised terms of reference and new membership. This Committee provides advice on the listing of products on the Prostheses List and the benefits payable for them.

Further information on the Prostheses List Advisory Committee

Contact details

Website Prostheses List website
Contact details Department of Health and Ageing
Private Health Insurance Branch (MDP 400)
GPO Box 9848
Phone: (02) 6289 9463
Fax: (02) 6289 9444

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Page currency, Latest update: 01 June, 2011