PHI 11/11

This circular issued by the Private Health Insurance Branch contains information on the February 2011 Prostheses List

Page last updated: 30 October 2013

Printable version of 11/11 (PDF 31 KB)

4 February 2011

February 2011 Prostheses List


The purpose of this Circular is to inform the health industry that:
  • the delegate of the Minister for Health and Ageing has made rules giving effect to a new version of the Prostheses List (February 2011); and
  • the February 2011 Prostheses List commences on 21 February 2011.
The Private Health Insurance (Prostheses) Rules 2011 (No. 1) ('the Rules') are now available on the Department's website. Please note that the Rules have been registered on the Federal Register of Legislative Instruments (FRLI) with a commencement date of 21 February 2011.

Variations from the previous Prostheses List – Part A (Prostheses)

The February 2011 Prostheses List (Part A) contains the following changes:
  • 412 new billing codes (213 for new products, 69 resulting from expansions, 123 resulting from transfers and 7 resulting from compressions). Note: Billing code SO041 had been conditionally listed- a benefit for the provision of this prosthesis is payable for a child under 18 years of age;
  • 1352 billing codes have had amendments to one or more of the following: benefit/s, product information text, product groups/subgroups; and
  • 273 billing codes have been removed (one (1) as it did not meet the criteria for listing, one (1) for not paying the ongoing listing fee, 113 at the request of the sponsor, 18 as a result of compressions, 17 as a result of expansions and 123 as a result of transfers).

Variations from the previous Prostheses List – Part B (Human Tissue)

The February 2011 Prostheses List (Part B) includes the following changes:
  • 25 existing products have had benefit amendments.

Gap permitted products

There are 2,286 (24.4%) products with potential gaps in part A of the February 2011 Prostheses List.
Human tissue prostheses in Part B of the Prostheses List do not have gap permitted products.

If you require further information please telephone: (02) 6289 9853/24 hr answering machine or email the enquiry to Private Health Insurance Branch

For more information visit 2012 Private Health Insurance (PHI) Circulars.

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