PHI 35/14

This circular issued by the Private Health Insurance Branch contains information about an Amendment to the Private Health Insurance (Prostheses) Rules 2014 (No. 1)

Page last updated: 13 June 2014

Printable version of 35/14 (PDF 474 KB)

13 June 2014

Amendment to the Private Health Insurance (Prostheses) Rules 2014 (No. 1)

The purpose of this Circular is to inform stakeholders that the delegate of the Minister for Health intends to amend the Prostheses List by making the Private Health Insurance (Prostheses) Amendment Rules 2014 (No. 2) (the Amendment Rules). The Amendment Rules are intended to commence on 27 June 2014.
The Amendment Rules will amend the Prostheses List to:
  • delete 2 billing codes, TO121 and TO122;
  • add an “LK” suffix to DE366;
  • expand BH171 into 2 new billing codes - BH360 and BH361;
  • fix an error in the group name for Bone - Milled 20-29gr (changing “22-60cc equivalent” to “48-58cc equivalent”) in Part B - Human Tissue.
  • increase the benefits for 61 Human Tissue items on Part B, supplied by the New South Wales Bone Bank, as set out below:
    Billing code
    Current benefit

    New benefit

    NBB62

    $903.00

    $1,169.00

    NBB61

    $1,647.00

    $2,131.00

    NBB60

    $2,498.00

    $3,232.00

    NBB65

    $903.00

    $1,169.00

    NBB64

    $1,647.00

    $2,131.00

    NBB63

    $2,498.00

    $3,232.00

    NBB05

    $1,224.00

    $1,584.00

    NBB09

    $922.00

    $1,193.00

    NBB59

    $2,271.00

    $2,939.00

    NBB17

    $1,606.00

    $2,078.00

    NBB57

    $2,778.00

    $3,595.00

    NBB13

    $2,507.00

    $3,244.00

    NBB56

    $1,687.00

    $2.183.00

    NBB55

    $1,687.00

    $2,183.00

    NBB10

    $2,778.00

    $3,595.00
Billing code
Current benefit

New benefit

NBB11

$2,606.00

$3,372.00

NBB12

$6,200.00

$8,023.00

NBB15

$2,921.00

$3,780.00

NBB14

$1,306.00

$1,690.00

NBB18

$6,041.00

$7,817.00

NBB54

$2,359.00

$3.053.00

NBB21

$2,905.00

$3,759.00

NBB24

$6,500.00

$8,411.00

NBB22

$2,705.00

$3,500.00

NBB23

$1,195.00

$1,546.00

NBB26

$1,545.00

$1,999.00

NBB50

$3,090.00

$3,998.00

NBB51

$1,671.00

$2,162.00

NBB25

$2,359.00

$3,053.00

NBB29

$3,142.00

$4,066.00

NBB30

$3,182.00

$4,118.00

NBB27

$2,769.00

$3,583.00

NBB28

$2,778.00

$3,595.00

NBB53

$1,448.00

$1,874.00

NBB31

$1,781.00

$2,305.00

NBB06

$3,024.00

$3,193.00

NBB49

$1,854.00

$2,399.00

NBB47

$2,975.00

$3,850.00

NBB01

$1,922.00

$2,487.00

NBB02

$2,228.00

$2,883.00

NBB69

$2,728.00

$3,530.00

NBB33

$2,147.00

$2,778.00

NBB68

$2,647.00

$3,425.00

NBB72

$2,184.00

$2,826.00

NBB73

$2,184.00

$2,826.00

NBB70

$2,185.00

$2,827.00

NBB67

$2,184.00

$2,826.00

NBB71

$2,184.00

$2,826.00

NBB35

$2,518.00

$3,258.00

NBB36

$2,551.00

$3,301.00

NBB46

$3,986.00

$5,158.00

NBB45

$1,448.00

$1,874.00

NBB37

$4,065.00

$5,260.00

NBB44

$5,455.00

$7,059.00

NBB41

$3,747.00

$4,849.00

NBB43

$2,450.00

$3.170.00

NBB42

$2,645.00

$3,423.00

NBB66

$1,208.00

$1,563.00

NBB07

$2,787.00

$3,606.00

NBB40

$1,854.00

$2,399.00

NBB38

$2,450.00

$3,170.00

Therapeutic Goods Administration (TGA) Safety and Hazard Alerts

The Prostheses Secretariat is monitoring prostheses listed on the Prostheses List that are subject to current safety and/or hazard alerts issued or circulated by the TGA.

The prostheses currently flagged on the Prostheses database are listed at Attachment A (Excel 13 KB) PDF version of Attachment A (PDF 195 KB).

The TGA has advised that the Cereform Breast Implants and associated sizers have been suspended from the Australian Register of Therapeutic Goods (ARTG) from 23 May 2014 for a period of up to six months. This means that the products cannot be supplied in Australia. The suspension will be lifted if the TGA can be satisfied that the products meet the regulatory requirements for inclusion on the ARTG. The products will remain listed on the Prostheses List in the interim, pending advice about the future of their inclusion on the ARTG.

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 2014 Private Health Insurance (PHI) Circulars.

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