The Prostheses List

The Prostheses List publication of the Private Health Insurance (Prostheses) Rules 2017 (No. 2)

Page last updated: 13 October 2017

Private Health Insurance (Prostheses) Rules

The Private Health Insurance (Prostheses) Rules provide the legal basis on which the Prostheses List operates.

Private Health Insurance (Prostheses) Rules 2017 (No. 2)

The Private Health Insurance (Prostheses) Rules 2017 (No. 2) was registered on the Federal Register of Legislation on 28 August 2017 and commenced on 28 September 2017.

Prostheses Benefit Reductions

On Friday 13 October 2017 the Minister for Health announced that the minimum benefits payable by private health insurers for devices on the Prostheses List would be reduced. The reduced benefits are to commence on 1 February 2018. For details on these changes go to the Prostheses Benefit Reductions page.

The Prostheses List is the list of surgically implanted prostheses, human tissue items and other medical devices that private health insurers must pay benefits for when:

  • they are provided to a patient with appropriate health insurance cover
  • they are provided as part of hospital treatment or hospital substitute treatment, and
  • there is a Medicare benefit payable for the service.

The list is aimed at Private Health Insurers, prostheses device manufacturers and other sponsors. To find consumer-specific information on private health insurance cover for prostheses go to the Private Health Insurance - Cover for Prostheses page.

The Private Health Insurance (Prostheses) Amendment Rules 2017 (No. 4) (the Amendment Rules) have been registered on the Federal Register of Legislation and become effective on 1 November 2017. The Prostheses List Database and Prostheses List Part A and Part C files below are consolidated versions of the Prostheses List.

The New Items, Deleted Items and Changed Items reports provide details of the amendments made to the Schedule of the Private Health Insurance (Prostheses) Rules 2017 (No. 2) - also known as the August 2017 Prostheses List. For ease of reference, both the amendments made when the August 2017 Prostheses List was first published, and the amendments made under Amendment Rules No. 4, are shown separately.

Current Prostheses List

The Department of Health publishes the current Prostheses List for the use of stakeholders to update their claims and payments systems.

The list is provided in MS Access format. Other formats are listed below.

Prostheses List in parts

Part A

PDF version: Prostheses List - Part A (including Amendment Rules No. 4) (PDF 10.7 MB)
Excel version: Prostheses List - Part A (including Amendment Rules No. 4) (Excel 1.4 MB)


New Prostheses Items

August 2017 Prostheses List

PDF version: New Items for Prostheses List - Part A (including Amendment Rules No. 4) (PDF 614 KB)
Excel version: New Items for Prostheses List - Part A (including Amendment Rules No. 4) (Excel 149 KB)

Amendment Rules 2017 No. 4 - October 2017

PDF version: New Items for Prostheses List - Part A (Amendment Rules 2017 No 4) (PDF 34 KB)
Excel version: New Items for Prostheses List - Part A (Amendment Rules 2017 No 4) (Excel 12 KB)


Deleted Prostheses Items

August 2017 Prostheses List

PDF version: Deleted Items for Prostheses List - Part A (including Amendment Rules No. 4) (PDF 298 KB)
Excel version: Deleted Items for Prostheses List - Part A (including Amendment Rules No. 4) (Excel 101 KB)

Amendment Rules 2017 No. 4 - October 2017

PDF version: Deleted Items for Prostheses List - Part A (Amendment Rules 2017 No 4) (PDF 13 KB)
Excel version: Deleted Items for Prostheses List - Part A (Amendment Rules 2017 No 4) (Excel 10 KB)


Changed Items for Prostheses List

August 2017 Prostheses List

PDF version: Changed Items for Prostheses List - Part A (including Amendment Rules No. 4) (PDF 274 KB)
Excel version: Changed Items for Prostheses List - Part A (including Amendment Rules No. 4) (Excel 77 KB)

Amendment Rules 2017 No. 4 - October 2017

PDF version: Changed Items for Prostheses List - Part A (Amendment Rules 2017 No 4) (PDF 16 KB)
Excel version: Changed Items for Prostheses List - Part A (Amendment Rules 2017 No 4) (Excel 10 KB)


Part B

Prostheses List Part B - Human Tissue

PDF version: Human Tissue - Prostheses List Part B (PDF 248 KB)
Excel version: Human Tissue - Prostheses List Part B (Excel 75.6 KB)


Part C

Prostheses List Part C - Others

PDF version: Other - Prostheses List Part C (including Amendment Rules No. 4) (PDF 43 KB)
Excel version: Other - Prostheses List Part C (including Amendment Rules No. 4) (Excel 14 KB)

New Items for Part C - Others

Amendment Rules 2017 No. 4 - October 2017

PDF version: New Items for Prostheses List - Part C (Amendment Rules 2017 No 4) (PDF 15 KB)
Excel version: New Items for Prostheses List - Part C (Amendment Rules 2017 No 4) (Excel 10 KB)


Contacts for further information

The Department of Health has made every effort to ensure the Microsoft Excel versions meet accessibility requirements. If you are experiencing difficulty accessing the information contained within this webpage, or cannot find the information you need, please contact the Prostheses secretariat by email at prostheses@health.gov.au



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