The Prostheses List

The Prostheses publication of the Private Health Insurance (Prostheses) Rules 2017 (No. 1) and Amendment Rules 2017 (No. 3)

Page last updated: 04 August 2017

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.

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.

New and changed items resulting from the Private Health Insurance (Prostheses) Amendment Rules 2017 (No. 3) are published below, along with updated versions of the amended Prostheses List.

New Items for Prostheses List – Amendment Rules No 3, 2017

PDF version: New Items for Prostheses List – Part A from Amendment Rules No 3, 2017 (PDF 159 KB)
Excel version: New Items for Prostheses List – Part A from Amendment Rules No 3, 2017 (Excel 15 KB)

PDF version: Changed Items for Prostheses List – Part B from Amendment Rules No 3, 2017 (PDF 8 KB)
Excel version: Changed Items for Prostheses List – Part B from Amendment Rules No 3, 2017 (Excel 11 KB)


Prostheses List in parts

PDF version: Prostheses List - Part A (PDF 3.98 MB)
Excel version: Prostheses List - Part A (Excel 1.4 MB)

New Prostheses Items

PDF version: New Items for Prostheses List – Part A (PDF 590 KB)
Excel version: New Items for Prostheses List – Part A (Excel 90 KB)

Deleted Prostheses Items

PDF version: Deleted Items for Prostheses List – Part A (PDF 260 KB)
Excel version: Deleted Items for Prostheses List – Part A (Execl 54 KB)

Changed Items for Prostheses List

PDF version: Changed Items for Prostheses List – Part A from Rules No 4, 2016 to No 1, 2017 (PDF 276 KB)
Excel version: Changed Items for Prostheses List – Part A from Rules No 4, 2016 to No 1, 2017 (Excel 47 KB)

Prostheses List Part B – Human Tissue

PDF version: Human Tissue – Prostheses List Part B (PDF 250 KB)
Excel version: Human Tissue – Prostheses List Part B (Excel 46 KB)

Corrections to Human Tissue List Part B

PDF version: Corrections to Human Tissue List Part B (PDF 28 KB)
Excel version: Corrections to Human Tissue List Part B (Excel 14 KB)

Prostheses List Part C – Others

PDF version: Other – Prostheses List Part C (PDF 159 KB)
Excel version: Other – Prostheses List Part C (Excel 17 KB)

The Department of Health has made every effort to ensure that the Microsoft Excel versions meet accessibility requirements. If you are experiencing difficulty accessing the information contained within this document, please email the Prostheses Section to arrange for an alternative format to be provided to you.


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. 1)

The Private Health Insurance (Prostheses) Rules 2017 (No. 1) was registered on the Federal Register of Legislation on 1 March 2017 and commenced on 28 March 2017.

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

The Private Health Insurance (Prostheses) Amendment Rules 2017 (No. 2) was registered on the Federal Register of Legislation on 20 March 2017, amending the Private Health Insurance (Prostheses) Rules 2017 (No. 1). The amendment commenced immediately after the commencement of the Private Health Insurance (Prostheses) Rules 2017 (No. 1) on 28 March 2017.

Private Health Insurance (Prostheses) Amendment Rules 2017 (No. 3)

The Private Health Insurance (Prostheses) Amendment Rules 2017 (No. 3) was registered on the Federal Register of Legislation on 28 April 2017. These Amendment Rules further amend the Private Health Insurance (Prostheses) Rules 2017 (No. 1). These Amendment Rules commence on 1 May 2017.

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




In this section