The Prostheses List

Benefits payable in respect of surgically implanted prostheses, human tissue items and other medical devices list.

Page last updated: 22 December 2015

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 as part of hospital treatment or hospital substitute treatment, and there is a Medicare benefit payable for the professional service.

The Prostheses List is a schedule to the Private Health Insurance (Prostheses) Rules (the Prostheses Rules). The Prostheses Rules are available at Government's legislation website.

The Prostheses Rules are made by the Minister for Health. In making the Rules, the Minister can have regard to advice from the Prostheses List Advisory Committee, and its sub-committees.

Consumer-specific information on private health insurance cover for prostheses can be found at this webpage - Prostheses - Information for consumers.

Applications to list new prostheses and requests to change listings

Medical device sponsors and suppliers who want to list their prostheses on the Prostheses List make applications and requests via the Prostheses List Management System (PLMS) or by completing a form available on this website and sending it to the Department of Health.

Prostheses List Guide

The Prostheses List – guide to listing and benefits for prostheses (the Prostheses List Guide (Word 986 KB)) provides information for stakeholders on the prostheses arrangements and guidance for applicants on the process to get a prosthesis listed.

The Prostheses List Guide (Word 986 KB) Prostheses List Guide - December 2015 (PDF 7118 KB) is published as a draft and feedback from stakeholders is welcome. Any feedback or queries should be emailed to Prostheses@health.gov.au, with “Prostheses List Guide feedback” in the subject line.

Prostheses List Database

The current Prostheses List is published on the website in an MS-Access database, for the use of stakeholders to update their claims and payments systems. It is also provided in PDF and Excel format. Download the Current Prostheses List

Contacts for further information

Please check the Prostheses List Guide first as the information might be available there.

If you cannot find the information you need, contact the Prostheses secretariat:
by email at Prostheses@health.gov.au
by phone on (02) 6289 9463.

Other relevant information

Publications

Private Health Insurance (PHI) Circulars and Prostheses List Bulletins