The Private Health Insurance Legislation Amendment Rules (No. 9) 2022 (the Amendment Rules) make consequential changes to the Private Health Insurance Rules to reflect changes to Medical Benefit Schedule (MBS) commencing 1 August 2022.
Further information on the new temporary item, including fact sheets and quick reference guides will be made available at MBS Online.
The Amendment Rules were registered on the Federal Register of Legislation to commence on 1 August 2022.
The amendments add temporary item 61527 to Schedule 3 of the Private Health Insurance (Benefit Requirements) Rules 2011 (the Benefit Requirements Rules) for the purpose of specifying minimum hospital accommodation benefit requirements, to classify the new temporary MBS item as Type C procedure.
MBS item 61527 is automatically categorised as Support treatment as it is in the Diagnostic Imaging Services Table (DIST). The new temporary item enables the use of FDG positron emission tomography (PET) when gallium-67 (Ga-67) is unavailable and is a direct substitute of items 61429, 61430, 61442, 61450 and 61453.
Private Health Insurance (Health Insurance Business) Rules 2018 (the Business Rules)
Following the cessation of temporary MBS items for COVID-19 specialist in-hospital telehealth on 30 June 2022, the Business Rules will also be amended to repeal the exclusion at Part 3 Rule 8 that had ensured the temporary MBS items would not be considered hospital treatment.
Further details on the Amendment Rules are included in the Explanatory Statement accompanying the Amendment Rules available on the Federal Register of Legislation or by searching ‘Private Health Insurance Legislation Amendment Rules (No. 9) 2022’.
Information and spreadsheets for MBS items assigned to a clinical category or procedure type are available at Private health insurance clinical category and procedure type.
Information on MBS item changes can be found at MBS Online.