PHI 55/20 Cardiac services and co-dependent pathology services changes – 1 August 2020

Private health insurance announcement.

Date published:
PHI circular type:
PHI announcement
Health sector

The Private Health Insurance Legislation Amendment Rules (No. 5) 2020 (the Amendment Rules) were registered on the Federal Register of Legislation on 31 July 2020 and commenced on 1 August 2020.

The Amendment Rules amend the:

  • Private Health Insurance (Benefit Requirement) Rules 2011 to:
    • list 23 new Medicare Benefit Schedule (MBS) cardiac services items as Type C Procedures, in Schedule 3 of the Rules, as they are not normally requiring hospital treatment
    • delete 18 cardiac services items from Schedule 3 as they are being deleted from the MBS.
  • Private Health Insurance (Complying Product) Rules 2015 to:
    • amend Schedule 7 to place new MBS cardiac services into the Support treatments category, and remove deleted MBS items
    • note 2 new co-dependent pathology service items to expand testing for access to Olaparib to patients who have BRCA variants will automatically be considered in Schedule 7 as they are listed in the Pathology Services Table of the MBS.

Further details on the amendments are included in the Explanatory Statement accompanying the Amendment Rules which is available from and searching for F2020L00978 or ‘Private Health Insurance Legislation Amendment Rules (No.5) 2020’.