PHI 62/24 Update on condition for reimbursement of surgical guides and biomodels

Publication about the outcome of consultation and next steps.

Date published:
PHI circular type:
Prescribed List announcement
Audience:
Health sector

On 13 November 2023, a condition for reimbursement was placed on 37 billing codes for surgical guides and biomodels.

At the time of applying this condition, we committed to monitoring the impact of the condition to ensure relevant adjustments could be made if there were unintended consequences.

As part of this commitment we undertook a short consultation on:

  • The requirement that implantable devices listed in ‘sub-category 07.03 – Dental Implants’ be ‘explicitly identified in the product name or description of the billing code for the surgical guide or biomodel’.

Based on the feedback to the consultation on the naming of dental implants part of the condition, we do not intend to make any changes. 

Additionally, we have received stakeholder feedback on the impact of the remaining parts of the condition on some surgeries.

We intend to review the text of the remaining parts of the condition to improve alignment with the policy intent. We will undertake further engagement with stakeholders on the outcome of this review and any proposed amendments prior to implementation. We appreciate the time taken by all stakeholders to provide feedback on the condition.