PHI 69/20 Minimum accommodation benefits and clinical categories amendments – 30 September 2020

Private health insurance announcement.

Date published:
PHI circular
PHI circular type:
PHI announcement
Health sector

The Private Health Insurance Legislation Amendment Rules (No. 6) 2020 (the Amendment Rules) were registered on the Federal Register of Legislation on 29 September 2020 and commence on 30 September 2020.

The Amendment Rules amend the:

  • Private Health Insurance (Benefit Requirement) Rules 2011 to:
    • increase the minimum benefits payable by private health insurers for private patients’ overnight and same-day accommodation in public hospitals in Tasmania
    • list 5 new Medicare Benefit Schedule (MBS) cardiac services items, and 4 new general practitioner (GP) and other medical practitioner (OMP) mental health services as Type C Procedures as they are not normally requiring hospital treatment.
  • Private Health Insurance (Complying Product) Rules 2015 to:
    • place 4 new GP and OMP mental health services for persons subject to public health orders into the ‘Hospital Psychiatric Services’ clinical category, mirroring arrangements for existing GP mental health attendance items.

(Note the new Diagnostic and Imaging Services Table cardiac MBS items will automatically be considered as Schedule 7 Support treatments.)

Further details on the amendments are included in the Explanatory Statement accompanying the Amendment Rules which is available from and searching for F2020L01244 or ‘Private Health Insurance Legislation Amendment Rules (No.6) 2020’.