PHI 79/21 Private Health Insurance Legislation Amendment Rules (No. 6) 2021

Private health insurance clinical category and procedure type updates following Medicare Benefits Schedule (MBS) item changes from 1 November 2021.

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

The Private Health Insurance Legislation Amendment Rules (No. 6) 2021 (the Amendment Rules) make consequential changes to the Private Health Insurance Rules to reflect changes to Medical Benefit Schedule (MBS) commencing 1 November 2021.

Further information on changes to the MBS for 1 November 2021, including fact sheets and quick reference guides is available at MBS Online.

The Amendment Rules were registered on the Federal Register of Legislation on 22 October 2021 and commence on 1 November 2021.

The amendments include re-classification of new and amended MBS items and removal of deleted items where appropriate, in the:

  • Private Health Insurance (Complying Product) Rules 2015 (the Complying Product Rules)

    • Schedule 5 for the Clinical categories
    • Schedule 6 for the Common treatments list
    • Schedule 7 for the Support treatments list; and
  • Private Health Insurance (Benefit Requirements) Rules 2011 (the Benefit Requirements Rules)

    • Schedule 1 for Type A Advanced surgical and Surgical procedures
    • Schedule 3 for Type B, and Type C procedures.

Further details on the Amendment Rules are included in the Explanatory Statement accompanying the Amendment Rules available on the Federal Register of Legislation at www.legislation.gov.au or by searching ‘Private Health Insurance Legislation Amendment Rules (No. 6) 2021’.

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 www.mbsonline.gov.au.