Prescribed List post-listing reviews

As part of reforms to the Prescribed List, we are introducing regular reviews of listed products. The reviews help ensure that privately insured Australians continue to have access to clinically effective devices that meet their healthcare needs.

Post-listing reviews

Through the Prescribed List reforms, we formalised post-listing reviews to safeguard the settings of the Prescribed List.

On 12 May 2022, the Prostheses List Advisory Committee (now the Medical Devices and Human Tissue Advisory Committee) supported pilot post-listing reviews for 4 groups of devices:

  • metal-backed patellae
  • surgical guides and biomodels
  • spinal cord stimulators
  • urogynaecological mesh (mid-urethral sling) devices.

Annual Work Plan

We maintain an annual workplan of devices or groupings that are planned for a post-listing review. The workplan is not a list of active reviews.

The table below shows the annual workplan for 2025-2026.

We used the learnings from these reviews to inform the finalisation of our post-listing review framework.

TopicGroups/Billing codesReview triggerProposed reviewProposed timeframe
Spinal fusion cages13.10.01.01 – Interbody, Integral Fixation – Cervical; 13.10.01.02 – Interbody, Integral Fixation – ThoracoLumbar / Lumbar; 13.10.02.01 – Interbody, No Integral Fixation – Cervical; 13.10.02.02 - Interbody, No Integral Fixation – ThoracoLumbar / Lumbar; 13.05.01.01 – Plate – Integral Fixation – Cervical (without suffix and with suffix >55mm); 13.05.01.02 – Plate – Integral Fixation – ThoracoLumbar / Lumbar / Lumbosacral; 13.05.02.01 – Plate – No Integral Fixation – Cervical (without suffix and with suffix >55mm); and 13.05.02.02 – Plate – No Integral Fixation – ThoracoLumbarStakeholder concerns about recent changes to PL groupings do not represent the clinical value of some innovative devices.&Focused HTA review of comparative clinical and cost effectiveness of spinal cages.

Project plan and scope planned for Q4 2025 

Consultation with stakeholders planned for Q4 2025 

Shoulder humeral components/humeral trays and inserts

06.02.04.05 – Shoulder–Humeral – Modular humeral component – metaphyseal, uncemented

06.02.04.14 – Shoulder–Humeral – Humeral cup; 06.02.05.04 – Shoulder – Glenoid – Glenoid insert; and 06.02.06.07 – Shoulder – Accessories – Reverse humeral tray.

There are a mix of different devices listed in the same subgroups.Review the current subgroups, suffixes and benefits of shoulder humeral component devices.

Project plan and scope planned for Q1 2026

Consultation with stakeholders planned for Q1 2026

Sternal fixation and deformity correction devices

06 – Specialist Orthopaedic

07 – Plastic and Reconstructive; 09 – Cardiothoracic.

There are at least 41 sternal fixation devices listed in 3 different categories on the PL, with similar devices listed across different groupings.

Review of the relevant billing codes to achieve consistency and clarity in the grouping structure of these devices, including consideration whether these devices should be listed in the same PL category.

Review the current groups, subgroups, suffices and benefits for sternal fixation devices.

Project plan and scope planned for Q2 2026

Consultation with stakeholders planned for Q2 2026

Craniomaxillofacial (CMF) surgical splints07.02 – Craniomaxillofacial (CMF) Implants.Surgical splints are listed in kits as items that can be claimed under surgical guides and biomodels billing codes.

Internal review of catalogue items under each applicable billing code.

Review of comparative clinical effectiveness and benefits payable for splints.

Commence after review of surgical guides and biomodels is complete.
External fixateurs and bone graft substitutes

06.03.11 – Specialist Orthopaedic – Skeletal Reconstruction – External Fixateurs

06.03.15 – Specialist Orthopaedic – Skeletal Reconstruction – Bone Graft Substitute

Review of the categories/listing and benefits for external fixateurs and bone graft substitutesA review of comparative cost-effectiveness and benefits payable on the PL. The department will seek further input from SOECAG.Project plan and scope planned for Q3 2026.

Active reviews

Completed reviews

Post-listing review framework

We prepared a post-listing review framework to promote a consistent approach for all post-listing reviews.

The framework outlines how we:

  • identify devices that may be appropriate for a post-listing review
  • prioritise devices identified as appropriate for a post-listing review
  • determine the scope of a post-listing review
  • undertake a post-listing review
  • inform and consult with stakeholders and sponsors during the post-listing review
  • action the outcomes and actions arising from a post-listing review.

Contact

Prescribed List post-listing reviews

Please contact us for more information about post-listing reviews of products on the Prescribed List.
Date last updated:

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