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Private health insurance clinical category definitions 1 July 2022

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Publication date: 
22 April 2022
Publication type: 
Dataset
Intended audience: 
General public
Description: 

Definitions of the clinical categories for hospital treatment policies as found in the Private Health Insurance (Complying Product) Rules 2015.

The clinical categories include an indicative list of Medicare Benefit Schedule (MBS) items that should be covered. The list of items is derived from the MBS XML Data file ‘MBS‑XML‑220701’ released on 8 April 2022, and includes 1 July 2022 changes which includes indexation changes to the General Medical Services Table (GMST), Pathology Services Table (PST) and Diagnostic Imaging Services Table (DIST).

The assignment of MBS items by clinical category reflects the PHI rules, accessible on the Federal Register of Legislation.

For older versions of this publication, review the Private health insurance clinical category and procedure type collection, or visit the National Library's web archive.