Health Insurance (Section 3C General Medical Services – Extracorporeal Photopheresis for Chronic Graft Versus Host Disease) Determination 2022

law://au/li/2022/f2022l00174@2026-11-13

Contents

1. Name #

This instrument is the Health Insurance (Section 3C General Medical Services – Extracorporeal Photopheresis for Chronic Graft Versus Host Disease) Determination 2022.

3.Authority#

This instrument is made under subsection 3C(1) of the Health Insurance Act 1973.

4. Definitions #

(1) In this instrument:

Act means the Health Insurance Act 1973.

Pharmaceutical Benefits Scheme means the scheme for the supply of pharmaceutical benefits established under Part VII of the National Health Act 1953.

relevant provisions means all provisions, of the Act and regulations made under the Act, and the National Health Act 1953 and regulations made under the National Health Act 1953, relating to medical services, professional services or items.

relevant service means a health service, as defined in subsection 3C(8) of the Act, that is specified in a Schedule.

Schedule means a Schedule to this instrument.

Note: The following terms are defined in subsection 3(1) of the Act:

 clinically relevant service;

 general medical services table;

 item;

 professional service.

(2) Unless the contrary intention appears, a reference in this instrument to a provision of the Act or the National Health Act 1953 or regulations made under the Act or under the National Health Act 1953 as applied, adopted or incorporated in relation to specifying a matter is a reference to those provisions as in force from time to time and any other reference to provisions of an Act or regulations is a reference to those provisions as in force from time to time.

5. Treatment of relevant services #

For subsection 3C(1) of the Act, a relevant service, provided in accordance with this instrument and as a clinically relevant service, is to be treated, for the relevant provisions, as if:

(a) it were both a professional service and a medical service; and

(b) there were an item in the general medical services table that:

(i) related to the service; and

(ii) specified for the service a fee in relation to each State, being the fee specified in the Schedule in relation to the service.

6. Requirements on the rendering practitioner #

(1)Clause 1.2.7 of the general medical services table shall have effect as if the items contained in the Schedule of the Determination were also specified in the clause.

(2)Clause 1.2.11 of the general medical services table shall have effect as if the items contained in the Schedule of the Determination were also specified in the clause.

7.Application of treatment cycle and session#

(1) For an item in the Schedule, treatment cycle means treatment that is required to deliver extracorporeal photopheresis that:

(a) begins on the day in which the treatment begins; and

(b) ends 12 weeks after the day specified in paragraph (a).

(2) For an item in the Schedule, treatment session means a single extracorporeal photopheresis treatment in a series of sessions that make up a treatment cycle.

8. Restriction on items #

Services rendered in certain circumstances or for certain purposes

(1)Clause 1.2.9 of the general medical services table shall have effect as if the items in the Schedule of the Determination were specified in the clause.

Services provided with harvesting, storage, in vitro processing, or injection of non-haematopoietic stem cells

(2)Clause 1.2.10 of the general medical services table shall have effect as if the items in the Schedule of the Determination were specified in the clause.

Services connected with provision of pain pump for post-surgical pain management

(3)Clause 5.1.1 of the general medical services table shall have effect as if the items in the Schedule of the Determination were specified in the clause.

Services provided on the same occasion as certain attendances

(4)An item in the Schedule does not apply to a service if it is associated with a service to which an item in Group A3 or Group A4 of the general medical service tables applies.

9. Indexation #

(1)At the start of 1 July 2026 (the indexation time), each amount covered by subsection (2) is replaced by the amount worked out using the following formula:

Note: The indexed fees could in 2026 be viewed on the Department of Health, Disability and Ageing’s MBS Online website (www.mbsonline.gov.au).

(2)The amounts covered by this subsection are the fee for each item in a Schedule of this Determination.

(3)An amount worked out under subsection (1) is to be rounded up or down to the nearest 5 cents (rounding down if the amount is an exact multiple of 2.5 cents).

Schedule · relevant services

Group T1—Miscellaneous Therapeutic Procedures
Column 1 Item	Column 2Description	Column 3Fee ($)
Subgroup 8—Haematology
13761	Extracorporeal photopheresis for the treatment of chronic graft-versus-host disease, if:Applicable once per treatment session (H)	1,908.35
13762	Extracorporeal photopheresis for the treatment of chronic graft-versus-host disease, if:Applicable once per treatment session (H)	1,908.35

Sourced from the Federal Register of Legislation at legislation.gov.au, © Commonwealth of Australia, licensed under CC BY 4.0. Compilations may have been reformatted.

Health Insurance (Section 3C General Medical Services – Extracorporeal Photopheresis for Chronic Graft Versus Host Disease) Determination 2022

Health Insurance (Section 3C General Medical Services – Extracorporeal Photopheresis for Chronic Graft Versus Host Disease) Determination 2022

1. Name #

3.Authority#

4. Definitions #

5. Treatment of relevant services #

6. Requirements on the rendering practitioner #

7.Application of treatment cycle and session#

8. Restriction on items #

9. Indexation #

Schedule · relevant services

History · 1 version

Connections

1. Name #

3.Authority#

4. Definitions #

5. Treatment of relevant services #

6. Requirements on the rendering practitioner #

7.Application of treatment cycle and session#

8. Restriction on items #

9. Indexation #

Schedule · relevant services

Key facts