Health Insurance (Section 3C Diagnostic Imaging Services – Complex gynaecological ultrasound) Determination 2025

law://au/li/2025/f2025l01015@2026-11-13

Contents

1.Name#

This instrument is the Health Insurance (Section 3C Diagnostic Imaging Services – Complex gynaecological ultrasound) Determination 2025.

3.Authority#

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

4.Definitions#

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

 clinically relevant service;

 diagnostic imaging services table;

 item;

 professional service.

(1) In this instrument:

Act means the Health Insurance Act 1973.

(R) has the meaning given by subsection 1.2.15(1) of the diagnostic imaging services table.

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 10AC(1) of the Act, that is specified in a Schedule.

Schedule means a Schedule to this instrument.

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 diagnostic imaging service; and

(b) there were an item in the diagnostic imaging services table that is:

(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.Application of provisions of the diagnostic imaging services table#

Clause 2.1.2 of the diagnostic imaging services table shall have effect as if item 55080 of Schedule 1 of this Determination was also specified in clause 2.1.2 of the diagnostic imaging services table.

7Indexation#

(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 Schedule 1 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 1 · Relevant services

Group I1—Ultrasound
Column 1Item	Column 2Description	Column 3Fee ($)
Subgroup 1—General
55080	Pelvis, ultrasound scan of, by any or all approaches (including transvaginal), if:(a) the patient is known to have, or the requesting practitioner suspects, a complex gynaecological condition; and(b) the service is considered a complex investigation requiring a minimum of 30 minutes scanning time; and(c) within 24 hours of the service, a service mentioned in item 55038, 55065, 55700, 55704, 55736, or 55739 is not performed on the same patient. (R)	255.00

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 Diagnostic Imaging Services – Complex gynaecological ultrasound) Determination 2025

Health Insurance (Section 3C Diagnostic Imaging Services – Complex gynaecological ultrasound) Determination 2025

1.Name#

3.Authority#

4.Definitions#

5.Treatment of relevant services#

6.Application of provisions of the diagnostic imaging services table#

7Indexation#

Schedule 1 · Relevant services

Key facts

Connections

1.Name#

3.Authority#

4.Definitions#

5.Treatment of relevant services#

6.Application of provisions of the diagnostic imaging services table#

7Indexation#

Schedule 1 · Relevant services

History · 1 version