PHI 09/12

This circular issued by the Private Health Insurance Branch contains Prostheses List information

Page last updated: 12 September 2014

Printable version of 09_12 (PDF 30 KB)

17 February 2012

February 2012 Prostheses List


The purpose of this Circular is to inform the health industry that:
  • the delegate of the Minister for Health and Ageing has made rules giving effect to a new version of the Prostheses List (February 2012); and
  • the February 2012 Prostheses List commences on 3 March 2012.
The Private Health Insurance (Prostheses) Rules 2012 (No. 1) ('the Rules') are now available on the Department's website. Please note that the Rules have been registered on the Federal Register of Legislative Instruments (FRLI) with a commencement date of 3 March 2012.

Variations from the previous Prostheses List – Part A (Prostheses)

The February 2012 Prostheses List (Part A) contains the following changes:
  • 1274 new billing codes (411 for new products, 611 resulting from expansions, 150 resulting from transfers, 83 resulting from compressions and 19 resulting from duplications).
  • 1352 billing codes have had amendments to one or more of the following: benefit/s, product information text, product groups/subgroups.

Variations from the previous Prostheses List – Part B (Human Tissue)

The February 2012 Prostheses List (Part B) includes the following changes:
  • 38 existing products have had benefit amendments; and
  • 4 products have been deleted.

Variations from the previous Prostheses List – Part C (Other Prostheses)

The February 2012 Prostheses List (Part C) includes the following change:
  • 1 new billing code (1 new product).

Conditionally listed products

  • Billing code CT016 - the provision of the prosthesis is associated with the service described in item 35597 of the general medical services table prescribed under section 4 of the Health Insurance Act 1973; and
  • Billing code SO041 - a benefit for the provision of this prosthesis is payable for a child under 18 years of age.
The February 2012 Prostheses List and associated reports are available on the Department’s website.

If you require further information please telephone: (02) 6289 9853/24 hr answering machine or email the enquiry to Private Health Insurance Branch

For more information visit 2012 Private Health Insurance (PHI) Circulars.

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