The Prescribed List of Medical Devices and Human Tissue Products (“Prescribed List”) arrangements are set out in Division 72 of the PHI Act and the Private Health Insurance (Medical Devices and Human Tissue Products) Rules. The Minister will make the rules under the authority of subsections 72-1, 72-10 and 333-20 of the PHI Act.
The Prescribed List sets out the medical devices and human tissue products private health insurers must pay benefits for to the patients who have appropriate insurance policies.
The Prescribed List is the schedule to the Medical Devices and Human Tissue Products Rules and is currently in four parts:
(1) Part A: medical devices that satisfy the criteria for listing agreed by the Medical Devices and Human Tissue Advisory Committee (MDHTAC) and approved by the Minister, including the requirement that the device is either a surgically implantable medical device, or essential to and specifically designed as an integral single-use aid for implanting a medical device, or critical to the continuing function of the surgically implanted medical device.
(2) Part B: human tissue (includes products that are substantially derived from human tissue where the tissue has been subject to processing or treatments, and whose supply [however described, including trade, sell, give or gift] is governed by state or territory law).
(3) Part C: medical devices that satisfy the criteria for listing on Part C. These criteria specify that a medical device will be listed in Part C if it is an insulin infusion pump, an implantable cardiac event recorder, a cardiac home/remote monitoring system, a cardiac ablation catheter, a mapping catheter for cardiac ablation or a patch for cardiac ablation.
(4) Part D: General use items.
The Prescribed List contains more than 11,000 items and lists the no-gap and gap-permitted medical devices and human tissue products and the benefits payable for them.
From 2019, the Prescribed List is published three times per year (effective 1 March, 1 July and 1 November), in accordance with a commitment in the Government’s Agreement with the Medical Technology Association of Australia (MTAA).
The Department accepts applications on a continuous basis. A medical device and human tissue product will be incorporated in the next released Prescribed List if the Minister has granted the application and the applicant has paid the initial listing fee.
The current version of the List is known as the July 2024 Prescribed List. The July 2024 Prescribed List has a commencement date of 1 July 2024.
The Prescribed List Database and Prescribed List (Part A, Part B, Part C and Part D) files below are consolidated versions of the Prescribed List. The New Items, Deleted Items and Changed Items reports provide information on differences between the previous prescribed list.
Private Health Insurance (Medical Devices and Human Tissue Products) Rules (No. 1) 2024 – commonly known as the July 2024 Prescribed List: effective 1 July 2024
Benefits payable in respect of the prescribed list of medical devices and human tissue products
Page last updated: 2 July 2024
|
ASSOCIATED REPORTS FROM THE JULY 2024 PRESCRIBED LIST – PART A
|
File Size
|
| July 2024 Prescribed List – Part A New Items – MS Excel Version | 53.61 KB |
| July 2024 Prescribed List – Part A Deletions – MS Excel Version | 62.99 KB |
| July 2024 Prescribed List – Part A Changes – MS Excel Version | 354.96 KB |
|
ASSOCIATED REPORTS FROM THE JULY 2024 PRESCRIBED LIST – PART B
|
File Size
|
| July 2024 Prescribed List – Part B (Human Tissue) Deletions – MS Excel Version | 13.13 KB |
| July 2024 Prescribed List – Part B (Human Tissue) Changes – MS Excel Version | 14.80 KB |
|
ASSOCIATED REPORTS FROM THE JULY 2024 PRESCRIBED LIST – PART C
|
File Size
|
| July 2024 Prescribed List – Part C (Other) New Items – MS Excel Version | 13.92 KB |
| July 2024 Prescribed List – Part C (Other) Deletions – MS Excel Version | 12.32 KB |
| July 2024 Prescribed List – Part C (Other) Changes – MS Excel Version | 12.30 KB |
|
ASSOCIATED REPORTS FROM THE JULY 2024 PRESCRIBED LIST – PART D
|
File Size
|
| July 2024 Prescribed List – Part D (General use items) New Items – MS Excel Version | 14.39 KB |
| July 2024 Prescribed List – Part D (General use items) Deletions – MS Excel Version | 14.97 KB |
| July 2024 Prescribed List – Part D (General use items) Changes – MS Excel Version | 12.49 KB |
Note: Due to limitations with Excel – cell height cannot be greater than 256 pixels – some cells in the spreadsheet may contain incomplete information. You are advised to reference another version of the Prescribed List if you find incomplete information.
|
XML DATABASE SCHEMA DOCUMENT
|
File Size
|
| Prescribed List – XML Schema document (version 1.3) – PDF Version | 529.77 KB |
| Prescribed List – XML Schema document (version 1.3) – MS Word Version | 250.74 KB |
|
RELEVANT DoHAC PHI CIRCULARS
|
File Size
|
| PHI 47/24 Further changes to format for new billing codes | 101.19 KB |
| PHI 45/24 Prescribed List Cost Recovery Implementation Statement 2024-25 | 91.38 KB |
| PHI 44/24 Issues with 6-digit billing code format in July 2024 Prescribed List | 103.17 KB |
| PHI 43/24 Issues in July 2024 Prescribed List release | 100.91 KB |
| PHI 40/24 Private Health Insurance (Medical Devices and Human Tissue Products) Rules (No. 1) 2024 | 89.74 KB |