Northern Territory of Australia
Government Gazette
ISSN-0157-833X
No. S95
24 September 2015
Northern Territory of Australia
Medical Services Act
Determination of Charges for Medical Services
I, Johan Wessel Elferink, Minister for Health:
(a)
under section 6(2)(b) of the Medical Services Act and with reference to
section 43 of the Interpretation Act, revoke the determination of charges for
medical services dated 7 July 2015 and published in Gazette No. S83 on
12 August 2015; and
(b)
under section 6(2) (b) of the Medical Services Act, determine that the charges to
be made for medical services provided under the Act are as specified in the
Schedule.
Dated 21 September 2015
J. W. Elferink
Minister for Health
Northern Territory Government Gazette No. S95, 24 September 2015
Schedule
T34.3.1
Public Patient
Nursing Home Type Patient
Fee per
day
$56.90
T34.3.2
Private Patient
Overnight Stay (includes
long stay acute)
Same Day Band 1
Fee per
day
Date effective
$339
1 July 2015
$246
1 July 2015
Same Day Band 2
$281
1 July 2015
Same Day Band 3
$326
1 July 2015
Date effective
20 March 2015
Same Day Band 4
$339
1 July 2015
Nursing Home Type Patient
$56.90
20 March 2015
Contribution (from patient)
Nursing Home Type Patient
Default Benefit (from
$86.10
20 March 2015
Insurer)
*Note: Private Long Stay Nursing Home Type patients are to be charged
both the Patient Contribution and the Patient Default Benefits amounts for
each overnight stay.
Specialist Fees (including
100% MBS
surgery)
Diagnostics (Pathology and
100% MBS
Radiology)
As per Private Insurance – Prostheses List –
See
Surgically Implanted
Surgically implanted Prostheses Fees
As per Federal Register of Legislative
Prostheses
Instruments F2015C00483 effective
18 March 2015
Page 2
Northern Territory Government Gazette No. S95, 24 September 2015
T34.3.3A
Compensable Patient
ICU, SCN, & CCU
Acute Care Overnight
(RDH/ASH)
Acute Care Same Day
(RDH/ASH)
Acute Care Overnight
(KH/TCH/GDH)
Acute Care Same Day
(KH/TCH/GDH)
Hospital in the Home (HITH)
Fee per day
Date Effective
$2,722
12 Aug 2015
$1,586
12 Aug 2015
$1,049
12 Aug 2015
$1,238
12 Aug 2015
$817
12 Aug 2015
$474
12 Aug 2015
Specialist Fees
120% MBS
T34.3.3B
Compensable Patient
Diagnostics
MRI, CT, Nuclear Medicine
Surgically Implanted
Prostheses
Medical Transport
T34.3.4A
Medicare Ineligible Patient
ICU, SCN, & CCU
Acute Care Overnight
(RDH/ASH)
Acute Care Same Day
(RDH/ASH)
Acute Care Overnight
(KH/TCH/GDH)
Acute Care Same Day
(KH/TCH/GDH)
Hospital in the Home (HITH)
Fee
120% MBS
120% MBS
As per Private Insurance – Prostheses List.
See
Surgically Implanted Prostheses Fees
As per Federal Register of Legislative
Instruments F2015C00483 effective
18 March 2015
See
Medical Transport Fees
T34.10.1A&B
Fee per day
Date effective
$2,722
12 Aug 2015
$1,586
12 Aug 2015
$1,049
12 Aug 2015
$1,238
12 Aug 2015
$817
12 Aug 2015
$474
12 Aug 2015
Page 3
Northern Territory Government Gazette No. S95, 24 September 2015
T34.3.4B
Medicare Ineligible Patient
Dialysis
Fee
Date effective
$776
12 Aug 2015
Specialist Fees
120% MBS
Diagnostics
120% MBS
MRI, CT, Nuclear Medicine
Surgically Implanted
Prostheses
Medical Transport
T34.3.6
Australian Defence Force
Personnel
Overnight Stay (includes
long stay acute)
Same Day Band 1
120% MBS
As per Private Insurance – Prostheses List
See
Surgically Implanted Prostheses Fees
As per Federal Register of Legislative
Instruments F2015C00483 effective
18 March 2015
See
Medical Transport
1 October 2013
Fees
T34.10.1A&B
Fee per day
Date Effective
$339
1 July 2015
$246
1 July 2015
Same Day Band 2
$281
1 July 2015
Same Day Band 3
$326
1 July 2015
Same Day Band 4
$339
1 July 2015
Specialist Fees
Diagnostics
Surgically Implanted
Prostheses
Medical Transport
100% MBS
100% MBS
As per Private Insurance – Prostheses List
See
Surgically Implanted Prostheses Fees
As per Federal Register of Legislative
Instruments F2015C00483 effective
18 March 2015
See Medical
Transport Fees
1 Oct 2014
T34.10.1
A&B
Page 4
Northern Territory Government Gazette No. S95, 24 September 2015
T34.3.7
Department of Veterans
Affairs
Nursing Home Type Patient
Contribution
Specialist Fees
Surgically Implanted
Prostheses
T34.3.8
Motor Accident
Compensation Act
Medical Transport
(interstate only)
Fee per day
Date effective
$56.90
20 March 2015
75% MBS
As per Private Insurance – Prostheses List
See
Surgically Implanted Prostheses Fees
As per Federal Register of Legislative
Instruments F2015C00483 effective
18 March 2015
Fee per day
Date effective
See
Medical Transport Fees
T34.10.1
A&B
1 Oct 2014
T34.4.2
Primary Care Referred Patient (Private)
Medical Consultation
85% MBS
Radiology
85% MBS
Pathology
85% MBS
Fee
*all services bulk-billed directly to Medicare
T34.4.3A
Compensable Patient –
Emergency Department
Resuscitation
Fee
Date effective
$1,854
12 Aug 2015
Emergency
$1,171
12 Aug 2015
Urgent
$858
12 Aug 2015
Semi-urgent
$509
12 Aug 2015
Non-urgent
$319
12 Aug 2015
Diagnostics
120% MBS
MRI, CT, Nuclear Medicine
120% MBS
Page 5
Northern Territory Government Gazette No. S95, 24 September 2015
T34.4.3B
Compensable Patient –
Outpatients
Medical Practitioner
Fee
Date effective
$406
12 Aug 2015
Allied Health or Clinical Nurse
$320
12 Aug 2015
Hyperbaric Unit
$645
12 Aug 2015
Minor operations
$596
12 Aug 2015
Chemotherapy
$898
12 Aug 2015
Diagnostic Services
120% MBS
T34.4.4A
Ineligible Patient – Emergency
Department
Resuscitation
Fee
Date effective
$1,854
12 Aug 2015
Emergency
$1,171
12 Aug 2015
Urgent
$858
12 Aug 2015
Semi-urgent
$509
12 Aug 2015
Non urgent
$319
12 Aug 2015
Diagnostics
120% MBS
MRI, CT, Nuclear Medicine
120%
T34.4.4B
Ineligible Patient –
Outpatients
Medical Practitioner
Fee
Date effective
$406
12 Aug 2015
Allied Health or Clinical Nurse
$320
12 Aug 2015
Hyperbaric unit
$645
12 Aug 2015
Minor operations
$596
12 Aug 2015
Chemotherapy
Diagnostic Services
$898
12 Aug 2015
120% MBS
Page 6
Northern Territory Government Gazette No. S95, 24 September 2015
T34.4.6A
Australian Defence Force
Personnel – Emergency
Department
Resuscitation
Fee
Date effective
$1,854
12 Aug 2015
Emergency
$1,171
12 Aug 2015
Urgent
$858
12 Aug 2015
Semi-urgent
$509
12 Aug 2015
Non urgent
$319
12 Aug 2015
Diagnostics
120% MBS
MRI, CT, Nuclear Medicine
120% MBS
T34.4.6B
Australian Defence Force
Personnel – Outpatients
Medical Practitioner
Fee
Date effective
$406
1 Oct 2014
Allied Health or Clinical Nurse
$320
1 Oct 2014
Hyperbaric unit
$645
1 Oct 2014
Minor operations
$596
1 Oct 2014
Chemotherapy
$898
1 Oct 2014
Diagnostic Services
120% MBS
T34.6.1
Ineligible & Compensable –
Outpatient Services
Aboriginal Health Worker
Fee
Date effective
$172
12 Aug 2015
Occupational Therapy
$148
12 Aug 2013
Speech Pathology
$232
29 July 2015
Social Work
$194
12 Aug 2015
Physiotherapy
Classes (including
hydrotherapy)
Medical Consultation
$111
12 Aug 2015
$51
12 Aug 2015
Case Management
$172
12 Aug 2015
Checklists
$48
12 Aug 2015
120% MBS
Page 7
Northern Territory Government Gazette No. S95, 24 September 2015
T37.7.1
Ineligible & Compensable
Patients
Dialysis
Fee
Date effective
$776
12 Aug 2015
T34.8.1A
Chargeable
Patient
Private
No-gap
prostheses
Gap
prostheses
Not listed
Minimum Benefit
Minimum Benefit
No charge*
DVA
Minimum Benefit
Ineligible
Minimum Benefit
Compensable
Minimum Benefit
ADF Personnel
Minimum Benefit
Immigration
Detainees
Minimum Benefit
Minimum Benefit
Maximum
Benefit
Maximum
Benefit
Maximum
Benefit
Maximum
Benefit
No charge*
Full cost
recovery
Full cost
recovery
Full cost
recovery
Full cost
recovery
*prior agreement with Health Insurer or DVA is required otherwise item cannot be
charged.
T34.8.1B
Private Patients
All items on the
Prostheses List
(excluding Cardiothoracic
and Ophthalmic items)
Health Insurer
Rebate
Discount
Details
No Invoice
required
Minimum Benefit
Cardiothoracic items
Minimum Benefit
7.5%
Ophthalmic items
Minimum Benefit
20%
No Invoice
required
No Invoice
required
Page 8
Northern Territory Government Gazette No. S95, 24 September 2015
T34.9.1
Prosthetic Services
Admitted
Non-admitted
Eligible Public*
No Charge
No Charge
Public
Chargeable
Chargeable
Private
Chargeable
Chargeable (except
when required for
discharge)
Chargeable
Chargeable
Ineligible
Chargeable
Chargeable
Compensable
Chargeable
Chargeable
ADF Personnel
Immigration
Detainees
Chargeable
Chargeable
Chargeable
Chargeable
DVA
MACA
Chargeable
Chargeable
* Prosthetic Fees do not apply to admitted or non-admitted public patients that hold a
valid Pensioner Concession Card (PCC) or Health Care Card (HCC) or are paediatric
patient 18 years old and under or who meet NTALS eligibility criteria. Compensable and
ineligible patients will be quoted a price once a prosthetic device is determined.
T34.9.1A
Prosthetic Services – Public Patient Only
Code Prosthetic Description
1A
TR work prosthesis, socket, hook, cable, harness, lock,
silicon liner
1B
TR dress prosthesis (self-suspend), socket, cosmetic
hand, glove, lock, silicon liner
1C
TR dress prosthesis (harness suspend), socket, cosmetic
hand, glove, cable, harness
1D
PH prosthesis, socket, hand, glove
2A
TH work prosthesis, socket, elbow unit, hook, cable,
harness, lock, silicon liner
2B
TH dress prosthesis, socket, elbow unit, cosmetic hand,
glove, cable, harness, lock, silicon liner
2C
TH dress prosthesis, socket, elbow unit, cosmetic hand,
glove, cable, harness
3A
SD, modular socket, shoulder, elbow, cosmetic hand,
glove, cable, harness, soft cover, adaptors
3B
SD prosthesis, standard, socket, shoulder unit, elbow unit,
hook, cable and harness
4A
Ankle Symes, socket, foot, socket adaptor
4B
Partial foot, socket, tibial tubercle height, with toe filler
5A
TT exoskeletal, socket, foot, ankle, shin, pelite liner
Fee
$3,935
$3,985
$2,770
$1,610
$4,915
$5,065
$3,750
$4,400
$7,170
$2,920
$2,570
$3,070
Page 9
Northern Territory Government Gazette No. S95, 24 September 2015
Code
5B
5C
6A
6B
6C
6D
7A
7B
8A
8B
8C
8D
9A
9B
10A
Prosthetic Description
TT endoskeletal, socket, foot, adaptors, soft cover, lock,
silicon liner
TT endoskeletal, socket, foot, adaptors, soft cover, PTB
cuff, PTS
TT, exoskeletal, socket, joints, thigh lacer, ankle, shin,
foot
TT, endoskeletal, socket, joints, thigh lacer, foot, soft
cover, adaptors
TT exoskeletal, socket, joints, ischial bearing thigh
section, shin, ankle, foot
TT endoskeletal, socket, joints, ischial bearing thigh
section, foot, soft cover, adaptors
KD endoskeletal, socket, foot, knee unit, soft cover,
adaptors
KD exoskeletal, socket, external knee joints, ankle, shin,
foot
TF exoskeletal, suction socket, knee unit, shin, ankle,
foot, valve
TF endoskeletal, socket, foot, knee unit, adaptors, soft
cover, lock, silicon liner
TF exoskeletal, socket, knee unit, ankle, shin, foot, waist
band, hip joint,
TF endoskeletal, socket, knee unit, foot, waist band, hip
joint, adaptors, soft cover
HD Canadian type, exoskeletal, socket, hip joint, knee
unit, shin, ankle, foot
HD Canadian type, endoskeletal, socket, hip joint, knee
unit, foot, adaptors, soft cover.
Removable Rigid Dressing
Fee
$4,850
$3,120
$4,510
$4,320
$4,870
$4,680
$6,300
$6,110
$6,700
$7,790
$6,553
$6,900
$8,260
$8,970
$530
Page 10
Northern Territory Government Gazette No. S95, 24 September 2015
T34.9.2
Orthotic Services
Admitted
Non-admitted
Public
No Charge
No Charge
Private
Chargeable
Chargeable (except
when required for
discharge)
Chargeable
Chargeable
Ineligible
Chargeable
Chargeable
Compensable
Chargeable
Chargeable
ADF Personnel
Immigration
Detainees
Chargeable
Chargeable
Chargeable
Chargeable
DVA
MACA
Chargeable
Chargeable
*Orthotic Fees do not apply to admitted or non-admitted public patients that hold a valid
Pensioner Concession Card (PCC) or Health Care Card (HCC) or for are paediatric
patients 18 years old and under.
T34.9.2A
Orthotic Services
Code
Orthotic Description
Fee
HO1
HO2
HO3
HO4
Helmets
Prefabricated Soft Helmet
Prefabricated Hard Helmet
Custom Made Hard Helmet
Paediatric Shaping Helmet
Spinal Orthotics and Supports
SP01
Patriot Collar
$138
SP02
SP03
SP04
SP05
SP06
SP07
SP08
SP09
SP10
SP11
SP12
SP13
SP14
SP15
SP16
One Piece Collar
The Original Philadelphia Collar
Philadelphia Tracheotomy Collar
Philadelphia Stabilizer
Atlas Collar
Miami J Advanced Cervical Collar
Miami J Cervical Collar
Occian Back
Miami Junior Cervical Collar
Papoose
Miami JTO Thoracic Extension
Non-Surgical Halo
Miami Lumbar Belt, LSO
Miami Lumbar TLSO
Elastic Sacro Cinch Brace
$138
$144
$143
$175
$174
$200
$238
$248
$210
$385
$475
$720
$379
$495
$160
$160
$390
$1,550
$1,550
Page 11
Northern Territory Government Gazette No. S95, 24 September 2015
Code
SP17
SP18
SP19
SP20
SP21
AB01
AB02
AB03
HIP01
HIP02
HIP03
T01
T02
T03
K01
K02
K03
K04
K05
K06
K07
K08
K09
K10
KAFO1
KAFO2
KAFO3
KAFO4
AFO1
AFO2
AFO3
AFO4
AFO5
AFO6
AFO7
Orthotic Description
Comfortmax Chair Back Brace
Flat Pack Low Taylor/Chair Back
Hyperextension Brace
CASH Brace
Spinal Orthotics and Supports
Flex Hyperextension Brace
Abdominal Binder
Soft, Elastic Abdominal Binder
Back Cinch Binder
Maternity Support Belt
Hip Orthotics
Custom Made Hip Knee Ankle Foot Orthotic, Plastic and
Metal, Knee and Hip
Custom Made Hip Abduction Brace
Prefabricated Hip Abduction Brace
Trusses
Custom Made Hernia Truss
Prefabricated Hernia Truss Scrotal
Prefabricated Hernia Truss Inguinal
Knee Orthotics
Post-Operative Knee Extension Brace
Knee Sleeve Neoprene
Patella Femoral Brace
Wrap Around Hinged Knee Support
Hinged Knee Support – Pull On
Prefabricated Knee Ligament Bracing
Custom Made Knee Ligament Bracing
Prefabricated Knee Osteoarthritis Bracing
Custom Made Knee Osteoarthritis Bracing
Swedish Knee Cage
Knee Ankle Foot Orthotics
Custom Made KAFO, Spring Loaded Lockable Knee,
Plastic, Metal Uprights
Custom Made KAFO, Free Knee Joints, Metal and
Leather
Custom Made Advanced KAFO
Prefabricated Advanced KAFO
Ankle Foot Orthotics
Grenace Ankle Brace
Grenace All Terrain Ankle Brace
Air Stirrup Ankle Brace
Active Ankle Brace T1 and T2
Positive Lock Night Splint
Paediatric Positive Lock Night Splint
Prefabricated Leaf Spring AFO
Fee
$235
$255
$349
$260
$380
$150
$150
$155
$1,410
$970
$610
$170
$150
$150
$150
$135
$178
$158
$155
$815
$1,200
$905
$1,555
$408
$2,770
$2,770
$3,500
$3,620
$172
$172
$188
$172
$170
$180
$176
Page 12
Northern Territory Government Gazette No. S95, 24 September 2015
Code
AFO8
AFO9
AFO10
AFO11
AFO12
AFO13
AFO14
AFO15
AFO16
AFO17
AFO18
AFO19
AFO20
AFO21
AFO22
AFO23
FO1
FO2
FO3
FO4
FO5
FO6
FO7
FO8
FO9
F10
F11
PO1
PO2
SBU1
SBU2
SBU3
SBU4
CMF
SM01
SM02
Orthotic Description
Fee
Custom Made Leaf Spring AFO
$530
Custom Made Solid Ankle AFO
$530
Custom Made Jointed AFO – Tamarack
$700
Custom Made Jointed AFO – Gillette
$700
Prefabricated Carbon Fibre Dynamic AFO
$545
Prefabricated Carbon AFO Light
$595
Foot Up No Shoe
$210
Foot Up With Shoe
$174
Custom Made GRAFO
$770
Custom Made PTB AFO
$890
Custom Made CROW Boot
$1,010
Custom Made Single/Double Upright AFO with Joint and $580
Ferrule
Total Contact Cast
$170
Ankle Foot Orthotics
Camwalker Standard
$165
Camwalker Short
$162
Bed Rest AFO
$250
Foot Orthotics
Insoles PPT/Pelite 3mm
$110
Insoles PPT/Pelite 6mm
$110
Heel Pads/Wedge PPT/Pelite
$110
Hallux Valgus Night Splint
$148
Hallux Valgus Day Splint
$127
Custom Made Medial Arch Supports/Metatarsal $410
Dome/Semi Rigid (pair)
Custom Made Medial Arch Supports/Metatarsal $530
Dome/Rigid (pair)
Custom Made Arch Supports with Heel Cup (Plastic) $410
(pair)
Custom Made UCBL (pair)
$410
Silicon Toe Spacer
$122
Foam Toe Spacer
$122
Post-Operative Boots
OTS Post-Operative Boots
$132
Triple Post-Operative Boots
$145
*Shoe Modifications
Shoe Build Up < 20mm
$170
Shoe Build Up > 20mm
$230
Shoe Build Up > 40mm
$290
Shoe Build Up > 60mm
$350
Custom Made Footwear
$1,000
Shoe Stiffener Plastic
$110
Shoe Stiffener Steel/Carbon Fibre
$170
Page 13
Northern Territory Government Gazette No. S95, 24 September 2015
Code
MIS01
Orthotic Description
*Shoe Modifications
Custom Made Rocker Sole
Custom Made Shoe Wedges
Metatarsal Bar
T Strap Fitted To Shoe
Round Ferrule Fitted To Shoe
Square Ferrule Fitted To Shoe
Paediatric
Parlick Harness G hips
Dennis Brown CDH Cuff and Bar
Wrist and Hand Orthotics
Pre-fabricated Neoprene Wrist Brace
Pre-fabricated Neoprene Wrist Brace with Extra
Supports
Pre-fabricated Palmer Wrist Brace
Pre-fabricated Resting Hand Splint
Pre-fabricated Wrist Brace with Thumb Abduction
Pre-fabricated Ulnar Deviation Brace
Custom Made Wrist Brace
Custom Made Finger Brace
Pre-fabricated Finger Brace
Elbow Orthotics
Pre-fabricated Elbow Range of Motion Brace
Shoulder Orthotics
Pre-fabricated Shoulder Abduction Sling
Pre-fabricated Shoulder Sling
Pre-fabricated AC Sling
Miscellaneous
Mobility Aid
MIS02
Special Order Aid/Appliance
SM03
SM04
SM05
SM06
SM07
SM08
P01
P02
W01
W02
W03
W04
W05
W06
W07
W08
W09
E01
SH01
SH02
SH03
Fee
$170
$170
$110
$170
$170
$170
$190
$200
$150
$155
$160
$168
$155
$150
$290
$170
$145
$290
$170
$150
$165
To
quote
as
needed
To
quote
as
needed
Page 14
Northern Territory Government Gazette No. S95, 24 September 2015
T34.10.1A
Aeromedical Transport
(Careflight, Royal Flying
Doctor Service)
Medical Evacuation (Doctor &
Nurse)
Medical Evacuation (Nurse)
Repatriation and Follow up
Visits
Repatriation and Follow up
Visits (Nurse)
T34.10.1B
Commercial Transport
Aeroplane, Bus etc.
Fee
$26.86 per aero
nautical mile
$26.86 per aero
nautical mile
$26.86 per aero
nautical mile
$26.86 per aero
nautical mile
Date effective
1 Oct 2015
1 Oct 2015
1 Oct 2015
1 Oct 2015
Fee
Date effective
Full Cost Recovery*
27 November 2013
* Full cost recovery – as per provider’s invoice
T34.11.2A
Patient Request
Search Fee
Copy of Medical Records
per search
Fee (GST
exempt)
$35.00
per page
$0.23
Calculated
Copy of Discharge Summary
Replacement Medical Certificate
Medical/Allied Health Report
(max 2 pages)
Medical Report
(additional pages)
Medical images to CD
Free
per certificate
$35.00
per report
$290.00
per page
$145.00
1 Study
2 Studies
More than 2 studies
$12.00
$18.00
$28.00
Page 15
Northern Territory Government Gazette No. S95, 24 September 2015
T34.11.2B
Third Party Request
Search Fee
Copies of Medical Records
Medical/ Allied Health Report
(max 2 pages)
Medical Report
(additional pages)
Medical images to CD
per search
Fee (GST
inclusive)
$38.50
per page
$0.89
per report
$319.00
per page
$159.50
1 Study
2 Studies
More than 2 studies
$19.80
$25.67
$37.22
Calculated
Page 16