- There is no change for diagnostic imaging practices located in Remoteness Area (RA) major cities (ie. metropolitan areas) which provide CT services.
- There is no change for diagnostic imaging practices located in RA outer regional, remote and very remote areas which provide CT services; automatic exemptions for these practices remain in place.
- The changes will affect a small number of diagnostic imaging practices providing CT services in RA inner regional areas. Practices that are concerned about the new arrangements should contact the Department of Health at Capital Sensitivity team to discuss how the changes may affect them.
What is the location based exemption?
Under the Capital Sensitivity measure, if equipment that has not been upgraded is older than the applicable effective life age, or if equipment that has been upgraded is older than the maximum extended life age, practices may be eligible for an exemption depending on the practice location.
Previously, for computed tomography (CT) services (MBS items 56001-57361), the service was eligible for schedule K items if it was provided more than 30 kilometres by road from a hospital or free standing facility providing services under the direction of a diagnostic radiologist. There were previously no exemptions for the relevant angiography services (MBS items 59903-59974).
From 27 November 2013, the exemptions that apply to CT and relevant angiography items have been amended so that they are consistent with other diagnostic imaging modalities (excluding PET services) in the Health Insurance (Diagnostic Imaging Services Table) Regulation 2013.
These exemptions include automatic exemptions for practices located in Australian Standard Geographical Classification (ASGC) Remoteness Area (RA) outer regional, remote and very remote areas, and exemptions granted by the Department to practices located in RA inner regional areas, where the location was previously classified under the Rural, Remote and Metropolitan Area (RRMA) classification system as RRMA4 or RRMA5.
There are no exemptions for practices located in RA major cities.
1) Automatic ExemptionsThis exemption will automatically apply to practices located in RA outer regional, remote and very remote areas. Practices in these remoteness areas are exempt from the capital sensitivity arrangements and do not need to apply to the Department for a remote area exemption.
Practices can identify what ASGC RA they fall under at the Department of Health’s DoctorConnect website.
2) Exemptions granted by the DepartmentTo grant an exemption for inner regional locations, the Department must be satisfied that the practice is located in a RA inner regional area, where the location was previously known by the Rural, Remote and Metropolitan Area (RRMA) classification system, RRMA4 or RRMA5, and:
- the diagnostic imaging equipment does not exceed the maximum extended life age by three years or more;
- the equipment is operated on a rare and sporadic basis; and
- the equipment provides crucial patient access to diagnostic imaging services.
- Inner Regional Australia Exemption Application Form (PDF 352 KB)
- Inner Regional Australia Exemption Application Form (Word 484 KB)
Practices will be notified by the Department upon receipt of a valid application. A completed form provided by a practice that does not meet the circumstances to be eligible for an exemption is not a valid application. From the time you receive your notice from the Department of Health that your application is valid and under consideration, you may claim the (K) items until you receive notice about the final outcome of your application. The Department of Health will notify you of its final decision within 28 days.
If there are any practices that are currently exempt for CT services under the ‘30km rule’, but will no longer be exempt because are they not in RA outer regional, remote, very remote areas, inner regional areas (RRMA4 or RRMA5), you should contact the Department of Health to discuss how the changes may affect you.