Australian Capital Territory
Health (Fees) Determination 2006 (No 1)
Disallowable Instrument DI2006-145
made under the
Health Act 1993, s 36 (Determination of Fees)

1.	Name of Instrument

This instrument is the Health (Fees) Determination 2006 (No 1).

2.	Revocation

	This instrument revokes DI2005-298 effective from 1 July 2006.

3.	Commencement

	This instrument commences on 1 July 2006.

4.	Determination of fees

	I make the following determinations:

(1).  Definitions

In this Determination, unless the contrary intention appears:

A right to recover from any person, by way of compensation or damages does not include a right to recover compensation pursuant to the Criminal Injuries Compensation Act 1983;

Act means Health Act 1993;

After Hours means the hours outside of ‘Business Hours’;

Australian resident means a person who is ordinarily resident in Australia and includes a person domiciled in Australia but does not include a person who is:

(a)	the head of a diplomatic mission, or the head of a consular post, established in Australia;

(b)	a member of the staff of a diplomatic mission, or a member of the consulate, established in Australia;

(c)	a member of the family of a person referred to in paragraph (a) or (b), being a member who forms part of the household of that person; or

(d)	employed on a full-time basis to perform domestic or other private services for a person referred to in paragraphs (a), (b) or (c);

being a person who is not an Australian citizen or is not a person domiciled in Australia;

Business Hours means the hours between 8:00am and 5:00pm Monday to Friday, excluding public holidays;

Cognitive behavioural therapy program means a service of The Canberra Hospital’s Pain Management Unit for the purpose of educating a patient to self-manage pain;

Community health centre means a community health centre conducted by ACT Health;

Compensable patient means in relation to a hospital, an inpatient of the hospital who in the opinion of the General Manager of The Canberra Hospital, has, or may have, a right to recover from any other person, by way of compensation for damages, the cost of the service;

Concessional means a person who is the:

(a)	holder of a Pensioner Concession Card or a dependent of
	the holder of a Pensioner Concession Card; or

(b)	holder of a Health Care Card or a dependent of the holder of Health Care Card; or

(c)	holder of a Commonwealth Seniors Health Card; or

(d)	holder of a Repatriation Health Card for All Conditions; or

(e)	holder of a Repatriation Health Card for Specific Conditions;

Coping and lifeskills program  means a service of The Canberra Hospital’s Pain Management Unit for the psychological management of comorbid depression and anxiety;

Day care patient means a person other than:

(a) 	a compensable patient; or

(b)	a non-eligible person, 

who attends hospital for a period that does not include a part of an overnight stay for the purpose of permitting the provision of professional attention to the person;

Exercise program means a service of The Canberra Hospital’s Pain Management Unit to increase mobility and wellbeing;

General means a person who is not concessional;

GST means tax that is payable under the GST law and imposed as goods and services tax by any of these:

(a) 	the A New Tax System (Goods and Services Tax Imposition – General) Act 1999; or

(b) 	the A New Tax System (Goods and Services Tax Imposition – Customs) Act 1999; or

(c) 	the A New Tax System (Goods and Services Tax Imposition – Excise) Act 1999;

Hostel means a hostel conducted by ACT Health;

Hospital means the premises known as The Canberra Hospital;

Hospital patient in relation to a hospital, means an inpatient of the hospital other than a private patient;

Inpatient means a person who is formally admitted to hospital and then after a period of time discharged;

Medical practitioner means a person registered as a medical practitioner under the Health Professionals Act 2004;

Medicare Benefits Schedule Book means the table of medical services prescribed for the purposes of subsection 4(1) of the Health Insurance Act 1973 (Cwlth);

Multidisciplinary assessment means a service of The Canberra Hospital’s Pain Management Unit made up of individual multidisciplinary consultations (physiotherapy, occupational therapy, psychology, nursing, medical assessment) case-conference, patient feedback, documentation and advice;

Multiple-bed room means a room in which 2 or more beds are situated;

Non-eligible person means:

(a)	a person who is not an Australian resident; or

(b)	a person in respect of whom, or a person included in a class of persons in respect of which, there is in force an order under subsection 6(2) of the Health Insurance Act 1973 (Cwlth);

Non-inpatient with respect to a hospital, means a patient other than an inpatient of the hospital who receives any examination(s), consultation(s) or other service(s) from an individual functional unit of a health services facility;

Nursing-home type patient means a nursing-home type patient for the purposes of the Health Insurance Act 1973 (Cwlth) but does not include a compensable patient or a non-eligible person;

Occupational therapy service means an occupational therapy service provided to:

(a)	a compensable non-inpatient; or

(b)	a non-eligible person,

at a community health centre conducted by ACT Health or at a hospital;

Outpatient service means any examination, consultation, treatment or other service provided to:

(a)	a non-inpatient; or

(b)	a non-eligible person;

Pathology service means a professional service in respect of which:

(a)	a fee is specified in an item in Pathology Services Category 6 of the Medicare Benefits Schedule Book; or
 
(b)	 a fee is determined by ACT Pathology for testing not specified in the Medicare Benefits Schedule Book;

Person domiciled in Australia means a person whose domicile is in Australia, other than a person in respect of whom the Minister for Health is satisfied that the person's permanent place of abode is outside Australia;

Physiotherapy service means any treatment or other service provided to:

(a)	a compensable non-inpatient; or

(b)	a non-eligible person,

at a community health centre conducted by ACT Health or at a hospital and which falls within the definition of physiotherapy in the Physiotherapists Act 1977;

Private patient, in relation to a hospital, means an inpatient of the hospital who:

(a)	has made an election to be treated as a private patient, and who has not revoked that election; or

(b)	is accommodated in a single room in the hospital at a patient's own request;

Professional service means a professional service within the meaning of the Health Insurance Act 1973 (Cwlth);

Psychology assessment means a service of The Canberra Hospital’s Pain Management Unit for a psychological appraisal of patients suffering chronic pain;

Single room means a room in which one bed is situated;

Standard patient, in relation to a hospital, means an inpatient of the hospital, other than:

(a)	a day care patient; or

(b)	a nursing-home type patient.

(2)  Request by a Patient

For the purposes of this Determination, a request by a patient shall, in relation to a patient who has not attained the age of 18 years, be read as including a request by a parent or guardian of the patient.

(3)  Period of accommodation

For the purpose of services listed at A, B, C, D and E and of the schedule to this Determination, the day on which a person commences to be accommodated in a hospital or a hostel as a patient and the day on which that person ceases to be so accommodated shall be counted together as one day.

(4)  Absences from a Hostel

(a)	For the purposes of the service listed at item D of the Schedule to this Determination, where a person who has been admitted to a hostel is absent from the hostel for a period not exceeding 3 days, the fee payable pursuant to the service listed at D shall apply as if the person had been accommodated in the hostel during the whole of the period.

(b)	For the purposes of sub-clause (5)(a) of this Determination, the day on which the absence of a person from a hostel begins and the day on which the person returns to the hostel shall be counted together as one day.

(5)  Schedule of Fees

The fee for the purposes of the service listed in Column 1 of the Schedule to this Determination shall be the amount listed in Column 2 of the Schedule where GST is not payable or Column 3 where GST is payable.  

Fee are payable to the provider, by the individual or organisation in receipt of the goods and/or services listed in the schedule. 

Katy Gallagher MLA
Minister for Health

Date 29 June 2006

A. Hospital Accommodation Fees – Standard Patients
1. If the patient is a private patient other than a compensable patient or a non-eligible  person, and is:				
(a) in a multiple-bed room;	per day	$269.00	n/a	
(b) in a single room, otherwise than at the patient’s request;	
per day	
$269.00	
n/a	
(c) in a single room at the patient’s request; or	
per day	
$466.00	
n/a	
(d) Hospital in the Home.	per day 	$162.00	n/a	
				
2. If the patient is a compensable patient or a non-eligible person, and is:				
(a) Critical Care;				
     (i) Intensive Care Unit;	per day	$3,822.00	n/a	
     (ii) Neonatal Intensive Care Unit; or	per day	$2,098.00	n/a	
     (iii)Coronary Care Unit.	per day	$1,101.00	n/a	
(b) Inpatient (other than critical care);	per day	$796.00	n/a	
(c) Hospital in the Home; or	per day 	$295.00	n/a	
(d) Operating room charges:				
i) If the treatment involves undergoing procedures that take longer than 1 hour carried out under general or regional anaesthetic or intravenous sedation and the patient is not a day only patient; or	

per treatment	

$2,000.00	

n/a	
ii) Other procedures (including day only surgical patients).	per treatment	
$700.00	
n/a	

B. Hospital Accommodation Fees – Day Care Patients
If the patient is a private patient and is provided with:				
				
(a) Type-B professional attention as determined under paragraph 4B(a) of the Commonwealth National Health Act 1953;	

per day	

$195.00	

n/a	
				
(b) procedures (other than those set out in paragraph 1) carried out under local anaesthetic, no sedation.  Theatre time (actual time in theatre) less than one hour;	

per day	

$219.00	

n/a	
				
(c) procedures (other than those set out in paragraph 1) carried out under general or regional anaesthetic or intravenous sedation.  Theatre time (actual time in theatre) less than one hour; or	

per day	

$240.00	

n/a	
				
(d) procedures (other than those set out in paragraph 1) carried out under general or regional anaesthetic or intravenous sedation.  Theatre time (actual time in theatre) one hour or more.	

per day	

$269.00	

n/a	

C. Hospital Accommodation Fees – Nursing Home Type Patients
				
1.  Hospital patient	per day	$36.40	n/a	
2.  Private patient	per day	$122.30	n/a	

D. Hostel Fees
1. Hostel Accommodation Fee	per day	$27.75	n/a	
				
2. Group House – Maintenance Fee	per fortnight	
$10.00	
n/a	

E. Other Accommodation
1. On wards				
(a) Ronald McDonald Family Room.	per day	$9.55	$10.50	
				
2. In residences - Patients				
(a) Room Only (Single); or	per day	$33.00 	n/a	
(b) Room Only (Double).	per day	$46.00 	n/a	
				
3. In residences – Non Patients				
(a) Room Only (Single); or	per day	$30.00	$33.00 	
(b) Room Only (Double).	per day	$41.82	$46.00 	
Note: GST is reduced to 5.5% after 28 consecutive days of stay.

F. Incidental Outpatient Charges
1. Dressings	per item	cost of material 
plus 10%	n/a	
2. Waterproof Lining for Plaster Casts	per item	cost of material 
plus 10%	n/a	
3. Diabetic Pneumatic Boot	per item	cost of material 
plus 10%	n/a	
Note: Cost of material is reviewed and set every 6 months to avoid regular fluctuation of prices.

G. Pathology Service Fees
1. Non-Medicare Testing:				
(a) BCL-2 Translocation;	per test	$104.00 	n/a	
(b) Cystic Fibrosis - Delta F508 mutation;	1 mutation	$88.00 	n/a	
(c) Cystic Fibrosis - 36 mutation screen;	36 mutations	
$207.00 	
n/a	
(d) DNA Extraction and Storage;	per test	$70.00 	n/a	
(e) IgH & TCR gamma Gene rearrangements;	
per test	
$207.00 	
n/a	
(f) ThinPrep Pap Test;	per test	$24.90	n/a	
(g) Spore Testing;	per ampoule	
$8.00	
$8.80	
(h) FiSH - Haematology Oncology;	per test	$250.00	n/a	
(i) Prenatal - Interphase FiSH;	per test	$250.00	n/a	
(j) Constitutional/Microdeletions;	per test	$250.00	n/a	
(k) Collection and transport of specimens for Paternity Testing; or	
per test	
$30.00	
$33.00	
(l) Histology testing on coronial post mortems.	per post mortem	
$284.00	
$312.40	

2. Where the Pathology Service provided involves Inpatient Services:				
(a) a non-eligible person;		100% of Medicare Benefits Schedule Fee	
n/a	
(b) a compensable patient; or		125% of Medicare Benefits Schedule Fee	
n/a	
(c) a private patient.		100% of Medicare Benefits Schedule Fee	
n/a	
				
3. Where the Pathology Service provided involves Outpatient Services:				
(a) a non-eligible person;		100% of Medicare Benefits Schedule Fee	
n/a	
(c) a compensable patient; or		125% of Medicare Benefits Schedule Fee	
n/a	
(a) other outpatients.		85% of Medicare Benefits Schedule Fee	
n/a	

H. Non-eligible or Compensable Outpatient Service Fee
Compensable non-inpatients and non-eligible persons:				
				
1. First visit	per visit	$152.00 	n/a	
2. Second and subsequent visits	per visit	$100.00	n/a	
3. Emergency Department Presentation	per visit	$357.00	n/a	

I. Pharmaceutical Co-payment
Collection of a co-payment for medications or pharmaceutical’s dispensed from hospital for:
1.  General non-inpatient	per item	$23.60	n/a	
2.  Concessional non-inpatient	per item	$4.70	n/a	

Thresholds:
1.	General non-inpatient – Once a patient reaches $960.10 worth of prescriptions dispensed from hospital in a calendar year, all further prescriptions will be charged at the concessional rate.
2.	Concessional non-inpatient - Once a patient reaches $253.80 worth of prescriptions dispensed from hospital in a calendar year, all further prescriptions will be supplied at no charge.

J. Capital Region Cancer Service Fees
1. Copies of mammograms	per set	$31.10	n/a	

K. Staff Vaccinations for Private Purposes
All vaccinations attract a $10.70 service fee plus the following vaccine cost - 
(a) ADT;	per vaccine	$5.00 	n/a	
(b) Flu;	per vaccine	$10.00 	n/a	
(c) Hepatitis A;	per vaccine	$31.00 	n/a	
(d) Hepatitis B;	per vaccine	$12.00 	n/a	
(e) Hepatitis A & B;	per vaccine	$42.00 	n/a	
(f) MMR;	per vaccine	nil	n/a	
(g) Meningococcal C;	per vaccine	$55.00 	n/a	
(h) Meningococcal A, C, W, Y;	per vaccine	$25.00 	n/a	
(i) Rabies;	per vaccine	$72.00 	n/a	
(j) Pertussis (Whooping Cough);	per vaccine	$25.00 	n/a	
(k) Typhoid; or	per vaccine	$26.00 	n/a	
(l) Varicella (Chicken Pox).	per vaccine	$45.00 	n/a	

L. Facilities Hire
1. The Canberra Hospital				
(a) Use of theatrette (after hours); or	per hour	$138.00	$151.80	
(b) Use of Seminar Room (after hours, non-health related).	per 4 hour block (min) or part thereof	

$124.00	

$136.40	
2. Community Health - Conference, Meeting and Group Rooms				
(a) Commercial Use				
     (i) Non-Health Related; or	per hour	$26.50 	$29.15 	
     (ii) Sessional Health Related.	per hour	$18.50 	$20.35 	
(b) Community Use				
     (i) Non-Health Related; or	per hour	$18.50 	$20.35 	
     (ii) Health Related.	per hour	$14.50 	$15.95 	
(c) Moore St Building - Theatrette	per hour	$79.50	$87.45	
				
3. Health Protection Service - Conference / Meeting EOC room				
(a) Commercial Use				
     (i) Non-Health Related; or	per hour	$26.50 	$29.15 	
     (ii) Sessional Health Related.	per hour	$18.50 	$20.35 	
(b) Community Use				
     (i) Non-Health Related; or	per hour	$18.50 	$20.35 	
     (ii) Health Related.	per hour	$14.50 	$15.95 	
M. Medical Records and Health Reports
1. Medical Practitioner/Health Professional Reports:			
(a) Preparation of a report by a treating medical practitioner/health professional appointed to or employed by ACT Health requiring no further examination of the patient;	

$184.00	

n/a	
			
(b) Preparation of a report by a medical practitioner/health professional appointed to or employed by ACT Health who has not previously treated the patient and no further examination of the patient is required;	

$214.00	

n/a	
			
(c) A report made by a treating medical practitioner/health professional appointed to or employed by ACT Health where a re-examination is required; or	

$244.00	

n/a	
			
(d) A report made by a treating medical practitioner/health professional appointed to or employed by ACT Health who has not previously treated the patient and where an examination is required.	

$305.00	

n/a	
2. Search Fees
Other than requests made by a party concerned with a patient's continued treatment or future management.

A search fee is to be charged where:

(a)	the applicant subsequently advises that a report/record is no longer required;
(b)	where a thorough search has ascertained that the patient has never attended the hospital for that episode of illness;
(c)	for Motor Accident and Comcare medical certificates completed other than at the time of consultation; or
(d)	requests for information on date and/or time of birth.	

$36.80	

n/a	
			
3. Health records provided to patient's solicitor 1&2

(a) Upon receipt of written consent from the patient for the solicitor to have copies of all or part of the health records - Provision of a copy of the health record or part thereof, e.g. Clinical notes, continuation notes, pathology materials (blockers and slides), pathology reports and charts.	

$135.00	

n/a	
			
4. Health records provided to insurer 1

(a) Upon written consent from the patient allowing the insurer to have copies of all or part of their Health records - Provision of a copy of the health record, or part thereof, e.g. Clinical notes, continuation notes, pathology reports and charts.	

$135.00	

n/a	
Notes:
1.	Where copies are provided these will be in grey scale unless required by the courts in colour (if available).
2.	For health records provided to a patient – see the Health Records (Privacy & Access) Act 1997.

N. Prostheses
1. Non-eligible (without insurance), self-insured and Compensable patients	
per item	
At Cost	
n/a	
				
2. Private patients	per item	For items with a minimum benefit only, the fee charged will be the minimum benefit amount in accordance with the Commonwealth Prostheses Schedule.	n/a	
		For items with a maximum and minimum benefit, the maximum charge for these prostheses is the maximum benefit level in accordance with the Commonwealth Prostheses Schedule. Reimbursement from health funds above the minimum benefit is at the discretion of health funds.	n/a	
Note: Commonwealth Prostheses Schedule of fees is derived from the Commonwealth National Health Act 1953 Determination made under subsections 73AAG sections (6) & (7).

O. Dental Services
Group 0 - Examination/Diagnostic			
		Comprehensive Oral Exam;	$7.00 	n/a	
		Periodic Exam;	$5.50 	n/a	
		Emergency Restorative Course of Care;	$30.00 	n/a	
		Emergency Prosthodontic Course of Care;	$30.00 	n/a	
		Consult (incl. Exam);	$8.00 	n/a	
		Consult Ext + 30 (incl. Exam);	$13.00 	n/a	
		Consult by Ref (incl. Exam);	nil	n/a	
		Consult  by Ref Ext +30 (incl. Exam);	nil	n/a	
		Letter of Referral;	nil	n/a	
		X-Ray -1 film PA or BW;	$5.50 	n/a	
		Intraoral radiograph - occlusal, maxillary or mandibular - single film;	$7.50 	
n/a	
		Extraoral radiograph - maxillary and/or mandibular - single film;	$8.50 	
n/a	
		Caries activity screening test;	$5.00 	n/a	
		Biopsy of Tissue;	$15.50 	n/a	
		Pulp Test Per visit;	nil	n/a	
		Diagnostic cast; or	$7.50 	n/a	
		Photographic records – intraoral.	$5.50 	n/a	
			
Group 1 - Preventative Services			
		Removal of Plaque and / or stain;	$7.00 	n/a	
		Recontouring - pre existing restoration/s;	$2.50 	n/a	
		Calculus (supra & subging) & Plaque Removal 1st visit;	$9.50 	n/a	
		Calculus (supra & subging) & Plaque Removal Addit. Visit;	$7.00 	n/a	
		Enamel micro- abrasion - per tooth;	$6.00 	n/a	
		Bleaching, internal - per tooth;	$34.00 	n/a	
		Bleaching, external - per tooth;	$30.00 	n/a	
		Fluoride - Topical (including tooth mousse);	$4.50 	n/a	
		Concentrated fluoride, application single tooth;	$3.50 	n/a	
		Dietary advice. Analysis and advice;	$4.50 	n/a	
		Oral Hygiene Instr.  (If more than 10 mins.);	$6.00 	n/a	
		Fissure Sealant - per tooth;	$6.50 	n/a	
		Apply Desensitising Agent; or	$3.50 	n/a	
		Odontoplasty - per tooth.	$6.50 	n/a	
			
Group 2 - Periodontics			
		Treatment of acute Periodontal Infection;	$8.50 	n/a	
		Root Planing & Curettage (per 8 teeth or less);	$17.00 	n/a	
		Non-surgical periodontal treatment not otherwise specified - per visit;	
$13.00 	
n/a	
		Gingivectomy (per 8 teeth or less);	$24.50 	n/a	
		Periodontal flap surgery  (per 8 teeth or less);	$43.50 	n/a	
		Osseous surgery (per 8 teeth or less);	$52.00 	n/a	
		Root resection - per root; or	$28.00 	n/a	
		Periodontal surgery involving one tooth or an implant.	$10.00 	n/a	
			
Group 3 - Oral Surgery			
		Removal of tooth or parts;	$15.50 	n/a	
		Sectional removal of tooth.  Bone removal maybe necessary;	$20.50 	n/a	
		Surgical removal of tooth or tooth fragment not including bone;	
$26.50 	
n/a	
		Surgical removal of tooth or tooth fragment including bone;	$32.50 	n/a	
		Surgical removal of tooth or tooth fragment requiring both bone and tooth division;	
$40.50 	
n/a	
		Alveolectomy per segment;	$16.50 	n/a	
		Ostectomy;	$66.50 	n/a	
		Reduction of fibrous tuberosity;	$23.00 	n/a	
		Reduction of flabby ridge - per segment;	$13.00 	n/a	
		Removal of fibrous hyperplasia;	$33.00 	n/a	
		Removal of tumour, cyst or scar;	$25.50 	n/a	
		Removal of tumour, cyst or scar involving muscle, bone or deep tissue;	
$89.50 	
n/a	
		Surgery to salivary duct;	$79.00 	n/a	
		Surgery to salivary gland;	$27.00 	n/a	
		Removal or repair of soft tissue  (not elsewhere defined);	$25.00 	n/a	
		Surgical removal of foreign body;	$14.00 	n/a	
		Marsupialization of cyst;	$46.50 	n/a	
		Surgical exposure to unerupted tooth;	$104.50 	n/a	
		Reposition tooth / Splint;	$23.50 	n/a	
		Replantation of /& Splinting of tooth;	$47.50 	n/a	
		Frenectomy;	$22.00 	n/a	
		Drainage of abscess or cyst;	$12.00 	n/a	
		Surgery involving the maxially antrum; or	$104.50 	n/a	
		Control of reactionary or secondary post operative haemorrhage.	
$7.50 	
n/a	
			
Group 4 - Endodontics			
		Direct pulp capping;	$4.50 	n/a	
		Pulpotomy;	$9.50 	n/a	
		Complete Endodontic treatment, incisor or canine tooth (415 & 417);	
$56.00 	
n/a	
		Complete Endodontic treatment, premolar tooth (415,417,416,& 418);	
$81.00 	
n/a	
		Complete Endodontic treatment, molar tooth(415,417[2x416 & 2x418]);	
$106.00 	
n/a	
		Extirpation of pulp and debridement of root canal(s) – emerg;	$17.00 	n/a	
		Resorbable root canal filling - primary tooth;	$34.50 	n/a	
		Periapical curettage - per root;	$34.50 	n/a	
		Apicectomy- per root;	$36.00 	n/a	
		Apical seal - per canal;	$15.50 	n/a	
		Sealing of perforation;	$42.50 	n/a	
		Surgical treatment or repair of external root resorption;	$56.00 	n/a	
		Exploration and/or negotiation of calcified canal -per canal, per visit;	
nil	
n/a	
		Removal of root filling, per canal;	$13.00 	n/a	
		Removal of cemented root canal post or post crown;	$13.00 	n/a	
		Removing or bypassing fractured endodontic instrument;	$11.00 	n/a	
		Additional visit for irrigation and/or dressing of the root canal system - per tooth; or	
$13.00 	
n/a	
		Interim therapeutic root filling - per tooth.	$17.50 	n/a	

Group 5 - Restorative Services			
		Metallic restoration  - 1 surface – direct;	$13.00 	n/a	
		Metallic restoration  - 2 surface – direct;	$16.00 	n/a	
		Metallic restoration  - 3 surface – direct;	$19.50 	n/a	
		Metallic restoration  - 4 surface – direct;	$23.00 	n/a	
		Metallic restoration - 5 surface – direct;	$26.50 	n/a	
		Adhesive restoration  - 1 surface - Anterior tooth – direct;	$15.00 	n/a	
		Adhesive restoration  - 2 surface - Anterior tooth – direct;	$18.00 	n/a	
		Adhesive restoration  - 3 surface - Anterior tooth – direct;	$21.00 	n/a	
		Adhesive restoration  - 4 surface - Anterior tooth – direct;	$24.50 	n/a	
		Adhesive restoration - 5 surface - Anterior tooth – direct;	$28.50 	n/a	
		Adhesive restoration - 1 surface  Posterior tooth – direct;	$16.00 	n/a	
		Adhesive restoration - 2 surface  Posterior tooth – direct;	$20.50 	n/a	
		Adhesive restoration - 3 surface  Posterior tooth – direct;	$25.00 	n/a	
		Adhesive restoration - 4 surface  Posterior tooth – direct;	$29.00 	n/a	
		Adhesive restoration - 5 surface  Posterior tooth – direct;	$32.50 	n/a	
		Provisional (Intermediate / temporary) restoration;	$6.00 	n/a	
		Provisional (Intermediate / temporary) restoration Endo;	nil	n/a	
		Metal band;	$5.00 	n/a	
		Pin restoration -per pin;	$4.00 	n/a	
		Stainless Steel Crown;	$36.50 	n/a	
		Cusp capping - per cusp;	$4.00 	n/a	
		Restoration of an incisal corner - per corner;	$4.00 	n/a	
		Removal of inlay/onlay;	$12.00 	n/a	
		Recementing onlay/inlay; or	$10.00 	n/a	
		Post – direct.	$18.50 	n/a	
			
Group 6 - Crown and Bridge			
		Provisional Crown;	$19.00 	n/a	
		Recrement Crown or veneer;	$11.00 	n/a	
		Recrement bridge or splint;	$12.50 	n/a	
		Removal of crown; or	$7.50 	n/a	
		Removal of bridge or splint.	$23.00 	n/a	

Group 7 - Prosthodontics			
		Full Maxillary denture;	$96.00 	n/a	
		Full Mandibular denture;	$96.00 	n/a	
		Metal plate or mesh;	$184.00 	n/a	
		Full Maxillary & Full Mandibular dentures;	$172.00 	n/a	
		Partial Max Denture - resin base;	$78.00 	n/a	
		Partial Mand Denture - resin base;	$78.00 	n/a	
		Partial Max Denture - cast CO/CR base;	$273.00 	n/a	
		Partial Mand Denture - cast CO/CR base;	$273.00 	n/a	
		Retainer - per tooth;	nil	n/a	
		Occlusal rest - per rest;	nil	n/a	
		Tooth/ Teeth ( partial denture);	nil	n/a	
		Overlays - per tooth;	nil	n/a	
		Immediate tooth replacement - per tooth;	nil	n/a	
		Resilient Lining in addition to new denture;	$20.00 	n/a	
		Wrought Bar;	$22.00 	n/a	
		Metal Backing - per backing;	$20.00 	n/a	
		Denture Adjustment (not new);	$30.00 	n/a	
		Denture Adjustment ( new);	nil	n/a	
		Reline -Complete denture;	$39.00 	n/a	
		Reline -Part denture;	$30.00 	n/a	
		Remodel - complete denture;	$71.00 	n/a	
		Remodel - Partial denture;	$56.00 	n/a	
		Clean and polish of pre-existing denture;	$30.00 	n/a	
		Denture base modification;	$35.50 	n/a	
		Reattaching pre-existing tooth or clasp to denture;	nil	n/a	
		Replacing/added clasp to denture;	nil	n/a	
		Repairing broken base of complete denture;	nil	n/a	
		Repairing broken base of partial denture;	nil	n/a	
		Added tooth to partial denture to replace an extraction or decoronated tooth;	
nil	
n/a	
		Repair to metal casting: one point;	$90.00 	n/a	
		Tissue conditioning preparatory to impressions  - per application;	
$7.00 	
n/a	
		Impression  for denture repair; or	nil	n/a	
		Identification.	$4.50 	n/a	
		
Group 7 - Provision for New Dentures  (No ADA Item Numbers)		
		1st Impression (New Denture) Per Impression;	nil	n/a	
		2nd Impression (New Denture) Per Impression;	nil	n/a	
		Bite (New Denture);	nil	n/a	
		Try In (New Denture); or	nil	n/a	
		Re Try (New Denture).	nil	n/a	

			
Group 8 - Orthodontics (When Used for an Adult)			
		Passive removable appliance - one arch;	nil	n/a	
		Active removable appliance - one arch;	nil	n/a	
		Functional orthopaedic appliance;	nil	n/a	
		Passive fixed appliance;	nil	n/a	
		Extra-oral appliance ;	nil	n/a	
		Orthodontic adjustment;	nil	n/a	
		Repair removable appliance;	nil	n/a	
		Repair removable appliance - clasp, spring or tooth;	nil	n/a	
		additional to removable appliance; or	nil	n/a	
		Relining removable appliance.	nil	n/a	
			
Group 9 - General Services			
		Palliative care;	$6.00 	n/a	
		After hours emergency;	nil	n/a	
		Travel to provide service;	$8.50 	n/a	
		Provision of medication/ medicaments;	$3.50 	n/a	
		Local anaesthesia (diagnosis or pain relief);	$2.50 	n/a	
		Treatment under G.A.;	$264.00 	n/a	
		Minor Occlusal adjustment;	$6.50 	n/a	
		Occlusal splint;	$65.00 	n/a	
		Adjust occlusal splint;	$9.50 	n/a	
		Repair/addition - occlusal splint;	$37.50 	n/a	
		Splinting and stabilization - direct - per tooth;	$12.00 	n/a	
		Post-operative care not elsewhere included; or	$8.50 	n/a	
		Treatment not otherwise included.	$6.00 	n/a	
		
Group A - Restorative Referral Scheme  (No ADA Item Numbers)		
		Complete Endodontic treatment, incisor or canine tooth (415 & 417);	
$68.50 	
n/a	
		Complete Endodontic treatment, premolar tooth (415,417,416,& 418); or	
$81.00 	
n/a	
		Complete Endodontic treatment, molar tooth(415,417[2x416 & 2x418]).	
$106.00 	
n/a	

			
Group B - Child & Youth Dental			
		Assessment or Screening Examination Visit;	nil	n/a	
		Standard fee per course of care; or	$45.00	n/a	
		Free for families meeting eligibility criteria. 	nil	n/a	
			
Group C - Child and Youth Extra Fee Services			
		Passive removable appliance - one arch;	$44.50 	n/a	
		Active removable appliance - one arch;	$44.50 	n/a	
		Functional orthopaedic appliance;	$35.00 	n/a	
		Passive fixed appliance;	$29.00 	n/a	
		Extra-oral appliance;	$115.50 	n/a	
		Treatment under G.A.;	$264.00 	n/a	
		Orthodontic adjustment;	nil	n/a	
		Repair removable appliance;	$10.00 	n/a	
		Repair removable appliance - clasp, spring or tooth;	$9.50 	n/a	
		Additional to removable appliance;	$10.00 	n/a	
		Relining removable appliance; or	$18.00 	n/a	
		Occlusal splint.	$35.00 	n/a	

Note Special Conditions apply below:
1.	Total fees charged per year to any Adult client, is capped at $300.00 for all services except:
a.	Group 7, Prosthodontics;
b.	Treatment under General Anaesthetic, item 949;
c.	Complete Endodontics treatment molar tooth; or
d.	External Specialist services (clients contribute 20% of the cost based on the estimate given by the private specialist).

2.	Children in care (foster care), providing appropriate documentation, are provided with assessment and treatment free of charge.

3.	Children screened at school, are screened without charge.

4.	Eligible children, under five years of age who live in the ACT, are provided with a free examination or screening.

5.	Exemption from fees and charges apply to clients for a range of services identified by Service Level Agreements (SLA) and/or Memorandum of Understanding (MOU’s) with other program/agencies.

6.	A free assessment session, oral hygiene and treatment planning is available for adult clients with medical conditions that complicate dental treatment, or where dental disease is a significant health risk, on the provision of a letter from a medical practitioner or other appropriate documentation. Eligible conditions include haemophilia; HIV/AIDS; clients at risk of Subacute Bacterial Endocarditis; people with a disability who have complex physical problems or associated medical conditions. Normal fees apply for all other treatment.

7.	Eligible, special needs clients, where appropriate documentation is provided from a responsible organisation, to show evidence that they are genuinely in this category, are provided with assessment and initial treatment to restore oral health at no charge.

8.	A $30.00 minimum fee applies for initial 'restorative' emergency appointment applies.

9.	A $30.00 minimum fee applies for a denture maintenance course of care.

10.	Repeat treatment on same tooth, same surface and same item number does not attract a fee within 3 months of initial treatment. 

11.	Repairs to new dentures attract no fee if denture was broken under normal usage within first 12 months. 

P. Alcohol and Drug Service
1. Opioid dispensed to clients on the Opioid Treatment Service for 6 months or more	
per week	
$15.00	
n/a	

Q. Medical Imaging Services
1. Services to patients - Copies of films to patients/solicitors/coroner/police/insurers etc.
(a) 18cm x 24cm sheet;	per sheet	$5.20 	n/a	
(b) 24cm x 30cm sheet;	per sheet	$6.20 	n/a	
(c) 35cm x 43cm sheet;	per sheet	$8.30 	n/a	
(d) 35mm slides;	each	$7.25 	n/a	
(e) Digital slides;	each	$2.05 	n/a	
(f) Laminating;	each	$2.05 	n/a	
(g) CDs;	each	$2.05 	n/a	
(h) OPG sheets;	per sheet	$6.20 	n/a	
(i) DVB Laser Film; and/or	per sheet	$8.30 	n/a	
(j) Service Fee.	per order processed	
$26.00	
$28.60	
				
2. Radiographer services to coroner				
(a) Monday to Friday;	per hour	$117.00 	$128.70 	
(b) Saturday and Sunday;	per hour	$128.00 	$140.80 	
(c) Public Holidays;	per hour	$171.00 	$188.10 	
(d) Film; and/or	per sheet	see above for rates excluding service fee	
(e) Processing.	per occasion of service	
$41.50	
$45.65	
				
3. Non-rebatable MRI services to outpatients	
per scan	
$275.00	
n/a	

4. Where the Medical Imaging Service provided involves Inpatient Services
(a) a non-eligible patient;		100% of Medicare Benefits Schedule Fee	
n/a	
(b) a compensable patient; or		125% of Medicare Benefits Schedule Fee	
n/a	
(c) a private patient.		100% of Medicare Benefits Schedule Fee	
n/a	

5. Where the Medical Imaging Service provided involves Outpatient Services 
 (a) a non-eligible patient;		100% of Medicare Benefits Schedule Fee	
n/a	
(b) a compensable patient; or		125% of Medicare Benefits Schedule Fee	
n/a	
(c) other outpatients.		85% of Medicare Benefits Schedule Fee	
n/a	

R. Pain Management Service
Provide to compensable non-inpatients and non-eligible non-inpatients of the Pain management Unit of The Canberra Hospital:
1. Multidisciplinary Assessment	per  assessment	
$917.00 	
n/a	
2. Cognitive Behavioural Therapy Program	per program	
$3,890.00 	
n/a	
3. Coping and Lifeskills Program	per program	$390.00 	n/a	
4. Exercise Program	per program	$6.75 	n/a	
5. Psychology Assessment	per  assessment	
$176.00 	
n/a	
6. Medical assessment and Follow-ups				
	(a) First visit; or	per visit	$200.00 	n/a	
	(b) Second and subsequent visits.	per visit	$100.00 	n/a	

S. Biomedical Repairs
Repairs on equipment and advice/training provided during:				
				
1. Business Hours	per hour	$104.00 
+ parts	$114.40 
+ parts	
2. After Hours	per hour	$135.00 
+ parts	$148.50
+ parts	

T. Community Rehabilitation Program
1.	Community – Based Rehabilitation Services
General services to whom fees apply and commercial consultancy services
(a)	Allied Health Staff				
	i) Appointment.		$93.00	$102.30	
(b)	Education and/or Training (for student groups, private and public sector staff groups)	
	i) Per facilitator – business hours; or	Per hour (half hour min)	
$54.00	
$59.40	
	ii) Per facilitator – after hours.	Per hour (half hour min)	
$81.50	
$89.65	

2. Independent Living Centre
(a) Appointment fee for clients with third party payer
	i) Assisted appointment and report writing; or	Per hour (half hour min)	
$93.00	
n/a	
	ii) Non attendance at appointment.		$14.50	$15.95	
(b) Unassisted appointment - service provided by staff member of another organisation	Per hour (half hour min)	

$31.00	

$34.10	
(c) Education and/or Training (for private organisations and interstate government staff)
	i) ILC Education; or	per half day	$67.50 	$74.25 	
	ii) ILC Education.	per full day	$124.00 	$136.40 	
(d) Second hand register (referral service)
	i) for items over $500;		$18.50 	$20.35 	
	ii) for items under $500; or		$9.00 	$9.90 	
	iii) for more than 1 item.		$18.50 	$20.35 	

(e) Consultancy fee for commercial advisory services (including travel)	Per hour (half hour min)	
$93.50	
$102.85	

3. Equipment Loan Service
(a) Default on loan agreements; or		Retail Price + 10% admin charge 	Retail Price + 11% admin charge 	
(b) Hire of pressure care products.				
i) Pressure Relief Mattress or Overlay Hire;	
per month	
$93.00 	
n/a	
ii) Pressure Relief Mattress or Overlay Hire – Pensioner Rate; or	
per month	
$46.60 	
n/a	
iii) Pressure Reduction Mattresses and Overlays.	
per month	
$23.20 	
n/a	

4. ACT Equipment Scheme
(a) Continence pads and aids for incontinence;	Per carton of continence pads or order of incontinence aids	

$22.70	

n/a	
(b) Orthopaedic footwear;		10% of total cost ($57.00 min.)	

n/a	
(c) Orthoses;		10% of total cost ($22.70 min.)	

n/a	
(d) Repairs to ACTES Equipment;		1/3 of total cost ($22.70 min.)	

n/a	
(e) Home modifications;		10% of total cost ($22.70 min.)	

n/a	
(f) Walking aids;		10% of total cost ($22.70 min.)	

n/a	
(g) Equipment and appliances for personal use;		10% of total cost ($22.70 min.)	

n/a	
(h) Wigs; or		$22.70 	n/a	
(i) Breast Prostheses Replacement.		$22.70 	n/a	
Notes:
1. For items other than above a client contribution may be payable direct to supplier.
2. Cost ceilings apply - excess is paid direct to supplier.
3. Only charges levied by ACT Health are listed above, additional costs may be payable to suppliers.
4. 'Total cost' above refers to cost of procurement or parts plus labour incurred by ACT Health.

5. Prosthetic and Orthotic Services
(a)	New prostheses or repairs for compensable clients;	Per hour (half hour min)	$93.00
+ components	
n/a	
(b)	New prostheses or repairs for non compensable clients not holding concession cards (cost ceilings apply);	Per hour (half hour min)	
15% of 
total cost 
($227 p.a. max.)	

n/a	
(c)	New orthoses;	Per hour (half hour min)	$93.00
+ components	
n/a	
(d)	Repairs to Orthoses;	Per hour (half hour min)	$93.00
+ components	$102.30
+ components	
(e)	Rehabilitation engineering maintenance/modification on equipment and advice/training; or	Per hour (half hour min)	
$68.50
+ components	
$75.35
+ components	
(f)	Orthotics assessment for private and compensable clients.	Per hour (half hour min)	
$93.00	
n/a	

6. Driver Rehabilitation Service
(a)	Initial Assessment – Non compensable;	
Per assessment	
$61.00 	
$67.10	
(b)	Initial Allied Health Assessment;	Per assessment	$652.00 	n/a	
(c)	Initial Assessment Report and Driving Instruction;	
Per assessment	
$298.00 	
n/a	
(d)	Lesson (compensable and non compensable);	
Per lesson	
$55.50 	
$61.05	
(e)	Re-assessment – Non compensable;	Per assessment	$55.50 	$61.05	
(f)	Allied Health Re-assessment; or	Per assessment	$279.00 	n/a	
(g)	Re-assessment Report and Driving Instruction.	
Per assessment	
$298.00 	
n/a	
Notes:
1. Cost ceilings apply to certain items - excess costs borne by client.
2.	'Total cost' above refers to cost of procurement or parts plus labour incurred by ACT Health.

7. Wheelchair and Posture Seating
(a)	ACT Residents, not including    residential care (covered by concession card); or		
Component costs	
Components costs + 10%	
(b)	Clients whom fees apply:				
	i) Occupational therapist;	Per hour (half hour min)	
$93.00 	
n/a	
	ii) Community Medical Officer; or	Per hour (half hour min)	
$109.00 	
n/a	
	iii) Technician.	Per hour (half hour min)	$68.50 
+ Component costs	n/a 
+ (Component Costs + 10%)	

U. Health Protection Services
1. Scientific Services
(a) Other than the ACT Coroner’s Office; or	
Per hour 	
$133.00	
$146.30	
(b)	ACT Coroners Office. 
        (Attorney-General’s Dept)	
Per matter	
$846.00	
$930.60	
	2. Other
(a)	Consultation - Business Hours;	Per hour 	$93.50 	$102.85 	
(b)	Consultation – After Hours; or	Per hour 	$115.00 	$126.50 	
(c)	Exhumations.	Per matter 	$333.00 	$366.30 	

V. Audiometry
Adult Hearing Tests 	per consultation	$31.40	n/a	

W. Other Community Health Fees
1. ACT Specialist Scheme				
(a)	Specialist Scheme.		20% of total costs	
n/a	
2. Community Health Care Program				
(a)	Chronic pain management course for compensation clients;	
per session 	
$37.50 	
$41.25 	
(b)	Nursing and Allied Health education - business hours;	
per hour	
$72.50 	
$79.75 	
(c)	Nursing and Allied Health education - after hours;	
per hour	
$108.50 	
$119.35 	
(d)	Nursing and Allied Health education (tertiary standard) - business hours;	

per hour	

$155.00 	

$170.50 	
(e)	Nursing and Allied Health education (tertiary standard) - after hours;	

per hour	

$232.00 	

$255.20 	
(f)	Sale of infection control manual;	per manual	$71.50 	$78.65 	
(g)	Podiatric Nail surgery
(materials);	per intervention	
$50.00 	
$55.00 	
(h)	Non moulded innersoles;	per pair	$25.40 	n/a	
(i)	Preformed Foot Orthoses;	per pair	$99.50 	n/a	
(j)	Custom made Foot Orthoses;	per pair	$135.00 	n/a	
(k)	Day care meals;	per meal	$5.70 	n/a	
(l)	Consultation in private hospitals;	per hour	$73.50 	$80.85 	
(m)	Community Nursing:	per hour	$73.50 	n/a	
	(i) Evening shift Mon-Fri (excluding public holidays); 	per hour	
At cost	
n/a	
	(ii) Night shift Mon – Fri (excluding public holidays);	per hour	
At cost	
n/a	
	(iii) After hours (midnight Fri - midnight Sat); or	per hour	
At cost	
n/a	
	(iv) After hours - midnight Sat - midnight Sun);	per hour	
At cost	
n/a	
(n)	Consultation overseas clients.	per hour	$71.50 	n/a	
3. Allied Health Fees
Compensable non-inpatients and non-eligible clients of Community Health Service:	
(a)	Physiotherapy – Antenatal
Exercise Classes	
per visit	
$5.50	
n/a	
				
4. Other Medical Supplies				
(a)	Orthotic Modifications;	per pair	$10.40 	n/a	
(b)	Foot Files;	per item	$3.00 	$3.30 	
(c)	Tubigrip - small/med;	per metre	$3.10 	n/a	
(d)	Tubigrip – large;	per metre	$10.40 	n/a	
(e)	Resistance Band;	per metre	$4.00 	$4.40 	
(f)	Exercise Putty;	per container	
$7.25 	
n/a	
(g)	Sportstape;	per roll	$6.00 	$6.60 	
(h)	Undertape;	per metre	$5.00 	$5.50 	
(i)	Lumbar Roll;	per item	$17.60 	n/a	
(j)	Neck Roll;	per item	$16.60 	n/a	
(k)	Collar;	per item	$10.40 	n/a	
(l)	PFX Probe;	per item	$20.70 	n/a	
(m)	Vaginal Cone;	per item	$16.60 	n/a	
(n)	TYOB Book;	per item	$18.50 	$20.35 	
(o)	TYON Book;	per item	$18.50 	$20.35 	
(p)	Women's Waterworks Book;	per item	$10.50 	$11.55 	
(q)	Lets Get Things Moving Book;	per item	$10.50 	$11.55 	
(r)	One Step at a time Book;	per item	$20.50 	$22.55 	
(s)	Parkinson’s Disease Book;	per item	$4.00 	$4.40 	
(t)	Stroke Survival Guide;	per item	$12.50 	$13.75 	
(u)	Hinged Ankle Brace;	per item	At Cost	n/a	
(v)	Fixed Ankle Brace;	per item	At Cost	n/a	
(w)	Limited motion brace (knee);	per item	At Cost	n/a	
(x)	Limited motion brace (elbow);	per item	At Cost	n/a	
(y)	Limited motion brace replacement foam;	
per item	
At Cost	
n/a	
(z)	Orthotics;	per pair	At Cost	n/a	
(aa)	Crutches;	per pair	At Cost	n/a	
(ab)	Crutch Tips and Handles;	per item	At Cost	n/a	
(ac)	Collar Cervical Rigid;	per item	At Cost	n/a	
(ad)	Walking Stick;	per item	At Cost	n/a	
(ae)	Wrist Splint Rigid;	per item	At Cost	n/a	
(af)	Wrist Splint Elastic;	per item	At Cost	n/a	
(ag)	Neoprene Thumb Splints;	per item	At Cost	n/a	
(ah)	Foam Blocks;	per item	At Cost	At cost + 10%	
(ai)	Coban Small;	per item	At Cost	n/a	
(aj)	Coban Large;	per item	At Cost	n/a	
(ak)	Tubigrip Sizes K;	per metre	At Cost	n/a	
(al)	Pressure Garment - ready made;	per item	At Cost	n/a	
(am)	Pressure Garment - made to measure;	
per item	
At Cost	
n/a	
(an)	Paediatric Feeding Consumables;	
per item	
At Cost	
n/a	
(ao)	Voice Prostheses/consumables;	per item	At Cost	n/a	
(ap)	Simple Splints;	per item	At Cost	n/a	
(aq)	Complex Splints; or	per item	At Cost	n/a	
(ar)	"Replacement of Child Personal Health Record" (Blue Book).	
per item	
$7.00	
$7.70	
				
5. Home Enteral Nutrition Program				
(a)	Equipment Only 0-6 years 11 months;	
per week	
$12.40	
n/a	
(b)	Equipment Only 7-12 years 11 months;	
per week	
$12.40	
n/a	
(c)	Equipment Only 13+ years;	per week	$12.40	n/a	
(d)	Supplementary Feeding 0-6 years 11 months; 	
per week	
$20.70	
n/a	
(e)	Supplementary Feeding 7-12 years 11 months;	
per week	
$36.30	
n/a	
(f)	Supplementary Feeding 13+ years;	
per week	
$37.30	
n/a	
(g)	Enteral Feeding 0-6 years 11 months;	
per week	
$25.90	
n/a	
(h)	Enteral Feeding 7-12 years 11 months; or	
per week	
$41.50	
n/a	
(i)	Enteral Feeding 13+ years.	per week	$43.60	n/a