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 from Part A to be removed from the Prescribed List on 1 July 2024.

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 November 2023 Prescribed List. The November 2023 Prescribed List has a commencement date of 1 November 2023.

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. 2) 2023 – commonly known as the November 2023 Prescribed List: effective 1 November 2023

Incorporates the Private Health Insurance (Medical Devices and Human Tissue Products) Amendment Rules (No. 2) 2023 (MDHTP Amendment Rules) that commence on 11 November 2023.

Benefits payable in respect of the prescribed list of medical devices and human tissue products

Page last updated: 13 November 2023

DATABASES
File Size
November 2023 Prescribed List – XML Version 10.76 MB
November 2023 Prescribed List – Part A – PDF Version 9.91 MB
November 2023 Prescribed List – Part A – MS Excel Version 1.15 MB
November 2023 Prescribed List – Part B (Human Tissue List) – PDF Version 340.23 KB
November 2023 Prescribed List – Part B (Human Tissue List) – MS Excel Version 40.61 KB
November 2023 Prescribed List – Part C (Other) – PDF Version 221.42 KB
November 2023 Prescribed List – Part C (Other) – MS Excel Version 29.65 KB
November 2023 Prescribed List – Part D (General use items) – PDF Version

general use items from Part A to be removed from the Prescribed List on 1 July 2024.

667.83 KB
November 2023 Prescribed List – Part D (General use items) – MS Excel Version

general use items from Part A to be removed from the Prescribed List on 1 July 2024.

76.72 KB

 

ASSOCIATED REPORTS FROM THE NOVEMBER 2023 PRESCRIBED LIST – PART A
File Size
November 2023 Prescribed List – Part A New Items – PDF Version 396.20 KB
November 2023 Prescribed List – Part A New Items – MS Excel Version 47.64 KB
November 2023 Prescribed List – Part A Deletions – PDF Version 132.74 KB
November 2023 Prescribed List – Part A Deletions – MS Excel Version 14.68 KB
November 2023 Prescribed List – Part A Changes – PDF Version 276.42 KB
November 2023 Prescribed List – Part A Changes – MS Excel Version 29.32 KB

 

ASSOCIATED REPORTS FROM THE NOVEMBER 2023 PRESCRIBED LIST – PART B
File Size
November 2023 Prescribed List – Part B (Human Tissue) New Items – PDF Version 77.64 KB
November 2023 Prescribed List – Part B (Human Tissue) New Items – MS Excel Version 10.97 KB
November 2023 Prescribed List – Part B (Human Tissue) Deletions – PDF Version 78.42 KB
November 2023 Prescribed List – Part B (Human Tissue) Deletions – MS Excel Version 11.03 KB
November 2023 Prescribed List – Part B (Human Tissue) Changes – PDF Version 113.85 KB
November 2023 Prescribed List – Part B (Human Tissue) Changes – MS Excel Version 12.04 KB

 

ASSOCIATED REPORTS FROM THE NOVEMBER 2023 PRESCRIBED LIST – PART C
File Size
November 2023 Prescribed List – Part C (Other) New Items – PDF Version 91.92 KB
November 2023 Prescribed List – Part C (Other) New Items – MS Excel Version 12.74 KB
November 2023 Prescribed List – Part C (Other) Changes – PDF Version 82.25 KB
November 2023 Prescribed List – Part C (Other) Changes – MS Excel Version 11.42 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 1.2) – PDF Version 754.91 KB
Prescribed List – XML Schema document (version 1.2) – MS Word Version 129.54 KB

 

RELEVANT DOHAC PHI CIRCULARS
File Size
PHI 74/23 Prescribed List – Private Health Insurance (Medical Devices and Human Tissue Products) Amendment Rules (No. 2) 2023 90.89 KB
PHI 73/23 Cost Recovery Implementation Statement for the National Joint Replacement Registry 91.81 KB
PHI 72/23 Update on new condition for surgical guides and biomodels on the Prescribed List 83.02 KB
PHI 68/23 Prescribed List cost recovery charges 86.41 KB
PHI 67/23 New condition for surgical guides and biomodels listed on the Prescribed List 90.45 KB
PHI 66/23 Private Health Insurance (Medical Devices and Human Tissue Products) Rules (No. 2) 2023 84.57 KB