Source document: https://docs-lawep.s3.us-east-2.amazonaws.com/1698938115135.pdf (New Zealand)
2018/215 Accident Compensation (Liability to Pay or Contribute to Cost of Treatment) Amendment Regulations 2018 Rt Hon Dame Sian Elias, Administrator of the Government Order in Council At Wellington this 5th day of November 2018 Present: Her Excellency the Administrator of the Government in Council These regulations are made under section 324 of the Accident Compensation Act 2001— (a) (b) on the advice and with the consent of the Executive Council; and on the recommendation of the Minister for ACC given in accordance with sec- tion 324(2) of that Act.
Contents Title Commencement Principal regulations Regulation 3 amended (Interpretation) Regulation 9 amended (Counsellors’ costs) Regulation 11 amended (Hyperbaric oxygen treatment costs) Regulation 13 amended (Medical practitioners’ costs) Regulation 14 amended (Nurses’ costs) Regulation 15 amended (Medical practitioners’ and nurses’ costs for combined treatment) Regulation 15A amended (Nurse practitioners’ costs) Regulation 16 amended (Specialists’ costs) Regulation 17 amended (Specified treatment providers’ costs) Page 2 2 2 2 2 2 2 3 3 4 4 4 1 Accident Compensation (Liability to Pay or Contribute to Cost of Treatment) Amendment Regulations 2018 2018/215 Schedule replaced Schedule Schedule replaced Regulations 4 5 Title These regulations are the Accident Compensation (Liability to Pay or Contrib- ute to Cost of Treatment) Amendment Regulations 2018.
Commencement These regulations come into force on 1 December 2018.

Principal regulations These regulations amend the Accident Compensation (Liability to Pay or Con- tribute to Cost of Treatment) Regulations 2003 (the principal regulations).
Regulation 3 amended (Interpretation) In regulation 3, insert in their appropriate alphabetical order: community services card means— (a) (b) a community services card issued under the Health Entitlement Cards Regulations 1993; or a corresponding card issued under corresponding regulations made or deemed to have been made under either or both of section 92(3) of the New Zealand Public Health and Disability Act 2000 and section 437 of the Social Security Act 2018 dependent child has the meaning given to it by section 3(1) of the Social Security Act 1964, but does not include a child for whom an orphan’s benefit or an unsupported child’s benefit is paid under that Act Regulation 9 amended (Counsellors’ costs) In regulation 9(2)(a), replace “$94.23” with “$95.70”.
In regulation 9(2)(b), replace “$73.88” with “$75.03”.

Regulation 11 amended (Hyperbaric oxygen treatment costs) In regulation 11(2)(a), replace “$53.08” with “$53.91”.
Regulation 13 amended (Medical practitioners’ costs) Replace regulation 13(2)(a) with: (a) whichever of the following applies: r 1 13 (1) (2) 6 7 (1) 2 2018/215 Accident Compensation (Liability to Pay or Contribute to Cost of Treatment) Amendment Regulations 2018 r 9 (i) (ii) (iii) (iv) $56.94, if the claimant is under 14 years old when the visit takes place: $32.02, if the claimant is 14 years old or over when the visit takes place and is not the holder of a community services card or the dependent child of a holder: $53.33, if the claimant is 14 years old or over when the visit takes place and is the holder of a community services card: $58.54, if the claimant is 14 years old or over but under 18 years old when the visit takes place and is the dependent child of a holder of a community services card; plus (2) In regulation 13(5)(b), replace “$43.43” with “$44.11”.
8 Regulation 14 amended (Nurses’ costs) Replace regulation 14(2)(a) with: (a) whichever of the following applies: (i) (ii) (iii) (iv) $31.93, if the claimant is under 14 years old when the visit takes place: $15.00, if the claimant is 14 years old or over when the visit takes place and is not the holder of a community services card or the dependent child of a holder: $27.61, if the claimant is 14 years old or over when the visit takes place and is the holder of a community services card: $32.83, if the claimant is 14 years old or over but under 18 years old when the visit takes place and is the dependent child of a holder of a community services card; plus 9 Regulation 15 amended (Medical practitioners’ and nurses’ costs for combined treatment) Replace regulation 15(2)(a) with: (a) whichever of the following applies: (i) (ii) (iii) (iv) $59.93, if the claimant is under 14 years old when the visit takes place: $35.02, if the claimant is 14 years old or over when the visit takes place and is not the holder of a community services card or the dependent child of a holder: $56.32, if the claimant is 14 years old or over when the visit takes place and is the holder of a community services card: $61.54, if the claimant is 14 years old or over but under 18 years old when the visit takes place and is the dependent child of a holder of a community services card; plus 3 r 10 Accident Compensation (Liability to Pay or Contribute to Cost of Treatment) Amendment Regulations 2018 2018/215 10 Regulation 15A amended (Nurse practitioners’ costs) Replace regulation 15A(2)(a) with: (a) whichever of the following applies: (i) (ii) (iii) (iv) $52.37, if the claimant is under 14 years old when the visit takes place: $27.46, if the claimant is 14 years old or over when the visit takes place and is not the holder of a community services card or the dependent child of a holder: $49.06, if the claimant is 14 years old or over when the visit takes place and is the holder of a community services card: $53.86, if the claimant is 14 years old
 or over but under 18 years old when the visit takes place and is the dependent child of a holder of a community services card; plus 11 (1) (2) (3) 12 Regulation 16 amended (Specialists’ costs) In regulation 16(2)(a)(i), replace “$94.23” with “95.70”.
In regulation 16(2)(a)(ii), replace “$73.88” with “75.03”.

In regulation 16(3)(a), replace “$36.94” with “37.52”.

Regulation 17 amended (Specified treatment providers’ costs) In regulation 17(3)(a), replace “$58.02” with “58.93”.

13 Schedule replaced Replace the Schedule with the Schedule set out in the Schedule of these regula- tions.
4 2018/215 Accident Compensation (Liability to Pay or Contribute to Cost of Treatment) Amendment Regulations 2018 Schedule Schedule Schedule replaced Schedule Costs of treatment Item number Treatment Counsellors’ costs C1 C2 Dentists’ costs Consultation provided by a counsellor who is a specialist Consultation provided by a counsellor Examination Dental consultation, including examination Periodic oral examination or review Extended initial examination (complex cases relating to dental implants, orthodontics, and advanced restorative work), including study models, photographs, and tomography Radiological examination and interpretation Periapical or bitewing film (each) Occlusal (each) Panorex Other additional images (per treatment episode) Acute sedation (IV only) (initial consultation only) Emergency temporary cover Emergency temporary cover General oral surgery Extractions Extraction of permanent or rooted deciduous tooth (per first tooth) Surgical removal of tooth, including insertion and removal of sutures Extraction of subsequent permanent or deciduous tooth in the same quadrant arch as for DG1 Surgery Management of lacerations by suturing (per operative site) Incision and drainage abscess cellulitis Excision of traumatic mucous cyst Splint application or removal (for 3 splint units) Cleaning of wound and removal of debris Reduction of fractured alveolar process Repositioning of displaced tooth (per tooth) or replacing avulsed tooth Occlusal adjustment (simple) Minor surgical operations not otherwise covered by this schedule Provision of bite splints DE1 DE2 DE3 DX1 DX2 DX3 DX4 DX7 DT1 DG1 DG2 DG4 DG5 DG7 DG8 DG10 DG11 DG14 DG15 DG17 DG22 DG23 r 13 rr 6, 7, 9–17 Cost ($) 46.59 29.96 128.64 23.29 23.29 60.88 9.19 160.79 45.11 120.32 192.95 65.75 125.42 141.49 167.23 96.47 44.10 93.92 46.95 31.28 134.69 192.95 5 Schedule Accident Compensation (Liability to Pay or Contribute to Cost of Treatment) Amendment Regulations 2018 DR1 DR2 DR3 DR6 DR7 DR8 DR9 DP1 DP2 DP5 DP7 DP8 DP11 DP13 DP14 Item number Treatment
 Restorative Amalgam 1 surface filling (including 2 fillings on the one surface) Amalgam 2 surface filling (approximo-occlusal) Complex amalgam restoration Non-metallic simple fillings (including 2 fillings on the one surface) Non-metallic filling (2 or more surfaces per tooth) Rebonding tooth fragment or coronal portion Complex reconstruction in composite resin (direct) Prosthodontics Plastic denture (1 tooth—material of choice) Each additional tooth (all dentures) Metal-framed partial denture (1 tooth) Transitional denture replacing missing tooth or teeth Full upper or lower denture Reline or rebase denture Repair (all types) Addition of tooth to existing denture (includes additional tooth) Crown and bridge Inlay or onlay and veneers Indirect inlay or onlay Porcelain veneer Composite resin veneer Post (wrought or preformed) Composite or amalgam core Cast post and core (metal or ceramic) Crowns All ceramic crown Porcelain fused to metal crown Cast gold crown (full and three-quarters) Bridges Maryland bridge Composite bridge (per unit) Re-cementing crown, bridge, veneer, or inlay Non-composite bridge (on injured teeth that meet the requirement for a crown) (3 units) Replacement of non-composite bridge Endodontics Pulpotomy or pulpectomy Irrigation and dressing of root canal system Complete preparation and obturation of root canal (per canal)—open or closed apex Apicectomy and retrograde filling (per canal) Removal of root filling (per canal) Removal of post, post crown, or crown DC3 DC6 DC7 DC8 DC9 DC11 DC19 DC20 DC25 DC26 DC15 DC16 DC17 DN1 DN2 DN3 DN5 DN6 DN7 DC27 6 2018/215 Cost ($) 2018/215 Accident Compensation (Liability to Pay or Contribute to Cost of Treatment) Amendment Regulations 2018 Item number Treatment DN8 DN9
 DN10 DN11 DN13 DD1 DD2 DD4 DD7 DD8 DD9 DM1 DM2 DM3 DM4 DM5 DM6 DM7 Bleaching, 1 non-vital tooth (per treatment) Pulp capping Removal of fractured post or instrument Repair of perforation Negotiation of calcified canal (can be used with item DN3) Periodontics Gingivectomy Crown lengthening (per tooth) Subgingival curettage (per tooth) Site preparation for dental implant Placement of membrane Substitute bone material Dental implants Resilient linings (tooth or teeth) Fixture head impressions and copings (per fixture) Dental implant crown (per single unit) Dental stent and guide (per fixture) Definitive abutment (per fixture) Temporary abutment (per fixture) Repairs to abutments (per fixture) Claimants under 18 years old Dental consultation (including examination) Temporary crown Temporary bridge Surgical decoronation Removal of deciduous teeth DY1 DY14 DY15 DY21 DY22 Hyperbaric oxygen treatment costs H1 H2 H3 H4 Medical practitioners’, nurses’, and nurse practitioners’ costs Neurological assay before recompression Neurological assay after recompression In-chamber treatment supervision (per hour) Out-of-chamber treatment supervision (per hour) MB1 MB2 MB3 MB4 MB5 MD1 MD2 MD3 Burn or abrasion Treatment of burn not exceeding 4 cm² Treatment of burn at single site exceeding 4 cm² Treatment of significant abrasions not exceeding 4 cm² at single site Treatment of significant abrasions exceeding 4 cm² at single site Significant burns or abrasions (not including fractures) at multiple sites (exceeding 4 cm²): necessary wound cleaning, preparation, and dressing Dislocation Dislocation of finger or toe with splint or strapping Dislocation of thumb: closed reduction and immobilisation Dislocation of elbow with radiological confirmation: closed reduction and immobilisation Schedule Cost ($) 160.79 37.57 226.07 226.07 226.07 107.72 225.10 89.88 328.73 352.20 140.87 67.63 361.59 1,127.07 122.11 361.59 45.08 78.23 60.65 112.71 112.71 394.48 27.56 89.83 80.82 93.91 46.03 31.44 61.91
 31.45 61.91 90.21 36.43 102.09 94.55 7 Schedule Accident Compensation (Liability to Pay or Contribute to Cost of Treatment) Amendment Regulations 2018 Item number Treatment MD4 MD5 Dislocation of shoulder: closed reduction and collar and cuff immobilisation Dislocation of patella: closed reduction and cast immobilisation Fracture Fractured finger or toe (proximal, middle, or distal phalanx): closed reduction and immobilisation Fractured finger or toe (proximal, middle, or distal phalanx): requiring local anaesthetic Fractured metatarsal: closed reduction (not requiring cast): closed reduction, immobilisation by strapping Fractured metacarpal(s) hand: with or without local anaesthetic, immobilisation by strapping Fractured carpal bone, including scaphoid: treatment by cast immobilisation, not requiring reduction Fractured tarsal or metatarsal bones (excluding calcaneum or talus): treatment by cast immobilisation Fractured calcaneum or talus: treatment by cast immobilisation Fractured clavicle Fractured distal radius and ulna: cast immobilisation not requiring reduction Fractured distal radius and ulna requiring closed reduction, involving regional or other form of anaesthesia Fractured shaft radius and ulna: treatment by cast immobilisation Fractured distal humerus (supracondylar or condylar): treatment by cast immobilisation Fractured proximal or shaft humerus: immobilisation by collar and cuff or U- slab Fractured shaft tibia or fibula, or both: treatment by cast immobilisation with reduction Fractured distal tibia or fibula, or both: treatment by cast immobilisation with reduction Fractured fibula (without tibial fracture): immobilisation with soft tissue strapping Miscellaneous Abscess or haematoma: drainage with incision (with or without local anaesthetic agent) Insertion of IV line for administration of IV medications or electrolytes or transfusion (if provided under local or national guideline approved by the Corporation) Nail, simple removal Nail, removal
 or wedge resection requiring the use of digital anaesthesia Removal of embedded or impacted foreign body from cornea or conjunctiva (with use of topical anaesthetic), or from auditory canal or nasal passages, or from skin or subcutaneous tissue with incision, or from rectum or vagina Pinch skin graft Dental anaesthetic Epistaxis: arrest during episode by nasal cavity packing with or without cautery MF1 MF2 MF3 MF4 MF5 MF6 MF7 MF8 MF9 MF10 MF11 MF12 MF13 MF14 MF15 MF16 MM1 MM2 MM3 MM4 MM5 MM6 MM7 MM8 8 2018/215 Cost ($) 68.11 162.05 36.43 50.37 36.43 50.37 113.46 162.05 162.05 68.11 113.46 135.66 113.46 113.46 68.81 162.05 162.05 68.81 28.38 56.75 22.72 94.55 30.55 70.95 26.51 41.90 2018/215 Accident Compensation (Liability to Pay or Contribute to Cost of Treatment) Amendment Regulations 2018 Item number Treatment MW1 MW2 MW3 MW4 MT1 MT2 MT3 Open wound Closure of open wound (or wounds) less than 2 cm: any necessary care and treatment, including cleaning and debriding, exploration, administration of anaesthetic, and dressing Closure of open wound (or wounds) of skin and subcutaneous tissue or mucous membrane 2 cm to 7 cm long: any necessary care and treatment, including cleaning and debriding, exploration, administration of anaesthetic, and dressing Closure of open wound (or wounds) of skin and subcutaneous tissue or mucous membrane exceeding 7 cm long: any necessary care and treatment, including cleaning and debriding, exploration, administration of anaesthetic, and dressing Amputation of digit, including use of anaesthetic, debridement of bone and soft tissue, and closure of wound Soft tissue injury Simple soft tissue injuries: management of simple sprain of wrist, ankle, knee, elbow, or other soft tissue injury requiring crepe bandage or similar immobilisation not requiring formal strapping Soft tissue injury (other than splinting of dislocated or fractured digit), unless specified elsewhere: application of plaster or padded splint or specific strapping within
 agreed guidelines (includes splinting of Achilles tendon injury and serious ankle sprains) Aspiration of inflamed joint, tendon, bursa, or other subcutaneous tissue or space (with or without injection) Extensor tendon: primary repair Ruptured Achilles tendon: management by plaster immobilisation MT4 MT5 Radiologists’ costs Extremities Sternum Sternoclavicular joints Clavicle Acromio-clavicular joints Scapula Shoulder Humerus Elbow joint Forearm Hand or wrist joint, or both Wrist or hand for bone age Upper limb (infant) Sacroiliac joints Pelvis or both hips (1 projection) Hip joint (more than 1 projection) Femur Knee joint Knee joint (and intercondylar or axial) Tibia and fibula Ankle joint Foot RA01 RA02 RA03 RA04 RA05 RA06 RA07 RA08 RA09 RA10 RA11 RA15 RA21 RA22 RA25 RA26 RA27 RA28 RA29 RA30 RA32 Schedule Cost ($) Schedule Accident Compensation (Liability to Pay or Contribute to Cost of Treatment) Amendment Regulations 2018 Item number Treatment RA35 RA40 Long legs (hips to ankles), including measurement Lower limb (infant) Head, neck, and spine Cervical spine Thoracic spine Lumbar spine, including lumbosacral joint Sacro-coccygeal spine Spine (scoliosis views) Skull Nasal bones Facial bones Optic foramina Auditory canals (plain films only) Nasal sinuses Nasopharynx Mastoids (bilateral) Larynx or trachea, or both Upper teeth Lower teeth Mandible or OPG or lateral cephalogram Temporo-mandibular joints Salivary gland Pharynx Chest, including breast Thoracic inlet Chest (1 view) Chest (more than 1 view) Chest and thoracic cage Chest and both oblique views Mammography Screening mammogram Recall mammogram Problem mammogram bilateral Problem mammogram unilateral Needle localisation Galactogram Breast aspiration biopsy Breast biopsy with stereotaxis GI, GU, and obstetrics—no contrast
 modifiers permitted Radiology Abdomen (1 projection) Abdomen (2 or more projections) Pelvimetry (1 view) Pelvimetry (2 or more views) RB01 RB02 RB03 RB04 RB08 RB10 RB12 RB13 RB14 RB16 RB21 RB22 RB23 RB24 RB31 RB32 RB33 RB34 RB35 RB37 RC05 RC06 RC07 RC08 RC09 RC31 RC32 RC35 RC36 RC40 RC41 RC45 RC46 RD01 RD02 RD07 RD08 10 2018/215 Cost ($) 2018/215 Accident Compensation (Liability to Pay or Contribute to Cost of Treatment) Amendment Regulations 2018 RS42 RS43 RS44 RS46 RS61 RS62 RS63 RS70 RS71 RS73 RD10 RD11 RD13 RD14 RD15 RD20 RD30 RD40 RD44 RD45 RD46 RD47 Item number Treatment Screening Contrast swallow (oesophagus only) Contrast study upper GI tract Small bowel meal Small bowel enema (enteroclysis) Contrast enema Dynamic proctogram ERCP IVP, including plain film and tomography Cystogram: retrograde or antegrade Urethrogram Micturating cysto-urethrogram Ascending urethrogram Special procedures Tube injection Dacrocystogram Sialogram Hysterosalpingogram Myelogram cervical Myelogram lumbar Myelogram multilevel Arthrogram Arthrogram—upper limb Arthrogram—lower limb Ultrasound Abdomen and pelvis US abdomen US abdomen and pelvis US renal tracts US abdominal aorta (without Doppler) US pelvis (transabdominal only) Infants US infant head US infant pylorus US infant heart US infant hips US infant miscellaneous Various US thyroid or neck US scrotum and testes US breast US veins US eye US chest RU20 RU21 RU22 RU23 RU24 RU25 RU01 RU02 RU03 RU04 RU06 RU10 RU11 RU12 RU13 RU19 Schedule Cost ($) 173.05
232.15 122.40 122.40 122.40 122.40 122.40 173.05 122.40 122.40 11 Schedule Accident Compensation (Liability to Pay or Contribute to Cost of Treatment) Amendment Regulations 2018 Item number Treatment RU27 RU28 RU29 US injection or aspiration US additional region US miscellaneous Skeletal US shoulder US musculo-skeletal US foreign body localisation US skeletal miscellaneous Intracavitary US prostate US anus or rectum US female pelvis (includes transvaginal and transabdominal, or transvaginal only) US trans-oesophageal US intraoperative US intracavitary (miscellaneous) Vascular Duplex or Doppler of chest Duplex or Doppler of additional limb (arterial or venous) Pregnancy US routine pregnancy less than 28 weeks US problem pregnancy US pregnancy exceeding 28 weeks US with amniocentesis US pregnancy (per extra foetus exceeding 1) Additional X-ray additional region Domiciliary X-ray (in addition) RU30 RU31 RU32 RU39 RU40 RU41 RU42 RU43 RU44 RU49 RU51 RU56 RU60 RU61 RU62 RU64 RU68 RX24 RX25 Specialists’ costs Repair recent wound Not exceeding 7 cm (superficial) Not exceeding 7 cm (deeper tissue) Exceeding 7 cm (superficial) Exceeding 7 cm (deeper tissue) Fractures (closed reduction) Phalanges Metacarpals (excluding Bennetts) Metatarsals Bennetts Carpal bones Colles Radius and ulna—shafts Radius—head and neck Humerus SR1 SR2 SR3 SR4 SF1 SF2 SF3 SF4 SF5 SF6 SF7 SF8 SF9 12 2018/215 Cost ($) 2018/215 Accident Compensation (Liability to Pay or Contribute to Cost of Treatment) Amendment Regulations 2018 Item number Treatment SF10 SF11 SF12 SF13 SF14 SF15 SF16 SF17 Talus—neck Calcaneus Other tarsals Ankle—fracture dislocation, Potts Tibia and fibula—shaft Tibia and fibula—upper end Tibia and fibula—involving joint traction Femur, any site (with or without traction) Haematoma, abscess, or
 other infection Small—aspiration Large—incision and drainage (local anaesthetic) Large—incision and drainage (general anaesthetic) Foreign body, removal of Under local anaesthetic Under general anaesthetic From cornea or sclera From ear (other than by simple syringing) From muscle, tendon, or other deep tissue From nose (other than by simple probing) From throat (additional fee) Dislocations (closed reduction) Elbow, wrist, thumb, and fingers with strapping or splint Shoulder Patella Hip Plaster Upper limb—above elbow Upper limb—below elbow Lower limb—above knee Lower limb—below knee Other Aspiration of joint Amputation of all or part of 1 digit Extensor tendon (primary repair) Nail (simple removal) SH1 SH2 SH3 SB1 SB2 SB3 SB4 SB5 SB6 SB7 SD1 SD2 SD3 SD4 SP1 SP2 SP3 SP4 SM1 SM2 SM3 SM4 Specified treatment providers’ costs TMT POD3 All treatment Podiatry: abscess or haematoma: drainage with incision (with or without local anaesthetic agent) Podiatry: nail, simple removal Podiatry: nail, removal or wedge resection requiring the use of digital anaesthesia X-ray services provided by chiropractor (maximum of 2 films per claimant per personal injury) POD4 POD5 XRAY Schedule Cost ($) Explanatory note Accident Compensation (Liability to Pay or Contribute to Cost of Treatment) Amendment Regulations 2018 2018/215 Rachel Hayward, acting for Clerk of the Executive Council.
Explanatory note This note is not part of the regulations, but is intended to indicate their general effect.

These regulations, which come into force on 1 December 2018, amend the Accident Compensation (Liability to Pay or Contribute to Cost of Treatment) Regulations 2003.
The amendments— • • • increase by 1.56% the amounts that the Accident Compensation Corporation is liable to pay for the treatments specified in those regulations, beginning on 1 December 2018; and increase the age of children who qualify for higher ACC contributions from those under 13 years to those under 14 years; and provide for holders of community service cards, and their dependent children, to qualify for higher ACC contributions.
Regulatory impact statement The Ministry of Business, Innovation and Employment produced a regulatory impact statement on 3 October 2018 to help inform the decisions taken by the Government relating to the contents of this instrument.
A copy of this regulatory impact statement can be found at— • • https://www.mbie.govt.nz/publications-research/publications/employment-and- skills/ris-acc-implementation-of-primary-care.pdf http://www.treasury.govt.nz/publications/informationreleases/ris Issued under the authority of the Legislation Act 2012.

Date of notification in Gazette: 8 November 2018.

These regulations are administered by the Ministry of Business, Innovation, and Employment.
Wellington, New Zealand: Published under the authority of the New Zealand Government—2018 14