Document ID: chunk:federal_register_of_legislation:F2025C00214:clause:1_18:p2
Version: federal_register_of_legislation:F2025C00214
Segment Type: clause
Provision Reference: sch 1 cl 18 (pt 2/2)
Character Range: 336230–338627

the patient is under 70 years of age; and
 (b) the first PSA quantitation test showed a PSA concentration of greater than 2 µg/L; and
 (c) the second PSA quantitation test showed a PSA concentration of greater than 5.5 µg/L; and
 (d) the patient has a first‑degree biological relative:
 (i) who has, or has had, prostate cancer; or
 (ii) who is suspected of carrying a BRCA 1 or BRCA 2 mutation.

2.5.9B  Restriction on item 63543—timing and purpose
 (1) Subject to subclauses (2) and (3), item 63543 is applicable to a service described in that item for a patient with a diagnosis of prostate cancer if it is:
 (a) the first service provided after the date of the diagnosis; or
 (b) the first service provided after 12 months after the date of the service mentioned in paragraph (a); or
 (c) the first service provided after 3 years after the date of a service to which item 63543 applied under paragraph (b) or this paragraph.
 (2) Subject to subclause (3), item 63543 is also applicable to a service described in that item if the clinical need for the service is:
 (a) stated in the request for the service; and
 (b) appropriately documented in the record of the service.
 (3) Item 63543 is not applicable to a service provided for the purposes of:
 (a) treatment planning; or
 (b) monitoring after treatment of prostate cancer.

Subdivision B—Subgroups 1 to 19 of Group I5

2.5.10  Items in Subgroups 1 to 19 of Group I5
  This clause sets out items in Subgroups 1 to 19 of Group I5.
Note: The fees in Group I5 are indexed in accordance with clause 2.7.1.

Group I5—Magnetic resonance imaging
Column 1                                                                                                       Column 2                                                                                                                                                                                                                                                        Column 3

Item                                                                                                           Description                                                                                                                                                                                                                                                     Fee ($)
Subgroup 1—Scan of head—for specified conditions