Document ID: chunk:federal_register_of_legislation:F2025L00198:schedule:1:p358
Version: federal_register_of_legislation:F2025L00198
Segment Type: schedule
Provision Reference: sch 1 (pt 358/706)
Character Range: 1171406–1174398

& JOHNSON MEDICAL PTY LTD
SY779  ProPlan  Patient Specific Craniofacial Anatomical Biomodel  Custom  $1,762.00  Prescribed List reimbursement is restricted to the use of the device in craniomaxillofacial surgery procedures involving insertion of an implantable medical device, where that implantable device is listed in either sub-category 07.01 - Craniomaxillofacial Reconstruction & Fixation, or 07.02 – Craniomaxillofacial Implants, or 07.04 – Distractor Systems of Schedule 1, or sub-category 07.03 - Dental Implants, but only if the implantable dental medical device is explicitly identified in the product name or description of the billing code for the surgical guide or biomodel and is used in hospital. Not limiting the above, for a claim for any implantation procedure (defined by the respective MBS items stated in the claim) for a patient, the Prescribed List reimbursement is limited to 3 or less PL benefits for any billing codes for surgical guides or biomodels, or no more than 6 benefits if both surgical guides and biomodels (maximum 3 for each) have been used in an implantation procedure for a patient. This restriction is not impacted by a number of devices implanted during a procedure.

     KLS MARTIN AUSTRALIA PTY LIMITED
KT004  UNIQOS Patient Specific Anatomical Biomodel  Patient specific antomical biomodel  Custom-Patient Specific  $1,762.00  Prescribed List reimbursement is restricted to the use of the device in craniomaxillofacial surgery procedures involving insertion of an implantable medical device, where that implantable device is listed in either sub-category 07.01 - Craniomaxillofacial Reconstruction & Fixation, or 07.02 – Craniomaxillofacial Implants, or 07.04 – Distractor Systems of Schedule 1, or sub-category 07.03 - Dental Implants, but only if the implantable dental medical device is explicitly identified in the product name or description of the billing code for the surgical guide or biomodel and is used in hospital. Not limiting the above, for a claim for any implantation procedure (defined by the respective MBS items stated in the claim) for a patient, the Prescribed List reimbursement is limited to 3 or less PL benefits for any billing codes for surgical guides or biomodels, or no more than 6 benefits if both surgical guides and biomodels (maximum 3 for each) have been used in an implantation procedure for a patient. This restriction is not impacted by a number of devices implanted during a procedure.

     LYKA SMITH PTY LTD
XU019  OrthoTin Anatomic Biomodel  Anatomic Biomodel  The device is custom so the size will vary  $1,762.00  Prescribed List reimbursement is restricted to the use of the device in craniomaxillofacial surgery procedures involving insertion of an implantable medical device, where that implantable device is listed in either sub-category 07.01 - Craniomaxillofacial Reconstruction & Fixation, or 07.02 – Craniomaxillofacial Implants, or 07.04 – Distractor Systems of Schedule 1, or sub-category