Document ID: chunk:federal_register_of_legislation:C2025C00156:section:10ada:p2
Version: federal_register_of_legislation:C2025C00156
Segment Type: section
Provision Reference: s 10ADA (pt 2/3)
Character Range: 106888–109482

was accepted for payment that the out‑of‑pocket expenses for the claim have been paid.
 (8) If:
 (a) this section applies to the current claim; but
 (b) the sum of the out‑of‑pocket expenses for all relevant prior claims for the expense year is less than the applicable safety‑net amount;
the benefit payable in respect of the claim is not increased under subsection (3) but is instead increased by the amount worked out using the formula:

where:
balance of safety‑net means the amount by which the sum of the out‑of‑pocket expenses for all relevant prior claims for the expense year is less than the applicable safety‑net amount.
 (8A) Despite subsections (3) and (8), if the current claim is for a service specified in an item determined under section 10B to be an item to which this subsection applies, the increase under this section in the benefit payable in respect of the claim cannot exceed the amount determined under section 10B as the maximum increase for that item.
Note: This subsection does not limit the increase payable in respect of a claim for a service specified in an item not determined under section 10B to be an item to which this subsection applies.
 (8AA) If:
 (a) 2 or more services (the original services) that are each specified in an item are deemed to constitute, or are treated as, one service (the deemed service) under this Act (other than a provision of this Act prescribed by the regulations); and
 (b) all of the items in which the original services are specified are items determined under section 10B to be items to which subsection (8A) of this section applies; and
 (c) the current claim is for the deemed service;
then, despite subsections (3) and (8) of this section, the increase under this section in the benefit payable in respect of the claim cannot exceed the sum of the amounts determined under section 10B as the maximum increases for those items.
Note: For when 2 or more services are deemed to constitute one service, see sections 15 and 16.
 (8B) If:
 (a) for the purposes of the pathology services table:
 (i) 2 or more pathology services are treated as a single pathology service; and
 (ii) the fee for the single service is the fee specified in one or more particular items in the table; and
 (b) one or more of those particular items (the limited increase items) are items determined under section 10B to be items to which subsection (8A) of this section applies;
then, for the purposes of that subsection, the single service is taken to be specified in the limited increase item or, if there are 2 or more limited increase items, in the