Document ID: chunk:federal_register_of_legislation:F2025L00198:schedule:1:p653
Version: federal_register_of_legislation:F2025L00198
Segment Type: schedule
Provision Reference: sch 1 (pt 653/706)
Character Range: 2134358–2137299

based on continuous glucose monitoring data
     INSULET AUSTRALIA PTY LTD
QQ717  Omnipod 5 Automated Insulin Delivery System  The Omnipod 5 (OP5) Automated Insulin Delivery (AID) System includes the tubeless insulin Pod, the Omnipod 5 App on the Insulet provided controller, and the chosen compatible glucose sensor. The glucose sensor sends CGM values and trends to the Pod. The Pod houses the insulin pump and a microprocessor which holds the SmartAdjustTM Technology that uses CGM values to make decisions and automatically adjust the insulin delivered. The Pod or the sensor also sends the CGM value to the Omnipod 5 App. This is used to display the data and to manually send commands to the Pod for bolusing and for basal insulin doses when not operating in automated mode.  One size only  $8,574.00  The Prescribed List reimbursement for the billing code is payable no more frequently than once every 4 years.

05 - Urogenital
Billing Code  Product Name  Description  Size  Minimum Benefit  Condition

05.03 - Voiding Dysfunction Prostheses
05.03.03 - Radiofrequency (RF) Delivery Devices for Transurethral Water Vapour Ablation
     BOSTON SCIENTIFIC PTY LTD
BS416  Rezum  Single-use radiofrequency delivery device kit for treatment of BPH  One size only  $1,950.00

08 - Cardiac
Billing Code  Product Name  Description  Size  Minimum Benefit  Condition

08.14 - Implantable Cardiac Event Recorders
08.14.01 - Implantable Cardiac Event Recorders
     ABBOTT MEDICAL AUSTRALIA PTY LTD.
QQ613  Assert IQ  Insertable Cardiac Monitor  46.5mm x 9.4mm x 3.1mm and  49mm x 9.4mm x 4.4mm   $2,886.00

SJ481  Jot Dx  Insertable Cardiac Monitor - with integrated remote monitoring capability via the myMerlin smart device App, including accessories for insertion (an incision tool and an insertion tool)  49 x 9.4 x 3.1 mm    $2,886.00

     BOSTON SCIENTIFIC PTY LTD
BS417  LUX-Dx™   Insertable Cardiac Monitor  7.2 mm x 44.8 mm x 4.0 mm, 1.2 cm3  $2,886.00

  i
     BIOTRONIK AUSTRALIA PTY LIMITED
QQ621  BIOMONITOR IV  Injectable cardiac monitor for continuous remote monitoring of patients   Dimensions (WxHxL) (overall) 77.5 mm x 8.6 mm x 4.6 mm Weight 4 g Volume (overall) 1.9 cm3  $2,886.00

BT247  BIOMONITOR III m    Injectable cardiac monitor for continuous remote monitoring of patients with extended AF Detection  77.5 mm x 8.6 mm x 4.6 mm; 4 g; 1.9 cm3  $2,886.00

     MEDTRONIC AUSTRALASIA PTY LTD
MI141  Reveal LINQ  Insertable Cardiac Monitor  44.8 mm x 7.2 mm x 4.0 mm,1.2 cm3  $2,886.00

MI438  Reveal LINQ II™  Insertable Cardiac Monitor  45.1 mm x 8mm x 4.2mm, 1.4cc  $2,886.00

  Remote Monitoring Service for ICM
     BOSTON SCIENTIFIC PTY LTD
BS432  LUX-Dx II, LUX-Dx II+  Insertable Cardiac Monitor with mobile remote monitoring   7.2 mm x 44.8 mm x 4.0 mm, 1.2 cm3  $3,388.00  The benefit payable for the billing code includes a component for remote monitoring services provided via a remote