Effective 1 November 2026, an amendment to item 45518 to reinstate the 85% out-of-hospital benefit that was previously removed on 1 March 2025.

Additionally, there will be minor amendments to items 45515 and 45518 for plastic and reconstructive surgery, to align terminology in the item descriptors with defined terms under the Health Insurance Act 1973 and clarify claiming requirements.

Further information is provided in the Factsheet below:

Word Version - Plastic and reconstructive surgery changes.docx

PDF Version - Plastic and reconstructive surgery changes.pdf