PHI 42/19 Prostheses List – Benefits for Surgical Cardiac Ablation Devices

Page last updated: 03 July 2019

PHI 42/19 Prostheses List – Benefits for Surgical Cardiac Ablation Devices (PDF 259 KB)

Surgical cardiac ablation devices were listed for the first time on the Prostheses List with effect from 1 July 2019.

The rules for benefits for surgical cardiac ablation devices are similar as those for catheter cardiac ablation devices that were listed for the first time on the March 2019 Prostheses List.

The minimum benefit for the combination of devices used within a procedure cannot exceed $6,399.

Where the benefit for the single device or the combination of devices used within a procedure is $6,399, the benefits for the device/s will be the default benefits listed on Part C of the Prostheses List.

Where the benefit for the combination of devices used within a procedure would exceed $6,399, a formula will be applied to calculate the benefits for the devices. For example,

Where default benefit of device Y + default benefit of device X > $6,399

  • The benefit for the device X = X (X+Y) x $6,399.
  • The benefit for device Y = Y (Y+X) x $6,399
The sum of the two minimum benefits is $6,399.