Accident Compensation (Liability to Pay or Contribute to Cost of Treatment) Amendment Regulations 2021

2021/41

Coat of Arms of New Zealand

Accident Compensation (Liability to Pay or Contribute to Cost of Treatment) Amendment Regulations 2021

Patsy Reddy, Governor-General

Order in Council

At Wellington this 15th day of March 2021

Present:
Her Excellency the Governor-General in Council

These regulations are made under section 324 of the Accident Compensation Act 2001 on the advice and with the consent of the Executive Council given on the recommendation of the Minister for ACC made after complying with section 324(2) of that Act.

Regulations

1 Title

These regulations are the Accident Compensation (Liability to Pay or Contribute to Cost of Treatment) Amendment Regulations 2021.

2 Commencement

These regulations come into force on 1 May 2021.

3 Principal regulations
4 Regulation 9 amended (Counsellors’ costs)

Replace regulation 9(1) and (2) with:

(1)

The Corporation is liable to pay the following for treatments provided by a counsellor:

(a)

$97.66 an hour for consultation provided by a counsellor who is a specialist:

(b)

$76.57 an hour for consultation provided by a counsellor who is not a specialist.

5 Regulation 10 amended (Dentists’ costs)
6 Regulation 11 amended (Hyperbaric oxygen treatment costs)

In regulation 11(2)(a), replace “$53.91” with “$54.84”.

7 Regulation 13 amended (Medical practitioners’ costs)

(1)

In regulation 13(2)(a)(i), replace “$56.94” with “$58.11”.

(2)

In regulation 13(2)(a)(ii), replace “$32.02” with “$32.68”.

(3)

In regulation 13(2)(a)(iii), replace “$53.33” with “$54.42”.

(4)

In regulation 13(2)(a)(iv), replace “$58.54” with “$59.74”.

(5)

In regulation 13(5)(b), replace “$44.11” with “$45.01”.

8 Regulation 14 amended (Nurses’ costs)

(1)

In regulation 14(2)(a)(i), replace “$31.93” with “$32.58”.

(2)

In regulation 14(2)(a)(ii), replace “$15.00” with “$15.31”.

(3)

In regulation 14(2)(a)(iii), replace “$27.61” with “$28.18”.

(4)

In regulation 14(2)(a)(iv), replace “$32.83” with “$33.50”.

9 Regulation 15 amended (Medical practitioners’ and nurses’ costs for combined treatment)

(1)

In regulation 15(2)(a)(i), replace “$59.93” with “$61.16”.

(2)

In regulation 15(2)(a)(ii), replace “$35.02” with “$35.74”.

(3)

In regulation 15(2)(a)(iii), replace “$56.32” with “$57.47”.

(4)

In regulation 15(2)(a)(iv), replace “$61.54” with “$62.80”.

10 Regulation 15A amended (Nurse practitioners’ costs)

(1)

In regulation 15A(2)(a)(i), replace “$52.37” with “$53.44”.

(2)

In regulation 15A(2)(a)(ii), replace “$27.46” with “$28.02”.

(3)

In regulation 15A(2)(a)(iii), replace “$49.06” with “$50.07”.

(4)

In regulation 15A(2)(a)(iv), replace “$53.86” with “$54.96”.

11 Regulation 16 amended (Specialists’ costs)

(1)

In regulation 16(2)(a)(i), replace “$95.70” with “$97.66”.

(2)

In regulation 16(2)(a)(ii), replace “$75.03” with “$76.57”.

(3)

In regulation 16(3)(a), replace “$37.52” with “$38.29”.

12 Regulation 17 amended (Specified treatment providers’ costs)

In regulation 17(3)(a), replace “$58.93” with “$60.14”.

13 Schedule replaced

Replace the Schedule with the Schedule set out in the Schedule of these regulations.

Schedule Schedule replaced

r 13

Schedule Costs of treatment

rr 6, 7, 9–17

Item numberTreatmentCost ($)
Dentists’ costs
Examination
DE1Dental consultation, including examination47.55
DE2Periodic oral examination or review30.57
DE3Extended initial examination (complex cases relating to dental implants, orthodontics, and advanced restorative work), including study models, photographs, and tomography131.28
Radiological examination and interpretation
DX1Periapical or bitewing film (each)23.77
DX2Occlusal (each)23.77
DX3Panorex62.13
DX4Other additional images (per treatment episode)9.38
DX7Acute sedation (IV only) (initial consultation only)164.09
Emergency temporary cover
DT1Emergency temporary cover46.03
General oral surgery
Extractions
DG1Extraction of permanent or rooted deciduous tooth (per first tooth)122.79
DG2Surgical removal of tooth, including insertion and removal of sutures 196.91
DG4Extraction of subsequent permanent or deciduous tooth in the same quadrant arch as for DG1 67.10
Surgery
DG5Management of lacerations by suturing (per operative site)127.99
DG7Incision and drainage abscess cellulitis144.39
DG8Excision of traumatic mucous cyst170.66
DG10Splint application or removal (for 3 splint units)98.45
DG11Cleaning of wound and removal of debris45.00
DG14Reduction of fractured alveolar process95.85
DG15Repositioning of displaced tooth (per tooth) or replacing avulsed tooth47.91
DG17Occlusal adjustment (simple)31.92
DG22Minor surgical operations not otherwise covered by this schedule137.45
DG23Provision of bite splints196.91
Restorative
DR1Amalgam 1 surface filling (including 2 fillings on the one surface)87.20
DR2Amalgam 2 surface filling (approximo-occlusal)114.06
DR3Complex amalgam restoration165.01
DR6Non-metallic simple fillings (including 2 fillings on the one surface)100.60
DR7Non-metallic filling (2 or more surfaces per tooth)134.17
DR8Rebonding tooth fragment or coronal portion90.19
DR9Complex reconstruction in composite resin (direct)179.14
Prosthodontics
DP1Plastic denture (1 tooth—material of choice)502.24
DP2Each additional tooth (all dentures)22.50
DP5Metal-framed partial denture (1 tooth)1,150.15
DP7Transitional denture replacing missing tooth or teeth457.57
DP8Full upper or lower denture750.11
DP11Reline or rebase denture234.83
DP13Repair (all types)76.70
DP14Addition of tooth to existing denture (includes additional tooth)140.88
Crown and bridge
Inlay or onlay and veneers
DC3Indirect inlay or onlay286.39
DC6Porcelain veneer843.13
DC7Composite resin veneer183.77
DC8Post (wrought or preformed)98.45
DC9Composite or amalgam core118.15
DC11Cast post and core (metal or ceramic)225.79
Crowns
DC15All ceramic crown996.91
DC16Porcelain fused to metal crown958.64
DC17Cast gold crown (full and three-quarters)901.16
Bridges
DC19Maryland bridge694.61
DC20Composite bridge (per unit)229.71
DC25Re-cementing crown, bridge, veneer, or inlay34.50
DC26Non-composite bridge (on injured teeth that meet the requirement for a crown) (3 units)2,347.85
DC27Replacement of non-composite bridge2,809.17
Endodontics
DN1Pulpotomy or pulpectomy131.28
DN2Irrigation and dressing of root canal system133.25
DN3Complete preparation and obturation of root canal (per canal)—open or closed apex295.36
DN5Apicectomy and retrograde filling (per canal)287.56
DN6Removal of root filling (per canal)230.70
DN7Removal of post, post crown, or crown230.70
DN8Bleaching, 1 non-vital tooth (per treatment)164.09
DN9Pulp capping38.34
DN10Removal of fractured post or instrument230.70
DN11Repair of perforation230.70
DN13Negotiation of calcified canal (can be used with item DN3)230.70
Periodontics
DD1Gingivectomy109.93
DD2Crown lengthening (per tooth)229.71
DD4Subgingival curettage (per tooth)91.72
DD7Site preparation for dental implant 335.47
DD8Placement of membrane359.42
DD9Substitute bone material143.76
Dental implants
DM1Resilient linings (tooth or teeth)69.02
DM2Fixture head impressions and copings (per fixture) 369.00
DM3Dental implant crown (per single unit)1,150.17
DM4Dental stent and guide (per fixture)124.61
DM5Definitive abutment (per fixture)369.00
DM6Temporary abutment (per fixture)46.00
DM7Repairs to abutments (per fixture) 79.83
Claimants under 18 years old
DY1Dental consultation (including examination)61.89
DY14Temporary crown115.02
DY15Temporary bridge115.02
DY21Surgical decoronation402.57
DY22Removal of deciduous teeth28.12
Hyperbaric oxygen treatment costs
H1Neurological assay before recompression91.38
H2Neurological assay after recompression 82.21
H3In-chamber treatment supervision (per hour)95.53
H4Out-of-chamber treatment supervision (per hour) 46.82
Medical practitioners’, nurses’, and nurse practitioners’ costs
Burn or abrasion
MB1Treatment of burn not exceeding 4 cm²32.08
MB2Treatment of burn at single site exceeding 4 cm²63.18
MB3Treatment of significant abrasions not exceeding 4 cm² at single site32.09
MB4Treatment of significant abrasions exceeding 4 cm² at single site63.18
MB5Significant burns or abrasions (not including fractures) at multiple sites (exceeding 4 cm²): necessary wound cleaning, preparation, and dressing92.06
Dislocation
MD1Dislocation of finger or toe with splint or strapping37.18
MD2Dislocation of thumb: closed reduction and immobilisation 104.18
MD3Dislocation of elbow with radiological confirmation: closed reduction and immobilisation96.49
MD4Dislocation of shoulder: closed reduction and collar and cuff immobilisation 69.51
MD5Dislocation of patella: closed reduction and cast immobilisation165.37
Fracture
MF1Fractured finger or toe (proximal, middle, or distal phalanx): closed reduction and immobilisation 37.18
MF2Fractured finger or toe (proximal, middle, or distal phalanx): requiring local anaesthetic 51.40
MF3Fractured metatarsal: closed reduction (not requiring cast): closed reduction, immobilisation by strapping 37.18
MF4Fractured metacarpal(s) hand: with or without local anaesthetic, immobilisation by strapping 51.40
MF5Fractured carpal bone, including scaphoid: treatment by cast immobilisation, not requiring reduction115.79
MF6Fractured tarsal or metatarsal bones (excluding calcaneum or talus): treatment by cast immobilisation165.37
MF7Fractured calcaneum or talus: treatment by cast immobilisation 165.37
MF8Fractured clavicle 69.51
MF9Fractured distal radius and ulna: cast immobilisation not requiring reduction 115.79
MF10Fractured distal radius and ulna requiring closed reduction, involving regional or other form of anaesthesia138.44
MF11Fractured shaft radius and ulna: treatment by cast immobilisation 115.79
MF12Fractured distal humerus (supracondylar or condylar): treatment by cast immobilisation115.79
MF13Fractured proximal or shaft humerus: immobilisation by collar and cuff or U-slab70.22
MF14Fractured shaft tibia or fibula, or both: treatment by cast immobilisation with reduction 165.37
MF15Fractured distal tibia or fibula, or both: treatment by cast immobilisation with reduction165.37
MF16Fractured fibula (without tibial fracture): immobilisation with soft tissue strapping 70.22
Miscellaneous
MM1Abscess or haematoma: drainage with incision (with or without local anaesthetic agent)28.96
MM2Insertion of IV line for administration of IV medications or electrolytes or transfusion (if provided under local or national guideline approved by the Corporation)57.91
MM3Nail, simple removal23.19
MM4Nail, removal or wedge resection requiring the use of digital anaesthesia96.49
MM5Removal of embedded or impacted foreign body from cornea or conjunctiva (with use of topical anaesthetic), or from auditory canal or nasal passages, or from skin or subcutaneous tissue with incision, or from rectum or vagina31.18
MM6Pinch skin graft 72.40
MM7Dental anaesthetic 27.05
MM8Epistaxis: arrest during episode by nasal cavity packing with or without cautery42.76
Open wound
MW1Closure of open wound (or wounds) less than 2 cm: any necessary care and treatment, including cleaning and debriding, exploration, administration of anaesthetic, and dressing34.09
MW2Closure of open wound (or wounds) of skin and subcutaneous tissue or mucous membrane 2 cm to 7 cm long: any necessary care and treatment, including cleaning and debriding, exploration, administration of anaesthetic, and dressing65.06
MW3Closure of open wound (or wounds) of skin and subcutaneous tissue or mucous membrane exceeding 7 cm long: any necessary care and treatment, including cleaning and debriding, exploration, administration of anaesthetic, and dressing86.09
MW4Amputation of digit, including use of anaesthetic, debridement of bone and soft tissue, and closure of wound96.49
Soft tissue injury
MT1Simple soft tissue injuries: management of simple sprain of wrist, ankle, knee, elbow, or other soft tissue injury requiring crepe bandage or similar immobilisation not requiring formal strapping15.14
MT2Soft tissue injury (other than splinting of dislocated or fractured digit), unless specified elsewhere: application of plaster or padded splint or specific strapping within agreed guidelines (includes splinting of Achilles tendon injury and serious ankle sprains)70.22
MT3Aspiration of inflamed joint, tendon, bursa, or other subcutaneous tissue or space (with or without injection)34.06
MT4Extensor tendon: primary repair173.69
MT5Ruptured Achilles tendon: management by plaster immobilisation170.26
Radiologists’ costs
Extremities
RA01Sternum60.11
RA02Sternoclavicular joints68.69
RA03Clavicle51.52
RA04Acromio-clavicular joints51.52
RA05Scapula51.52
RA06Shoulder55.81
RA07Humerus55.81
RA08Elbow joint47.23
RA09Forearm47.23
RA10Hand or wrist joint, or both47.23
RA11Wrist or hand for bone age47.23
RA15Upper limb (infant)55.81
RA21Sacroiliac joints55.81
RA22Pelvis or both hips (1 projection)55.81
RA25Hip joint (more than 1 projection)60.11
RA26Femur55.81
RA27Knee joint51.52
RA28Knee joint (and intercondylar or axial)60.11
RA29Tibia and fibula51.52
RA30Ankle joint55.81
RA32Foot51.52
RA35Long legs (hips to ankles), including measurement64.40
RA40Lower limb (infant)60.11
Head, neck, and spine
RB01Cervical spine64.40
RB02Thoracic spine60.11
RB03Lumbar spine, including lumbosacral joint60.11
RB04Sacro-coccygeal spine55.81
RB08Spine (scoliosis views)64.40
RB10Skull60.11
RB12Nasal bones51.52
RB13Facial bones55.81
RB14Optic foramina47.23
RB16Auditory canals (plain films only)60.11
RB21Nasal sinuses47.23
RB22Nasopharynx55.81
RB23Mastoids (bilateral)60.11
RB24Larynx or trachea, or both51.52
RB31Upper teeth47.23
RB32Lower teeth47.23
RB33Mandible or OPG or lateral cephalogram64.40
RB34Temporo-mandibular joints64.40
RB35Salivary gland55.81
RB37Pharynx55.81
Chest, including breast
RC05Thoracic inlet55.81
RC06Chest (1 view)55.81
RC07Chest (more than 1 view)55.81
RC08Chest and thoracic cage68.69
RC09Chest and both oblique views68.69
Mammography
RC31Screening mammogram94.46
RC32Recall mammogram128.81
RC35Problem mammogram bilateral188.91
RC36Problem mammogram unilateral124.51
RC40Needle localisation253.31
RC41Galactogram253.31
RC45Breast aspiration biopsy253.31
RC46Breast biopsy with stereotaxis253.31
GI, GU, and obstetrics—no contrast modifiers permitted
Radiology
RD01Abdomen (1 projection)55.81
RD02Abdomen (2 or more projections)55.81
RD07Pelvimetry (1 view)55.81
RD08Pelvimetry (2 or more views)55.81
Screening
RD10Contrast swallow (oesophagus only)437.94
RD11Contrast study upper GI tract437.94
RD13Small bowel meal 437.94
RD14Small bowel enema (enteroclysis)734.17
RD15Contrast enema437.94
RD20Dynamic proctogram437.94
RD30ERCP437.94
RD40IVP, including plain film and tomography253.31
RD44Cystogram: retrograde or antegrade437.94
RD45Urethrogram437.94
RD46Micturating cysto-urethrogram437.94
RD47Ascending urethrogram437.94
Special procedures
RS42Tube injection253.31
RS43Dacrocystogram253.31
RS44Sialogram 253.31
RS46Hysterosalpingogram437.94
RS61Myelogram cervical437.94
RS62Myelogram lumbar 437.94
RS63Myelogram multilevel437.94
RS70Arthrogram253.31
RS71Arthrogram—upper limb253.31
RS73Arthrogram—lower limb253.31
Ultrasound
Abdomen and pelvis
RU01US abdomen133.10
RU02US abdomen and pelvis167.44
RU03US renal tracts124.51
RU04US abdominal aorta (without Doppler)124.51
RU06US pelvis (transabdominal only)124.51
Infants
RU10US infant head124.51
RU11US infant pylorus124.51
RU12US infant heart236.14
RU13US infant hips124.51
RU19US infant miscellaneous124.51
Various
RU20US thyroid or neck124.51
RU21US scrotum and testes124.51
RU22US breast124.51
RU23US veins176.03
RU24US eye124.51
RU25US chest124.51
RU27US injection or aspiration249.02
RU28US additional region90.16
RU29US miscellaneous124.51
Skeletal
RU30US shoulder176.03
RU31US musculo-skeletal133.10
RU32US foreign body localisation98.75
RU39US skeletal miscellaneous133.10
Intracavitary
RU40US prostate154.56
RU41US anus or rectum154.56
RU42US female pelvis (includes transvaginal and transabdominal, or transvaginal only)154.56
RU43US trans-oesophageal261.90
RU44US intraoperative261.90
RU49US intracavitary (miscellaneous)154.56
Vascular
RU51Duplex or Doppler of chest210.38
RU56Duplex or Doppler of additional limb (arterial or venous)167.44
Pregnancy
RU60US routine pregnancy less than 28 weeks133.10
RU61US problem pregnancy167.44
RU62US pregnancy exceeding 28 weeks167.44
RU64US with amniocentesis249.02
RU68US pregnancy (per extra foetus exceeding 1)64.40
Additional
RX24X-ray additional region47.23
RX25Domiciliary X-ray (in addition)90.16
Specialists’ costs
Repair recent wound
SR1Not exceeding 7 cm (superficial)137.49
SR2Not exceeding 7 cm (deeper tissue)183.31
SR3Exceeding 7 cm (superficial)229.16
SR4Exceeding 7 cm (deeper tissue)274.98
Fractures (closed reduction)
SF1Phalanges91.67
SF2Metacarpals (excluding Bennett’s fracture)164.99
SF3Metatarsals128.34
SF4Bennett’s fracture238.32
SF5Carpal bones 119.14
SF6Colles’ fracture219.97
SF7Radius and ulna—shafts 265.79
SF8Radius—head and neck 238.32
SF9Humerus 265.79
SF10Talus—neck 247.49
SF11Calcaneus 247.49
SF12Other tarsals 155.85
SF13Ankle—fracture dislocation (Pott’s fracture) 384.96
SF14Tibia and fibula—shaft439.94
SF15Tibia and fibula—upper end 384.96
SF16Tibia and fibula—involving joint traction 449.09
SF17Femur, any site (with or without traction) 678.27
Haematoma, abscess, or other infection
SH1Small—aspiration22.96
SH2Large—incision and drainage (local anaesthetic)109.42
SH3Large—incision and drainage (general anaesthetic)119.14
Foreign body, removal of
SB1Under local anaesthetic87.13
SB2Under general anaesthetic192.47
SB3From cornea or sclera59.62
SB4From ear (other than by simple syringing)91.67
SB5From muscle, tendon, or other deep tissue274.98
SB6From nose (other than by simple probing)109.99
SB7From throat (additional fee)91.67
Dislocations (closed reduction)
SD1Elbow, wrist, thumb, and fingers with strapping or splint183.31
SD2Shoulder109.99
SD3Patella155.85
SD4Hip219.97
Plaster
SP1Upper limb—above elbow137.49
SP2Upper limb—below elbow119.14
SP3Lower limb—above knee164.99
SP4Lower limb—below knee137.49
Other
SM1Aspiration of joint22.96
SM2Amputation of all or part of 1 digit201.67
SM3Extensor tendon (primary repair)320.80
SM4Nail (simple removal)91.67
Specified treatment providers’ costs
POD3Podiatry: abscess or haematoma: drainage with incision (with or without local anaesthetic agent)28.96
POD4Podiatry: nail, simple removal23.19
POD5Podiatry: nail, removal or wedge resection requiring the use of digital anaesthesia96.49
XRAYX-ray services provided by chiropractor (maximum of 2 films per claimant per personal injury)14.66
TMTAny other treatment23.90

Michael Webster,
Clerk of the Executive Council.

Explanatory note

This note is not part of the regulations, but is intended to indicate their general effect.

These regulations, which come into force on 1 May 2021, amend the Accident Compensation (Liability to Pay or Contribute to Cost of Treatment) Regulations 2003 (the principal regulations). The amendments increase by 2.05% the costs that the Accident Compensation Corporation (ACC) is liable to pay under the principal regulations for the treatments those regulations relate to.

In addition, these regulations amend regulation 10 (dentists’ costs) of the principal regulations by revoking the provisions that apply to subsequent dentistry treatment on a tooth that has previously been treated (restored or crowned). At present, if ACC was not liable for the previous treatment, its liability for the subsequent treatment is reduced. The effect of the amendment is that ACC is liable to pay 100% of the amount specified in the principal regulations for the subsequent treatment.

Regulatory impact assessment

The Ministry of Business, Innovation, and Employment produced a regulatory impact assessment on 25 June 2020 to help inform the decisions taken by the Government relating to the contents of this instrument.

Issued under the authority of the Legislation Act 2012.

Date of notification in Gazette: 18 March 2021.

These regulations are administered by the Ministry of Business, Innovation, and Employment.