Hospital Same-Day Accommodation Bands
Same-day accommodation bands apply to hospital admissions that do not include an overnight stay. They help determine the minimum accommodation benefit payable by a private health insurer for eligible treatment.
These accommodation bandings are established under Australian Government private health insurance legislation, specifically the Private Health Insurance (Benefit Requirements) Rules 2011.
The applicable band depends on the procedure performed, the anaesthetic or sedation used and, for Bands 3 and 4, the actual time spent in theatre.
| Band | Criteria |
|---|---|
| Band 1 | Procedures specifically listed as Band 1 under the Medicare Benefits Schedule (MBS), as well as other eligible same-day admissions that do not meet the criteria for Bands 2–4. |
| Band 2 | Procedure performed under Local anaesthetic without sedation, excluding Band 1 treatments. |
| Band 3 | Procedure performed under general or regional anaesthetic, or intravenous sedation, with less than 60 minutes of actual theatre time, excluding Band 1 treatments. |
| Band 4 | Procedure performed under general or regional anaesthetic, or intravenous sedation, with 60 minutes or more of actual theatre time, excluding band 1 treatments. |
Theatre time means the actual time the patient spends in theatre, rather than just the duration of the procedure.
For the full criteria and relevant MBS item lists, refer to the Private Health Insurance (Benefit Requirements) Rules 2011 — Schedule 3, Part 2, clauses 4–6.
Where a hospital has a negotiated agreement with a health fund, the benefit payable is determined by that agreement.
