Federal Register of Legislation - Australian Government

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Determinations/Health as made
This Determination creates new Medicare items for video consultation services provided by a range of specialists or consultant physicians to patients in eligible areas of Australia.
Administered by: Health
Registered 06 Jun 2011
Tabling HistoryDate
Tabled HR14-Jun-2011
Tabled Senate15-Jun-2011
Date of repeal 19 Mar 2014
Repealed by Health (Spent and Redundant Instruments) Repeal Regulation 2014

I, NICOLA ROXON, Minister for Health and Ageing, make this Determination under section 3C of the Health Insurance Act 1973.

Dated  23rd May  2011

 

NICOLA ROXON


Contents

Part 1                    Preliminary                                                                                    2

                        1      Name of Determination                                                                       2

                        2      Commencement and term                                                                    2

                        3      Definitions                                                                                          2

                        4      Treatment of relevant services                                                             3

                        5      Amount under clause 5                                                                        4

                        6      Amount under Table 1                                                                         4

                        7      Limitation on support services                                                             5

                        8      Midwifery services                                                                              5

                        9      Nurse practitioner services                                                                  6

 

Schedule 1          Services and fees                                                                      7

 

Part 1                             Specialist services and fees                                                                7

Part 2                             Medical Practitioner services and fees                                               11

Part 3                             Practice Nurse and Aboriginal Health Worker services and fees           15

Part 4                             Midwifery services and fees                                                              16

Part 5                             Nurse practitioner services and fees                                                   17


Part 1                 Preliminary

  

1              Name of Determination

                This Determination is the Health Insurance (Telehealth Services) Determination 2011.

2              Commencement and term

                This Determination commences on 1 July 2011 and shall remain in force until midnight 31 October 2011.

3              Definitions

         (1)   In this Determination:

Aboriginal health worker means a person:

(a)        who is employed by, or whose services are otherwise retained

by, a medical practitioner, a general practice or a health service in relation to which a direction made under subsection 19 (2) of the Act applies; and

(b)        holds a Certificate III in Aboriginal or Torres Strait Islander Health Worker Primary Health Care (Clinical) or other appropriate qualification; or

(c)        who is registered, and holds a current registration issued by a

State or Territory regulatory authority, as an Aboriginal health

worker

Act means the Health Insurance Act 1973.

care recipient means a person approved as a care recipient under Part 2.3 of the Aged Care Act 1997.

collaborative arrangement means:

(a)    for a participating midwife’s patient, a collaborative arrangement mentioned in regulation 2C of the Health Insurance Regulations 1975; or

(b)   for a participating nurse practitioner’s patient, a collaborative arrangement mentioned in regulation 2F of the Health Insurance Regulations 1975.

Inner metropolitan area means an area classified as an inner metropolitan area in the document titled ‘Telehealth Eligible Service Areas’, as in force on 30 June 2011 and approved by the Minister.

Note   A copy of ‘Telehealth Eligible Service Areas’ can be found at mbsonline.gov.au.

participating in a video consultation means participating in a consultation via video conference with a specialist or consultant physician practising in their specialty where:

(a)    there is an item that relates to the specialist or consultant physician’s service; and

(b)   the specialist or consultant physician’s service is rendered in Australia.

practice nurse means a registered or an enrolled nurse who is employed

by, or whose services are otherwise retained by, a general practice or a

health service to which a direction under subsection 19 (2) of the Act applies.

relevant provisions means all provisions, relating to professional services or medical services, of:

                (a)    the Act and regulations made under the Act; and

               (b)    the National Health Act 1953 and regulations made under that Act.

 

Note       Unless the contrary intention appears, expressions used in this Determination have the same meaning as in the Act – see section 13 of the Legislative Instruments Act 2003.  The following terms are defined in subsection 3 (1) of the Act:

·      general medical services table

·      general practitioner

·      medical practitioner

·      participating midwife

·      participating nurse practitioner

 

relevant service means a health service that is specified in the Schedule.

residential care service has the same meaning as in the Aged Care Act 1997.

specified health professional means a medical practitioner, practice nurse,  Aboriginal health worker, participating midwife` or participating nurse practitioner.

 

(2)    Unless the contrary intention appears, a reference in this Determination to a provision of the Act or the National Health Act 1953 or regulations made under the Act or under the National Health Act 1953 as applied, adopted or incorporated in relation to specifying a matter is a reference to those provisions as in force from time to time and any other reference to provisions of an Act or regulations is a reference to those provisions as in force from time to time.

4              Treatment of relevant services

                For subsection 3C (1) of the Act, a relevant service provided in accordance with this Determination is to be treated, for the relevant provisions, as if:

                (a)    it were both a professional service and a medical service; and

               (b)    there were an item in the general medical services table that:

                          (i)    related to the service; and

                         (ii)    specified for the service a fee in relation to each State, being the fee specified in Schedule 1 in relation to the service.

Note       For this Determination, an internal Territory is deemed to form part of the State of New South Wales — see subsection 3C (7) of the Act.

5              Amount under clause 5

 

                In this Determination:

amount under clause 5 means 50% of the fee for the item with which the relevant service is associated

Example   Where item 99 is provided in association with item 104, the fee for item 99 is 50% of the fee for item 104. The fee for item 104 is specified in the general medical services table.

6              Amount under Table 1

                For an item of Part 2 of the Schedule, as mentioned in column 2 of Table 1:

amount under Table 1 means the sum of:

                (a)    the fee mentioned in column 3 for the item; and

               (b)    either:

                          (i)    if a specified health professional attends not more than 6 patients in a single attendance — the amount mentioned in column 4 for the item, divided by the number of patients attended; or

                         (ii)    if a specified health professional attends more than 6 patients in a single attendance — the amount mentioned in column 5 for the item.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Table 1

Item

Item/s of the table

Fee

Amount if not more than 6 patients (to be divided by the number of patients)

Amount if more than 6 patients

1

2122

The fee for item 2100

$24.50

$1.85

2

2125

The fee for item 2100

$44.05

$3.15

3

2137

The fee for item 2126

$24.50

$1.85

4

2138

The fee for item 2126

$44.05

$3.15

5

2147

The fee for item 2143

$24.50

$1.85

6

2179

The fee for item 2143

$44.05

$3.15

7

2199

The fee for item 2195

$24.50

$1.85

8

2220

The fee for item 2195

$44.05

$3.15

 

 

 

 

 

 

 

 

 

7              Limitation on support services

(1)    Use this section for items in Parts 2 – 5 of Schedule 1.

(2)     An item applies only when both of the following are met:

(a)     the service is provided in the course of a personal attendance by a single specified health professional on a single patient on a single occasion; and

          (b)     no other service described in an item in Parts 2-5 of Schedule 1 is provided to the patient on the same occasion.

8              Midwifery services

         (1)   An item in Part 4 of Schedule 1 applies to a service only if:

                (a)    the service is provided to the patient in accordance with a collaborative arrangement applying to that patient; and

               (b)    the midwife:

                          (i)    is not employed by the proprietor of a hospital that is not a private hospital; or

                         (ii)    both:

                                   (A)     is employed by the proprietor of a hospital that is not a private hospital; and

                                   (B)     provides the service otherwise than in the course of employment by that proprietor.

         (2)   Subsection (1) applies whether or not another person provides essential assistance to the participating midwife in accordance with accepted clinical practice.

9              Nurse practitioner services

         (1)   An item in Part 5 of Schedule 1 applies to a service only if:

                (a)    the service is provided to the patient in accordance with a collaborative arrangement applying to that patient;  and

               (b)    the service is  within the scope of practice of the participating nurse practitioner who provides the service; and

\               (c)    the nurse practitioner:

                          (i)    is not employed by the proprietor of a hospital that is not a private hospital; or

                         (ii)    both:

                                   (A)     is employed by the proprietor of a hospital that is not a private hospital; and

                                   (B)     provides the service otherwise than in the course of employment by that proprietor.

         (2)   Subsection (1) applies whether or not another person provides essential assistance to the participating nurse practitioner in accordance with accepted clinical practice.

            


Schedule 1                  Services and fees

Part 1          Specialist services and fees

Item

Service

Fee for all States

($)

99

The initiation, by a specialist, practising in his or her speciality, of a professional attendance via video conference, rendered to a patient who is:

a) a care recipient receiving care in a residential care service; or 

b) at an Aboriginal Medical Service or Aboriginal Community Controlled Health Service in relation to which a direction made under subsection 19(2) of the Act applies; or

c) located outside an inner metropolitan area, not being an admitted patient;

and being a service associated with item 104 or 105.

 

Amount under clause 5

112

The initiation, by a consultant physician practising in his or her specialty, of a professional attendance via video conference, rendered to a patient who is:

a) a care recipient receiving care in a residential care service; or 

b) at an Aboriginal Medical Service or Aboriginal Community Controlled Health Service in relation to which a direction made under subsection 19(2) of the Act applies; or

c) located outside an inner metropolitan area, not being an admitted patient;

and being a service associated with item 110, 116, 119, 132 or 133.

 

Amount under clause 5

149

The initiation, by a consultant physician or specialist practising in his or her specialty of geriatric medicine, of a professional attendance via video conference, rendered to a patient who is:

a) a care recipient receiving care in a residential care service; or 

b) at an Aboriginal Medical Service or Aboriginal Community Controlled Health Service in relation to which a direction made under subsection 19(2) of the Act applies; or

c) located outside an inner metropolitan area, not being an admitted patient;

and being a service associated with item 141 or 143.

 

Amount under clause 5

288

The initiation, by a consultant physician practising in his or her specialty of psychiatry, of a professional attendance via video conference, rendered to a patient who is:

a) a care recipient receiving care in a residential care service; or 

b) at an Aboriginal Medical Service or Aboriginal Community Controlled Health Service in relation to which a direction made under subsection 19(2) of the Act applies; or

c) located outside an inner metropolitan area, not being an admitted patient;

and being a service associated with item 291, 293, 296, 300, 302, 304, 306, 308, 310, 312, 314, 316, 318, 319, 348, 350 or 352.

 

Amount under clause 5

389

The initiation, by a consultant occupational physician practising in his or her specialty of occupational medicine, of a professional attendance via video conference, rendered to a patient who is:

a) a care recipient receiving care in a residential care service; or 

b) at an Aboriginal Medical Service or Aboriginal Community Controlled Health Service in relation to which a direction made under subsection 19(2) of the Act applies; or

c) located outside an inner metropolitan area, not being an admitted patient;

and being a service associated with item 385 or 386.

 

Amount under clause 5

2820

The initiation, by a consultant physician or specialist practising in his or her specialty of pain medicine, of a professional attendance via video conference, rendered to a patient who is:

a) a care recipient receiving care in a residential care service; or 

b) at an Aboriginal Medical Service or Aboriginal Community Controlled Health Service in relation to which a direction made under subsection 19(2) of the Act applies; or

c) located outside an inner metropolitan area, not being an admitted patient;

and being a service associated with item 2801, 2806 or 2814.

 

Amount under clause 5

3015

The initiation, by a consultant physician or specialist practising in his or her specialty of palliative medicine, of a professional attendance via video conference, rendered to a patient who is:

a) a care recipient receiving care in a residential care service; or 

b) at an Aboriginal Medical Service or Aboriginal Community Controlled Health Service in relation to which a direction made under subsection 19(2) of the Act applies; or

c) located outside an inner metropolitan area, not being an admitted patient;

and being a service associated with item 3005, 3010 or 3014.

 

Amount under clause 5

6016

The initiation, by a specialist practising in his or her specialty of neurosurgery, of a professional attendance via video conference, rendered to a patient who is:

a) a care recipient receiving care in a residential care service; or 

b) at an Aboriginal Medical Service or Aboriginal Community Controlled Health Service in relation to which a direction made under subsection 19(2) of the Act applies; or

c) located outside an inner metropolitan area, not being an admitted patient;

and being a service associated with item 6007, 6009, 6011, 6013 or 6015.

 

Amount under clause 5

13210

The initiation, by a specialist practising in his or her speciality, of a professional attendance via video conference, rendered to a patient who is:

a) a care recipient receiving care in a residential care service; or 

b) at an Aboriginal Medical Service or Aboriginal Community Controlled Health Service in relation to which a direction made under subsection 19(2) of the Act applies; or

c) located outside an inner metropolitan area, not being an admitted patient;

and being a service associated with item 13209.

 

Amount under clause 5

16399

The initiation, by a specialist practising in his or her specialty of obstetrics, of a professional attendance via video conference, rendered to a patient who is:

a) a care recipient receiving care in a residential care service; or 

b) at an Aboriginal Medical Service or Aboriginal Community Controlled Health Service in relation to which a direction made under subsection 19(2) of the Act applies; or

c) located outside an inner metropolitan area, not being an admitted patient;

and being a service associated with item 16401, 16404, 16406, 16500, 16590 or 16591.

 

Amount under clause 5

17609

The initiation, by a specialist practising in his or her specialty of anaesthesia, of a professional attendance via video conference, rendered to a patient who is:

a) a care recipient receiving care in a residential care service; or 

b) at an Aboriginal Medical Service or Aboriginal Community Controlled Health Service in relation to which a direction made under subsection 19(2) of the Act applies; or

c) located outside an inner metropolitan area, not being an admitted patient;

and being a service associated with item 17610, 17615, 17620, 17625, 17640, 17645, 17650, 17655 or 17690.

 

Amount under clause 5


Part 2         Medical Practitioner services and fees

 

Item

Service

Fee for all States

($)

2100

A professional attendance at consulting rooms lasting at least 5 minutes (whether or not continuous) by a medical practitioner that requires the provision of clinical support to a patient who is:

a)  at an Aboriginal Medical Service or Aboriginal Community Controlled Health Service in relation to which a direction made under subsection 19(2) of the Act applies; or

b)  located outside an inner metropolitan area, not being an admitted patient;

and who is participating in a video consultation.

 

21.60

2122

A professional attendance by a medical practitioner, other than in consulting rooms lasting at least 5 minutes (whether or not continuous) that requires the provision of clinical support to a patient who is located outside an inner metropolitan area, not being an admitted patient and who is not:

a) a care recipient receiving care in a residential care service; or

b)  at an Aboriginal Medical Service or Aboriginal Community Controlled Health Service in relation to which a direction made under subsection 19(2) of the Act applies;

and who is participating in a video consultation ― an attendance on 1 or more patients at 1 place on 1 occasion ― each patient.

 

Amount under Table 1

2125

A professional attendance by a medical practitioner lasting at least 5 minutes (whether or not continuous) that requires the provision of clinical support to a patient participating in a video consultation who is:

a) a care recipient receiving care in a residential care service; or

b) at consulting rooms situated within such a complex if the patient is a care recipient receiving care in a residential aged care service;

and the professional attendance is not provided at a self-contained unit ―an attendance on 1 or more patients at 1 place on 1 occasion ― each patient.

 

Amount under Table 1

2126

A professional attendance at consulting rooms lasting less than 20 minutes (whether or not continuous) by a medical practitioner that requires the provision of clinical support to a patient who is:

a)  at an Aboriginal Medical Service or Aboriginal Community Controlled Health Service in relation to which a direction made under subsection 19(2) of the Act applies; or

b)  located outside an inner metropolitan area, not being an admitted patient;

and who is participating in a video consultation.

 

47.10

2137

A professional attendance by a medical practitioner, other than in consulting rooms lasting less than 20 minutes (whether or not continuous) that requires the provision of clinical support to a patient who is located outside an inner metropolitan area, not being an admitted patient and who is not:

a) a care recipient receiving care in a residential care service; or

b)  at an Aboriginal Medical Service or Aboriginal Community Controlled Health Service in relation to which a direction made under subsection 19(2) of the Act applies;

and who is participating in a video consultation ― an attendance on 1 or more patients at 1 place on 1 occasion ― each patient.

 

Amount under Table 1

2138

A professional attendance by a medical practitioner lasting less than 20 minutes (whether or not continuous) that requires the provision of clinical support to a patient participating in a video consultation who is:

a) a care recipient receiving care in a residential care service; or

b) at consulting rooms situated within such a complex if the patient is a care recipient receiving care in a residential aged care service;

and the professional attendance is not provided at a self-contained unit ―an attendance on 1 or more patients at 1 place on 1 occasion ― each patient.

 

Amount under Table 1

2143

A professional attendance at consulting rooms lasting at least 20 minutes (whether or not continuous) by a medical practitioner that requires the provision of clinical support to a patient who is:

a)  at an Aboriginal Medical Service or Aboriginal Community Controlled Health Service in relation to which a direction made under subsection 19(2) of the Act applies; or

b)  located outside an inner metropolitan area, not being an admitted patient;

and who is participating in a video consultation.

 

91.35

2147

A professional attendance by a medical practitioner, other than in consulting rooms lasting at least 20 minutes (whether or not continuous) that requires the provision of clinical support to a patient who is located outside an inner metropolitan area, not being an admitted patient and who is not:

a) a care recipient receiving care in a residential care service; or

b)  at an Aboriginal Medical Service or Aboriginal Community Controlled Health Service in relation to which a direction made under subsection 19(2) of the Act applies;

and who is participating in a video consultation ― an attendance on 1 or more patients at 1 place on 1 occasion ― each patient.

 

Amount under Table 1

2179

A professional attendance by a medical practitioner lasting at least 20 minutes (whether or not continuous) that requires the provision of clinical support to a patient participating in a video consultation who is:

a) a care recipient receiving care in a residential care service; or

b) at consulting rooms situated within such a complex if the patient is a care recipient receiving care in a residential aged care service;

and the professional attendance is not provided at a self-contained unit ―an attendance on 1 or more patients at 1 place on 1 occasion ― each patient.

 

Amount under Table 1

2195

A professional attendance at consulting rooms lasting at least 40 minutes (whether or not continuous) by a medical practitioner that requires the provision of clinical support to a patient who is:

a)  at an Aboriginal Medical Service or Aboriginal Community Controlled Health Service in relation to which a direction made under subsection 19(2) of the Act applies; or

b)  located outside an inner metropolitan area, not being an admitted patient;

and who is participating in a video consultation.

 

134.40

2199

A professional attendance by a medical practitioner, other than in consulting rooms lasting at least 40 minutes (whether or not continuous) that requires the provision of clinical support to a patient who is located outside an inner metropolitan area, not being an admitted patient and who is not:

a) a care recipient receiving care in a residential care service; or

b)  at an Aboriginal Medical Service or Aboriginal Community Controlled Health Service in relation to which a direction made under subsection 19(2) of the Act applies;

and who is participating in a video consultation ― an attendance on 1 or more patients at 1 place on 1 occasion ― each patient.

 

Amount under Table 1

2220

A professional attendance by a medical practitioner lasting at least 40 minutes (whether or not continuous) that requires the provision of clinical support to a patient participating in a video consultation who is:

a) a care recipient receiving care in a residential care service; or

b) at consulting rooms situated within such a complex if the patient is a care recipient receiving care in a residential aged care service;

and the professional attendance is not provided at a self-contained unit ―an attendance on 1 or more patients at 1 place on 1 occasion ― each patient.

 

Amount under Table 1

 


Part 3         Practice Nurse and Aboriginal Health Worker services and fees

Item

Service

Fee for all States ($)

10983

An attendance by a practice nurse or Aboriginal health worker provided on behalf of, and under the supervision of, a medical practitioner that requires the provision of clinical support to a patient participating in a video consultation who is:

a)  the patient is located at an Aboriginal Medical Service or Aboriginal Community Controlled Health Service in relation to which a direction made under subsection 19(2) of the Act applies; or

b)  located outside an inner metropolitan area, not being an admitted patient;  

and the attendance is not provided at a self-contained unit.

 

31.20

10984

An attendance by a practice nurse or Aboriginal health worker provided on behalf of, and under the supervision of, a medical practitioner that requires the provision of clinical support to a patient participating in a video consultation who is:

a) a care recipient receiving care in a residential care service; or

b) at consulting rooms situated within such a complex if the patient is a care recipient receiving care in a residential aged care service; and

the professional attendance is not provided at a self-contained unit.

 

31.20

 

 


Part 4          Midwifery services and fees

 

Item

Service

Fee for all States ($)

82150

A professional attendance lasting less than 20 minutes (whether or not continuous) by a participating midwife that requires the provision of clinical support to a patient who is:

a) located outside an inner metropolitan area, not being an admitted patient; or

b) at an Aboriginal Medical Service or Aboriginal Community Controlled Health Service in relation to which a direction made under subsection 19(2) of the Act applies;

and who is participating in a video consultation with a specialist practising in his or her speciality of obstetrics or a specialist or consultant physician practising in his or her speciality of paediatrics.

 

27.20

82151

A professional attendance lasting at least 20 minutes (whether or not continuous) by a participating midwife that requires the provision of clinical support to a patient who is:

a) located outside an inner metropolitan area, not being an admitted patient; or

b) at an Aboriginal Medical Service or Aboriginal Community Controlled Health Service in relation to which a direction made under subsection 19(2) of the Act applies;

and who is participating in a video consultation with a specialist practising in his or her speciality of obstetrics or a specialist or consultant physician practising in his or her speciality of paediatrics.

 

51.65

82152

A professional attendance lasting at least 40 minutes (whether or not continuous) by a participating midwife that requires the provision of clinical support to a patient who is:

a) located outside an inner metropolitan area, not being an admitted patient; or

b) at an Aboriginal Medical Service or Aboriginal Community Controlled Health Service in relation to which a direction made under subsection 19(2) of the Act applies;

and who is participating in a video consultation with a specialist practising in his or her speciality of obstetrics or a specialist or consultant physician practising in his or her speciality of paediatrics.

 

76.00


Part 5          Nurse practitioner services and fees

Item

Service

Fee for all States ($)

82220

A professional attendance lasting less than 20 minutes (whether or not continuous) by a participating nurse practitioner that requires the provision of clinical support to a patient who is:

a) located outside an inner metropolitan area, not being an admitted patient; or

b) at an Aboriginal Medical Service or Aboriginal Community Controlled Health Service in relation to which a direction made under subsection 19(2) of the Act applies;

and who is participating in a video consultation.

 

27.20

82221

A professional attendance lasting at least 20 minutes (whether or not continuous) by a participating nurse practitioner that requires the provision of clinical support to a patient who is:

a) located outside an inner metropolitan area, not being an admitted patient; or

b) at an Aboriginal Medical Service or Aboriginal Community Controlled Health Service in relation to which a direction made under subsection 19(2) of the Act applies;

and who is participating in a video consultation.

 

51.65     

82222

A professional attendance lasting at least 40 minutes (whether or not continuous) by a participating nurse practitioner that requires the provision of clinical support to a patient who is:

a) located outside an inner metropolitan area, not being an admitted patient; or

b) at an Aboriginal Medical Service or Aboriginal Community Controlled Health Service in relation to which a direction made under subsection 19(2) of the Act applies;

and who is participating in a video consultation.

 

76.00

82223

A professional attendance lasting less than 20 minutes (whether or not continuous) by a participating nurse practitioner that requires the provision of clinical support to a patient participating in a video consultation who is:

a) a care recipient receiving care in a residential care service; or

b) at consulting rooms situated within such a complex if the patient is a care recipient receiving care in a residential aged care service; and

the professional attendance is not provided at a self-contained unit.

 

27.20

82224

A professional attendance lasting at least 20 minutes (whether or not continuous) by a participating nurse practitioner that requires the provision of clinical support to a patient participating in a video consultation who is:

a) a care recipient receiving care in a residential care service; or

b) at consulting rooms situated within such a complex if the patient is an approved care recipient receiving care in a residential aged care service; and

the professional attendance is not provided at a self-contained unit.

 

51.65

82225

A professional attendance lasting at least 40 minutes (whether or not continuous) by a participating nurse practitioner that requires the provision of clinical support to a patient participating in a video consultation who is:

a) a care recipient receiving care in a residential care service; or

b) at consulting rooms situated within such a complex if the patient is an approved care recipient receiving care in a residential aged care service; and

the professional attendance is not provided at a self-contained unit.

 

76.00

 

Note

1.         All legislative instruments and compilations are registered on the Federal Register of Legislative Instruments kept under the Legislative Instruments Act 2003. See http://www.frli.gov.au