Health Insurance (Section 3C General Medical Services – GP and Allied Health COVID‑19 Services) Determination 2020
made under subsection 3C(1) of the
Health Insurance Act 1973
Compilation No. 1
Compilation date: 13 March 2020
Includes amendments up to: F2020L00255
Registered: 20 March 2020
About this compilation
This compilation
This is a compilation of the Health Insurance (Section 3C General Medical Services – GP and Allied Health COVID-19 Services) Determination 2020 that shows the text of the law as amended and in force on 13 March 2020 (the compilation date).
The notes at the end of this compilation (the endnotes) include information about amending laws and the amendment history of provisions of the compiled law.
Uncommenced amendments
The effect of uncommenced amendments is not shown in the text of the compiled law. Any uncommenced amendments affecting the law are accessible on the Legislation Register (www.legislation.gov.au). The details of amendments made up to, but not commenced at, the compilation date are underlined in the endnotes. For more information on any uncommenced amendments, see the series page on the Legislation Register for the compiled law.
Application, saving and transitional provisions for provisions and amendments
If the operation of a provision or amendment of the compiled law is affected by an application, saving or transitional provision that is not included in this compilation, details are included in the endnotes.
Editorial changes
For more information about any editorial changes made in this compilation, see the endnotes.
Modifications
If the compiled law is modified by another law, the compiled law operates as modified but the modification does not amend the text of the law. Accordingly, this compilation does not show the text of the compiled law as modified. For more information on any modifications, see the series page on the Legislation Register for the compiled law.
Self‑repealing provisions
If a provision of the compiled law has been repealed in accordance with a provision of the law, details are included in the endnotes.
1. Name
This instrument is the Health Insurance (Section 3C General Medical Services – GP and Allied Health COVID‑19 Services) Determination 2020.
2. Commencement
(1) Each provision of this instrument specified in column 1 of the table commences, or is taken to have commenced, in accordance with column 2 of the table. Any other statement in column 2 has effect according to its terms.
| Commencement information |
| Column 1 | Column 2 | Column 3 |
| Provisions | Commencement | Date/Details |
| 1. The whole of this instrument | 13 March 2020 | |
Note: This table relates only to the provisions of this instrument as originally made. It will not be amended to deal with any later amendments of this instrument.
(2) Any information in column 3 of the table is not part of this instrument. Information may be inserted in this column, or information in it may be edited, in any published version of this instrument.
3. Cessation
Unless earlier revoked this instrument ceases on 30 September 2020.
4. Authority
This instrument is made under subsection 3C(1) of the Health Insurance Act 1973.
5. Definitions
(1) In this instrument:
Act means the Health Insurance Act 1973.
admitted patient means a patient who is receiving a service that is provided:
(a) as part of an episode of hospital treatment; or
(b) as part of an episode of hospital substitute treatment in respect of which the person to whom the treatment is provided choses to receive a benefit from a private health insurer
NOTE: hospital treatment and hospital‑substitute treatment have the same meaning as defined in the Health Insurance Act 1973
bulk‑billed: a service in the Determination is bulk‑billed if:
(a) a medicare benefit is payable to a person in relation to the service; and
(b) under an agreement entered into under section 20A of the Act:
(i) the person assigns to the practitioner by whom, or on whose behalf, the service is provided, the person’s right to the payment of the medicare benefit; and
(ii) the practitioner accepts the assignment in full payment of the practitioner’s fee for the service provided.
health professional is at risk of COVID‑19 virus means a person that:
(a) has been diagnosed with COVID‑19 virus but who is not a patient of a hospital; or
(b) has been required to isolate themselves in quarantine in accordance with home isolation guidance issued by Australian Health Protection Principal Committee; or
patient at risk of COVID‑19 virus means a person that:
(a) has been diagnosed with COVID‑19 virus but who is not a patient of a hospital; or
(b) has been required to isolate themselves in quarantine in accordance with home isolation guidance issued by Australian Health Protection Principal Committee; or
(c) considered more susceptible to the COVID‑19 virus being:
(i) at least 70 years old, or
(ii) at least 50 years old or over if of Aboriginal or Torres Strait Islander descent; or
(iii) pregnant; or
(iv) a parent of a child under 12 months; or
(v) a person under treatment for chronic health conditions or who are immune compromised; or
(d) the person meets the current national triage protocol criteria for suspected COVID‑19 infection.
phone attendance means a professional attendance by telephone where the health practitioner:
(a) has the capacity to provide the full service through this means safely and in accordance with professional standards; and
(b) is satisfied that it is clinically appropriate to provide the service to the patient; and
(c) maintains an audio link with the patient
relevant provisions means all provisions, of the Act and regulations made under the Act, and the National Health Act 1953 and regulations made under the National Health Act 1953, relating to medical services, professional services or items.
relevant service means a health service, as defined in subsection 3C(8) of the Act, that is specified in a Schedule.
Schedule means a Schedule to this instrument.
Note: The following terms are defined in subsection 3(1) of the Act:
· clinically relevant service;
· general medical services table;
· item;
· professional service.
telehealth attendance means a professional attendance by video conference where the health practitioner:
(a) has the capacity to provide the full service through this means safely and in accordance with professional standards; and
(b) is satisfied that it is clinically appropriate to provide the service to the patient; and
(c) maintains a visual and audio link with the patient; and
(d) is satisfied that the software and hardware used to deliver the service meets the applicable laws for security and privacy.
(2) Unless the contrary intention appears, a reference in this instrument 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.
6. Treatment of relevant services
For subsection 3C(1) of the Act a relevant service, provided in accordance with this Instrument where a clinically relevant service, 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 the Schedule in relation to the service.
Schedule 1 – Relevant Services
Division 1.1 – Services and fees – COVID‑19 medical practitioner attendances
1.1.1 – Application of COVID‑19 medical practitioner telehealth services
(1) For items in 91806, 91807 and 91808, “eligible area” has the meaning given by section 4 of the Health Insurance (Section 3C General Medical Services – Other Medical Practitioner) Determination 2018.
(2) For items in Division 1.1, “medical practitioner” has the meaning given by section 4 of the Health Insurance (Section 3C General Medical Services – Other Medical Practitioner) Determination 2018.
(3) Clause 2.22.7 of the general medical services table shall have effect as if items 91818 and 91819 were also specified in that clause.
(4) Clause 1.9.4 of the Health Insurance (Section 3C General Medical Services – Other Medical Practitioner) Determination 2018 shall have effect as if items 91820 and 91821 were also specified in that clause.
(5) For items in Subgroups 1 and 2, the rendering practitioner must not perform a service in subgroup 2 if the practitioner and the patient have the capacity to undertake an attendance by telehealth.
(6) For items in Subgroup 1 and 2, the rendering practitioner must have had at least one face to face attendance with the patient in the preceding 12 months if the patient is considered to be more susceptible to the COVID‑19.
| Group A40 – COVID‑19 general practice telehealth services | |
| Item | Description | Fee ($) |
| Subgroup 1 – COVID‑19 general practice telehealth services |
| 91800 | Telehealth attendance by a general practitioner lasting less than 20 minutes if: (a) the attendance is where: (i) the person is a patient at risk of COVID‑19 virus; or (ii) the general practitioner is a health professional at risk of COVID‑19 virus; and (b) the attendance includes any of the following that are clinically relevant: (i) taking a patient history; (ii) arranging any necessary investigation (iii) conducting or supervising such clinical examinations as may be practical; (iv) implementing a management plan; (v) providing appropriate preventative health care where the service is bulk‑billed | 44.90 |
| 91801 | Telehealth attendance by a general practitioner lasting at least 20 minutes if: (a) the attendance is where: (i) the person is a patient at risk of COVID‑19 virus; or (ii) the general practitioner is a health professional at risk of COVID‑19 virus; and (b) the attendance includes any of the following that are clinically relevant: (i) taking a patient history; (ii) arranging any necessary investigation (iii) conducting or supervising such clinical examinations as may be practical; (iv) implementing a management plan; (v) providing appropriate preventative health care where the service is bulk‑billed | 87.00 |
| 91802 | Telehealth attendance by a general practitioner lasting at least 40 minutes if: (a) the attendance is where: (i) the person is a patient at risk of COVID‑19 virus; or (ii) the general practitioner is a health professional at risk of COVID‑19 virus; and (b) the attendance includes any of the following that are clinically relevant: (i) taking a patient history; (ii) arranging any necessary investigation (iii) conducting or supervising such clinical examinations as may be practical; (iv) implementing a management plan; (v) providing appropriate preventative health care where the service is bulk‑billed | 128.05 |
| 91803 | Telehealth attendance by a medical practitioner of more than 5 minutes in duration but not more than 25 minutes if: (a) the attendance is where: (i) the person is a patient at risk of COVID‑19 virus; or (ii) the medical practitioner is a health professional at risk of COVID‑19 virus; and (b) the attendance includes any of the following that are clinically relevant: (i) taking a patient history; (ii) arranging any necessary investigation (iii) conducting or supervising such clinical examinations as may be practical; (iv) implementing a management plan; (v) providing appropriate preventative health care where the service is bulk‑billed | 24.70 |
| 91804 | Telehealth attendance by a medical practitioner of more than 25 minutes in duration but not more than 45 minutes if: (a) the attendance is where: (i) the person is a patient at risk of COVID‑19 virus; or (ii) the medical practitioner is a health professional at risk of COVID‑19 virus; and (b) the attendance includes any of the following that are clinically relevant: (i) taking a patient history; (ii) arranging any necessary investigation (iii) conducting or supervising such clinical examinations as may be practical; (iv) implementing a management plan; (v) providing appropriate preventative health care where the service is bulk‑billed | 44.70 |
| 91805 | Telehealth attendance by a medical practitioner of at least 45 minutes in duration if: (a) the attendance is where: (i) the person is a patient at risk of COVID‑19 virus; or (ii) the medical practitioner is a health professional at risk of COVID‑19 virus; and (b) the attendance includes any of the following that are clinically relevant: (i) taking a patient history; (ii) arranging any necessary investigation (iii) conducting or supervising such clinical examinations as may be practical; (iv) implementing a management plan; (v) providing appropriate preventative health care where the service is bulk‑billed | 71.75 |
| 91806 | Telehealth attendance by a medical practitioner, in an eligible area, of more than 5 minutes in duration but not more than 25 minutes if: (a) the attendance is where: (i) the person is a patient at risk of COVID‑19 virus; or (ii) the medical practitioner is a health professional at risk of COVID‑19 virus; and (b) the attendance includes any of the following that are clinically relevant: (i) taking a patient history; (ii) arranging any necessary investigation (iii) conducting or supervising such clinical examinations as may be practical; (iv) implementing a management plan; (v) providing appropriate preventative health care where the service is bulk‑billed | 35.90 |
| 91807 | Telehealth attendance by a medical practitioner, in an eligible area, of more than 25 minutes in duration but not more than 45 minutes if: (a) the attendance is where: (i) the person is a patient at risk of COVID‑19 virus; or (ii) the medical practitioner is a health professional at risk of COVID‑19 virus; and (b) the attendance includes any of the following that are clinically relevant: (i) taking a patient history; (ii) arranging any necessary investigation (iii) conducting or supervising such clinical examinations as may be practical; (iv) implementing a management plan; (v) providing appropriate preventative health care where the service is bulk‑billed | 69.55 |
| 91808 | Telehealth attendance by a medical practitioner, in an eligible area, of at least 45 minutes in duration if: (a) the attendance is where: (i) the person is a patient at risk of COVID‑19 virus; or (ii) the medical practitioner is a health professional at risk of COVID‑19 virus; and (b) the attendance includes any of the following that are clinically relevant: (i) taking a patient history; (ii) arranging any necessary investigation (iii) conducting or supervising such clinical examinations as may be practical; (iv) implementing a management plan; (v) providing appropriate preventative health care where the service is bulk‑billed | 102.45 |
| Subgroup 2 – COVID‑19 general practice phone services |
| 91809 | Phone attendance by a general practitioner lasting less than 20 minutes if: (a) the attendance is where: (i) the person is a patient at risk of COVID‑19 virus; or (ii) the general practitioner is a health professional at risk of COVID‑19 virus; and (b) the attendance includes any of the following that are clinically relevant: (i) taking a short patient history; (ii) limited examination and management; where the service is bulk‑billed | 44.90 |
| 91810 | Phone attendance by a general practitioner lasting at least 20 minutes if: (a) the attendance is where: (i) the person is a patient at risk of COVID‑19 virus; or (ii) the general practitioner is a health professional at risk of COVID‑19 virus; and (b) the attendance includes any of the following that are clinically relevant: (i) taking a short patient history; (ii) limited examination and management; where the service is bulk‑billed | 87.00 |
| 91811 | Phone attendance by a general practitioner lasting at least 40 minutes if: (a) the attendance is where: (i) the person is a patient at risk of COVID‑19 virus; or (ii) the general practitioner is a health professional at risk of COVID‑19 virus; and (b) the attendance includes any of the following that are clinically relevant: (i) taking a short patient history; (ii) limited examination and management; where the service is bulk‑billed | 128.05 |
| 91812 | Phone attendance by a medical practitioner of more than 5 minutes in duration but not more than 25 minutes if: (a) the attendance is where: (i) the person is a patient at risk of COVID‑19 virus; or (ii) the medical practitioner is a health professional at risk of COVID‑19 virus; and (b) the attendance includes any of the following that are clinically relevant: (i) taking a short patient history; (ii) limited examination and management; where the service is bulk‑billed | 24.70 |
| 91813 | Phone attendance by a medical practitioner of at least 25 minutes in duration but not more than 45 minutes if: (a) the attendance is where: (i) the person is a patient at risk of COVID‑19 virus; or (ii) the medical practitioner is a health professional at risk of COVID‑19 virus; and (b) the attendance includes any of the following that are clinically relevant: (i) taking a short patient history; (ii) limited examination and management; where the service is bulk‑billed | 44.70 |
| 91814 | Phone attendance by a medical practitioner of at least 45 minutes in duration if: (a) the attendance is where: (i) the person is a patient at risk of COVID‑19 virus; or (ii) the medical practitioner is a health professional at risk of COVID‑19 virus; and (b) the attendance includes any of the following that are clinically relevant: (i) taking a short patient history; (ii) limited examination and management; where the service is bulk‑billed | 71.75 |
| 91815 | Phone attendance by a medical practitioner, in an eligible area, of more than 5 minutes in duration but not more than 25 minutes if: (a) the attendance is where: (i) the person is a patient at risk of COVID‑19 virus; or (ii) the medical practitioner is a health professional at risk of COVID‑19 virus; and (b) the attendance includes any of the following that are clinically relevant: (i) taking a short patient history; (ii) limited examination and management; where the service is bulk‑billed | 35.90 |
| 91816 | Phone attendance by a medical practitioner, in an eligible area, of more than 25 minutes in duration but not more than 45 minutes if: (a) the attendance is where: (i) the person is a patient at risk of COVID‑19 virus; or (ii) the medical practitioner is a health professional at risk of COVID‑19 virus; and (b) the attendance includes any of the following that are clinically relevant: (i) taking a short patient history; (ii) limited examination and management; where the service is bulk‑billed | 69.55 |
| 91817 | Phone attendance by a medical practitioner, in an eligible area, of more than 45 minutes in duration if: (a) the attendance is where: (i) the person is a patient at risk of COVID‑19 virus; or (ii) the medical practitioner is a health professional at risk of COVID‑19 virus; and (b) the attendance includes any of the following that are clinically relevant: (i) taking a short patient history; (ii) limited examination and management; where the service is bulk‑billed | 102.45 |
| Subgroup 3 – COVID‑19 Focussed Psychological Strategies telehealth services |
| 91818 | Telehealth attendance for a patient at risk for COVID‑19 virus by a general practitioner, for the purpose of providing focussed psychological strategies for assessed mental disorders if: (a) the practitioner is registered with the Chief Executive Medicare as meeting the credentialing requirements for provision of this service; and (b) the service lasts at least 30 minutes, but less than 40 minutes; where the service is bulk‑billed | 110.85 |
| 91819 | Telehealth attendance for a patient at risk for COVID‑19 virus by a general practitioner, for the purpose of providing focussed psychological strategies for assessed mental disorders if: (a) the practitioner is registered with the Chief Executive Medicare as meeting the credentialing requirements for provision of this service; and (b) the service lasts at least 40 minutes; where the service is bulk‑billed | 158.60 |
| 91820 | Telehealth attendance for a patient at risk for COVID‑19 virus by a medical practitioner, for the purpose of providing focussed psychological strategies for assessed mental disorders if: (a) the practitioner is registered with the Chief Executive Medicare as meeting the credentialing requirements for provision of this service; and (b) the service lasts at least 30 minutes, but less than 40 minutes; where the service is bulk‑billed | 88.70 |
| 91821 | Telehealth attendance for a patient at risk for COVID‑19 virus by a medical practitioner, for the purpose of providing focussed psychological strategies for assessed mental disorders if: (a) the practitioner is registered with the Chief Executive Medicare as meeting the credentialing requirements for provision of this service; and (b) the service lasts at least 40 minutes; where the service is bulk‑billed | 126.90 |
Division 1.2 – Services and fees – COVID‑19 allied health telehealth services
1.2.1 – Application of COVID‑19 allied health attendances
(1) For items in Division 1.2, “eligible clinical psychologist”, “eligible psychologist”, “eligible occupational therapist” and “eligible social worker” have the meanings given by section 4 of the Health Insurance (Allied Health Services) Determination 2014.
(2) For items 91166 and 91167, sections 7 and 9 of the Health Insurance (Allied Health Services) Determination 2014 shall have effect as if the items were also specified in those clauses.
| Group M18 – COVID‑19 allied health telehealth services | |
| Item | Description | Fee ($) |
| Subgroup 1 – COVID‑19 psychological therapies telehealth services |
| 91166 | Psychological therapy health service provided by telehealth attendance by an eligible clinical psychologist if: (a) the attendance is where: (i) the person is a patient at risk of COVID‑19 virus; or (ii) the eligible clinical psychologist is a health professional at risk of COVID‑19 virus; and (b) the person is referred by: (i) a medical practitioner, either as part of a GP Mental Health Treatment Plan, or as part of a shared care plan or as part of a psychiatrist assessment and management plan; or (ii) a specialist or consultant physician specialising in the practice of his or her field of psychiatry; or (iii) a specialist or consultant physician specialising in the practice of his or her field of paediatrics; and (c) the service is provided to the person individually; and (d) at the completion of a course of treatment, the referring medical practitioner reviews the need for a further course of treatment; and (e) on the completion of the course of treatment, the eligible clinical psychologist gives a written report to the referring medical practitioner on assessments carried out, treatment provided and recommendations on future management of the person’s condition; and (f) the service is at least 30 minutes but less than 50 minutes duration; where the service is bulk‑billed | 101.35 |
| 91167 | Psychological therapy health service provided by telehealth attendance by an eligible clinical psychologist if: (a) the attendance is where: (i) the person is a patient at risk of COVID‑19 virus; or (ii) the eligible clinical psychologist is a health professional at risk of COVID‑19 virus; and (b) the person is referred by: (i) a medical practitioner, either as part of a GP Mental Health Treatment Plan, or as part of a shared care plan or as part of a psychiatrist assessment and management plan; or (ii) a specialist or consultant physician specialising in the practice of his or her field of psychiatry; or (iii) a specialist or consultant physician specialising in the practice of his or her field of paediatrics; and (c) the service is provided to the person individually; and (d) at the completion of a course of treatment, the referring medical practitioner reviews the need for a further course of treatment; and (e) on the completion of the course of treatment, the eligible clinical psychologist gives a written report to the referring medical practitioner on assessments carried out, treatment provided and recommendations on future management of the person’s condition; and (f) the service is at least 50 minutes duration; where the service is bulk‑billed | 148.80 |
| Subgroup 2 – COVID‑19 psychologist focussed psychological strategies telehealth services |
| 91169 | Focussed psychological strategies health service provided by telehealth attendance by an eligible psychologist if: (a) the attendance is where: (i) the person is a patient at risk of COVID‑19 virus; or (ii) the eligible psychologist is a health professional at risk of COVID‑19 virus; and (b) the person is referred by: (i) a medical practitioner, either as part of a GP Mental Health Treatment Plan, or as part of a shared care plan or as part of a psychiatrist assessment and management plan; or (ii) a specialist or consultant physician specialising in the practice of his or her field of psychiatry; or (iii) a specialist or consultant physician specialising in the practice of his or her field of paediatrics; and (c) the service is provided to the person individually; and (d) at the completion of a course of treatment, the referring medical practitioner reviews the need for a further course of treatment; and (e) on the completion of the course of treatment, the eligible psychologist gives a written report to the referring medical practitioner on assessments carried out, treatment provided and recommendations on future management of the person’s condition; and (g) the service is at least 20 minutes but less than 50 minutes duration; where the service is bulk‑billed | 71.80 | | 91170 | Focussed psychological strategies health service provided by telehealth attendance by an eligible psychologist if: (a) the attendance is where: (i) the person is a patient at risk of COVID‑19 virus; or (ii) the eligible psychologist is a health professional at risk of COVID‑19 virus; and (b) the person is referred by: (i) a medical practitioner, either as part of a GP Mental Health Treatment Plan, or as part of a shared care plan or as part of a psychiatrist assessment and management plan; or (ii) a specialist or consultant physician specialising in the practice of his or her field of psychiatry; or (iii) a specialist or consultant physician specialising in the practice of his or her field of paediatrics; and (c) the service is provided to the person individually; and (d) at the completion of a course of treatment, the referring medical practitioner reviews the need for a further course of treatment; and (e) on the completion of the course of treatment, the eligible psychologist gives a written report to the referring medical practitioner on assessments carried out, treatment provided and recommendations on future management of the person’s condition; and (f) the service is at least 50 minutes duration; where the service is bulk‑billed | 101.35 | |
| Subgroup 3 – COVID‑19 occupational therapist focussed psychological strategies telehealth services |
| 91172 | Focussed psychological strategies health service provided by telehealth attendance by an eligible occupational therapist if: (a) the attendance is where: (i) the person is a patient at risk of COVID‑19 virus; or (ii) the eligible occupational therapist is a health professional at risk of COVID‑19 virus; and (a) the person is referred by: (i) a medical practitioner, either as part of a GP Mental Health Treatment Plan, or as part of a shared care plan or as part of a psychiatrist assessment and management plan; or (ii) a specialist or consultant physician specialising in the practice of his or her field of psychiatry; or (iii) a specialist or consultant physician specialising in the practice of his or her field of paediatrics; and (b) the service is provided to the person individually; and (c) at the completion of a course of treatment, the referring medical practitioner reviews the need for a further course of treatment; and (d) on the completion of the course of treatment, the eligible occupational therapist gives a written report to the referring medical practitioner on assessments carried out, treatment provided and recommendations on future management of the person’s condition; and (e) the service is at least 20 minutes but less than 50 minutes duration where the service is bulk‑billed | 63.25 | | 91173 | Focussed psychological strategies health service provided by telehealth attendance by an eligible occupational therapist if: (a) the attendance is where: (i) the person is a patient at risk of COVID‑19 virus; or (ii) the eligible occupational therapist is a health professional at risk of COVID‑19 virus; and (b) the person is referred by: (i) a medical practitioner, either as part of a GP Mental Health Treatment Plan, or as part of a shared care plan or as part of a psychiatrist assessment and management plan; or (ii) a specialist or consultant physician specialising in the practice of his or her field of psychiatry; or (iii) a specialist or consultant physician specialising in the practice of his or her field of paediatrics; and (c) the service is provided to the person individually; and (d) at the completion of a course of treatment, the referring medical practitioner reviews the need for a further course of treatment; and (e) on the completion of the course of treatment, the eligible occupational therapist gives a written report to the referring medical practitioner on assessments carried out, treatment provided and recommendations on future management of the person’s condition; and (f) the service is at least 50 minutes in duration where the service is bulk‑billed | 89.35 | |
| Subgroup 4 – COVID‑19 social worker focussed psychological strategies telehealth services |
| 91175 | Focussed psychological strategies health service provided by an eligible social worker if: (a) the attendance is where: (i) the person is a patient at risk of COVID‑19 virus; or (ii) the eligible social worker is a health professional at risk of COVID‑19 virus; and (b) the person is referred by: (i) a medical practitioner, either as part of a GP Mental Health Treatment Plan, or as part of a shared care plan or as part of a psychiatrist assessment and management plan; or (ii) a specialist or consultant physician specialising in the practice of his or her field of psychiatry; or (iii) a specialist or consultant physician specialising in the practice of his or her field of paediatrics; and (b) the service is provided to the person individually; and (c) at the completion of a course of treatment, the referring medical practitioner reviews the need for a further course of treatment; and (d) on the completion of the course of treatment, the eligible social worker gives a written report to the referring medical practitioner on assessments carried out, treatment provided and recommendations on future management of the person’s condition; and (e) the service is at least 20 minutes but less than 50 minutes duration where the service is bulk‑billed | 63.25 | | 91176 | Focussed psychological strategies health service provided to a person at risk for COVID‑19 virus by an eligible social worker if: (a) the attendance is where: (i) the person is a patient at risk of COVID‑19 virus; or (ii) the eligible social worker is a health professional at risk of COVID‑19 virus; and (b) the person is referred by: (i) a medical practitioner, either as part of a GP Mental Health Treatment Plan, or as part of a shared care plan or as part of a psychiatrist assessment and management plan; or (ii) a specialist or consultant physician specialising in the practice of his or her field of psychiatry; or (iii) a specialist or consultant physician specialising in the practice of his or her field of paediatrics; and (c) the service is provided to the person individually; and (d) at the completion of a course of treatment, the referring medical practitioner reviews the need for a further course of treatment; and (e) on the completion of the course of treatment, the eligible social worker gives a written report to the referring medical practitioner on assessments carried out, treatment provided and recommendations on future management of the person’s condition; and (f) the service is at least 50 minutes duration where the service is bulk‑billed | 89.35 | |
| Subgroup 5 – COVID‑19 nurse practitioner telehealth services | |
| 91178 | Telehealth attendance by a participating nurse practitioner lasting less than 20 minutes if: (i) The person is at risk of COVID‑19 virus; or (ii) The participating nurse practitioner is a health professional at risk of COVID‑19 virus; and (a) The attendance includes any of the following that are clinically relevant: (i) taking a history; (ii) undertaking clinical examination; (iii) arranging any necessary investigation; (iv) implementing a management plan; (v) providing appropriate preventive health care; where the service is bulk‑billed. | 21.30 | |
| 91179 | Telehealth attendance by a participating nurse practitioner lasting at least 20 minutes if: (a) The attendance is where: (i) The person is at risk of COVID‑19 virus; or (ii) The participating nurse practitioner is a health professional at risk of COVID‑19 virus; and (b) The attendance includes any of the following that are clinically relevant: (i) taking a history; (ii) undertaking clinical examination; (iii) arranging any necessary investigation; (iv) implementing a management plan; (v) providing appropriate preventive health care; where the service is bulk‑billed. | 40.40 | |
| 91180 | Telehealth attendance by a participating nurse practitioner lasting at least 40 minutes if: (a) The attendance is where: (i) The person is at risk of COVID‑19 virus; or (ii) The participating nurse practitioner is a health professional at risk of COVID‑19 virus; and (b) The attendance includes any of the following that are clinically relevant: (i) taking a history; (ii) undertaking clinical examination; (iii) arranging any necessary investigation; (iv) implementing a management plan; (v) providing appropriate preventive health care; where the service is bulk‑billed. | 59.50 | |
| | | | | |
Division 1.3 ‑ Services and fees – COVID‑19 medical practitioner attendances
1.3.1 Application of COVID‑19 medical practitioner phone services
Insert:
(1) For items in the subgroup below, the rendering practitioner must not perform a service in subgroup 10 if the practitioner and the patient have the capacity to undertake an attendance by telehealth.
| Group A40 – COVID‑19 medical practitioner phone services | |
| Item | Description | Fee ($) |
| Subgroup 10 – COVID‑19 Focussed Psychological Strategies phone services |
| 91842 | Phone attendance for a patient at risk for COVID‑19 virus by a general practitioner, for the purpose of providing focussed psychological strategies for assessed mental disorders if: (a) the practitioner is registered with the Chief Executive Medicare as meeting the credentialing requirements for provision of this service; and (b) the service lasts at least 30 minutes, but less than 40 minutes; where the service is bulk‑billed | 110.85 |
| 91843 | Phone attendance for a patient at risk for COVID‑19 virus by a general practitioner, for the purpose of providing focussed psychological strategies for assessed mental disorders if: (a) the practitioner is registered with the Chief Executive Medicare as meeting the credentialing requirements for provision of this service; and (b) the service lasts at least 40 minutes; where the service is bulk‑billed | 158.60 |
| 91844 | Phone attendance for a patient at risk for COVID‑19 virus by a medical practitioner, for the purpose of providing focussed psychological strategies for assessed mental disorders if: (a) the practitioner is registered with the Chief Executive Medicare as meeting the credentialing requirements for provision of this service; and (b) the service lasts at least 30 minutes, but less than 40 minutes; where the service is bulk‑billed | 88.70 |
| 91845 | Phone attendance for a patient at risk for COVID‑19 virus by a medical practitioner, for the purpose of providing focussed psychological strategies for assessed mental disorders if: (a) the practitioner is registered with the Chief Executive Medicare as meeting the credentialing requirements for provision of this service; and (b) the service lasts at least 40 minutes; where the service is bulk‑billed | 126.90 |
Division 1.4 ‑ Services and fees – Services and fees – COVID‑19 allied health phone services
1.4.1 – Application of COVID‑19 allied health attendances
(1) For items in Division 1.4, “eligible clinical psychologist”, “eligible psychologist”, “eligible occupational therapist” and “eligible social worker” have the meanings given by section 4 of the Health Insurance (Allied Health Services) Determination 2014.
(2) For items 91181 and 91189, sections 7 and 9 of the Health Insurance (Allied Health Services) Determination 2014 shall have effect as if the items were also specified in those clauses.
(3) For items in subgroups below the rendering practitioner must not perform a service in these subgroups 6, 7, 8, 9 and 10 if the practitioner and the patient have the capacity to undertake an attendance by telehealth.
| Group M18 – COVID‑19 allied health telehealth services | |
| Item | Description | Fee ($) |
| Subgroup 6 – COVID‑19 psychological therapies phone services |
| 91181 | Psychological therapy health service provided by phone attendance by an eligible clinical psychologist if: (a) the attendance is where: (i) the person is a patient at risk of COVID‑19 virus; or (ii) the eligible clinical psychologist is a health professional at risk of COVID‑19 virus; and (b) the person is referred by: (i) a medical practitioner, either as part of a GP Mental Health Treatment Plan, or as part of a shared care plan or as part of a psychiatrist assessment and management plan; or (ii) a specialist or consultant physician specialising in the practice of his or her field of psychiatry; or (iii) a specialist or consultant physician specialising in the practice of his or her field of paediatrics; and (c) the service is provided to the person individually; and (d) at the completion of a course of treatment, the referring medical practitioner reviews the need for a further course of treatment; and (e) on the completion of the course of treatment, the eligible clinical psychologist gives a written report to the referring medical practitioner on assessments carried out, treatment provided and recommendations on future management of the person’s condition; and (f) the service is at least 30 minutes but less than 50 minutes duration; where the service is bulk‑billed | 101.35 |
| 91182 | Psychological therapy health service provided by phone attendance by an eligible clinical psychologist if: (a) the attendance is where: (i) the person is a patient at risk of COVID‑19 virus; or (ii) the eligible clinical psychologist is a health professional at risk of COVID‑19 virus; and (b) the person is referred by: (i) a medical practitioner, either as part of a GP Mental Health Treatment Plan, or as part of a shared care plan or as part of a psychiatrist assessment and management plan; or (ii) a specialist or consultant physician specialising in the practice of his or her field of psychiatry; or (iii) a specialist or consultant physician specialising in the practice of his or her field of paediatrics; and (c) the service is provided to the person individually; and (d) at the completion of a course of treatment, the referring medical practitioner reviews the need for a further course of treatment; and (e) on the completion of the course of treatment, the eligible clinical psychologist gives a written report to the referring medical practitioner on assessments carried out, treatment provided and recommendations on future management of the person’s condition; and (f) the service is at least 50 minutes duration; where the service is bulk‑billed | 148.80 |
| Subgroup 7 – COVID‑19 psychologist focussed psychological strategies phone services |
| 91183 | Focussed psychological strategies health service provided by phone attendance by an eligible psychologist if: (a) the attendance is where: (i) the person is a patient at risk of COVID‑19 virus; or (ii) the eligible psychologist is a health professional at risk of COVID‑19 virus; and (b) the person is referred by: (i) a medical practitioner, either as part of a GP Mental Health Treatment Plan, or as part of a shared care plan or as part of a psychiatrist assessment and management plan; or (ii) a specialist or consultant physician specialising in the practice of his or her field of psychiatry; or (iii) a specialist or consultant physician specialising in the practice of his or her field of paediatrics; and (c) the service is provided to the person individually; and (d) at the completion of a course of treatment, the referring medical practitioner reviews the need for a further course of treatment; and (e) on the completion of the course of treatment, the eligible psychologist gives a written report to the referring medical practitioner on assessments carried out, treatment provided and recommendations on future management of the person’s condition; and (g) the service is at least 20 minutes but less than 50 minutes duration; where the service is bulk‑billed | 71.80 | | 91184 | Focussed psychological strategies health service provided by phone attendance by an eligible psychologist if: (a) the attendance is where: (i) the person is a patient at risk of COVID‑19 virus; or (ii) the eligible psychologist is a health professional at risk of COVID‑19 virus; and (b) the person is referred by: (i) a medical practitioner, either as part of a GP Mental Health Treatment Plan, or as part of a shared care plan or as part of a psychiatrist assessment and management plan; or (ii) a specialist or consultant physician specialising in the practice of his or her field of psychiatry; or (iii) a specialist or consultant physician specialising in the practice of his or her field of paediatrics; and (c) the service is provided to the person individually; and (d) at the completion of a course of treatment, the referring medical practitioner reviews the need for a further course of treatment; and (e) on the completion of the course of treatment, the eligible psychologist gives a written report to the referring medical practitioner on assessments carried out, treatment provided and recommendations on future management of the person’s condition; and (f) the service is at least 50 minutes duration; where the service is bulk‑billed | 101.35 | |
| Subgroup 8 – COVID‑19 occupational therapist focussed psychological strategies phone services |
| 91185 | Focussed psychological strategies health service provided by phone attendance by an eligible occupational therapist if: (a) the attendance is where: (i) the person is a patient at risk of COVID‑19 virus; or (ii) the eligible occupational therapist is a health professional at risk of COVID‑19 virus; and (a) the person is referred by: (i) a medical practitioner, either as part of a GP Mental Health Treatment Plan, or as part of a shared care plan or as part of a psychiatrist assessment and management plan; or (ii) a specialist or consultant physician specialising in the practice of his or her field of psychiatry; or (iii) a specialist or consultant physician specialising in the practice of his or her field of paediatrics; and (b) the service is provided to the person individually; and (c) at the completion of a course of treatment, the referring medical practitioner reviews the need for a further course of treatment; and (d) on the completion of the course of treatment, the eligible occupational therapist gives a written report to the referring medical practitioner on assessments carried out, treatment provided and recommendations on future management of the person’s condition; and (e) the service is at least 20 minutes but less than 50 minutes duration where the service is bulk‑billed | 63.25 | | 91186 | Focussed psychological strategies health service provided by phone attendance by an eligible occupational therapist if: (a) the attendance is where: (i) the person is a patient at risk of COVID‑19 virus; or (ii) the eligible occupational therapist is a health professional at risk of COVID‑19 virus; and (b) the person is referred by: (i) a medical practitioner, either as part of a GP Mental Health Treatment Plan, or as part of a shared care plan or as part of a psychiatrist assessment and management plan; or (ii) a specialist or consultant physician specialising in the practice of his or her field of psychiatry; or (iii) a specialist or consultant physician specialising in the practice of his or her field of paediatrics; and (c) the service is provided to the person individually; and (d) at the completion of a course of treatment, the referring medical practitioner reviews the need for a further course of treatment; and (e) on the completion of the course of treatment, the eligible occupational therapist gives a written report to the referring medical practitioner on assessments carried out, treatment provided and recommendations on future management of the person’s condition; and (f) the service is at least 50 minutes in duration where the service is bulk‑billed | 89.35 | |
| Subgroup 9 – COVID‑19 social worker focussed psychological strategies phone services |
| 91187 | Focussed psychological strategies health service provided by phone attendance by an eligible social worker if: (a) the attendance is where: (i) the person is a patient at risk of COVID‑19 virus; or (ii) the eligible social worker is a health professional at risk of COVID‑19 virus; and (b) the person is referred by: (i) a medical practitioner, either as part of a GP Mental Health Treatment Plan, or as part of a shared care plan or as part of a psychiatrist assessment and management plan; or (ii) a specialist or consultant physician specialising in the practice of his or her field of psychiatry; or (iii) a specialist or consultant physician specialising in the practice of his or her field of paediatrics; and (b) the service is provided to the person individually; and (c) at the completion of a course of treatment, the referring medical practitioner reviews the need for a further course of treatment; and (d) on the completion of the course of treatment, the eligible social worker gives a written report to the referring medical practitioner on assessments carried out, treatment provided and recommendations on future management of the person’s condition; and (e) the service is at least 20 minutes but less than 50 minutes duration where the service is bulk‑billed | 63.25 | | 91188 | Focussed psychological strategies health service provided by phone attendance by an eligible social worker if: (a) the attendance is where: (i) the person is a patient at risk of COVID‑19 virus; or (ii) the eligible social worker is a health professional at risk of COVID‑19 virus; and (b) the person is referred by: (i) a medical practitioner, either as part of a GP Mental Health Treatment Plan, or as part of a shared care plan or as part of a psychiatrist assessment and management plan; or (ii) a specialist or consultant physician specialising in the practice of his or her field of psychiatry; or (iii) a specialist or consultant physician specialising in the practice of his or her field of paediatrics; and (c) the service is provided to the person individually; and (d) at the completion of a course of treatment, the referring medical practitioner reviews the need for a further course of treatment; and (e) on the completion of the course of treatment, the eligible social worker gives a written report to the referring medical practitioner on assessments carried out, treatment provided and recommendations on future management of the person’s condition; and (f) the service is at least 50 minutes duration where the service is bulk‑billed | 89.35 | |
| Subgroup 10 – COVID‑19 nurse practitioner phone services |
| 91189 | Phone attendance by a participating nurse practitioner lasting less than 20 minutes if: (a) The attendance is where: (i) The person is at risk of COVID‑19 virus; or (ii) The participating nurse practitioner is a health professional at risk of COVID‑19 virus; and (b) The attendance includes any of the following that are clinically relevant: (i) taking a history; (ii) undertaking clinical examination; (iii) arranging any necessary investigation; (iv) implementing a management plan; (v) providing appropriate preventive health care; where the service is bulk‑billed. | 21.30 | |
| 91190 | Phone attendance by a participating nurse practitioner lasting at least 20 minutes if: (a) The attendance is where: (i) The person is at risk of COVID‑19 virus; or (ii) The participating nurse practitioner is a health professional at risk of COVID‑19 virus; and (b) The attendance includes any of the following that are clinically relevant: (i) taking a history; (ii) undertaking clinical examination; (iii) arranging any necessary investigation; (iv) implementing a management plan; (v) providing appropriate preventive health care; where the service is bulk‑billed. | 40.40 | |
| 91191 | Phone attendance by a participating nurse practitioner lasting at least 40 minutes if: (a) The attendance is where: (i) The person is at risk of COVID‑19 virus; or (ii) The participating nurse practitioner is a health professional at risk of COVID‑19 virus; and (b) The attendance includes any of the following that are clinically relevant: (i) taking a history; (ii) undertaking clinical examination; (iii) arranging any necessary investigation; (iv) implementing a management plan; (v) providing appropriate preventive health care; where the service is bulk‑billed. | 59.50 | |
| | | | | |
Endnotes
Endnote 1—About the endnotes
The endnotes provide information about this compilation and the compiled law.
The following endnotes are included in every compilation:
Endnote 1—About the endnotes
Endnote 2—Abbreviation key
Endnote 3—Legislation history
Endnote 4—Amendment history
Abbreviation key—Endnote 2
The abbreviation key sets out abbreviations that may be used in the endnotes.
Legislation history and amendment history—Endnotes 3 and 4
Amending laws are annotated in the legislation history and amendment history.
The legislation history in endnote 3 provides information about each law that has amended (or will amend) the compiled law. The information includes commencement details for amending laws and details of any application, saving or transitional provisions that are not included in this compilation.
The amendment history in endnote 4 provides information about amendments at the provision (generally section or equivalent) level. It also includes information about any provision of the compiled law that has been repealed in accordance with a provision of the law.
Editorial changes
The Legislation Act 2003 authorises First Parliamentary Counsel to make editorial and presentational changes to a compiled law in preparing a compilation of the law for registration. The changes must not change the effect of the law. Editorial changes take effect from the compilation registration date.
If the compilation includes editorial changes, the endnotes include a brief outline of the changes in general terms. Full details of any changes can be obtained from the Office of Parliamentary Counsel.
Misdescribed amendments
A misdescribed amendment is an amendment that does not accurately describe the amendment to be made. If, despite the misdescription, the amendment can be given effect as intended, the amendment is incorporated into the compiled law and the abbreviation “(md)” added to the details of the amendment included in the amendment history.
If a misdescribed amendment cannot be given effect as intended, the abbreviation “(md not incorp)” is added to the details of the amendment included in the amendment history.
Endnote 2—Abbreviation key
| ad = added or inserted | o = order(s) |
| am = amended | Ord = Ordinance |
| amdt = amendment | orig = original |
| c = clause(s) | par = paragraph(s)/subparagraph(s) |
| C[x] = Compilation No. x | /sub‑subparagraph(s) |
| Ch = Chapter(s) | pres = present |
| def = definition(s) | prev = previous |
| Dict = Dictionary | (prev…) = previously |
| disallowed = disallowed by Parliament | Pt = Part(s) |
| Div = Division(s) | r = regulation(s)/rule(s) |
| ed = editorial change | reloc = relocated |
| exp = expires/expired or ceases/ceased to have | renum = renumbered |
| effect | rep = repealed |
| F = Federal Register of Legislation | rs = repealed and substituted |
| gaz = gazette | s = section(s)/subsection(s) |
| LA = Legislation Act 2003 | Sch = Schedule(s) |
| LIA = Legislative Instruments Act 2003 | Sdiv = Subdivision(s) |
| (md) = misdescribed amendment can be given | SLI = Select Legislative Instrument |
| effect | SR = Statutory Rules |
| (md not incorp) = misdescribed amendment | Sub‑Ch = Sub‑Chapter(s) |
| cannot be given effect | SubPt = Subpart(s) |
| mod = modified/modification | underlining = whole or part not |
| No. = Number(s) | commenced or to be commenced |
Endnote 3—Legislation history
| Name | Registration | Commencement | Application, saving and transitional provisions |
| Health Insurance (Section 3C General Medical Services – GP and Allied Health COVID‑19 Services) Determination 2020 | 12 Mar 2020 (F2020L00249) | 13 Mar 2020 (s 2(1) item 1) | |
| Health Insurance (Section 3C General Medical Services – GP and Allied Health COVID‑19 Services) Amendment Determination No.1 2020 | 13 Mar 2020 (F2020L00255) | Sch 1: 13 Mar 2020 (s 2(1) item 1) | — |
Endnote 4—Amendment history
| Provision affected | How affected |
| s 2............................................. | rep LA s 48D |
| s 5............................................. | am F2020L00255 |
| | ed C1 |
| Schedule 1 | |
| Division 1.1 | |
| para 1.1.1.................................. | rs F2020L00255 |
| Division 1.2 | |
| Group M18 table....................... | am F2020L00255 |
| Division 1.3 | |
| Division 1.3.............................. | ad F2020L00255 |
| para 1.3.1.................................. | ad F2020L00255 |
| Division 1.4 | |
| Division 1.4.............................. | ad F2020L00255 |
| para 1.4.1.................................. | ad F2020L00255 |
Endnote 5—Editorial changes
In preparing this compilation for registration, the following kinds of editorial change(s) were made under the Legislation Act 2003.
Kind of editorial change
Give effect to the misdescribed amendment as intended
Details of editorial change
Subsection 2(1) (table item 1, column 2) of the Health Insurance (Section 3C General Medical Services – GP and Allied Health COVID‑19 Services) Amendment Determination No.1 2020 appears as follows:
Immediately after the registration of the Health Insurance (Section 3C General Medical Services – GP and Allied Health COVID‑19 Services) Determination 2020.
The explanatory statement makes it clear that the amendments were to commence immediately after the commencement of the Health Insurance (Section 3C General Medical Services – GP and Allied Health COVID‑19 Services) Determination 2020 on 13 March 2020.
This compilation was editorially changed to read the commencement of the Health Insurance (Section 3C General Medical Services – GP and Allied Health COVID‑19 Services) Amendment Determination No.1 2020 as if it commenced immediately after the commencement of the Health Insurance (Section 3C General Medical Services – GP and Allied Health COVID‑19 Services) Determination 2020 and give effect to the misdescribed amendment as intended.
Section 5 (definition of patient at risk of COVID‑19 virus)
Kind of editorial change
Give effect to the misdescribed amendment as intended and changes to punctuation
Details of editorial change
Schedule 1 item 1 of Health Insurance (Section 3C General Medical Services – GP and Allied Health COVID‑19 Services) Amendment Determination No.1 2020 provides as follows:
1. Within the definition of Patient at risk of COVID‑19 of section 5 Definitions
Insert after (c)(v):
or
(d) the person meets the current national triage protocol criteria for suspected COVID‑19 infection
A semicolon is missing before the word “or” and a full stop is missing at the end of paragraph (d).
The definition of Patient at risk of COVID‑19 does not appear in section 5. However, the definition of patient at risk of COVID‑19 virus does appear.
This compilation was editorially changed to insert “; or (d) the person meets the current national triage protocol criteria for suspected COVID‑19 infection.” at the end of subparagraph (c)(v) of the definition of patient at risk of COVID‑19 virus in section 5 to give effect to the misdescribed amendment as intended and make changes to punctuation.