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Determinations/Health as made
This instrument amends the Health Insurance (Section 3C General Medical Services – Specialist, Consultant Physician and Consultant Psychiatrist COVID-19 Telehealth Services) Determination 2020 to modify the descriptors for the consultant psychiatrist telehealth and phone service items (91828 to 91831 and 91838 to 91841) to clarify the timing of the attendance by replacing the words “of more than” with “at least” in subclause (c).
Administered by: Health
Registered 16 Mar 2020
Tabling HistoryDate
Tabled HR23-Mar-2020
Tabled Senate23-Mar-2020
To be repealed 18 Sep 2020
Repealed by Division 1 of Part 3 of Chapter 3 of the Legislation Act 2003
Table of contents.

Commonwealth Coat of Arms of Australia

 

Health Insurance (Section 3C General Medical Services – Specialist, Consultant Physician and Consultant Psychiatrist COVID-19 Telehealth Services) Amendment Determination No.2 2020 

I, GREG HUNT, Minister for Health, make the following Determination.

Dated   16   March 2020

Greg Hunt  

Minister for Health

 

 

 


Contents

1  Name........................................................................................................................................ 1

2  Commencement........................................................................................................................ 1

3  Authority.................................................................................................................................. 1

4  Schedules................................................................................................................................. 1

Schedule 1— Amendments to Health Insurance (Section 3C General Medical Services – Specialist, Consultant Physician and Consultant Psychiatrist COVID-19 Telehealth Services) Determination 2020 2

 

 


1  Name

                        This instrument is the Health Insurance (Section 3C General Medical Services – Specialist, Consultant Physician and Consultant Psychiatrist COVID-19 Telehealth Services) Amendment Determination No.2 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

Immediately after the commencement of the Health Insurance (Section 3C General Medical Services – Specialist, Consultant Physician and Consultant Psychiatrist COVID-19) Telehealth Services) Determination 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  Authority

                        This instrument is made under subsection 3C(1) of the Health Insurance Act 1973.

4  Schedules

                        Each instrument that is specified in a Schedule to this instrument is amended or repealed as set out in the applicable items in the Schedule concerned, and any other item in a Schedule to this instrument has effect according to its terms.


 

Schedule 1— Amendments to Health Insurance (Section 3C General Medical Services – Specialist, Consultant Physician and Consultant Psychiatrist COVID-19 Telehealth Services) Determination 2020

1.    Schedule 1 – Relevant Services

Division 1.3 – Services and Fees – Consultant psychiatrist attendances via video conference

            Repeal the table at Subgroup 6 - COVID-19 - consultant psychiatrist telehealth services, substitute:

 

Subgroup 6 – COVID-19 – consultant psychiatrist telehealth services

 

91827

 

Telehealth attendance for a person by a consultant psychiatrist; if:

(a)     the attendance is where:

(i)                       the person is a patient at risk of COVID-19 virus; or

(ii)                     the consultant psychiatrist is a health professional at risk of COVID-19 virus; and

(b)     the attendance follows a referral of the patient to the consultant psychiatrist by a referring practitioner; and

(c)     the attendance was not more than 15 minutes duration; and

(d)     the patient is not an admitted patient; and

(e)     the service is bulk-billed.

44.70

 

91828

 

Telehealth attendance for a person by a consultant psychiatrist; if:

(a)     the attendance is where:

(i)                       the person is a patient at risk of COVID-19 virus; or

(ii)                     the consultant psychiatrist is a health professional at risk of COVID-19 virus; and

(b)     the attendance follows a referral of the patient to the consultant psychiatrist by a referring practitioner; and

(c)     the attendance was at least 15 minutes, but not more than 30 minutes in duration; and

(d)     the patient is not an admitted patient; and

(e)     the service is bulk-billed.

89.15

 

91829

 

Telehealth attendance for a person by a consultant psychiatrist; if:

(a)     the attendance is where:

(i)                       the person is a patient at risk of COVID-19 virus; or

(ii)                     the consultant psychiatrist is a health professional at risk of COVID-19 virus; and

(b)     the attendance follows a referral of the patient to the consultant psychiatrist by a referring practitioner; and

(c)     the attendance was at least 30 minutes, but not more than 45 minutes in duration; and 

(d)     the patient is not an admitted patient; and

(e)     the service is bulk-billed.

137.25

 

91830

 

Telehealth attendance for a person by a consultant psychiatrist; if:

(a)     the attendance is where:

(i)                       the person is a patient at risk of COVID-19 virus; or

(ii)                     the consultant psychiatrist is a health professional at risk of COVID-19 virus; and

(b)     the attendance follows a referral of the patient to the consultant psychiatrist by a referring practitioner; and

(c)     the attendance was at least 45 minutes, but not more than 75 minutes in duration; and

(d)     the patient is not an admitted patient; and

(e)     the service is bulk-billed.

189.40

 

91831

 

Telehealth attendance for a person by a consultant psychiatrist; if:

(a)     the attendance is where:

(i)                       the person is a patient at risk of COVID-19 virus; or

(ii)                     the consultant psychiatrist is a health professional at risk of COVID-19 virus; and

(b)     the attendance follows a referral of the patient to the consultant psychiatrist by a referring practitioner; and

(c)     the attendance was at least 75 minutes in duration; and

(d)     the patient is not an admitted patient; and

(e)     the service is bulk-billed.

219.80

 

2.    Schedule 1 – Relevant Services

Division 1.6 – Services and Fees – Consultant psychiatrist attendances via phone services 

            Repeal the table at Subgroup 9 COVID-19 consultant psychiatrist phone services, substitute:

Subgroup 9 – COVID-19 – consultant psychiatrist phone services

Item

Description

Fee($)

 

91837

 

Phone attendance for a person by a consultant psychiatrist; if:

(a)     the attendance is where:

(i)                       the person is a patient at risk of COVID-19 virus; or

(ii)                     the consultant psychiatrist is a health professional at risk of COVID-19 virus; and

(b)     the attendance follows a referral of the patient to the consultant psychiatrist by a referring practitioner; and

(c)     the attendance was not more than 15 minutes duration; and

(d)     the patient is not an admitted patient; and

(e)     the service is bulk-billed.

44.70

 

91838

 

Phone attendance for a person by a consultant psychiatrist; if:

(a)     the attendance is where:

(i)                       the person is a patient at risk of COVID-19 virus; or

(ii)                     the consultant psychiatrist is a health professional at risk of COVID-19 virus; and

(b)     the attendance follows a referral of the patient to the consultant psychiatrist by a referring practitioner; and

(c)     the attendance was at least 15 minutes, but not more than 30 minutes in duration; and

(d)     the patient is not an admitted patient; and

(e)     the service is bulk-billed.

89.15

 

91839

 

Phone attendance for a person by a consultant psychiatrist; if:

(f)      the attendance is where:

(j)                      the person is a patient at risk of COVID-19 virus; or

(jj)                    the consultant psychiatrist is a health professional at risk of COVID-19 virus; and

(g)     the attendance follows a referral of the patient to the consultant psychiatrist by a referring practitioner; and

(h)     the attendance was at least 30 minutes, but not more than 45 minutes in duration; and 

(i)       the patient is not an admitted patient; and

(j)      the service is bulk-billed.

137.25

 

91840

 

Phone attendance for a person by a consultant psychiatrist; if:

(a)     the attendance is where:

(i)                       the person is a patient at risk of COVID-19 virus; or

(ii)                     the consultant psychiatrist is a health professional at risk of COVID-19 virus; and

(b)     the attendance follows a referral of the patient to the consultant psychiatrist by a referring practitioner; and

(c)     the attendance was at least 45 minutes, but not more than 75 minutes in duration; and

(d)     the patient is not an admitted patient; and

(e)     the service is bulk-billed.

189.40

 

91841

 

Phone attendance for a person by a consultant psychiatrist; if:

(a)     the attendance is where:

(i)                       the person is a patient at risk of COVID-19 virus; or

(ii)                     the consultant psychiatrist is a health professional at risk of COVID-19 virus; and

(b)     the attendance follows a referral of the patient to the consultant psychiatrist by a referring practitioner; and

(c)     the attendance was at least 75 minutes in duration; and

(d)     the patient is not an admitted patient; and

(e)     the service is bulk-billed.

219.80

3.    After Division 1.6 of Schedule 1

Insert:

Division 1. 7– Services and Fees – obstetric attendances via telehealth services  

1.7.1        – Application of COVID-19 obstetrics telehealth and phone services

(1)   For items in Division 1.7, ‘midwife’ has the same meaning as provided in clause 2.41.2 of the Health Insurance (General Medical Services Table) Regulations 2019.

(2)   Application of item 91850 and 91855

1)      Item 91850 and 91855 applies to an antenatal service provided to a patient by a midwife, nurse or Aboriginal and Torres Strait Islander health practitioner only if:

(a)      the midwife, nurse or Aboriginal and Torres Strait Islander health practitioner has the appropriate training and skills to perform an antenatal service; and

(b)      the medical practitioner under whose supervision the antenatal service is provided retains responsibility for clinical outcomes and for the health and safety of the patient; and

(c)      the midwife, nurse or Aboriginal and Torres Strait Islander health practitioner complies with relevant legislative or regulatory requirements regarding the provision of the antenatal service in the State or Territory where the service is provided.

2)      Item 91850 and 91855 does not apply in conjunction with another antenatal attendance item for the same patient, on the same day by the same practitioner.

3)      Item 91850 and 91855 does not apply in conjunction with items 10990, 10991 or 10992.

4)      For any particular patient, item 91850 and 91855 applies not more than 10 times in a 9 month period.

(3)   For items in Subgroups 1 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.

 

Group T4—Obstetrics

Item

Description

Fee ($)

Subgroup 1 – COVID-19 obstetric telehealth services

91850

Antenatal telehealth service provided by a midwife, nurse or an Aboriginal and Torres Strait Islander health practitioner, to a maximum of 10 services per pregnancy, if:

(a)     the attendance is where:

(i)                   the person is at risk of COVID-19 virus; or

(ii)                 the practitioner rendering the service is a health professional at risk of COVID-19 virus; and

(b)     the service is provided on behalf of, and under the supervision of, a medical practitioner; and

(c)     the service is provided at, or from, a practice location in a regional, rural or remote area; and

(d)     the service is not performed in conjunction with another antenatal attendance item in Group T4 for the same patient on the same day by the same practitioner; and

(e)      the service is not provided for an admitted patient of a hospital or approved day facility; and

(f)      The services is bulk billed.

27.70

91851

Postnatal telehealth attendance by an obstetrician or general practitioner (other than a service to which any other item applies) if:

(a)     the attendance is where:

(i)                   the person is at risk of COVID-19 virus; or

(ii)                 the practitioner rendering the service is a health professional at risk of COVID-19 virus; and

(b)     is between 4 and 8 weeks after the birth; and

(c)     lasts at least 20 minutes in duration; and

(d)     includes a mental health assessment (including screening for drug and alcohol use and domestic violence) of the patient; and

(e)     is for a pregnancy in relation to which a service to which item 82140 applies is not provided; and

(f)      the service is bulk billed. 

Applicable once for a pregnancy

72.85

91852

Postnatal telehealth attendance (other than attendance at consulting rooms, a hospital or a residential aged care facility or a service to which any other item applies) if:

(a)     the attendance is rendered by:

(i)                   a midwife (on behalf of and under the supervision of the medical practitioner who attended the birth); or

(ii)                 an obstetrician; or

(iii)                a general practitioner; and

(b)     the attendance is where:

(i)                   the person is at risk of COVID-19 virus; or

(ii)                 the practitioner rendering the service is a health professional at risk of COVID-19 virus; and

(c)     is between 1 week and 4 weeks after the birth; and

(d)     lasts at least 20 minutes; and

(e)     is for a patient who was privately admitted for the birth; and

(f)      is for a pregnancy in relation to which a service to which item 82130, 82135 or 82140 applies is not provided; and

(g)     the service is bulk billed.

Applicable once for a pregnancy

54.25

91853

Antenatal telehealth attendance if:

(a)     the attendance is where:

(i)                   the person is at risk of COVID-19 virus; or

(ii)                 the practitioner rendering the service is a health professional at risk of COVID-19 virus; and

(b)     the service is bulk billed.

47.90

Subgroup 2 – COVID-19 obstetric phone services

91855

Antenatal phone service provided by a midwife, nurse or an Aboriginal and Torres Strait Islander health practitioner, to a maximum of 10 services per pregnancy, if:

(a)     the attendance is where:

(i)                   the person is at risk of COVID-19 virus; or

(ii)                 the practitioner rendering the service is a health professional at risk of COVID-19 virus; and

(b)     the service is provided on behalf of, and under the supervision of, a medical practitioner; and

(c)     the service is provided at, or from, a practice location in a regional, rural or remote area; and

(d)     the service is not performed in conjunction with another antenatal attendance item in Group T4 for the same patient on the same day by the same practitioner; and

(e)      the service is not provided for an admitted patient of a hospital or approved day facility; and

(f)      The services is bulk billed.

27.70

91856

Postnatal phone attendance by an obstetrician or general practitioner (other than a service to which any other item applies) if:

(a)     the attendance is where:

(i)                   the person is at risk of COVID-19 virus; or

(ii)                 the practitioner rendering the service is a health professional at risk of COVID-19 virus; and

(b)     is between 4 and 8 weeks after the birth; and

(c)     lasts at least 20 minutes in duration; and

(d)     includes a mental health assessment (including screening for drug and alcohol use and domestic violence) of the patient; and

(e)     is for a pregnancy in relation to which a service to which item 82140 applies is not provided; and

(f)      the service is bulk billed. 

Applicable once for a pregnancy

72.85

91857

Postnatal phone attendance other than attendance at consulting rooms, a hospital or a residential aged care facility or a service to which any other item applies) if:

(a)     the attendance is rendered by:

(i)                   a midwife (on behalf of and under the supervision of the medical practitioner who attended the birth); or

(ii)                 an obstetrician; or

(iii)                a general practitioner; and

(b)     the attendance is where:

(i)                   the person is at risk of COVID-19 virus; or

(ii)                 the practitioner rendering the service is a health professional at risk of COVID-19 virus; and

(c)     is between 1 week and 4 weeks after the birth; and

(d)     lasts at least 20 minutes; and

(e)     is for a patient who was privately admitted for the birth; and

(f)      is for a pregnancy in relation to which a service to which item 82130, 82135 or 82140 applies is not provided; and

(g)     the service is bulk billed.

Applicable once for a pregnancy

54.25

91858

Antenatal phone attendance if:

(a)     the attendance is where:

(i)                   the person is at risk of COVID-19 virus; or

(ii)                 the practitioner rendering the service is a health professional at risk of COVID-19 virus; and

(b)     the service is bulk billed.

47.90