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Determinations/Health as made
This instrument amends the Health Insurance (Section 3C General Medical Services - COVID-19 Telehealth and Telephone Attendances) Determination 2020 to remove the requirement for specialists and consultant physicians, nurse practitioners, midwifes and allied health professionals to bulk-bill certain telehealth or phone health consultations. The instrument also lists 28 additional telehealth and phone service items relating to neurosurgery consultations, public health physician consultations, Aboriginal and Torres Strait Islander health practitioner consultations and group psychotherapy services performed by psychiatrists.
Administered by: Health
Registered 17 Apr 2020
Tabling HistoryDate
Tabled HR12-May-2020
Tabled Senate12-May-2020
To be repealed 13 Aug 2020
Repealed by Division 1 of Part 3 of Chapter 3 of the Legislation Act 2003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 – COVID-19 Telehealth and Telephone Attendances) Amendment (Bulk-billing Requirement and New Remote Attendance Services) Determination 2020

I, the Hon Greg Hunt MP, Minister for Health, make the following determination.

Dated   17 April 2020

Greg Hunt

Minister for Health

 


Contents

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

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

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

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

Schedule 1—Amendments                                                                                           1

Health Insurance (Section 3C General Medical Services - COVID-19 Telehealth and Telephone Attendances) Determination 2020                                                                                                                              1

2.1.2  Application of item 92513 to 92516 and 92521 to 92524.................................................. 1

4.1.2  Application of items 93200 to 93203................................................................................. 1

 

 


1  Name

                   This instrument is the Health Insurance (Section 3C General Medical Services – COVID-19 Telehealth and Telephone Attendances) Amendment (Bulk-billing Requirement and New Remote Attendance 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.

20 April 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 1Amendments

Health Insurance (Section 3C General Medical Services - COVID-19 Telehealth and Telephone Attendances) Determination 2020

1  Subsection 5(1) (definition of multidisciplinary care plan)

Repeal the definition, substitute:

multidisciplinary care plan:

(a)   for items 92026, 92027, 92070, 92071, 92057, 92058, 92101 and 92102—has the meaning given by clause 2.18.6 of the general medical services table; and

(b)   for items 93201 and 93203—has the meaning given by clause 4.1.2. 

2  Subsection 8(4)

Omit “a Schedule”, insert “Schedule 1”.

3  Subsection 8(5)

Omit “An”, substitute “Subject to subsection (6), an”.

4  At the end of section 8

Insert:

             (6)  Subsection (5) does not apply to items 92455 to 92457 and 92495 to 92497.

5  Subclause 2.1.1(1) of Schedule 2

Omit “26 or 32”, substitute “26, 32, 34 or 36”.

6  After clause 2.1.1 of Schedule 2

Insert:

2.1.2  Application of item 92513 to 92516 and 92521 to 92524

             (1)  Clause 2.13.1 of the general medical services table shall have effect as if items 92513 to 92516 and 92521 to 92524 were specified in the clause.

7  Schedule 2 (item 92437, column 2, paragraph (b))

Omit “or 91837 to 91841”, insert “, 91837 to 91841, 92455 to 93457 or 92495 to 92497”.

8  Schedule 2 (after item 92437)

Insert:

 

92455

Telehealth attendance for group psychotherapy (including any associated consultations with a patient taking place on the same occasion and relating to the condition for which group therapy is conducted):

(a) of not less than 1 hour in duration; and

(b) given under the continuous direct supervision of a consultant physician in the practice of the consultant physician’s specialty of psychiatry; and

(c) involving a group of 2 to 9 unrelated patients or a family group of more than 3 patients, each of whom is referred to the consultant physician by a referring practitioner;

—each patient

50.85

92456

Telehealth attendance for group psychotherapy (including any associated consultations with a patient taking place on the same occasion and relating to the condition for which group therapy is conducted):

(a) of not less than 1 hour in duration; and

(b) given under the continuous direct supervision of a consultant physician in the practice of the consultant physician’s specialty of psychiatry; and

(c) involving a family group of 3 patients, each of whom is referred to the consultant physician by a referring practitioner;

—each patient

67.50

92457

Telehealth attendance for group psychotherapy (including any associated consultations with a patient taking place on the same occasion and relating to the condition for which group therapy is conducted):

(a) of not less than 1 hour in duration; and

(b) given under the continuous direct supervision of a consultant physician in the practice of the consultant physician’s specialty of psychiatry; and

(c) involving a family group of 2 patients, each of whom is referred to the consultant physician by a referring practitioner;

—each patient

99.80

9  Schedule 2 (item 92477, column 2, paragraph (b))

Omit “or 91837 to 91841”, insert “, 91837 to 91841, 92455 to 93457 or 92495 to 92497”.

10  Schedule 2 (after item 92477)

Insert:

 

92495

Phone attendance for group psychotherapy (including any associated consultations with a patient taking place on the same occasion and relating to the condition for which group therapy is conducted):

(a) of not less than 1 hour in duration; and

(b) given under the continuous direct supervision of a consultant physician in the practice of the consultant physician’s specialty of psychiatry; and

(c) involving a group of 2 to 9 unrelated patients or a family group of more than 3 patients, each of whom is referred to the consultant physician by a referring practitioner;

—each patient

50.85

92496

Phone attendance for group psychotherapy (including any associated consultations with a patient taking place on the same occasion and relating to the condition for which group therapy is conducted):

(a) of not less than 1 hour in duration; and

(b) given under the continuous direct supervision of a consultant physician in the practice of the consultant physician’s specialty of psychiatry; and

(c) involving a family group of 3 patients, each of whom is referred to the consultant physician by a referring practitioner;

—each patient

67.50

92497

Phone attendance for group psychotherapy (including any associated consultations with a patient taking place on the same occasion and relating to the condition for which group therapy is conducted):

(a) of not less than 1 hour in duration; and

(b) given under the continuous direct supervision of a consultant physician in the practice of the consultant physician’s specialty of psychiatry; and

(c) involving a family group of 2 patients, each of whom is referred to the consultant physician by a referring practitioner;

—each patient

99.80

11  Schedule 2 (after item 92629)

Insert:

 

Subgroup 33— Public health physician – Telehealth Services 

92513

Telehealth attendance by a public health physician in the practice of the public health physician’s specialty of public health medicine—attendance for an obvious problem characterised by the straightforward nature of the task that requires a short patient history and, if required, limited management

20.15

92514

Telehealth attendance by a public health physician in the practice of the public health physician’s specialty of public health medicine, lasting less than 20 minutes and including any of the following that are clinically relevant:

(a) taking a patient history;

(b) arranging any necessary investigation;

(c) implementing a management plan;

(d) providing appropriate preventive health care;

for one or more health‑related issues, with appropriate documentation

44.10

92515

Telehealth attendance by a public health physician in the practice of the public health physician’s specialty of public health medicine, lasting at least 20 minutes and including any of the following that are clinically relevant:

(a) taking a detailed patient history;

(b) arranging any necessary investigation;

(c) implementing a management plan;

(d) providing appropriate preventive health care;

for one or more health‑related issues, with appropriate documentation

85.25

92516

Telehealth attendance by a public health physician in the practice of the public health physician’s specialty of public health medicine, lasting at least 40 minutes and including any of the following that are clinically relevant:

(a) taking an extensive patient history;

(b) arranging any necessary investigation;

(c) implementing a management plan;

(d) providing appropriate preventive health care;

for one or more health‑related issues, with appropriate documentation

125.55

Subgroup 34— Public health physician – Phone Services  

92521

Phone attendance by a public health physician in the practice of the public health physician’s specialty of public health medicine—attendance for an obvious problem characterised by the straightforward nature of the task that requires a short patient history and, if required, limited management

20.15

92522

Phone attendance by a public health physician in the practice of the public health physician’s specialty of public health medicine, lasting less than 20 minutes and including any of the following that are clinically relevant:

(a) taking a patient history;

(b) arranging any necessary investigation;

(c) implementing a management plan;

(d) providing appropriate preventive health care;

for one or more health‑related issues, with appropriate documentation

44.10

92523

Phone attendance by a public health physician in the practice of the public health physician’s specialty of public health medicine, lasting at least 20 minutes and including any of the following that are clinically relevant:

(a) taking a detailed patient history;

(b) arranging any necessary investigation;

(c) implementing a management plan;

(d) providing appropriate preventive health care;

for one or more health‑related issues, with appropriate documentation

85.25

92524

Phone attendance by a public health physician in the practice of the public health physician’s specialty of public health medicine, lasting at least 40 minutes and including any of the following that are clinically relevant:

(a) taking an extensive patient history;

(b) arranging any necessary investigation;

(c) implementing a management plan;

(d) providing appropriate preventive health care;

for one or more health‑related issues, with appropriate documentation

125.55

Subgroup 35— Neurosurgery attendances – Telehealth Services 

92610

Telehealth attendance by a specialist in the practice of neurosurgery following referral of the patient to the specialist (other than a second or subsequent attendance in a single course of treatment)

133.65

92611

Telehealth attendance by a specialist in the practice of neurosurgery following referral of the patient to the specialist—a minor attendance after the first in a single course of treatment

44.35

92612

Telehealth attendance by a specialist in the practice of neurosurgery following referral of the patient to the specialist—an attendance after the first in a single course of treatment, involving arranging any necessary investigations in relation to one or more complex problems and of more than 15 minutes in duration but not more than 30 minutes in duration

88.25

92613

Telehealth attendance by a specialist in the practice of neurosurgery following referral of the patient to the specialist—an attendance after the first in a single course of treatment, involving arranging any necessary investigations in relation to one or more complex problems and of more than 30 minutes in duration but not more than 45 minutes in duration

122.20

92614

Telehealth attendance by a specialist in the practice of neurosurgery following referral of the patient to the specialist—an attendance after the first in a single course of treatment, involving arranging any necessary investigations in relation to one or more complex problems and of more than 45 minutes in duration

155.60

Subgroup 36—Neurosurgery attendances – Phone Services

92617

Phone attendance by a specialist in the practice of neurosurgery following referral of the patient to the specialist (other than a second or subsequent attendance in a single course of treatment)

133.65

92618

Phone attendance by a specialist in the practice of neurosurgery following referral of the patient to the specialist—a minor attendance after the first in a single course of treatment

44.35

92619

Phone attendance by a specialist in the practice of neurosurgery following referral of the patient to the specialist—an attendance after the first in a single course of treatment, involving arranging any necessary investigations in relation to one or more complex problems and of more than 15 minutes in duration but not more than 30 minutes in duration

88.25

92620

Phone attendance by a specialist in the practice of neurosurgery following referral of the patient to the specialist—an attendance after the first in a single course of treatment, involving arranging any necessary investigations in relation to one or more complex problems and of more than 30 minutes in duration but not more than 45 minutes in duration

122.20

92621

Phone attendance by a specialist in the practice of neurosurgery following referral of the patient to the specialist—an attendance after the first in a single course of treatment, involving arranging any necessary investigations in relation to one or more complex problems and of more than 45 minutes in duration

155.60

 

12  Schedule 4 (heading)

Omit “and midwife services”, substitute “, midwife and Aboriginal and Torres Strait Islander health practitioner services”.

13  Clause 4.1.1 (heading)

Repeal the heading, substitute:

4.1.1  Application of nurse practitioner and Aboriginal and Torres Strait Islander health practitioner phone services 

14  Subclause 4.1.1(1)

Omit “subgroup 10”, substitute “Subgroup 10 or 24”.

15  After clause 4.1.1 of Schedule 4

Insert:

4.1.2  Application of items in Subgroups 11 and 12 of Group M18

             (1)  In items 93201 and 93203:

                            GP management plan means a plan under:

                             (a)  item 721 or 732 of the general medical services table (for coordination of a review of a GP management plan under item 721); or

                             (b)  item 229 or 233 of the Other Medical Practitioner Determination (for coordination of a review of a GP management plan under item 229); or                 

                             (c)  item 92024, 92028, 92055, 92059, 92068, 92072, 92099 or 92103 (for coordination of a review of a GP management plan under item 92024,  92055, 92068 or 92099);

                            multidisciplinary care plan means a plan under:

                             (a)  item 729 or 731 of the general medical services table; or

                             (b)  item 231 or 232 of the Other Medical Practitioner Determination; or

                             (c)  item 92026, 92027, 92057, 92058, 92070, 92071, 92101 or 92102;

                            person with a chronic disease means a person who has a care plan under

                             (a)  item 721, 723, 729, 731 or 732 of the general medical services table; or

                             (b)  item 229, 230, 231, 232 or 233 of the Other Medical Practitioner Determination; or

                             (c)  item 92024 to 92028, 92055 to 92059, 92068 to 92072 or 92099 to 92103.

             (2)  A person cannot receive a service under item 93200 or 93202 if, in the same calendar year, the person has received 10 services to which any of the following items apply:

                     (a)  item 10987 of the general medical services table; or

                     (b)  item 93200 or 93202.

             (3)  A person cannot receive a service under item 93201 or 93203 if, in the same calendar year, the person has received 5 services to which any of the following items apply:

                     (a)  item 10997 of the general medical services table; or

                     (b)  item 93201 or 93203.

16  Schedule 4 (after item 91191)

Insert:

Subgroup 23—Follow up service provided by a practice nurse or Aboriginal and Torres Strait Islander health practitioner – Telehealth Services

93200

Follow‑up telehealth attendance provided by a practice nurse or an Aboriginal and Torres Strait Islander health practitioner, on behalf of a medical practitioner, for an Indigenous person who has received a health check if:

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

(b) the service is consistent with the needs identified through the health assessment.

28.70

 

93201

Telehealth attendance provided by a practice nurse or an Aboriginal and Torres Strait Islander health practitioner to a person with a chronic disease if:

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

(b) the person has a GP management plan, team care arrangements or multidisciplinary care plan in place and the service is consistent with the plan or arrangements.

14.35

 

Subgroup 24—Follow up service provided by a practice nurse or Aboriginal and Torres Strait Islander health practitioner – Phone Services

93202

Follow‑up phone attendance provided by a practice nurse or an Aboriginal and Torres Strait Islander health practitioner, on behalf of a medical practitioner, for an Indigenous person who has received a health check if:

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

(b) the service is consistent with the needs identified through the health assessment.

28.70

 

93203

Phone attendance provided by a practice nurse or an Aboriginal and Torres Strait Islander health practitioner to a person with a chronic disease if:

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

(b) the person has a GP management plan, team care arrangements or multidisciplinary care plan in place and the service is consistent with the plan or arrangements.

14.35