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Determinations/Health as amended, taking into account amendments up to Health Insurance Legislation Amendment (Section 3C General Medical and Diagnostic Imaging Services – Medicare Indexation) Determination 2021
Administered by: Health
Registered 27 Jul 2021
Start Date 01 Jul 2021
Table of contents.

Commonwealth Coat of Arms of Australia

Health Insurance (Section 3C General Medical Services – Mental Health Services for Bushfire Response) Determination 2020

made under subsection 3C(1) of the

Health Insurance Act 1973

Compilation No. 3

Compilation date:                              1 July 2021

Includes amendments up to:            F2021L00426

Registered:                                         27 July 2021

About this compilation

This compilation

This is a compilation of the Health Insurance (Section 3C General Medical Services – Mental Health Services for Bushfire Response) Determination 2020 that shows the text of the law as amended and in force on 1 July 2021 (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.

  

  

  


Contents

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

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

4............ Definitions..................................................................................................................... 1

5............ Treatment of relevant services....................................................................................... 2

6............ Application of provisions of the general medical services table..................................... 2

7............ Mental health services for bushfire limits...................................................................... 2

Schedule 1 – relevant services                                                                                                                   3

Division 1.1 – Services and fees – allied health mental health services                         3

Division 1.2 – Services and fees – general practitioner mental health services          7

Division 1.3 – Services and fees – Non-specialist Practitioner mental health services     9

Endnotes                                                                                                                                                               11

Endnote 1—About the endnotes                                                                                                      11

Endnote 2—Abbreviation key                                                                                                          12

Endnote 3—Legislation history                                                                                                       13

Endnote 4—Amendment history                                                                                                     14

 


1.  Name

              This instrument is the Health Insurance (Section 3C General Medical Services – Mental Health Services for Bushfire Response) Determination 2020.

3.  Authority

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

4.  Definitions

 (1)    In this instrument:

affected by bushfire means an adverse change in the patient’s mental health as a result of a bushfire which occurred in the 2019-20 financial year.

eligible clinical psychologist has the same meaning as in the Health Insurance (Allied Health Services) Determination 2014.

eligible occupational therapist has the same meaning as in the Health Insurance (Allied Health Services) Determination 2014.

eligible psychologist has the same meaning as in the Health Insurance (Allied Health Services) Determination 2014.

eligible social worker has the same meaning as in the Health Insurance (Allied Health Services) Determination 2014.

focussed psychological strategies means any of the following mental health care management strategies, each of which has been derived from evidence‑based psychological therapies:

(a)              psycho‑education;

(b)              cognitive‑behavioural therapy that involves cognitive or behavioural interventions;

(c)                relaxation strategies;

(d)                skills training;

(e)                interpersonal therapy;

(f)                 narrative therapy.

mental health service for bushfires means an item in Schedule 1 of this Determination.

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.

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;

·         medical practitioner;

·         professional service.

             (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.

 

5.  Treatment of relevant services

 

For subsection 3C(1) of the Act, a relevant service, provided in accordance with this instrument and as 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.

6.  Application of provisions of the general medical services table

(1)  Clause 1.2.5 of the general medical services table shall have effect as if items 91283, 91285, 91286, 91287, 91371, 91372, 91721, 91723, 91725, 91727, 91729 and 91731 of this Determination were specified in subclause 1.2.5(1) of the general medical services table.

(2)  Clause 1.2.6 of the general medical services table shall have effect as if items 91283, 91285, 91286, 91287, 91371, 91372, 91721, 91723, 91725, 91727, 91729 and 91731 of this Determination were also specified in subclause 1.2.6(1).

(3)  Clause 1.2.7 of the general medical services table shall have effect as if items 91283, 91285, 91286, 91287, 91371, 91372, 91721, 91723, 91725, 91727, 91729 and 91731 of this Determination were also specified in subclause 1.2.7(1).

7.  Mental health services for bushfire limits 

(1)   For any particular patient, items in Schedule 1 of this Determination apply only if the service is one of the first 10 mental health services for bushfires provided to the patient in the calendar year.

 

Schedule 1 – relevant services

Division 1.1 – Services and fees – allied health mental health services

1.1.1 – Application of allied health mental health services

(1)   For any particular patient, items in Division 1.1 only apply if a private health insurance benefit has not been claimed for the service.

 

Group M17 – Bushfire Recovery Access Initiative – Psychologist Services and Allied Health Focussed Psychological Strategies

 

Item

Description

Fee ($)

91000

 

 

Psychological therapy health service provided to a patient in consulting rooms (but not as an admitted patient of a hospital) by an eligible clinical psychologist if:

    (a)   the patient is affected by bushfire; and             

    (b)   the service is provided to the patient individually and in person; and

    (c)   the service is at least 30 minutes but less than 50 minutes duration

103.80

91001

 

 

Psychological therapy health service provided to a patient (but not as an admitted patient of a hospital) by an eligible clinical psychologist if:

    (a)   the patient is affected by bushfire; and             

    (b)   the service is provided to the patient individually; and

    (c)   the attendance is by video conference; and

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

    (e)   the service is at least 30 minutes but less than 50 minutes duration

103.80

91005

 

 

Psychological therapy health service provided to a patient at a place other than consulting rooms (but not as an admitted patient of a hospital) by an eligible clinical psychologist in accordance with the requirements of item 91000

129.70

91010

 

 

Psychological therapy health service provided to a patient in consulting rooms (but not as an admitted patient of a hospital) by an eligible clinical psychologist if:

    (a)   the patient is affected by bushfire; and

 (b)   the service is provided to the patient individually and in person; and

    (c)   the service is at least 50 minutes duration

152.40

91011

 

 

Psychological therapy health service provided to a patient (but not as an admitted patient of a hospital) by an eligible clinical psychologist if:

    (a)   the patient is affected by bushfire; and

    (b)  the service is provided to the patient individually; and

    (c)   the attendance is by video conference; and

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

    (e)   the service is at least 50 minutes duration

152.40

91015

 

 

Psychological therapy health service provided to a patient at a place other than consulting rooms (but not as an admitted patient of a hospital) by an eligible clinical psychologist in accordance with the requirements of item 91010

178.30

91100

 

 

Focussed psychological strategies health service provided to a patient in consulting rooms (but not as an admitted patient of a hospital) by an eligible psychologist if:

    (a)   the patient is affected by bushfire; and                             

    (b)   the service is provided to the patient individually and in person; and

    (c)   the service is at least 20 minutes but less than 50 minutes duration

73.55

91101

 

 

Focussed psychological strategies health service provided to a patient (but not as an admitted patient of a hospital) by an eligible psychologist if:

    (a)   the patient is affected by bushfire; and             

    (b)   the service is provided to the patient individually; and

    (c)   the attendance is by video conference; and

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

    (e)   the service is at least 20 minutes but less than 50 minutes duration

73.55

91105

 

 

Focussed psychological strategies health service provided to a patient at a place other than consulting rooms (but not as an admitted patient of a hospital) by an eligible psychologist in accordance with the requirements of item 91100

100.05

91110

 

 

Focussed psychological strategies health service provided to a patient in consulting rooms (but not as an admitted patient of a hospital) by an eligible psychologist if:

    (a)   the patient is affected by bushfire; and             

    (b)   the service is provided to the patient individually and in person; and

    (c)   the service is at least 50 minutes duration

103.80

91111

 

 

Focussed psychological strategies health service provided to a patient (but not as an admitted patient of a hospital) by an eligible psychologist if:

    (a)   the patient is affected by bushfire; and             

    (b)   the service is provided to the patient individually; and

    (c)   the attendance is by video conference; and

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

    (e)   the service is at least 50 minutes duration

103.80

91115

 

 

Focussed psychological strategies health service provided to a patient at a place other than consulting rooms (but not as an admitted patient of a hospital) by an eligible psychologist in accordance with the requirements of item 91110

130.35

91125

 

 

Focussed psychological strategies health service provided to a patient in consulting rooms (but not as an admitted patient of a hospital) by an eligible occupational therapist if:

    (a)   the patient is affected by bushfire; and             

    (b)   the service is provided to the patient individually and in person; and

    (c)   the service is at least 20 minutes but less than 50 minutes duration

64.80

91126

 

 

Focussed psychological strategies health service provided to a patient (but not as an admitted patient of a hospital) by an eligible occupational therapist if:

    (a)   the patient is affected by bushfire; and

    (b)  the service is provided to the patient individually; and

    (c)   the attendance is by video conference; and

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

    (e)   the service is at least 20 minutes but less than 50 minutes duration

64.80

91130

 

 

Focussed psychological strategies health service provided to a patient at a place other than consulting rooms (but not as an admitted patient of a hospital) by an eligible occupational therapist in accordance with the requirements of item 91125

91.25

91135

 

 

Focussed psychological strategies health service provided to a patient in consulting rooms (but not as an admitted patient of a hospital) by an eligible occupational therapist if:

    (a)   the patient is affected by bushfire; and             

    (b)   the service is provided to the patient individually and in person; and

    (c)   the service is at least 50 minutes duration

91.50

91136

 

 

Focussed psychological strategies health service provided to a patient (but not as an admitted patient of a hospital) by an eligible occupational therapist if:

    (a)   the patient is affected by bushfire; and             

    (b)   the service is provided to the patient individually; and

    (c)   the attendance is by video conference; and

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

    (e)   the service is at least 50 minutes duration

91.50

91140

 

 

Focussed psychological strategies health service provided to a patient at a place other than consulting rooms (but not as an admitted patient of a hospital) by an eligible occupational therapist in accordance with the requirements of item 91135

117.95

91150

 

 

Focussed psychological strategies health service provided to a patient in consulting rooms (but not as an admitted patient of a hospital) by an eligible social worker if:

    (a)   the patient is affected by bushfire; and             

    (b)   the service is provided to the patient individually and in person; and

    (c)   the service is at least 20 minutes but less than 50 minutes duration

64.80

91151

 

 

Focussed psychological strategies health service provided to a patient (but not as an admitted patient of a hospital) by an eligible social worker if:

    (a)   the patient is affected by bushfire; and             

    (b)   the service is provided to the patient individually; and

    (c)   the attendance is by video conference; and

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

    (e)   the service is at least 20 minutes but less than 50 minutes duration

64.80

91155

 

 

Focussed psychological strategies health service provided to a patient at a place other than consulting rooms (but not as an admitted patient of a hospital) by an eligible social worker in accordance with the requirements of item 91150

91.25

91160

 

 

Focussed psychological strategies health service provided to a patient in consulting rooms (but not as an admitted patient of a hospital) by an eligible social worker if:

    (a)   the patient is affected by bushfire; and             

    (b)   the service is provided to the patient individually and in person; and

    (c)   the service is at least 50 minutes duration

91.50

91161

 

 

Focussed psychological strategies health service provided to a patient (but not as an admitted patient of a hospital) by an eligible social worker if:

    (a)   the patient is affected by bushfire; and             

    (b)   the service is provided to the patient individually; and

    (c)   the attendance is by video conference; and

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

    (e)   the service is at least 50 minutes duration

91.50

91165

 

 

Focussed psychological strategies health service provided to a patient at a place other than consulting rooms (but not as an admitted patient of a hospital) by an eligible social worker in accordance with the requirements of item 91160

117.95


 

Division 1.2 – Services and fees – general practitioner mental health services

1.2.1      Meaning of amount under table 1.2.1

(1)          An amount under table 1.2.1, for an item mentioned in column 1 of table 1.2.1, means the sum of:

(a)    the fee for the item mentioned in column 2 of the table; and

(b)   either:

(i)    if not more than 6 patients are attended at a single attendance—the amount mentioned in column 3 for the item, divided by the number of patients attended; or

(ii)   if more than 6 patients are attended at a single attendance—the amount mentioned in column 4 for the item.

Table 1.2.1 – Amount under clause 1.2.1

Item

Column 1

Item of the table

Column 2

Fee

Column 3

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

Column 4

Amount if more than 6 patients ($)

1

91723

The fee for item 91721

31.75

2.45

2

91727

The fee for item 91725

31.75

2.45

 

1.2.2    Application of items 91721, 91723, 91725, 91727, 91729, 91731

 

(1)          Items 91721, 91723, 91725, 91727, 91729, 91731 apply to a service which:

         (b)  is provided by a general practitioner:

   (i)   whose name is entered in the register maintained by the Chief Executive Medicare under section 33 of the Human Services (Medicare) Regulations 2017; and

   (ii)  who is identified in the register as a medical practitioner who can provide services to which Subgroup 2 of Group A20 of the general medical services table or items 91721, 91723, 91725, 91727, 91729, 91731 applies; and

   (iii)  who meets any training and skills requirements, as determined by the General Practice Mental Health Standards Collaboration for providing services to which Subgroup 2 of Group A20 of the general medical services table or items 91721, 91723, 91725, 91727, 91729, 91731 applies.

Group A39 – Bushfire Recovery Access Initiative – GP and Medical Practitioner Focussed Psychological Strategies

Item

Description

Fee ($)

91721

Professional attendance at consulting rooms by a general practitioner (not including a specialist or a consultant physician), for providing focussed psychological strategies for mental health services to a patient with mental health issues, if:

(a) the patient is affected by bushfire; and

(b) the service is at least 30 minutes but less than 40 minutes duration

113.50

91723

Professional attendance at a place other than consulting rooms by a general practitioner (not including a specialist or a consultant physician), for providing focussed psychological strategies for mental health services to a patient with mental health issues, if:

(a) the patient is affected by bushfire; and

(b) the service is at least 30 minutes but less than 40 minutes duration

Amount under clause 1.2.1

91725

Professional attendance at consulting rooms by a general practitioner (not including a specialist or a consultant physician), for providing focussed psychological strategies for mental health services to a patient with mental health issues, if:

(a) the patient is affected by bushfire; and

(b) the service is at least 40 minutes duration

162.45

91727

Professional attendance at a place other than consulting rooms by a general practitioner (not including a specialist or a consultant physician), for providing focussed psychological strategies for mental health services to a patient with mental health issues, if:

(a) the patient is affected by bushfire; and

(b) the service is at least 40 minutes duration

Amount under clause 1.2.1

91729

 

Professional attendance at consulting rooms by a general practitioner, for providing focussed psychological strategies for mental health services to a patient with mental health issues, if:

(a) the patient is affected by bushfire; and

(b) the attendance is by video conference; and

(c) the service is at least 30 minutes but less than 40 minutes duration

113.50

91731

 

Professional attendance at consulting rooms by a general practitioner, for providing focussed psychological strategies for mental health services to a patient with mental health issues, if:

(a) the patient is affected by bushfire; and

(b) the attendance is by video conference; and

(c) the service is at least 40 minutes duration

162.45

 


 

Division 1.3 – Services and fees – Non-specialist Practitioner mental health services

1.3.1      Definitions in Division 1.3

(1)                   For the purpose of Division 1.3.1, the meaning of medical practitioner has the same meaning as in the Health Insurance (Section 3C General Medical Services – Other Medical Practitioner) Determination 2018.

 (2)         An amount under table 1.3.1, for an item mentioned in column 1 of table 1.3.1, means the sum of:

(a)     the fee for the item mentioned in column 2 of the table; and

(b)     either:

(i)    if not more than 6 patients are attended at a single attendance—the amount mentioned in column 3 for the item, divided by the number of patients attended; or

(ii)   if more than 6 patients are attended at a single attendance—the amount mentioned in column 4 for the item.

 

 Table 1.3.1—Amount under clause 1.3.1

Item

Column 1

Item of the table

Column 2

Fee

Column 3

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

Column 4

Amount per patient if more than 6 patients ($)

1

91285

The fee for item 91283

25.40

1.95

2

91287

The fee for item 91286

25.40

1.95

 

1.3.2      Application of items 91283, 91285, 91286, 91287, 91371 and 91372

(1)          Items 91283, 91285, 91286, 91287, 91371 and 91372 apply to a service which:

(a)     is provided by a medical practitioner:

(i)    whose name is entered in the register maintained by the Chief Executive Medicare under section 33 of the Human Services (Medicare) Regulations 2017; and

(ii)   who is identified in the register as a medical practitioner who can provide services to which Subgroup 2 of Group A20 of the general medical services table or items 91283, 91285, 91286, 91287, 91371 and 91372 applies; and

(iii)  who meets any training and skills requirements, as determined by the General Practice Mental Health Standards Collaboration for providing services to which Subgroup 2 of Group A20 of the general medical services table or items 91283, 91285, 91286, 91287, 91371 and 91372 applies.

Group A39 – Bushfire Recovery Access Initiative – GP and Medical Practitioner Focussed Psychological Strategies

Item

Description

Fee($)

91283

 

Professional attendance at consulting rooms by a medical practitioner, for providing focussed psychological strategies for mental health services to a patient with mental health issues, if:

(a) the patient is affected by bushfire; and

(b) the service is at least 30 minutes but less than 40 minutes duration

90.80

91285

 

Professional attendance at a place other than consulting rooms by a medical practitioner, for providing focussed psychological strategies for mental health services to a patient with mental health issues, if:

(a) the patient is affected by bushfire; and

(b) the service is at least 30 minutes but less than 40 minutes duration

Amount under clause 1.3.1

91286

 

Professional attendance at consulting rooms by a medical practitioner, for providing focussed psychological strategies for mental health services to a patient with mental health issues, if:

(a) the patient is affected by bushfire; and

(b) the service is at least 40 minutes duration

129.95

91287

 

Professional attendance at a place other than consulting rooms by a medical practitioner, for providing focussed psychological strategies for mental health services to a patient with mental health issues, if:

(a) the patient is affected by bushfire; and

(b) the service is at least 40 minutes duration

Amount under clause 1.3.1

91371

 

Professional attendance at consulting rooms by a medical practitioner, for providing focussed psychological strategies for mental health services to a patient with mental health issues, if:

(a) the patient is affected by bushfire; and

(b) the attendance is by video conference; and

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

(d)  the service is at least 30 minutes but less than 40 minutes duration

90.80

91372

 

Professional attendance at consulting rooms by a medical practitioner, for providing focussed psychological strategies for mental health services to a patient with mental health issues, if:

(a) the patient is affected by bushfire; and

(b) the attendance is by video conference; and

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

(d)  the service is at least 40 minutes duration

129.95


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 – Mental Health Services for Bushfire Response) Determination 2020

16 Jan 2020 (F2020L00030)

17 Jan 2020 (s 2(1) item 1)

 

Health Insurance Legislation Amendment (Section 3C – Medical and Diagnostic Imaging Services) Determination 2020

29 Apr 2020 (F2020L00518)

1 May 2020 (s 2(1) item 1)

Health Insurance Legislation Amendment (Section 3C General Medical and Diagnostic Imaging Services – Medicare Indexation) Determination 2020

18 June 2020 (F2020L00748)

Sch 1 (items 45–78): 1 July 2020 (s 2(1) item 1)

Health Insurance Legislation Amendment (Section 3C General Medical and Diagnostic Imaging Services – Medicare Indexation) Determination 2021

8 Apr 2021 (F2021L00426)

Sch 1 (items 319–352): 1 July 2021 (s 2(1) item 1)

 

Endnote 4—Amendment history

 

Provision affected

How affected

s 2........................................

rep LA s 48D

s 6........................................

am F2020L00518

Schedule 1

 

Schedule 1........................... ............................................

am F2020L00478; F2021L00426