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This instrument amends the Health Insurance (Section 3C General Medical Services – COVID-19 Telehealth and Telephone Attendances) Determination 2020 to list 40 new temporary items for specialist telehealth and phone services performed by the admitting medical practitioner or the admitting dental practitioner for private patients admitted to hospital.
Administered by: Health
Registered 14 Sep 2021
Table of contents.

Commonwealth Coat of Arms of Australia

 

Health Insurance (Section 3C General Medical Services – COVID-19 Telehealth and Telephone Attendances) Amendment (In-Hospital Telehealth and Phone Services) Determination 2021

I, Travis Haslam, delegate of the Minister for Health and Aged Care, make the following Determination.

Dated 14 September 2021

Travis Haslam

Acting First Assistant Secretary

Medical Benefits Division

Health Resourcing Group

Department of Health

 

 

 


Contents

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

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

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

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

Schedule 1— Amendments................................................................................................... 2

 

 


1  Name

                        This instrument is the Health Insurance (Section 3C General Medical Services – COVID-19 Telehealth and Telephone Attendances) Amendment (In-Hospital Telehealth and Phone Services) Determination 2021.

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

15 September 2021

 

                Note:        This table relates only to the provisions of this instrument as originally made.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

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

1.    Subsection 5(1)

Insert:

admitting dental practitioner means the dental practitioner responsible for the patient’s treatment at the time the patient is admitted to hospital.

admitting medical practitioner means the medical practitioner responsible for the patient’s treatment at the time the patient is admitted to hospital.

2.    After subsection 8(1)

Insert:

(1A) Subsection (1) does not apply to an item in Schedule 5 of this Determination.

3.    After Schedule 4

Insert:

 

Schedule 5 – In-hospital services

 

Division 5.1 – Services and fees – COVID‑19 in-hospital specialist, consultant physician and consultant psychiatrist telehealth and phone services

 

5.1.1  Application of COVID-19 in-hospital specialist, consultant physician and consultant psychiatrist telehealth and phone services – general

(1)   Clause 1.2.2 of the general medical services table shall have effect as if all items in Division 5.1 of this Determination were specified in the clause.

(2)   An item in Division 5.1 of this Determination only applies to a service if:

(a)    the patient to whom the service is provided is admitted to hospital; and

(b)   the medical practitioner who performs the service is:

                                                           (i)      located in an area determined by the Commonwealth Chief Medical Officer to be a COVID-19 hotspot; or

                                                         (ii)      in COVID-19 isolation because of a State or Territory public health order; or

                                                       (iii)      in COVID-19 quarantine because of a State or Territory public health order.

 

(3)   An item in Division 5.1 of this Determination only applies to a service if the service is performed by the admitting medical practitioner for the patient.

 

5.1.2  Application of COVID-19 in-hospital public health physician telehealth and phone services

(1)   Clause 2.13.1 of the general medical services table shall have effect as if items 92517 to 92520 and 92525 to 92528 were specified in the clause.

 

Group A40 – COVID-19 services

 

Subgroup 4 – COVID‑19 – specialist attendances telehealth services

 

Item

Description

Fee ($)

 

 91846

Telehealth attendance for a person by a specialist in the practice of the specialist’s specialty if:

(a)   the attendance follows referral of the patient to the specialist; and

(b)   the attendance was of more than 5 minutes in duration;

where the attendance was other than a second or subsequent attendance as part of a single course of treatment

90.35

 

 91847

Telehealth attendance for a person by a specialist in the practice of the specialist’s specialty if:

(a)   the attendance follows referral of the patient to the specialist; and

(b)   the attendance was of more than 5 minutes in duration;

where the attendance is after the first attendance as part of a single course of treatment

45.40

 

Subgroup 5 – COVID‑19 – consultant physician telehealth services

 

 92471

Telehealth attendance for a person by a consultant physician in the practice of the consultant physician’s specialty (other than psychiatry) if:

(a)   the attendance follows referral of the patient to the specialist; and

(b)   the attendance was of more than 5 minutes in duration;

where the attendance was other than a second or subsequent attendance as part of a single course of treatment

159.35

 

 92472

Telehealth attendance for a person by a consultant physician in the practice of the consultant physician’s specialty (other than psychiatry) if:

(a)   the attendance follows referral of the patient to the specialist; and

(b)   the attendance was of more than 5 minutes in duration;

where the attendance is not a minor attendance after the first as part of a single course of treatment

79.75

 

92473

Telehealth attendance for a person by a consultant physician in the practice of the consultant physician’s specialty (other than psychiatry) if:

(a)   the attendance follows referral of the patient to the specialist; and

(b)   the attendance was of more than 5 minutes in duration;

where the attendance is a minor attendance after the first as part of a single course of treatment

45.40

 

Subgroup 6 – COVID‑19 – consultant psychiatrist telehealth services

 

 92461

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

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

(b)   the attendance was not more than 15 minutes duration

45.75

 

 92462

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

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

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

91.30

 

 92463

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

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

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

140.55

 

 92464

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

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

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

194.00

 

 92465

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

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

(b)   the attendance was at least 75 minutes in duration

225.10

 

 92466

Telehealth attendance of more than 45 minutes in duration by a consultant physician in the practice of the consultant physician’s speciality of psychiatry following referral of the patient to the consultant physician by a referring practitioner:

(a)   if the patient:

(i) is a new patient for this consultant physician; or

(ii) has not received an attendance from this consultant physician in the preceding 24 months; and

(b)   the patient has not received an attendance under this item, or item 91827 to 91831, 91837 to 91841, 92455 to 92457, 92495 to 92497 or 92477, or item 296, 297, 299, 300 to 346, 353 to 358 or 361 to 370 of the general medical services table, in the preceding 24 months

274.95

 

Subgroup 7 – COVID‑19 – specialist attendances phone services

 

 91848

Phone attendance for a person by a specialist in the practice of the specialist’s specialty if:

(a)  the attendance follows referral of the patient to the specialist; and

(b)   the attendance was of more than 5 minutes in duration;

where the attendance was other than a second or subsequent attendance as part of a single course of treatment

90.35

 

 91849

 

Phone attendance for a person by a specialist in the practice of the specialist’s specialty if:

(a)   the attendance follows referral of the patient to the specialist; and

(b)   the attendance was of more than 5 minutes in duration;

where the attendance is after the first attendance as part of a single course of treatment

45.40

 

Subgroup 8 – COVID‑19 – consultant physician phone services

 

 92425

Phone attendance for a person by a consultant physician in the practice of the consultant physician’s specialty (other than psychiatry) if:

(a)   the attendance follows referral of the patient to the specialist; and

(b)   the attendance was of more than 5 minutes in duration; 

where the attendance was other than a second or subsequent attendance as part of a single course of treatment

159.35

 

 92426

Phone attendance for a person by a consultant physician in the practice of the consultant physician’s specialty (other than psychiatry) if:

(a)   the attendance follows referral of the patient to the specialist; and

(b)   the attendance was of more than 5 minutes in duration;

where the attendance is not a minor attendance after the first as part of a single course of treatment

79.75

 

92427

 

Phone attendance for a person by a consultant physician in the practice of the consultant physician’s specialty (other than psychiatry) if:

(a)   the attendance follows referral of the patient to the specialist; and

(b)   the attendance was of more than 5 minutes in duration;

where the attendance is a minor attendance after the first as part of a single course of treatment

45.40

 

Subgroup 9 – COVID‑19 – consultant psychiatrist phone services

 

 92501

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

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

(b)   the attendance was not more than 15 minutes duration

45.75

 

 92502

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

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

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

91.30

 

 92503

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

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

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

140.55

 

 92504

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

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

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

194.00

 

 92505

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

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

(b)   the attendance was at least 75 minutes in duration

225.10

 

 92506

Phone attendance of more than 45 minutes in duration by a consultant physician in the practice of the consultant physician’s speciality of psychiatry following referral of the patient to the consultant physician by a referring practitioner:

(a)   if the patient:

(i) is a new patient for this consultant physician; or

(ii) has not received an attendance from this consultant physician in the preceding 24 months; and

(b)   the patient has not received an attendance under this item, item 91827 to 91831, 91837 to 91841, 92455 to 92457, 92495 to 92497 or 92437, or item 296, 297, 299, 300 to 346, 353 to 358, or 361 to 370 of the general medical services table, in the preceding 24 months

274.95

 

Subgroup 33— Public health physician – Telehealth Services 

 

 92517

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

20.65

 

 92518

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

45.15

 

 92519

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

87.35

 

92520

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

128.60

 

Subgroup 34— Public health physician – Phone Services 

 

 92525

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

20.65

 

 92526

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

45.15

 

 92527

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

87.35

 

 92528

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

128.60

 

Subgroup 35— Neurosurgery attendances – Telehealth Services 

 

92615

 

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)

136.85

 

 92616

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

45.40

 

Subgroup 36—Neurosurgery attendances – Phone Services

 

92625

 

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)

136.85

 

 92626

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

45.40

 

Subgroup 37 —Specialist, anaesthesia telehealth services

92702

Telehealth attendance by a medical practitioner in the practice of anaesthesia for a consultation on a patient undergoing advanced surgery or who has complex medical problems, involving a selective history and the formulation of a written patient management plan documented in the patient notes, and lasting more than 15 minutes (other than a service associated with a service to which any of items 2801 to 3000 of the general medical services table apply)

90.35

Subgroup 38 —Specialist, anaesthesia phone services

92713

Phone attendance by a medical practitioner in the practice of anaesthesia for a consultation on a patient undergoing advanced surgery or who has complex medical problems, involving a selective history and the formulation of a written patient management plan documented in the patient notes, and lasting more than 15 minutes (other than a service associated with a service to which any of items 2801 to 3000 of the general medical services table apply)

90.35

 

Division 5.2 – Services and fees – COVID‑19 in-hospital dental practitioner telehealth and phone services

 

5.2.1 – Application of dental practitioner services

(1)   This clause applies to items 54006, 54007, 54011 and 54012.

(2)   An item mentioned in subclause (1) only applies to a service provided in the course of dental practice by a dental practitioner approved by the Minister before
1 November 2004 for the definition of professional service in subsection 3(1) of the Act.

(3)   An item mentioned in subsection (1) only applies to a service if:

(a)    the patient to whom the service is provided is admitted to hospital; and

(b)   the dental practitioner who performs the service is:

                                                              i.      located in an area determined by the Commonwealth Chief Medical Officer to be a COVID-19 hotspot; or

                                                            ii.      in COVID-19 isolation because of a State or Territory public health order; or

                                                          iii.      in COVID-19 quarantine because of a State or Territory public health order.

(4)   An item mention in subclause (1) only applies to a service if the service is performed by the admitting dental practitioner for the patient.

 

 

Group O1—Consultations

 

Subgroup 1—dental practitioner telehealth services

 

Item

Description

Fee ($)

 

54006

Telehealth attendance (other than a second or subsequent attendance in a single course of treatment) by an approved dental practitioner in the practice of oral and maxillofacial surgery, if the patient is referred to the approved dental practitioner

89.00

 

54007

Telehealth attendance by an approved dental practitioner in the practice of oral and maxillofacial surgery, each attendance after the first in a single course of treatment, if the patient is referred to the approved dental practitioner

44.75

 

Subgroup 2—dental practitioner phone services

54011

Phone attendance (other than a second or subsequent attendance in a single course of treatment) by an approved dental practitioner in the practice of oral and maxillofacial surgery, if the patient is referred to the approved dental practitioner

89.00

54012

Phone attendance by an approved dental practitioner in the practice of oral and maxillofacial surgery, each attendance after the first in a single course of treatment, if the patient is referred to the approved dental practitioner

44.75