Federal Register of Legislation - Australian Government

Primary content

This instrument allows Medicare benefits to be payable in respect of a professional service which has been agreed to be provided under the Memorandum of Understanding between the Department of Health and the New South Wales Government from 1 July 2022 to 30 July 2025.
Administered by: Health and Aged Care
Registered 30 Jun 2022
To be ceased 30 Jul 2025
Ceased by Self Ceasing

 

AUSTRALIAN GOVERNMENT

DEPARTMENT OF HEALTH

 

HEALTH INSURANCE ACT 1973

Health Insurance (Medicare Benefits Payable in Respect of Professional Services – Council of Australian Governments’ Improving Access to Primary Care in Rural and Remote Areas – COAG s19(2) Exemptions Initiative – New South Wales Direction 2022

I, Nigel Murray, Assistant Secretary, MBS Policy and Specialist Services Branch,

Medical Benefits Division, Health Resourcing Group, delegate for the Minister for Health, acting under subsection 19(2) of the Health Insurance Act 1973, hereby:

(1)   REVOKE the Direction made under subsection 19(2) of the Act that was granted on
16 December 2021, that Medicare benefits shall be payable in respect of professional services provided by health services in New South Wales that are a part of the Council of Australian Governments’ Improving Access to Primary Care in Rural and Remote Areas – COAG s19(2) Exemptions Initiative, as described in the Memorandum of Understanding between the Australian Government and New South Wales dated 13 December 2016; and

 

(2)   DIRECT that Medicare Benefits shall be payable in respect of

(a)   A professional service (as defined in Section 3 of the Health Insurance Act 1973) which has been agreed to be provided under the Memorandum of Understanding (MOU) between the Department of Health (ABN: 24 004 196 909) and the New South Wales (ABN: 92 697 899 630) 13 May 2022 as part of the Council of Australian Governments’ Improving Access to Primary Care in Rural and Remote Areas – COAG s19(2) Exemptions Initiative relating to primary care services for which:

(i)           items specified in Schedule A of this Direction; and of the general medical services table (means the table prescribed under subsection 4(1) of the Health Insurance Act 1973), diagnostic imaging services table (means the table prescribed under subsection 4AA(1) of the Health Insurance Act 1973) and pathology services table (means the table prescribed under subsection 4A(1) of the Health Insurance Act 1973) relates: and

(b)   where the profession service is provided to:

(i)           an eligible person (as defined in Section 3 of the Health Insurance Act 1973); and

(ii)         a patient who is not part of an episode of hospital treatment (as defined in Section 121-5 of the Private Health Insurance Act 2007); and

(c)    The professional services referred to in a clause in (2)(a):

(i)     is provided at an approved Modified Monash Model 5-7 area (as defined in Section 7.1.1 of the general medical services table) practice location specified in Schedule B; and

                                                                          i.      is a professional non-referred service provided by a state remunerated medical practitioner, participating midwife, or participating nurse practitioner; or

                                                                        ii.      is a professional referred service provided by a state remunerated allied health and dental health practitioner; and

 

 

DECLARED that this Direction shall have effect from the date of signature until
30 July 2025 inclusive unless earlier revoked.

Date this 29th day of June 2022

 

 

Nigel Murray

Assistant Secretary

MBS Policy and Specialist Services Branch

Medical Benefits Division

Health Resourcing Group

Department of Health 


 

 

SCHEDULE A

 

MEDICARE BENEFITS SCHEDULE ITEMS AS Approved Practice Locations AS AGREED under the Council of Australian Governments’ Improving Access to Primary Care in Rural and Remote Areas – COAG s19(2) Exemptions Initiative – New South wales

 

For services listed in the below tables, all provisions of the Health Insurance Act 1973 (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 apply.

General Medical Services Table

Group

Group Name

Subgroup

Subgroup Name

A1

General practitioner attendances to which no other item applies

A2

Other non-referred attendances to which no other item applies

A5

Prolonged attendances to which no other item applies

A6

Group Therapy

A7

Acupuncture and non-specialist practitioner items

A9

Contact lenses – attendances

A10

Optometrical attendances

A11

Urgent attendance after hours

A14

Health assessments

A15

GP management plans, team care arrangements, multidisciplinary care plans

A17

Domiciliary and residential management plans

A18

General Practitioner attendance associated with PIP incentive payments to which no other item applies

A19

Other non-referred attendances associated with PIP incentive payments to which no other item applies

A20

General Practitioner mental health treatment

A22

General Practitioner after-hours attendances to which no other item applies

A23

Other non-referred after-hours attendances to which no other item applies

A27

Pregnancy support counselling

A30

Medical practitioner (including General Practitioner, specialist or consultant physician) telehealth attendances*

A35

Services for patients in Residential Aged Care Facilities

A40

Telehealth and phone services  

1

General practice telehealth services

2

General practice phone services

3

Focussed psychological strategies telehealth services

10

Focussed psychological strategies phone services

11

Health assessments for Aboriginal and Torres Strait Islander People - telehealth services

13

GP management plans, team care arrangements and multidisciplinary care plans via telehealth attendance 

15

GP pregnancy support counselling telehealth services

16

GP pregnancy support counselling phone services

17

GP, Specialist and Consultant Physician Autism Service Telehealth Service

19

GP mental health treatment plan telehealth services

20

GP mental health treatment plan phone services

21

GP Eating Disorder Treatment and Management Plan telehealth services

27

GP - Eating Disorder Focussed Psychological Strategies telehealth services

28

GP - Eating Disorder Focussed Psychological Strategies phone services

29

GP and Other Medical Practitioner urgent after-hours service in unsociable hours telehealth services

39

GP and Other Medical Practitioner - urgent after hours service in unsociable hours phone services

40

GP Blood borne viruses, sexual or reproductive health consultation telehealth service

A41

Additional focussed psychological strategies

A42

Mental health planning for care recipients of a residential aged care facility

A43

Care recipient of a Residential Aged Care Facility planning and contribution items

A45

Nicotine and Smoking Cessation Counselling

M1

Management of bulk-billed services

M3

Allied Health services

M6

Psychological therapy services

M7

Focussed psychological strategies

M8

Pregnancy support counselling

M9

Allied Health group services

M10

Autism, pervasive developmental disorder and disability services

M11

Allied Health services for Indigenous Australians who have had a health check

M12

Services provided by a Practice Nurse or Aboriginal and Torres Strait Islander health practitioner on behalf of a medical practitioner

M14

Nurse Practitioners

M15

Diagnostic audiology services

M16

Eating Disorder services

M18

Allied health telehealth services

1

Psychological therapies telehealth services

2

Psychologist focussed psychological strategies telehealth services

3

Occupational therapist focussed psychological strategies telehealth services

4

Social worker focussed psychological strategies telehealth services

5

Nurse practitioner telehealth services

6

Psychological therapies phone services

7

Psychologist focussed psychological strategies phone service

8

Occupational therapist focussed psychological strategies phone services

9

Social worker focussed psychological strategies phone services

10

Nurse practitioner phone services

11

General allied health telehealth services

12

General allied health phone services

13

Pregnancy support counselling telehealth services

14

Pregnancy support counselling phone services

15

Autism, pervasive developmental disorder and disability telehealth services

16

Autism, pervasive developmental disorder and disability phone services

17

Telehealth attendance to person of Aboriginal and Torres Strait Islander descent

18

Phone attendance to person of Aboriginal and Torres Strait Islander descent

23

COVID-19 Follow up service provided by a practice nurse or Aboriginal and Torres Strait Islander health practitioner – Telehealth Services

25

COVID-19 Allied health, group dietetics telehealth services

26

COVID-19 Allied health, group dietetics phone

M25

Additional psychological therapy services

M26

Additional focussed psychological strategies (allied mental health)

M27

Initial psychological therapy services

M28

Initial focussed psychological strategies (allied mental health)

M29

Additional allied health services

M30

Allied health services for Indigenous Australians in RACF

M31

Allied health group services in RACF

D1

Miscellaneous diagnostic procedures and investigations

1

Neurology

2

Ophthalmology

5

Vascular

7

Gastroenterology and colorectal

8

Genito/urinary physiological investigations

D2

Nuclear medicine (non-imaging)

T1

Miscellaneous therapeutic procedures

6

Gastroenterology

* Note: Claims under any item Group A30 in the General Medical Services Table may only be exempt from Subsection 19(2) of the HIA 1973 when the services are claimed by a General Practitioner.

 

General Medical Services Table – permitted items

Group

Group Name

Items

Item overview

A29

Early intervention services for children with autism, pervasive developmental disorder or disability

139

Professional attendance by a general practitioner for assessment, diagnosis and preparation of a treatment and management plan for a patient with an eligible disability.

A36

Eating disorder services

90250-90257, 90264, 90265, 90271-90282

Eating disorder services provided by General Practitioners or Medical Practitioners

A40

COVID-19 services

92170, 92171, 92176, 92177

General Practitioner and Other Medical Practitioner items

A44

General Practice attendance for assessing patient suitability for a COVID-19 vaccine

93625, 93627, 93635, 93637, 93645, 93647, 93654, 93656, 93661, 93666, 10660, 10661

General Practice Attendance for Assessing Patient Suitability for a COVID-19 Vaccine

D1

Miscellaneous diagnostic procedures and investigations

11300-11318, 11330, 11333-11339, 11503-11507, 11512, 11707, 12000-12004, 12012-12024, 12200, 12306-12326

Non-referred services only

M13

Midwifery services

82100-82115, 82130-82152

Midwifery items

T1

Miscellaneous therapeutic procedures

13105-13110

Haemodialysis provided by a registered nurse, Aboriginal health worker or Aboriginal and Torres Strait Islander health practitioner in a very remote location.

T4

Obstetrics

16400, 16406-16500, 16502-16591, 91850, 91855, 91851, 91856, 91852, 91857, 91853, 91858, 91855

Antenatal and postnatal attendances

T8

Surgical operations

30001-30006, 30010, 30023, 30026-30055, 30061-30072, 30187, 30189, 30192-30219, 47015, 47042, 47057, 47069, 47301, 47348,

47354, 47361, 47387, 47423, 47444, 47453, 47462, 47466. 47471, 47543, 47561, 47579, 47595, 47663, 47735, 47904-47918

Minor surgical procedures

O1

Consultations

51700- 51703, 54001-54004

Dental practitioner attendances

 

Diagnostic Imaging Services Table

Group

Group Name

I1

Ultrasound

I3

Diagnostic radiology

I6

Management of bulk-billed services

 

Pathology Services Table

Group

Group Name

P9

Simple basic pathology tests

P12

Management of bulk-billed services

P13

Bulk-billing incentive


 

 

SCHEDULE B

 

Approved Practice Locations AS AGREED under the Council of Australian Governments’ Improving Access to Primary Care in Rural and Remote Areas – COAG s19(2) Exemptions Initiative – New South Wales

Approved locations:

Location

Practice Name

Street Address

Mailing Address

Balranald

Balranald Multi Purpose Service

41-43 Court Street

Balranald NSW 2715

41-43 Court Street

BALRANALD  NSW  2715

Barham

Barham Multi-Purpose Service

80 Punt Road

Barham NSW 2732

80 Punt Road

BARHAM  NSW  2732

Batlow

Batlow-Adelong Multi-Purpose Service

61-81 Pioneer Street

Batlow NSW 2730

61-81 Pioneer Street

BATLOW  NSW  2730

Berrigan

Berrigan Health Service

47-49 Davis Street

Berrigan NSW 2712

47-49 Davis Street

BERRIGAN  NSW  2712

Bingara

Bingara Multipurpose Service

Copeton Dam Road

Bingara NSW 2404

Copeton Dam Road

BINGARA  NSW  2404

Blayney

Blayney Health Service

3 Osman Street

Blayney NSW 2799

3 Osman Street

BLAYNEY  NSW  2799

Boorowa

Boorowa Multipurpose Service

62-80 Dry Street

Boorowa NSW 2586

62-80 Dry Street

BOOROWA  NSW  2586

Coolamon

Coolamon-Ganmain Multipurpose Service

1 Doctor Buchanan Drive

Coolamon NSW 2701

1 Doctor Buchanan Drive

COOLAMON  NSW  2701

Culcairn

Culcairn Multipurpose Service

51-55 Balfour Street

Culcairn NSW 2660

51-55 Balfour Street

CULCAIRN  NSW  2660

Dareton

Dareton Primary and Community Health Centre

42-44 Tapio Avenue

Dareton NSW 2717

42-44 Tapio Avenue

DARETON  NSW  2717

Dungog

Dungog Community Hospital

22 Hospital Road

Dungog NSW 2420

22 Hospital Road

DUNGOG  NSW  2420

Finley

Finley Health Service

24 Dawe Avenue

Finley NSW 2713

24 Dawe Avenue

FINLEY  NSW  2713

Gloucester

Gloucester Soldiers Memorial Hospital & Gloucester Community Health Centre

Church Street

Gloucester NSW 2422

Church Street

GLOUCESTER  NSW  2422

Gundagai

Gundagai Health (Multipurpose) Service

50 Tor Street

Gundagai NSW 2722

50 Tor Street

GUNDAGAI  NSW  2722

Guyra

Guyra Multipurpose Service

44-48 Sole Street

Guyra NSW 2365

44-48 Sole Street

GUYRA  NSW  2365

Harden

Murrumburrah-Harden Hospital and Health Service

53 Scott Street

Harden NSW 2587

53 Scott Street

HARDEN  NSW  2587

Hay

Hay District Hospital

351 Murray St

Hay NSW 2711

351 Murray St

HAY  NSW  2711

Henty

Henty Multipurpose Service

7 Keighran Street

Henty NSW 2658

7 Keighran Street

HENTY  NSW  2658

Hillston

Hillston Hospital and Health Service

48C Burns Street

Hillston NSW 2675

48C Burns Street

HILLSTON  NSW  2675

Holbrook

Holbrook Hospital

30 Bowler Street

Holbrook NSW 2644

30 Bowler Street

HOLBROOK  NSW  2644

Jerilderie

Jerilderie Hospital and Health Service

33-39 Southey Street

Jerilderie NSW 2716

PO Box 116

JERILDERIE  NSW  2716

Junee

Junee Multi-Purpose Service

67 Broadway Street

Junee NSW 2663

67 Broadway Street

JUNEE  NSW  2663

Kyogle

Kyogle Multipurpose Service

Summerland Way

Kyogle NSW 2474

Summerland Way

KYOGLE  NSW  2474

Lake Cargelligo

Lake Cargelligo Hospital and Health Service

34 Uabba Street

Lake Cargelligo NSW 2672

34 Uabba Street

LAKE CARGELLIGO  NSW  2672

Lockhart

Lockhart Hospital and Health Service

53-55 Hebden Street

Lockhart NSW 2656

53-55 Hebden Street

LOCKHART  NSW  2656

Manilla

Manilla Multipurpose Service

Court Street

Manilla NSW 2346

Court Street

MANILLA  NSW  2346

Merriwa

Merriwa Multipurpose Service

Mackenzie Street

Merriwa NSW 2329

Mackenzie Street

MERRIWA  NSW  2329

Murrurundi

Wilson Memorial Community Hospital Murrurundi & Murrurundi Community Health Centre

Corner Paradise and O'Connell Streets

Murrurundi NSW 2338

PO Box 8

MURRURUNDI  NSW  2338

Narrandera

Narrandera Health Service

54 Adams Street

Narrandera NSW 2700

54 Adams Street

NARRANDERA  NSW  2700

Nimbin

Nimbin Multipurpose Service

35 Cullen Street

Nimbin NSW 2480

35 Cullen Street

NIMBIN  NSW  2480

Nyngan

Nyngan Hospital and Community Health Service

Hoskins Street

Nyngan NSW 2825

PO Box 96

NYNGAN  NSW  2825

Oberon

Oberon Health Service

North St

Oberon NSW 2787

North Street

OBERON  NSW  2787

Quirindi

Quirindi Health Service

50 Nowland Street

Quirindi NSW 2343

50 Nowland Street

QUIRINDI  NSW  2343

Rylstone

Rylstone Multi-Purpose Service

Fitzgerald Street

Rylstone NSW 2849

Fitzgerald Street

RYLSTONE  NSW  2849

Temora

Temora Health Service

169-189 Loftus Street

Temora NSW 2666

169-189 Loftus Street

TEMORA  NSW  2666

Tocumwal

Tocumwal Health Service

6-12 Adams Street

Tocumwal NSW 2714

6-12 Adams Street

TOCUMWAL  NSW  2714

Tottenham

Tottenham Multi-Purpose Service

10 Moondana Street

Tottenham NSW 2873

10 Moondana Street

TOTTENHAM  NSW  2873

Trangie

Trangie Multi-Purpose Service

28 Harris Street

Trangie NSW 2823

28 Harris Street

TRANGIE  NSW  2823

Trundle

Trundle Multi-Purpose Service

44 Brookview Street

Trundle NSW 2875

44 Brookview Street

TRUNDLE  NSW  2875

Tullamore

Tullamore Multi-Purpose Service

Kitchener Street

Tullamore NSW 2874

Kitchener Street

TULLAMORE  NSW  2874

Tumbarumba

Tumbarumba Multipurpose Service

4 Mitchell Street

Tumbarumba NSW 2653

4 Mitchell Street

TUMBARUMBA  NSW  2653

Urana

Urana Health Multipurpose Service

127-129 Princess Street

Urana NSW 2645

127-129 Princess Street

URANA  NSW  2645

Urbenville

Urbenville Multipurpose Service

45 Beaury Street

Urbenville NSW 2475

45 Beaury Street

URBENVILLE  NSW  2475

Warialda

Warialda Multi-Purpose Service

Long Street

Warialda NSW 2402

Long Street

WARIALDA  NSW  2402

Wee Waa

Wee Waa Community Hospital & Wee Waa Community Health Centre

60 Alma Street

Wee Waa NSW 2388

PO Box 417

WEE WAA  NSW  2388

Wentworth

Wentworth Health Services

Silver City Highway

Wentworth NSW 2648

Silver City Highway

WENTWORTH  NSW  2648

West Wyalong

West Wyalong Hospital

70 Ungarie Road

West Wyalong NSW 2671

70 Ungarie Road

WEST WYALONG  NSW  2671