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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 Western Australian 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 – Western Australia 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 Western Australia 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 Western Australia 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 Western Australia (ABN: 28 684 750 332) 1 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 – WEStern Australia

 

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 – Western Australia

Approved locations and outreach services:

Location

Practice Name

Street Address

Mailing Address

Bridgetown

Bridgetown Hospital

28 Peninsula Road, Bridgetown, WA 6255

PO Box 136

BRIDGETOWN WA 6255

Carnarvon

Carnarvon Hospital

Cleaver Street

Carnarvon WA 6701

PO Box 417

CARNARVON  WA  6701

Burringurrah

Burringurrah Nursing Post

Sixth Street

Burringurrah Community

C/- PO Box 417

CARNARVON  WA  6701

Coral Bay

Coral Bay Nursing Post

67 Robinson Street

Coral Bay WA 6701

67 Robinson Street

CORAL BAY  WA  6701

Denham

Shark Bay Silver Chain Health Centre

53 Hughes Street

Denham WA 6537

53 Hughes Street

DENHAM  WA  6537

Gascoyne Junction

Gascoyne Junction Outreach Clinic

C/- Community Resource Centre

Lot 4 Scott Street

Gascoyne Junction WA 6705

C/- PO Box 417

CARNARVON  WA  6701

Useless Loop

Useless Loop Medical Centre

1 Wilson Rise

Useless Loop WA 6537

1 Wilson Rise

USELESS LOOP  WA  6537

Derby

Derby Hospital

67-71 Clarendon Street

Derby WA 6728

PMB 938

DERBY  WA  6728

Lombadina

Lombadina Health Centre

 Lot 404 Lombadina Road

Dampier Peninsula WA 6725

PMB 6

via BROOME  WA  6725

Looma

Looma Clinic

19H Ngaliwanya Street

Camballin WA 6728

PMB 903

via DERBY  WA  6728

One Arm Point

One Arm Point Health Centre

One Arm Point Community

89 One Arm Point Rd

Broome WA 6725

PMB 13

via BROOME  WA  6725

Exmouth

Exmouth Health Service

Lot 1448 Lyon Street, Exmouth, WA 6707

Lot 1448 Lyon Street

EXMOUTH WA 6707

Fitzroy Crossing

Fitzroy Crossing Health Service

82 Fallon Road

Fitzroy Crossing WA 6765

PO Box 5

FITZROY CROSSING  WA  6765

Bayulu

Bayulu Clinic

Lot 10 Lamey Ave

St Georges Ranges

Via Fitzroy Crossing WA 6765

PO Box 27

Bayulu Community

Via FITZROY CROSSING  WA 6765

Nookanbah

Nookanbah Clinic

Nookanbah Community

Fitzroy Crossing WA 6765

PO Box 14

FITZROY CROSSING  WA  6765

Wangkatjungka

Wangkatjungka Clinic

Wangkatjungka Clinic

Christmas Creek

Fitzroy Crossing WA 6765

PO Box 288

FITZROY CROSSING  WA  6765

Halls Creek

Halls Creek Hospital

70 Roberta Ave

Halls Creek WA 6770

70 Roberta Ave

HALLS CREEK  WA  6770

Yiyili

Yiyili Clinic

Lot 1 Louisa Downs Rd

Halls Creek WA 6770

PMB 12

HALLS CREEK WA 6770

Katanning

Katanning Health Service

11-31 Kobeelya Avenue

Katanning WA 6317

Katanning Hospital Site

Francis Street

KATANNING  WA  6317

Gnowangerup

Gnowangerup Hospital

3493 Broomehill-Gnowangerup Road Gnowangerup WA 6335

3493 Broomehill-Gnowangerup Road

GNOWANGERUP  WA  6335

Kojonup

Kojonup Hospital

36-50 Spring Street

Kojonup WA 6395

36-50 Spring Street

KOJONUP  WA  6395

Tambellup

Tambellup Health Centre

30 Norrish Street

Tambellup WA 6320

30 Norrish Street

TAMBELLUP  WA  6320

Kununurra

Kununurra District Hospital

96 Coolibah Drive

Kununurra WA 6743

PO Box 239

KUNUNURRA  WA  6743

Kalumburu

Kalumburu Health Clinic

138 Kalumburu Bvd

Kalumburu WA 6740

PMB 12

via WYNDHAM  WA  6740

Warmun

Warmun Health Clinic

Ord Street

Warmun WA 6749

Ord Street

WARMUN  WA  6749

Laverton

Laverton District Hospital

2 Beria Road, Laverton, WA 6440

2 Beria Road

LAVERTON WA 6440

Leonora

Leonora District Hospital

967 Sadie Canning Drive, Leonora, WA 6438

967 Sadie Canning Drive

LEONORA WA 6438

Meekatharra

Meekatharra Hospital

Savage Street Meekatharra, WA 6642

Savage Street

MEEKATHARRA WA 6642

Norseman

Norseman District Hospital

1 Talbot Street, Norseman, WA 6443

1 Talbot Street

NORSEMAN WA 6443

Onslow

Onslow Hospital

73 Second Avenue, Onslow, WA 6710

73 Second Avenue

ONSLOW WA 6710

Mount Barker

Plantagenet – Cranbrook Health Service

59 Langton Road, Mount Barker, WA 6324

59 Langton Road

MOUNT BARKER WA 6324

Ravensthorpe

Ravensthorpe Health Centre

Martin Street

Ravensthorpe WA 6346

PO Box 53

RAVENSTHORPE  WA  6346

Bremer Bay

Bremer Bay Health Centre

29 John Street

Bremer Bay WA 6339

29 John Street

BREMER BAY WA 6339

Jerramungup

Bremer Bay (Jerramungup) Health Centre

7 Kokoda Road

Jerramungup WA 6337

7 Kokoda Road

JERRAMUNGUP  WA  6337

Denham

Shark Bay WA Health and Community Service incl Useless Loop

53 Hughes Street, Denham, WA 6537

53 Hughes Street

DENHAM WA 6537

Manjimup

Warren (Manjimup) Health Service

16 Hospital Avenue, Manjimup, WA 6258

16 Hospital Avenue

MANJIMUP WA 6258

Wyndham

Wyndham District Hospital

43 Minderoo St, Wyndham, WA 6740

43 Minderoo St

WYNDHAM WA 6740