1. Name

This determination is the Health Insurance (Section 3C General Medical Services - General Practitioner Telehealth Services) Determination 2018.

3. Authority

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

4. Definitions

(1) In this Determination:

Act means the Health Insurance Act 1973.

drought affected eligible area means an area within New South Wales, Queensland or Victoria that is a Modified Monash 3 area, Modified Monash 4 area, Modified Monash 5 area, Modified Monash 6 area or Modified Monash 7 area.

flood affected eligible area means an area that is a local government area of Burdekin, Burke, Charters Towers, Cloncurry, Cook, Doomadgee, Douglas, Flinders, McKinlay, Palm Island, Richmond, Townsville, Winton, and Wujal Wujal in the State of Queensland.

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

(a) psycho‑education;

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

(d) skills training;

(e) interpersonal therapy.

mental disorder means a significant impairment of any or all of an individual’s cognitive, affective and relational abilities that:

(a) may require medical intervention; and

(b) may be a recognised, medically diagnosable illness or disorder; and

Modified Monash 4 area means a Statistical Area Level 1 under the ASGS that:

(a) is categorised under the ASGS as RA 1 (Inner Regional Australia) or RA 2 (Outer Regional Australia); and

(b) satisfies any of the following criteria:

(i) the area is in an Urban Centre and Locality with a 2013 estimated resident population of at least 5,000 but no more than 15,000;

(ii) the area is in an Urban Centre and Locality, the geographic centre of which is no more than 10 kilometres road distance from the boundary of another Urban Centre and Locality with a 2013 estimated resident population of at least 5,000 but no more than 15,000;

(iii) the area is not in an Urban Centre and Locality, but the geographic centre of the area is no more than 10 kilometres road distance from the boundary of an Urban Centre and Locality with a 2013 estimated resident population of at least 5,000 but no more than 15,000; and

Modified Monash 5 area means a Statistical Area Level 1 under the ASGS that:

(a) is categorised under the ASGS as RA 1 (Inner Regional Australia) or RA 2 (Outer Regional Australia); and

(b) is not a Modified Monash 2 area, Modified Monash 3 area, Modified Monash 4 area or Modified Monash 7 area.

Modified Monash 6 area means a Statistical Area Level 1 under the ASGS that:

(a) is categorised under the ASGS as RA 3 (Remote Australia); and

(b) is not a Modified Monash 7 area.

Modified Monash 7 area means a Statistical Area Level 1 under the ASGS that:

(a) is entirely located on an island or islands more than 5 kilometres from the Australian mainland or Tasmania, as measured between coastlines at the low water mark; or

(b) is located on Magnetic Island; or

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.

relevant service means a health service, as defined in subsection 3C(8) of the Act, that is specified in a Schedule.

Schedule means a Schedule to this Determination.

Note: The following terms are defined in subsection 3(1) of the Act:

clinically relevant service
general medical services table
item
professional service

telehealth eligible area means an area that is a Modified Monash 4 area, Modified Monash 5 area, Modified Monash 6 area or Modified Monash 7 area.

(2) Unless the contrary intention appears, a reference in this Determination 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 Determination 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 items

Items 2121, 2150, 2196, 2729 and 2731 do not apply if the patient or the general practitioner travels to a place to satisfy the requirement in paragraph (d) of the item.

7. Application of provisions of the general medical services table

Clause 2.22.7 of the general medical services table shall have effect as if items 2729 and 2731 were also specified in this clause.

Schedule 1 – Relevant Services

Group A20—Mental health care
Subgroup 2—Focussed psychological strategies
Item	Description	Fee ($)
2729	Professional attendance at consulting rooms by a general practitioner, for the purpose of providing focussed psychological strategies for assessed mental disorders by a general practitioner registered with the Chief Executive Medicare as meeting the credentialing requirements for provision of this service, and lasting at least 30 minutes, but less than 40 minutes if: (a) the attendance is by video conference; and (b) the patient is not an admitted patient; and (c) the patient is located within a telehealth eligible area; and (d) the patient is, at the time of the attendance, at least 15 kilometres by road from the general practitioner.	92.75
2731	Professional attendance at consulting rooms by a general practitioner, for the purpose of providing focussed psychological strategies for assessed mental disorders by a general practitioner registered with the Chief Executive Medicare as meeting the credentialing requirements for provision of this service, and lasting at least 40 minutes if: (a) the attendance is by video conference; and (b) the patient is not an admitted patient; and (c) the patient is located within a telehealth eligible area; and (d) the patient is, at the time of the attendance, at least 15 kilometres by road from the general practitioner.	132.75

Group A30—Medical Practitioner video conferencing consultation
Subgroup 3—Mental health and well-being video conferencing consultation
Item		Description	Fee ($)
2121	Professional attendance at consulting rooms by a general practitioner, lasting less than 20 minutes, for providing mental health services to a patient with mental health issues, if: (a) the attendance is by video conference; and (b) the patient is not an admitted patient; and (c) the patient and the general practitioner are located within a drought affected eligible area; and (d) the patient is, at the time of the attendance, at least 15 kilometres by road from the general practitioner; and (e) the patient has an existing relationship with the general practitioner.			44.20
2150	Professional attendance at consulting rooms by a general practitioner, lasting at least 20 minutes, for providing mental health services to a patient with mental health issues, if: (a) the attendance is by video conference; and (b) the patient is not an admitted patient; and (c) the patient and the general practitioner are located within a drought affected eligible area; and (d) the patient is, at the time of the attendance, at least 15 kilometres by road from the general practitioner; and (e) the patient has an existing relationship with the general practitioner.			85.60
2196	Professional attendance at consulting rooms by a general practitioner, lasting at least 40 minutes, for providing mental health services to a patient with mental health issues, if: (a) the attendance is by video conference; and (b) the patient is not an admitted patient; and (c) the patient and the general practitioner are located within a drought affected eligible area; and (d) the patient is, at the time of the attendance, at least 15 kilometres by road from the general practitioner; and (e) the patient has an existing relationship with the general practitioner.			126.05

Group A30—Medical Practitioner video conferencing consultation
Subgroup 4— Non-referred telehealth consultations to which no other item applies
Item		Description	Fee ($)
2095	Professional attendance at consulting rooms by a general practitioner, for an obvious problem characterised by the straightforward nature of the task that requires a short patient history and, if required, limited examination and management, if: (a) the attendance is by video conference; and (b) the patient is located within a flood affected eligible area.			20.20
2144	Professional attendance at consulting rooms by a general practitioner, lasting less than 20 minutes, if: (a) the attendance is by video conference; and (b) the patient is located within a flood affected eligible area.			44.20
2180	Professional attendance at consulting rooms by a general practitioner, lasting at least 20 minutes, if: (a) the attendance is by video conference; and (b) the patient is located within a flood affected eligible area.			85.60
2193	Professional attendance at consulting rooms by a general practitioner, lasting at least 40 minutes, if: (a) the attendance is by video conference; and (b) the patient is located within a flood affected eligible area.			126.05

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.

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

	o = order(s)
ad = added or inserted	Ord = Ordinance
am = amended	orig = original
amdt = amendment	par = paragraph(s)/subparagraph(s)
c = clause(s)	/sub‑subparagraph(s)
C[x] = Compilation No. x	pres = present
Ch = Chapter(s)	prev = previous
def = definition(s)	(prev…) = previously
Dict = Dictionary	Pt = Part(s)
disallowed = disallowed by Parliament	r = regulation(s)/rule(s)
Div = Division(s)
exp = expires/expired or ceases/ceased to have	reloc = relocated
effect	renum = renumbered
F = Federal Register of Legislation	rep = repealed
gaz = gazette	rs = repealed and substituted
LA = Legislation Act 2003	s = section(s)/subsection(s)
LIA = Legislative Instruments Act 2003	Sch = Schedule(s)
(md) = misdescribed amendment can be given	Sdiv = Subdivision(s)
effect	SLI = Select Legislative Instrument
(md not incorp) = misdescribed amendment	SR = Statutory Rules
cannot be given effect	Sub‑Ch = Sub‑Chapter(s)
mod = modified/modification	SubPt = Subpart(s)
No. = Number(s)	underlining = whole or part not
	commenced or to be commenced

Endnote 3—Legislation history

Name	Registration	Commencement	Application, saving and transitional provisions
Health Insurance (Section 3C General Medical Services - General Practitioner Telehealth Services) Determination 2018	15 October 2018 (F2018L01430)	1 November 2018
Health Insurance (Section 3C General Medical Services – General Practice Telehealth Services) Amendment Determination 2018	29 October 2018 (F2018L01498)	Sch 1 (items 1–4): 1 November 2018	—
Health Insurance (Section 3C General Medical Services - General Practitioner Telehealth Services) Determination 2019	1 March 2019 (F2019L00226)	Sch 1 (items 1, 2): 2 March 2019 (s 2(1) item 1)	—

Endnote 4—Amendment history

Provision affected	How affected
s 2.....................	rep LA s 48D
s 4.....................	am F2018L01498; F2019L00226
s 6.....................	am F2018L01498
s 7.....................	am F2018L01498
Schedule 1
Schedule 1................	am F2018L01498; F2019L00226