AUSTRALIAN GOVERNMENT
DEPARTMENT OF HEALTH
HEALTH INSURANCE ACT 1973
Health Insurance (Medicare Benefits Payable in Respect of Professional Services – Queensland State Government and Royal Flying Doctor Service) Direction 2021
I, LOUISE RILEY, ACTING FIRST ASSISTANT SECRETARY, delegate for the Minister for Health and Aged Care, acting under subsection 19(2) of the Health Insurance Act 1973 (the Act) hereby:
(1) REVOKE the Direction made under subsection 19(2) of the Act in respect of professional services provided by the Queensland State Government or Royal Flying Doctor Service dated 29 June 2021; and
(2) DIRECT that a medicare benefit shall be payable in respect of:
(a) a professional service (as defined in Section 3 of the Act) provided by a salaried provider employed or engaged by the Queensland State Government or the Royal Flying Doctor Service and provided in a clinic listed in Schedule B to this Direction, for which;
(i) items specified in Schedule A to this Direction of the general medical services table (means the table prescribed under subsection 4(1) of the Act), diagnostic imaging services table (means the table prescribed under subsection 4AA(1) of the Act) and pathology services table (means the table prescribed under subsection 4A(1) of the Act) relates; and
(ii) the professional service is provided to an eligible person (as defined in Section 3 of the Act).
Note: ‘Professional service’ as used in this Direction is defined in the Act.
This Direction shall have effect from the date of signature until 30 June 2024 inclusive, unless earlier revoked.
Date this 7th day of July 2021.
Louise Riley
Acting First Assistant Secretary
Medical Benefits Division
Department of Health
SCHEDULE A
PERMITTED MEDICARE BENEFITS SCHEDULE items
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.
All items in the Groups listed in Table 1 are permitted. Services provided under this instrument must meet all the requirements of the items claimed, as provided in the relevant item descriptors.
Table 1: General Medical Services Table – item groups
Group | Group Name | Group | Group Name |
A1 | General Practitioner attendances to which no other item applies | A15 | GP management plans, team care arrangements, multidisciplinary care plans |
A2 | Other non-referred attendances to which no other item applies | A17 | Domiciliary and residential management plans |
A5 | Prolonged attendances to which no other item applies | A18 | General Practitioner attendance associated with PIP incentive payments to which to other item applies |
A6 | Group therapy | A19 | Other non-referred attendances associated with PIP incentive payments to which no other item applies |
A7 | Acupuncture and non-specialist practitioner items | A20 | General Practitioner mental health treatment |
A9 | Contact lenses – attendances | A22 | General Practitioner after-hours attendances to which to other item applies |
A10 | Optometrical attendances | A23 | Other non-referred after-hours attendances to which no other item applies |
A11 | Urgent attendance after hours | A27 | Pregnancy support counselling |
A14 | Health assessments | A30 | Medical practitioner (including General Practitioner, specialist or consultant physician) telehealth attendances |
A35 | Services for patients in Residential Aged Care Facilities | M11 | Allied Health services for Indigenous Australians who have had a health check |
A39 | Bushfire recovery access initiative – GP and Medical Practitioner focussed psychological strategies | M12 | Services provided by a Practice Nurse or Aboriginal and Torres Strait Islander health practitioner on behalf of a medical practitioner |
A41 | Additional focussed psychological strategies | M13 | Midwifery services |
A42 | Mental health planning for care recipients of a residential aged care facility | M14 | Nurse Practitioners |
A43 | Care recipient of a Residential Aged Care Facility planning and contribution items | M15 | Diagnostic audiology services |
A44 | General Practice attendance for assessing patient suitability for a COVID-19 vaccine | M16 | Eating Disorder services |
D2 | Nuclear medicine (non-imaging) | M25 | Additional psychological therapy services |
M1 | Management of bulk-billed services | M26 | Additional focussed psychological strategies (allied mental health) |
M3 | Allied Health services | M27 | Initial psychological therapy services |
M6 | Psychological therapy services | M28 | Initial focussed psychological strategies (allied mental health) |
M7 | Focussed psychological strategies | M29 | Additional allied health services |
M8 | Pregnancy support counselling | M30 | Allied health services for Indigenous Australians in RACF |
M9 | Allied Health group services | M31 | Allied health group services in RACF |
M10 | Autism, pervasive developmental disorder and disability services |
|
|
All items in the Subgroups listed in Table 2 are permitted.
Table 2: General Medical Services Table – item subgroups
Group | Group Name | Subgroup | Subgroup Name |
A40 | COVID-19 services | 1 | COVID-19 General Practice telehealth services |
A40 | COVID-19 services | 2 | COVID-19 General Practice phone services |
A40 | COVID-19 services | 3 | COVID-19 focussed psychological strategies telehealth services |
A40 | COVID-19 services | 10 | COVID-19 focussed psychological strategies phone services |
A40 | COVID-19 services | 11 | COVID-19 health assessment for Aboriginal and Torres Strait Islander people – telehealth service |
A40 | COVID-19 services | 13 | COVID-19 chronic disease management (CDM) service – telehealth service |
A40 | COVID-19 services | 15 | COVID-19 GP pregnancy support counselling – telehealth service |
A40 | COVID-19 services | 16 | COVID-19 GP pregnancy support counselling – phone service |
A40 | COVID-19 services | 19 | COVID-19 GP mental health treatment plan – telehealth service |
A40 | COVID-19 services | 20 | COVID-19 GP mental health treatment plan – phone service |
A40 | COVID-19 services | 21 | COVID-19 GP eating disorder treatment and management plan – telehealth service |
A40 | COVID-19 services | 27 | COVID-19 GP eating disorder focussed psychological strategies – telehealth service |
A40 | COVID-19 services | 28 | COVID-19 GP eating disorder focussed psychological strategies – phone service |
A40 | COVID-19 services | 29 | COVID-19 GP and Other Medical Practitioner – urgent after-hours service in unsociable hours – telehealth service |
COVID-19 services | 39 | GP Blood borne viruses, sexual or reproductive health consultation – telehealth service | |
A40 | COVID-19 services | 40 | GP Blood borne viruses, sexual or reproductive health consultation – phone service |
D1 | Miscellaneous diagnostic procedures and investigations | 1 | Neurology |
D1 | Miscellaneous diagnostic procedures and investigations | 2 | Ophthalmology |
D1 | Miscellaneous diagnostic procedures and investigations | 5 | Vascular |
D1 | Miscellaneous diagnostic procedures and investigations | 6 | Cardiovascular |
D1 | Miscellaneous diagnostic procedures and investigations | 7 | Gastroenterology and colorectal |
D1 | Miscellaneous diagnostic procedures and investigations | 8 | Genito/urinary physiological investigations |
D1 | Miscellaneous diagnostic procedures and investigations | 9 | Allergy testing |
D1 | Miscellaneous diagnostic procedures and investigations | 10 | Other diagnostic procedures and interventions |
T1 | Miscellaneous therapeutic procedures | 5 | Cardiovascular |
T1 | Miscellaneous therapeutic procedures | 6 | Gastroenterology |
All items listed in Table 3 are permitted.
Table 3: General Medical Services Table – items
Group | Group Name | Items | Item Description |
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 | 92145, 92170, 92171, 92176, 92177 | General Practitioner and Other Medical Practitioner items |
D1 | Miscellaneous diagnostic procedures and investigations | 11300-11318, 11330, 11333-11339, 11503-11507, 11512 | Non-referred services only |
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 | Antenatal and postnatal attendances |
T8 | Surgical operations | 30001-30006, 30026-30055, 30061-30072, 30187, 30189, 30192-30219 | Minor surgical procedures |
O1 | Consultations | 51700- 51703, 54001-54004 | Dental practitioner attendances |
All items in the Groups listed in Table 4 are permitted.
Table 4: Diagnostic Imaging Services Table
Group | Group Name |
I1 | Ultrasound |
I3 | Diagnostic radiology |
I6 | Management of bulk-billed services |
All items in the Groups listed in Table 5 are permitted.
Table 5: Pathology Services Table
Group | Group Name |
P9 | Simple basic pathology tests |
P12 | Management of bulk-billed services |
P13 | Bulk-billing incentive |
SCHEDULE B
Approved Services - QUEENSLAND
Practice Name | Street Address | Mailing Address |
Torres and Cape Hospital and Health Service | ||
Aurukun Health Service | Kang Kang Road, Aurukun, QLD, 4892 | C/o Post Office, Aurukun, QLD, 4892 |
Badu Island Primary Health Care Centre | 181 Tamwoy Street, Badu Island, QLD, 4875 | PO Box 95, Badu Island, QLD, 4875 |
Bamaga Primary Health Care Centre | 175 Adidi Street, Bamaga, QLD, 4876 | PO Box 95, Bamaga, QLD, 4876 |
Bamaga Hospital | 82 Sagaukaz Street, Bamaga, QLD, 4876 | PO Box 99, Bamaga, QLD, 4876 |
Boigu Island Primary Health Care Centre | Chambers Street, Boigu Island, QLD, 4875 |
|
Coen Primary Health Care Centre | 2 Armbrust Street, Coen, QLD, 4892 | C/o Coen Post Office, Coen, QLD, 4892 |
Cooktown Multipurpose Health Service | 48 Hope Street, Cooktown, QLD, 4895 | PO Box 101, Cooktown, QLD, 4895 |
Dauan Island Primary Health Care Centre | Lot 16 Dauan Island, QLD, 4875 | C/ Dauan Island Health Care Centre, Dauan Island, QLD, 4875 |
Erub (Darnley) Island Primary Health Care Centre | Lot 64 The Esplanade, Erub Island, QLD, 4875 | C/ Erub (Darnley) Island Primary Health Care Centre, Erub Island, QLD, 4875 |
Hope Vale Primary Health Care Centre | Aerodrome Road, Hope Vale, QLD, 4895 | C/o Post Office, Hope Vale, QLD, 4895 |
Iama (Yam) Island Primary Health Care Centre | Lot 13 Garth Lane, Iama Island, QLD, 4875 | C/ Iama (Yam) Island Primary Health Care Centre, Iama Island, QLD, 4875 |
Kowanyama Primary Health Care Centre | Carrington Street, Kowanyama, QLD, 4892 | C/o Post Office, Kowanyama, QLD, 892 |
Kubin Primary Health Care Centre | Lot 77 Kubin Village Health Centre, Kubin Village, Moa Island, QLD, 4875 | C/ Kubin Health Centre, Lot 77 Kubin, QLD, 4875 |
Laura Primary Health Care Centre | 1 Gladwell Street, Laura, QLD, 4871 | Health Centre, Laura, QLD, 4871 |
Lockhart River Primary Health Care Centre | Lockhart River, QLD, 4892 | C/o Post Office, Lockhart River, QLD, 4892 |
Mabuiag Island Primary Health Care Centre | Lot 2 Map Street, Mabuiag Island, QLD, 4875 | C/ Mabuiag Island Primary Health Care Centre, Mabuiag Island, QLD, 4875 |
Malakoola (Napranum) Primary Health Care Centre | Munding Road, Napranum, QLD, 4874 | PO Box 52, Weipa, QLD, 4874 |
Mapoon Primary Health Care Centre | Red Beach Road, Mapoon, QLD, 4874 | PO Box 341, Weipa, QLD, 4874 |
Masig (Yorke) Island Primary Health Care Centre | Yorke Island, QLD, 4875 | C/ Yorke Island, QLD, 4875 |
Mer (Murray) Island Primary Health Care Centre | Murray Island, QLD, 4875 | C/ Post Office, Murray Island, QLD, 4875 |
New Mapoon Primary Health Care Centre | 46 Langie-Drah Street, New Mapoon, QLD, 4876 | PO Box 95, Bamaga, QLD, 4876 |
Ngurapai (Horn) Island Primary Health Care Centre | 29 Nawie Street, Horn Island, QLD, 4875 | Po Box 64, Horn Island, QLD, 4875 |
Pormpuraaw Primary Health Care Centre | 8 Korka Street, Pormpuraaw, QLD, 4892 | C/o Post Office, Pormpuraaw, QLD, 4892 |
Poruma (Coconut) Island Primary Health Care Centre | William Street, Poruma (Coconut) Island, QLD, 4875 | C/ Poruma (Coconut) Island Primary Health Care Centre, Poruma, QLD, 4875 |
Saibai Island Primary Health Care Centre | Saibai Island, QLD, 4875 | C/ Saibai Island, QLD, 4875 |
St Paul’s Primary Health Care Centre | Lot 33 Main Street, St Paul’s Village, Moa Island, QLD, 4875 | C/ St Paul’s Primary Health Care Centre, Moa Island, QLD, 4875 |
Seisa Primary Health Care Centre | Lot 100 Mugai Street, Seisia, QLD, 4876 | PO Box 95, Bamaga, QLD, 4876 |
Thursday Island Community Wellness Centre | Thursday Island Hospital Precint, 163 Douglas Street, Thursday Island, QLD, 4875 | PO Box 391, Thursday Island, QLD, 4875 |
Thursday Island Hospital | 163 Douglas Street, Thursday Island, QLD, 4875 | PO Box 391, Thursday Island, QLD, 4875 |
Sibuwani Ngurpai Meta (Thursday Island Primary Health Care Centre) | 74 Douglas Street, Thursday Island, QLD, 4875 | PO Box 624, Thursday Island, QLD, 4875 |
Ugar (Stephen) Island Primary Health Care Centre | Lot 10 Orankie Street, Ugar (Stephen) Island, QLD, 4875 | C/ Ugar (Stephens) Island Primary Health Care Centre, Ugar (Stephens) Island, QLD, 4875 |
Umagico Primary Health Care Centre | Charlie Street, Umagico, QLD, 4876 | PO Box 95, Bamaga, QLD, 4876 |
Warraber (Sue) Island Primary Health Care Centre | Corner Esplanade and Aikuru Street, Warraber, QLD, 4875 | C/ Warraber Primary Health Care Centre, Warraber, QLD, 4875 |
Weipa Integrated Health Service | Lot 407 John Evans Drive, Weipa, QLD, 4874 | PO Box 341, Weipa, QLD, 4874 |
Wujal Wujal Primary Health Centre | 100 Douglas Street, Wujal Wujal, QLD, 4895 | PMB 1011, Cooktown, QLD, 4895 |
Cairns and Hinterland Hospital and Health Service | ||
Jumbun Community Health Care Centre | Murray Upper Road, Jumbun, QLD, 4854 | C/o Cassowary Area Community Health, PO Box 2463, Innisfail, QLD, 4860 |
Yarrabah Emergency Service | 1 Bukki Road, Yarrabah, QLD, 4871 |
|
Central Queensland Hospital and Health Service | ||
Woorabinda Multipurpose Health Service | 1 Munns Drive, Woorabinda, QLD, 4713 |
|
Darling Downs Hospital and Health Service | ||
Cherbourg Hospital and Community Health | Fisher Street, Cherbourg, QLD, 4605 | PO Box 361, Murgon, QLD, 4605 |
Goondiwindi Hospital | Bowen Street, Goondiwindi, QLD, 4390 | PO Box 339, Goondiwindi, QLD, 4390 |
Metro South Hospital and Health Service | ||
Marie Rose Centre | 36 Oxley Parade, Dunwich, QLD, 4183 | PO Box 20, Dunwich, QLD, 4183 |
The Southern Queensland Centre of Excellence in Aboriginal and Torres Strait Islander Primary Health Care, Inala | 37 Wirraway Parade, Inala, QLD, 4077 |
|
South West Hospital and Health Service | ||
Charleville Hospital | 72 King Street, Charleville, QLD, 4470 | PO Box 219, Charleville, QLD, 4470 |
Cunnamulla Hospital | 56 Wicks Street, Cunnamulla, QLD, 4490 | PO Box 78, Cunnamulla, QLD, 4490 |
Townsville Hospital and Health Service | ||
Ayr Health Service | 2 Chippendale Street, Ayr, QLD, 4807 | PO Box 971, Ayr, QLD, 4807 |
Charters Towers Health Service | 137-139 Gill Street, Charters Towers, QLD, 4820 | PO Box 63, Charters Towers, QLD, 4820 |
Home Hill Health Service | Tenth Avenue, Home Hill, QLD, 4806 | PO Box 53, Home Hill, QLD, 4806 |
Joyce Palmer Health Service | Beach Road, Palm Island, QLD, 4816 |
|
North West Hospital and Health Service | ||
Burketown Primary Health Care Clinic | Beames St, Burketown, QLD, 4830 | PO Box 70, Burketown, QLD, 4830 |
Cloncurry Hospital | Musgrave Street, Cloncurry, QLD, 4824 |
|
Camooweal Primary Health Care Clinic | 52-60 Morrison Street, Camooweal, QLD, 4828 |
|
Dajarra Health Centre | Matheson Street, Mount Isa, QLD, 4825 | Locked Mail Bag, Private Mail 17, Mount Isa, QLD, 4825 |
Doomadgee Rural Hospital | Sharpe Street, Doomadgee, QLD, 4830 |
|
McKinlay Shire Multipurpose Health Service | 1 Burke Street, Julia Creek, QLD, 4823 | PO Box 93, Julia Creek, QLD, 4823 |
Karumba Health Centre | 140-160 Walker Street, Karumba, QLD, 4891 | PO Box 44, Karumba, QLD, 4891 |
Mornington Island Hospital | Lardyl Street, Mornington Island, QLD, 4871 |
|
Normanton Hospital | Hospital Road, Normanton, QLD, 4890 | PO Box 33, Normanton, QLD, 4890 |
APPROVED SERVICES – ROYAL FLYING DOCTOR SERVICE UNDER CONTRACT TO QUEENSLAND HEALTH
Practice Name | Street Address | Mailing Address |
Torres and Cape Hospital and Health Service | ||
Aurukun Health Service | Kang Kang Road, Aurukun, QLD, 4892 | C/o Post Office, Aurukun, QLD, 4892 |
Coen Primary Health Care Centre | 2 Armbrust Street, Coen, QLD, 4892 | C/o Coen Post Office, Coen, QLD, 4892 |
Kowanyama Primary Health Care Centre | Carrington Street, Kowanyama, QLD, 4892 | C/o Post Office, Kowanyama, QLD, 892 |
Lockhart River Primary Health Care Centre | Lockhart River, QLD, 4892 | C/o Post Office, Lockhart River, QLD, 4892 |
Malakoola (Napranum) Primary Health Care Centre | Munding Road, Napranum, QLD, 4874 | PO Box 52, Weipa, QLD, 4874 |
Pormpuraaw Primary Health Care Centre | 8 Korka Street, Pormpuraaw, QLD, 4892 | C/o Post Office, Pormpuraaw, QLD, 4892 |
Weipa Integrated Health Service | Lot 407 John Evans Drive, Weipa, QLD, 4874 | PO Box 341, Weipa, QLD, 4874 |