AUSTRALIAN GOVERNMENT

DEPARTMENT OF HEALTH AND AGED CARE

 

HEALTH INSURANCE ACT 1973

Health Insurance (Medicare Benefits Payable in Respect of Professional Services – Tasmanian Health Service) Direction 2023

I, Daniel McCabe, First Assistant Secretary, Medicare Benefits and Digital Health Division, Health Resourcing Group, delegate for the Minister for Health and Aged Care, acting under subsection 19(2) of the Health Insurance Act 1973, hereby:

  1. 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 Rural General Practice and Rural Generalist Single Employer Model Trial Memorandum of Understanding between the Department of Health and Aged Care (ABN: 83 605 426 759), the Tasmanian Health Service (ABN: 15 359 196 040) and the Tasmanian Department of Health (ABN: 11 255 872 006) in relation to the rural general practice and rural generalists single employer model 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 professional service is provided to:

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

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

(iii)  a patient who also is not receiving a service which attracts a payment through the 2020-2025 Addendum to the National Health Reform Agreement for a service rendered to a public patient; and

 

(c)   the professional services referred to in clause (a) must be provided:

(i)     at a general practice (as defined in Section 7.1.1 of the general medical services table); and

(ii)  at:

  1.  a rural or remote practice location specified in Schedule B in Modified Monash Model 2-7 (as defined in Section 7.1.1 of the general medical services table); or
  2. A location described in the Rural General Practice and Rural Generalist Single Employer Model Trial Memorandum of Understanding between the Department of Health and Aged Care, the Tasmanian Health Service and the Tasmanian Department of Health; and

(iii)  by a participating rural generalist and rural general practice trainee mentioned in (a):

  1. who is formally enrolled in:
    1. the Australian College of Rural and Remote Medicine Independent Pathway;
    2. The Royal Australian College of General Practitioners Fellowship Support Program, or equivalent;
    3. The Australian General Practice Training Program;
    4. The Rural Generalist Training Scheme; or
    5. The Remote Vocational Training Scheme; and
  2. who is employed by the Tasmanian Health Service for the provision of primary and acute care services; and

(iv) by one of the twenty rural generalist and rural general practice participants who are eligible to use this Direction at any one time.
 

DECLARED that this Direction shall have effect from 1 July 2023 until
30 June 2027 inclusive unless earlier revoked.

 

Date this    13  day of June 2023

 

 

Daniel McCabe

First Assistant Secretary  

Medicare Benefits and Digital Health Division

Health Resourcing Group

Department of Health and Aged Care 


SCHEDULE A

MEDICARE BENEFITS SCHEDULE ITEMS AS AGREED under the tasmanian health service rural general practice and rural Generalist SINGLE EMPLOYER Model TRIAL

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

All

 

A11

Urgent attendances after-hours

A14

Health assessments

A15

GP Management plans, team care arrangements and multidisciplinary care plans and case

1

GP Management plans, team care arrangements and multidisciplinary care plans

2

Case conferences

A17

Domiciliary and residential medication management reviews

A20

GP Mental Health treatment

All

 

A22

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

A23

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

A27

Pregnancy support counselling

A29

Attendance services for complex neurodevelopmental disorder or disability

A30

Medical practitioner video conferencing consultation

1

Video conferencing consultation attendance at consulting rooms, home visit of other institution

2

Video conferencing consultation attendance at a residential aged care facility

A35

Non-referred attendance at a residential aged care facility

A36

Eating Disorder Services

1

GP and Medical Practitioner eating disorder treatment and management plans

3

Review of eating disorder treatment and management plan

4

GP and medical practitioner eating disorder s psychological treatment services

A40

Telehealth and phone attendance 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 services

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

22

GP Eating Disorder Treatment and Management Plans - phone services

25

Review of an eating disorder Plan - telehealth services

26

Review of an Eating Disorder Plan – phone services

27

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

37

Specialist, anaesthesia – Telehealth Services

39

GP Sexual and Reproductive Health Consultation – Telehealth Service

40

GP Sexual and Reproductive Health Consultation – Phone Service

A45

Nicotine and Smoking Cessation Counselling

A46

COVID-19 management support service

M1

Management of bulk billed services

M12

Services provided by a practice nurse, an Aboriginal health worker or an Aboriginal and Torres Strait Islander health practitioner on behalf of a medical practitioner

1

Video conferencing consultation support service provided by a practice nurse, an Aboriginal health worker or an Aboriginal and Torres Strait Islander health practitioner on behalf of a medical practitioner

2

Video conferencing consultation support service provided at a residential aged care facility on behalf of a medical practitioner

3

Services provided by a practice nurse or an Aboriginal and Torres Strait Islander health practitioner on behalf of a medical practitioner

D1

Miscellaneous diagnostic procedures and investigations

2

Ophthalmology

3

Otolaryngology

4

Respiratory

5

Vascular

6

Cardiovascular

8

Genito-urinary physiological investigations

9

Allergy testing

10

Other diagnostic procedures and investigations

D2

Nuclear Medicine (non-imaging)

T1

Miscellaneous therapeutic procedures

2

Dialysis

4

Paediatric and neonatal

5

Cardiovascular

8

Haematology

9

Procedures associated with intensive care and cardiopulmonary support

11

Chemotherapeutic procedures

13

Other therapeutic procedures

T2

Radiation oncology

1

Superficial

T3

Therapeutic nuclear medicine

T4

Obstetrics

T6

Examination by anaesthetist

T7

Regional or field nerve blocks

T8

Surgical Operations

1

General

2

Colorectal

3

Vascular

4

Gynaecological

5

Urological

6

Cardio-thoracic

7

Neurosurgical

8

Ear, nose and throat

9

Ophthalmology

11

Paediatric

12

Amputations

13

Plastic and reconstructive surgery

14

Hand surgery

15

Orthopaedic

T9

Assistance at operations

T10

Anaesthesia performed in connect with certain services (relative value guide)

All

 

 

 

Diagnostic Imaging Services Table

Group

Group Name

Subgroup

Subgroup Name

I1

Ultrasound

6

Musculoskeletal ultrasound

I3

 

 

Diagnostic Radiology

 

 

1

Radiographic examination of extremities

2

Radiographic examination of shoulder or pelvis

3

Radiographic examination of head

4

Radiographic examination of spine

5

Bone age study and skeletal survey

6

Radiographic examination of thoracic region

7

Radiographic examination of urinary tract

8

Radiographic examination of alimentary tract and biliary system

12

Radiographic examination with opaque or contrast media

I6

Management of bulk billed Services

 

Pathology Services Table

Group

Group Name

P1

Haematology

P2

Chemical

P9

Simple Basic Pathology Tests

P12

Management of bulk billed services

 


SCHEDULE B

 

Approved Modified Monash 2-7 rural and remote Practice Locations AS AGREED under the Tasmanian health service rural general practice and rural Generalist SINGLE EMPLOYERModel TRIAL

 

Approved primary care Modified Monash Model (MMM) 2 locations:

MM2 Location

Practice Name

Street Address

Howrah

Glebe Hill Family Practice

45 Hance Road, Howrah, TAS 7018

Launceston

Launceston Medical Centre

247 Wellington Street, Launceston, TAS 7250

Lenah Valley

Ochre Medical Centre Augusta Road

120 Augusta Road, Lenah Valley, TAS 7008

Claremont

Ochre Medical Centre Claremont

Claremont Plaza, shop 24-25, 35 Main Rd, Claremont, TAS 7011

Hobart

Ochre Medical Centre Hobart

1/242 Liverpool St, Hobart, TAS 7000

Prospect

Prospect Medical Centre

4 Trotters Lane, Prospect, TAS 7250

Summerhill

Summerdale Medical Centre

Corner Peel and Stanley Streets, Summerhill, TAS 7250

 

Approved primary care Modified Monash Model (MMM) 3 locations:

MMM 3 location

Practice Name

Street Address

Burnie

Bass House Surgery

83 Wilmot Street, Burnie, TAS 7320

Devonport

Don Medical Clinic

SHOP 7/48-54 Oldaker Street, Devonport, TAS 7310

Ulverstone

Patrick Street Clinic

6 Patrick Street, Ulverstone, TAS 7315

 

 

 

Approved primary care Modified Monash Model (MMM) 5 locations:

MMM 5 location

Practice Name

Street Address

Deloraine

Deloraine Medical Centre

22 Tower Hill Street, Deloraine, TAS 7304

Dover

Dover Medical Centre

15 Chapman Avenue, Dover, TAS 7117

Scottsdale

Ochre Medical Centre Scottsdale

2 Fosters Rd, Scottsdale, TAS 7260

Smithton

Ochre Medical Centre Smithton

14 King Street, Smithton, TAS 7330

St Helens

Ochre Medical Centre St Helens

11 Pendrigh Place, St Helens, TAS 7216

Westbury

Westbury Medical Centre

80 Meander Valley Road, Westbury, TAS 7303

Approved primary care Modified Monash Model (MMM) 6 locations:

MM6 Location

Practice Name

Street Address

Huonville

Ochre Health Medical Centre Huonville

85 Main Street, Huonville, TAS 7109

Swansea

Swansea General Practice

37 Wellington St, Swansea, TAS 7190