AUSTRALIAN GOVERNMENT

DEPARTMENT OF HEALTH AND AGED CARE

HEALTH INSURANCE ACT 1973

Health Insurance (Medicare Benefits Payable in Respect of Professional Services – Services Rendered under the Commonwealth Urgent Care Clinic Program) 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 Commonwealth Medicare Urgent Care Clinic Program between the Department of Health and Aged Care (ABN: 83 605 426 759) and the practices listed in Schedule B of this direction in relation to medical services available to patients who attend a Commonwealth Urgent Care Clinic Location 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) 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);

(iii)  a patient who also is not receiving a service:

1. which attracts a payment through the 2020-2025 Addendum to the National Health Reform Agreement for a service rendered to a public patient; or
2. which attracts a payment through another government arrangement outside of the Commonwealth Medicare Urgent Care Clinic program for a service rendered to the 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)  by a general practitioner or participating nurse practitioner mentioned in (a) who is registered to provide services, in Schedule A, with Services Australia under the Commonwealth Urgent Care Clinic program.

DECLARE that this Direction shall have effect from 30 June 2023 until 30 June 2026 inclusive unless earlier revoked.

Date this    15  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 Urgent care clinic program

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

SCHEDULE B

Approved COMMONWEALTH Urgent care clinic Locations AS AGREED under the Commonwealth urgent care clinic program

Approved primary care locations: