AUSTRALIAN GOVERNMENT

DEPARTMENT OF HEALTH AND AGED CARE

 

HEALTH INSURANCE ACT 1973

Health Insurance (Medicare Benefits Payable in Respect of Professional Services – Commonwealth Urgent Care Clinic Program – Victoria) 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:

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:

(i)     under a Schedule to the Federation Funding Agreement executed on
28 June 2023 between the Commonwealth (represented by the Department of Health and Aged Care, ABN: 83 605 426 759) and the State of Victoria (represented by the Victorian Department of Treasury and Finance,
ABN: 44 128 890 975); and

(ii)  as part of the Commonwealth Urgent Care Clinic Program for which 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 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 practice location specified in Schedule B of this Direction; and

(ii)  by a general practitioner or participating nurse practitioner mentioned in (a) who is registered to provide services with Services Australia under the Commonwealth Urgent Care Clinic program.

DECLARE that this Direction shall have effect from 17 July 2023 until
30 June 2026 inclusive unless earlier revoked.

 

 

 

Date this 7 day of July 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

Group

Group Name

Subgroup

Subgroup Name

Item Number

A1

GP attendances to which no other item applies

1

Level A

3

2

Level B

23

3

Level C

36

4

Level D

44

A5

Prolonged Attendance to Which no Other Item Applies

1

Prolonged Professional Attendance

A20

GP Mental health Care

1

GP Mental Health Treatment Plans

2713

A22

General Practitioner After-Hours Attendances To Which No Other Item Applies

1

Level A

5000

2

Level B

5020

3

Level C

5040

4

Level D

5060

T4

Obstetrics

16500

T7

Regional or Field Nerve Blocks

18213

T8

Surgical Operations

1

General

30003, 30006, 30026, 30029, 30032, 30035, 30038, 30042, 30045, 30049, 30061, 30064, 30099, 30216, 30219

2

Colorectal

32147

5

Urological

36800

8

Ear, Nose and Throat

41500, 41677

9

Ophthalmology

42644, 42650

14

Hand Surgery

46513, 46528, 46531

15

Orthopaedic

47904, 47915, 47916, 47015, 47030, 47042, 47057, 47063, 47069, 47301, 47348, 47354, 47361, 47387, 47423, 47444, 47453, 47462, 47466, 47471, 47543, 47561, 47579, 47595, 47637, 47663, 47735

M1

Management of Bulk Billed Services

 

 

10990, 10991, 10992, 75855, 75856, 75857, 75858

M14

Nurse Practitioners

1

Nurse Practitioners

82200, 82205, 82210, 82215

 


SCHEDULE B

 

Approved PRACTICE LOCATIONS As agreed under the federation funding agreement between the commonwealth and the VICTORIAN government

 

Approved primary care locations:

State

Location/ Town

Practice Name

Legal Name

Street Address

VIC

Shepparton

The University of Melbourne Shepparton Medical Centre

Melbourne Teaching Health Clinics LTD. Trading as The University of Melbourne Shepparton Medical Clinics

45 Graham St, Shepparton VIC 3630

VIC

Frankston

Sandringham Ambulatory Care Centre

Sandringham Ambulatory Care Centre Pty Ltd

28 Cranbourne Road, Frankston 3199

VIC

Geelong

Eastbrooke Medical

Eastbrooke Medical Centres Pty Ltd

Eastbrooke Health Hub, 75 Roslyn Road, Belmont 3216

VIC

Ballarat

UFS Medical

UFS Dispensaries LTD

4 Windemere Street, Ballarat 3350

VIC

Heidelberg

Interconnect Healthcare

Trustee for Interconnect Healthcare unit trust (trading as Kerrie Road Family Medical Centre)

455 Upper Heidelberg Road, Heidelberg Heights 3081

VIC

Narre Warren

ForHealth - Narregate Medical & Dental Centre

ldameneo (No. 123) Pty Ltd as the Trustee for Artlu Unit Trust

60 Victor Crescent, Narre Warren, VIC 3805

VIC

Prahan

Sandringham Ambulatory Care Centre

Sandringham Ambulatory Care Centre Pty Ltd

20 Commercial Road, Melbourne 3011

VIC

Werribee

Werribee PPCC Werribee Medical and Dental (operated by ForHealth)

ldameneo (No. 123) Pty Ltd as the Trustee for Artlu Unit Trust trading as Werribee Medical & Dental Centre

1-5 Station Place, Werribee 3030

VIC

Sunbury

Goonawarra Medical Centre Sunbury

Goonawarra Medical Centre Sunbury The Trustee for Napier Medical Trust

1/5 Dornoch Dr, Sunbury VIC 34229