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 –Queensland Primary Care Pilot) Direction (No. 3) 2023

I, Nigel Murray, Assistant Secretary, MBS Policy and Specialist Programs Branch, 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. REVOKE the Health Insurance (Medicare Benefits Payable in Respect of Professional Services –Commonwealth Urgent Care Clinic Program –Queensland Primary Care Pilot) Direction (No. 2) 2023 made under subsection 19(2) of the Act that was signed on 30 October 2023; and

 

2.      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 13 June 2023 between the Commonwealth (represented by the Department of Health and Aged Care, ABN: 83 605 426 759) and the State of Queensland (represented by the Queensland Department of Health, ABN: 66 329 169 412); 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.

DECLARED that this Direction commences on 1 December 2023 and ceases to have effect at the end of 30 June 2024 unless earlier revoked.

 

Date this 25th day of November 2023

 

 

 

 

Nigel Murray

Assistant Secretary  

MBS Policy and Specialist Programs Branch

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

5

Level E

123

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

5

Level E

5071

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

1

Management of General Bulk Billed Services

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

2

General Support Service

75870, 75871, 75872, 75873, 75874, 75875, 75876

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 State of Queensland

 

Approved primary care locations:

State

Location/ Town

Practice Name

Legal Name

Street Address

QLD

Toowoomba

Toowoomba Medical and Dental Centre

Idameneo (No. 123) Pty Ltd as the Trustee for Artlu Unit Trust trading as Toowoomba Medical and Dental Centre

Corner West and 261-269 James Street, Toowoomba QLD 4350

QLD

Townsville

Eastbrooke Family Clinic Townsville

Eastbrooke Medical Centres Pty Ltd

86 Thuringowa Drive, Thuringowa Central QLD 4817