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 – New South Wales Urgent Care Services) Direction 2024

I, Nigel Murray, Acting 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)     between the Commonwealth (represented by the Department of Health and Aged Care, ABN: 83 605 426 759) and the State of New South Wales (represented by the New South Wales Department of Health, ABN: 92 697 899 630) by New South Wales Urgent Care Services that has been assessed as meeting the requirements of the Commonwealth Urgent Care Clinic program; and

(ii)  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 15 January 2024 and ceases to have effect at the end of 30 June 2025 unless earlier revoked.

Date this 3rd day of January 2024

Nigel Murray

Acting 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 PRACTICE LOCATIONS As agreed under the URGENT CARE SERVICES agreement between the commonwealth and the STATE OF NEW SOUTH WALES

Approved primary care locations: