AUSTRALIAN GOVERNMENT
DEPARTMENT OF HEALTH AND AGED CARE
HEALTH INSURANCE ACT 1973
Health Insurance (Medicare Benefits Payable in Respect of Professional Services – Council of Australian Governments’ Improving Access to Primary Care in Rural and Remote Areas – COAG s19(2) Exemptions Initiative – Queensland) Direction 2024
I, Louise Riley, Acting First Assistant Secretary, Medical 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 Direction made under subsection 19(2) of the Act titled Health Insurance (Medicare Benefits Payable in Respect of Professional Services – Council of Australian Governments’ Improving Access to Primary Care in Rural and Remote Areas – COAG s19(2) Exemptions Initiative – Queensland) Direction 2023 that was granted on 14 December 2023, that Medicare benefits shall be payable in respect of professional services provided by health services in Queensland that are a part of the Council of Australian Governments’ Improving Access to Primary Care in Rural and Remote Areas – COAG s19(2) Exemptions Initiative, as described in the Memorandum of Understanding between the Australian Government and Queensland dated 9 June 2022; 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 under the Memorandum of Understanding (MOU) between the Department of Health and Aged Care (ABN: 83 605 426 759) and the Queensland Department of Health (ABN: 75 818 456 675) dated 9 June 2022 as part of the Council of Australian Governments’ Improving Access to Primary Care in Rural and Remote Areas – COAG s19(2) Exemptions Initiative relating to primary care services 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 profession service is provided to:
(i) an eligible person (as defined in Section 3 of the Health Insurance Act 1973); and
(ii) a patient who is not part of an episode of hospital treatment (as defined in Section 121-5 of the Private Health Insurance Act 2007); and
(c) The professional service referred to in paragraph (2)(a):
(i) is provided at an approved Modified Monash Model 5-7 area (as defined in Section 7.1.1 of the general medical services table) practice location specified in Schedule B; and
(ii) is either:
(A) a professional non-referred service provided by a state remunerated medical practitioner, participating midwife, or participating nurse practitioner; or
(B) a professional referred service provided by a state remunerated allied health and dental health practitioner.
DECLARED that this Direction commences on 3 June 2024 and ceases to have effect at the end of 30 June 2025 unless earlier revoked.
Date this 22 day of May 2024
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 At Approved Practice Locations AS AGREED under the Council of Australian Governments’ Improving Access to Primary Care in Rural and Remote Areas – COAG s19(2) Exemptions Initiative – queensland
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 | ||
A9 | Contact lenses – attendances | ||
A10 | Optometrical services provided by an optometrist | ||
A11 | Urgent attendance after hours | ||
A14 | Health assessments | ||
A15 | GP management plans, team care arrangements, multidisciplinary care plans | 1 | GP management plans, team care arrangements and multidisciplinary care plans |
A17 | Domiciliary and residential management reviews | ||
A20 | General Practitioner mental health treatment | ||
A22 | General Practitioner after-hours attendances to which no other item applies | ||
A23 | Other non-referred after-hours attendances to which no other item applies | ||
A27 | Pregnancy support counselling | ||
A35 | Services for patients in Residential Aged Care Facilities | ||
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 | ||
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 | ||
27 | GP - 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 | ||
39 | GP Blood Borne Viruses, Sexual or Reproductive Health Consultation – Telehealth Service | ||
40 | GP Blood Borne Viruses, Sexual or Reproductive Health Consultation – Phone Service | ||
A46 | COVID-19 management support service | ||
M1 | Management of bulk-billed services | 1 | Management of General Bulk Billed Services |
2 | General Support Service | ||
3 | Patients enrolled in MyMedicare | ||
M3 | Allied Health services | ||
M6 | Psychological therapy services | ||
M7 | Focussed psychological strategies | ||
M8 | Pregnancy support counselling | ||
M9 | Allied Health group services | ||
M10 | Complex neurodevelopmental disorder and disability services | ||
M11 | Allied Health services for Aboriginal and Torres Strait Islander people | ||
M12 | Services provided by a Practice Nurse or Aboriginal and Torres Strait Islander health practitioner on behalf of a medical practitioner | ||
M14 | Nurse Practitioners | ||
M15 | Diagnostic audiology services | ||
M16 | Eating Disorder services | ||
M18 | Allied health telehealth services | 1 | Psychological therapies telehealth services |
2 | Psychologist focussed psychological strategies telehealth services | ||
3 | Occupational therapist focussed psychological strategies telehealth services | ||
4 | Social worker focussed psychological strategies telehealth services | ||
5 | Nurse practitioner telehealth services | ||
6 | Psychological therapies phone services | ||
7 | Psychologist focussed psychological strategies phone service | ||
8 | Occupational therapist focussed psychological strategies phone services | ||
9 | Social worker focussed psychological strategies phone services | ||
10 | Nurse practitioner phone services | ||
11 | General allied health telehealth services | ||
12 | General allied health phone services | ||
13 | Pregnancy support counselling telehealth services | ||
14 | Pregnancy support counselling phone services | ||
15 | Complex neurodevelopmental disorder and disability telehealth services | ||
16 | Complex neurodevelopmental disorder and disability phone services | ||
17 | Telehealth attendance to person of Aboriginal and Torres Strait Islander descent | ||
18 | Phone attendance to person of Aboriginal and Torres Strait Islander descent | ||
23 | Follow up service provided by a practice nurse or Aboriginal and Torres Strait Islander health practitioner – Telehealth Services | ||
25 | Allied health, group dietetics telehealth services | ||
26 | Allied health, group dietetics phone services | ||
T1 | Miscellaneous therapeutic procedures | 6 | Gastroenterology |
General Medical Services Table – permitted items
Group | Group Name | Items | Item overview |
A15 | GP management plans, team care arrangements and multidisciplinary care plans | 735, 739, 743, 747-758, 930-945 | Case conferences |
A29 | Attendance services for complex neurodevelopmental disorder or disability | 139 | Professional attendance by a general practitioner for assessment, diagnosis and preparation of a treatment and management plan for a patient with an eligible disability. |
A36 | Eating disorder services | 90250-90257, 90264, 90265, 90271-90282 | Eating disorder services provided by General Practitioners or Medical Practitioners |
A40 | Telehealth and phone attendance services | 92142, 92170, 92171, 92176, 92177 | General Practitioner and Prescribed Medical Practitioner items |
A44 | General Practice attendance for assessing patient suitability for a COVID-19 vaccine | 93645, 93647, 93654, 93656, 93661, 93666, 10660, 10661 | General Practice Attendance for Assessing Patient Suitability for a COVID-19 Vaccine |
D1 | Miscellaneous diagnostic procedures and investigations | 11300-11318, 11505, 11506, 11602-11615, 11707, 11729, 11730, 12001-12004, 12012, 12017, 12200, 12306, 12312, 12315, 12320-12322, 12325, 12326 | Non-referred services only |
D2 | Nuclear Medicine (non-imaging) | 12500, 12524, 12527 | Nuclear Medicine (non-imaging) |
M13 | Midwifery services | 82100-82115, 82130-82140 | Midwifery items |
T1 | Miscellaneous therapeutic procedures | 13105, 14206 | Haemodialysis provided by a registered nurse, Aboriginal health worker or Aboriginal and Torres Strait Islander health practitioner in a very remote location. Hormone or living tissues implantation by cannula |
T4 | Obstetrics | 16400, 16406-16500, 16502-16514, 16530, 16590, 16591, 91850-91858 | Antenatal and postnatal attendances |
T8 | Surgical operations | 30003, 30006, 30023, 30026-30055, 30061-30072, 30107, 30192-30207, 30216, 30219, 31356, 32072, 32147, 35503, 41500, 47015, 47042, 47057, 47069, 47301, 47348, 47354, 47361, 47387, 47423, 47444, 47453, 47462, 47466, 47471, 47543, 47561, 47579, 47595, 47663, 47735, 47904, 47915, 47916, 47918 | Minor surgical procedures |
O1 | Consultations | 51700- 51703, 54001-54004 | Dental practitioner attendances |
Diagnostic Imaging Services Table
Group | Group Name |
I1 | Ultrasound |
I3 | Diagnostic radiology |
I6 | Management of bulk-billed services |
Pathology Services Table
Group | Group Name |
P9 | Simple basic pathology tests |
P12 | Management of bulk-billed services |
P13 | Bulk-billing incentive |
SCHEDULE B
Approved Practice Locations AS AGREED under the Council of Australian Governments’ Improving Access to Primary Care in Rural and Remote Areas – COAG s19(2) Exemptions Initiative - Queensland
Approved locations:
Location | Practice Name | Legal Name | Street Address | Mailing Address |
Alpha | Alpha Hospital and Multi-Purpose Health Service | Central West Hospital and Health Service | 1 Burns Street Alpha QLD 4724
| 1 Burns Street Alpha QLD 4724 |
Augathella | Augathella Multi-Purpose Health Service | South West Hospital and Health Service | Cavanagh Street Augathella QLD 4477
| PO Box 84 Augathella QLD 4477 |
Aramac | Aramac Primary Health Clinic | Central West Hospital and Health Service | 2 Lodge Street Aramac QLD 4726 | 2 Lodge Street Aramac QLD 4726 |
Babinda | Babinda Hospital Multi-Purpose Health Service
| Cairns and Hinterland Hospital and Health Service | 128 Munro Street Babinda QLD 4861
| PO Box 160 Babinda QLD 4861 |
Barcaldine | Barcaldine Hospital Multi-Purpose Health Service
| Central West Hospital and Health Service | 25 Oak Street Barcaldine QLD 4725 | 25 Oak Street Barcaldine QLD 4725 |
Biggenden | Biggenden Multi-Purpose Health Service
| Wide Bay Hospital and Health Service | 57 Alice Street Biggenden QLD 4621 | 57 Alice St Biggenden QLD 4621 |
Blackall | Blackall Hospital
| Central West Hospital and Health Service | 189 Landsborough Highway Blackall QLD 4472
| PO Box 131 Blackall QLD 4472 |
Blackwater | Blackwater Hospital Multi-Purpose Health Service | Central Queensland Hospital and Health Service | 41 McKenzie Street Blackwater QLD 4717 | PO Box 47 Blackwater QLD 4717 |
Bollon | Bollon Community Clinic | South West Hospital and Health Service
| 37 Main Street Bollon QLD 4488 | PO Box 17 Bollon QLD 4488 |
Boulia | Boulia Primary Health Centre | Central Queensland Hospital and Health Service | 49 Wills Street Boulia QLD 4829 | PO Box 24 Boulia QLD 4829 |
Capella | Capella Outpatients Clinic | Central Queensland Hospital and Health Service | 5 Slider Street Capella QLD 4723 | 5 Slider Street Capella QLD 4723 |
Cardwell | Cardwell Community Health Centre | Townsville Hospital and Health Service | Victoria Street Cardwell QLD 4819 | PO Box 391 Cardwell QLD 4819 |
Cecil Plains | Millmerran Multi-Purpose Health Service – Outreach Primary Clinic (Cecil Plains) | Darling Downs Hospital and Health Service | Co located at Anglicare, 24 Geraghty Street Cecil Plains QLD 4407 | Co Located at Anglicare 24 Geraghty Street Cecil Plains QLD 4407 |
Childers | Childers Multi-Purpose Health Service | Wide Bay Hospital and Health Service | 44 Broadhurst Street Childers QLD 4660 | PO Box 62 Childers QLD 4660 |
Chillagoe | Chillagoe Primary Health Centre | Cairns and Hinterland Hospital and Health Service | 21 Hospital Avenue Chillagoe QLD 4871 | PO Box 4 Chillagoe QLD 4871 |
Collinsville | Collinsville Multi-Purpose Health Service | Mackay Hospital and Health Service | 81-91 Garrick Street Collinsville QLD 4804 | PO Box 56 Collinsville QLD 4808 |
Cow Bay | Cow Bay Primary Health Centre | Cairns and Hinterland Hospital and Health Service | 69 Tea Tree Road Diwan QLD 4873 | Pmb 3 Cape Tribulation QLD 4873 |
Dimbulah | Dimbulah Primary Health Centre | Cairns and Hinterland Hospital and Health Service | 1-5 Stephen Street Dimbulah QLD 4872 | PO Box 148 Dimbulah QLD 4872 |
Dirranbandi | Dirranbandi Multi-Purpose Health Service | South West Hospital and Health Service | Corner of Jane and Crothers Streets Dirranbandi QLD 4486 | PO Box 20 Dirranbandi QLD 4486 |
Eidsvold | Eidsvold Multi-Purpose Health Service | Wide Bay Hospital and Health Service | Cracow Road Eidsvold QLD 4627 | PO Box 40 Eidsvold QLD 4627 |
Gayndah | Gayndah Hospital | Wide Bay Hospital and Health Service | 69 Warton Street Gayndah QLD 4625 | PO Box 41 Gayndah QLD 4625 |
Gin Gin | Gin Gin Hospital | Wide Bay Hospital and Health Service | 5 King Street Gin Gin QLD 4671 | PO Box 14 Gin Gin QLD 4671 |
Hughenden | Hughenden Multi-Purpose Health Service | Townsville Hospital and Health Service | Richmond Hill Drive Hughenden QLD 4821 | PO Box 228 Hughenden QLD 4821 |
Inglewood | Inglewood Multi-Purpose Health Service | Darling Downs Hospital and Health Service | Cunningham Highway Inglewood QLD 4387 | PO Box 42 Inglewood QLD 4387 |
Injune | Injune Multi-Purpose Health Service | South West Hospital and Health Service | Fifth Avenue Injune QLD 4454 | PO Box 35 Injune QLD 4454 |
Isisford | Isisford Primary Health Centre | Central West Hospital and Health Service | St Helena Street Isisford QLD 4731 | St Helena Street Isisford QLD 4731 |
Jandowae | Jandowae Health Services | Darling Downs Hospital and Health Service | 13 Dalby Street Jandowae QLD 4410 | PO Box 75 Jandowae QLD 4410 |
Jericho | Jericho Health Clinic | Central West Hospital and Health Service | 19 Pasteur Street Jericho QLD 4728 | 19 Pasteur Street Jericho QLD 4728 |
Jundah | Jundah Primary Health Centre | Central West Hospital and Health Service | 1 Hospital Road Jundah QLD 4736 | PO Box 26 Jundah QLD 4736 |
Longreach | Longreach Hospital | Central West Hospital and Health Service | Corner Jabiru and Plover Streets Longreach QLD 4730 | Corner Jabiru and Plover Streets Longreach QLD 4730 |
Maleny | Maleny Soldiers Memorial Hospital | Sunshine Coast Hospital and Health Service | 17 Bean Street Maleny QLD 4552 | 17 Bean Street Maleny QLD 4552 |
Miles | Miles Health Service | Darling Downs Hospital and Health Service | 5-11 Colamba Street Miles QLD 4415 | PO Box 187 Miles QLD 4415 |
Millmerran | Millmerran Multi-Purpose Health Service | Darling Downs Hospital and Health Service | 50 Commens Street Millmerran QLD 4357 | 50 Commens Street Millmerran QLD 4357 |
Mitchell | Mitchell Multi-Purpose Health Service | South West Hospital and Health Service | 95 Ann Street Mitchell QLD 4465 | 95 Ann Street Mitchell QLD 4465 |
Monto | Monto Hospital | Wide Bay Hospital and Health Service | 35 Flinders Street Monto QLD 4630 | PO Box 220 Monto QLD 4630 |
Morven | Morven Community Clinic | South West Hospital and Health Service | Warrego Highway Morven QLD 4468 | PO Box 18 Morven QLD 4468 |
Mossman | Mossman Multi-Purpose Health Service | Cairns and Hinterland Hospital and Health Service | 9 Hospital Street Mossman QLD 4873 | 9 Hospital Street Mossman QLD 4873 |
Moura | Moura Multi-Purpose Health Service | Central Queensland Hospital and Health Service | 14 Nott Street Moura QLD 4718 | 14 Nott Street Moura QLD 4718 |
Mundubbera | Mundubbera Health Service | Wide Bay Hospital and Health Service | 96 Leichardt Street Mundubbera QLD 4626 | PO Box 35 Mundubbera QLD 4626 |
Mungindi | Mungindi Multi-Purpose Health Service | South West Hospital and Health Service | 90 Barwon Street Mungindi QLD 2406 | 90 Barwon St Mungindi QLD 2406 |
Murgon | Murgon Health Service | Darling Downs Hospital and Health Service | Coronation Drive Murgon QLD 4605 | Coronation Drive Murgon QLD 4605 |
Muttaburra | Muttaburra Primary Health Care Centre | Central West Hospital and Health Service | Edkins Street Muttaburra QLD 4732 | Edkins Street Muttaburra QLD 4732 |
Nanango | Nanango Health Service | Darling Downs Hospital and Health Service | 135 Brisbane Street Nanango QLD 4615 | PO Box 60 Nanango QLD 4615 |
Oakey | Oakey Health Services – Oakey Hospital | Darling Downs Hospital and Health Service | Cnr Beale and Fitzpatrick Streets Oakey QLD 4401 | Cnr Beale and Fitzpatrick Streets Oakey QLD 4401 |
Proserpine | Proserpine Hospital and Community Health Centre | Mackay Hospital and Health Service | 26-32 Taylor Street Proserpine QLD 4800 | PO Box 229 Proserpine QLD 4800 |
Quilpie | Quilpie Multi-Purpose Health Service | South West Hospital and Health Service | 30 Gyrica Street Quilpie QLD 4480 | PO Box 27 Quilpie QLD 4480 |
Richmond | Richmond Multi-Purpose Health Service | Townsville Hospital and Health Service | Gallagher Drive Richmond QLD 4822 | PO Box 24 Richmond QLD 4822 |
Sapphire | Gemfields Outpatient Clinic | Central Queensland Hospital and Health Service | 984 Rubyvale Road Sapphire QLD 4702 | PO Box 342 Sapphire QLD 4702 |
Springsure | Springsure Multi-Purpose Health Service | Central Queensland Hospital and Health Service | 21 Woodbine Street Springsure QLD 4722 | PO Box 14 Springsure QLD 4722 |
Surat | Surat Hospital Multi-Purpose Health Service | South West Hospital and Health Service | 2 Ivan Street Surat QLD 4417 | PO Box 2, Surat QLD 4417 |
Tambo | Tambo Primary Health Care Centre | Central West Hospital and Health Service | Garden Street Tambo QLD 4478 | Garden Street Tambo QLD 4478 |
Tara | Tara Hospital | Darling Downs Hospital and Health Service | 15 Bilton Street Tara QLD 4421 | 15 Bilton Street Tara QLD 4421 |
Taroom | Taroom Hospital | Darling Downs Hospital and Health Service | 14 Miller Street Taroom QLD 4420 | PO Box 358 Taroom QLD 4420 |
Texas | Texas Multi-Purpose Health Service | Darling Downs Hospital and Health Service | Mingoola Road Texas QLD 4385 | PO Box 91 Texas QLD 4385 |
Tully | Tully Hospital | Cairns and Hinterland Hospital and Health Service | 17 Bryant Street Tully QLD 4854 | PO Box 489 Tully QLD 4854 |
Wallumbilla | Wallumbilla Community Clinic | South West Hospital and Health Service | Stakeyard Road Wallumbilla QLD 4428 | PO Box 21 Wallumbilla QLD 4428 |
Windorah | Windorah Primary Health Centre | Central West Hospital and Health Service | 25 Cecil Street Windorah QLD 4481 | 25 Cecil Street Windorah QLD 4481 |
Winton | Winton Multi-Purpose Health Service | Central West Hospital and Health Service | 70 Oondooroo Street Winton QLD 4735 | PO Box 295 Winton QLD 4735 |