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 – New South Wales) Direction 2024

I, Louise Riley, Acting First Assistant Secretary, Medicare Benefits and Digital Health Division, Health Resourcing Group, delegate for the Minister for Health, 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 – New South Wales) Direction 2023 that was granted on 25 August 2023, that Medicare benefits shall be payable in respect of professional services provided by health services in New South Wales 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 New South Wales dated 13 May 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 NSW Ministry of Health (ABN: 92 697 899 630) dated 13 May 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

(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 23 day of May 2024

Louise Riley

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 – New South Wales

Approved locations:

Location	Practice Name	Legal Name	Street Address	Mailing Address
Balranald	Balranald Multi-Purpose Service	Far West Local Health District	41-43 Court Street Balranald NSW 2715	41-43 Court Street Balranald NSW 2715
Barham	Barham Multi-Purpose Service	Murrumbidgee Local Health District	80 Punt Road Barham NSW 2732	80 Punt Road Barham NSW 2732
Batlow	Batlow-Adelong Multi-Purpose Service	Murrumbidgee Local Health District	61-81 Pioneer Street Batlow NSW 2730	61-81 Pioneer Street Batlow NSW 2730
Berrigan	Berrigan Health Service	Murrumbidgee Local Health District	47-49 Davis Street Berrigan NSW 2712	47-49 Davis Street Berrigan NSW 2712
Bingara	Bingara Multi-Purpose Service	Hunter New England Local Health District	Copeton Dam Road Bingara NSW 2404	Copeton Dam Road Bingara NSW 2404
Blayney	Blayney Health Service	Western NSW Local Health District	3 Osman Street Blayney NSW 2799	3 Osman Street Blayney NSW 2799
Bonalbo	Bonalbo Multi-Purpose Service	Northern NSW Local Health District	Hospital Road Bonalbo NSW 2469	Hospital Road Bonalbo NSW 2469
Boorowa	Boorowa Multi-Purpose Service	Murrumbidgee Local Health District	62-80 Dry Street Boorowa NSW 2586	62-80 Dry Street Boorowa NSW 2586
Coolamon	Coolamon-Ganmain Multi-Purpose Service	Murrumbidgee Local Health District	1 Doctor Buchanan Drive Coolamon NSW 2701	1 Doctor Buchanan Drive Coolamon NSW 2701
Culcairn	Culcairn Multi-Purpose Service	Murrumbidgee Local Health District	51-55 Balfour Street Culcairn NSW 2660	51-55 Balfour Street Culcairn NSW 2660
Dareton	Dareton Primary and Community Health Centre	Far West Local Health District	42-44 Tapio Avenue Dareton NSW 2717	42-44 Tapio Avenue Dareton NSW 2717
Dungog	Dungog Community Hospital	Hunter New England Local Health District	22 Hospital Road Dungog NSW 2420	22 Hospital Road Dungog NSW 2420
Finley	Finley Health Service	Murrumbidgee Local Health District	24 Dawe Avenue Finley NSW 2713	24 Dawe Avenue Finley NSW 2713
Gloucester	Gloucester Soldiers Memorial Hospital & Gloucester Community Health Centre	Hunter New England Local Health District	Church Street Gloucester NSW 2422	Church Street Gloucester NSW 2422
Gundagai	Gundagai Health (Multi-Purpose) Service	Murrumbidgee Local Health District	50 Tor Street Gundagai NSW 2722	50 Tor Street Gundagai NSW 2722
Guyra	Guyra Multi-Purpose Service	Hunter New England Local Health District	44-48 Sole Street Guyra NSW 2365	44-48 Sole Street Guyra NSW 2365
Harden	Murrumburrah-Harden Hospital and Health Service	Murrumbidgee Local Health District	53 Scott Street Harden NSW 2587	53 Scott Street Harden NSW 2587
Hay	Hay District Hospital	Murrumbidgee Local Health District	351 Murray St Hay NSW 2711	351 Murray St Hay NSW 2711
Henty	Henty Multi-Purpose Service	Murrumbidgee Local Health District	7 Keighran Street Henty NSW 2658	7 Keighran Street Henty NSW 2658
Hillston	Hillston Hospital and Health Service	Murrumbidgee Local Health District	48C Burns Street Hillston NSW 2675	48C Burns Street Hillston NSW 2675
Holbrook	Holbrook Hospital	Murrumbidgee Local Health District	30 Bowler Street Holbrook NSW 2644	30 Bowler Street Holbrook NSW 2644
Jerilderie	Jerilderie Hospital and Health Service	Murrumbidgee Local Health District	33-39 Southey Street Jerilderie NSW 2716	PO Box 116 Jerilderie NSW 2716
Junee	Junee Multi-Purpose Service	Murrumbidgee Local Health District	67 Broadway Street Junee NSW 2663	67 Broadway Street Junee NSW 2663
Kyogle	Kyogle Multi-Purpose Service	Northern NSW Local Health District	Summerland Way Kyogle NSW 2474	Summerland Way Kyogle NSW 2474
Lake Cargelligo	Lake Cargelligo Hospital and Health Service	Murrumbidgee Local Health District	34 Uabba Street Lake Cargelligo NSW 2672	34 Uabba Street Lake Cargelligo NSW 2672
Lockhart	Lockhart Hospital and Health Service	Murrumbidgee Local Health District	53-55 Hebden Street Lockhart NSW 2656	53-55 Hebden Street Lockhart NSW 2656
Manilla	Manilla Multi-Purpose Service	Hunter New England Local Health District	Court Street Manilla NSW 2346	Court Street Manilla NSW 2346
Merriwa	Merriwa Multi-Purpose Service	Hunter New England Local Health District	Mackenzie Street Merriwa NSW 2329	Mackenzie Street Merriwa NSW 2329
Murrurundi	Wilson Memorial Community Hospital Murrurundi & Murrurundi Community Health Centre	Hunter New England Local Health District	Corner Paradise and O'Connell Streets Murrurundi NSW 2338	PO Box 8 Murrurundi NSW 2338
Narrandera	Narrandera Health Service	Murrumbidgee Local Health District	54 Adams Street Narrandera NSW 2700	54 Adams Street Narrandera NSW 2700
Nimbin	Nimbin Multi-Purpose Service	Northern NSW Local Health District	35 Cullen Street Nimbin NSW 2480	35 Cullen Street Nimbin NSW 2480
Nyngan	Nyngan Hospital and Community Health Service	Western NSW Local Health District	Hoskins Street Nyngan NSW 2825	PO Box 96 Nyngan NSW 2825
Oberon	Oberon Health Service	Western NSW Local Health District	North Street Oberon NSW 2787	North Street Oberon NSW 2787
Quirindi	Quirindi Health Service	Hunter New England Local Health District	50 Nowland Street Quirindi NSW 2343	50 Nowland Street Quirindi NSW 2343
Rylstone	Rylstone Multi-Purpose Service	Western NSW Local Health District	Fitzgerald Street Rylstone NSW 2849	Fitzgerald Street Rylstone NSW 2849
Temora	Temora Health Service	Murrumbidgee Local Health District	169-189 Loftus Street Temora NSW 2666	169-189 Loftus Street Temora NSW 2666
Tocumwal	Tocumwal Health Service	Murrumbidgee Local Health District	6-12 Adams Street Tocumwal NSW 2714	6-12 Adams Street Tocumwal NSW 2714
Tottenham	Tottenham Multi-Purpose Service	Western NSW Local Health District	10 Moondana Street Tottenham NSW 2873	10 Moondana Street Tottenham NSW 2873
Trangie	Trangie Multi-Purpose Service	Western NSW Local Health District	28 Harris Street Trangie NSW 2823	28 Harris Street Trangie NSW 2823
Trundle	Trundle Multi-Purpose Service	Western NSW Local Health District	44 Brookview Street Trundle NSW 2875	44 Brookview Street Trundle NSW 2875
Tullamore	Tullamore Multi-Purpose Service	Western NSW Local Health District	Kitchener Street Tullamore NSW 2874	Kitchener Street Tullamore NSW 2874
Tumbarumba	Tumbarumba Multi-Purpose Service	Murrumbidgee Local Health District	4 Mitchell Street Tumbarumba NSW 2653	4 Mitchell Street Tumbarumba NSW 2653
Urana	Urana Health Multi-Purpose Service	Murrumbidgee Local Health District	127-129 Princess Street Urana NSW 2645	127-129 Princess Street Urana NSW 2645
Urbenville	Urbenville Multi-Purpose Service	Northern NSW Local Health District	45 Beaury Street Urbenville NSW 2475	45 Beaury Street Urbenville NSW 2475
Warialda	Warialda Multi-Purpose Service	Hunter New England Local Health District	Long Street Warialda NSW 2402	Long Street Warialda NSW 2402
Wee Waa	Wee Waa Community Hospital & Wee Waa Community Health Centre	Hunter New England Local Health District	60 Alma Street Wee Waa NSW 2388	PO Box 417 Wee Waa NSW 2388
West Wyalong	West Wyalong Hospital	Murrumbidgee Local Health District	70 Ungarie Road West Wyalong NSW 2671	70 Ungarie Road West Wyalong NSW 2671