AUSTRALIAN GOVERNMENT

DEPARTMENT OF HEALTH AND AGED CARE

 

HEALTH INSURANCE ACT 1973

Health Insurance (Medicare Benefits Payable in Respect of Professional Services – Queensland - Medical Services performed under the Single Employer Model Trial) Direction 2025

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 (the Act), hereby:

  1.    REPEAL the Health Insurance (Medicare Benefits Payable in Respect of Professional Services – Queensland - Medical Services performed under the Single Employer Model Trial) Direction 2024; and
  2.    DIRECT that Medicare Benefits shall be payable in respect of:
    1.    A professional service (as defined in Section 3 of the Act) which has been agreed to be provided under the Rural General Practice and Rural Generalist Single Employer Model Trial Memorandum of Understanding between the Department of Health and Aged Care (ABN: 83 605 426 759) and the State of Queensland acting through Queensland Health (ABN: 66 329 169 412) in relation to the Rural General Practice and Rural Generalist Single Employer Model Trial for which:
      1.       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 Act), diagnostic imaging services table (means the table prescribed under subsection 4AA(1) of the Act) and pathology services table (means the table prescribed under subsection 4A(1) of the Act) relates: and
    2.    Where the professional service is provided to:
      1.       an eligible person (as defined in Section 3 of the Health Insurance Act 1973);
      2.       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); and
      3.       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
    3.    The professional services referred to in paragraph (2)(a) must be provided:
      1.       at a general practice (as defined in Section 7.1.1 of the general medical services table); and
      2.       at a rural or remote practice location specified in Schedule B in an eligible area (as defined in the Dictionary of the of the general medical services table); and
      3.       by a participating rural generalist or rural general practice trainee participating in the program mentioned in paragraph (2)(a):
        1. who is formally enrolled in a fellowship training program that meets the standards of either the:
          1.         The Australian College of Rural and Remote Medicine; and/or
          2.       The Royal Australian College of General Practitioners; and
        2. who is employed by Queensland Health for the provision of primary and acute care services; and
  3.    DECLARE that this Direction commences on the day after registration and ceases to have effect at the end of 31 December 2028 unless earlier revoked.

 

Note, this program covers the sixty rural generalist and rural general practice participants who are eligible to use this Direction at any one time.

 

Date: 20 February 2025

 

 

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 (MBS) ITEMS AS AGREED under the QUEENSLAND rural Generalist SINGLE EMPLOYER Model TRIAL

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. Medical practitioners and health services must ensure they fulfil the MBS requirements for all items.

General Medical Services Table

Standard Primary Care Services Table

For services listed in the below table, this list of items includes MBS items that are commonly claimed by doctors in primary care.

Group

Group Name

Subgroup

Subgroup Name

A1

General practitioner attendances to which no other item applies

A2

Other nonreferred attendances to which no other item applies

A5

Prolonged attendances to which no other item applies

A6

Group therapy

A7

Acupuncture and nonspecialist practitioner items

A11

Urgent attendances after—hours

A14

Health assessments

A15

GP management plans, team care arrangements and multidisciplinary care plans and case conferences

1

GP management plans, team care arrangements and multidisciplinary care plans

2

Case conferences

A17

Domiciliary and residential medication management reviews

A20

Mental health care

A22

General practitioner afterhours attendances to which no other item applies

A23

Other nonreferred afterhours attendances to which no other item applies

A27

Pregnancy support counselling

A29

Attendance services for complex neurodevelopmental disorder or disability

A35

Nonreferred attendance at a residential aged care facility

A36

Eating disorder services

1

Preparation of eating disorder treatment and management plans: general practitioners and nonspecialist medical practitioners

3

Review of eating disorder treatment and management plans

4

Providing treatments under eating disorder treatment and management plans

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 Service

13

GP management plans, team care arrangements and multidisciplinary care plans via telehealth attendance

15

GP Pregnancy Support Counselling  Telehealth Service

16

GP Pregnancy Support Counselling  Phone Service

17

GP, specialist and consultant physician complex neurodevelopmental disorder or disability service  telehealth service

19

GP Mental Health Treatment Plan  Telehealth Service

20

GP Mental Health Treatment Plan  Phone Service

21

GP Eating Disorder Treatment and Management Plan – Telehealth Service

25

Review of an Eating Disorder Plan  Telehealth Service

26

Review of an Eating Disorder Plan – Phone Service

27

Eating Disorder Psychological Treatment Services – Telehealth Service

28

Eating Disorder Psychological Treatment Strategies – Phone Service

29

GP and Other Medical Practitioner  Urgent After Hours Service in Unsociable Hours  Telehealth Service

37

Specialist, anaesthesia 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

A44

General Practice Attendance for Assessing Patient Suitability for a COVID19 Vaccine

M1

Management of bulkbilled services

M12

Services provided by a practice nurse, an Aboriginal health worker or an Aboriginal and Torres Strait Islander health practitioner on behalf of a medical practitioner

1

Video conferencing consultation support service provided by a practice nurse, an Aboriginal health worker or an Aboriginal and Torres Strait Islander health practitioner on behalf of a medical practitioner

3

Services provided by a practice nurse or an Aboriginal and Torres Strait Islander health practitioner on behalf of a medical practitioner

 

Non-Standard Primary Care Services Table

For services listed in the below table, this list of items includes MBS items that are not commonly claimed by doctors in primary care.

Group

Group Name

Subgroup

Subgroup Name

D1

Miscellaneous diagnostic procedures and investigations

2

Ophthalmology

3

Otolaryngology

4

Respiratory

5

Vascular

6

Cardiovascular

8

Genitourinary physiological investigations

9

Allergy testing

10

Other diagnostic procedures and investigations

D2

Nuclear medicine (nonimaging)

T1

Miscellaneous therapeutic procedures

2

Dialysis

4

Paediatric and neonatal

5

Cardiovascular

8

Haematology

9

Procedures associated with intensive care and cardiopulmonary support

11

Chemotherapeutic procedures

13

Miscellaneous therapeutic procedures

T3

Therapeutic nuclear medicine

T4

Obstetrics

T6

Examination by anaesthetist

T7

Regional or field nerve blocks

T8

Surgical operations

1

General

2

Colorectal

3

Vascular

4

Gynaecological

5

Urological

6

Cardiothoracic

7

Neurosurgical

8

Ear, nose and throat

9

Ophthalmology

11

Paediatric

12

Amputations

13

Plastic and reconstructive surgery

14

Hand or wrist surgery

15

Orthopaedic

T9

Assistance at operations

T10

Anaesthesia performed in connection with certain services (Relative Value Guide)

 

Diagnostic Imaging Services Table

Group

Group Name

Subgroup

Subgroup Name

I1

ultrasound

6

Musculoskeletal ultrasound

I3

diagnostic radiology

1

Radiographic examination of extremities

2

Radiographic examination of shoulder or pelvis

3

Radiographic examination of head

4

Radiographic examination of spine

5

Bone age study and skeletal survey

6

Radiographic examination of thoracic region

7

Radiographic examination of urinary tract

8

Radiographic examination of alimentary tract and biliary system

12

Radiographic examination with opaque or contrast media

I6

management of bulkbilled services

 

Pathology Services Table

Group

Group Name

P1

haematology

P2

chemical

P9

simple basic pathology tests

P12

management of bulkbilled services

 


SCHEDULE B

 

Approved Modified Monash 2-7 rural and remote Practice Locations AS AGREED under the Queensland rural general practice and rural Generalist SINGLE EMPLOYER Model TRIAL

Approved primary care Modified Monash Model (MMM) 4 locations:

MMM 4 location

Practice Name

Legal Name

Street Address

Ayr

Outback Family Medicine

WIN Medical Practice Pty Ltd

140 Mackenzie Street Ayr QLD 4807

Dalby

Myall Medical Practice

The Trustee for Archibald Street Services Trust

37 North Street Dalby QLD 4405

Emerald

Emerald Medical Group

Central Highlands Healthcare Ltd

Lot 1 Pilot Farm Road Emerald QLD 4720

Goondiwindi

Goondiwindi Medical Centre

GMC Medical Services Pty Ltd

49 Bowen Street Goondiwindi QLD 4390

Innisfail

Rankin Street Medical

Bayvex Pty Ltd

57 Rankin Street Innisfail QLD 4860

Kingaroy

Taabinga Family Practice

Taabinga Family Practice Pty Ltd

213 Haly Street Kingaroy QLD 4610

Kingaroy

South Burnett Medical Centre

The Trustee for Amarula Trust

19 Avoca Street Kingaroy QLD 4610

Kingaroy

Bunya Pines Family Practice

Dolzan, Glen Alexander

219a Haly Street Kingaroy QLD 4610

Kingaroy

Kingaroy General Practice

Kingaroy General Practice Pty Ltd

25 Markwell Street Kingaroy QLD 4610

Roma

Maranoa Medical Centre

MMC Unit Trust

27 Quintin Street Roma QLD 4455

Warwick

Condamine Medical Centre

Condamine Medical Centre (QLD) Pty Ltd

53 Wood Street Warwick QLD 4370

Approved primary care Modified Monash Model (MMM) 5 locations:

MMM 5 location

Practice Name

Legal Name

Street Address

Blackbutt

Blackbutt Medical Centre

Medical First Clinics Pty Ltd

91 Coulson St Blackbutt QLD 4314

Chinchilla

Chinchilla Medical  Practice

The Trustee for Chinchilla Unit Trust and T.P Clarke & K.J Gilmour

58 Middle Street Chinchilla QLD 4413

Inglewood

Inglewood Medical Centre

Owen, Colin Edward

57 Albert St Inglewood QLD 4387

Killarney

Killarney Memorial Medical Centre

Killarney Memorial Aged Care Ltd

7 Eucalyptus St Killarney QLD 4373

Maleny

Maleny Doctors

The Trustee for Hinterland Heath Unit Trust

7/15 Maple Street Maleny QLD 4552

Miles

Miles Medical Centre

The Trustee for Mandikiza Medical Trust

79 Marian Street Miles QLD 4415

Mission Beach

Mission Medical

The Trustee for The Radmak Discretionary Trust

Shop 9 & 10 Mission Beach Shopping Centre

Murgon

Murgon Family Medical Practice

G.S. McAllister Medical Pty Ltd

43 Stephens Street W Murgon QLD 4605

Ravenshoe

Ravenshoe Medical Centre

Rural Health  Management Services Pty Ltd

62 Grigg Street Ravenshoe QLD 4888

Tara

Tara Medical Centre

Outback Health and Medical Services Pty LTD

33 Day Street Tara QLD 4421

Tully

Tully Medical Centre & Mission Medical

The Trustee for The Radmak Discretionary Trust

10 Watkins Steet Tully QLD 4854

Wongaling Beach

Mission Medical

The Trustee for The Radmak Discretionary Trust

34-40 Dickinson Street Wongaling Beach QLD 4852

Approved primary care Modified Monash Model (MMM) 6 locations:

MMM 6 location

Practice Name

Legal Name

Street Address

Cloncurry

Ramsay Street General Practice

Hoarec GP Pty Ltd

27 Ramsay Street Cloncurry QLD 4824

Mount Isa City

Mount Isa Medical Centre

Mbaogu, Michael

71 Camooweal Street Mount Isa City QLD 4825