AUSTRALIAN GOVERNMENT

DEPARTMENT OF HEALTH, DISABILITY AND AGEING

 

HEALTH INSURANCE ACT 1973

Health Insurance (Medicare Benefits Payable in Respect of Professional Services - Services Rendered under the Commonwealth Urgent Care Clinic Program – Northern Territory) 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 Ageing, 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 - Services Rendered under the Commonwealth Urgent Care Clinic Program – Northern Territory) 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:
    1.        under a Schedule to the Federation Funding Agreement executed on 20 June 2023 between the Commonwealth (represented by the Department of Health and Aged Care (ABN: 83 605 426 759) and the Northern Territory (represented by the Chief Minister, Minister for Health (ABN: 84 085 734 992)); and
    2.      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 Act), the diagnostic imaging services table (means the table prescribed under section 4AA of the Act), or the pathology service table (means the table prescribed under section 4A of the Act) relates: and
  2.      Where the professional service is provided to:
  1.        an eligible person (as defined in section 3 of the Act);
  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);
  3.   a patient who also is not receiving a service which attracts a payment through the 2020-2025 Addendum, schedule K, one year extension to the National Health Reform Agreement for a service rendered to a public patient; and
  1.      The professional services referred to in paragraph (2)(a) must be provided:
    1.        at a practice location specified in Schedule B of this Direction; and
    2.      by a general practitioner, prescribed medical practitioner or participating nurse practitioner who is registered to provide services with Services Australia under the Commonwealth Urgent Care Clinic program mentioned in paragraph (2)(a).
  1.    DECLARE that this Direction commences on 1 July 2025 and ceases to have effect at the end of 30 June 2026 unless earlier revoked.

 

Dated  20 June 2025

 

 

Nigel Murray

Assistant Secretary  

MBS Policy and Specialist Programs Branch

Medicare Benefits and Digital Health Division

Health Resourcing Group

Department of Health, Disability and Ageing 


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 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

General practitioner attendances to which no other item applies

3, 23, 36, 44, 123

A5

Prolonged attendances to which no other item applies

A7

Acupuncture and non-specialist practitioner items

2

Prescribed medical practitioner attendance to which no other item applies

179, 185, 189, 203

9

Prescribed medical practitioner mental health care

279

10

Prescribed Medical Practitioner after‑hours attendances to which no other item applies

733, 737, 741, 745

A20

GP Mental health treatment

1

GP mental health treatment plans

2713

A22

General practitioner after-hours attendances to which no other item applies

5000, 5020, 5040, 5060, 5071

D1

Miscellaneous diagnostic procedures and investigations

6

Cardiovascular

11707

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, 41659, 41677

9

Ophthalmology

42644, 42650

14

Hand or wrist 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

*Note: Claims under any item in Group A7 in the General Medical Services Table may only be exempt from subsection 19(2) of the Act when the services are claimed by a Prescribed Medical Practitioner operating under the Medicare Urgent Care Clinic Program.

 

Diagnostic Imaging Services Table

Group

Group Name

Subgroup

Subgroup Name

Item Number

I1

Ultrasound

1

General

55028, 55032, 55036, 55038, 55048, 55054, 55065, 55066, 55070, 55071, 55076

3

Vascular

55238, 55244, 55246, 55252, 55274, 55276, 55278

4

Urological

55600

5

Obstetric And Gynaecological

55700, 55704, 55706, 55707, 55712, 55718, 55721

6

Musculoskeletal

55812, 55844, 55848, 55850, 55856, 55858, 55860, 55862, 55864, 55866, 55868, 55870, 55872, 55874, 55876, 55878, 55880, 55882, 55884, 55886, 55888, 55890, 55892, 55894

7

Transthoracic Echocardiogram and Stress Echocardiogram

55126, 55132, 55133, 55141

I2

Computed Tomography

1

Head

56001, 56007, 56013, 56016, 56022, 56028, 56030, 56036

2

Neck

56101, 56107

3

Spine

56220, 56221, 56223, 56226, 56233, 56237

4

Chest and upper abdomen

56301, 56307

5

Upper abdomen only

56401, 56407, 56409, 56412

6

Upper abdomen and pelvis

56501, 56507

7

Extremities

56620, 56622, 56623, 56627, 56629,

8

Chest, abdomen, pelvis and neck

56801, 56807

9

Brain, chest and upper abdomen

57001, 57007

11

Interventional techniques

57341

12

Spiral angiography

57352, 57353, 57354, 57357

I3

Diagnostic Radiology

1

Radiographic Examination Of Extremities

57509, 57515, 57521, 57523, 57527

2

Radiographic Examination Of Shoulder Or Pelvis

57703, 57709, 57712, 57715

3

Radiographic Examination Of Head

57901, 57907, 57915, 57921, 57924, 57927, 57945, 57960, 57963, 57969

4

Radiographic Examination Of Spine

58100, 58103, 58106, 58109, 58112, 58115

6

Radiographic Examination Of Thoracic Region

58503, 58509, 58521, 58524

7

Radiographic Examination Of Urinary Tract

58700

8

Radiographic Examination Of Alimentary Tract And Biliary System

58903, 58909 

9

Radiographic Examination For Localisation Of Foreign Bodies

59103 

10

Radiographic Examination Of Breasts

59300, 59302, 59303, 59305, 59314 

12

Radiographic Examination With Opaque Or Contrast Media

59751 

17

Interventional Techniques

61109 

I4

Nuclear Medicine Imaging

1

Nuclear medicine- non PET

61329, 61345, 61357, 61421, 61425, 61473 

3

Adjunctive services

61505 

I5

Magnetic Resonance Imaging

1

Scan Of Head – For Specified Conditions

63001, 63007

2

Scan Of Head - For Specified Conditions

63040, 63049, 63058, 63064 

6

Scan Of Spine - One Region Or Two Contiguous Regions - For Infection or Tumour

63151

7

Scan Of Spine - One Region Or Two Contiguous Regions - For Other Conditions

63161, 63167, 63173, 63176, 63179, 63182, 63185 

8

Scan Of Spine - Three Contiguous Regions Or Two Non-Contiguous Regions - For Infection or Tumour

63201

9

Scan Of Spine - Three Contiguous Regions Or Two Non-Contiguous Regions - For Other Conditions

63219, 63228

11

Scan Of Musculoskeletal System - For Tumour, Infection or Osteonecrosis

63301

12

Scan Of Musculoskeletal System - For Joint Derangement

63322, 63325, 63328, 63331, 63334, 63337, 63340

19

Scan Of Body - For Specified Conditions

63461 

20

Scans Of Pelvis And Upper Abdomen - For Specified Conditions

63740 

33

Scan of Body - Person Under the Age of 16 Years - General Practice Requests

63507, 63513, 63522

34

Scan of Body - Person Over the Age of 16 Years - General Practice Requests

63551, 63554, 63557, 63560 

 

Pathology Services Table

Group

Group Name

Item Number

P1

Haematology

65060, 65070, 65072, 65075, 65078, 65081, 65090, 65093, 65096, 65111, 65114, 65120, 65123, 65126, 65129, 65137, 65144, 65156, 65178, 65179

P2

Chemical

66500, 66503, 66506, 66509, 66512, 66518, 66519, 66536, 66542, 66548, 66551, 66554, 66560, 66563, 66566, 66584, 66593, 66596, 66605, 66607, 66623, 66626, 66632, 66635, 66638, 66641, 66650, 66653, 66655, 66656, 66659, 66660, 66665, 66686, 66695, 66697, 66698, 66701, 66704, 66707, 66716, 66719, 66722, 66725, 66728, 66731, 66734, 66750, 66751, 66752, 66756, 66758, 66764, 66767, 66770, 66779, 66800, 66803, 66812, 66816, 66819, 66820, 66822, 66828, 66833, 66837, 66838, 66839, 66840, 66841, 66900

P3

Microbiology

69300, 69303, 69306, 69309, 69312, 69317, 69318, 69319, 69321, 69324, 69330, 69333, 69336, 69345, 69354, 69363, 69384, 69387, 69390, 69393, 69396, 69400, 69401, 69405, 69411, 69413, 69415, 69471, 69474, 69475, 69478, 69480, 69481, 69482, 69483, 69484, 69488, 69491, 69494, 69495, 69496, 69497, 69498, 69499

P4

Immunology

71057, 71058, 71059, 71060, 71069, 71071, 71072, 71073, 71075, 71079, 71083, 71085, 71097, 71099, 71101, 71103, 71106, 71119, 71123, 71125, 71143, 71147, 71151, 71153, 71155, 71157, 71163, 71164, 71165, 71166, 71167, 71168, 71180, 71183, 71186, 71198, 71200,

P5

Tissue Pathology

72816, 72817, 72818, 72823, 72824, 72825, 72830, 72846, 72847, 72849

P6

Cytology

73045, 73047, 73049, 73063, 73070, 73071, 73072, 73074, 73076

P7

Genetics

73289, 73292, 73308, 73311, 73314, 73317, 73320, 73325

P8

Infertility and Pregnancy Test

73523, 73527, 73529

P9

Simple basic pathology tests

73806

P10

Patient Episode Initiation

73922, 73924, 73926, 73928, 73930, 73932, 73934, 73936, 73937, 73938, 73939

P11

Specimen Referred

73940 


SCHEDULE B

APPROVED PRACTICE LOCATIONS AS AGREED UNDER THE FEDERATION FUNDING AGREEMENT BETWEEN THE COMMONWEALTH AND THE NORTHERN TERRITORY GOVERNMENT

Approved primary care locations:

State

MMM 2 Location

Practice Name

Legal Name

Street Address

NT

Palmerston

Palmerston Medicare Urgent Care Clinic

FCD Health Ltd

3 Gurd Street, Farrar NT 0830