Commonwealth Coat of Arms of Australia

 

 

Health Insurance (Section 3C General Medical Services – GP and Allied Health COVID-19 Services) Amendment Determination No. 2 2020

I, Greg Hunt, Minister for Health, make the following determination.

Dated    16 March 2020

 

 

 

 

Greg Hunt

Minister for Health

 

 

 

 

 


Contents

1. Name

2. Commencement

3. Authority

4. Schedules

Schedule 1 – Amendments to the Health Insurance (Section 3C General Medical Services – GP and Allied Health COVID-19 Services) Determination 2020

 


1.      Name

 This instrument is the Health Insurance (Section 3C General Medical Services – GP and Allied Health COVID-19 Services) Amendment Determination No. 2 2020.

2.      Commencement

(1) Each provision of this instrument specified in column 1 of the table commences, or is taken to have commenced, in accordance with column 2 of the table. Any other statement in column 2 has effect according to its terms.

 

Commencement information

Column 1

Column 2

Column 3

Provisions

Commencement

Date/Details

1.  Sections 1 to 4

Immediately after the registration

 

2.  Schedule 1

This Schedule is taken to have commenced on 13 March 2020

 

 Note: This table relates only to the provisions of this instrument as originally made. It will not be amended to deal with any later amendments of this instrument.

(2) Any information in column 3 of the table is not part of this instrument. Information may be inserted in this column, or information in it may be edited, in any published version of this instrument.

3.      Authority

This instrument is made under subsection 3C(1) of the Health Insurance Act 1973.

4.      Schedules

Each instrument that is specified in a Schedule to this instrument is amended or repealed as set out in the applicable items in the Schedule concerned, and any other item in a Schedule to this instrument has effect according to its terms.


Schedule 1 – Amendments to the Health Insurance (Section 3C General Medical Services – GP and Allied Health COVID-19 Services) Determination 2020

  1. Subsection 5(1) (at the end of the note in the subsection)

Repeal the note, substitute:

Note:     The following terms are defined in subsection 3(1) of the Act:

          clinically relevant service;

          general medical services table;

          item;

          participating midwife;

          participating nurse practitioner;

          professional service

 

 

 

2.     Subclause 1.1.1(6) of Schedule 1

Repeal the subclause, substitute:

(6)    For items in Subgroups 1 and 2, a person who meets the requirements of a “patient at risk for COVID-19 virus” in paragraph (c) of the definition must:

(a)   have had at least one face to face attendance rendered in the preceding 12 months by the practitioner who renders the COVID-19 virus service; or

(b)   have had at least one face to face attendance service rendered in the preceding 12 months at (or arranged by) the medical practice where the practitioner who renders the COVID-19 virus service is employed.

 

3.     Table in Division 1.1

Repeal the Table, substitute:

Group A40 – COVID-19 general practice telehealth services

 

Item

Description

Fee ($)

Subgroup 1 – COVID-19 general practice telehealth services

91800

 

Telehealth attendance by a general practitioner lasting less than 20 minutes if:

(a)     the attendance is where:

(i)   the person is a patient at risk of COVID-19 virus; or

(ii)  the general practitioner is a health professional at risk of COVID-19 virus; and

(b)    the attendance includes any of the following that are clinically relevant:

(i)      taking a short patient history;

(ii)     arranging any necessary investigation

(iii)   implementing a management plan;

(iv)   providing appropriate preventative health care;

where the service is bulk-billed

44.90

91801

Telehealth attendance by a general practitioner lasting at least 20 minutes if:

(a)     the attendance is where:

(i)   the person is a patient at risk of COVID-19 virus; or

(ii)  the general practitioner is a health professional at risk of COVID-19 virus; and

(b)    the attendance includes any of the following that are clinically relevant:

(i)      taking a detailed patient history;

(ii)     arranging any necessary investigation

(iii)   implementing a management plan;

(iv)   providing appropriate preventative health care;

where the service is bulk-billed

87.00

91802

Telehealth attendance by a general practitioner lasting at least 40 minutes if:

(a)     the attendance is where:

(i)   the person is a patient at risk of COVID-19 virus; or

(ii)  the general practitioner is a health professional at risk of COVID-19 virus; and

(b)    the attendance includes any of the following that are clinically relevant:

(i)                  taking an extensive patient history;

(ii)                arranging any necessary investigation

(iii)              implementing a management plan;

(iv)               providing appropriate preventative health care;

where the service is bulk-billed

128.05

91803

Telehealth attendance by a medical practitioner of more than 5 minutes in duration but not more than 25 minutes if:

(a)     the attendance is where:

(i)   the person is a patient at risk of COVID-19 virus; or

(ii)  the medical practitioner is a health professional at risk of COVID-19 virus; and

(b)    the attendance includes any of the following that are clinically relevant:

(i)      taking a short patient history;

(ii)     arranging any necessary investigation

(iii)   implementing a management plan;

(iv)   providing appropriate preventative health care;

where the service is bulk-billed

24.70

91804

Telehealth attendance by a medical practitioner of more than 25 minutes in duration but not more than 45 minutes if:

(a)     the attendance is where:

(i)   the person is a patient at risk of COVID-19 virus; or

(ii)  the medical practitioner is a health professional at risk of COVID-19 virus; and

(b)    the attendance includes any of the following that are clinically relevant:

(i)      taking a detailed patient history;

(ii)     arranging any necessary investigation

(iii)   implementing a management plan;

(iv)   providing appropriate preventative health care;

where the service is bulk-billed

44.70

91805

Telehealth attendance by a medical practitioner of at least 45 minutes in duration if:

(a)     the attendance is where:

(i)   the person is a patient at risk of COVID-19 virus; or

(ii)  the medical practitioner is a health professional at risk of COVID-19 virus; and

(b)    the attendance includes any of the following that are clinically relevant:

(i)      taking an extensive patient history;

(ii)     arranging any necessary investigation

(iii)   implementing a management plan;

(iv)   providing appropriate preventative health care;

where the service is bulk-billed

71.75

91806

Telehealth attendance by a medical practitioner, in an eligible area, of more than 5 minutes in duration but not more than 25 minutes if:

(a)     the attendance is where:

(i)   the person is a patient at risk of COVID-19 virus; or

(ii)  the medical practitioner is a health professional at risk of COVID-19 virus; and

(b)    the attendance includes any of the following that are clinically relevant:

(i)      taking a short patient history;

(ii)     arranging any necessary investigation

(iii)   implementing a management plan;

(iv)   providing appropriate preventative health care;

where the service is bulk-billed

35.90

91807

Telehealth attendance by a medical practitioner, in an eligible area, of more than 25 minutes in duration but not more than 45 minutes if:

(a)     the attendance is where:

(i)   the person is a patient at risk of COVID-19 virus; or

(ii)  the medical practitioner is a health professional at risk of COVID-19 virus; and

(b)    the attendance includes any of the following that are clinically relevant:

(i)      taking a detailed patient history;

(ii)     arranging any necessary investigation

(iii)   implementing a management plan;

(iv)   providing appropriate preventative health care;

where the service is bulk-billed

69.55

91808

Telehealth attendance by a medical practitioner, in an eligible area, of at least 45 minutes in duration if:

(a)     the attendance is where:

(i)   the person is a patient at risk of COVID-19 virus; or

(ii)  the medical practitioner is a health professional at risk of COVID-19 virus; and

(b)    the attendance includes any of the following that are clinically relevant:

(i)      taking an extensive patient history;

(ii)     arranging any necessary investigation

(iii)   implementing a management plan;

(iv)   providing appropriate preventative health care;

where the service is bulk-billed

102.45

Subgroup 2 – COVID-19 general practice phone services

91809

Phone attendance by a general practitioner lasting less than 20 minutes if:

(a)     the attendance is where:

(i)   the person is a patient at risk of COVID-19 virus; or

(ii)  the general practitioner is a health professional at risk of COVID-19 virus; and

(b)    the attendance includes any of the following that are clinically relevant:

(i)      taking a short patient history;

(ii)     arranging any necessary investigation;

(iii)   implementing a management plan;

(iv)   providing appropriate preventative health care;

where the service is bulk-billed

44.90

91810

Phone attendance by a general practitioner lasting at least 20 minutes if:

(a)     the attendance is where:

(i)   the person is a patient at risk of COVID-19 virus; or

(ii)  the general practitioner is a health professional at risk of COVID-19 virus; and

(b)    the attendance includes any of the following that are clinically relevant:

(i)      taking a detailed patient history;

(ii)     arranging any necessary investigation;

(iii)   implementing a management plan;

(iv)   providing appropriate preventative health care;

where the service is bulk-billed

87.00

91811

Phone attendance by a general practitioner lasting at least 40 minutes if:

(a)     the attendance is where:

(i)   the person is a patient at risk of COVID-19 virus; or

(ii)  the general practitioner is a health professional at risk of COVID-19 virus; and

(b)    the attendance includes any of the following that are clinically relevant:

(i)      taking an extensive patient history;

(ii)     arranging any necessary investigation;

(iii)   implementing a management plan;

(iv)   providing appropriate preventative health care;

where the service is bulk-billed

128.05

91812

Phone attendance by a medical practitioner of more than 5 minutes in duration but not more than 25 minutes if:

(a)     the attendance is where:

(i)   the person is a patient at risk of COVID-19 virus; or

(ii)  the medical practitioner is a health professional at risk of COVID-19 virus; and

(b)    the attendance includes any of the following that are clinically relevant:

(i)      taking a short patient history;

(ii)     arranging any necessary investigation;

(iii)   implementing a management plan;

(iv)   providing appropriate preventative health care;

where the service is bulk-billed

24.70

91813

Phone attendance by a medical practitioner of at least 25 minutes in duration but not more than 45 minutes if:

(a)     the attendance is where:

(i)   the person is a patient at risk of COVID-19 virus; or

(ii)  the medical practitioner is a health professional at risk of COVID-19 virus; and

(b)    the attendance includes any of the following that are clinically relevant:

(i)      taking a detailed patient history;

(ii)     arranging any necessary investigation;

(iii)   implementing a management plan;

(iv)   providing appropriate preventative health care;

where the service is bulk-billed

44.70

91814

Phone attendance by a medical practitioner of at least 45 minutes in duration if:

(a)     the attendance is where:

(i)   the person is a patient at risk of COVID-19 virus; or

(ii)  the medical practitioner is a health professional at risk of COVID-19 virus; and

(b)    the attendance includes any of the following that are clinically relevant:

(i)      taking an extensive patient history;

(ii)     arranging any necessary investigation;

(iii)   implementing a management plan;

(iv)   providing appropriate preventative health care;

where the service is bulk-billed

71.75

91815

Phone attendance by a medical practitioner, in an eligible area, of more than 5 minutes in duration but not more than 25 minutes if:

(a)     the attendance is where:

(i)   the person is a patient at risk of COVID-19 virus; or

(ii)  the medical practitioner is a health professional at risk of COVID-19 virus; and

(b)    the attendance includes any of the following that are clinically relevant:

(i)      taking a short patient history;

(ii)     arranging any necessary investigation;

(iii)   implementing a management plan;

(iv)   providing appropriate preventative health care;

where the service is bulk-billed

35.90

91816

Phone attendance by a medical practitioner, in an eligible area, of more than 25 minutes in duration but not more than 45 minutes if:

(a)     the attendance is where:

(i)   the person is a patient at risk of COVID-19 virus; or

(ii)  the medical practitioner is a health professional at risk of COVID-19 virus; and

(b)    the attendance includes any of the following that are clinically relevant:

(i)      taking a detailed patient history;

(ii)     arranging any necessary investigation;

(iii)   implementing a management plan;

(iv)   providing appropriate preventative health care;

where the service is bulk-billed

69.55

91817

Phone attendance by a medical practitioner, in an eligible area, of more than 45 minutes in duration if:

(a)     the attendance is where:

(i)   the person is a patient at risk of COVID-19 virus; or

(ii)  the medical practitioner is a health professional at risk of COVID-19 virus; and

(b)    the attendance includes any of the following that are clinically relevant:

(i)      taking an extensive patient history;

(ii)     arranging any necessary investigation

(iii)   implementing a management plan;

(iv)   providing appropriate preventative health care;

where the service is bulk-billed

102.45

Subgroup 3 – COVID-19 Focussed Psychological Strategies telehealth services

91818

Telehealth attendance by a general practitioner, for the purpose of providing focussed psychological strategies for assessed mental disorders if:

(a)     the attendance is where:

(i)   the person is a patient at risk of COVID-19 virus; or

(ii)  the general practitioner is a health professional at risk of COVID-19 virus; and

(b)    the practitioner is registered with the Chief Executive Medicare as meeting the credentialing requirements for provision of this service; and

(c)     the service lasts at least 30 minutes, but less than 40 minutes;

where the service is bulk-billed

110.85

91819

Telehealth attendance by a general practitioner, for the purpose of providing focussed psychological strategies for assessed mental disorders if:

(a)     the attendance is where:

(i)   the person is a patient at risk of COVID-19 virus; or

(ii)  the general practitioner is a health professional at risk of COVID-19 virus; and

(b)    the practitioner is registered with the Chief Executive Medicare as meeting the credentialing requirements for provision of this service; and

(c)     the service lasts at least 40 minutes;

where the service is bulk-billed

158.60

91820

Telehealth attendance by a medical practitioner, for the purpose of providing focussed psychological strategies for assessed mental disorders if:

(a)     the attendance is where:

(i)   the person is a patient at risk of COVID-19 virus; or

(ii)  the medical practitioner is a health professional at risk of COVID-19 virus; and

(b)    the practitioner is registered with the Chief Executive Medicare as meeting the credentialing requirements for provision of this service; and

(c)     the service lasts at least 30 minutes, but less than 40 minutes;

where the service is bulk-billed

88.70

91821

Telehealth attendance by a medical practitioner, for the purpose of providing focussed psychological strategies for assessed mental disorders if:

(a)     the attendance is where:

(i)   the person is a patient at risk of COVID-19 virus; or

(ii)  the medical practitioner is a health professional at risk of COVID-19 virus; and

(b)    the practitioner is registered with the Chief Executive Medicare as meeting the credentialing requirements for provision of this service; and

(c)     the service lasts at least 40 minutes;

where the service is bulk-billed

126.90

 

4.     Table in Division 1.2 (items 91175, 91176, 91178, 91179 and 91180)

Repeal the items, substitute:

91175

Focussed psychological strategies health service provided by telehealth attendance by an eligible social worker if:

(a) the attendance is where:

(i)   the person is a patient at risk of COVID-19 virus; or

(ii)  the eligible social worker is a health professional at risk of COVID-19 virus; and

(b)  the person is referred by:

(i)  a medical practitioner, either as part of a GP Mental Health Treatment Plan, or as part of a shared care plan or as part of a psychiatrist assessment and management plan; or

(ii)   a specialist or consultant physician specialising in the practice of his or her field of psychiatry; or

(iii)   a specialist or consultant physician specialising in the practice of his or her field of paediatrics; and

(b)  the service is provided to the person individually; and

(c)  at the completion of a course of treatment, the referring medical practitioner reviews the need for a further course of treatment; and

(d)  on the completion of the course of treatment, the eligible social worker gives a written report to the referring medical practitioner on assessments carried out, treatment provided and recommendations on future management of the person’s condition; and

(e)  the service is at least 20 minutes but less than 50 minutes duration

where the service is bulk-billed

63.25

91176

Focussed psychological strategies health service provided by telehealth attendance by an eligible social worker if:

(a) the attendance is where:

(i)   the person is a patient at risk of COVID-19 virus; or

(ii)  the eligible social worker is a health professional at risk of COVID-19 virus; and

(b)  the person is referred by:

(i)  a medical practitioner, either as part of a GP Mental Health Treatment Plan, or as part of a shared care plan or as part of a psychiatrist assessment and management plan; or

(ii)   a specialist or consultant physician specialising in the practice of his or her field of psychiatry; or

(iii)   a specialist or consultant physician specialising in the practice of his or her field of paediatrics; and

(c)  the service is provided to the person individually; and

(d)  at the completion of a course of treatment, the referring medical practitioner reviews the need for a further course of treatment; and

(e)  on the completion of the course of treatment, the eligible social worker gives a written report to the referring medical practitioner on assessments carried out, treatment provided and recommendations on future management of the person’s condition; and

(f)  the service is at least 50 minutes duration

where the service is bulk-billed

89.35

91178

Focussed psychological strategies health service provided by telehealth attendance by a participating nurse practitioner lasting less than 20 minutes if:

(a)     the attendance is where:

(i)      the person is a patient at risk of COVID-19 virus; or

(ii)     the participating nurse practitioner is a health professional at risk of COVID-19 virus; and

(b)    the attendance includes any of the following that are clinically relevant:

(i)      taking a short history;

(ii)     arranging any necessary investigation;

(iii)   implementing a management plan;

(iv)   providing appropriate preventive health care;

where the service is bulk-billed.

21.30

91179

Focussed psychological strategies health service provided by telehealth attendance by a participating nurse practitioner lasting at least 20 minutes if:

(a)     the attendance is where:

(i)      the person is a patient at risk of COVID-19 virus; or

(ii)     the participating nurse practitioner is a health professional at risk of COVID-19 virus; and

(b)    the attendance includes any of the following that are clinically relevant:

(i)      taking a detailed history;

(ii)    arranging any necessary investigation;

(iii)  implementing a management plan;

(iv)   providing appropriate preventive health care;

where the service is bulk-billed.

40.40

91180

Focussed psychological strategies health service provided by telehealth attendance by a participating nurse practitioner lasting at least 40 minutes if:

(a)     the attendance is where:

(i)      the person is a patient at risk of COVID-19 virus; or

(ii)     the participating nurse practitioner is a health professional at risk of COVID-19 virus; and

(b)    the attendance includes any of the following that are clinically relevant:

(i)      taking an extensive history;

(ii)     arranging any necessary investigation;

(iii)   implementing a management plan;

(iv)   providing appropriate preventive health care;

where the service is bulk-billed.

59.50

 

5.     Table in Division 1.3

Repeal the Table, substitute:

Group A40 – COVID-19 medical practitioner phone services

 

Item

Description

Fee ($)

Subgroup  10 – COVID-19 Focussed Psychological Strategies phone services

91842

Phone attendance by a general practitioner, for the purpose of providing focussed psychological strategies for assessed mental disorders if:

(a)     the attendance is where:

(i)      the person is a patient at risk of COVID-19 virus; or

(ii)     the general practitioner is a health professional at risk of COVID-19 virus; and

(b)    the practitioner is registered with the Chief Executive Medicare as meeting the credentialing requirements for provision of this service; and

(c)     the service lasts at least 30 minutes, but less than 40 minutes;

where the service is bulk-billed

110.85

91843

Phone attendance by a general practitioner, for the purpose of providing focussed psychological strategies for assessed mental disorders if:

(a)     the attendance is where:

(i)      the person is a patient at risk of COVID-19 virus; or

(ii)     the general practitioner is a health professional at risk of COVID-19 virus; and

(b)    the practitioner is registered with the Chief Executive Medicare as meeting the credentialing requirements for provision of this service; and

(c)     the service lasts at least 40 minutes;

where the service is bulk-billed

158.60

91844

Phone attendance by a medical practitioner, for the purpose of providing focussed psychological strategies for assessed mental disorders if:

(a)     the attendance is where:

(i)      the person is a patient at risk of COVID-19 virus; or

(ii)     the medical practitioner is a health professional at risk of COVID-19 virus; and

(b)       the practitioner is registered with the Chief Executive Medicare as meeting the credentialing requirements for provision of this service; and

(c)       the service lasts at least 30 minutes, but less than 40 minutes;

where the service is bulk-billed

88.70

91845

Phone attendance by a medical practitioner, for the purpose of providing focussed psychological strategies for assessed mental disorders if:

(a)     the attendance is where:

(i)      the person is a patient at risk of COVID-19 virus; or

(ii)     the medical practitioner is a health professional at risk of COVID-19 virus; and

(b)    the practitioner is registered with the Chief Executive Medicare as meeting the credentialing requirements for provision of this service; and

(c)     the service lasts at least 40 minutes;

where the service is bulk-billed

126.90

 

6.     Table in Division 1.4 (items 91189, 91190, and 91191)

Repeal the items, substitute:

91189

Phone attendance by a participating nurse practitioner lasting less than 20 minutes if:

(a)     the attendance is where:

(i)      the person is a patient at risk of COVID-19 virus; or

(ii)     the participating nurse practitioner is a health professional at risk of COVID-19 virus; and

(b)    the attendance includes any of the following that are clinically relevant:

(i)      taking a short history;

(ii)    arranging any necessary investigation;

(iii)   implementing a management plan;

(iv)   providing appropriate preventive health care;

where the service is bulk-billed.

21.30

91190

Phone attendance by a participating nurse practitioner lasting at least 20 minutes if:

(a)     the attendance is where:

(i)      the person is a patient at risk of COVID-19 virus; or

(ii)     the participating nurse practitioner is a health professional at risk of COVID-19 virus; and

(b)    the attendance includes any of the following that are clinically relevant:

(i)      taking a detailed history;

(ii)    arranging any necessary investigation;

(iii)  implementing a management plan;

(iv)   providing appropriate preventive health care;

where the service is bulk-billed.

40.40

91191

Phone attendance by a participating nurse practitioner lasting at least 40 minutes if:

(a)     the attendance is where:

(i)      the person is a patient at risk of COVID-19 virus; or

(ii)     the participating nurse practitioner is a health professional at risk of COVID-19 virus; and

(b)    the attendance includes any of the following that are clinically relevant:

(i)      taking an extensive history;

(ii)     arranging any necessary investigation;

(iii)   implementing a management plan;

(iv)   providing appropriate preventive health care;

where the service is bulk-billed.

59.50

 

 

7.     After Division 1.4 of Schedule 1

Insert:

Division 1.5 - Services and fees – Services and fees – COVID-19 midwifery telehealth and phone services

1.5.1 – Application of COVID-19 midwifery telehealth and phone services

(1)    For items in Division 1.5, “collaborative arrangements” has the meaning given by section 4 of the Health Insurance (Midwife and Nurse Practitioner) Determination 2015.

 

Group M19 – COVID-19 midwifery telehealth and phone services

 

Item

Description

Fee ($)

Subgroup 1 – COVID-19 midwifery telehealth services

91211

Short antenatal telehealth attendance by a participating midwife, lasting up to 40 minutes, if:

(a)     the attendance is where:

(i)                  the person is a patient at risk of COVID-19 virus; or

(ii)                the participating midwife is a health professional at risk of COVID-19 virus; and

(b)     the attendance is bulk-billed

32.80

91212

Long antenatal telehealth attendance by a participating midwife, lasting at least 40 minutes, if:

(a)     the attendance is where:

(i)                  the person is a patient at risk of COVID-19 virus; or

(ii)                the participating midwife is a health professional at risk of COVID-19 virus; and

(b)     the attendance is bulk-billed

54.25

91214

Short postnatal telehealth attendance by a participating midwife, lasting up to 40 minutes, if:

(a)     the attendance is where:

(i)                  the person is a patient at risk of COVID-19 virus; or

(ii)                the participating midwife is a health professional at risk of COVID-19 virus; and

(b)     the attendance is bulk-billed

54.25

91215

Long postnatal telehealth attendance by a participating midwife, lasting at least 40 minutes, if:

(a)     the attendance is where:

(i)                  the person is a patient at risk of COVID-19 virus; or

(ii)                the participating midwife is a health professional at risk of COVID-19 virus; and

(b)     the attendance is bulk-billed

 

79.75

Subgroup 2 – COVID-19 midwifery phone services

91218

Short antenatal phone attendance by a participating midwife, lasting up to 40 minutes, if:

(a)     the attendance is where:

(i)                  the person is a patient at risk of COVID-19 virus; or

(ii)                the participating midwife is a health professional at risk of COVID-19 virus; and

(b)     the attendance is bulk-billed

32.80

91219

Long antenatal phone attendance by a participating midwife, lasting at least 40 minutes, if:

(a)     the attendance is where:

(i)                  the person is a patient at risk of COVID-19 virus; or

(ii)                the participating midwife is a health professional at risk of COVID-19 virus; and

(b)     the attendance is bulk-billed

54.25

91221

Short postnatal phone attendance by a participating midwife, lasting up to 40 minutes, if:

(a)     the attendance is where:

(i)                  the person is a patient at risk of COVID-19 virus; or

(ii)                the participating midwife is a health professional at risk of COVID-19 virus; and

(b)     the attendance is bulk-billed

54.25

91222

Long postnatal telehealth attendance by a participating midwife, lasting at least 40 minutes, if:

(a)     the attendance is where:

(i)                  the person is a patient at risk of COVID-19 virus; or

(ii)                the participating midwife is a health professional at risk of COVID-19 virus; and

(b)     the attendance is bulk-billed

79.75