1. Sections 1 to 4

Immediately after registration of this instrument

2.  Schedule 1

This Schedule is taken to have commenced immediately after the commencement of the Health Insurance (Section 3C General Medical – Expansion of GP and Allied Health Mental Health Services) Amendment (Care Recipient in a Residential Aged Care Facility) Determination 2020.

Group A20—Mental health care

Subgroup 2—Focussed psychological strategies

2733

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

(a) the person is a care recipient in a residential aged care facility (but not as an admitted patient of a hospital); and

(b) the service is clinically indicated under a GP mental health treatment plan or a psychiatrist assessment and management plan; and

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

112.50

2735

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

(a) the person is a care recipient in a residential aged care facility (but not as an admitted patient of a hospital); and

(b) the service is clinically indicated under a GP mental health treatment plan or a psychiatrist assessment and management plan; and

(c)  the service lasts at least 40 minutes

161.00

Group A7 – Acupuncture and Non-Specialist Practitioner Items

Subgroup 9 – Non Specialist Practitioner mental health care

941

Professional attendance by a medical practitioner (not including a general practitioner, specialist or a consultant physician), for the purpose of providing focussed psychological strategies for assessed mental disorders if:

(a) the person is a care recipient in a residential aged care facility (but not as an admitted patient of a hospital); and

(b) the service is clinically indicated under a GP mental health treatment plan or a psychiatrist assessment and management plan; and

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

90.00

942

Professional attendance by a medical practitioner (not including a general practitioner, specialist or a consultant physician), for the purpose of providing focussed psychological strategies for assessed mental disorders if:

(a) the person is a care recipient in a residential aged care facility (but not as an admitted patient of a hospital); and

(b) the service is clinically indicated under a GP mental health treatment plan or a psychiatrist assessment and management plan; and

(c)  the service lasts at least 40 minutes

128.80

1

92024 and 92068

(a) In the 3 months before performance of the service, being a service to which item 729, 731, 732, 231, 731, 233, 92026, 92027, 92028, 92070, 92071, 92072, or item 93469 or 93475 of the Health Insurance (Section 3C General Medical – Expansion of GP and Allied Health Chronic Disease Management Services for Care Recipients of a Residential Aged Care Facility) Determination 2020 applies (for reviewing a GP management plan) applies but had not been performed for the patient; and

(b) the service is not performed more than once in a 12 month period; and

(c) the service is not performed by a general practitioner:

(i) who is a recognised specialist in palliative medicine; and

(ii) who is treating a palliative patient that has been referred to the general practitioner; and

(iii) to which an item in Subgroup 3 or 4 of Group A24 applies because of the treatment of the palliative patient by the general practitioner

2

92025 and 92069

(a) In the 3 months before performance of the service, being a service to which item 732, 233, 92028, 92072, or item 93469 or 93475 of the Health Insurance (Section 3C General Medical – Expansion of GP and Allied Health Chronic Disease Management Services for Care Recipients of a Residential Aged Care Facility) Determination 2020 applies(for coordinating a review of team care arrangements, a multi‑disciplinary community care plan or a multi‑disciplinary discharge care plan) applies but had not been performed for the patient; and

(b) the service is performed not more than once in a 12 month period; and

(c) the service is not performed by a general practitioner:

(i) who is a recognised specialist in palliative medicine; and

(ii) who is treating a palliative patient that has been referred to the general practitioner; and

(iii) to which an item in Subgroup 3 or 4 of Group A24 applies because of the treatment of the palliative patient by the general practitioner

3

92026 and 92070

(a) either:

(i) in the 3 months before performance of the service, being a service to which item 731, 732, 232, 233, 92027, 92028, 92071, 92072, or item 93469 or 93475 of the Health Insurance (Section 3C General Medical – Expansion of GP and Allied Health Chronic Disease Management Services for Care Recipients of a Residential Aged Care Facility) Determination 2020 applies but had not been performed for the patient; or

(ii) in the 12 months before performance of the service, being a service that has not been performed for the patient:

(A) by the general practitioner who performs the service to which item 729, 92026 or 92070 would, but for this item, apply; and

(B) for which a payment has been made under item 721 or 723 of the general medical services table or 92024, 92025, 92068, 92069; and

(b) the service is performed not more than once in a 3 month period

4

92027 and 92071

(a) In the 3 months before performance of the service, being a service to which item 721, 723, 729, 732, 229, 230, 231, 233, 92024, 92025, 92026, 92028, 92068, 92069, 92070, 92070, or item 93469 or 93475 of the Health Insurance (Section 3C General Medical – Expansion of GP and Allied Health Chronic Disease Management Services for Care Recipients of a Residential Aged Care Facility) Determination 2020 applies but had not been performed for the patient; and

(b) the service is performed not more than once in a 3 month period

5

92028 and 92072

(a) In the 3 months before performance of the service, being a service to which item 93469 or 93475 of the Health Insurance (Section 3C General Medical – Expansion of GP and Allied Health Chronic Disease Management Services for Care Recipients of a Residential Aged Care Facility) Determination 2020 applies but had not been performed for the patient; and

 (b) once in a 3 month period; and

(c) on the same day; but

(d) may not be performed by a general practitioner:

(i) who is a recognised specialist in palliative medicine; and

(ii) who is treating a palliative patient that has been referred to the general practitioner; and

(iii) to which an item in Subgroup 3 or 4 of Group A24 applies because of the treatment of the palliative patient by the general practitioner

1

92055 and 92099

(a)    In the 3 months before performance of the service, being a service to which item 729, 731 or 732 of the general medical services table, item  231, 232 or 233 of the Other Medical Practitioner Determination, item 93469 or 93475 of the Health Insurance (Section 3C General Medical – Expansion of GP and Allied Health Chronic Disease Management Services for Care Recipients of a Residential Aged Care Facility) Determination 2020 or item 92026, 92027, 92028, 92057, 92058, 92059, 92070, 92071, 92072, 92101, 92102 or 92103 applies (for reviewing a GP management plan) but had not been performed for the patient; and

(b) a service to which item 721 of the general medical services table or 229 of the Other Medical Practitioner Determination or items 92024, 92055, 92068 or 92099 applies has not been performed in the past 12 months; and

(c) the service is not performed more than once in a 12 month period; and

(d) the service is not performed by a person:

(i) who is a recognised specialist in palliative medicine; and

(ii) who is treating a palliative patient that has been referred to the medical practitioner; and

(iii) to which an item in Subgroup 3 or 4 of Group A24 of the Other Medical Practitioner Determination applies because of the treatment of the palliative patient by the medical practitioner

2

92056 and 92100

(a) In the 3 months before performance of the service, being a service to which item 732 of the general medical services table or item 233 of the Other Medical Practitioner Determination, item 93469 or 93475 of the Health Insurance (Section 3C General Medical – Expansion of GP and Allied Health Chronic Disease Management Services for Care Recipients of a Residential Aged Care Facility) Determination 2020 or item 92028, 92059, 92072 or 92103 applies (for coordinating a review of team care arrangements, a multi‑disciplinary community care plan or a multi‑disciplinary discharge care plan)  but had not been performed for the patient; and

(b) a service to which item 723 of the general medical services table or 230 of the Other Medical Practitioner Determination or items 92025, 92026, 92069 or 92100 applies is performed not more than once in a 12 months; and

(c) the service is performed not more than once in a 12 month period; and

(d) the service is not performed by a person:

(i) who is a recognised specialist in palliative medicine; and

(ii) who is treating a palliative patient that has been referred to the medical practitioner; and

(iii) to which an item in Subgroup 3 or 4 of Group A24 of the Other Medical Practitioner Determination applies because of the treatment of the palliative patient by the general practitioner

3

92057 and 92101

(a) either:

(i) in the 3 months before performance of the service, being a service to which item 731 or 732 of the general medical services table or item 232 or 233 of the Other Medical Practitioner Determination, item 93469 or 93475 of the Health Insurance (Section 3C General Medical – Expansion of GP and Allied Health Chronic Disease Management Services for Care Recipients of a Residential Aged Care Facility) Determination 2020 or item 92027, 92028, 92058, 92059, 92071, 92072, 92102 or 92103 applies but had not been performed for the patient; or

(ii) in the 12 months before performance of the service, being a service that has not been performed for the patient:

(A) by the medical practitioner who performs the service to which item 729 of the general medical services table or item 231 of the Other Medical Practitioner Determination or item 92026, 92057, 92070 or 92101 would, but for this item, apply; and

(B) for which a payment has been made under item 721 or 723 of the general medical services table or item 229 or 230 of the Other Medical Practitioner Determination or item 92024, 92025, 92055, 92066, 92068, 92069, 92099 or 92100; and

(b) a service to which item 729 of the general medical services table or 231 of the Other Medical Practitioner Determination or item 92026, 92057, 92070 or 92101 applies is performed not more than once in a 3 month period; and

(c) the service is performed not more than once in a 3 month period.

4

92058 and 92102

(a) In the 3 months before performance of the service, being a service to which item 721, 723, 729 or 732 of the general medical services table or item 229, 230, 231 or 233 of the Other Medical Practitioner Determination, item 93469 or 93475 of the Health Insurance (Section 3C General Medical – Expansion of GP and Allied Health Chronic Disease Management Services for Care Recipients of a Residential Aged Care Facility) Determination 2020 or item 92024, 92025, 92026, 92028, 92055, 92056, 92057, 92059, 92068, 92069, 92070, 92072, 92099, 92100, 92101, 92103 applies but had not been performed for the patient; and

(b) a service to which item 731 of the general medical services table or item 92027 or 92071 applies is performed not more than once in a 3 month period; and

(c) the service is performed not more than once in a 3 month period.

5

92059 and 92103

Each service may be performed if a service to which item 732 of the general medical services table, item 93469 or 93475 of the Health Insurance (Section 3C General Medical – Expansion of GP and Allied Health Chronic Disease Management Services for Care Recipients of a Residential Aged Care Facility) Determination 2020 or item 92028 or 92072 has not been claimed in the past three months;

(a) once in a 3 month period; and

(b) on the same day; but

(c) may not be performed by a person:

(i) who is a recognised specialist in palliative medicine; and

(ii) who is treating a palliative patient that has been referred to the general practitioner; and

(iii) to which an item in Subgroup 3 or 4 of Group A24 of the Other Medical Practitioner Determination applies because of the treatment of the palliative patient by the general practitioner

1

229

(a)    In the 3 months before performance of the service, being a service to which item 729, 731 or 732 of the general services table, item 231, 232 or 233, item 92026, 92027, 92028, 92057, 92058, 92059, 92070, 92071, 92072, 92101, 92102 or 92103 of the COVID-19 Determination, or item 93469 or 93475 of the Health Insurance (Section 3C General Medical – Expansion of GP and Allied Health Chronic Disease Management Services for Care Recipients of a Residential Aged Care Facility) Determination 2020 applies (for reviewing a GP management plan) but had not been performed for the patient; and

(b) a service to which item 721 of the general services table or items 92024, 92026, 92055 or 92099 of the COVID-19 Determination apply has not been performed in the past 12 months

(c) the service is not performed more than once in a 12 month period; and

(d) the service is not performed by a person:

(i) who is a recognised specialist in palliative medicine; and

(ii) who is treating a palliative patient that has been referred to the medical practitioner; and

(iii) to which an item in Subgroup 3 or 4 of Group A24 applies because of the treatment of the palliative patient by the medical practitioner

2

230

(a) In the 3 months before performance of the service, being a service to which item 732 of the general services table or item 233 or item 92028, 92059, 92072 or 92103 of the COVID-19 Determination, or item 93469 or 93475 of the Health Insurance (Section 3C General Medical – Expansion of GP and Allied Health Chronic Disease Management Services for Care Recipients of a Residential Aged Care Facility) Determination 2020 applies (for coordinating a review of team care arrangements, a multi‑disciplinary community care plan or a multi‑disciplinary discharge care plan)  but had not been performed for the patient; and

(b) a service to which item 723 of the general services table or items 92025, 92056, 92069 or 92100 of the COVID-19 Determination applies is performed not more than once in a 12 months

(c) the service is performed not more than once in a 12 month period; and

(d) the service is not performed by a person:

(i) who is a recognised specialist in palliative medicine; and

(ii) who is treating a palliative patient that has been referred to the medical practitioner; and

(iii) to which an item in Subgroup 3 or 4 of Group A24 applies because of the treatment of the palliative patient by the general practitioner

3

231

(a) either:

(i) in the 3 months before performance of the service, being a service to which item 731 or 732 of the general services table or item 232 or 233 or item 92027, 92028, 92058, 92059, 92071, 92072, 92102 or 92103 of the COVID-19 Determination, or item 93469 or 93475 of the Health Insurance (Section 3C General Medical – Expansion of GP and Allied Health Chronic Disease Management Services for Care Recipients of a Residential Aged Care Facility) Determination 2020 applies but had not been performed for the patient; or

(ii) in the 12 months before performance of the service, being a service that has not been performed for the patient:

(A) by the medical practitioner who performs the service to which item 729 of the general services table or item 231 or item 92026, 92057, 92070 or 92101 of the COVID-19 Determination would, but for this item, apply; and

(B) for which a payment has been made under item 721 or 723 of the general medical services table or item 229 or 230 or item 92024, 92025, 92055, 92056, 92068, 92069, 92099 or 92100 of the COVID-19 Determination; and

(b) a service to which item 729 of the general medical services table or item 92026, 92057, 92070 or 92101 of the COVID-19 Determination applies is performed not more than once in a 3 month period; and

(c) the service is performed not more than once in a 3 month period

4

232

(a) In the 3 months before performance of the service, being a service to which item 721, 723, 729 or 732 of the general services table or item 229, 230, 231 or 233 or item 92024, 92025, 92026, 92028, 92055, 92056, 92057, 92059, 92068, 92069, 92070, 92072, 92099, 92100, 92101 or 92103 of the COVID-19 Determination, or item 93469 or 93475 of the Health Insurance (Section 3C General Medical – Expansion of GP and Allied Health Chronic Disease Management Services for Care Recipients of a Residential Aged Care Facility) Determination 2020 applies but had not been performed for the patient; and

(b) a service to which item 731 of the general services table or item 92027, 92058, 92071 or 92102 of the COVID-19 Determination applies is performed not more than once in a 3 month period; and

(c) the service is performed not more than once in a 3 month period

5

233

Each service may be performed if a service to which item 732 of the general services table, item 92028, 92059, 92072 or 92103 of the COVID-19 Determination or item 93469 or 93475 of the Health Insurance (Section 3C General Medical – Expansion of GP and Allied Health Chronic Disease Management Services for Care Recipients of a Residential Aged Care Facility) Determination 2020 has not been claimed in the past three months;

(a) once in a 3 month period; and

(b) on the same day; but

(c) may not be performed by a person:

(i) who is a recognised specialist in palliative medicine; and

(ii) who is treating a palliative patient that has been referred to the general practitioner; and

(iii) to which an item in Subgroup 3 or 4 of Group A24 applies because of the treatment of the palliative patient by the general practitioner