AUSTRALIAN GOVERNMENT
DEPARTMENT OF HEALTH AND AGED CARE
HEALTH INSURANCE ACT 1973
Health Insurance (Medicare Benefits Payable in Respect of Professional Services –Commonwealth Urgent Care Clinic Program –Victorian Priority Primary Care Centres) Direction (No. 2) 2023
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, hereby:
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:
(i) between the Commonwealth (represented by the Department of Health and Aged Care, ABN: 83 605 426 759) and the State of Victoria (represented by the Victorian Department of Health, ABN: 74 410 330 756) by a Victorian Priority Primary Care Centre that has been assessed as meeting the requirements of the Commonwealth Urgent Care Clinic program; and
(ii) 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 Health Insurance Act 1973) relates; and
(b) Where the professional service is provided to:
(i) an eligible person (as defined in Section 3 of the Health Insurance Act 1973);
(ii) 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);
(iii) 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
(c) the professional services referred to in clause (a) must be provided:
(i) at a practice location specified in Schedule B of this Direction; and
(ii) by a general practitioner or participating nurse practitioner mentioned in (a) who is registered to provide services, with Services Australia under the Commonwealth Urgent Care Clinic program.
DECLARED that this Direction commences on 1 November 2023 and ceases to have effect at the end of 30 June 2024 unless earlier revoked.
Date this 30 day of October 2023
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 ITEMS AS AGREED under the Urgent care clinic program
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 | Item Number |
A1 | GP attendances to which no other item applies | 1 | Level A | 3 |
2 | Level B | 23 | ||
3 | Level C | 36 | ||
4 | Level D | 44 | ||
5 | Level E | 123 | ||
A5 | Prolonged Attendance to Which no Other Item Applies | 1 | Prolonged Professional Attendance | |
A20 | GP Mental health Care | 1 | GP Mental Health Treatment Plans | 2713 |
A22 | General Practitioner After-Hours Attendances To Which No Other Item Applies | 1 | Level A | 5000 |
2 | Level B | 5020 | ||
3 | Level C | 5040 | ||
4 | Level D | 5060 | ||
5 | Level E | 5071 | ||
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, 41677 | ||
9 | Ophthalmology | 42644, 42650 | ||
14 | Hand 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 |
SCHEDULE B
Approved PRACTICE LOCATIONS As agreed under the priority primary care centre agreement between the commonwealth and the state of victoria
Approved primary care locations:
State | Location/ Town | Practice Name | Legal Name | Street Address |
VIC | Baw Baw | Central Clinic Warragul | The Trustee for Barkly Street Medical Trust | 170 Normanby Street, Warragul VIC 3820 |
VIC | Bendigo | Bendigo Primary Care | Bendigo Primary Care Centre Limited | 121 Arnold Street, Bendigo VIC 3550 |
VIC | Craigieburn | Craigieburn Medical and Dental Centre | The Trustee for Artlu Unit Trust | 70 Central Park Avenue, Craigieburn VIC 3064 |
VIC | Dandenong | Greens Medical Group | Keys Medical Centre Pty Ltd | 1/134 Logis Boulevard, Dandenong South VIC 3175 |
VIC | Epping | Epping Plaza Medical and Dental Centre | The Trustee for Artlu Unit Trust | Shop 216, Epping Plaza Regional Centre, 571‑583 High Street, Epping VIC 3076 |
VIC | Forest Hill | Forest Hill Medical and Dental Centre | The Trustee for Artlu Unit Trust | 490-524 Springvale Road, Forest Hill VIC 3131 |
VIC | Glen Waverley | Interconnect Healthcare | The Trustee for Interconnect Healthcare Unit Trust | 476 Blackburn Road, Glen Waverley VIC 3150 |
VIC | Latrobe | Latrobe Community Health Service | Latrobe Community Health Service Unlimited | 42-44 Fowler Street, Moe VIC 3825 |
VIC | Maribyrnong | Edgewater Medical Centre | The Trustee for Edgewater Medical Clinic Unit Trust | G01B/31 Edgewater Boulevard, Maribyrnong VIC 3032 |
VIC | Maroondah | M3 Health Bayswater Medical Clinic | The Trustee for Modern Medical Bayswater Unit Trust | Mountain High Shopping Centre, Shop 28, 7-13 High Street, Bayswater VIC 3153 |
VIC | Mildura | Sunraysia Community Health | Sunraysia Community Health Services Limited | 137 Thirteenth Street, Mildura VIC 3500 |
VIC | Moonee Ponds | Moonee Ponds Medical and Dental Centre | The Trustee for Artlu Unit Trust | 34/46 Holmes Road, Moonee Ponds VIC 3039 |
VIC | Richmond | Access Health and Community Richmond | Access Health and Community Limited | 283 Church Street, Richmond VIC 3121 |
VIC | Royal Children’s Hospital | CoHealth | CoHealth Limited | Royal Children’s Hospital, 50 Flemington Road, Parkville VIC 3052 |
VIC | Sunshine | Sunshine Medi Health | The Trustee for Sunshine Medi‑Health Unit Trust | 421 Ballarat Road, Sunshine VIC 3020 |
VIC | Wodonga | Wodonga Sarkon Medical | Sarkon Healthcare Pty Ltd | White Box Rise Shopping Centre, Shop 1A-2, 81 Victoria Cross Parade, Wodonga VIC 3690 |