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:

  1. REVOKE the Health Insurance (Medicare Benefits Payable in Respect of Professional Services –Commonwealth Urgent Care Clinic Program –Victorian Priority Primary Care Centres) Direction 2023 made under subsection 19(2) of the Act that was signed on 26 September 2023; and

 

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, 571583 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 MediHealth 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