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 – Victoria) Direction (No. 3) 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 – Victoria) Direction (No. 2) 2023 made under subsection 19(2) of the Act that was signed on 30 October 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) under a Schedule to the Federation Funding Agreement executed on
28 June 2023 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 Treasury and Finance,
ABN: 44 128 890 975); and
(ii) 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 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.
DECLARE that this Direction commences on 1 December 2023 and ceases to have effect at the end of 30 June 2026 unless earlier revoked.
Date this 25th day of November 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 federation funding agreement between the commonwealth and the VICTORIAN government
Approved primary care locations:
State | Location/ Town | Practice Name | Legal Name | Street Address |
VIC | Ballarat | Ballarat Priority Primary Care Centre (UFS Medical) | UFS Dispensaries Limited | 4 Windemere Street, Ballarat VIC 3350 |
VIC | Frankston | Frankston Priority Primary Care Centre | Sandringham Ambulatory Care Centre Pty Ltd | 1-3/49 Beach Street, Frankston VIC 3199 |
VIC | Geelong | Eastbrooke Family Clinic Belmont | Eastbrooke Medical Centres Pty Ltd | 75 Roslyn Road, Belmont VIC 3216 |
VIC | Heidelberg | Heidelberg Priority Primary Care Centre | Trustee for Interconnect Healthcare Unit Trust | 455 Upper Heidelberg Road, Heidelberg Heights VIC 3081 |
VIC | Inner Melbourne | Carlton Medical and Urgent Care Clinic | Idameneo (No. 123) Pty Ltd as the Trustee for Artlu Unit Trust | 2/221 Drummond Street, Carlton VIC 3053 |
VIC | Narre Warren | Narregate Medical and Dental Centre | ldameneo (No. 123) Pty Ltd as the Trustee for Artlu Unit Trust | 60 Victor Crescent, Narre Warren VIC 3805 |
VIC | Prahran | Prahran Priority Primary Care Centre | Sandringham Ambulatory Care Centre Pty Ltd | 4/20 Commercial Road, Melbourne VIC 3004 |
VIC | Shepparton | The University of Melbourne Shepparton Medical Centre | Melbourne Teaching Health Clinics Ltd | 49 Graham Street, Shepparton VIC 3630 |
VIC | Sunbury | Goonawarra Medical Centre Sunbury | The Trustee for Napier Medical Trust | 1-5 Dornoch Drive, Sunbury VIC 3429 |
VIC | Werribee | Werribee Medical and Dental Centre | ldameneo (No. 123) Pty Ltd as the Trustee for Artlu Unit Trust | 1-5 Station Place, Werribee VIC 3030 |