AUSTRALIAN GOVERNMENT

DEPARTMENT OF HEALTH AND AGED CARE

HEALTH INSURANCE ACT 1973

Health Insurance (Medicare Benefits Payable in Respect of Professional Services – New South Wales - Medical Services performed under the Single Employer Model Trial) Direction 2024

I, Nigel Murray, Acting First Assistant Secretary, 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:

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 under the Rural Generalist Single Employer Model Trial Memorandum of Understanding between the Department of Health and Aged Care (ABN: 83 605 426 759) and the Health Administration Corporation for and on behalf of the NSW Ministry of Health (ABN: 45 100 538 161) in relation to the rural generalists single employer model for which;

(i) 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), diagnostic imaging services table (means the table prescribed under subsection 4AA(1) of the Health Insurance Act 1973) and pathology services table (means the table prescribed under subsection 4A(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); and

(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

(i) at a general practice (as defined in Section 7.1.1 of the general medical services table); and

(ii) at:

a rural or remote practice location specified in Schedule B in Modified Monash Model 2-7 (as defined in Section 7.1.1 of the general medical services table); or
A location described in the Rural Generalist Single Employer Model Trial Memorandum of Understanding between the Department of Health and Aged Care and the New South Wales Ministry of Health; and

(iii) by a participating rural generalist trainee mentioned in (a):

who is formally enrolled in a fellowship training program that meets the training standards of either:
1. the Australian College of Rural and Remote Medicine; and/or
2. The Royal Australian College of General Practitioners.
who is employed by the Government of New South Wales for the provision of primary and acute care services; and

(iv) by one of the eighty rural generalist participants who are eligible to use this Direction at any one time.

DECLARE that this Direction commences on 8 January 2024 and ceases to have effect at the end of 30 June 2027 unless earlier revoked.

Date this 3rd day of January 2024

Nigel Murray

Acting First Assistant Secretary

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 New South Wales health service rural general practice and rural Generalist SINGLE EMPLOYER Model TRIAL

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
A1	General practitioner attendances to which no other item applies
A2	Other non-referred attendances to which no other item applies
A5	Prolonged attendances to which no other item applies
A6	Group therapy
A7	Acupuncture and non-specialist practitioner items	All
A11	Urgent attendances after-hours
A14	Health assessments
A15	GP Management plans, team care arrangements and multidisciplinary care plans and case	1	GP Management plans, team care arrangements and multidisciplinary care plans
A15		2	Case conferences
A17	Domiciliary and residential medication management reviews
A20	GP Mental Health treatment	All
A22	General practitioner after-hours attendances to which no other item applies
A23	Other non-referred after-hour attendances to which no other item applies
A27	Pregnancy support counselling
A29	Attendance services for complex neurodevelopmental disorder or disability
A35	Non-referred attendance at a residential aged care facility
A36	Eating Disorder Services	1	GP and Medical Practitioner eating disorder treatment and management plans
		3	Review of eating disorder treatment and management plan
		4	GP and medical practitioner eating disorder s psychological treatment services
A40	Telehealth and phone attendance services	1	General practice telehealth services
		2	General practice phone services
		3	Focussed psychological strategies telehealth services
		10	Focussed psychological strategies phone services
		11	Health assessments for Aboriginal and Torres Strait Islander People - telehealth services
		13	GP management plans, team care arrangements and multidisciplinary care plans via telehealth attendance
		15	GP pregnancy support counselling - telehealth services
		16	GP pregnancy support counselling - phone services
		17	GP, Specialist and Consultant Physician autism service - telehealth services
		19	GP mental health treatment plan - telehealth services
		20	GP mental health treatment plan - phone services
		21	GP Eating Disorder Treatment and Management Plan – telehealth services
		22	GP Eating Disorder Treatment and Management Plans - phone services
		25	Review of an eating disorder Plan - telehealth services
		26	Review of an Eating Disorder Plan – phone services
		27	Eating Disorder Focussed Psychological Strategies – telehealth services
		28	GP - Eating Disorder Focussed Psychological Strategies – phone services
		29	GP and Other Medical Practitioner - urgent after hours service in unsociable hours - telehealth services
		37	Specialist, anaesthesia – Telehealth Services
		39	GP Sexual and Reproductive Health Consultation – Telehealth Service
		40	GP Sexual and Reproductive Health Consultation – Phone Service
A44	General practice attendance for assessing patient suitability for a COVID-19 vaccine
A46	COVID-19 management support service
M1	Management of bulk billed services
M12	Services provided by a practice nurse, an Aboriginal health worker or an Aboriginal and Torres Strait Islander health practitioner on behalf of a medical practitioner	1	Video conferencing consultation support service provided by a practice nurse, an Aboriginal health worker or an Aboriginal and Torres Strait Islander health practitioner on behalf of a medical practitioner
		2	Video conferencing consultation support service provided at a residential aged care facility on behalf of a medical practitioner
		3	Services provided by a practice nurse or an Aboriginal and Torres Strait Islander health practitioner on behalf of a medical practitioner
D1	Miscellaneous diagnostic procedures and investigations	2	Ophthalmology
		3	Otolaryngology
		4	Respiratory
		5	Vascular
		6	Cardiovascular
		8	Genito-urinary physiological investigations
		9	Allergy testing
		10	Other diagnostic procedures and investigations
D2	Nuclear Medicine (non-imaging)
T1	Miscellaneous therapeutic procedures	2	Dialysis
		4	Paediatric and neonatal
		5	Cardiovascular
		8	Haematology
		9	Procedures associated with intensive care and cardiopulmonary support
		11	Chemotherapeutic procedures
		13	Other therapeutic procedures
T2	Radiation oncology	1	Superficial
T3	Therapeutic nuclear medicine
T4	Obstetrics
T6	Examination by anaesthetist
T7	Regional or field nerve blocks
T8	Surgical Operations	1	General
		2	Colorectal
		3	Vascular
		4	Gynaecological
		5	Urological
		6	Cardio-thoracic
		7	Neurosurgical
		8	Ear, nose and throat
		9	Ophthalmology
		11	Paediatric
		12	Amputations
		13	Plastic and reconstructive surgery
		14	Hand surgery
		15	Orthopaedic
T9	Assistance at operations
T10	Anaesthesia performed in connect with certain services (relative value guide)	All

Diagnostic Imaging Services Table

Group	Group Name	Subgroup	Subgroup Name
I1	Ultrasound	6	Musculoskeletal ultrasound
I3	Diagnostic Radiology	1	Radiographic examination of extremities
		2	Radiographic examination of shoulder or pelvis
		3	Radiographic examination of head
		4	Radiographic examination of spine
		5	Bone age study and skeletal survey
		6	Radiographic examination of thoracic region
		7	Radiographic examination of urinary tract
		8	Radiographic examination of alimentary tract and biliary system
		12	Radiographic examination with opaque or contrast media
I6	Management of bulk billed Services

Pathology Services Table

Group	Group Name
P1	Haematology
P2	Chemical
P9	Simple Basic Pathology Tests
P12	Management of bulk billed services

SCHEDULE B

Approved Modified Monash 2-7 rural and remote Practice Locations AS AGREED under the New South Wales health service rural general practice and rural Generalist SINGLE EMPLOYERModel TRIAL

Approved primary care Modified Monash Model (MMM) 2 locations:

MMM 2 location	Practice Name	Legal Name	Street Address
Medowie	Peppertree GP Medical Centre	Dissanayake, Rohan Senarath Bandara	Shop 7/12 Peppertree Rd, Medowie NSW 2318

Approved primary care Modified Monash Model (MMM) 3 locations:

MMM 3 location	Practice Name	Legal Name	Street Address
Broken Hill	Broken Hill GP Super Clinic	The trustee for Broken Hill GP Super Clinic Trust	235 Thomas Street, Broken Hill, NSW 2880
Broken Hill	Clive Bishop Medical Centre, Royal Flying Doctor Service (SE Section)	Royal Flying Doctor Service Of Australia (South Eastern Section)	Broken Hill Airport, Pro Hart Way, Broken Hill, NSW 2880
Coffs Harbour	CHC Medical Centre	The Trustee for Coffs Medical Alliance Trust	Level One Suite 105-107, 343 - 345 Pacific Hwy, Coffs Harbour NSW 2450
Lake Cathie	Lake Cathie Medical	Lake Cathie Medical Centre Pty Ltd	1459 Ocean Dr, Lake Cathie NSW 2445
Port Macquarie	Five Star Medical	Lewis & Plunkett Services Pty Ltd	1/158 Gordon St, Port Macquarie NSW 2444
Port Macquarie	Flynns Beach Medical Centre	Heise Holdings Pty Ltd	54 Pacific Dr, Port Macquarie NSW 2444
Port Macquarie	Greenmeadows Medical	Clarke, Robert	152 Greenmeadows Dr, Port Macquarie NSW 2444
Port Macquarie	Lachlan Medical Centre	Heise Holdings Pty Ltd	3/66 Lord St, Port Macquarie NSW 2444
Port Macquarie	Medical on William	The trustee for The King Trust	97 William St, Port Macquarie NSW 2444
Port Macquarie	Port GPs / Port Macquarie GP Super Clinic	Port Macquarie GP Super Clinic Pty Ltd	38 Clifton Drive Port Macquarie NSW 2444
Port Macquarie	The Good Shepherd Medical & Dental Port Macquarie	The Trustee for The Good Shepherd Trust	10 Jindalee Road, Port Macquarie NSW 2444
Port Macquarie	The Grange Family Medical Centre	The trustee for The King Trust	Suite 1/82 Lake Rd, Port Macquarie NSW 2444
Port Macquarie	Westside Medical Centre	Port Westside Pty Ltd	11 Highfields Cct, Port Macquarie NSW 2444
Toormina	Toormina Medical Centre	FeelAlright Pty Ltd	9 Minorca Place Toormina NSW 2452
Tamworth	Tallowood Health	Tamworth Family Medicine Pty Ltd	121 Johnston Street, Tamworth NSW 2340
Wauchope	Hastings Medical	Hastings Medical Centre	70 High St, Wauchope NSW 2446
Wauchope	The Good Shepherd Medical & Dental Centre - Wauchope	The Trustee for The Good Shepherd Trust	153 High St, Wauchope NSW 2446

Approved primary care Modified Monash Model (MMM) 4 locations:

MMM 4 location	Practice Name	Legal Name	Street Address
Bonny Hills	Bonny Hills Medical	Lake Cathie Medical Centre Pty Ltd	Shop 4, 10 Jungarra Crescent, Bonny Hills NSW 2445
Cooma	Ochre Medical Centre	Ochre Health Pty Limited	184 Sharp St, Cooma NSW 2630
Cooma	Bombala Street Clinic	The Trustee for The Bombala Street Surgery	62 Bombala St, Cooma NSW 2630
Cootamundra	Cootamundra Medical Centre	The Trustee for Cootamundra Medical Centre Unit Trust	118 MacKay St, Cootamundra NSW 2590
Corowa	Redgum Medical Group	The trustee for Corowa Medical Centre Trust	61 Guy Street, Corowa, NSW 2646
Cowra	Cowra Medical Associates / Kendal Street Medical Practice	The Trustee for CMA Services Unit Trust	165-169 Kendal St, Cowra NSW 2794
Deniliquin	Central Clinic Deniliquin	Dumbrell, Ian	409 George St, Deniliquin NSW 2710
Forbes	Forbes Medical Centre	Fernando Health Services Pty Ltd & Josette Medical Pty Ltd & Thivin Medics Pty Ltd	4-6 Elgin St, Forbes NSW 2871
Forbes	Forbes Medicine and Mind	BBOB Enterprises Pty Ltd	12 Cross St, Forbes NSW 2871
Glen Innes	East Avenue Medical Centre	Calala Unit Trust	39 East Avenue Glen Innes NSW 2370
Gunnedah	Barber Street Practice	Gunnedah Independent Doctors Pty Ltd	110 Barber Street, Gunnedah NSW 2380
Gunnedah	Northwest Family Medical	The Trustee for For NWHG Unit Trust	59 Barber Street, Gunnedah NSW 2380
Inverell	Macintyre Medical Centre	J S Hall Pty Ltd	75 Otho Street, Inverell NSW 2360
Kempsey	St Colluthus medical centre	Mina Philopater Pty Ltd	30 Clyde St, Kempsey NSW 2440
Lakewood	Your Family Practice - Lakewood	YFP Pty Ltd	106 Sirius Dr, Lakewood NSW 2439
Laurieton	Camden Haven Medical Centre	Camden Haven Medical Centre Pty Ltd	5/16 Laurie St, Laurieton NSW 2443
Leeton	Leeton Medical Centre	Willimbong Pty. Ltd.	11 Wade Ave Leeton, NSW 2705
Merimbula	Sapphire Clinic	The Trustee for Sapphire Clinic Management Trust	44 Merimbula Dr, Merimbula NSW 2548
Moree	Associate Medical Practice	Lorikeet Unit Trust	342 Frome Street, Moree NSW 2400
Moree	Gwydir Medical	Big Sky Services Pty Ltd	147 Balo Street, Moree NSW 2400
Mudgee	Mudgee Medical Centre	C.G Alpren & J.V Barling & G Bennett & A Egan & P Leal & P Rorberts	145 Church St, Mudgee NSW 2850
Mudgee	South Mudgee Medical Centre/South Mudgee Surgery	Tamryn Pty Limited	9 Oporto Rd, Mudgee NSW 2850
Narrabri	Narrabri Medical Practice	C.C. Angel Pty Ltd	110 Tibbereena Street, Narrabri NSW 2390
Parkes	Ochre - Parkes	Ochre Health Pty Limited	335 Clarinda Street, Parkes, NSW 2870
Singleton Heights	Singleton Heights Medical Practice	Panere Unit Trust	108 Blaxland Ave, Singleton Heights NSW 2330
South West Rocks	Seascape Medical Centre	The Trustee for SWR Medical Services Unit Trust	289-293 Gregory St, South West Rocks NSW 2431
Tumut	Tumut Family Medical Centre	Tumut Family Medical Practice Pty Ltd	95 Wynyard Street Tumut, NSW 2720
West Kempsey	A B Surgery	The Trustee for Ackerly & Bielich Service Trust	26 Elbow St, West Kempsey NSW 2440
West Kempsey	Kempsey Medical Centre	The Trustee for KMC Management Trust	35 Elbow St, West Kempsey NSW 2440
Young	Young District Medical Centre	The Trustee for The Young Medical Service Trust	16 Cloete St, Young NSW 2594

Approved primary care Modified Monash Model (MMM) 5 locations:

MMM 5 location	Practice Name	Legal Name	Street Address
Bega	Bega Valley Medical Practice	Mackinnon Medical Services Pty Ltd	61 Carp St, Bega NSW 2550
Bellingen	Bellingen Family Medical Centre	The Trustee for Platypus Medical Trust	16 Church St, Bellingen NSW 2454
Bellingen	Three Rivers Health	The Trustee for Three Rivers Health & Medical	9 Church St, Bellingen NSW 2454
Bermagui	Bermagui Medical Centre	Braveheart Healthcare Pty Ltd	24 Bunga St, Bermagui NSW 2546
Blayney	Blayney Family Medical Practice	Blayney Family Medical Practice Pty Ltd	1-3 Osman Street, Blayney NSW 2799
Brunswick Heads	Brunswick Heads Medical Centre	The Trustee for Brunswick Heads Medical Centre Unit Trust	2/14 Mullumbimbi St, Brunswick Heads NSW 2483
Coolamon	Coolamon Regional Medical Centre	The Trustee for CRMC Unit Trust	59 Wallace Street, Coolamon NSW 2701
Coonabarabran	Warrumbungle Medical Centre	Aneve Pty. Limited	59 Cassilis St, Coonabarabran NSW 2357
Dungog	The Medical Practice	Dungog Medical Pty Ltd	245 Dowling Street, Dungog 2420
Manilla	Rural Medical Clinic Manilla	The Trustee for Rural Medical Clinic Trust	113 Manilla Street, Manilla 2346
Mullumbimby	Mullumbimby Medical Centre	Weber, Norbert Wilhelm	123 Dalley Street, Mullumbimby 2482
Warialda	Warialda Medical Centre	Warialda Family Practice Pty Ltd	22 Hope Street, Warialda
Gilgandra	RFDS - Gilgandra	Royal Flying Doctor Service South Eastern Section Medical Services Pty Ltd	1a Warren Rd, Gilgandra NSW 2827
Grenfell	Main St Medical Service (Grenfell)	Pakmed Group Australia Pty Ltd	156 Main St, Grenfell NSW 2810
Gundagai	Gundagai Medical Centre	The Trustee For Gundagai Medical Centre Unit Trust	95 Sheridan St, Gundagai NSW 2722
Kyogle	McKid Medical	The Trustee For The Potumuthu Trust	199 Summerland Way, Kyogle NSW 2474
Maclean	Maclean Medical	Jimkenzella Pty Ltd	265 River St, Maclean NSW 2463
Moruya	Moruya Medical Centre	The Trustee for Moruya Medical Services Trust	73A Queen St, Moruya NSW 2537
Narooma	Lighthouse Surgery	Braveheart Healthcare Pty Ltd	80 Princes Highway Narooma NSW 2546
Narrandera	Narrandera Medical Centre	NGPM Pty Limited	3/7 Victoria Square, Narrandera NSW 2700
Temora	Temora Medical Complex	The Trustee for T M C Unit Trust No 2	296/298 Hoskins St, Temora NSW 2666
Warren	RFDS - Warren	Warren Medical Services Pty Ltd	21 Lawson St, Warren NSW 2824
Wellington	Swift Street Medical Centre (Wellington)	Ian G Spencer Pty Ltd	53 Swift St, Wellington NSW 2820

Approved primary care Modified Monash Model (MMM) 6 locations:

MM6 Location	Practice Name	Legal Name	Street Address
Baradine	Baradine Medical Centre	The Trustee For The Nguyen And Hua Family Trust	5-9 Darling St, Baradine NSW 2396
Bourke	Ochre - Bourke	Ochre Health Pty Limited	14 Darling Street, Bourke, NSW 2840
Collarenebri	Ochre - Collarenebri	Ochre Health Pty Limited	62 Walgett Street, Collarenebri, NSW 2833
Coonamble	Ochre - Coonamble	Ochre Health Pty Limited	29 Tooloon Street, Coonamble, NSW 2829
Lightning Ridge	Ochre - Lightning Ridge	Ochre Health Pty Limited	17 Pandora Street, Lightning Ridge, NSW 2834
Nyngan	Bogan Shire Medical Centre	Bogan Shire Council	76C Pangee St, Nyngan NSW 2825
Walgett	Ochre - Walgett	Ochre Health Pty Limited	141 Fox Street, Walgett, NSW 2832

Approved primary care Modified Monash Model (MMM) 7 locations:

MM7 Location	Practice Name	Legal Name	Street Address
Brewarrina	Ochre - Brewarrina	Ochre Health Pty Limited	4 Sandon Street, Brewarrina, NSW 2839