AUSTRALIAN GOVERNMENT

DEPARTMENT OF HEALTH AND AGED CARE

 

HEALTH INSURANCE ACT 1973

Health Insurance (Medicare Benefits Payable in Respect of Professional Services – Services Rendered at Tasmania Urgent Care Clinic - Devonport) Direction 2024

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 (the Act), hereby:

(1)     REVOKE the Health Insurance (Medicare Benefits Payable in Respect of Professional Services – Services Rendered at Tasmania Urgent Care Clinic - Devonport) Direction (No.2) 2023 made under subsection 19(2) of the Act that was signed on 19 December 2023; and

(2)     DIRECT that Medicare Benefits shall be payable in respect of:

(a)     A professional service (as defined in section 3 of the Act) which has been agreed to be provided under a Schedule to the Federation Funding Agreement executed on
1 June 2023 between the Commonwealth (represented by the Department of Health and Aged Care, ABN: 83 605 426 759) and the Tasmanian Premier Minister for Health (The Crown in Right of Tasmania (represented by the Tasmanian Department of Health, ABN: 11 255 872 006); and

(i)       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 Act) and pathology service table (means the table prescribed under section 4A of the Act) relates; or

(i)       as part of the Commonwealth Urgent Care Clinic Program for which items specified in Schedule B of this Direction and of the general medical services table (means the table prescribed under subsection 4(1) of the Act) and pathology service table (means the table prescribed under section 4A of the Act) relates; and

(A)   are provided during the hours of operation; and

(B)    at the time the service is being provided, there is not a practitioner who is described in paragraph (2)(c) of this Direction, in attendance at the practice listed in Schedule C to provide the service in person; and

(b)     Where the professional service is provided to:

(i)       an eligible person (as defined in section 3 of the Act);

(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;

(c)     The professional services referred to in paragraph (2)(a) must be provided:

(i)        at a practice location specified in Schedule C of this Direction; and

(ii)     by a general practitioner, prescribed medical practitioner or participating nurse practitioner who is registered to provide services in Schedule A and B with Services Australia under the Commonwealth Urgent Care Clinic program mentioned in paragraph (2)(a).

DECLARE that this Direction commences on 29 June 2024 and ceases to have effect at the end of 30 June 2026 unless earlier revoked.

 

Date this 17 day of June 2024

 

 

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 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

General practitioner attendances to which no other item applies

3, 23, 36, 44, 123

A5

Prolonged attendances to which no other item applies

A7

Acupuncture and non-specialist practitioner items

2

Prescribed medical practitioner attendance to which no other item applies

179, 185, 189, 203

9

Prescribed medical practitioner mental health care

279

10

Prescribed Medical Practitioner after‑hours attendances to which no other item applies

733, 737, 741, 745

A20

Mental health care

1

GP mental health treatment plans

2713

A22

General practitioner after-hours attendances to which no other item applies

5000, 5020, 5040, 5060, 5071

D1

Miscellaneous diagnostic procedures and investigations

6

Cardiovascular

11707

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, 41659, 41677

9

Ophthalmology

42644, 42650

14

Hand or wrist 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

*Note: Claims under any item in Group A7 in the General Medical Services Table may only be exempt from subsection 19(2) of the Act when the services are claimed by a Prescribed Medical Practitioner operating under the Medicare Urgent Care Clinic Program.

 

Pathology Services Table

Group

Group Name

Item Number

P9

simple basic pathology tests

73806


SCHEDULE B

MEDICARE BENEFITS SCHEDULE ITEMS WHERE A PRACTITIONER IS NOT ON SITE TO PROVIDE FACE-TO-FACE SERVICES AS AGREED UNDER THE URGENT CARE CLINIC PROGRAM

For services listed in the below tables, all provisions of 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

A40

Telehealth and phone attendance services

1

General practice telehealth services

91790, 91800, 91801, 91802, 91920

19

GP Mental Health Treatment Plan ‑ Telehealth Service

92115

T4

Obstetrics

1

Obstetric telehealth services

91853

 

 


SCHEDULE C

Approved PRACTICE LOCATIONS As agreed under the federation funding agreement between the commonwealth and the TASMANIAN government

Approved primary care locations:

State

MMM 3 Location

Practice Name

Legal Name

Street Address

TAS

Devonport

My Clinic Plus

The Trustee for My Clinic Plus Trust

127 - 133 Steele Street, Devonport TAS 7310