AUSTRALIAN GOVERNMENT

DEPARTMENT OF HEALTH AND AGED CARE

 

HEALTH INSURANCE ACT 1973

Health Insurance (Medicare Benefits Payable in Respect of Professional Services – Services Rendered under the Commonwealth Medicare Urgent Care Clinic Program) Direction (No. 1) 2025

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.                REPEAL the Health Insurance (Medicare Benefits Payable in Respect of Professional Services – Services Rendered under the Commonwealth Medicare Urgent Care Clinic Program) Direction (No. 4) 2024; and
  2.                DIRECT that Medicare Benefits shall be payable in respect of:
  1.      A professional service (as defined in section 3 of the Act) which has been agreed to be provided under the Commonwealth Medicare Urgent Care Clinic Program between the Department of Health and Aged Care (ABN: 83 605 426 759) and the practices listed in Schedule D and E of this direction in relation to medical services available to patients who attend a Commonwealth Medicare Urgent Care Clinic Location for which:
    1.        items specified in Schedules A, B and C of this Direction; and of the general medical services table (means the table prescribed under subsection 4(1) of the Act) or pathology service table (means the table prescribed under section 4A of the Act) relates; and
  2.      Where the professional service is provided to:
  1.        an eligible person (as defined in section 3 of the Act);
  2.      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);
  3.   a patient who also is not receiving a service:
    1.    which attracts a payment through the 2020-2025 Addendum to the National Health Reform Agreement for a service rendered to a public patient; or
    2.     which attracts a payment through another government arrangement outside of the Commonwealth Medicare Urgent Care Clinic Program for a service rendered to the patient; and
  1.      The professional services referred to in paragraph (2)(a) must be provided:
    1.        if the service is specified in Schedule A:
      1.    at a practice location specified in Schedule D or E of this Direction; and
      2.     by a general practitioner, prescribed medical practitioner or participating nurse practitioner who is registered to provide services with Services Australia under the Commonwealth Medicare Urgent Care Clinic Program mentioned in paragraph (2)(a).
    2.      if the service is specified in Schedule B:
      1.    at a practice location specified in Schedule D of this Direction; and
      2.     by a prescribed medical practitioner who is registered to provide services with Services Australia under the Commonwealth Medicare Urgent Care Clinic Program mentioned in paragraph (2)(a).
    3.   if the service is specified in Schedule C:
    1.    at a practice location specified in Schedule E of this Direction; and
    2.     by a prescribed medical practitioner who is registered to provide services with Services Australia under the Commonwealth Medicare Urgent Care Clinic Program mentioned in paragraph (2)(a).
  1.                DECLARE that this Direction commences on 1 February 2025 and ceases to have effect at the end of 30 June 2026 unless earlier revoked.

 

Note, a number of expressions used in this direction are defined in the below instruments:

 

Date 16 January 2025

 

 

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 COMMONWEALTH MEDICARE 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

9

Prescribed medical practitioner mental health care

279

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 Commonwealth 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 clinic is located in MMM 1 locations

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

A2

Other non-referred attendances to which no other item applies

1

Other medical practitioner attendances

52, 53, 54, 57

A23

Other non-referred after-hours attendances to which no other item applies

5200, 5203, 5207, 5208

*Note: Claims under any item in Group A2 and A23 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 Commonwealth Medicare Urgent Care Clinic Program.


SCHEDULE C

MEDICARE BENEFITS SCHEDULE ITEMS WHERE A CLINIC IS LOCATED IN MMM 2-7 LOCATIONS

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

A7

Acupuncture and non-specialist practitioner items

2

Prescribed medical practitioner attendance to which no other item applies

179, 185, 189, 203

10

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

733, 737, 741, 745

*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 Commonwealth Medicare Urgent Care Clinic Program.


SCHEDULE D

APPROVED COMMONWEALTH MEDICARE URGENT CARE CLINIC MMM 1 LOCATIONS AS AGREED UNDER THE COMMONWEALTH MEDICARE URGENT CARE CLINIC PROGRAM

Approved primary care locations:

NEW SOUTH WALES

State

MMM 1 Location

Practice Name

Legal Name

Street Address

NSW

Bankstown

Bankstown Medical and Dental Centre

The Trustee for ARTLU UNIT TRUST

67 Rickard Road, Bankstown NSW 2200

NSW

Carlton

Eastbrooke Medical Centre

Eastbrooke Medical Centres Pty Limited

354-356 Railway Parade, Carlton NSW 2218

NSW

Dapto

Dapto Medical and Dental Centre

The Trustee for ARTLU UNIT TRUST

112 Princes Highway, Dapto NSW 2530

NSW

Fairfield

Fairfield Chase Medical & Dental

The Trustee for ARTLU UNIT TRUST

49-61 Spencer Street, Fairfield NSW 2165

NSW

Lake Haven

Coastal Lakes Medical Practice Lake Haven

The Trustee for The Lake Haven Medical Centre Trust

Lake Haven Shopping Centre, 127 Lake Haven Drive, Lake Haven NSW 2263

NSW

Liverpool

Myhealth Liverpool

Myhealth Liverpool Pty Ltd

Shop 2090, Level 2, Liverpool Westfield, Macquarie Street, Liverpool NSW 2170

NSW

Newcastle

Charlestown Medical and Dental Centre

The Trustee for ARTLU UNIT TRUST

316 Charlestown Road, Charlestown NSW 2290

NSW

Maroubra

Maroubra Medical and Dental Centre

The Trustee for ARTLU UNIT TRUST

806-812 Anzac Parade, Maroubra NSW 2035

NSW

Peninsula

Providence Medical Umina

Providence Medical Umina Pty Ltd

297 West Street, Umina Beach NSW 2257

NSW

Penrith

Our Medical Home

Wycombe Services Pty Ltd

2227 Wolseley Street, Jamisontown NSW 2750

NSW

Queanbeyan

Brindabella Family Practice

Brindabella Medical Practice Services Pty Ltd

 7-9 Morissett Street Queanbeyan NSW 2620

NSW

Rooty Hill

Rooty Hill Medical and Dental Centre

The Trustee for Meditech Trust

31 Rooty Hill Road, Rooty Hill NSW 2766

NSW

Ryde

Myhealth Top Ryde

Myhealth Medical Top Ryde Pty Ltd

MM17C, Top Ryde City Shopping Centre, Blaxland Road and Devlin Street, Ryde NSW 2112

NSW

Westmead

Wentworthville Medical and Dental Centre

The Trustee for ARTLU UNIT TRUST

122-128 Station Street, Wentworthville NSW 2145

NSW

Wollongong

Corrimal Medical and Dental Centre

The Trustee for ARTLU UNIT TRUST

46-50 Underwood Street, Corrimal NSW 2518

QUEENSLAND

State

MMM 1 Location

Practice Name

Legal Name

Street Address

QLD

Gold Coast

Our Medical Home Gold Coast

The Trustee for Gold Coast GP Super Clinic Operating Trust

2 Leo Graham Way, Oxenford QLD 4210

QLD

Goodna

Goodna Family Medical Centre

Goodna Family Medical Centre Pty Ltd

 

2 Smiths Road,

Goodna QLD  4300

QLD

Ipswich

Riverlink Medical and Dental Centre

The Trustee for ARTLU UNIT TRUST

FS1 Riverlink Shopping Centre, 2 The Terrace, North Ipswich QLD 4305

QLD 

Logan (Browns Plains)

Browns Plains Medical and Dental Centre

The Trustee for ARTLU UNIT TRUST

2-10 Grand Plaza Drive, Browns Plains QLD 4118

QLD

Morayfield

Morayfield Accident & Illness Clinic Pty Ltd

Morayfield Accident & Illness Clinic Pty Ltd

19-31 Dickson Rd, Morayfield QLD 4506

QLD

Murrumba Downs

Murrumba Downs Medical and Dental Centre

The Trustee for ARTLU UNIT TRUST

Corner Goodrich Road and Dohles Rocks Road, Murrumba Downs QLD 4503

QLD

North Brisbane

Family Doctors Kedron Urgent Care Clinic

Medical Centre Services Pty Ltd

Corner Gympie and Brookfield Road, Kedron QLD 4031

QLD

Oxley

Growlife Medical

Sante Medical Services Pty Ltd

Ground Floor, Canossa Hospital, 169 Seventeen Mile Rocks Rd, Oxley QLD 4075

QLD

South Brisbane

Cornwall Street Medical Centre

UQ Health Care Limited

Level 4, PACE Building, 20 Cornwall Street, Woolloongabba QLD 4102

QLD

Southport

Southport Medical & Dental Centre

The Trustee for ARTLU UNIT TRUST

178 Nerang Street,

Southport QLD 4215

 

SOUTH AUSTRALIA

State

MMM 1 Location

Practice Name

Legal Name

Street Address

SA

Elizabeth

Elizabeth Medical and Dental Centre

The Trustee for ARTLU UNIT TRUST

30 Philip Highway, Elizabeth SA 5112

SA

Marion

Marion Domain Medical and Dental Centre

The Trustee for ARTLU UNIT TRUST

453 Morphett Road, Oaklands Park SA 5046

SA

Morphett Vale

Morphett Vale Family Practice

The Trustee for THE DOCTORS ROAD TRUST

1 Doctors Road, Morphett Vale SA 5162

SA

Para Hills

McIntyre Medical Centre

Manor Family Care Pty Ltd

33 McIntyre Road,   Para Hills SA 5096

SA

Western

Old Port Road Medical and Dental Centre

The Trustee for ARTLU UNIT TRUST

1202-1210 Old Port Road, Royal Park SA 5014

 

WESTERN AUSTRALIA

State

MMM 1 Location

Practice Name

Legal Name

Street Address

WA

Armadale

ARCHE HEALTH LTD

ARCHE HEALTH LTD

Unit 1, 2227 Albany Highway Gosnells WA 6110

WA

Beeliar

Lagoon Medical Centre

FGMC Pty Ltd

Unit 1, Beeliar Hive Shopping Centre, 283 Beeliar Drive, Yangebup WA 6164

WA

Clarkson

Clarkson Urgent Care Clinic

Ocean Keys Medical Practitioners Pty Ltd

Unit 6/5 Ebb Way, Clarkson WA 6030

WA

Midland

North Street Medical Centre

The Trustee for the Building Blocks Medical Unit Trust

40 Great Northern Highway, Midland WA 6056

WA

Perth City

Rudloc Road Medical and Dental Centre

The Trustee for ARTLU UNIT TRUST

40 Rudloc Road, Morley WA 6062

WA

Rockingham

Rockingham Medical and Dental Centre

The Trustee for ARTLU UNIT TRUST

18 Civic Boulevard, Rockingham WA 6168


SCHEDULE E

APPROVED COMMONWEALTH MEDICARE URGENT CARE CLINIC MMM 2-7 LOCATIONS AS AGREED UNDER THE COMMONWEALTH MEDICARE URGENT CARE CLINIC PROGRAM

Approved primary care locations:

NEW SOUTH WALES

State

MMM 2 Location

Practice Name

Legal Name

Street Address

NSW

Albury

Border Urgent Care Centre

Border Urgent Care Centre Pty Ltd

425 David Street, Albury NSW 2640

 

State

MMM 3 Location

Practice Name

Legal Name

Street Address

NSW

Cessnock

All Ways Healthcare

The Trustee for ARTLU UNIT TRUST

1/275 Vincent Street, Cessnock NSW 2325

NSW

Coffs Harbour

CHC Medical

The Trustee for Coffs Medical Alliance Trust

Suite 106, 343-345 Pacific Highway, Coffs Harbour NSW 2450

NSW

Lismore

Lismore GP Super Clinic

Lismore GP Super Clinic Pty Ltd

33-35 Rous Road, Goonellabah NSW 2480

NSW

Tamworth

Northwest Health

The trustee for the Northwest Health Unit Trust

279b Marius Street, Tamworth NSW 2340

 

State

MMM 4 Location

Practice Name

Legal Name

Street Address

NSW

Batemans Bay

Batemans Bay Medicare Urgent Care Clinic

The Trustee for ARTLU UNIT TRUST

7 Pacific Street Batemans Bay NSW 2536

 

QUEENSLAND

State

MMM 2 Location

Practice Name

Legal Name

Street Address

QLD

Bundaberg

Central Medical Bundaberg

The Trustee for ARTLU UNIT TRUST

53 Commercial Street Kensington

Bundaberg QLD 4670

QLD

Cairns

Cairns Urgent Care Clinic

Cairns Urgent Care Clinic Pty Ltd

5b Walker Road, Edmonton QLD 4869

QLD

Hervey Bay

Pialba Medical Centre

The Trustee for ARTLU UNIT TRUST

5/166 Boat Harbour Drive, Pialba QLD 4655

QLD

Rockhampton

Rockhampton Central Medical Centre

The Trustee for ARTLU UNIT TRUST

Ground Floor, 120-331 Yaamba Road, Rockhampton QLD 4701

 

 

 

SOUTH AUSTRALIA

State

MMM 3 Location

Practice Name

Legal Name

Street Address

SA

Mount Gambier

Mount Gambier Family Health

The Trustee for Try Family Trust

13 Crouch Street, South Mount Gambier SA 5290

 

WESTERN AUSTRALIA

State

MMM 2 Location

Practice Name

Legal Name

Street Address

WA

Greater Bunbury

Medicare Urgent Care Clinic Bunbury at Eaton Fair

Urgent Care Clinic Bunbury Pty Ltd

T82, Eaton Fair Shopping Centre, Recreation Drive, Eaton WA 6232