Health Insurance (Section 3C – Allied Health Services) Amendment Determination 2019 (Cth)

Case

Health Insurance (Section 3C – Allied Health Services) Amendment Determination 2019

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I, ELIZABETH DOWD, delegate of the Minister for Health, make the following determination. 

Dated           5 April 2019

Elizabeth Dowd

Assistant Secretary

MBS Policy and Specialist Services Branch

Medical Benefits Division

Health Financing Group

Department of Health

Contents

1.           Name

2.           Commencement

3.           Authority

4.           Schedules

Schedule 1 – Amendments

Health Insurance (Allied Health Services) Determination 2014

  1. Name

This Determination is the Health Insurance (Section 3C – Allied Health Services) Amendment Determination 2019.

  1. Commencement

(1)        Each provision of this instrument specified in column 1 of the table commences, or is taken to have commenced, in accordance with column 2 of the table. Any other statement in column 2 has effect according to its terms.

Commencement information
Column 1 Column 2 Column 3
Provisions Commencement Date/Details
1.  The whole of this instrument 1 July 2019

Note:          This table relates only to the provisions of this instrument as originally made. It will not be amended to deal with any later amendments of this instrument.

(2)        Any information in column 3 of the table is not part of this instrument. Information may be inserted in this column, or information in it may be edited, in any published version of this instrument.

  1. Authority     

This Determination is made under subsection 3C(1) of the Health Insurance Act 1973.

  1. Schedules

Each instrument that is specified in a Schedule to this Instrument is amended or repealed as set out in the applicable items in the Schedule concerned, and any other item in a Schedule to this Instrument has effect according to its terms.

Schedule 1 – Amendments

Health Insurance (Allied Health Services) Determination 2014

  1. Subsection 4(1) (definition of CPD year)

Repeal the definition, substitute:

CPD year means the period of time in which focussed psychological strategies continuing professional development must be completed being from 1 July to 30 June annually.

  1. Subsection 4(1) (definition of GP Mental Health Treatment Plan)

Repeal the definition, substitute:

GP Mental Health Treatment Plan, for a patient, means a GP Mental Health Treatment Plan for the patient to which item 2700, 2701, 2715 or 2717 of the general medical services table applies or item 272, 276, 281 or 282 of the Health Insurance (Section 3C General Medical Services – Other Medical Practitioner) Determination 2018 applies.

  1. Part 1 of Schedule 2 (below the heading)

Repeal the table, substitute:

Group M3 – Allied health services
Item Service Fee ($)
10950

Aboriginal and Torres Strait Islander health service provided to a person by an eligible Aboriginal health worker or eligible Aboriginal and Torres Strait Islander health practitioner if:

   (a)  the service is provided to a person who has:

(i)      a chronic condition; and

(ii)     complex care needs being managed by a medical practitioner (including a general practitioner, but not a specialist or consultant physician) under a shared care plan or under both a GP Management Plan and Team Care Arrangements or, if the person is a resident of an aged care facility, the person’s medical practitioner has contributed to a multidisciplinary care plan; and

  (b)   the service is recommended in the person’s Team Care Arrangements, multidisciplinary care plan or shared care plan as part of the management of the person’s chronic condition and complex care needs; and

  (c)   the person is referred to the eligible Aboriginal health worker or eligible Aboriginal and Torres Strait Islander health practitioner by the medical practitioner using a referral form that has been issued by the Department or a referral form that contains all the components of the form issued by the Department; and

  (d)  the person is not an admitted patient of a hospital; and

(e)   the service is provided to the person individually and in person; and

(f)   the service is of at least 20 minutes duration; and

(g)   after the service, the eligible Aboriginal health worker or eligible Aboriginal and Torres Strait Islander health practitioner gives a written report to the referring medical practitioner mentioned in paragraph (c):

(i)      if the service is the only service under the referral—in relation to that service; or

       (ii)     if the service is the first or last service under the referral—in relation to that service; or

       (iii)    if neither subparagraph (i) nor (ii) applies but the service involves matters that the referring medical practitioner would reasonably expect to be informed of —in relation to those matters;

to a maximum of 5 services (including any services to which this item or any other item in Part 1 of this Schedule applies) in a calendar year

This item is subject to section 9

 63.25
10951

Diabetes education health service provided to a person by an eligible diabetes educator if:

   (a)  the service is provided to a person who has:

(i) a chronic condition; and

 63.25

        (ii)   complex care needs being managed by a medical practitioner (including a general practitioner, but not a specialist or consultant physician) under a shared care plan or under both a GP Management Plan and Team Care Arrangements or, if the person is a resident of an aged care facility, the person’s medical practitioner has contributed to a multidisciplinary care plan; and

   (b)  the service is recommended in the person’s Team Care Arrangements, multidisciplinary care plan or shared care plan as part of the management of the person’s chronic condition and complex care needs; and

   (c)  the person is referred to the eligible diabetes educator by the medical practitioner using a referral form that has been issued by the Department or a referral form that contains all the components of the form issued by the Department; and

  (d)  the person is not an admitted patient of a hospital; and

   (e)  the service is provided to the person individually and in person; and

   (f)  the service is of at least 20 minutes duration; and

(g)  after the service, the eligible diabetes educator gives a written report to the referring medical practitioner mentioned in paragraph (c):

         (i)   if the service is the only service under the referral—in relation to that service; or

        (ii)   if the service is the first or last service under the referral—in relation to that service; or

       (iii)   if neither subparagraph (i) nor (ii) applies but the service involves matters that the referring medical practitioner would reasonably expect to be informed of—in relation to those matters;

to a maximum of 5 services (including any services to which this item or any other item in Part 1 of this Schedule applies) in a calendar year

This item is subject to section 9
10952

Audiology health service provided to a person by an eligible audiologist if:

   (a)  the service is provided to a person who has:

(i)      a chronic condition; and

(ii)     complex care needs being managed by a medical practitioner (including a general practitioner, but not a specialist or consultant physician) under a shared care plan or under both a GP Management Plan and Team Care Arrangements or, if the person is a resident of an aged care facility, the person’s medical practitioner has contributed to a multidisciplinary care plan; and

   (b)  the service is recommended in the person’s Team Care Arrangements, multidisciplinary care plan or shared care plan as part of the management of the person’s chronic condition and complex care needs; and        

   (c)  the person is referred to the eligible audiologist by the medical practitioner using a referral form that has been issued by the Department or a referral form that contains all the components of the form issued by the Department; and

  (d)  the person is not an admitted patient of a hospital; and

 63.25

   (e)  the service is provided to the person individually and in person; and

   (f)  the service is of at least 20 minutes duration; and

   (g)  after the service, the eligible audiologist gives a written report to the referring medical practitioner mentioned in paragraph (c):

         (i)   if the service is the only service under the referral—in relation to that service; or

        (ii)   if the service is the first or last service under the referral—in relation to that service; or

       (iii)   if neither subparagraph (i) nor (ii) applies but the service involves matters that the referring medical practitioner would reasonably expect to be informed of—in relation to those matters;

to a maximum of 5 services (including any services to which this item or any other item in Part 1 of this Schedule applies) in a calendar year

This item is subject to section 9
10953

Exercise physiology health service provided to a person by an eligible exercise physiologist if:

   (a)  the service is provided to a person who has:

(i)      a chronic condition; and

(ii)     complex care needs being managed by a medical practitioner (including a general practitioner, but not a specialist or consultant physician) under a shared care plan or under both a GP Management Plan and Team Care Arrangements or, if the person is a resident of an aged care facility, the person’s medical practitioner has contributed to a multidisciplinary care plan; and

   (b)  the service is recommended in the person’s Team Care Arrangements, multidisciplinary care plan or shared care plan as part of the management of the person’s chronic condition and complex care needs; and        

   (c)  the person is referred to the eligible exercise physiologist by the medical practitioner using a referral form that has been issued by the Department or a referral form that contains all the components of the form issued by the Department; and

  (d)  the person is not an admitted patient of a hospital; and

   (e)  the service is provided to the person individually and in person; and

   (f)  the service is of at least 20 minutes duration; and

   (g)  after the service, the eligible exercise physiologist gives a written report to the referring medical practitioner mentioned in paragraph (c):

         (i)   if the service is the only service under the referral—in relation to that service; or

        (ii)   if the service is the first or last service under the referral—in relation to that service; or

       (iii)   if neither subparagraph (i) nor (ii) applies but the service involves matters that the referring medical practitioner would reasonably expect to be informed of—in relation to those matters;

to a maximum of 5 services (including any services to which this item or any other item in Part 1 of this Schedule applies) in a calendar year

This item is subject to section 9

 63.25
10954

Dietetics health service provided to a person by an eligible dietician if:

   (a)  the service is provided to a person who has:

(i)      a chronic condition; and

(ii)     complex care needs being managed by a medical practitioner (including a general practitioner, but not a specialist or consultant physician) under a shared care plan or under both a GP Management Plan and Team Care Arrangements or, if the person is a resident of an aged care facility, the person’s medical practitioner has contributed to a multidisciplinary care plan; and

   (b)  the service is recommended in the person’s Team Care Arrangements, multidisciplinary care plan or shared care plan as part of the management of the person’s chronic condition and complex care needs; and

 63.25

   (c)  the person is referred to the eligible dietician by the medical practitioner using a referral form that has been issued by the Department or a referral form that contains all the components of the form issued by the Department; and

  (d)  the person is not an admitted patient of a hospital; and

   (e)  the service is provided to the person individually and in person; and

   (f)  the service is of at least 20 minutes duration; and

   (g)  after the service, the eligible dietician gives a written report to the referring medical practitioner mentioned in paragraph (c):

         (i)   if the service is the only service under the referral—in relation to that service; or

        (ii)   if the service is the first or last service under the referral—in relation to that service; or

       (iii)   if neither subparagraph (i) nor (ii) applies but the service involves matters that the referring medical practitioner would reasonably expect to be informed of—in relation to those matters;

to a maximum of 5 services (including any services to which this item or any other item in Part 1 of this Schedule applies) in a calendar year

This item is subject to section 9
10956

Mental health service provided to a person by an eligible mental health worker if:

   (a)  the service is provided to a person who has:

(i)      a chronic condition; and

(ii)     complex care needs being managed by a medical practitioner (including a general practitioner, but not a specialist or consultant physician) under a shared care plan or under both a GP Management Plan and Team Care Arrangements or, if the person is a resident of an aged care facility, the person’s medical practitioner has contributed to a multidisciplinary care plan; and

   (b)  the service is recommended in the person’s Team Care Arrangements, multidisciplinary care plan or shared care plan as part of the management of the person’s chronic condition and complex care needs; and        

   (c)  the person is referred to the eligible mental health worker by the medical practitioner using a referral form that has been issued by the Department or a referral form that contains all the components of the form issued by the Department; and

   (d)  the person is not an admitted patient of a hospital; and

   (e)  the service is provided to the person individually and in person; and

   (f)  the service is of at least 20 minutes duration; and

   (g)  after the service, the eligible mental health worker gives a written report to the referring medical practitioner mentioned in paragraph (c):

             (i)      if the service is the only service under the referral—in relation to that service; or

(ii)  if the service is the first or last service under the referral—in relation to that service; or

(iii) if neither subparagraph (i) nor (ii) applies but the service involves matters that the referring medical practitioner would reasonably expect to be informed of—in relation to those matters;

to a maximum of 5 services (including any services to which this item or any other item in Part 1 of this Schedule applies) in a calendar year

This item is subject to section 9

 63.25
10958

Occupational therapy health service provided to a person by an eligible occupational therapist if:

   (a)  the service is provided to a person who has:

(i)      a chronic condition; and

(ii)     complex care needs being managed by a medical practitioner (including a general practitioner, but not a specialist or consultant physician) under a shared care plan or under both a GP Management Plan and Team Care Arrangements or, if the person is a resident of an aged care facility, the person’s medical practitioner has contributed to a multidisciplinary care plan; and

(b)     the service is recommended in the person’s Team Care Arrangements, multidisciplinary care plan or shared care plan as part of the management of the person’s chronic condition and complex care needs; and

(c)     the person is referred to the eligible occupational therapist by the medical practitioner using a referral form that has been issued by the Department or a referral form that contains all the components of the form issued by the Department; and

  (d)  the person is not an admitted patient of a hospital; and

   (e)  the service is provided to the person individually and in person; and

   (f)  the service is of at least 20 minutes duration; and

   (g)  after the service, the eligible occupational therapist gives a written report to the referring medical practitioner mentioned in paragraph (c):

        (i)   if the service is the only service under the referral—in relation to that service; or

(ii)     if the service is the first or last service under the referral—in relation to that service; or

(iii)    if neither subparagraph (i) nor (ii) applies but the service involves matters that the referring medical practitioner would reasonably expect to be informed of—in relation to those matters;

to a maximum of 5 services (including any services to which this item or any other item in Part 1 of this Schedule applies) in a calendar year

This item is subject to section 9

 63.25
10960

Physiotherapy health service provided to a person by an eligible physiotherapist if:

   (a)  the service is provided to a person who has:

(i)      a chronic condition; and

(ii)     complex care needs being managed by a medical practitioner (including a general practitioner, but not a specialist or consultant physician) under a shared care plan or under both a GP Management Plan and Team Care Arrangements or, if the person is a resident of an aged care facility, the person’s medical practitioner has contributed to a multidisciplinary care plan; and

   (b)  the service is recommended in the person’s Team Care Arrangements, multidisciplinary care plan or shared care plan as part of the management of the person’s chronic condition and complex care needs; and

   (c)  the person is referred to the eligible physiotherapist by the medical practitioner using a referral form that has been issued by the Department or a referral form that contains all the components of the form issued by the Department; and

(d)   the person is not an admitted patient of a hospital; and

   (e)  the service is provided to the person individually and in person; and

   (f)  the service is of at least 20 minutes duration; and

   (g)  after the service, the eligible physiotherapist gives a written report to the referring medical practitioner mentioned in paragraph (c):

         (i)   if the service is the only service under the referral—in relation to that service; or

        (ii)   if the service is the first or last service under the referral—in relation to that service; or

       (iii)   if neither subparagraph (i) nor (ii) applies but the service involves matters that the referring medical practitioner would reasonably expect to be informed of—in relation to those matters;

to a maximum of 5 services (including any services to which this item or any other item in Part 1 of this Schedule applies) in a calendar year

This item is subject to section 9

 63.25
10962

Podiatry health service provided to a person by an eligible podiatrist if:

   (a)  the service is provided to a person who has:

(i)      a chronic condition; and

(ii)     complex care needs being managed by a medical practitioner (including a general practitioner, but not a specialist or consultant physician) under a shared care plan or under both a GP Management Plan and Team Care Arrangements or, if the person is a resident of an aged care facility, the person’s medical practitioner has contributed to a multidisciplinary care plan; and

(b)   the service is recommended in the person’s Team Care  Arrangements, multidisciplinary care plan or shared care plan as part of the management of the person’s chronic condition and complex care needs; and        

  (c)  the person is referred to the eligible podiatrist by the medical practitioner using a referral form that has been issued by the Department or a referral form that contains all the components of the form issued by the Department; and

  (d)  the person is not an admitted patient of a hospital; and

   (e)  the service is provided to the person individually and in person; and

   (f)  the service is of at least 20 minutes duration; and

   (g)  after the service, the eligible podiatrist gives a written report to the referring medical practitioner mentioned in paragraph (c):

(i)      if the service is the only service under the referral—in relation to that service; or

(ii)     if the service is the first or last service under the referral—in relation to that service; or 

(iii)    if neither subparagraph (i) nor (ii) applies but the service involves matters that the referring medical practitioner would reasonably expect to be informed of—in relation to those matters;

to a maximum of 5 services (including any services to which this item or any other item in Part 1 of this Schedule applies) in a calendar year

This item is subject to section 9

 63.25
10964

Chiropractic health service provided to a person by an eligible chiropractor if:

   (a)  the service is provided to a person who has:

(i)      a chronic condition; and

(ii)     complex care needs being managed by a medical practitioner (including a general practitioner, but not a specialist or consultant physician) under a shared care plan or under both a GP Management Plan and Team Care Arrangements or, if the person is a resident of an aged care facility, the person’s medical practitioner has contributed to a multidisciplinary care plan; and

(b)     the service is recommended in the person’s Team Care Arrangements, multidisciplinary care plan or shared care plan as part of the management of the person’s chronic condition and complex care needs; and        

  (c)    the person is referred to the eligible chiropractor by the medical practitioner using a referral form that has been issued by the Department or a referral form that contains all the components of the form issued by the Department; and

(d)   the person is not an admitted patient of a hospital; and

   (e)  the service is provided to the person individually and in person; and

   (f)  the service is of at least 20 minutes duration; and

   (g)  after the service, the eligible chiropractor gives a written report to the referring medical practitioner mentioned in paragraph (c):

(i)      if the service is the only service under the referral—in relation to that service; or

          (ii)        if the service is the first or last service under the referral—in relation to that service; or

(iii)    if neither subparagraph (i) nor (ii) applies but the service involves matters that the referring medical practitioner would reasonably expect to be informed of —in relation to those matters;

to a maximum of 5 services (including any services to which this item or any other item in Part 1 of this Schedule applies) in a calendar year

This item is subject to section 9

 63.25
10966

Osteopathy health service provided to a person by an eligible osteopath if:

   (a)  the service is provided to a person who has:

(i)      a chronic condition; and

(ii)     complex care needs being managed by a medical practitioner (including a general practitioner, but not a specialist or consultant physician) under a shared care plan or under both a GP Management Plan and Team Care Arrangements or, if the person is a resident of an aged care facility, the person’s medical practitioner has contributed to a multidisciplinary care plan; and

   (b)  the service is recommended in the person’s Team Care Arrangements, multidisciplinary care plan or shared care plan as part of the management of the person’s chronic condition and complex care needs; and        

   (c)  the person is referred to the eligible osteopath by the medical practitioner using a referral form that has been issued by the Department or a referral form that contains all the components of the form issued by the Department; and

  (d)  the person is not an admitted patient of a hospital; and

   (e)  the service is provided to the person individually and in person; and

   (f)  the service is of at least 20 minutes duration; and

   (g)  after the service, the eligible osteopath gives a written report to the referring medical practitioner mentioned in paragraph (c):

         (i)   if the service is the only service under the referral—in relation to that service; or

        (ii)   if the service is the first or last service under the referral—in relation to that service; or

       (iii)   if neither subparagraph (i) nor (ii) applies but the service involves matters that the referring medical practitioner would reasonably expect to be informed of —in relation to those matters;

to a maximum of 5 services (including any services to which this item or any other item in Part 1 of this Schedule applies) in a calendar year

This item is subject to section 9

 63.25
10968

Psychology health service provided to a person by an eligible psychologist if:

   (a)  the service is provided to a person who has:

(i)      a chronic condition; and

(ii)     complex care needs being managed by a medical practitioner (including a general practitioner, but not a specialist or consultant physician) under a shared care plan or under both a GP Management Plan and Team Care Arrangements or, if the person is a resident of an aged care facility, the person’s medical practitioner has contributed to a multidisciplinary care plan; and

(b)      the service is recommended in the person’s Team Care Arrangements, multidisciplinary care plan or shared care plan as part of the management of the person’s chronic condition and complex care needs; and        

   (c)   the person is referred to the eligible psychologist by the medical       practitioner using a referral form that has been issued by the            Department or a referral form that contains all the components of the form issued by the Department; and

  (d)  the person is not an admitted patient of a hospital; and

   (e)  the service is provided to the person individually and in person; and

   (f)  the service is of at least 20 minutes duration; and

   (g)  after the service, the eligible psychologist gives a written report to the referring medical practitioner mentioned in paragraph (c):

(i)      if the service is the only service under the referral—in relation to that service; or

(ii)     if the service is the first or last service under the referral—in relation to that service; or

(iii)    if neither subparagraph (i) nor (ii) applies but the service involves matters that the referring medical practitioner would reasonably expect to be informed of—in relation to those matters;

to a maximum of 5 services (including any services to which this item or any other item in Part 1 of this Schedule applies) in a calendar year

This item is subject to section 9

 63.25
10970

Speech pathology health service provided to a person by an eligible speech pathologist if:

   (a)  the service is provided to a person who has:

(i)      a chronic condition; and

(ii)     complex care needs being managed by a medical practitioner (including a general practitioner, but not a specialist or consultant physician) under a shared care plan or under both a GP Management Plan and Team Care Arrangements or, if the person is a resident of an aged care facility, the person’s medical practitioner has contributed to a multidisciplinary care plan; and

(b)     the service is recommended in the person’s Team Care Arrangements, multidisciplinary care plan or shared care plan as part of the management of the person’s chronic condition and complex care needs; and

 63.25

 (c)   the person is referred to the eligible speech pathologist by the medical practitioner using a referral form that has been issued by the Department or a referral form that contains all the components of the form issued by the Department; and

  (d)  the person is not an admitted patient of a hospital; and

(e)   the service is provided to the person individually and in person; and

(f)   the service is of at least 20 minutes duration; and

   (g)  after the service, the eligible speech pathologist gives a written report to the referring medical practitioner mentioned in paragraph (c):

         (i)   if the service is the only service under the referral—in relation to that service; or

(ii)  if the service is the first or last service under the referral—in relation to that service; or

       (iii)   if neither subparagraph (i) nor (ii) applies but the service involves matters that the referring medical practitioner would reasonably expect to be informed of —in relation to those matters;

to a maximum of 5 services (including any services to which this item or any other item in Part 1 of this Schedule applies) in a calendar year

This item is subject to section 9

 63.25

  1. Part 2 of Schedule 2 (below the heading)

Repeal the table, substitute:

Group M6 – Psychological Therapy Services
Item Service Fee($)
80000

Psychological therapy health service provided to a person in consulting rooms (but not as an admitted patient of a hospital) by an eligible clinical psychologist if:

   (a)  the person is referred by:

         (i)   a medical practitioner, either as part of a GP Mental Health Treatment Plan, or as part of a shared care plan or as part of a psychiatrist assessment and management plan; or

        (ii)   a specialist or consultant physician specialising in the practice of his or her field of psychiatry; or

       (iii)   a specialist or consultant physician specialising in the practice of his or her field of paediatrics; and

  (b)  the service is provided to the person individually and in person; and

   (c)  at the completion of a course of treatment, the referring medical practitioner reviews the need for a further course of treatment; and

  (d)  on the completion of the course of treatment, the eligible clinical psychologist gives a written report to the referring medical practitioner on assessments carried out, treatment provided and recommendations on future management of the person’s condition; and

   (e)  the service is at least 30 minutes but less than 50 minutes duration

This item is subject to sections 6, 7 and 9

 101.35
80001

Psychological therapy health service provided to a person (but not as an admitted patient of a hospital) by an eligible clinical psychologist if:

   (a)  the person is referred by:

         (i)   a medical practitioner, either as part of a GP Mental Health Treatment Plan, or as part of a shared care plan or as part of a psychiatrist assessment and management plan; or

        (ii)   a specialist or consultant physician specialising in the practice of his or her field of psychiatry; or

       (iii)   a specialist or consultant physician specialising in the practice of his or her field of paediatrics; and

  (b)  the service is provided to the person individually; and

   (c)  the attendance is by video conference; and

  (d)  the patient is not an admitted patient; and

   (e)  the patient is located within a telehealth eligible area; and

   (f)  the patient is, at the time of the attendance, at least 15 kilometres by road from the clinical psychologist; and

   (g)  at the completion of a course of treatment, the referring medical practitioner reviews the need for a further course of treatment; and

  (h)  on the completion of the course of treatment, the eligible clinical psychologist gives a written report to the referring medical practitioner on assessments carried out, treatment provided and recommendations on future management of the person’s condition; and

   (i)  the service is at least 30 minutes but less than 50 minutes duration

This item is subject to sections 6B, 7 and 9

 101.35
80005

Psychological therapy health service provided to a person at a place other than consulting rooms (but not as an admitted patient of a hospital) by an eligible clinical psychologist in accordance with the requirements of item 80000

This item is subject to sections 6, 7 and 9

 126.65
80010

Psychological therapy health service provided to a person in consulting rooms (but not as an admitted patient of a hospital) by an eligible clinical psychologist if:

   (a)  the person is referred by:

         (i)   a medical practitioner, either as part of a GP Mental Health Treatment Plan, or as part of a shared care plan or as part of a psychiatrist assessment and management plan; or

        (ii)   a specialist or consultant physician specialising in the practice of his or her field of psychiatry; or

       (iii)   a specialist or consultant physician specialising in the practice of his or her field of paediatrics; and

  (b)  the service is provided to the person individually and in person; and

   (c)  at the completion of a course of treatment, the referring medical practitioner reviews the need for a further course of treatment; and

  (d)  on the completion of the course of treatment, the eligible clinical psychologist gives a written report to the referring medical practitioner on assessments carried out, treatment provided and recommendations on future management of the person’s condition; and

   (e)  the service is at least 50 minutes duration

This item is subject to sections 6, 7 and 9

 148.80
80011

Psychological therapy health service provided to a person (but not as an admitted patient of a hospital) by an eligible clinical psychologist if:

   (a)  the person is referred by:

         (i)   a medical practitioner, either as part of a GP Mental Health Treatment Plan, or as part of a shared care plan or as part of a psychiatrist assessment and management plan; or

        (ii)   a specialist or consultant physician specialising in the practice of his or her field of psychiatry; or

       (iii)   a specialist or consultant physician specialising in the practice of his or her field of paediatrics; and

  (b)  the service is provided to the person individually; and

   (c)  the attendance is by video conference; and

  (d)  the patient is not an admitted patient; and

   (e)  the patient is located within a telehealth eligible area; and

   (f)  the patient is, at the time of the attendance, at least 15 kilometres by road from the clinical psychologist; and

   (g)  at the completion of a course of treatment, the referring medical practitioner reviews the need for a further course of treatment; and

  (h)  on the completion of the course of treatment, the eligible clinical psychologist gives a written report to the referring medical practitioner on assessments carried out, treatment provided and recommendations on future management of the person’s condition; and

   (i)  the service is at least 50 minutes duration

This item is subject to sections 6B, 7 and 9

 148.80
80015

Psychological therapy health service provided to a person at a place other than consulting rooms (but not as an admitted patient of a hospital) by an eligible clinical psychologist in accordance with the requirements of item 80010

This item is subject to sections 6, 7 and 9

 174.10
80020

Psychological therapy health service provided to a person as part of a group of 6 to 10 patients (but not as an admitted patient of a hospital) by an eligible clinical psychologist if:

   (a)  the person is referred by:

        (i)   a medical practitioner, either as part of a GP Mental Health Treatment Plan, or as part of a shared care plan or as part of a psychiatrist assessment and management plan; or

        (ii)   a specialist or consultant physician specialising in the practice of his or her field of psychiatry; or

       (iii)   a specialist or consultant physician specialising in the practice of his or her field of paediatrics; and

  (b)  the service is provided in person; and

   (c)  the service is at least 60 minutes duration;

This item is subject to sections 6A, 7 and 9

 37.80
80021

Psychological therapy health service provided to a person as part of a group of 6 to 10 patients (but not as an admitted patient of a hospital) by an eligible clinical psychologist if:

   (a)  the person is referred by:

        (i)   a medical practitioner, either as part of a GP Mental Health Treatment Plan, or as part of a shared care plan or as part of a psychiatrist assessment and management plan; or

        (ii)   a specialist or consultant physician specialising in the practice of his or her field of psychiatry; or

       (iii)   a specialist or consultant physician specialising in the practice of his or her field of paediatrics; and

  (b)  the attendance is by video conference; and

   (c)  the patient is not an admitted patient; and

  (d)  the patient is located within a telehealth eligible area; and

   (e)  the patient is, at the time of the attendance, at least 15 kilometres by road from the clinical psychologist; and

   (f)  the service is at least 60 minutes duration

This item is subject to sections 6C, 7 and 9

 37.80
Group M7 – Focussed Psychological Strategies (Allied Mental Health)
80100

Focussed psychological strategies health service provided to a person in consulting rooms (but not as an admitted patient of a hospital) by an eligible psychologist if:

   (a)  the person is referred by:

        (i)   a medical practitioner, either as part of a GP Mental Health Treatment Plan, or as part of a shared care plan or as part of a psychiatrist assessment and management plan; or

        (ii)   a specialist or consultant physician specialising in the practice of his or her field of psychiatry; or

       (iii)   a specialist or consultant physician specialising in the practice of his or her field of paediatrics; and

  (b)  the service is provided to the person individually and in person; and

   (c)  at the completion of a course of treatment, the referring medical practitioner reviews the need for a further course of treatment; and

  (d)  on the completion of the course of treatment, the eligible psychologist gives a written report to the referring medical practitioner on assessments carried out, treatment provided and recommendations on future management of the person’s condition; and

   (e)  the service is at least 20 minutes but less than 50 minutes duration

This item is subject to sections 6, 7 and 9

 71.80
80101

Focussed psychological strategies health service provided to a person (but not as an admitted patient of a hospital) by an eligible psychologist if:

   (a)  the person is referred by:

         (i)   a medical practitioner, either as part of a GP Mental Health Treatment Plan, or as part of a shared care plan or as part of a psychiatrist assessment and management plan; or

        (ii)   a specialist or consultant physician specialising in the practice of his or her field of psychiatry; or

       (iii)   a specialist or consultant physician specialising in the practice of his or her field of paediatrics; and

  (b)  the service is provided to the person individually; and

   (c)  the attendance is by video conference; and

  (d)  the patient is not an admitted patient; and

   (e)  the patient is located within a telehealth eligible area; and

   (f)  the patient is, at the time of the attendance, at least 15 kilometres by road from the psychologist; and

   (g)  at the completion of a course of treatment, the referring medical practitioner reviews the need for a further course of treatment; and

  (h)  on the completion of the course of treatment, the eligible psychologist gives a written report to the referring medical practitioner on assessments carried out, treatment provided and recommendations on future management of the person’s condition; and

   (i)  the service is at least 20 minutes but less than 50 minutes duration

This item is subject to sections 6B, 7 and 9

 71.80
80105

Focussed psychological strategies health service provided to a person at a place other than consulting rooms (but not as an admitted patient of a hospital) by an eligible psychologist in accordance with the requirements of item 80100

This item is subject to sections 6, 7 and 9

 97.70
80110

Focussed psychological strategies health service provided to a person in consulting rooms (but not as an admitted patient of a hospital) by an eligible psychologist if:

   (a)  the person is referred by:

        (i)   a medical practitioner, either as part of a GP Mental Health Treatment Plan, or as part of a shared care plan or as part of a psychiatrist assessment and management plan; or

        (ii)   a specialist or consultant physician specialising in the practice of his or her field of psychiatry; or

       (iii)   a specialist or consultant physician specialising in the practice of his or her field of paediatrics; and

  (b)  the service is provided to the person individually and in person; and

   (c)  at the completion of a course of treatment, the referring medical practitioner reviews the need for a further course of treatment; and

  (d)  on the completion of the course of treatment, the eligible psychologist gives a written report to the referring medical practitioner on assessments carried out, treatment provided and recommendations on future management of the person’s condition; and

   (e)  the service is at least 50 minutes duration

This item is subject to sections 6, 7 and 9

 101.35
80111

Focussed psychological strategies health service provided to a person (but not as an admitted patient of a hospital) by an eligible psychologist if:

   (a)  the person is referred by:

         (i)   a medical practitioner, either as part of a GP Mental Health Treatment Plan, or as part of a shared care plan or as part of a psychiatrist assessment and management plan; or

        (ii)   a specialist or consultant physician specialising in the practice of his or her field of psychiatry; or

       (iii)   a specialist or consultant physician specialising in the practice of his or her field of paediatrics; and

  (b)  the service is provided to the person individually; and

   (c)  the attendance is by video conference; and

  (d)  the patient is not an admitted patient; and

   (e)  the patient is located within a telehealth eligible area; and

   (f)  the patient is, at the time of the attendance, at least 15 kilometres by road from the psychologist; and

   (g)  at the completion of a course of treatment, the referring medical practitioner reviews the need for a further course of treatment; and

  (h)  on the completion of the course of treatment, the eligible psychologist gives a written report to the referring medical practitioner on assessments carried out, treatment provided and recommendations on future management of the person’s condition; and

   (i)  the service is at least 50 minutes duration

This item is subject to sections 6B, 7 and 9

 101.35
80115

Focussed psychological strategies health service provided to a person at a place other than consulting rooms (but not as an admitted patient of a hospital) by an eligible psychologist in accordance with the requirements of item 80110

This item is subject to sections 6, 7 and 9

 127.30
80120

Focussed psychological strategies health service provided to a person as part of a group of 6 to 10 patients (but not as an admitted patient of a hospital) by an eligible psychologist if:

   (a)  the person is referred by:

        (i)   a medical practitioner, either as part of a GP Mental Health Treatment Plan, or as part of a shared care plan or as part of a psychiatrist assessment and management plan; or

        (ii)   a specialist or consultant physician specialising in the practice of his or her field of psychiatry; or

       (iii)   a specialist or consultant physician specialising in the practice of his or her field of paediatrics; and

  (b)  the service is provided in person; and

   (c)  the service is at least 60 minutes duration;

This item is subject to sections 6A, 7 and 9

 25.85
80121

Focussed psychological strategies health service provided to a person as part of a group of 6 to 10 patients (but not as an admitted patient of a hospital) by an eligible psychologist if:

   (a)  the person is referred by:

        (i)   a medical practitioner, either as part of a GP Mental Health Treatment Plan, or as part of a shared care plan or as part of a psychiatrist assessment and management plan; or

        (ii)   a specialist or consultant physician specialising in the practice of his or her field of psychiatry; or

       (iii)   a specialist or consultant physician specialising in the practice of his or her field of paediatrics; and

  (b)  the attendance is by video conference; and

   (c)  the patient is not an admitted patient; and

  (d)  the patient is located within a telehealth eligible area; and

   (e)  the patient is, at the time of the attendance, at least 15 kilometres by road from the psychologist; and

   (f)  the service is at least 60 minutes duration

This item is subject to sections 6C, 7 and 9

 25.85
80125

Focussed psychological strategies health service provided to a person in consulting rooms (but not as an admitted patient of a hospital) by an eligible occupational therapist if:

   (a)  the person is referred by:

        (i)   a medical practitioner, either as part of a GP Mental Health Treatment Plan, or as part of a shared care plan or as part of a psychiatrist assessment and management plan; or

        (ii)   a specialist or consultant physician specialising in the practice of his or her field of psychiatry; or

       (iii)   a specialist or consultant physician specialising in the practice of his or her field of paediatrics; and

  (b)  the service is provided to the person individually and in person; and

   (c)  at the completion of a course of treatment, the referring medical practitioner reviews the need for a further course of treatment; and

  (d)  on the completion of the course of treatment, the eligible occupational therapist gives a written report to the referring medical practitioner on assessments carried out, treatment provided and recommendations on future management of the person’s condition; and

   (e)  the service is at least 20 minutes but less than 50 minutes duration

This item is subject to sections 6, 7 and 9

 63.25
80126

Focussed psychological strategies health service provided to a person (but not as an admitted patient of a hospital) by an eligible occupational therapist if:

   (a)  the person is referred by:

        (i)   a medical practitioner, either as part of a GP Mental Health Treatment Plan, or as part of a shared care plan or as part of a psychiatrist assessment and management plan; or

        (ii)   a specialist or consultant physician specialising in the practice of his or her field of psychiatry; or

       (iii)   a specialist or consultant physician specialising in the practice of his or her field of paediatrics; and

  (b)  the service is provided to the person individually; and

   (c)  the attendance is by video conference; and

  (d)  the patient is not an admitted patient; and

   (e)  the patient is located within a telehealth eligible area; and

   (f)  the patient is, at the time of the attendance, at least 15 kilometres by road from the occupational therapist; and

   (g)  at the completion of a course of treatment, the referring medical practitioner reviews the need for a further course of treatment; and

  (h)  on the completion of the course of treatment, the eligible occupational therapist gives a written report to the referring medical practitioner on assessments carried out, treatment provided and recommendations on future management of the person’s condition; and

   (i)  the service is at least 20 minutes but less than 50 minutes duration

This item is subject to sections 6B, 7 and 9

 63.25
80130

Focussed psychological strategies health service provided to a person at a place other than consulting rooms (but not as an admitted patient of a hospital) by an eligible occupational therapist in accordance with the requirements of item 80125

This item is subject to sections 6, 7 and 9

 89.10
80135

Focussed psychological strategies health service provided to a person in consulting rooms (but not as an admitted patient of a hospital) by an eligible occupational therapist if:

   (a)  the person is referred by:

        (i)   a medical practitioner, either as part of a GP Mental Health Treatment Plan, or as part of a shared care plan or as part of a psychiatrist assessment and management plan; or

        (ii)   a specialist or consultant physician specialising in the practice of his or her field of psychiatry; or

       (iii)   a specialist or consultant physician specialising in the practice of his or her field of paediatrics; and

  (b)  the service is provided to the person individually and in person; and

   (c)  at the completion of a course of treatment, the referring medical practitioner reviews the need for a further course of treatment; and

  (d)  on the completion of the course of treatment, the eligible occupational therapist gives a written report to the referring medical practitioner on assessments carried out, treatment provided and recommendations on future management of the person’s condition; and

   (e)  the service is at least 50 minutes duration

This item is subject to sections 6, 7 and 9

 89.35
80136

Focussed psychological strategies health service provided to a person (but not as an admitted patient of a hospital) by an eligible occupational therapist if:

   (a)  the person is referred by:

        (i)   a medical practitioner, either as part of a GP Mental Health Treatment Plan, or as part of a shared care plan or as part of a psychiatrist assessment and management plan; or

        (ii)   a specialist or consultant physician specialising in the practice of his or her field of psychiatry; or

       (iii)   a specialist or consultant physician specialising in the practice of his or her field of paediatrics; and

  (b)  the service is provided to the person individually; and

   (c)  the attendance is by video conference; and

  (d)  the patient is not an admitted patient; and

   (e)  the patient is located within a telehealth eligible area; and

   (f)  the patient is, at the time of the attendance, at least 15 kilometres by road from the occupational therapist; and

   (g)  at the completion of a course of treatment, the referring medical practitioner reviews the need for a further course of treatment; and

  (h)  on the completion of the course of treatment, the eligible occupational therapist gives a written report to the referring medical practitioner on assessments carried out, treatment provided and recommendations on future management of the person’s condition; and

   (i)  the service is at least 50 minutes duration

This item is subject to sections 6B, 7 and 9

 89.35
80140

Focussed psychological strategies health service provided to a person at a place other than consulting rooms (but not as an admitted patient of a hospital) by an eligible occupational therapist in accordance with the requirements of item 80135

This item is subject to sections 6, 7 and 9

 115.15
80145

Focussed psychological strategies health service provided to a person as part of a group of 6 to 10 patients (but not as an admitted patient of a hospital) by an eligible occupational therapist if:

   (a)  the person is referred by:

        (i)   a medical practitioner, either as part of a GP Mental Health Treatment Plan, or as part of a shared care plan or as part of a psychiatrist assessment and management plan; or

        (ii)   a specialist or consultant physician specialising in the practice of his or her field of psychiatry; or

       (iii)   a specialist or consultant physician specialising in the practice of his or her field of paediatrics; and

  (b)  the service is provided in person; and

   (c)  the service is at least 60 minutes duration;

This item is subject to sections 6A, 7 and 9

 22.70
80146

Focussed psychological strategies health service provided to a person as part of a group of 6 to 10 patients (but not as an admitted patient of a hospital) by an eligible occupational therapist if:

   (a)  the person is referred by:

        (i)   a medical practitioner, either as part of a GP Mental Health Treatment Plan, or as part of a shared care plan or as part of a psychiatrist assessment and management plan; or

        (ii)   a specialist or consultant physician specialising in the practice of his or her field of psychiatry; or

       (iii)   a specialist or consultant physician specialising in the practice of his or her field of paediatrics; and

  (b)  the attendance is by video conference; and

   (c)  the patient is not an admitted patient; and

  (d)  the patient is located within a telehealth eligible area; and

   (e)  the patient is, at the time of the attendance, at least 15 kilometres by road from the occupational therapist; and

   (f)  the service is at least 60 minutes duration

This item is subject to sections 6C, 7 and 9

 22.70
80150

Focussed psychological strategies health service provided to a person in consulting rooms (but not as an admitted patient of a hospital) by an eligible social worker if:

   (a)  the person is referred by:

        (i)   a medical practitioner, either as part of a GP Mental Health Treatment Plan, or as part of a shared care plan or as part of a psychiatrist assessment and management plan; or

        (ii)   a specialist or consultant physician specialising in the practice of his or her field of psychiatry; or

       (iii)   a specialist or consultant physician specialising in the practice of his or her field of paediatrics; and

  (b)  the service is provided to the person individually and in person; and

   (c)  at the completion of a course of treatment, the referring medical practitioner reviews the need for a further course of treatment; and

 63.25

  (d)  on the completion of the course of treatment, the eligible social worker gives a written report to the referring medical practitioner on assessments carried out, treatment provided and recommendations on future management of the person’s condition; and

   (e)  the service is at least 20 minutes but less than 50 minutes duration

This item is subject to sections 6, 7 and 9
80151

Focussed psychological strategies health service provided to a person (but not as an admitted patient of a hospital) by an eligible social worker if:

   (a)  the person is referred by:

        (i)   a medical practitioner, either as part of a GP Mental Health Treatment Plan, or as part of a shared care plan or as part of a psychiatrist assessment and management plan; or

        (ii)   a specialist or consultant physician specialising in the practice of his or her field of psychiatry; or

       (iii)   a specialist or consultant physician specialising in the practice of his or her field of paediatrics; and

  (b)  the service is provided to the person individually; and

   (c)  the attendance is by video conference; and

  (d)  the patient is not an admitted patient; and

   (e)  the patient is located within a telehealth eligible area; and

   (f)  the patient is, at the time of the attendance, at least 15 kilometres by road from the social worker; and

   (g)  at the completion of a course of treatment, the referring medical practitioner reviews the need for a further course of treatment; and

  (h)  on the completion of the course of treatment, the eligible social worker gives a written report to the referring medical practitioner on assessments carried out, treatment provided and recommendations on future management of the person’s condition; and

   (i)  the service is at least 20 minutes but less than 50 minutes duration

This item is subject to sections 6B, 7 and 9

 63.25
80155

Focussed psychological strategies health service provided to a person at a place other than consulting rooms (but not as an admitted patient of a hospital) by an eligible social worker in accordance with the requirements of item 80150

This item is subject to sections 6, 7 and 9

 89.10
80160

Focussed psychological strategies health service provided to a person in consulting rooms (but not as an admitted patient of a hospital) by an eligible social worker if:

   (a)  the person is referred by:

        (i)   a medical practitioner, either as part of a GP Mental Health Treatment Plan, or as part of a shared care plan or as part of a psychiatrist assessment and management plan; or

        (ii)   a specialist or consultant physician specialising in the practice of his or her field of psychiatry; or

       (iii)   a specialist or consultant physician specialising in the practice of his or her field of paediatrics; and

  (b)  the service is provided to the person individually and in person; and

   (c)  at the completion of a course of treatment, the referring medical practitioner reviews the need for a further course of treatment; and

  (d)  on the completion of the course of treatment, the eligible social worker gives a written report to the referring medical practitioner on assessments carried out, treatment provided and recommendations on future management of the person’s condition; and

   (e)  the service is at least 50 minutes duration

This item is subject to sections 6, 7 and 9

 89.35
80161

Focussed psychological strategies health service provided to a person (but not as an admitted patient of a hospital) by an eligible social worker if:

   (a)  the person is referred by:

        (i)   a medical practitioner, either as part of a GP Mental Health Treatment Plan, or as part of a shared care plan or as part of a psychiatrist assessment and management plan; or

        (ii)   a specialist or consultant physician specialising in the practice of his or her field of psychiatry; or

       (iii)   a specialist or consultant physician specialising in the practice of his or her field of paediatrics; and

  (b)  the service is provided to the person individually; and

   (c)  the attendance is by video conference; and

  (d)  the patient is not an admitted patient; and

   (e)  the patient is located within a telehealth eligible area; and

   (f)  the patient is, at the time of the attendance, at least 15 kilometres by road from the social worker; and

   (g)  at the completion of a course of treatment, the referring medical practitioner reviews the need for a further course of treatment; and

  (h)  on the completion of the course of treatment, the eligible social worker gives a written report to the referring medical practitioner on assessments carried out, treatment provided and recommendations on future management of the person’s condition; and

   (i)  the service is at least 50 minutes duration

This item is subject to sections 6B, 7 and 9

 89.35
80165

Focussed psychological strategies health service provided to a person at a place other than consulting rooms (but not as an admitted patient of a hospital) by an eligible social worker in accordance with the requirements of item 80160

This item is subject to sections 6, 7 and 9

 115.15
80170

Focussed psychological strategies health service provided to a person as part of a group of 6 to 10 patients (but not as an admitted patient of a hospital) by an eligible social worker if:

   (a)  the person is referred by:

        (i)   a medical practitioner, either as part of a GP Mental Health Treatment Plan, or as part of a shared care plan or as part of a psychiatrist assessment and management plan; or

        (ii)   a specialist or consultant physician specialising in the practice of his or her field of psychiatry; or

       (iii)   a specialist or consultant physician specialising in the practice of his or her field of paediatrics; and

  (b)  the service is provided in person; and

   (c)  the service is at least 60 minutes duration;

This item is subject to sections 6A, 7 and 9

 22.70
80171

Focussed psychological strategies health service provided to a person as part of a group of 6 to 10 patients (but not as an admitted patient of a hospital) by an eligible social worker if:

   (a)  the person is referred by:

        (i)   a medical practitioner, either as part of a GP Mental Health Treatment Plan, or as part of a shared care plan or as part of a psychiatrist assessment and management plan; or

        (ii)   a specialist or consultant physician specialising in the practice of his or her field of psychiatry; or

       (iii)   a specialist or consultant physician specialising in the practice of his or her field of paediatrics; and

  (b)  the attendance is by video conference; and

   (c)  the patient is not an admitted patient; and

  (d)  the patient is located within a telehealth eligible area; and

   (e)  the patient is, at the time of the attendance, at least 15 kilometres by road from the eligible social; and

   (f)  the service is at least 60 minutes duration

This item is subject to sections 6C, 7 and 9

 22.70

  1. Part 3 of Schedule 2 (below the heading)

Repeal the table, substitute:

Group M8 – Pregnancy support counselling
Item Service Fee($)
81000

Non‑directive pregnancy support counselling health service provided to a person, who is currently pregnant or who has been pregnant in the preceding 12 months, (but not as an admitted patient of a hospital) by an eligible psychologist if:

   (a)  the person is concerned about a current pregnancy or a pregnancy that occurred in the 12 months preceding the provision of the first service; and

  (b)  the person is referred by a medical practitioner who is not a specialist or consultant physician; and

(ba)  the service is provided to the person individually and in person; and

   (c)  the eligible psychologist does not have a direct pecuniary interest in a health service that has as its primary purpose the provision of services for pregnancy termination; and

  (d)  the service is at least 30 minutes duration;

to a maximum of 3 services (including services to which items 81000, 81005, 81010 and 4001* apply) for each pregnancy

The service may be used to address any pregnancy related issues for which non‑directive counselling is appropriate

This item is subject to section 9

[* in the general medical services table]

[** in the Health Insurance (Section 3C General Medical Services – Other Medical Practitioner) Determination 2018]

 74.30
81005

Non‑directive pregnancy support counselling health service provided to a person, who is currently pregnant or who has been pregnant in the preceding 12 months, (but not as an admitted patient of a hospital) by an eligible social worker if:

   (a)  the person is concerned about a current pregnancy or a pregnancy that occurred in the 12 months preceding the provision of the first service; and

  (b)  the person is referred by a medical practitioner who is not a specialist or consultant physician; and

(ba)  the service is provided to the person individually and in person; and

   (c)  the eligible social worker does not have a direct pecuniary interest in a health service that has as its primary purpose the provision of services for pregnancy termination; and

  (d)  the service is at least 30 minutes duration;

to a maximum of 3 services (including services to which items 81000, 81005, 81010 and 4001* apply) for each pregnancy

The service may be used to address any pregnancy related issues for which non‑directive counselling is appropriate

This item is subject to section 9

[* in the general medical services table]

[** in the Health Insurance (Section 3C General Medical Services – Other Medical Practitioner) Determination 2018]

 74.30
81010

Non‑directive pregnancy support counselling health service provided to a person, who is currently pregnant or who has been pregnant in the preceding 12 months, (but not as an admitted patient of a hospital) by an eligible mental health nurse if:

   (a)  the person is concerned about a current pregnancy or a pregnancy that occurred in the 12 months preceding the provision of the first service; and

  (b)  the person is referred by a medical practitioner who is not a specialist or consultant physician; and

(ba)  the service is provided to the person individually and in person; and

   (c)  the eligible mental health nurse does not have a direct pecuniary interest in a health service that has as its primary purpose the provision of services for pregnancy termination; and

  (d)  the service is at least 30 minutes duration;

to a maximum of 3 services (including services to which items 81000, 81005, 81010, 4001* and 792 ** apply) for each pregnancy

The service may be used to address any pregnancy related issues for which non‑directive counselling is appropriate

This item is subject to section 9

[* in the general medical services table]

[** in the Health Insurance (Section 3C General Medical Services – Other Medical Practitioner) Determination 2018]

 74.30

  1. Division 4.1, Part 4 of Schedule 2 (below the heading)

Repeal the table, substitute:

Group M9 – Allied health group services
Item Service Fee($)
81100

Diabetes education health service provided to a person by an eligible diabetes educator for assessing the person’s suitability for group services for the management of type 2 diabetes, including taking a comprehensive patient history, identifying an appropriate group services program based on the patient’s needs and preparing the person for the group services if:

(a)   the person has type 2 diabetes; and

(b)   the person is being managed by a medical practitioner (including a general practitioner, but not a specialist or consultant physician) under a shared care plan or a GP Management Plan or, if the person is a resident of an aged care facility, the person’s medical practitioner has contributed to a multidisciplinary care plan; and

(c)   the person is referred to an eligible diabetes educator by the medical practitioner using a referral form that has been issued by the Department, or a referral form that contains all the components of the form issued by the Department; and

(d)   the person is not an admitted patient of a hospital; and

(e)   the service is provided to the person individually and in person; and

(f)   the service is of at least 45 minutes duration; and

(g)   after the service, the eligible diabetes educator gives a written report to the referring medical practitioner mentioned in paragraph (c);

payable once in a calendar year for this or any other assessment for group services item (including services in items 81100, 81110 and 81120)

This item is subject to section 9

 81.15
81105

Diabetes education health service provided to a person by an eligible diabetes educator, as a group service for the management of type 2 diabetes if:

(a)   the person has been assessed as suitable for a type 2 diabetes group service under assessment item 81100, 81110 or 81120; and

(b)   the service is provided to a person who is part of a group of between 2 and 12 patients; and

(c)   the person is not an admitted patient of a hospital; and

(d)   the service is provided in person; and

(e)   the service is of at least 60 minutes duration; and

 20.20
(f)   after the last service in the group services program provided to the person under item 81105, 81115 or 81125, the eligible diabetes educator prepares, or contributes to, a written report to be provided to the referring medical practitioner; and

(g)   an attendance record for the group is maintained by the eligible diabetes educator;

to a maximum of 8 group services in a calendar year (including services in items 81105, 81115 and 81125)

This item is subject to section 9

  1. Division 4.2, Part 4 of Schedule 2 (below the heading)

Repeal the table, substitute:

Group M9 – Allied health group services
Item Service Fee($)
81110

Exercise physiology health service provided to a person by an eligible exercise physiologist for assessing the person’s suitability for group services for the management of type 2 diabetes, including taking a comprehensive patient history, identifying an appropriate group services program based on the patient’s needs and preparing the person for the group services if:

(a)   the person has type 2 diabetes; and

(b)   the person is being managed by a medical practitioner (including a general practitioner, but not a specialist or consultant physician) under a shared care plan or a GP Management Plan or, if the person is a resident of an aged care facility, the person’s medical practitioner has contributed to a multidisciplinary care plan; and

(c)   the person is referred to an eligible exercise physiologist by the medical practitioner using a referral form that has been issued by the Department, or a referral form that contains all the components of the form issued by the Department; and

(d)   the person is not an admitted patient of a hospital; and

(e)   the service is provided to the person individually and in person; and

(f)   the service is of at least 45 minutes duration; and

(g)   after the service, the eligible exercise physiologist gives a
written report to the referring medical practitioner mentioned
in paragraph (c);

payable once in a calendar year for this or any other assessment for group services item (including services in items 81100, 81110 and 81120)

This item is subject to section 9

 81.15
81115

Exercise physiology health service provided to a person by an eligible exercise physiologist, as a group service for the management of type 2 diabetes if:

(a)   the person has been assessed as suitable for a type 2 diabetes group service under assessment item 81100, 81110 or 81120; and

(b)   the service is provided to a person who is part of a group of between 2 and 12 patients; and

(c)   the person is not an admitted patient of a hospital; and

(d)   the service is provided in person; and

(e)   the service is of at least 60 minutes duration; and

(f)   after the last service in the group services program provided to the person under item 81105, 81115 or 81125, the eligible exercise physiologist prepares, or contributes to, a written report to be provided to the referring medical practitioner; and

(g)   an attendance record for the group is maintained by the eligible exercise physiologist;

to a maximum of 8 group services in a calendar year (including services in items 81105, 81115 and 81125)

This item is subject to section 9

 20.20

  1. Division 4.3, Part 4 of Schedule 2 (below the heading)

Repeal the table, substitute:

Group M9 – Allied health group services
Item Service Fee($)
81120

Dietetics health service provided to a person by an eligible dietician for assessing the person’s suitability for group services for the management of type 2 diabetes, including taking a comprehensive patient history, identifying an appropriate group services program based on the patient’s needs and preparing the person for the group services if:

(a)   the person has type 2 diabetes; and

(b)   the person is being managed by a medical practitioner (including a general practitioner, but not a specialist or consultant physician) under a shared care plan or a GP Management Plan or, if the person is a resident of an aged care facility, the person’s medical practitioner has contributed to a multidisciplinary care plan; and

(c)   the person is referred to an eligible dietician by the medical practitioner using a referral form that has been issued by the Department, or a referral form that contains all the components of the form issued by the Department; and

(d)   the person is not an admitted patient of a hospital; and

(e)   the service is provided to the person individually and in person; and

(f)   the service is of at least 45 minutes duration; and

(g)   after the service, the eligible dietician gives a written report to the referring medical practitioner mentioned in paragraph (c);

payable once in a calendar year for this or any other assessment for group services item (including services in items 81100, 81110 and 81120)

This item is subject to section 9

 81.15
81125

Dietetics health service provided to a person by an eligible dietician, as a group service for the management of type 2 diabetes if:

(a)   the person has been assessed as suitable for a type 2 diabetes group service under assessment item 81100, 81110 or 81120; and

(b)   the service is provided to a person who is part of a group of between 2 and 12 patients; and

(c)   the person is not an admitted patient of a hospital; and

(d)   the service is provided in person; and

(e)   the service is of at least 60 minutes duration; and

(f)   after the last service in the group services program provided to the person under item 81105, 81115 or 81125, the eligible dietician prepares, or contributes to, a written report to be provided to the referring medical practitioner; and

(g)   an attendance record for the group is maintained by the eligible dietician;

to a maximum of 8 group services in a calendar year (including services to which items 81105, 81115 and 81125 apply)

This item is subject to section 9

 20.20

  1. Part 5 of Schedule 2 (below the heading)

Repeal the table, substitute:

Group M10 – Autism, pervasive developmental disorder and disability services
Item Service Fee($)
82000

Psychology health service provided to a child aged under 13 years by an eligible psychologist if:

(a)   the child was referred to the eligible psychologist by an eligible practitioner:

         (i)   to assist with the diagnosis of the child by the practitioner; or

        (ii)   to contribute to the child’s PDD or disability treatment and management plan, developed by the practitioner; and

  (b)  the eligible practitioner is:

(i)    for a child with PDD, a consultant physician specialising in the practice of his or her field of psychiatry or paediatrics; or

(ii)   for a child with disability, a specialist or consultant physician practising in his or her specialty, or a general practitioner; and

   (c)  the eligible psychologist attending the child is registered with the Department of Human Services as meeting the credentialing requirements for the provision of that service; and

  (d)  the child is not an admitted patient of a hospital; and

   (e)  the service is provided to the child individually and in person; and

   (f)  the service is at least 50 minutes duration;

to a maximum of 4 services (including services to which this item or items 82005, 82010 and 82030 apply)

Up to 4 services may be provided to the same child on the same day

This item is subject to sections 8, 8A, 9 and 9A

 101.35
82005

Speech pathology health service provided to a child aged under 13 years by an eligible speech pathologist if:

   (a)  the child was referred to the eligible speech pathologist by an eligible practitioner:

         (i)   to assist with the diagnosis of the child by the practitioner: or

        (ii)   to contribute to the child’s PDD or disability treatment and management plan, developed by the practitioner; and

  (b)  the eligible practitioner is:

(i)    for a child with PDD, a consultant physician specialising in the practice of his or her field of psychiatry or paediatrics;

(ii)   for a child with disability, a specialist or consultant physician practising in his or her specialty, or a general practitioner; and

   (c)  the eligible speech pathologist attending the child is registered with the Department of Human Services as meeting the credentialing requirements for the provision of that service; and

  (d)  the child is not an admitted patient of a hospital; and

   (e)  the service is provided to the child individually and in person; and

 89.35

   (f)  the service is at least 50 minutes duration;

to a maximum of 4 services (including services to which this item or items 82000, 82010 and 82030 apply)

Up to 4 services may be provided to the same child on the same day

This item is subject to sections 8, 8A, 9 and 9A
82010

Occupational therapy health service provided to a child aged under 13 years by an eligible occupational therapist if:

   (a)  the child was referred to the eligible occupational therapist by an eligible practitioner:

         (i)   to assist with the diagnosis of the child by the practitioner: or

        (ii)   to contribute to the child’s PDD or disability treatment and management plan, developed by the practitioner; and

  (b)  the eligible practitioner is:

(i)    for a child with PDD, a consultant physician specialising in the practice of his or her field of psychiatry or paediatrics;

(ii)   for a child with disability, a specialist or consultant physician practising in his or her field of specialty, or a general practitioner; and

   (c)  the eligible occupational therapist attending the child is registered with the Department of Human Services as meeting the credentialing requirements for the provision of that service; and

  (d)  the child is not an admitted patient of a hospital; and

   (e)  the service is provided to the child individually and in person; and

   (f)  the service is at least 50 minutes duration;

to a maximum of 4 services (including services to which this item or items 82000, 82005 and 82030 apply)

Up to 4 services may be provided to the same child on the same day

This item is subject to sections 8, 8A, 9 and 9A

 89.35
82015

Psychology health service provided to a child aged under 15 years for treatment of a pervasive developmental disorder (PDD) or eligible disability by an eligible psychologist, if:

   (a)  the child has been diagnosed with a PDD or an eligible disability; and

  (b)  the child, while aged under 13 years, received a PDD or disability treatment and management plan as prepared by the eligible practitioner; and

   (c)  the child was referred by an eligible practitioner for services consistent with the child’s PDD or disability treatment and management plan; and

  (d)  the eligible practitioner is:

(i)    for a child with PDD, a consultant physician specialising in the practice of his or her field of psychiatry or paediatrics;

(ii)   for a child with disability, a specialist or consultant physician practising in his or her field of specialty, or a general practitioner; and

   (e)  the eligible psychologist attending the child is registered with the Department of Human Services as meeting the credentialing requirements for the provision of those services; and

   (f)     on the completion of the course of treatment, the eligible psychologist gives a written report to the referring eligible practitioner on assessments carried out, treatment provided and recommendations on future management of the child’s condition; and

   (g)  the eligible practitioner is:

(i)      for a child with PDD, a consultant physician specialising in the practice of his or her field of psychiatry or paediatrics;

(ii)     for a child with disability, a specialist or consultant physician practising in his or her specialty, or a general practitioner; and

  (h)  the child is not an admitted patient of a hospital; and

   (i)  the service is provided to the child individually and in person; and

   (j)  the service is at least 30 minutes duration;

to a maximum of 20 services (including services to which this item or items 82020, 82025 and 82035 apply)

Up to 4 services may be provided to the same child on the same day

This item is subject to sections 8, 8A and 9

 101.35
82020

Speech pathology health service provided to a child aged under 15 years for treatment of a pervasive developmental disorder (PDD) or eligible disability by an eligible speech pathologist, if:

   (a)  the child has been diagnosed with a PDD or an eligible disability; and

  (b)  the child, while aged under 13 years, received a PDD or disability treatment and management plan as prepared by the eligible practitioner; and

   (c)  the child was referred by an eligible practitioner for services consistent with the child’s PDD or disability treatment and management plan; and

  (d)  the eligible practitioner is:

(i)    for a child with PDD, a consultant physician specialising in the practice of his or her field of psychiatry or paediatrics;

(ii)   for a child with disability, a specialist or consultant physician practising in his or her specialty, or a general practitioner; and

   (e)  the eligible speech pathologist attending the child is registered with the Department of Human Services as meeting the credentialing requirements for the provision of those services; and

   (f)  on the completion of the course of treatment, the eligible speech pathologist gives a written report to the referring eligible practitioner on assessments carried out, treatment provided and recommendations on future management of the child’s condition; and

   (g)  the child is not an admitted patient of a hospital; and

  (h)  the service is provided to the child individually and in person; and

   (i)  the service is at least 30 minutes duration;

to a maximum of 20 services (including services to which this item or items 82015, 82025 and 82035 apply)

Up to 4 services may be provided to the same child on the same day

This item is subject to sections 8, 8A and 9

 89.35
82025

Occupational therapy health service provided to a child aged under 15 years for treatment of a pervasive developmental disorder (PDD) or eligible disability by an eligible occupational therapist if:

   (a)  the child has been diagnosed with a PDD or an eligible disability; and

  (b)  the child, while aged under 13 years, received a PDD or disability treatment and management plan as prepared by the eligible practitioner; and

   (c)  the child was referred by an eligible practitioner for services consistent with the child’s PDD or disability treatment and management plan; and

  (d)  the eligible practitioner is:

(i)    for a child with PDD, a consultant physician specialising in the practice of his or her field of psychiatry or paediatrics;

(ii)   for a child with disability, a specialist or consultant physician practising in his or her specialty, or a general practitioner; and

   (e)  the eligible occupational therapist attending the child is registered with the Department of Human Services as meeting the credentialing requirements for the provision of those services; and

   (f)  on the completion of the course of treatment, the eligible occupational therapist gives a written report to the referring eligible practitioner on assessments carried out, treatment provided and recommendations on future management of the child’s condition; and

 89.35

   (g)  the child is not an admitted patient of a hospital; and

  (h)  the service is provided to the child individually and in person; and

   (i)  the service is at least 30 minutes duration;

to a maximum of 20 services (including services to which this item or items 82015, 82020 and 82035 apply)

Up to 4 services may be provided to the same child on the same day

This item is subject to sections 8, 8A and 9
82030

Audiology, optometry, orthoptic or physiotherapy health service provided to a child aged under 13 years by an eligible audiologist, optometrist, orthoptist or physiotherapist if:

   (a)  the child was referred to the eligible audiologist, optometrist, orthoptist or physiotherapist by an eligible practitioner:

         (i)   to assist with the diagnosis of the child by the practitioner; or

        (ii)   to contribute to the child’s PDD or disability treatment and management plan, developed by the practitioner; and

  (b)  the eligible practitioner is:

(i)    for a child with PDD, a consultant physician specialising in the practice of his or her field of psychiatry or paediatrics;

(ii)   for a child with disability, a specialist or consultant physician practising in his or her specialty, or a general practitioner; and

   (c)  the eligible audiologist, optometrist, orthoptist or physiotherapist attending the child is registered with the Department of Human Services as meeting the credentialing requirements for the provision of that service; and

  (d)  the child is not an admitted patient of a hospital; and

 89.35

   (e)  the service is provided to the child individually and in person; and

   (f)  the service is at least 50 minutes duration;

to a maximum of 4 services (including services to which this item or items 82000, 82005 and 82010 apply)

Up to 4 services may be provided to the same child on the same day

This item is subject to sections 8, 8A, 9 and 9A
82035

Audiology, optometry, orthoptic or physiotherapy health service provided to a child aged under 15 years for treatment of a pervasive developmental disorder (PDD) or eligible disability by an eligible audiologist, optometrist, orthoptist or physiotherapist, if:

   (a)  the child has been diagnosed with a PDD or an eligible disability; and

  (b)  the child, while aged under 13 years, received a PDD or disability treatment and management plan as prepared by the eligible practitioner; and

   (c)  the child was referred by an eligible practitioner for services consistent with the child’s PDD or disability treatment and management plan; and

  (d)  the eligible practitioner is:

(i)    for a child with PDD, a consultant physician specialising in the practice of his or her field of psychiatry or paediatrics;

(ii)   for a child with disability, a specialist or consultant physician practising in his or her specialty, or a general practitioner; and

   (e)  the eligible audiologist, optometrist, orthoptist or physiotherapist attending the child is registered with the Department of Human Services as meeting the credentialing requirements for the provision of those services; and

   (f)  on the completion of the course of treatment, the eligible audiologist, optometrist, orthoptist or physiotherapist gives a written report to the referring eligible practitioner on assessments carried out, treatment provided and recommendations on future management of the child’s condition; and

   (g)  the child is not an admitted patient of a hospital; and

  (h)  the service is provided to the child individually and in person; and

   (i)  the service is at least 30 minutes duration;

to a maximum of 20 services (including services to which this item or items 82015, 82020 and 82025 apply)

Up to 4 services may be provided to the same child on the same day

This item is subject to sections 8, 8A and 9 

89.35

  1. Part 6 of Schedule 2 (below the heading)

Repeal the table, substitute:

Group M11 – Allied health services for Indigenous Australians who have had a health check
Item Service Fee($)
81300

Aboriginal and Torres Strait Islander health service provided to a person of Aboriginal or Torres Strait Islander descent by an eligible Aboriginal health worker or eligible Aboriginal and Torres Strait Islander health practitioner if:

   (a)  either:

(i)      a medical practitioner has undertaken a health assessment and identified a need for follow-up allied health services; or

(ii)     the person’s shared care plan identifies the need for follow-up allied health services; and

  (b)  the person is referred to the eligible Aboriginal health worker or eligible Aboriginal and Torres Strait Islander health practitioner by a medical practitioner using a referral form issued by the Department or a referral form that contains all the components of the form issued by the Department; and

   (c)  the person is not an admitted patient of a hospital; and

  (d)  the service is provided to the person individually and in person; and

   (e)  the service is of at least 20 minutes duration; and

   (f)  after the service, the eligible Aboriginal health worker or eligible Aboriginal and Torres Strait Islander health practitioner gives a written report to the referring medical practitioner mentioned in paragraph (b):

(i)      if the service is the only service under the referral—in relation to that service; or

(ii)     if the service is the first or the last service under the referral—in relation to that service; or

(iii)    if neither subparagraph (i) nor (ii) applies but the service involves matters that the referring medical practitioner would reasonably expect to be informed of—in relation to those matters;

to a maximum of 5 services (including any services to which this item or any other item in Part 6 of this Schedule applies) in a calendar year

This item is subject to section 9

 63.25
81305

Diabetes education health service provided to a person who is of Aboriginal or Torres Strait Islander descent by an eligible diabetes educator if:

   (a)  either:

(i)      a medical practitioner has undertaken a health assessment and identified a need for follow-up allied health services; or

(ii)     the person’s shared care plan identifies the need for follow-up allied health services; and

  (b)  the person is referred to the eligible diabetes educator by a medical practitioner using a referral form issued by the Department or a referral form that contains all the components of the form issued by the Department; and

   (c)  the person is not an admitted patient of a hospital; and

  (d)  the service is provided to the person individually and in person; and

   (e)  the service is of at least 20 minutes duration; and

 63.25

   (f)  after the service, the eligible diabetes educator gives a written report to the referring medical practitioner mentioned in paragraph (b):

(i)      if the service is the only service under the referral—in relation to that service; or

(ii)     if the service is the first or the last service under the referral—in relation to that service; or

(iii)    if neither subparagraph (i) nor (ii) applies but the service involves matters that the referring medical practitioner would reasonably expect to be informed of—in relation to those matters;

to a maximum of 5 services (including any services to which this item or any other item in Part 6 of this Schedule applies) in a calendar year

This item is subject to section 9
81310

Audiology health service provided to a person who is of Aboriginal or Torres Strait Islander descent by an eligible audiologist if:

   (a)  either:

(i)      a medical practitioner has undertaken a health assessment and identified a need for follow-up allied health services; or

(ii)     the person’s shared care plan identifies the need for follow-up allied health services; and      (b)     the person is referred to the eligible audiologist by a medical practitioner using a referral form issued by the Department or a referral form that contains all the components of the form issued by the Department; and

   (c)  the person is not an admitted patient of a hospital; and

  (d)  the service is provided to the person individually and in person; and

   (e)  the service is of at least 20 minutes duration; and

   (f)  after the service, the eligible audiologist gives a written report to the referring medical practitioner mentioned in paragraph (b):

(i)      if the service is the only service under the referral—in relation to that service; or

(ii)     if the service is the first or the last service under the referral—in relation to that service; or

(iii)    if neither subparagraph (i) nor (ii) applies but the service involves matters that the referring medical practitioner would reasonably expect to be informed of—in relation to those matters;

to a maximum of 5 services (including any services to which this item or any other item in Part 6 of this Schedule applies) in a calendar year

This item is subject to section 9

 63.25
81315

Exercise physiology health service provided to a person who is of Aboriginal or Torres Strait Islander descent by an eligible exercise physiologist if:

   (a)  either:

(i)      a medical practitioner has undertaken a health assessment and identified a need for follow-up allied health services; or

(ii)     the person’s shared care plan identifies the need for follow-up allied health services; and

  (b)  the person is referred to the eligible exercise physiologist by a medical practitioner using a referral form issued by the Department or a referral form that contains all the components of the form issued by the Department; and

   (c)  the person is not an admitted patient of a hospital; and

  (d)  the service is provided to the person individually and in person; and

   (e)  the service is of at least 20 minutes duration; and

   (f)  after the service, the eligible exercise physiologist gives a written report to the referring medical practitioner mentioned in paragraph (b):

(i)      if the service is the only service under the referral—in relation to that service; or

(ii)     if the service is the first or the last service under the referral—in relation to that service; or

(iii)    if neither subparagraph (i) nor (ii) applies but the service involves matters that the referring medical practitioner would reasonably expect to be informed of—in relation to those matters;

to a maximum of 5 services (including any services to which this item or any other item in Part 6 of this Schedule applies) in a calendar year

This item is subject to section 9

 63.25
81320

Dietetics health service provided to a person who is of Aboriginal or Torres Strait Islander descent by an eligible dietician if:

   (a)  either:

(i)      a medical practitioner has undertaken a health assessment and identified a need for follow-up allied health services; or

(ii)     the person’s shared care plan identifies the need for follow-up allied health services; and

  (b)  the person is referred to the eligible dietician by a medical practitioner using a referral form issued by the Department or a referral form that contains all the components of the form issued by the Department; and

   (c)  the person is not an admitted patient of a hospital; and

  (d)  the service is provided to the person individually and in person; and

   (e)  the service is of at least 20 minutes duration; and

   (f)  after the service, the eligible dietician gives a written report to the referring medical practitioner mentioned in paragraph (b):

(i)      if the service is the only service under the referral—in relation to that service; or

(ii)     if the service is the first or the last service under the referral—in relation to that service; or

(iii)    if neither subparagraph (i) nor (ii) applies but the service involves matters that the referring medical practitioner would reasonably expect to be informed of—in relation to those matters;

to a maximum of 5 services (including any services to which this item or any other item in Part 6 of this Schedule applies) in a calendar year

This item is subject to section 9

 63.25
81325

Mental health service provided to a person who is of Aboriginal or Torres Strait Islander descent by an eligible mental health worker if:

   (a)  either:

(i)      a medical practitioner has undertaken a health assessment and identified a need for follow-up allied health services; or

(ii)     the person’s shared care plan identifies the need for follow-up allied health services; and

  (b)  the person is referred to the eligible mental health worker by a medical practitioner using a referral form issued by the Department or a referral form that contains all the components of the form issued by the Department; and

   (c)  the person is not an admitted patient of a hospital; and

  (d)  the service is provided to the person individually and in person; and

 (e)  the service is of at least 20 minutes duration; and

 63.25

   (f)  after the service, the eligible mental health worker gives a written report to the referring medical practitioner mentioned in paragraph (b):

(i)      if the service is the only service under the referral—in relation to that service; or

(ii)     if the service is the first or the last service under the referral—in relation to that service; or

(iii)    if neither subparagraph (i) nor (ii) applies but the service involves matters that the referring medical practitioner would reasonably expect to be informed of—in relation to those matters;

to a maximum of 5 services (including any services to which this item or any other item in Part 6 of this Schedule applies) in a calendar year

This item is subject to section 9
81330

Occupational therapy health service provided to a person who is of Aboriginal or Torres Strait Islander descent by an eligible occupational therapist if:

   (a)  either:

(i)      a medical practitioner has undertaken a health assessment and identified a need for follow-up allied health services; or

(ii)     the person’s shared care plan identifies the need for follow-up allied health services; and

  (b)  the person is referred to the eligible occupational therapist by a medical practitioner using a referral form issued by the Department or a referral form that contains all the components of the form issued by the Department; and

   (c)  the person is not an admitted patient of a hospital; and

  (d)  the service is provided to the person individually and in person; and

 (e)   the service is of at least 20 minutes duration; and

 63.25

  (f)   after the service, the eligible occupational therapist gives a written report to the referring medical practitioner mentioned in paragraph (b):

(i)      if the service is the only service under the referral—in relation to that service; or

(ii)     if the service is the first or the last service under the referral—in relation to that service; or

(iii)    if neither subparagraph (i) nor (ii) applies but the service involves matters that the referring medical practitioner would reasonably expect to be informed of—in relation to those matters;

to a maximum of 5 services (including any services to which this item or any other item in Part 6 of this Schedule applies) in a calendar year

This item is subject to section 9
81335

Physiotherapy health service provided to a person who is of Aboriginal or Torres Strait Islander descent by an eligible physiotherapist if:

   (a)  either:

(i)      a medical practitioner has undertaken a health assessment and identified a need for follow-up allied health services; or

(ii)     the person’s shared care plan identifies the need for follow-up allied health services; and

 63.25

  (b)  the person is referred to the eligible physiotherapist by a medical practitioner using a referral form issued by the Department or a referral form that contains all the components of the form issued by the Department; and

   (c)  the person is not an admitted patient of a hospital; and

   (d)  the service is provided to the person individually and in person; and

   (e)  the service is of at least 20 minutes duration; and

   (f)  after the service, the eligible physiotherapist gives a written report to the referring medical practitioner mentioned in paragraph (b):

(i)      if the service is the only service under the referral—in relation to that service; or

(ii)     if the service is the first or the last service under the referral—in relation to that service; or

(iii)    if neither subparagraph (i) nor (ii) applies but the service involves matters that the referring medical practitioner would reasonably expect to be informed of—in relation to those matters;

to a maximum of 5 services (including any services to which this item or any other item in Part 6 of this Schedule applies) in a calendar year

This item is subject to section 9
81340

Podiatry health service provided to a person who is of Aboriginal or Torres Strait Islander descent by an eligible podiatrist if:

   (a)  either:

(i)      a medical practitioner has undertaken a health assessment and identified a need for follow-up allied health services; or

(ii)     the person’s shared care plan identifies the need for follow-up allied health services; and

  (b)  the person is referred to the eligible podiatrist by a medical practitioner using a referral form issued by the Department or a referral form that contains all the components of the form issued by the Department; and

   (c)  the person is not an admitted patient of a hospital; and

  (d)  the service is provided to the person individually and in person; and

   (e)  the service is of at least 20 minutes duration; and

   (f)  after the service, the eligible podiatrist gives a written report to the referring medical practitioner mentioned in paragraph (b):

(i)      if the service is the only service under the referral—in relation to that service; or

(ii)     if the service is the first or the last service under the referral – in relation to that service; or

(iii)    if neither subparagraph (i) nor (ii) applies but the service involves matters that the referring medical practitioner would reasonably expect to be informed of—in relation to those matters;

to a maximum of 5 services (including any services to which this item or any other item in Part 6 of this Schedule applies) in a calendar year

This item is subject to section 9

 63.25
81345

Chiropractic health service provided to a person who is of Aboriginal or Torres Strait Islander descent by an eligible chiropractor if:

   (a)  either:

(i)      a medical practitioner has undertaken a health assessment and identified a need for follow-up allied health services; or

(ii)     the person’s shared care plan identifies the need for follow-up allied health services; and

  (b)  the person is referred to the eligible chiropractor by a medical practitioner using a referral form issued by the Department or a referral form that contains all the components of the form issued by the Department; and

   (c)  the person is not an admitted patient of a hospital; and

  (d)  the service is provided to the person individually and in person; and

 (e)   the service is of at least 20 minutes duration; and

 63.25

   (f)  after the service, the eligible chiropractor gives a written report to the referring medical practitioner mentioned in paragraph (b):

(i)      if the service is the only service under the referral—in relation to that service; or

(ii)     if the service is the first or the last service under the referral—in relation to that service; or

(iii)    if neither subparagraph (i) nor (ii) applies but the service involves matters that the referring medical practitioner would reasonably expect to be informed of—in relation to those matters;

to a maximum of 5 services (including any services to which this item or any other item in Part 6 of this Schedule applies) in a calendar year

This item is subject to section 9
81350

Osteopathy health service provided to a person who is of Aboriginal or Torres Strait Islander descent by an eligible osteopath if:

   (a)  either:

(i)      a medical practitioner has undertaken a health assessment and identified a need for follow-up allied health services; or

(ii)     the person’s shared care plan identifies the need for follow-up allied health services; and

  (b)  the person is referred to the eligible osteopath by a medical practitioner using a referral form issued by the Department or a referral form that contains all the components of the form issued by the Department; and

   (c)  the person is not an admitted patient of a hospital; and

  (d)  the service is provided to the person individually and in person; and

   (e)  the service is of at least 20 minutes duration; and

   (f)  after the service, the eligible osteopath gives a written report to the referring medical practitioner mentioned in paragraph (b):

(i)      if the service is the only service under the referral—in relation to that service; or

(ii)     if the service is the first or the last service under the referral—in relation to that service; or

(iii)    if neither subparagraph (i) nor (ii) applies but the service involves matters that the referring medical practitioner would reasonably expect to be informed of—in relation to those matters;

to a maximum of 5 services (including any services to which this item or any other item in Part 6 of this Schedule applies) in a calendar year

This item is subject to section 9

 63.25
81355

Psychology health service provided to a person who is of Aboriginal or Torres Strait Islander descent by an eligible psychologist if:

   (a)  either:

(i)      a medical practitioner has undertaken a health assessment and identified a need for follow-up allied health services; or

(ii)     the person’s shared care plan identifies the need for follow-up allied health services; and      (b)     the person is referred to the eligible psychologist by a medical practitioner using a referral form issued by the Department or a referral form that contains all the components of the form issued by the Department; and

   (c)  the person is not an admitted patient of a hospital; and

  (d)  the service is provided to the person individually and in person; and

   (e)  the service is of at least 20 minutes duration; and

 63.25

   (f)  after the service, the eligible psychologist gives a written report to the referring medical practitioner mentioned in paragraph (b):

(i)      if the service is the only service under the referral—in relation to that service; or

(ii)     if the service is the first or the last service under the referral—in relation to that service; or

(iii)    if neither subparagraph (i) nor (ii) applies but the service involves matters that the referring medical practitioner would reasonably expect to be informed of—in relation to those matters;

to a maximum of 5 services (including any services to which this item or any other item in Part 6 of this Schedule applies) in a calendar year

This item is subject to section 9
81360

Speech pathology health service provided to a person who is of Aboriginal or Torres Strait Islander descent by an eligible speech pathologist if:

   (a)  either:

(i)      a medical practitioner has undertaken a health assessment and identified a need for follow-up allied health services; or

(ii)     the person’s shared care plan identifies the need for follow-up allied health services; and

  (b)  the person is referred to the eligible speech pathologist by a medical practitioner using a referral form issued by the Department or a referral form that contains all the components of the form issued by the Department; and

   (c)  the person is not an admitted patient of a hospital; and

  (d)  the service is provided to the person individually and in person; and

   (e)  the service is of at least 20 minutes duration; and

   (f)  after the service, the eligible speech pathologist gives a written report to the referring medical practitioner mentioned in paragraph (b):

(i)      if the service is the only service under the referral—in relation to that service; or

(ii)     if the service is the first or the last service under the referral—in relation to that service; or

(iii)    if neither subparagraph (i) nor (ii) applies but the service involves matters that the referring medical practitioner would reasonably expect to be informed of—in relation to those matters;

to a maximum of 5 services (including any services to which this item or any other item in Part 6 of this Schedule applies) in a calendar year

This item is subject to section 9

 63.25

  1. Part 7 of Schedule 2 (below the heading)

Repeal the table, substitute:

Group M15 – Diagnostic audiology services
Item Service Fee($)
82300

Audiology health service, consisting of brain stem evoked response audiometry, performed on a person by an eligible audiologist if:

   (a)  the service is performed pursuant to a written request made by an eligible practitioner to assist the eligible practitioner in the diagnosis and/or treatment and/or management of ear disease or a related disorder in the person; and

  (b)  the eligible practitioner is a specialist in the specialty of otolaryngology head and neck surgery; and

   (c)  the service is not performed for the purpose of a hearing screening; and

  (d)  the person is not an admitted patient of a hospital; and

   (e)  the service is performed on the person individually and in person; and

   (f)  after the service, the eligible audiologist provides a copy of the results of the service performed, together with relevant comments in writing that the eligible audiologist has on those results, to the eligible practitioner who requested the service; and

   (g)  a service to which item 11300 applies has not been performed on the person on the same day. 

This item is subject to sections 9 and 12.

 156.40

82306

Audiology health service, consisting of non-determinate audiometry performed on a person by an eligible audiologist if:

   (a)  the service is performed pursuant to a written request made by an eligible practitioner to assist the eligible practitioner in the diagnosis and/or treatment and/or management of ear disease or a related disorder in the person; and

  (b)  the eligible practitioner is a specialist in the specialty of otolaryngology head and neck surgery; and

   (c)  the service is not performed for the purpose of a hearing screening; and

  (d)  the person is not an admitted patient of a hospital; and

   (e)  the service is performed on the person individually and in person; and

   (f)  after the service, the eligible audiologist provides a copy of the results of the service performed, together with relevant comments in writing that the eligible audiologist has on those results, to the eligible practitioner who requested the service; and

   (g)  a service to which item 11306 applies has not been performed on the person on the same day. 

This item is subject to sections 9 and 12.

 17.80
82309

Audiology health service, consisting of an air conduction audiogram performed on a person by an eligible audiologist if:

   (a)  the service is performed pursuant to a written request made by an eligible practitioner to assist the eligible practitioner in the diagnosis and/or treatment and/or management of ear disease or a related disorder in the person; and

  (b)  the eligible practitioner is:       

        (i)   a specialist in the specialty of otolaryngology head and neck surgery; or

        (ii)   a specialist or consultant physician in the specialty of neurology; and

(c)   the service is not performed for the purpose of a hearing screening; and

(d)    the person is not an admitted patient of a hospital; and

(e)   the service is performed on the person individually and in person; and

(f)   after the service, the eligible audiologist provides a copy of the results of the service performed, together with relevant comments in writing that the eligible audiologist has on those results, to the eligible practitioner who requested the service; and

(g)   a service to which item 11309 applies has not been performed on the person on the same day.

This item is subject to sections 9 and 12. 

21.40
82312

Audiology health service, consisting of an air and bone conduction audiogram or air conduction and speech discrimination audiogram performed on a person by an eligible audiologist if:

   (a)  the service is performed pursuant to a written request made by an eligible practitioner to assist the eligible practitioner in the diagnosis and/or treatment and/or management of ear disease or a related disorder in the person; and

  (b)  the eligible practitioner is:       

        (i)   a specialist in the specialty of otolaryngology head and neck surgery; or

        (ii)   a specialist or consultant physician in the specialty of neurology; and

   (c)  the service is not performed for the purpose of a hearing screening; and

  (d)  the person is not an admitted patient of a hospital; and

   (e)  the service is performed on the person individually and in person; and

   (f)  after the service, the eligible audiologist provides a copy of the results of the service performed, together with relevant comments in writing that the eligible audiologist has on those results, to the eligible practitioner who requested the service; and

   (g)  a service to which item 11312 applies has not been performed on the person on the same day.

This item is subject to sections 9 and 12.

 30.20
82315

Audiology health service, consisting of an air and bone conduction and speech discrimination audiogram performed on a person by an eligible audiologist if:

   (a)  the service is performed pursuant to a written request made by an eligible practitioner to assist the eligible practitioner in the diagnosis and/or treatment and/or management of ear disease or a related disorder in the person; and

(b)  the eligible practitioner is:       

        (i)   a specialist in the specialty of otolaryngology head and neck surgery; or

        (ii)   a specialist or consultant physician in the specialty of neurology; and

(c)   the service is not performed for the purpose of a hearing screening; and

  (d)  the person is not an admitted patient of a hospital; and

   (e)  the service is performed on the person individually and in person; and

   (f)     after the service, the eligible audiologist provides a copy of the results of the service performed, together with relevant comments in writing that the eligible audiologist has on those results, to the eligible practitioner who requested the service; and

   (g)  a service to which item 11315 applies has not been performed on the person on the same day.

This item is subject to sections 9 and 12.

 40.00
82318

Audiology health service, consisting of an air and bone conduction and speech discrimination audiogram with other cochlear tests performed on a person by an eligible audiologist if:

   (a)  the service is performed pursuant to a written request made by an eligible practitioner to assist the eligible practitioner in the diagnosis and/or treatment and/or management of ear disease or a related disorder in the person; and

  (b)  the eligible practitioner is:       

        (i)   a specialist in the specialty of otolaryngology head and neck surgery; or

        (ii)   a specialist or consultant physician in the specialty of neurology; and

   (c)  the service is not performed for the purpose of a hearing screening; and

  (d)  the person is not an admitted patient of a hospital; and

   (e)  the service is performed on the person individually and in person; and

   (f)  after the service, the eligible audiologist provides a copy of the results of the service performed, together with relevant comments in writing that the eligible audiologist has on those results, to the eligible practitioner who requested the service; and

   (g)  a service to which item 11318 applies has not been performed on the person on the same day.

This item is subject to sections 9 and 12.

 49.40
82324

Audiology health service, consisting of an impedance audiogram involving tympanometry and measurement of static compliance and acoustic reflex performed on a person by an eligible audiologist (not being a service associated with a service to which item 82309, 82312, 82315 or 82318 applies) if:

   (a)  the service is performed pursuant to a written request made by an eligible practitioner to assist the eligible practitioner in the diagnosis and/or treatment and/or management of ear disease or a related disorder in the person; and

  (b)  the eligible practitioner is:       

        (i)   a specialist in the specialty of otolaryngology head and neck surgery; or

        (ii)   a specialist or consultant physician in the specialty of neurology; and

(c)   the service is not performed for the purpose of a hearing screening; and

(d)   the person is not an admitted patient of a hospital; and

(e)   the service is performed on the person individually and in person; and

(f)   after the service, the eligible audiologist provides a copy of the results of the service performed, together with relevant comments in writing that the eligible audiologist has on those results, to the eligible practitioner who requested the service; and

   (g)  a service to which item 11324 applies has not been performed on the person on the same day.

This item is subject to sections 9 and 12.

 26.70
82327

Audiology health service, consisting of an impedance audiogram involving tympanometry and measurement of static compliance and acoustic reflex performed on a person by an eligible audiologist (being a service associated with a service to which item 82309, 82312, 82315 or 82318 applies) if:

   (a)  the service is performed pursuant to a written request made by an eligible practitioner to assist the eligible practitioner in the diagnosis and/or treatment and/or management of ear disease or a related disorder in the person; and

  (b)  the eligible practitioner is:       

        (i)   a specialist in the specialty of otolaryngology head and neck surgery; or

        (ii)   a specialist or consultant physician in the specialty of neurology; and

   (c)  the service is not performed for the purpose of a hearing screening; and

  (d)  the person is not an admitted patient of a hospital; and

   (e)  the service is performed on the person individually and in person; and

   (f)            after the service, the eligible audiologist provides a copy of the results of the service performed, together with relevant comments in writing that the eligible audiologist has on those results, to the eligible practitioner who requested the service; and

16.05

   (g)  a service to which item 11327 applies has not been performed on the person on the same day.

This item is subject to sections 9 and 12.
82332

Audiology health service, consisting of an oto-acoustic emission audiometry for the detection of permanent congenital hearing impairment performed by an eligible audiologist on an infant or child in circumstances in which:

   (a)  the service is performed pursuant to a written request made by an eligible practitioner who is:

        (i)   a specialist in the specialty of otolaryngology head and neck surgery; or

        (ii)   a specialist or consultant physician in the specialty of neurology; and

  (b)  the infant or child is at risk due to 1 or more of the following factors:

        (i)   admission to a neonatal intensive care unit;

        (ii)   family history of hearing impairment;

       (iii)   intra-uterine or perinatal infection (either suspected or confirmed);

       (iv)   birthweight less than 1.5kg;

        (v)   craniofacial deformity;

       (vi)   birth asphyxia;

      (vii)   chromosomal abnormality, including Down Syndrome;

     (viii)   exchange transfusion; and

   (c)  middle ear pathology has been excluded by specialist opinion; and

  (d)  the infant or child is not an admitted patient of a hospital; and

   (e)  the service is performed on the infant or child individually and in person; and

   (f)  after the service, the eligible audiologist provides a copy of the results of the service performed, together with relevant comments in writing that the eligible audiologist has on those results, to the eligible practitioner who requested the service; and

   (g)  a service to which item 11332 applies has not been performed on the infant or child on the same day.

This item is subject to sections 9 and 12.

 47.60
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