Health Insurance (Section 3C General Medical Services – Specialist, Consultant Physician and Consultant Psychiatrist COVID-19 Telehealth Services) Amendment Determination No.1 2020 (Cth)
Health Insurance (Section 3C General Medical Services – Specialist, Consultant Physician and Consultant Psychiatrist COVID-19 Telehealth Services) Amendment Determination No.1 2020
I, DAVID WEISS delegate of the Minister for Health, make the following Determination.
Dated 13 March 2020
David Weiss
First Assistant Secretary
Medical Benefits Division
Health Financing Group
Department of Health
Contents
1 Name........................................................................................................................................ 1
2 Commencement........................................................................................................................ 1
3 Authority.................................................................................................................................. 1
4 Schedules................................................................................................................................. 1
Schedule 1— Amendments to Health Insurance (Section 3C General Medical Services – Specialist, Consultant Physician and Consultant Psychiatrist COVID-19 Telehealth Services) Determination 2020 2
Division 1.4 Services and fees – specialist attendances via phone services 2
Division 1.5 – Services and fees – consultant physician (other than psychiatry) attendances via phone services 3
Division 1.6 – Services and fees – Consultant psychiatrist attendances via phone services 5
1 Name
This instrument is the Health Insurance (Section 3C General Medical Services – Specialist, Consultant Physician and Consultant Psychiatrist COVID-19 Telehealth Services) Amendment Determination No.1 2020.
2 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 | Immediately after the commencement of the Health Insurance (Section 3C General Medical Services – Specialist, Consultant Physician and Consultant Psychiatrist COVID-19) Telehealth Services) Determination 2020 | |
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.
3 Authority
This instrument is made under subsection 3C(1) of the Health Insurance Act 1973.
4 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 to Health Insurance (Section 3C General Medical Services – Specialist, Consultant Physician and Consultant Psychiatrist COVID-19 Telehealth Services) Determination 2020
Within the definition of ‘Patient at risk of COVID-19 virus’ of section 5 Definitions
Insert after (c)(v):
or
(d)the person meets the current national triage protocol criteria for suspected COVID-19 infection
After ‘Patient at risk of COVID-19 virus’ of section 5 Definition
Insert:
phone attendance means a professional attendance by telephone where the health practitioner:
(a)has the capacity to provide the full service through this means safely and in accordance with professional standards; and
(b)is satisfied that it is clinically appropriate to provide the service to the patient; and
(c)maintains an audio link with the patient.
After Division 1.3 of Schedule 1
Insert:
Division 1.4 Services and fees – specialist attendances via phone services
1.4.1 Application of COVID-19 medical practitioner phone services
Insert:
(1) For items in Subgroups 4, and 7 the rendering practitioner must not perform a service in subgroup 7 if the practitioner and the patient have the capacity to undertake an attendance by telehealth.
| Group A40 – COVID-19 – medical practitioner phone services | ||
| Subgroup 7 – COVID-19 – specialist attendances phone services | ||
| Item | Description | Fee ($) |
| 91832 | Phone attendance for a person by a specialist in the practice of the specialist’s specialty if: (a) the attendance is where: (i) the person is a patient at risk of COVID-19 virus; or (ii) the specialist is a health professional at risk of COVID-19 virus; and (b) the attendance follows referral of the patient to the specialist; and (c) the attendance was of more than 5 minutes in duration; and (d) the patient is not an admitted patient; and (e) the service is bulk-billed. Where the attendance was other than a second or subsequent attendance as part of a single course of treatment. | 88.25 |
| 91833 | Phone attendance for a person by a specialist in the practice of the specialist’s specialty if: (a) the attendance is where: (i) the person is a patient at risk of COVID-19 virus; or (ii) the specialist is a health professional at risk of COVID-19 virus; and (b) the attendance follows referral of the patient to the specialist; and (c) the attendance was of more than 5 minutes in duration; and (d) the patient is not an admitted patient; and (e) the service is bulk-billed. Where the attendance is after the first attendance as part of a single course of treatment. | 44.35 |
Division 1.5 – Services and fees – consultant physician (other than psychiatry) attendances via phone services
1.5.1 Application of COVID-19 medical practitioner phone services
Insert:
(1) For items in Subgroups 5, and 8 the rendering practitioner must not perform a service in subgroup 8 if the practitioner and the patient have the capacity to undertake an attendance by telehealth.
| Group A40 – COVID-19 – medical practitioner phone services | |||||||||||
| Subgroup 8 – COVID-19 – consultant physician phone services | |||||||||||
| Item | Description | Fee ($) | |||||||||
| 91834 | Phone attendance for a person by a consultant physician in the practice of the consultant physician’s specialty (other than psychiatry) if: (a) the attendance is where: (i) the person is a patient at risk of COVID-19 virus; or (ii) the consultant physician is a health professional at risk of COVID-19 virus; and (b) the attendance follows referral of the patient to the specialist; and (c) the attendance was of more than 5 minutes in duration; and (d) the patient is not an admitted patient; and (e) the service is bulk-billed. Where the attendance was other than a second or subsequent attendance as part of a single course of treatment. | 155.60 | |||||||||
| 91835 | Phone attendance for a person by a consultant physician in the practice of the consultant physician’s specialty (other than psychiatry) if: (a) the attendance is where: (i) the person is a patient at risk of COVID-19 virus; or (ii) the consultant physician is a health professional at risk of COVID-19 virus; and (b) the attendance follows referral of the patient to the specialist; and (c) the attendance was of more than 5 minutes in duration; and (d) the patient is not an admitted patient; and (e) the service is bulk-billed. Where the attendance is not a minor attendance after the first as part of a single course of treatment. | 77.90 | |||||||||
| 91836 | Phone attendance for a person by a consultant physician in the practice of the consultant physician’s specialty (other than psychiatry) if: (a) the attendance is where: (i) the person is a patient at risk of COVID-19 virus; or (ii) the specialist is a health professional at risk of COVID-19 virus; and (b) the attendance follows referral of the patient to the specialist; and (c) the attendance was of more than 5 minutes in duration; and (d) the patient is not an admitted patient; and (e) the service is bulk-billed. Where the attendance is a minor attendance after the first as part of a single course of treatment. | 44.35 | |||||||||
Division 1.6 – Services and fees – Consultant psychiatrist attendances via phone services
1.6.1 Application of COVID-19 medical practitioner phone services
Insert:
(1) For items in Subgroups 6, and 9 the rendering practitioner must not perform a service in subgroup 9 if the practitioner and the patient have the capacity to undertake an attendance by telehealth.
| Group A40 – COVID-19 – medical practitioner phone services | ||||||
| Subgroup 9 – COVID-19 – consultant psychiatrist phone services | ||||||
| Item | Description | Fee($) | ||||
| 91837 | Phone attendance for a person by a consultant psychiatrist; if: (a) the attendance is where: (i) the person is a patient at risk of COVID-19 virus; or (ii) the consultant psychiatrist is a health professional at risk of COVID-19 virus; and (b) the attendance follows a referral of the patient to the consultant psychiatrist by a referring practitioner; and (c) the attendance was not more than 15 minutes duration; and (d) the patient is not an admitted patient; and (e) the service is bulk-billed. | 44.70 | ||||
| 91838 | Phone attendance for a person by a consultant psychiatrist; if: (a) the attendance is where: (i) the person is a patient at risk of COVID-19 virus; or (ii) the consultant psychiatrist is a health professional at risk of COVID-19 virus; and (b) the attendance follows a referral of the patient to the consultant psychiatrist by a referring practitioner; and (c) the attendance was of more than 15 minutes, but not more than 30 minutes in duration; and (d) the patient is not an admitted patient; and (e) the service is bulk-billed. | 89.15 | ||||
| 91839 | Phone attendance for a person by a consultant psychiatrist; if: (a) the attendance is where: (i) the person is a patient at risk of COVID-19 virus; or (ii) the consultant psychiatrist is a health professional at risk of COVID-19 virus; and (b) the attendance follows a referral of the patient to the consultant psychiatrist by a referring practitioner; and (c) the attendance was of more than 30 minutes, but not more than 45 minutes in duration; and (d) the patient is not an admitted patient; and (e) the service is bulk-billed. | 137.25 | ||||
| 91840 | Phone attendance for a person by a consultant psychiatrist; if: (a) the attendance is where: (i) the person is a patient at risk of COVID-19 virus; or (ii) the consultant psychiatrist is a health professional at risk of COVID-19 virus; and (b) the attendance follows a referral of the patient to the consultant psychiatrist by a referring practitioner; and (c) the attendance was of more than 45 minutes, but not more than 75 minutes in duration; and (d) the patient is not an admitted patient; and (e) the service is bulk-billed. | 189.40 | ||||
| 91841 | Phone attendance for a person by a consultant psychiatrist; if: (a) the attendance is where: (i) the person is a patient at risk of COVID-19 virus; or (ii) the consultant psychiatrist is a health professional at risk of COVID-19 virus; and (b) the attendance follows a referral of the patient to the consultant psychiatrist by a referring practitioner; and (c) the attendance was of more than 75 minutes in duration; and (d) the patient is not an admitted patient; and (e) the service is bulk-billed. | 219.80 | ||||
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