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

Administered by Department of Health, Disability and Ageing

Legislation au F2025N00498 Not in force Notifiable Instrument

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AUSTRALIAN GOVERNMENT

DEPARTMENT OF HEALTH, DISABILITY AND AGEING

 

HEALTH INSURANCE ACT 1973

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

I, Nigel Murray, Assistant Secretary, MBS Policy and Specialist Programs Branch, Medicare Benefits and Digital Health Division, Health Resourcing Group, delegate for the Minister for Health and Ageing, acting under subsection 19(2) of the Health Insurance Act 1973 (the Act), hereby:

  1.      REPEAL the Health Insurance (Medicare Benefits Payable in Respect of Professional Services – Commonwealth Medicare Urgent Care Clinic Program – Tasmania) Direction (No. 2) 2024; and
  2.      DIRECT that Medicare Benefits shall be payable in respect of:
  1.      A professional service (as defined in section 3 of the Act) which has been agreed to be provided:
    1.        under a Schedule to the Federation Funding Agreement executed on 1 June 2023 between the Commonwealth (represented by the Department of Health and Aged Care, ABN: 83 605 426 759) and the Tasmanian Premier Minister for Health (The Crown in Right of Tasmania (represented by the Tasmanian Department of Health, ABN: 11 255 872 006)); and
    2.      as part of the Commonwealth Medicare Urgent Care Clinic Program for which items specified in Schedule A of this Direction; and of the general medical services table (means the table prescribed under subsection 4(1) of the Act), the diagnostic imaging services table (means the table prescribed under section 4AA of the Act) or the pathology service table (means the table prescribed under section 4A of the Act) relates; and
  2.      Where the professional service is provided to:
  1.        an eligible person (as defined in section 3 of the Act);
  2.      a patient who is not receiving the service as part of an episode of hospital treatment (as defined in section 121-5 of the Private Health Insurance Act 2007);
  3.   a patient who also is not receiving a service which attracts a payment through the 2020-2025 Addendum, schedule K, one year extension to the National Health Reform Agreement for a service rendered to a public patient; and
  1.      The professional services referred to in paragraph (2)(a) must be provided:
    1.        at a practice location specified in Schedule B of this Direction; and
    2.      by a general practitioner, prescribed medical practitioner or participating nurse practitioner who is registered to provide services in Schedule A with Services Australia under the Commonwealth Medicare Urgent Care Clinic program mentioned in paragraph (2)(a).
  1.      DECLARE that this Direction commences on 1 July 2025 and ceases to have effect at the end of 30 June 2026 unless earlier revoked.

 

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

  • Health Insurance Act 1973: the meaning of general practitioner, participating nurse practitioner and professional service; and
  • Health Insurance (General Medical Services Table) Regulations 2021: the meaning of prescribed medical practitioner.

 

Dated:  20 June 2025

 

 

 

Nigel Murray

Assistant Secretary  

MBS Policy and Specialist Programs Branch

Medicare Benefits and Digital Health Division

Health Resourcing Group

Department of Health, Disability and Ageing 


SCHEDULE A

MEDICARE BENEFITS SCHEDULE ITEMS AS AGREED under the MEDICARE Urgent care clinic program

For services listed in the below tables, all provisions of the Act and regulations made under the Act, and the National Health Act 1953 and regulations made under the National Health Act 1953, relating to medical services, professional services or items apply.

General Medical Services Table

Group

Group Name

Subgroup

Subgroup Name

Item Number

A1

General practitioner attendances to which no other item applies

3, 23, 36, 44, 123

A5

Prolonged attendances to which no other item applies

A7

Acupuncture and non-specialist practitioner items

2

Prescribed medical practitioner attendance to which no other item applies

179, 185, 189, 203

9

Prescribed medical practitioner mental health care

279

10

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

733, 737, 741, 745

A20

GP Mental health treatment

1

GP mental health treatment plans

2713

A22

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

5000, 5020, 5040, 5060, 5071

D1

Miscellaneous diagnostic procedures and investigations

6

Cardiovascular

11707

T4

Obstetrics

16500

T7

Regional or field nerve blocks

18213

T8

Surgical operations

1

General

30003, 30006, 30026, 30029, 30032, 30035, 30038, 30042, 30045, 30049, 30061, 30064, 30099, 30216, 30219

2

Colorectal

32147

5

Urological

36800

8

Ear, nose and throat

41500, 41659, 41677

9

Ophthalmology

42644, 42650

14

Hand or wrist surgery

46513, 46528, 46531

15

Orthopaedic

47904, 47915, 47916, 47015, 47030, 47042, 47057, 47063, 47069, 47301, 47348, 47354, 47361, 47387, 47423, 47444, 47453, 47462, 47466, 47471, 47543, 47561, 47579, 47595, 47637, 47663, 47735

M1

Management of bulk-billed services

1

Management of general bulk-billed services

10990, 10991, 10992, 75855, 75856, 75857, 75858

2

General support service

75870, 75871, 75872, 75873, 75874, 75875, 75876

M14

Nurse practitioners

1

Nurse practitioners

82200, 82205, 82210, 82215

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

 

Diagnostic Imaging Services Table

I1

Ultrasound

1

General

55028, 55032, 55036, 55038, 55048, 55054, 55065, 55066, 55070, 55071, 55076

3

Vascular

55238, 55244, 55246, 55252, 55274, 55276, 55278

4

Urological

55600

5

Obstetric And Gynaecological

55700, 55704, 55706, 55707, 55712, 55718, 55721

6

Musculoskeletal

55812, 55844, 55848, 55850, 55856, 55858, 55860, 55862, 55864, 55866, 55868, 55870, 55872, 55874, 55876, 55878, 55880, 55882, 55884, 55886, 55888, 55890, 55892, 55894

7

Transthoracic Echocardiogram and Stress Echocardiogram

55126, 55132, 55133, 55141

I2

Computed Tomography

1

Head

56001, 56007, 56013, 56016, 56022, 56028, 56030, 56036,

2

Neck

56101, 56107

3

Spine

56220, 56221, 56223, 56226, 56233, 56237

4

Chest and upper abdomen

56301, 56307

5

Upper abdomen only

56401, 56407, 56409, 56412

6

Upper abdomen and pelvis

56501, 56507

7

Extremities

56620, 56622, 56623, 56627, 56629,

8

Chest, abdomen, pelvis and neck

56801, 56807

9

Brain, chest and upper abdomen

57001, 57007

11

Interventional techniques

57341

12

Spiral angiography

57352, 57353, 57354, 57357

I3

Diagnostic Radiology

1

Radiographic Examination Of Extremities

57509, 57515, 57521, 57523, 57527

2

 Radiographic Examination Of Shoulder Or Pelvis

57703, 57709, 57712, 57715

3

Radiographic Examination Of Head

57901, 57907, 57915, 57921, 57924, 57927, 57945, 57960, 57963, 57969

4

Radiographic Examination Of Spine

58100, 58103, 58106, 58109, 58112, 58115

6

Radiographic Examination Of Thoracic Region

58503, 58509, 58521, 58524

7

Radiographic Examination Of Urinary Tract

58700

8

Radiographic Examination Of Alimentary Tract And Biliary System

58903, 58909 

9

Radiographic Examination For Localisation Of Foreign Bodies

59103 

10

Radiographic Examination Of Breasts

59300, 59302, 59303, 59305, 59314 

12

Radiographic Examination With Opaque Or Contrast Media

59751 

17

Interventional Techniques

61109 

I4

Nuclear Medicine Imaging

1

Nuclear medicine- non PET

61329, 61345, 61357, 61421, 61425, 61473 

3

Adjunctive services

61505 

I5

Magnetic Resonance Imaging

1

Scan Of Head – For Specified Conditions

63001, 63007

2

Scan Of Head - For Specified Conditions

63040, 63049, 63058, 63064 

6

Scan Of Spine - One Region Or Two Contiguous Regions - For Infection or Tumour

63151

7

Scan Of Spine - One Region Or Two Contiguous Regions - For Other Conditions

63161, 63167, 63173, 63176, 63179, 63182, 63185 

8

Scan Of Spine - Three Contiguous Regions Or Two Non-Contiguous Regions - For Infection or Tumour

63201

9

Scan Of Spine - Three Contiguous Regions Or Two Non-Contiguous Regions - For Other Conditions

63219, 63228

11

Scan Of Musculoskeletal System - For Tumour, Infection or Osteonecrosis

63301

12

Scan Of Musculoskeletal System - For Joint Derangement

63322, 63325, 63328, 63331, 63334, 63337, 63340

19

Scan Of Body - For Specified Conditions

63461 

20

Scans Of Pelvis And Upper Abdomen - For Specified Conditions

63740 

33

Scan of Body - Person Under the Age of 16 Years - General Practice Requests

63507, 63513, 63522

34

Scan of Body - Person Over the Age of 16 Years - General Practice Requests

63551, 63554, 63557, 63560 

 

Pathology Services Table

P1

Haematology

65060, 65070, 65072, 65075, 65078, 65081, 65090, 65093, 65096, 65111, 65114, 65120, 65123, 65126, 65129, 65137, 65144, 65156, 65178, 65179,

P2

Chemical

66500, 66503, 66506, 66509, 66512, 66518, 66519, 66536, 66542, 66548, 66551, 66554, 66560, 66563, 66566, 66584, 66593, 66596, 66605, 66607, 66623, 66626, 66632, 66635, 66638, 66641, 66650, 66653, 66655, 66656, 66659, 66660, 66665, 66686, 66695, 66697, 66698, 66701, 66704, 66707, 66716, 66719, 66722, 66725, 66728, 66731, 66734, 66750, 66751, 66752, 66756, 66758, 66764, 66767, 66770, 66779, 66800, 66803, 66812, 66816, 66819, 66820, 66822, 66828, 66833, 66837, 66838, 66839, 66840, 66841, 66900

P3

Microbiology

69300, 69303, 69306, 69309, 69312, 69317, 69318, 69319, 69321, 69324, 69330, 69333, 69336, 69345, 69354, 69363, 69384, 69387, 69390, 69393, 69396, 69400, 69401, 69405, 69411, 69413, 69415, 69471, 69474, 69475, 69478, 69480, 69481, 69482, 69483, 69484, 69488, 69491, 69494, 69495, 69496, 69497, 69498, 69499

P4

Immunology

71057, 71058, 71059, 71060, 71069, 71071, 71072, 71073, 71075, 71079, 71083, 71085, 71097, 71099, 71101, 71103, 71106, 71119, 71123, 71125, 71143, 71147, 71151, 71153, 71155, 71157, 71163, 71164, 71165, 71166, 71167, 71168, 71180, 71183, 71186, 71198, 71200,

P5

Tissue Pathology

72816, 72817, 72818, 72823, 72824, 72825, 72830, 72846, 72847, 72849

P6

Cytology

73045, 73047, 73049, 73063, 73070, 73071, 73072, 73074, 73076

P7

Genetics

73289, 73292, 73308, 73311, 73314, 73317, 73320, 73325

P8

Infertility and Pregnancy Test

73523, 73527, 73529

P9

Simple basic pathology tests

73806

P10

Patient Episode Initiation

73922, 73924, 73926, 73928, 73930, 73932, 73934, 73936, 73937, 73938, 73939

P11

Specimen Referred

73940 

 


SCHEDULE B

APPROVED PRACTICE LOCATIONS AS AGREED UNDER THE FEDERATION FUNDING AGREEMENT BETWEEN THE COMMONWEALTH AND THE TASMANIAN GOVERNMENT

Approved primary care locations:

State

MMM 2 Location

Practice Name

Legal Name

Street Address

TAS

Bridgewater

Jordan River Health

Your Hobart Doctor Pty Ltd

9-11 Hurst St, Bridgewater TAS 7030

TAS

Hobart

Ochre Health Urgent Care Clinic Hobart

Ochre Health Pty Ltd

Unit 1B 232-242 Liverpool Street, Hobart TAS 7000

TAS

Hobart

Your Hobart Doctor

Your Hobart Doctor Pty Ltd

71 Bathurst Street, Hobart TAS 7000

TAS

Launceston

Launceston Urgent Care Clinic

Launceston Central Medical Centre Pty Ltd

215 Wellington Street, Launceston TAS 7250

 

Overview

The Health Insurance (Medicare Benefits Payable in Respect of Professional Services – Commonwealth Medicare Urgent Care Clinic Program – Tasmania) Direction (No. 1) 2025 was enacted to address a gap in urgent care services in Tasmania, as part of a broader strategy to enhance healthcare accessibility and efficiency. The Direction, issued under the authority of the Health Insurance Act 1973, aims to facilitate the provision of Medicare benefits for professional services delivered under the Commonwealth Medicare Urgent Care Clinic Program in Tasmania. This initiative was enacted to ensure that urgent care services are accessible and well-coordinated across the state, responding to the specific needs identified in the Federation Funding Agreement executed on 1 June 2023. The policy objective is to ensure that eligible individuals receive timely and effective medical care, thereby improving overall health outcomes and reducing strain on emergency departments. The Direction outlines the specific services and conditions under which Medicare benefits will be payable, ensuring clarity and consistency in service provision.

Scope and Application

The Health Insurance (Medicare Benefits Payable in Respect of Professional Services – Commonwealth Medicare Urgent Care Clinic Program – Tasmania) Direction (No. 1) 2025 applies to medical services provided under the Commonwealth Medicare Urgent Care Clinic Program in Tasmania. It specifies that Medicare Benefits are payable for certain professional services listed in Schedule A of this Direction, provided that they are performed by a general practitioner, prescribed medical practitioner, or participating nurse practitioner registered to provide services under the program, at a practice location specified in Schedule B, and to an eligible person who is not receiving the service as part of an episode of hospital treatment or as part of a service attracting a payment through the 2020-2025 Addendum, schedule K, one year extension to the National Health Reform Agreement for a service rendered to a public patient. The professional services must relate to items specified in the general medical services table, the diagnostic imaging services table, or the pathology service table. This Direction operates within the framework of the Health Insurance Act 1973, and its provisions are applicable to the services listed in the schedules attached to the Direction. The Direction will commence on 1 July 2025 and cease to have effect at the end of 30 June 2026 unless earlier revoked. The Act and regulations made under the Act, as well as the National Health Act 1953 and regulations made under that Act, apply to the services listed in the schedules, with specific provisions relating to medical services, professional services, or items.

Key Provisions

The Health Insurance (Medicare Benefits Payable in Respect of Professional Services – Commonwealth Medicare Urgent Care Clinic Program – Tasmania) Direction (No. 1) 2025, issued under the authority of the Health Insurance Act 1973, repeals the previous direction from 2024 and outlines the new terms for the Commonwealth Medicare Urgent Care Clinic Program in Tasmania. This Direction allows for Medicare Benefits to be payable for professional services provided under a Schedule to the Federation Funding Agreement executed on 1 June 2023 between the Commonwealth and the Tasmanian Government, specifically for items listed in Schedule A of the Direction. These services must be provided to eligible persons, not as part of an episode of hospital treatment, and not as a service attracting payment through the 2020-2025 Addendum, schedule K, one-year extension to the National Health Reform Agreement for a service rendered to a public patient. The professional services must be performed by a general practitioner, prescribed medical practitioner, or participating nurse practitioner registered with Services Australia and provided at a location specified in Schedule B. The Act imposes several obligations on the parties involved. Service providers must ensure that the professional services are rendered to eligible persons and that these services are not part of an episode of hospital treatment or a service attracting payment through the 2020-2025 Addendum. Furthermore, the services must be provided at the approved locations listed in Schedule B of the Direction. The Commonwealth and Tasmanian Government must ensure that the Federation Funding Agreement is adhered to, and Services Australia must maintain accurate records of registered practitioners and approved locations. The legislation does not explicitly detail offences, penalties, or civil/criminal consequences for breaches. However, any non-compliance with the terms of the Direction or the underlying Act could result in the cessation of Medicare Benefits payments for the services in question. Additionally, any fraudulent claims or misrepresentations could attract penalties under other relevant sections of the Health Insurance Act 1973 or other applicable legislation.

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Sourced from the Federal Register of Legislation at 26 August 2026. For the latest information on Australian Government law please go to https://www.legislation.gov.au.