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 – Victoria) 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:
- REPEAL the Health Insurance (Medicare Benefits Payable in Respect of Professional Services – Commonwealth Urgent Care Clinic Program – Victoria) Direction (No. 2) 2024; and
- DIRECT that Medicare Benefits shall be payable in respect of:
- A professional service (as defined in section 3 of the Act which has been agreed to be provided:
- under a Schedule to the Federation Funding Agreement executed on
28 June 2023 between the Commonwealth (represented by the Department of Health and Aged Care, ABN: 83 605 426 759) and the State of Victoria (represented by the Victorian Department of Treasury and Finance, ABN: 44 128 890 975); and - as part of the Commonwealth Urgent Care Clinic Program for which items specified in Schedules A, B and C of this Direction; and of the general medical services table (means the table prescribed under subsection 4(1) of the Act) , 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
- under a Schedule to the Federation Funding Agreement executed on
- Where the professional service is provided to:
- an eligible person (as defined in section 3 of the Act);
- a patient who is not receiving the service as part of an episode of hospital treatment (as defined in section 121-5 of the Private Health Insurance Act 2007); and
- a patient who also is not receiving a service which attracts a payment through the 2020-2025 Addendum to the National Health Reform Agreement for a service rendered to a public patient; and
- The professional services referred to in paragraph (2)(a) must be provided:
- if the service is specified in Schedule A:
- at a practice location specified in Schedule D or E of this Direction; and
- by a general practitioner, prescribed medical practitioner or participating nurse practitioner who is registered to provide services with Services Australia under the Commonwealth Urgent Care Clinic program mentioned in paragraph (2)(a).
- if the service is specified in Schedule B:
- at a practice location specified in Schedule D of this Direction; and
- by a prescribed medical practitioner who is registered to provide services with Services Australia under the Commonwealth Urgent Care Clinic program mentioned in paragraph (2)(a).
- if the service is specified in Schedule C:
- at a practice location specified in Schedule E of this Direction; and
- by a prescribed medical practitioner who is registered to provide services with Services Australia under the Commonwealth Urgent Care Clinic program mentioned in paragraph (2)(a).
- if the service is specified in Schedule A:
- DECLARE that this Direction commences on the day after registration 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 6 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 Urgent care clinic program
For services listed in the below tables, all provisions of the Act and regulations made under the Act, and the National Health Act 1953 and regulations made under the National Health Act 1953, relating to medical services, professional services or items apply.
General Medical Services Table
Group | Group Name | Subgroup | Subgroup Name | Item Number |
A1 | General practitioner attendances to which no other item applies | 3, 23, 36, 44, 123 | ||
A5 | Prolonged attendances to which no other item applies | |||
A7 | Acupuncture and non-specialist practitioner items | 9 | Prescribed medical practitioner mental health care | 279 |
A20 | 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
Group | Group Name | Subgroup | Subgroup Name | Item Number |
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
Group | Group Name | Item Number |
|
|
|
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
MEDICARE BENEFITS SCHEDULE ITEMS where a clinic is located in MMM 1 locations
For services listed in the below tables, all provisions of the Act and regulations made under the Act, and the National Health Act 1953 and regulations made under the National Health Act 1953, relating to medical services, professional services or items apply.
General Medical Services Table
Group | Group Name | Subgroup | Subgroup Name | Item Number |
A2 | Other non-referred attendances to which no other item applies | 1 | Other medical practitioner attendances | 52, 53, 54, 57 |
A23 | Other non-referred after-hours attendances to which no other item applies | 5200, 5203, 5207, 5208 | ||
*Note: Claims under any item in Group A2 and A23 in the General Medical Services Table may only be exempt from subsection 19(2) of the Act when the services are claimed by a Prescribed Medical Practitioner operating under the Medicare Urgent Care Clinic Program.
SCHEDULE C
MEDICARE BENEFITS SCHEDULE ITEMS where a clinic is located in MMM 2-7 locations
For services listed in the below tables, all provisions of the Act and regulations made under the Act, and the National Health Act 1953 and regulations made under the National Health Act 1953, relating to medical services, professional services or items apply.
General Medical Services Table
Group | Group Name | Subgroup | Subgroup Name | Item Number |
A7 | Acupuncture and non-specialist practitioner items | 2 | Prescribed medical practitioner attendance to which no other item applies | 179, 185, 189, 203 |
10 | Prescribed Medical Practitioner after‑hours attendances to which no other item applies | 733, 737, 741, 745 |
*Note: Claims under any item in Group A7 in the General Medical Services Table may only be exempt from subsection 19(2) of the Act when the services are claimed by a Prescribed Medical Practitioner operating under the Medicare Urgent Care Clinic Program.
SCHEDULE D
Approved MMM 1 PRACTICE LOCATIONS As agreed under the Federal Funding agreement between the commonwealth and the Victorian Government
Approved primary care locations:
State | MMM 1 Location | Practice Name | Legal Name | Street Address |
VIC | Dandenong | Greens Medical Group | Keys Medical Centre Pty Ltd | 1/134 Logis Boulevard, Dandenong South VIC 3175 |
VIC | Epping | Epping Plaza Medical and Dental Centre | The Trustee for ARTLU UNIT TRUST | Shop 216, Epping Plaza Regional Centre, 571‑583 High Street, Epping VIC 3076 |
VIC | Frankston | Frankston Priority Primary Care Centre | Sandringham Ambulatory Care Centre Pty Ltd | 1-3/49 Beach Street, Frankston VIC 3199 |
VIC | Geelong | Eastbrooke Family Clinic Belmont | Bupa Health Centres Pty Ltd | 75 Roslyn Road, Belmont VIC 3216 |
VIC | Mount Waverley | Mount Waverely Urgent Care Clinic | Interconnect Healthcare Pty Ltd | 408 Huntingdale Road Mount Waverley VIC 3149 |
VIC | Heidelberg | Heidelberg Medicare Urgent Care Clinic | Interconnect Healthcare Pty Ltd | 152 Burgundy Street Heidelberg VIC 3084 |
VIC | Inner Melbourne | Carlton Medical and Urgent Care Clinic | The Trustee for ARTLU UNIT TRUST | 1/221 Drummond Street, Carlton VIC 3053 |
VIC | Maribyrnong | Edgewater Medical Centre | The Trustee for Edgewater Medical Clinic Unit Trust | G01B/31 Edgewater Boulevard, Maribyrnong VIC 3032 |
VIC | Maroondah | M3 Health Bayswater Medical Clinic | The Trustee for Modern Medical Bayswater Unit Trust | Mountain High Shopping Centre, Shop 30, 7-13 High Street, Bayswater VIC 3153 |
VIC | Melton | Melton Medical & Dental Centre | The Trustee for ARTLU UNIT TRUST
| 247/251 Station Rd, Melton VIC 3337 |
VIC | Narre Warren | Narregate Medical and Dental Centre | The Trustee for ARTLU UNIT TRUST
| 60 Victor Crescent, Narre Warren VIC 3805 |
State | MMM 1 Location | Practice Name | Legal Name | Street Address |
VIC | Prahran | Prahran Medicare Urgent Care Clinic | Sandringham Ambulatory Care Centre Pty Ltd | 55 Commercial Road Melbourne VIC 3004 |
VIC | Sunbury | Goonawarra Medical Centre Sunbury | The Trustee for Napier Medical Trust | 1-5 Dornoch Drive, Sunbury VIC 3429 |
VIC | Werribee | Werribee Medical and Dental Centre | The Trustee for ARTLU UNIT TRUST
| 1-5 Station Place, Werribee VIC 3030 |
SCHEDULE E
Approved MMM 2-7 PRACTICE LOCATIONS As agreed under the federation funding agreement between the commonwealth and the victorian government
Approved primary care locations:
State | MMM 2 Location | Practice Name | Legal Name | Street Address |
VIC | Ballarat | Ballarat Priority Primary Care Centre (UFS Medical) | UFS HEALTHCARE LTD | 1010 Sturt Street Ballarat VIC 3350 |
VIC | Bendigo | Bendigo Primary Care Centre | Bendigo Primary Care Centre Limited | 121 Arnold Street, Bendigo VIC 3550 |
State | MMM 3 Location | Practice Name | Legal Name | Street Address |
VIC | Shepparton | The University of Melbourne Shepparton Medical Centre | Melbourne Teaching Health Clinics Ltd | 49 Graham Street, Shepparton VIC 3630 |