Health Insurance (Medicare Benefits Payable in Respect of Professional Services – Council of Australian Governments’ Improving Access to Primary Care in Rural and Remote Areas – COAG s19(2) Exemptions Initiative – New South Wales) Direction (No. 1) 2025 - Legislation

AUSTRALIAN GOVERNMENT

DEPARTMENT OF HEALTH, DISABILITY AND AGEING

HEALTH INSURANCE ACT 1973

Health Insurance (Medicare Benefits Payable in Respect of Professional Services – Council of Australian Governments’ Improving Access to Primary Care in Rural and Remote Areas – COAG s19(2) Exemptions Initiative – New South Wales) Direction (No. 1) 2025

I, Nigel Murray, Assistant Secretary, MBS Policy and Specialist Programs Branch, 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:

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 the Memorandum of Understanding (MOU) between the Department of Health and Aged Care (ABN: 83 605 426 759) and the NSW Ministry of Health (ABN: 92 697 899 630) dated 18 March 2025 as part of the Council of Australian Governments’ Improving Access to Primary Care in Rural and Remote Areas – COAG s19(2) Exemptions Initiative relating to primary care services for which:
1. 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), diagnostic imaging services table (means the table prescribed under subsection 4AA(1) of the Act) or pathology services table (means the table prescribed under subsection 4A(1) of the Act) relates; and
where the profession service is provided to:
1. an eligible person (as defined in Section 3 of the Act); and
2. a patient who is not part of an episode of hospital treatment (as defined in Section 121-5 of the Private Health Insurance Act 2007); and
The professional service referred to in paragraph (2)(a):
1. is provided at an approved Modified Monash Model 5-7 area (as defined in Section 7.1.1 of the general medical services table) practice location specified in Schedule B; and
2. is either:
  1. a professional non-referred service provided by a state remunerated medical practitioner, participating midwife, or participating nurse practitioner; or
  2. a professional referred service provided by a state remunerated allied health and dental health practitioner.

DECLARE that this Direction commences on 1 July 2025 and ceases to have effect at the end of 30 June 2027 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 dental practitioner, participating midwife, participating nurse practitioner, and professional service; and
Health Insurance (General Medical Services Table) Regulations 2021: the meaning of prescribed medical practitioner.
Health Insurance (Section 3C General Medical Services – Allied Health Services) Determination 2024: the meaning of allied health professional.

Date: 16 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 At Approved Practice Locations AS AGREED under the Council of Australian Governments’ Improving Access to Primary Care in Rural and Remote Areas – COAG s19(2) Exemptions Initiative – NEW SOUTH WALES

For services listed in the below tables, all provisions of the Health Insurance Act 1973 (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
A2	Other non‑referred attendances to which no other item applies
A5	Prolonged attendances to which no other item applies
A6	Group therapy
A7	Acupuncture and non‑specialist practitioner items
A9	Contact lenses
A10	Optometric services provided by optometrist
A11	Urgent attendances after hours
A14	Health assessments
A15	GP chronic condition management plans, multidisciplinary care plans and case conferences	1	GP chronic condition management plans and multidisciplinary care plans
A15		2	Case Conferences	735, 739, 743, 747-758, 930-945
A17	Domiciliary and residential medication management reviews
A20	Mental health care
A22	General practitioner after‑hours attendances to which no other item applies
A23	Other non‑referred after‑hours attendances to which no other item applies
A27	Pregnancy support counselling
A29	Attendance services for complex neurodevelopmental disorder or disability			139
A35	Non‑referred attendance at a residential aged care facility
A36	Eating disorders	1	Preparation of eating disorder treatment and management plans: general practitioners and non‑specialist medical practitioners	90250-90257
		3	Review of eating disorder treatment and management plans	90264, 90265
		4	Providing treatments under eating disorder treatment and management plans	90271-90278
A40	Telehealth attendance services	1	General practice video services
		2	General practice phone services
		3	Focussed Psychological Strategies ‑ Video Services
		10	Focussed Psychological Strategies phone services
		11	Health Assessments for Aboriginal and Torres Strait Islander People ‑ Video Services
		13	GP management plans, team care arrangements and multidisciplinary care plans services – Video Services
		15	GP Pregnancy Support Counselling ‑ Video Services
		16	GP Pregnancy Support Counselling ‑ Phone Service
		17	GP, specialist and consultant physician complex neurodevelopmental disorder or disability service ‑ Video Services	92142
		19	GP Mental Health Treatment Plan ‑ Video Services
		20	GP Mental Health Treatment Plan ‑ Phone Service
		21	GP Eating Disorder Treatment and Management Plan – Video Services
		25	Review of an Eating Disorder Plan ‑ Video Services	92170, 92171
		26	Review of an Eating Disorder Plan – Phone Service	92176, 92177
		27	Eating Disorder Psychological Treatment Services – Video Services
		28	Eating Disorder Psychological Treatment Strategies – Phone Service
		29	GP and Other Medical Practitioner ‑ Urgent After Hours Service in Unsociable Hours ‑ Video Services
		39	GP Blood Borne Viruses, Sexual or Reproductive Health Consultation – Video Services
		40	GP Blood Borne Viruses, Sexual or Reproductive Health Consultation – Phone Service
D1	Miscellaneous diagnostic procedures and investigations	3	Otolaryngology	11300-11318
		4	Respiratory	11505, 11506
		5	Vascular	11602-11615
		6	Cardiovascular	11707, 11729, 11730
		9	Allergy testing	12001-12004, 12012, 12017
		10	Other diagnostic procedures and investigations	12200, 12306, 12312, 12315, 12320-12322, 12325, 12326
D2	Nuclear medicine (non‑imaging)			12500, 12524, 12527
M1	Management of bulk‑billed services	1	Management of general bulk‑billed services
		2	General support service
		3	Patients enrolled in MyMedicare
M3	Allied health services
M6	Psychological Therapy Services
M7	Focussed Psychological Strategies (Allied Mental Health)
M8	Pregnancy support counselling
M9	Allied health group services
M10	Complex neurodevelopmental disorder and disability services
M11	Allied health services for Aboriginal and Torres Strait Islander people
M12	Services provided by a practice nurse, an Aboriginal health worker or an Aboriginal and Torres Strait Islander health practitioner on behalf of a medical practitioner
M13	Midwifery Services	1	MBS items for participating midwives	82100-82115, 82130-82140
M14	Nurse practitioners
M15	Diagnostic audiology services
M16	Eating disorders services
M18	Allied Health telehealth services	1	Psychological therapies video services
		2	Psychologist focussed psychological strategies video services
		3	Occupational Therapist focussed psychological strategies video services
		4	Social Worker focussed psychological strategies video services
		5	Nurse practitioner video services
		6	Psychological therapies phone services
		7	Psychologist focussed psychological strategies phone service
		8	Occupational therapist focussed psychological strategies phone services
		9	Social worker focussed psychological strategies phone services
		10	Nurse practitioner phone services
		11	General allied health video services
		12	General allied health phone services
		13	Pregnancy support counselling video services
		14	Pregnancy support counselling phone services
		15	Complex neurodevelopmental disorder and disability video services
		16	Complex neurodevelopmental disorder and disability phone services
		17	Video attendance to person of Aboriginal and Torres Strait Islander descent
		18	Phone attendance to person of Aboriginal and Torres Strait Islander descent
		23	Follow up service provided by a practice nurse or Aboriginal and Torres Strait Islander health practitioner – Telehealth Services
		25	Allied health, group dietetics video services
		26	Allied health, group dietetics phone services
T1	Miscellaneous therapeutic procedures	2	Dialysis	13105
		6	Gastroenterology
		13	Miscellaneous therapeutic procedures	14206
T4	Obstetrics			16400, 16406-16500, 16502-16514, 16530, 16590, 16591
		1	Obstetric video services	91850-91853
		2	Obstetric phone services	91855-91858
T8	Surgical operations	1	General	30003, 30006, 30023, 30026-30055, 30061-30072, 30107, 30192-30207, 30216, 30219, 31356
		2	Colorectal	32072, 32147
		4	Gynaecological	35503
		8	Ear, nose and throat	41500
		15	Orthopaedic	47015, 47042, 47057, 47069, 47301, 47348, 47354, 47361, 47387, 47423, 47444, 47453, 47462, 47466, 47471, 47543, 47561, 47579, 47595, 47663, 47735, 47904, 47915, 47916, 47918
O1	Consultations			51700, 51703
		1	dental practitioner video services	54001, 54002
		2	dental practitioner phone services	54004

Diagnostic Imaging Services Table

Group	Group Name
I1	Ultrasound
I3	Diagnostic radiology
I6	Management of bulk‑billed services

Pathology Services Table

Group	Group Name
P9	Simple basic pathology tests
P12	Management of bulk‑billed services
P13	Bulk‑billing incentive

SCHEDULE B

Approved Practice Locations AS AGREED under the Council of Australian Governments’ Improving Access to Primary Care in Rural and Remote Areas – COAG s19(2) Exemptions Initiative – New South Wales

Approved locations:

Health Insurance (Medicare Benefits Payable in Respect of Professional Services – Council of Australian Governments’ Improving Access to Primary Care in Rural and Remote Areas – COAG s19(2) Exemptions Initiative – New South Wales) Direction (No. 1) 2025

Administered by Department of Health, Disability and Ageing

Interactions

Location	Practice Name	Legal Name	Street Address	Mailing Address
Balranald	Balranald Multi-Purpose Service	Far West Local Health District	41-43 Court Street, Balranald NSW 2715	41-43 Court Street, Balranald NSW 2715
Barham	Barham Multi-Purpose Service	Murrumbidgee Local Health District	80 Punt Road, Barham NSW 2732	80 Punt Road, Barham NSW 2732
Batlow	Batlow-Adelong Multi-Purpose Service	Murrumbidgee Local Health District	61-81 Pioneer Street, Batlow NSW 2730	61-81 Pioneer Street, Batlow NSW 2730
Berrigan	Berrigan Health Service	Murrumbidgee Local Health District	47-49 Davis Street, Berrigan NSW 2712	47-49 Davis Street, Berrigan NSW 2712
Bingara	Bingara Multi-Purpose Service	Hunter New England Local Health District	8 Copeton Dam Road, Bingara NSW 2404	8 Copeton Dam Road, Bingara NSW 2404
Blayney	Blayney Health Service	Western NSW Local Health District	3 Osman Street, Blayney NSW 2799	3 Osman Street, Blayney NSW 2799
Bonalbo	Bonalbo Multi-Purpose Service	Northern NSW Local Health District	Hospital Road,Bonalbo NSW 2469	Hospital Road, Bonalbo NSW 2469
Boorowa	Boorowa Multi-Purpose Service	Murrumbidgee Local Health District	62-80 Dry Street, Boorowa NSW 2586	62-80 Dry Street, Boorowa NSW 2586
Coolamon	Coolamon-Ganmain Multi-Purpose Service	Murrumbidgee Local Health District	1 Doctor Buchanan Drive, Coolamon NSW 2701	1 Doctor Buchanan Drive, Coolamon NSW 2701
Culcairn	Culcairn Multi-Purpose Service	Murrumbidgee Local Health District	51-55 Balfour Street, Culcairn NSW 2660	51-55 Balfour Street, Culcairn NSW 2660
Dareton	Dareton Primary and Community Health Centre	Far West Local Health District	42-44 Tapio Avenue, Dareton NSW 2717	42-44 Tapio Avenue, Dareton NSW 2717
Dungog	Dungog Community Hospital	Hunter New England Local Health District	22 Hospital Road, Dungog NSW 2420	22 Hospital Road, Dungog NSW 2420
Finley	Finley Health Service	Murrumbidgee Local Health District	24 Dawe Avenue, Finley NSW 2713	24 Dawe Avenue, Finley NSW 2713
Gloucester	Gloucester Soldiers Memorial Hospital & Gloucester Community Health Centre	Hunter New England Local Health District	166-182 Church Street, Gloucester NSW 2422	166-182 Church Street, Gloucester NSW 2422
Gundagai	Gundagai Health (Multi-Purpose) Service	Murrumbidgee Local Health District	50 Tor Street, Gundagai NSW 2722	50 Tor Street, Gundagai NSW 2722
Guyra	Guyra Multi-Purpose Service	Hunter New England Local Health District	44-48 Sole Street, Guyra NSW 2365	44-48 Sole Street, Guyra NSW 2365
Harden	Murrumburrah-Harden Hospital and Health Service	Murrumbidgee Local Health District	53 Scott Street, Harden NSW 2587	53 Scott Street, Harden NSW 2587
Hay	Hay District Hospital	Murrumbidgee Local Health District	351 Murray St, Hay NSW 2711	351 Murray St, Hay NSW 2711
Henty	Henty Multi-Purpose Service	Murrumbidgee Local Health District	7 Keighran Street, Henty NSW 2658	7 Keighran Street, Henty NSW 2658
Hillston	Hillston Hospital and Health Service	Murrumbidgee Local Health District	48C Burns Street, Hillston NSW 2675	48C Burns Street, Hillston NSW 2675
Holbrook	Holbrook Hospital	Murrumbidgee Local Health District	30 Bowler Street, Holbrook NSW 2644	30 Bowler Street, Holbrook NSW 2644
Jerilderie	Jerilderie Hospital and Health Service	Murrumbidgee Local Health District	33-39 Southey Street, Jerilderie NSW 2716	PO Box 116, Jerilderie NSW 2716
Junee	Junee Multi-Purpose Service	Murrumbidgee Local Health District	67 Broadway Street, Junee NSW 2663	67 Broadway Street, Junee NSW 2663
Kyogle	Kyogle Multi-Purpose Service	Northern NSW Local Health District	Summerland Way, Kyogle NSW 2474	Summerland Way, Kyogle NSW 2474
Lake Cargelligo	Lake Cargelligo Hospital and Health Service	Murrumbidgee Local Health District	34 Uabba Street, Lake Cargelligo NSW 2672	34 Uabba Street, Lake Cargelligo NSW 2672
Lockhart	Lockhart Hospital and Health Service	Murrumbidgee Local Health District	53-55 Hebden Street, Lockhart NSW 2656	53-55 Hebden Street, Lockhart NSW 2656
Manilla	Manilla Multi-Purpose Service	Hunter New England Local Health District	Court Street, Manilla NSW 2346	Court Street, Manilla NSW 2346
Merriwa	Merriwa Multi-Purpose Service	Hunter New England Local Health District	Mackenzie Street, Merriwa NSW 2329	Mackenzie Street, Merriwa NSW 2329
Murrurundi	Wilson Memorial Community Hospital Murrurundi & Murrurundi Community Health Centre	Hunter New England Local Health District	Corner Paradise Road and O'Connell Street, Murrurundi NSW 2338	PO Box 8, Murrurundi NSW 2338
Narrandera	Narrandera Health Service	Murrumbidgee Local Health District	54 Adams Street, Narrandera NSW 2700	54 Adams Street, Narrandera NSW 2700
Nimbin	Nimbin Multi-Purpose Service	Northern NSW Local Health District	35 Cullen Street, Nimbin NSW 2480	35 Cullen Street, Nimbin NSW 2480
Nyngan	Nyngan Hospital and Community Health Service	Western NSW Local Health District	15 Hoskins Street, Nyngan NSW 2825	PO Box 96, Nyngan NSW 2825
Oberon	Oberon Health Service	Western NSW Local Health District	67-75 North Street, Oberon NSW 2787	North Street, Oberon NSW 2787
Quirindi	Quirindi Health Service	Hunter New England Local Health District	50 Nowland Street, Quirindi NSW 2343	50 Nowland Street, Quirindi NSW 2343
Rylstone	Rylstone Multi-Purpose Service	Western NSW Local Health District	24 Fitzgerald Street, Rylstone NSW 2849	Fitzgerald Street, Rylstone NSW 2849
Temora	Temora Health Service	Murrumbidgee Local Health District	169-189 Loftus Street, Temora NSW 2666	169-189 Loftus Street, Temora NSW 2666
Tocumwal	Tocumwal Health Service	Murrumbidgee Local Health District	6-12 Adams Street, Tocumwal NSW 2714	6-12 Adams Street, Tocumwal NSW 2714
Tottenham	Tottenham Multi-Purpose Service	Western NSW Local Health District	10 Moondana Street, Tottenham NSW 2873	10 Moondana Street, Tottenham NSW 2873
Trangie	Trangie Multi-Purpose Service	Western NSW Local Health District	28 Harris Street, Trangie NSW 2823	28 Harris Street, Trangie NSW 2823
Trundle	Trundle Multi-Purpose Service	Western NSW Local Health District	44 Brookview Street, Trundle NSW 2875	44 Brookview Street, Trundle NSW 2875
Tullamore	Tullamore Multi-Purpose Service	Western NSW Local Health District	1-5 Hinkler Street, Tullamore NSW 2874	Kitchener Street, Tullamore NSW 2874
Tumbarumba	Tumbarumba Multi-Purpose Service	Murrumbidgee Local Health District	4 Mitchell Street, Tumbarumba NSW 2653	4 Mitchell Street, Tumbarumba NSW 2653
Urana	Urana Health Multi-Purpose Service	Murrumbidgee Local Health District	127-129 Princess Street, Urana NSW 2645	127-129 Princess Street, Urana NSW 2645
Urbenville	Urbenville Multi-Purpose Service	Northern NSW Local Health District	45 Beaury Street, Urbenville NSW 2475	45 Beaury Street, Urbenville NSW 2475
Warialda	Warialda Multi-Purpose Service	Hunter New England Local Health District	146 Long Street, Warialda NSW 2402	Long Street, Warialda NSW 2402
Wee Waa	Wee Waa Community Hospital & Wee Waa Community Health Centre	Hunter New England Local Health District	60 Alma Street, Wee Waa NSW 2388	PO Box 417, Wee Waa NSW 2388
West Wyalong	West Wyalong Hospital	Murrumbidgee Local Health District	70 Ungarie Road, West Wyalong NSW 2671	70 Ungarie Road, West Wyalong NSW 2671

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