AUSTRALIAN GOVERNMENT
DEPARTMENT OF HEALTH AND AGED CARE
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 – Northern Territory) Direction 2024
I, Louise Riley, First Assistant Secretary, Medical Benefits and Digital Health Division, Health Resourcing Group, delegate for the Minister for Health and Aged Care, acting under subsection 19(2) of the Health Insurance Act 1973, hereby:
(1) REVOKE the Direction made under subsection 19(2) of the Act titled 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 – Northern Territory Direction 2022 that was granted on 29 June 2022, that Medicare benefits shall be payable in respect of professional services provided by health services in Northern Territory that are a part of the Council of Australian Governments’ Improving Access to Primary Care in Rural and Remote Areas – COAG s19(2) Exemptions Initiative, as described in the Memorandum of Understanding between the Australian Government and Northern Territory dated 5 May 2022; and
(2) DIRECT that Medicare Benefits shall be payable in respect of
(a) A professional service (as defined in Section 3 of the Health Insurance Act 1973) 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 Northern Territory of Australia (ABN: 84 085 734 992) dated 5 May 2022 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:
(i) 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 Health Insurance Act 1973), diagnostic imaging services table (means the table prescribed under subsection 4AA(1) of the Health Insurance Act 1973) and pathology services table (means the table prescribed under subsection 4A(1) of the Health Insurance Act 1973) relates; and
(b) where the profession service is provided to:
(i) an eligible person (as defined in Section 3 of the Health Insurance Act 1973); and
(ii) 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
(c) The professional service referred to in paragraph (2)(a):
(i) 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
(ii) is either:
(A) a professional non-referred service provided by a state remunerated medical practitioner, participating midwife, or participating nurse practitioner; or
(B) a professional referred service provided by a state remunerated allied health and dental health practitioner.
DECLARED that this Direction commences on 3 June 2024 and ceases to have effect at the end of 30 June 2025 unless earlier revoked.
Date this 22 day of May 2024
Louise Riley
Acting First Assistant Secretary
Medical Benefits and Digital Health Division
Health Resourcing Group
Department of Health and Aged Care
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 – Northern Territory
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 |
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 – attendances | ||
A10 | Optometrical services provided by an optometrist | ||
A11 | Urgent attendance after hours | ||
A14 | Health assessments | ||
A15 | GP management plans, team care arrangements, multidisciplinary care plans | 1 | GP management plans, team care arrangements and multidisciplinary care plans |
A17 | Domiciliary and residential management reviews | ||
A20 | General Practitioner mental health treatment | ||
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 | ||
A35 | Services for patients in Residential Aged Care Facilities | ||
A40 | Telehealth and phone attendance services | 1 | General practice telehealth services |
2 | General practice phone services | ||
3 | Focussed psychological strategies telehealth services | ||
10 | Focussed psychological strategies phone services | ||
11 | Health assessments for Aboriginal and Torres Strait Islander People - telehealth services | ||
13 | GP management plans, team care arrangements and multidisciplinary care plans via telehealth attendance | ||
15 | GP pregnancy support counselling telehealth services | ||
16 | GP pregnancy support counselling phone services | ||
19 | GP mental health treatment plan telehealth services | ||
20 | GP mental health treatment plan phone services | ||
21 | GP Eating Disorder Treatment and Management Plan telehealth services | ||
27 | GP - Eating Disorder Focussed Psychological Strategies telehealth services | ||
28 | GP - Eating Disorder Focussed Psychological Strategies phone services | ||
29 | GP and Other Medical Practitioner urgent after-hours service in unsociable hours telehealth services | ||
39 | GP Blood Borne Viruses, Sexual or Reproductive Health Consultation – Telehealth Service | ||
40 | GP Blood Borne Viruses, Sexual or Reproductive Health Consultation – Phone Service | ||
A46 | COVID-19 management support service | ||
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 | ||
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 or Aboriginal and Torres Strait Islander health practitioner on behalf of a medical practitioner | ||
M14 | Nurse Practitioners | ||
M15 | Diagnostic audiology services | ||
M16 | Eating Disorder services | ||
M18 | Allied health telehealth services | 1 | Psychological therapies telehealth services |
2 | Psychologist focussed psychological strategies telehealth services | ||
3 | Occupational therapist focussed psychological strategies telehealth services | ||
4 | Social worker focussed psychological strategies telehealth services | ||
5 | Nurse practitioner telehealth 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 telehealth services | ||
12 | General allied health phone services | ||
13 | Pregnancy support counselling telehealth services | ||
14 | Pregnancy support counselling phone services | ||
15 | Complex neurodevelopmental disorder and disability telehealth services | ||
16 | Complex neurodevelopmental disorder and disability phone services | ||
17 | Telehealth 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 telehealth services | ||
26 | Allied health, group dietetics phone services | ||
T1 | Miscellaneous therapeutic procedures | 6 | Gastroenterology |
General Medical Services Table – permitted items
Group | Group Name | Items | Item overview |
A15 | GP management plans, team care arrangements and multidisciplinary care plans | 735, 739, 743, 747-758, 930-945 | Case conferences |
A29 | Attendance services for complex neurodevelopmental disorder or disability | 139 | Professional attendance by a general practitioner for assessment, diagnosis and preparation of a treatment and management plan for a patient with an eligible disability. |
A36 | Eating disorder services | 90250-90257, 90264, 90265, 90271-90282 | Eating disorder services provided by General Practitioners or Medical Practitioners |
A40 | Telehealth and phone attendance services | 92142, 92170, 92171, 92176, 92177 | General Practitioner and Prescribed Medical Practitioner items |
A44 | General Practice attendance for assessing patient suitability for a COVID-19 vaccine | 93645, 93647, 93654, 93656, 93661, 93666, 10660, 10661 | General Practice Attendance for Assessing Patient Suitability for a COVID-19 Vaccine |
D1 | Miscellaneous diagnostic procedures and investigations | 11300-11318, 11505, 11506, 11602-11615, 11707, 11729, 11730, 12001-12004, 12012, 12017, 12200, 12306, 12312, 12315, 12320-12322, 12325, 12326 | Non-referred services only |
D2 | Nuclear Medicine (non-imaging) | 12500, 12524, 12527 | Nuclear Medicine (non-imaging) |
M13 | Midwifery services | 82100-82115, 82130-82140 | Midwifery items |
T1 | Miscellaneous therapeutic procedures | 13105, 14206 | Haemodialysis provided by a registered nurse, Aboriginal health worker or Aboriginal and Torres Strait Islander health practitioner in a very remote location. Hormone or living tissues implantation by cannula |
T4 | Obstetrics | 16400, 16406-16500, 16502-16514, 16530, 16590, 16591, 91850-91858 | Antenatal and postnatal attendances |
T8 | Surgical operations | 30003, 30006, 30023, 30026-30055, 30061-30072, 30107, 30192-30207, 30216, 30219, 31356, 32072, 32147, 35503, 41500, 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 | Minor surgical procedures |
O1 | Consultations | 51700- 51703, 54001-54004 | Dental practitioner attendances |
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 – Northern Territory
Approved locations:
Location | Practice Name | Legal Name | Street Address | Mailing Address |
Adelaide River | Adelaide River Health Centre | Northern Territory of Australia | 21 Becker Street Adelaide River NT 0846 | C/- Adelaide River PO NT 0846 |
Batchelor | Batchelor Health Clinic | Northern Territory of Australia | 27 Pinaroo Crescent Batchelor NT 0845 | C/- Batchelor Post Office NT 0845 |
Jabiru | Jabiru Community Health Centre | Northern Territory of Australia | 14 Flinders Street Jabiru NT 0886 | PO Box 221 Jabiru NT 0886 |
Katherine | Katherine Hospital | Northern Territory of Australia | 155 Giles Street Katherine NT 0852 | PMB 73 Katherine NT 0852 |
Nhulunbuy | Gove District Hospital | Northern Territory of Australia | Matthew Flinders Way Nhulunbuy NT 0880 | PO Box 421 Nhulunbuy NT 0881 |
Tennant Creek | Tennant Creek Hospital | Northern Territory of Australia | 45 Schmidt Street Tennant Creek NT 0860 | PO Box 346 Tennant Creek NT 0861 |