AUSTRALIAN GOVERNMENT
DEPARTMENT OF HEALTH
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 - Queensland Direction 2022
I, Nigel Murray, Assistant Secretary, MBS Policy and Specialist Services Branch,
Medical Benefits Division, Health Resourcing Group, delegate for the Minister for Health, acting under subsection 19(2) of the Health Insurance Act 1973, hereby:
(1) REVOKE the Direction made under subsection 19(2) of the Act that was granted on
16 December 2021, that Medicare benefits shall be payable in respect of professional services provided by health services in Queensland 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 Queensland dated 13 December 2016; 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 (ABN: 24 004 196 909) and the Queensland (ABN: 75 818 456 675) 9 June 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 services referred to in a clause in (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
- is a professional non-referred service provided by a state remunerated medical practitioner, participating midwife, or participating nurse practitioner; or
- is a professional referred service provided by a state remunerated allied health and dental health practitioner; and
DECLARED that this Direction shall have effect from the date of signature until
30 July 2025 inclusive unless earlier revoked.
Date this 29th day of June 2022
Nigel Murray
Assistant Secretary
MBS Policy and Specialist Services Branch
Medical Benefits Division
Health Resourcing Group
Department of Health
SCHEDULE A
MEDICARE BENEFITS SCHEDULE ITEMS AS 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 – queensland
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 attendances | ||
A11 | Urgent attendance after hours | ||
A14 | Health assessments | ||
A15 | GP management plans, team care arrangements, multidisciplinary care plans | ||
A17 | Domiciliary and residential management plans | ||
A18 | General Practitioner attendance associated with PIP incentive payments to which no other item applies | ||
A19 | Other non-referred attendances associated with PIP incentive payments to which no other item applies | ||
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 | ||
A30 | Medical practitioner (including General Practitioner, specialist or consultant physician) telehealth attendances* | ||
A35 | Services for patients in Residential Aged Care Facilities | ||
A40 | Telehealth and phone 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 | ||
17 | GP, Specialist and Consultant Physician Autism Service Telehealth Service | ||
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 and Other Medical Practitioner - urgent after hours service in unsociable hours phone services | ||
40 | GP Blood borne viruses, sexual or reproductive health consultation telehealth service | ||
A41 | Additional focussed psychological strategies | ||
A42 | Mental health planning for care recipients of a residential aged care facility | ||
A43 | Care recipient of a Residential Aged Care Facility planning and contribution items | ||
A45 | Nicotine and Smoking Cessation Counselling | ||
M1 | Management of bulk-billed services | ||
M3 | Allied Health services | ||
M6 | Psychological therapy services | ||
M7 | Focussed psychological strategies | ||
M8 | Pregnancy support counselling | ||
M9 | Allied Health group services | ||
M10 | Autism, pervasive developmental disorder and disability services | ||
M11 | Allied Health services for Indigenous Australians who have had a health check | ||
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 | Autism, pervasive developmental disorder and disability telehealth services | ||
16 | Autism, pervasive developmental 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 | COVID-19 Follow up service provided by a practice nurse or Aboriginal and Torres Strait Islander health practitioner – Telehealth Services | ||
25 | COVID-19 Allied health, group dietetics telehealth services | ||
26 | COVID-19 Allied health, group dietetics phone | ||
M25 | Additional psychological therapy services | ||
M26 | Additional focussed psychological strategies (allied mental health) | ||
M27 | Initial psychological therapy services | ||
M28 | Initial focussed psychological strategies (allied mental health) | ||
M29 | Additional allied health services | ||
M30 | Allied health services for Indigenous Australians in RACF | ||
M31 | Allied health group services in RACF | ||
D1 | Miscellaneous diagnostic procedures and investigations | 1 | Neurology |
2 | Ophthalmology | ||
5 | Vascular | ||
7 | Gastroenterology and colorectal | ||
8 | Genito/urinary physiological investigations | ||
D2 | Nuclear medicine (non-imaging) | ||
T1 | Miscellaneous therapeutic procedures | 6 | Gastroenterology |
* Note: Claims under any item Group A30 in the General Medical Services Table may only be exempt from Subsection 19(2) of the HIA 1973 when the services are claimed by a General Practitioner.
General Medical Services Table – permitted items
Group | Group Name | Items | Item overview |
A29 | Early intervention services for children with autism, pervasive developmental 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 | COVID-19 services | 92170, 92171, 92176, 92177 | General Practitioner and Other Medical Practitioner items |
A44 | General Practice attendance for assessing patient suitability for a COVID-19 vaccine | 93625, 93627, 93635, 93637, 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, 11330, 11333-11339, 11503-11507, 11512, 11707, 12000-12004, 12012-12024, 12200, 12306-12326 | Non-referred services only |
M13 | Midwifery services | 82100-82115, 82130-82152 | Midwifery items |
T1 | Miscellaneous therapeutic procedures | 13105-13110 | Haemodialysis provided by a registered nurse, Aboriginal health worker or Aboriginal and Torres Strait Islander health practitioner in a very remote location. |
T4 | Obstetrics | 16400, 16406-16500, 16502-16591, 91850, 91855, 91851, 91856, 91852, 91857, 91853, 91858, 91855 | Antenatal and postnatal attendances |
T8 | Surgical operations | 30001-30006, 30010, 30023, 30026-30055, 30061-30072, 30187, 30189, 30192-30219, 47015, 47042, 47057, 47069, 47301, 47348, 47354, 47361, 47387, 47423, 47444, 47453, 47462, 47466. 47471, 47543, 47561, 47579, 47595, 47663, 47735, 47904-47918 | 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 - Queensland
Approved locations:
Location | Practice Name | Street Address | Mailing Address |
Babinda | Babinda Hospital Multi-Purpose Health Service
| 128 Munro Street, Babinda, QLD 4861
| PO Box 160 BABINDA QLD 4861 |
Barcaldine | Barcaldine Hospital Multi-Purpose Health Service
| 25 Oak Street, Barcaldine, QLD 4725 | 25 Oak Street BARCALDINE QLD 4725 |
Alpha | Alpha Hospital and Multipurpose Health Service | 1 Burns Street Alpha QLD 4724
| 1 Burns Street ALPHA QLD 4724 |
Aramac | Aramac Primary Health Clinic | 2 Lodge Street Aramac QLD 4726 | 2 Lodge Street ARAMAC QLD 4726 |
Jericho | Jericho Health Clinic
| 19 Pasteur Street Jericho QLD 4728 | 19 Pasteur Street JERICHO QLD 4728 |
Muttaburra | Muttaburra Primary Health Care Centre | Edkins Street Muttaburra QLD 4732 | Edkins Street MUTTABURRA QLD 4732 |
Biggenden | Biggenden MPHS
| 57 Alice Street, Biggenden, QLD 4621 | 57 Alice St BIGGENDEN QLD 4621 |
Blackall | Blackall Hospital
| Hospital Road, Blackall, QLD 4472
| PO BOX 131 BLACKALL QLD 4472 |
Blackwater | Blackwater Hospital Multi-Purpose Health Service | 41 McKenzie Street, Blackwater, Qld 4717 | PO Box 47 BLACKWATER QLD 4717 |
Boulia | Boulia Primary Health Centre | 49 Wills Street, Boulia, QLD 4829 | 49 Wills Street BOULIA QLD 4829 |
Capella | Capella Outpatients Clinic | 5 Slider Street, Capella, QLD 4723 | 5 Slider Street CAPELLA QLD 4723 |
Cardwell | Cardwell Community Health Centre | Victoria Street, Cardwell, QLD 4819 | PO Box 391 CARDWELL QLD 4819 |
Childers | Childers Hospital Multi-Purpose Health Service | 44 Broadhurst Street, Childers, QLD 4660 | PO Box 62 CHILDERS QLD 4660 |
Chillagoe | Chillagoe Primary Health Centre | 21 Hospital Avenue, Chillagoe, QLD 4871 | PO Box 4 CHILLAGOE QLD, 4871 |
Collinsville | Collinsville Hospital | 81-91 Garrick Street, Collinsville, QLD 4804 | PO Box 56 COLLINSVILLE QLD 4808 |
Dimbulah | Dimbulah Primary Health Centre | 1-5 Stephen Street, Dimbulah, QLD 4872 | PO Box 148 DIMBULAH QLD 4872 |
Dirranbandi | Dirranbandi Multipurpose Health Service | Corner of Jane and Crothers Streets, Dirranbandi, QLD 4486 | PO Box 20 DIRRANBANDI QLD 4486 |
Eidsvold | Eidsvold Multi-Purpose Health Service | Cracow Rd, Eidsvold, QLD 4627 | PO Box 40 EIDSVOLD QLD 4627 |
Gayndah | Gayndah Hospital | 69 Warton Street, Gayndah, QLD 4625 | PO Box 41 GAYNDAH QLD 4625 |
Sapphire | Gemfields Outpatient Clinic | 984 Rubyvale Road, Sapphire, QLD 4702 | PO Box 342 SAPPHIRE QLD 4702 |
Gin Gin | Gin Gin Hospital | 5 King Street, Gin Gin, QLD 4671 | PO Box 14 GIN GIN QLD 4671 |
Hughenden | Hughenden Health Centre | Richmond Hill Drive, Hughenden, QLD 4821 | PO Box 228 HUGHENDEN QLD 4821 |
Inglewood | Inglewood Multi-Purpose Health Service | Cunningham Highway, Inglewood, QLD 4387 | PO Box 42 INGLEWOOD QLD 4387 |
Injune | Injune Multi-Purpose Health Service | Fifth Avenue, Injune, QLD 4454 | PO Box 35 INJUNE QLD 4454 |
Isisford | Isisford Primary Health Centre | St Helena Street, Isisford, QLD 4731 | St Helena Street ISISFORD QLD 4731 |
Jandowae | Jandowae Health Services | Jandowae Hospital, 13 Dalby Street, Jandowae, QLD 4410 | PO Box 75 JANDOWAE QLD 4410 |
Jundah | Jundah Primary Health Centre | 1 Hospital Road, Jundah, QLD 4736 | 1 Hospital Road JUNDAH QLD 4736 |
Longreach | Longreach Hospital | Corner Jabiru and Plover Streets, Longreach, QLD 4730 | Corner Jabiru and Plover Streets LONGREACH QLD 4730 |
Miles | Miles Hospital Health Service | 5-11 Colamba Street, Miles, QLD 4415 | PO Box 187 MILES QLD 4415 |
Millmerran | Millmerran Multi-Purpose Health Service | 50 Commens Street, Millmerran, QLD 4357 | 50 Commens Street MILLMERRAN QLD 4357 |
Cecil Plains | Millmerran Multi-Purpose Health Service - Outreach Primary Clinic (Cecil Plains) | Co located at Anglicare, 24 Geraghty Street, Cecil Plains, QLD 4407 | Co located at Anglicare 24 Geraghty Street CECIL PLAINS QLD 4407 |
Mitchell | Mitchell Hospital | 95 Ann Street, Mitchell, QLD 4465 | 95 Ann Street MITCHELL QLD 4465 |
Monto | Monto Health Service | Flinders Street, Monto, QLD 4630 | PO Box 220 MONTO QLD 4630 |
Mossman | Mossman Multi-Purpose Health Service | 9 Hospital Street, Mossman, QLD 4873 | 9 Hospital Street MOSSMAN QLD 4873 |
Cow Bay | Cow Bay Primary Health Centre | 69 Tea Tree Road Diwan QLD 4873 | PMB 3 CAPE TRIBULATION QLD 4873 |
Moura | Moura Multi-Purpose Health Service | 14 Nott Street, Moura, QLD 4718 | 14 Nott Street MOURA QLD 4718 |
Mundubbera | Mundubbera Health Service | 96 Leichardt Street, Mundubbera QLD 4626 | PO Box 35 MUNDUBBERA QLD 4626 |
Mungindi | Mungindi Multi-Purpose Health Service | 90 Barwon St, Mungindi, QLD 2406 | 90 Barwon St MUNGINDI QLD 2406 |
Murgon | Murgon Health Service | Coronation Drive, Murgon, QLD 4605 | Coronation Drive MURGON QLD 4605 |
Nanango | Nanango Health Service | 135 Brisbane Street, Nanango, QLD 4615 | PO Box 60 NANANGO QLD 4615 |
Oakey | Oakey Health Services – Oakey Hospital | Cnr Beale and Fitzpatrick Streets, Oakey, QLD 4401 | Cnr Beale and Fitzpatrick Streets OAKEY QLD 4401 |
Proserpine | Proserpine Hospital and Community Health Centre | 26-32 Taylor Street, Proserpine, QLD 4800 | PO Box 229 PROSERPINE QLD 4800 |
Quilpie | Quilpie Multi-Purpose Health Service | 30 Gyrica Street, Quilpie, QLD 4480 | PO Box 27 QUILPIE QLD 4480 |
Richmond | Richmond Health Service | Gallagher Drive, Richmond, QLD 4822 | PO Box 24 RICHMOND QLD 4822 |
Springsure | Springsure Multi-Purpose Health Service | 21 Woodbine Street, Springsure, QLD 4722 | PO Box 14 SPRINGSURE QLD 4722 |
Surat | Surat Hospital Multi-Purpose Health Service | 2 Ivan St, Surat, QLD 4417 | PO Box 2, SURAT QLD 4417 |
Tambo | Tambo Primary Health Care Centre | Garden Street, Tambo, QLD 4478 | Garden Street TAMBO QLD 4478 |
Tara | Tara Hospital | 15 Bilton Street, Tara, QLD 4421 | 15 Bilton Street TARA QLD 4421 |
Taroom | Taroom Hospital | Taroom Hospital, 14 Miller Street, Taroom QLD 4420 | PO Box 358 TAROOM QLD 4420 |
Texas | Texas Multi Purpose Health Service | Mingoola Road, Texas, QLD 4385 | PO Box 91 TEXAS QLD 4385 |
Tully | Tully Hospital | 17 Bryant Street, Tully, QLD 4854 | PO Box 489 TULLY QLD 4854 |
Wallumbilla | Wallumbilla Community Health Care Clinic | Stakeyard Road, Wallumbilla, QLD 4428 | PO Box 21 WALLUMBILLA QLD 4428 |
Windorah | Windorah Primary Healthcare Centre | 15 Victoria Street, Windorah, QLD 4481 | 15 Victoria Street WINDORAH QLD 4481 |
Winton | Winton Hospital and Multi-Purpose Health Service | Oondooroo Street, Winton, QLD 4735 | Oondooroo Street WINTON QLD 4735 |