AUSTRALIAN GOVERNMENT
DEPARTMENT OF HEALTH
HEALTH INSURANCE ACT 1973
Health Insurance (Medicare Benefits Payable in Respect of Professional Services – Noarlunga and Smaller Medical Services in South Australia) Direction (No.2) 2021
I, NIGEL MURRAY, ASSISTANT SECRETARY, 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
1 July 2021, in respect of professional services provided by, or on behalf of, or under an arrangement with South Australia Health; 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 by, or on behalf of, or under an arrangement with South Australia Health (ABN: 97 643 356 590) for which:
(i) items specified in Schedule A of this Direction; and
(ii) 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 professional 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 receiving hospital treatment or 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 clause (a):
(i) is provided at a practice location specified in Schedule B of this Direction.
DECLARED that this Direction shall have effect from the date of signature until
30 June 2025 inclusive unless earlier revoked.
Date this 22 day of December 2021
Nigel Murray
Assistant Secretary
Medical Benefits Division
Health Resourcing Group
Department of Health
SCHEDULE A
MEDICARE BENEFITS SCHEDULE ITEMS AS AGREED BETWEEN THE DEPARTMENT OF HEALTH AND south australia health
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.
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 | All |
|
A11 | Urgent attendances after-hours | ||
A14 | Health assessments | ||
A15 | GP Management plans, team care arrangements and multidisciplinary care plans and case | 1 | GP Management plans, team care arrangements and multidisciplinary care plans |
2 | Case conferences | ||
A17 | Domiciliary and residential medication management reviews | ||
A18 | Attendances associated with Practice Incentive Program payments | All |
|
A19 | Attendances associated with Practice Incentive Program payments | All |
|
A20 | Mental health Care | All |
|
A22 | General practitioner after-hours attendances to which no other item applies | ||
A23 | Other non-referred after-hour attendances to which no other item applies | ||
A27 | Pregnancy support counselling | ||
A29 | Early intervention services for children with autism, pervasive development disorder or disability | ||
A30 | Medical practitioner video conferencing consultation | 1 | Video conferencing consultation attendance at consulting rooms, home visit of other institution |
2 | Video conferencing consultation attendance at a residential aged care facility | ||
3 | Mental health and well-being video conferencing consultation | ||
5 | General practitioner video conferencing consultation attendance for patients in rural and remote areas | ||
6 | Other non-referred video conferencing consultation attendance for patients in rural and remote areas | ||
7 | Non-specialist practitioner video conferencing consultation for patients in rural and remote areas | ||
A35 | Non-referred attendance at a residential aged care facility | ||
A36 | Eating Disorder Services | 1 | GP and Medical Practitioner eating disorder treatment and management plans |
3 | Review of eating disorder treatment and management plan | ||
4 | GP and medical practitioner eating disorder s psychological treatment services | ||
A39 | Bushfire Recovery Access Initiative – GP and Medical Practitioner Focussed Psychological Strategies | ||
A40 | COVID-19 Services | 1 | COVID-19 general practice - telehealth services |
2 | COVID-19 general practice - phone services | ||
3 | COVID-19 Focussed psychological strategies - telehealth services | ||
10 | COVID-19 Focussed psychological strategies - phone services | ||
11 | Health assessments for Aboriginal and Torres Strait Islander People - telehealth services | ||
12 | Health assessments for Aboriginal and Torres Strait Islander People - phone Services | ||
13 | GP management plans, team care arrangements and multidisciplinary care plans via telehealth attendance | ||
14 | GP management plans, team care arrangements and multidisciplinary care plans via phone attendance | ||
15 | GP pregnancy support counselling - telehealth services | ||
16 | GP pregnancy support counselling - phone services | ||
17 | GP, Specialist and Consultant Physician autism service - telehealth services | ||
18 | GP, Specialist and Consultant Physician autism service - 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 | ||
22 | GP Eating Disorder Treatment and Management Plans - phone services | ||
25 | Review of an eating disorder Plan - telehealth services | ||
26 | Review of an Eating Disorder Plan – phone 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 | ||
30 | GP and Other Medical Practitioner - urgent after hours service in unsociable hours - phone services | ||
M1 | Management of bulk billed services | ||
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 | 1 | Video conferencing consultation support service provided by a practice nurse, an Aboriginal health worker or an Aboriginal and Torres Strait Islander health practitioner on behalf of a medical practitioner |
2 | Video conferencing consultation support service provided at a residential aged care facility on behalf of a medical practitioner | ||
3 | Services provided by a practice nurse or an Aboriginal and Torres Strait Islander health practitioner on behalf of a medical practitioner | ||
D1 | Miscellaneous diagnostic procedures and investigations | 2 | Ophthalmology |
3 | Otolaryngology | ||
4 | Respiratory | ||
5 | Vascular | ||
6 | Cardiovascular | ||
8 | Genito-urinary physiological investigations | ||
9 | Allergy testing | ||
10 | Other diagnostic procedures and investigations | ||
D2 | Nuclear Medicine (non-imaging) | ||
T1 | Miscellaneous therapeutic procedures | 2 | Dialysis |
4 | Paediatric and neonatal | ||
5 | Cardiovascular | ||
8 | Haematology | ||
9 | Procedures associated with intensive care and cardiopulmonary support | ||
11 | Chemotherapeutic procedures | ||
13 | Miscellaneous therapeutic procedures | ||
T2 | Radiation oncology | 1 | Superficial |
T3 | Therapeutic nuclear medicine | ||
T4 | Obstetrics | ||
T6 | Examination by anaesthetist | ||
T7 | Regional or field nerve blocks | ||
T8 | Surgical Operations | 1 | General |
2 | Colorectal | ||
3 | Vascular | ||
4 | Ear, nose and throat | ||
5 | Urological | ||
6 | Cardio-thoracic | ||
7 | Neurosurgical | ||
8 | Ear, nose and throat | ||
9 | Ophthalmology | ||
11 | Paediatric | ||
12 | Amputations | ||
13 | Plastic and reconstructive surgery | ||
14 | Hand surgery | ||
15 | Orthopaedic | ||
T9 | Assistance at operations | ||
T10 | Anaesthesia performed in connect with certain services (relative value guide) | All
|
|
Diagnostic Imaging Services Table
Group | Group Name | Subgroup | Subgroup Name |
I1 | Ultrasound | 6 | Musculoskeletal ultrasound |
I3
| Diagnostic Radiology
| 1 | Radiographic examination of extremities |
2 | Radiographic examination of shoulder or pelvis | ||
3 | Radiographic examination of head | ||
4 | Radiographic examination of spine | ||
5 | Cardiovascular | ||
6 | Radiographic examination of thoracic region | ||
7 | Radiographic examination of urinary tract | ||
8 | Radiographic examination of alimentary tract and biliary system | ||
12 | Radiographic examination with opaque or contrast media | ||
I6 | Management of bulk billed Services | ||
Pathology Services Table
Group | Group Name |
P1 | Haematology |
P2 | Chemical |
P9 | Simple Basic Pathology Tests |
P12 | Management of bulk billed services |
SCHEDULE B
Approved Practice Locations
Approved locations:
Location | Practice Name | Street Address | Mailing Address |
Sefton Park | Sefton Park Community Health Care Service | Shop 5, 22 Main North Road, Sefton Park, South Australia 5083 | Shop 5, 22 Main North Road, Sefton Park, South Australia 5083 |
Port Adelaide | Watto Purrunna Aboriginal Health Service | Wonggangga Turtpandi, | Wonggangga Turtpandi, |
Elizabeth | Youth Health Service | 6 Gillingham Street, Elizabeth, South Australia 5112 | 6 Gillingham Street, Elizabeth, South Australia 5112 |
Angel Park | Youth Health Service | 40-44 Trafford Street, Angle Park, South Australia 5010 | 40-44 Trafford Street, Angle Park, South Australia 5010 |
Christies Beach | Youth Health Service | 50A Beach Road, Christies Beach, South Australia 5165 | 50A Beach Road, Christies Beach, South Australia 5165 |
Noarlunga Centre | Noarlunga Health Service | 20 Alexander Kelly Drive, Noarlunga Centre, South Australia 5168. | 20 Alexander Kelly Drive, Noarlunga Centre, South Australia 5168. |