Health Insurance (Medicare Benefits Payable in Respect of Professional Services – Primary Health Networks Program: General Practice Incentive Fund) Direction 2025

AUSTRALIAN GOVERNMENT

DEPARTMENT OF HEALTH, DISABILITY AND AGEING

HEALTH INSURANCE ACT 1973

Health Insurance (Medicare Benefits Payable in Respect of Professional Services – Primary Health Networks Program: General Practice Incentive Fund) Direction 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:

1.                REPEAL the Health Insurance (Medicare Benefits Payable in Respect of Professional Services – Primary Health Networks Program: General Practice Incentive Fund Direction 2024; and
2.                DIRECT that Medicare benefits shall be payable in respect of:

1.      a professional service (as defined in section 3 of the Act) which has been agreed to be provided in accordance with the Primary Health Networks Program: General Practice Incentive Fund managed by the Department of Health and Aged Care (ABN: 83 605 426 759) and the organisations listed in Schedule B of this Direction, in relation to medical 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) relate
2.      Where the professional service is provided to:
   1.        an eligible person (as defined in section 3 of the Act) who is;
      1. 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
      2. not receiving a service which attracts a payment through the 2020-2025 Addendum, schedule K, one year extension, to the National Health Reform Agreement for a service rendered to a public patient; and
3.      the professional services referred to in paragraph (1)(a) must be provided:
   1.        by a person who is employed or engaged by an organisation listed in Schedule B of this Direction; and
   2.   by a general practitioner (as defined in section 3 of the Act) who is registered to provide services with Services Australia under the General Practice Incentive Fund Program mentioned in paragraph (1)(a).

1.             DECLARE that this Direction commences on 1 July 2025 and ceases to have effect at the end of 30 June 2027 unless earlier revoked.

Dated: 24 June 2025

Nigel MurrayAssistant SecretaryMBS Policy and Specialist Programs BranchMedicare Benefits and Digital Health DivisionHealth Resourcing Group Department of Health, Disability and Ageing

SCHEDULE A

MEDICARE BENEFITS SCHEDULE (MBS) ITEMS AS AGREED under the General Practice Incentive Fund

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. Medical practitioners and health services must ensure they fulfil the MBS requirements for all items.

General Medical Services Table

SCHEDULE B

Approved locations for provision of services under the General PRACTICE Incentive fund

QUEENSLAND