AUSTRALIAN GOVERNMENT
DEPARTMENT OF HEALTH, DISABILITY AND AGEING
HEALTH INSURANCE ACT 1973
Health Insurance (Medicare Benefits Payable in Respect of Professional Services – Riverland Mallee Coorong Local Health Network - Medical Services performed under the Single Employer Model Trial) 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:
- REPEAL the Health Insurance (Medicare Benefits Payable in Respect of Professional Services – Riverland Mallee Coorong Local Health Network) Direction 2022; and
- 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 Rural General Practice and Rural Generalist Single Employer Model Trial Memorandum of Understanding between the Department of Health, Disability and Ageing (ABN: 24 004 196 909), the Riverland Mallee Coorong Local Health Network (ABN: 44 685 908 941) and the South Australian Department for Health and Wellbeing (ABN: 97 643 356 590) in relation to the Rural General Practice and Rural Generalists Single Employer Model for which:
- 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) and pathology services table (means the table prescribed under subsection 4A(1) of the Act) relates: and
- Where the professional service is provided to:
- an eligible person (as defined in Section 3 of the Act); and
- a patient who is 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
- a patient who also is not receiving a service which attracts a payment through Schedule K of the 2020-2025 Addendum to the National Health Reform Agreement for a service rendered to a public patient; and
- the professional services referred to in paragraph (2)(a) must be provided:
- at a general practice (as defined in Section 7.1.1 of the general medical services table); and
- at a rural or remote practice location specified in Schedule B in an eligible area (as defined in the Dictionary of the general medical services table); and
- by a participating rural generalist or rural general practice trainee participating in the program mentioned in paragraph (2)(a):
- who is formally enrolled in a fellowship training program that meets the training standards of either:
- the Australian College of Rural and Remote Medicine Independent Pathway; and/or
- the Royal Australian College of General Practitioners; and
- who is employed by the Riverland Mallee Coorong Local Health Network for the provision of primary and acute care services; and
- is registered in the Riverland Academy of Clinical Excellence rural generalist training program within the Riverland Mallee Coorong Local Health Network region; and
- who is formally enrolled in a fellowship training program that meets the training standards of either:
- DECLARE that this Direction commences on 12 January 2026 and ceases to have effect at the end of 31 December 2028 unless earlier repealed.
Note, this program covers the twenty rural generalist and rural general practice participants who are eligible to use this Direction at any one time.
Date: 17 December 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 AS AGREED under the Riverland Mallee Coorong Local Health Network rural GenERAL PRACTICE AND RURAL Generalist SINGLE EMPLOYER Model TRIAL
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
Standard Primary Care Services Table
For services listed in the below table, this list of items includes MBS items that are commonly claimed by doctors in primary care.
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 | 5 | Prescribed medical practitioner health assessments |
6 | Prescribed medical practitioner chronic condition management plans, multidisciplinary care plans and case conferences | ||
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 |
2 | Case conferences | ||
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-hour attendances to which no other item applies | ||
A27 | Pregnancy support counselling | ||
A29 | Attendance services for complex neurodevelopmental disorder or disability | ||
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 |
3 | Review of eating disorder treatment and management plans | ||
4 | Providing treatments under eating disorder treatment and management plans | ||
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 | ||
19 | GP Mental Health Treatment Plan - Video Services | ||
21 | GP Eating Disorder Treatment and Management Plan – Video Services | ||
25 | Review of an Eating Disorder Plan - Video Services | ||
26 | Review of an Eating Disorder Plan – Phone Service | ||
27 | GP - Eating Disorder Psychological Treatment Services – Video Services | ||
28 | GP - Eating Disorder Psychological Treatment Strategies – Phone Service | ||
29 | GP and Other Medical Practitioner - Urgent After Hours Service in Unsociable Hours - Video Services | ||
37 | Specialist, anaesthesia 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 | ||
M1 | Management of bulk billed services | ||
M12 | Services provided by a practice nurse, an Aboriginal and Torres Strait Islander 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 and Torres Strait Islander health worker or an Aboriginal and Torres Strait Islander health practitioner 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 | ||
Non-Standard Primary Care Services Table For services listed in the below table, this list of items includes MBS items that are not commonly claimed by doctors in primary care. | |||
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 | ||
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 | Gynaecological | ||
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 or wrist surgery | ||
15 | Orthopaedic | ||
T9 | Assistance at operations | ||
T10 | Anaesthesia performed in connection with certain services (Relative Value Guide) | ||
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 | Bone age study and skeletal survey | ||
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 Modified Monash 3-7 rural and remote Practice Locations AS AGREED under the Riverland Mallee Coorong Local Health Network rural GENERAL PRACTICE ANd RURAL Generalist SINGLE EMPLOYER Model TRIAL
Approved primary care Modified Monash Model (MMM) 3 locations:
MMM 3 location | Practice Name | Legal Name | Street Address |
Murray Bridge | Bridge Clinic | Bridge Clinic | 8 Standen Street, Murray Bridge SA 5253 |
Approved primary care Modified Monash Model (MMM) 5 locations:
MMM 5 location | Practice Name | Legal Name | Street Address |
Renmark | Renmark Medical Clinic | H.W. Eske & J.E. Mcleod & Z Wang | 65 Thurk Street, Renmark SA 5341 |
Berri | Berri Medical Clinic | G. Dalamagas & K.J. Stanton | 29 McGilton Road, Berri SA 5343 |
Barmera | Barmera Medical Clinic | The Trustee for Barmera Medical Clinic Trust | 24 Hawdon Street, Barmera SA 5345 |
Loxton | Loxton Health Centre | The Trustee for Loxton Health Centre Unit Trust | 11 Anzac Crs, Loxton SA 5333 |
Mannum | Mannum Medical Centre | The Trustee for Mannum Medical Services Unit Trust | 61-63 Adelaide Road, Mannum SA 5238 |
Meningie | Coorong Medical Centre | M.J. & D.G. Kerrigan Pty Ltd. | 2 South Terrace, Meningie SA 5264 |
Waikerie | Waikerie Medical Centre | The Trustee for Waikerie Medical Centre Unit Trust | 2 Strangman Road, Waikerie SA 5330 |