Health Insurance (Medicare Benefits Payable in Respect of Professional Services – South Australia - Medical Services performed under the Single Employer Model Trial) Direction 2025 - Legislation

AUSTRALIAN GOVERNMENT

DEPARTMENT OF HEALTH AND AGED CARE

HEALTH INSURANCE ACT 1973

Health Insurance (Medicare Benefits Payable in Respect of Professional Services – South Australia - 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 Aged Care, 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 – South Australia - Medical Services performed under the Single Employer Model Trial) Direction (No.2) 2024; and
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 under the Rural General Practice and Rural Generalist Single Employer Model Trial Memorandum of Understanding between the Department of Health and Aged Care (ABN: 83 605 426 759) and the South Australian Department of Health and Wellbeing (ABN: 97 643 356 590) in relation to the Rural General Practice and Rural Generalist Single Employer Model Trial within regional South Australia 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), diagnostic imaging services table (means the table prescribed under subsection 4AA(1) of the Act) or pathology services table (means the table prescribed under subsection 4A(1) of the Act) relates: and
2. Where the professional service is provided to:
  1. an eligible person (as defined in section 3 of the Act); and
  2. 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
  3. a patient who also is not receiving a service which attracts a payment through the 2020-2025 Addendum to the National Health Reform Agreement for a service rendered to a public patient; and
3. The professional services referred to in paragraph (2)(a) must be provided:
  1. at a general practice (as defined in Section 7.1.1 of the general medical services table); and
  2. at a rural or remote practice location specified in Schedule B in an eligible area (as defined in the Dictionary of the of the general medical services table); and
  3. by a participating rural generalist or rural general practice trainee participating in the program mentioned in paragraph (2)(a):
    1. who is formally enrolled in a fellowship training program that meets the training standards of either:
      1. the Australian College of Rural and Remote Medicine; and/or;
      2. the Royal Australian College of General Practitioners.
    2. who is employed by the South Australian Department of Health and Wellbeing for the provision of primary and acute care services; and
DECLARE that this Direction commences on the day after registration and ceases to have effect at the end of 31 December 2028 unless earlier revoked.

Note, this program covers the sixty rural generalist and rural general practice participants who are eligible to use this Direction at any one time.

Date: 20 February 2025

Nigel Murray
Assistant Secretary
MBS Policy and Specialist Programs Branch
Medicare Benefits and Digital Health Division
Health Resourcing Group
Department of Health and Aged Care

SCHEDULE A

MEDICARE BENEFITS SCHEDULE (MBs) ITEMS AS AGREED under the SOuTH AUSTRALIAN 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
A11	Urgent attendances after—hours
A14	Health assessments
A15	GP management plans, team care arrangements and multidisciplinary care plans and case conferences	1	GP management plans, team care arrangements and multidisciplinary care plans
A15		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‑hours 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 disorder services	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 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 Service
		13	GP management plans, team care arrangements and multidisciplinary care plans via telehealth attendance
		15	GP Pregnancy Support Counselling ‑ Telehealth Service
		16	GP Pregnancy Support Counselling ‑ Phone Service
		17	GP, specialist and consultant physician complex neurodevelopmental disorder or disability service ‑ telehealth service
		19	GP Mental Health Treatment Plan ‑ Telehealth Service
		20	GP Mental Health Treatment Plan ‑ Phone Service
		21	GP Eating Disorder Treatment and Management Plan – Telehealth Service
		25	Review of an Eating Disorder Plan ‑ Telehealth Service
		26	Review of an Eating Disorder Plan – Phone Service
		27	Eating Disorder Psychological Treatment Services – Telehealth Service
		28	Eating Disorder Psychological Treatment Strategies – Phone Service
		29	GP and Other Medical Practitioner ‑ Urgent After Hours Service in Unsociable Hours ‑ Telehealth Service
		37	Specialist, anaesthesia 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
A44	General Practice Attendance for Assessing Patient Suitability for a COVID‑19 Vaccine
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
M12		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.

Group	Group Name	Subgroup	Subgroup Name
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

MEDICARE BENEFITS SCHEDULE (MBS) ITEMS AS AGREED under the SOUTH AUSTRALIAN rural general practice and rural Generalist SINGLE EMPLOYER Model TRIAL

Approved primary care Modified Monash Model (MMM) 2 locations:

MMM 2 location	Practice Name	Legal Name	Street Address
Gumeracha	Gumeracha Medical Practice	Gum Medical Pty Ltd	29 Albert Street Gumeracha SA 5233

Approved primary care Modified Monash Model (MMM) 3 locations:

MMM 3 location	Practice Name	Legal Name	Street Address
Goolwa	Goolwa Medical Centre	Goolwa Medical Services Trust	9 Crocker Street Goolwa SA 5214
Littlehampton	Littlehampton Medical Centre	The Trustee For Littlehampton Medical Management Trust	89 North Terrace Littlehampton SA 5250
Middleton	Mill House Medical Centre	Mill House Medical Centre Pty Ltd	5 Goolwa Road Middleton SA 5213
Mount Barker	Adelaide Hills Country Medical Centre	Adelaide Hills Country Practice Pty Ltd	38 Adelaide Road Mount Barker SA 5251
Mount Barker	GP Care (part of Summit Health)	Summit Health Incorporated	85 Wellington Road Mount Barker SA 5251
Mount Barker	Mount Barker / Balhannah Medical Centre	The Trustee For BALMED SERVICE TRUST	59 Wellington Road Mount Barker SA 5251
Mount Barker	Mount Barker Medical Clinic	Hills Medical Pty Ltd	Suite 1/ 15-19 Victoria Crescent Mount Barker SA 5251
Mount Barker	Mount Barker South Medical Centre	Hills Medical Pty Ltd	58 Wellington Road Mount Barker SA 5251
Mount Gambier	Hawkins Medical Clinic	The Trustee for The Hawkins Medical Clinic Practice Trust	30 Sturt St Mount Gambier SA 5290
Suttontown	Hawkins@Pinehall General Medical Practice	The Trustee for The Hawkins Medical Clinic Practice Trust	10-12 Pinehall Ave Suttontown, Mount Gambier SA 5291
Victor Harbor	Skintech Medical	Brooks Medical Pty Ltd	23 Mayfield Terrace Victor Harbor SA 5211
Victor Harbor	Victor Medical Centre	D.K Batt & N Dixon & A.G Doley & R.J Greasley & K Hancock & A.M Hoile & D.S Makoy & J Mintz & C North & C.L Price & E.M Radcliffe & J Shute & T Sullivan & K Van Gordon & G.A Wildman	11 Torrens Street Victor Harbor SA 5211
Whyalla Norrie	Bunyarra Medical Clinic	Bunyarra Medical Clinic Pty Ltd	153 Nicolson Avenue Whyalla Norrie SA 5608
Whyalla Stuart	McRitchie Crescent Surgery	The Trustee for the Connolly Family Trust	31 McRitchie Crescent Whyalla Stuart SA 5608

Approved primary care Modified Monash Model (MMM) 4 locations:

MMM 4 location	Practice Name	Legal Name	Street Address
Angaston	Angaston Medical Centre	Angaston Medical Centre Pty Ltd	46 Murray Street Angaston SA 5353
Angaston	Angaston Medical Centre - Health on Washington	Angaston Medical Centre Pty Ltd	3-7 Fife Street Angaston SA 5353
Port Augusta	Augusta Westside Medical Centre	The Trustee For David Hazel Family Trust	25 Loudon Road Port Augusta West SA 5700
Port Augusta	Port Augusta Medical Centre	Omar Hayat Nominees Pty Ltd	15-19 Gibson Street Port Augusta SA 5700
Port Pirie	Terrace Clinic	Terrace Clinic Pty Ltd	138 The Terrace Port Pirie SA 5540
Port Pirie	Central Clinic	Medical Sixth Group Pty Ltd	101 Florence St Port Pirie SA 5540

Approved primary care Modified Monash Model (MMM) 5 locations:

MMM 5 location	Practice Name	Legal Name	Street Address
Ardrossan	Medical HQ Ardrossan	Ardrossan Medical Practice Pty Ltd	10 Second St Ardrossan 5571
Booleroo Centre	Booleroo Medical Centre	Yorke And Northern Local Health Network Incorporated	11b Stephens St Booleroo Centre SA 5482
Clare	Clare Medical Centre	G.T Considine & P.D Gribble & L.Y Koo & T.R Nottage & M.W Nugent & T.A Owen & M.S Scheepers	41 Old North Road, Clare SA 5453
Crystal Brook	Crystal Brook Medical Practice	Forrester Medical Pty Ltd & H Deer Medical Pty Ltd & Kc Chen Family Medical Practice Pty Ltd	1 Claridge Road Crystal Brook SA 5523
Eudunda	Eudunda Medical Practice	The Trustee For Kapunda Surgery Unit Trust	25a Bruce Street Eudunda SA 5374
Hawker	Hawker Medical Centre	Flinders And Upper North Local Health Network Incorporated	9 Druid Range Drive Hawker SA 5434
Jamestown	Goyder's Line Medical Practice	Jamestown Peterborough Medical Practice Pty Ltd	66 Irvine St Jamestown SA 5491
Kadina	Kadina Medical Associates	The Trustee For The Kma Services Unit Trust	77-79 Port Road Kadina SA 5554
Kapunda	Kapunda Medical Practice	The Trustee For Kapunda Surgery Unit Trust	32 Hill Street Kapunda SA 5373
Kapunda	Kapunda Medical Practice (Willow Drive)	The Trustee For Kapunda Surgery Unit Trust	4 Willow Drive Kapunda SA 5373
Kingston SE	Kingston Medical Centre	The Trustee For Limestone Coast Health Unit Trust	89 Agnes Street Kingston SE SA 5275
Laura	Laura District Medical Practice	The Trustee For Laura District Medical Practice Unit Trust	53-55 Mill Street Laura SA 5480
Lobethal	Lobethal Medical Centre	Gum Medical Pty Ltd	5 Wattle Street Lobethal SA 5241
Maitland	Medical HQ Maitland	Medical Hq Group Pty Ltd	69 Robert St Maitland SA 5573
Mount Pleasant	Talunga Clinic	The Trustee For Talunga Clinic Unit Trust	28 Hospital Road Mount Pleasant SA 5253
Naracoorte	Kincraig Medical Clinic	Naracoorte Medical Centre Pty Ltd	6 Cedar Ave Naracoorte SA 5271
Nuriootpa	Nuriootpa Medical Centre	The Trustee For Nuriootpa Medical Clinic Trust	6 Memorial Avenue Nuriootpa SA 5355
Port Broughton	Broughton Clinic	N.P. Witford Pty Ltd & Dr A.R. Edwards	22 Bay Street Port Broughton SA 5522
Robe	Robe Medical Centre	The Trustee For Limestone Coast Health Unit Trust	1 Smillie Street Robe SA 5276
Strathalbyn	Strathalbyn Family Medical Centre	Hills Medical Pty Ltd	Unit 4/10-14 Braemar Drive Strathalbyn SA 5255
Strathalbyn	Strathalbyn Medical Clinic	Sempire Strathalbyn Medical Clinic Pty Ltd	24 West Terrace Strathalbyn SA 5255
Tanunda	Tanunda Medical Centre	W.J Geyer & S.M Malone & J.M Myatt & N.K Payne & D.K Pellegrini & M.S Teague & S.G Teague & F.J Vivian	13 Mill Street Tanunda SA 5352
Yankalilla	Southern Fleurieu Family Practice	The Trustee For Southern Fleurieu Medical Service Trust	175 Main South Road Yankalilla 5203

Approved primary care Modified Monash Model (MMM) 6 locations:

MMM 6 location	Practice Name	Legal Name	Street Address
Coffin Bay	Lower Eyre Family Practice	Dr Gc Quigley Pty Ltd	5/61 Esplanade Coffin Bay SA 5607
Cummins	Lower Eyre Family Practice	Dr Gc Quigley Pty Ltd	Tumby Bay Road Cummins SA 5631
Port Lincoln	The Investigator Clinic	The Trustee For Investigator Clinic Unit Trust	86 Liverpool Street Port Lincoln SA 5606
Port Lincoln	Lincoln Medical Centre	The Trustee For Lincoln Medical Centre Trust	10 Haigh Street Port Lincoln SA 5606
Port Lincoln	Boston Bay Family Health Practice	The Trustee For The Dg & Ac Bascomb Family Trust	10 New West Road Port Lincoln SA 5606
Roxby Downs	Roxby Downs Doctors Surgery	Rdds Pty Ltd	16-28 Burgoyne Street Roxby Downs SA 5725
Roxby Downs	Roxby Downs Family Practice	Lockwood Medical Group Pty Ltd	24 Gregory Street Roxby Downs SA 5725
Streaky Bay	Shoreline Medical	The Trustee For MLB Unit Trust	1 Flinders Drive Streaky Bay SA 5680
Tumby Bay	Tumby Bay Medical Clinic	The Trustee For Bayview Medical Services Trust	8 Esplanade Tumby Bay SA 5605

Approved primary care Modified Monash Model (MMM) 7 locations:

MMM 7 location	Practice Name	Legal Name	Street Address
Ceduna	Ceduna Family Medical Practice	Eyre And Far North Local Health Network Inc	3 Eyre Highway Ceduna SA 5690
Coober Pedy	Coober Pedy Medical Practice	Eyre And Far North Local Health Network Inc	89 Mcdougall Road Coober Pedy SA 5723
Kingscote	Kangaroo Island Medical Clinic	The Trustee For Island Locum Trust	64 Murray Street Kingscote 5223
Wudinna	Wudinna Medical Practice	The Trustee For Scott Lewis Trust	8 Richards Avenue Wudinna SA 5652

Health Insurance (Medicare Benefits Payable in Respect of Professional Services – South Australia - Medical Services performed under the Single Employer Model Trial) Direction 2025

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