Health Insurance (Medicare Benefits Payable in Respect of Professional Services – Victoria - Medical Services performed under the Single Employer Model Trial) Direction 2024 - Legislation

AUSTRALIAN GOVERNMENT

DEPARTMENT OF HEALTH AND AGED CARE

HEALTH INSURANCE ACT 1973

Health Insurance (Medicare Benefits Payable in Respect of Professional Services – Victoria - Medical Services performed under the Single Employer Model Trial) Direction 2024

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:

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 Generalist Single Employer Model Trial Memorandum of Understanding between the Department of Health and Aged Care (ABN: 83 605 426 759) and the State of Victoria as represented by the Department of Health (ABN: 74 410 330 756) in relation to the Rural Generalist Single Employer Model Trial 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);
  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 (1)(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 rural generalist trainee participating in the program mentioned in paragraph (1)(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 State of Victoria as represented by the Department of Health for the provision of primary and acute care services; and
DECLARE that this Direction commences on 3 February 2025 and ceases to have effect at the end of 31 December 2026 unless earlier revoked.

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

Date: 18 December 2024

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 Victorian 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

Approved Modified Monash 2-7 rural and remote Practice Locations AS AGREED under the Victorian rural Generalist SINGLE EMPLOYER Model TRIAL

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

MMM 2 location	Practice Name	Legal Name	Street Address
Bendigo	Bendigo Community Health Services	Bendigo Community Health Services Limited	75 Mitchell Street Bendigo VIC 3550
Drysdale	Trinity Family Medical Centre	Trinity Family Medical Centre Pty Ltd	49 Clifton Spring Rd Drysdale VIC 3222

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

MMM 3 location	Practice Name	Legal Name	Street Address
Echuca	Dove Medical Centre	The Trustee for The RMJ Trust	309 High Street Echuca VIC 3564
Echuca	Echuca Moama Family Medical Practice	The Trustee for the Nish Street Unit Trust	179-183 Annesley Street Echuca VIC 3564
Echuca	Rich River Health Group	Family Doctor Pty Ltd	214 Ogilvie Ave Echuca VIC 3564
Horsham	Lister House Medical Clinic	Lister House Clinic Administration Trust	146 Baillie St Horsham VIC 3400
Horsham	Read Street Medical Clinic	Grampians Health	6-12 Read Street Horsham VIC 3400
Mildura	Deakin Medical Centre	The Trustee for DM Unit Trust	255 Deakin Avenue Mildura VIC 3500
Mildura	Kure Medical Mildura	KMG Mildura Pty Ltd	133-137 Langtree Avenue Mildura VIC 3500
Mildura	Lime Medical Clinic	Family Doctor Pty Ltd	154 Lime Ave Mildura VIC 3500
Mildura	Mildura Health Private Hospital	Mildura District Hospital Fund Ltd.	220 - 228 Thirteenth Street Mildura VIC 3500
Mildura	Ontario Family Practice	The Trustee for Ontario Family Practice Unit Trust	202 Ontario Avenue Mildura VIC 3500
Mildura	Ontario Medical Clinic	Ontario Medical Clinic Unit Trust	196-200 Ontario Avenue Mildura VIC 3500
Moama	Echuca Moama Family Medical Practice	The Trustee for the Nish Street Unit Trust	1 Martin Street Moama NSW 2731
Red Cliffs	Sunraysia Medical Centre	The Trustee for Medicentre Medical Trust	49 Indi Avenue Red Cliffs VIC 3496
Shepparton	Shepparton Medical Centre	Melbourne Teaching Health Clinics Ltd	49 Graham Street Shepparton VIC 3630
Trafalgar	Trafalgar Medical Centre	The Trustee for Trafmc Unit Trust	24a Contingent Street Trafalgar VIC 3824
Wangaratta	Wangaratta Medical Centre	MG MEDICAL CO PTY LTD	34 Green St Wangaratta VIC 3677
Warrnambool	Middle Island Medical Clinic	The Mckellar Group Pty Ltd	43 Fairy St Warrnambool VIC 3280

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

MMM 4 location	Practice Name	Legal Name	Street Address
Ararat	Ararat Medical Centre	F Ahmad & M.J Connellan & P Fonseka & P Pretorius & C.S Wong	55 High Street Ararat VIC 3377
Bairnsdale	Dr Jane's Place	D.G. Campbell Proprietary Limited	188 Macleod Street Bairnsdale VIC 3875
Bairnsdale	Macleod Street Medical Centre	Macleod Street Medical Centre	93 Macleod Street Bairnsdale VIC 3875
Castlemaine	Botanical Gardens Health	The Trustee for Botanical Gardens Health Services Trust	137 Cornish Street Castlemaine VIC 3450
Castlemaine	Goldfields Medical Group T/A Lyttleton St Medical Clinic	The Trustee for Goldfields Medical Group Trust	64 Lyttleton St Castlemaine VIC 3450
Castlemaine	Mostyn Street Clinic	The Trustee For Mostyn Street Clinic Trust	11 Mostyn Street Castlemaine VIC 3450
Corowa	Redgum Medical Group	The Trustee for Corowa Medical Centre Trust	61 Guy Street Corowa NSW 2646
Kilmore	Stepping Stones Medical Centre	The Trustee for Stepping Stones Unit Trust	1A Mill Road Kilmore VIC 3764
Kyabram	Kyabram Regional Clinic	The Trustee for the New Kyabram Regional Clinic Unit Trust	98 Fenaughty St Kyabram VIC 3620
Lakes Entrance	Cunninghame Arm Medical Centre	D.G. Campbell Proprietary Limited	8 Whiters Street Lakes Entrance VIC 3909
Lakes Entrance	Gippsland Lakes Complete Health	Gippsland Lakes Complete Health Limited	18-26 Jemmeson Street Lakes Entrance VIC 3909
Maryborough	Nightingale Clinic	The Trustee for Nightingale Clinic Unit Trust	6 Neill Street Maryborough VIC 3465
Sale	Clocktower Medical Centre	Y Jiang & G Pathania & R Sudan & W Truong & T Walsh	284 Raymond Street Sale VIC 3850
Sale	Inglis Medical Centre	The Trustee for Inglis Medical Centre Service Trust	12 Inglis Street Sale VIC 3850
Sale	Sale Medical Centre	Nicolson Medical Services Pty Ltd	73 Pearson St Sale VIC 3850
Stawell	Stawell Medical Centre	Grampians Health	26 Wimmera Street Stawell VIC 3380
Swan Hill	Swan Hill Primary Health Medical Center (High Street)	Swan Hill District Health	31 High street Swan Hill VIC 3585
Swan Hill	Swan Hill Primary Health Medical Centre (McCrae Street)	Swan Hill District Health	54-56 McCrae Street Swan Hill VIC 3585
Yarrawonga	Yarrawonga Medical Clinic	The Trustee For Guha Family Trust	29 Hume Street Yarrawonga VIC 3730

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

MMM 5 location	Practice Name	Legal Name	Street Address
Beaufort	Beaufort Family Practice	Beaufort Family Practice Pty Ltd	54 Neill Street Beaufort VIC 3373
Cobden	Cobden Family Practice	Cobden District Health Services Inc	5 Victoria Street Cobden VIC 3266
Cohuna	Ochre Health Cohuna	Ochre Health Pty Limited	111 King George Street Cohuna VIC 3564
Daylesford	Springs Medical	The Trustee For Springs Medical Centre Service Trust	10 Hospital Street Daylesford VIC 3460
Foster	Foster Medical Centre	The Trustee for the Medical Services Trust	97 Station Road Foster VIC 3960
Heyfield	Heyfield Medical Centre	Peter Michael Stevens Pty Ltd.	19 Tyson Road Heyfield VIC 3858
Kerang	Kerang Medical Centre	Kerang District Health	47 Victoria St Kerang VIC 3579
Leongatha	Leongatha Healthcare Services	The Trustee for Leongatha Healthcare Services Trust	14 Koonwarra Road Leongatha VIC 3953
Mansfield	Mansfield Medical Clinic	Mansfield Medical Clinic Pty Ltd.	49 Highett St Mansfield VIC 3722
Murchison	Murchison Medical Clinic	The Trustee for Aluthge Family Trust	21 Impey Street Murchison VIC 3610
Myrtleford	Alba Health	Alba Health Pty Ltd	153-157 Myrtle Street Myrtleford VIC 3737
Nagambie	Nagambie Medical Centre	The Trustee for Atif Medical Practice Trust	20 Church Street Nagambie VIC 3608
Ouyen	Mallee Track Medical Clinic Ouyen	Mallee Track Health and Community Service	28 Britt Street Ouyen VIC 3490
Port Fairy	Port Fairy Medical Clinic	The Trustee for Oigles Service Trust	28 Villiers Street Port Fairy VIC 3284
Robinvale	RFDS Health Group Robinvale	Royal Flying Doctor Service of Australia (Victorian Section)	128-132 Latje Road Robinvale VIC 3549
Sea Lake	Mallee Track Medical Clinic Sea Lake	Mallee Track Health and Community Service	33-43 McClelland Avenue Sea Lake VIC 3533
Teesdale	Teesdale Family Medical Centre	Trinity Medical Group Pty Ltd	33 Bruce St Teesdale VIC 3328

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

MM6 Location	Practice Name	Legal Name	Street Address
Mallacoota	Mallacoota Medical Centre	The Trustee For The Mallamed Unit Trust	21-23 Maurice Ave Mallacoota VIC 3892

Health Insurance (Medicare Benefits Payable in Respect of Professional Services – Victoria - Medical Services performed under the Single Employer Model Trial) Direction 2024

Administered by Department of Health, Disability and Ageing

Interactions

Legislation content

Interactions

Authorises

All Versions