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Health Insurance (Medicare Benefits Payable in Respect of Professional Services – Western Australia – Medical Services performed under the Single Employer Model Trial) Direction 2026

Health Insurance (Medicare Benefits Payable in Respect of Professional Services – Western Australia – Medical Services performed under the Single Employer Model Trial) Direction 2026

Administered by Department of Health, Disability and Ageing

Legislation au F2026N00422 In force Notifiable Instrument

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I, Nigel Murray, delegate for the Minister for Health and Ageing, make the following Notifiable Instrument.

Dated 11 June 2026

Nigel Murray

Assistant Secretary
MBS Policy and Specialist Services Branch
Medicare Benefits and Digital Health Division
Health Resourcing Group

Department of Health, Disability and Ageing

Contents

1 Name...................................................1

2 Commencement............................................1

3 Authority................................................1

4 Repeals.................................................1

5 Definitions...............................................1

6 Medicare benefits payable in respect of the Single Employer Model Trial..........2

Schedule 1—Relevant services 4

Schedule 2—Approved clinic locations 9

1 Name

This instrument is the Health Insurance (Medicare Benefits Payable in Respect of Professional Services – Western Australia – Medical Services performed under the Single Employer Model Trial) Direction 2026.

2 Commencement

Each provision of this instrument specified in column 1 of the table commences, or is taken to have commenced, in accordance with column 2 of the table. Any other statement in column 2 has effect according to its terms.

Commencement information
Column 1	Column 2	Column 3
Provisions	Commencement	Date/Details
1. The whole of this instrument	1 July 2026.	1 July 2026

Note: This table relates only to the provisions of this instrument as originally made. It will not be amended to deal with any later amendments of this instrument.

Any information in column 3 of the table is not part of this instrument. Information may be inserted in this column, or information in it may be edited, in any published version of this instrument.

3 Authority

This instrument is made under subsection 19(2) of the Act.

4 Repeals

This instrument is repealed on 31 December 2028 at 11:59pm, unless repealed earlier.

5 Definitions

Act means the Health Insurance Act 1973.

diagnostic imaging services table means the table prescribed under section 4AA of the Act.

eligible person has the meaning given by subsection 3(1) of the Act.

general medical services table means the table prescribed under section 4 of the Act.

general practice has the meaning given by Part 7.1.1 of the Health Insurance (General Medical Services Table) Regulations 2021.

general practitioner has the meaning given by subsection 3(1) of the Act.

hospital treatment has the meaning given by section 121‑5 of the Private Health Insurance Act 2007.

MBS means the Medicare Benefits Schedule.

MMM means the Modified Monash Model.

pathology services table means the table prescribed under section 4A of the Act.

professional service has the meaning given by subsection 3(1) of the Act.

prescribed medical practitioner has the meaning given by Part 7.1.1 of the Health Insurance (General Medical Services Table) Regulations 2021.

6 Medicare benefits payable in respect of the Single Employer Model Trial

A Medicare benefit shall be payable in respect of a professional service where the following are met.

The professional service has been agreed to be provided under the Western Australia Rural Generalist Single Employer Model Trial Memorandum of Understanding between the Department of Health, Disability and Ageing (ABN: 83 605 426 759), the WA Country Health Service (ABN: 28 680 145 816) and the Western Australian Department of Health (ABN: 28 684 750 332).
The professional service is provided to the following:

an eligible person;
a patient who is not receiving the service as part of an episode of hospital treatment;
a patient who also is not receiving a service which attracts a payment:

through the 2026-31 Addendum to the National Health Reform Agreement for a service rendered to a public patient; or
through another government arrangement outside of the Single Employer Model Trial for the professional service rendered to the patient.

The professional service corresponds with an MBS group, subgroup or item specified in Schedule 1.
The professional service referred to in paragraph (a) must be provided:
1. at a general practice; and
2. at a rural or remote location specified in Schedule 2; and
3. by a rural generalist or rural general practice trainee participating in the Single Employer Model Trial, who is employed by the WA Country Health Service for the provision of primary and acute care services, and who is formally enrolled in a fellowship training program that meets the standards of:

(A) the Australian College of Rural and Remote Medicine; and/or

(B) the Royal Australian College of General Practitioners.

Schedule 1—Relevant services

1.1 The items identified in this table are provided for in the general medical services table.

Standard Primary Care Services Table

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 nonspecialist practitioner items	5	Prescribed medical practitioner health assessments
A7	Acupuncture and nonspecialist practitioner items	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
A15		2	Case conferences
A17	Domiciliary and residential medication management reviews
A20	Mental health care
A22	General practitioner afterhours attendances to which no other item applies
A23	Other non-referred afterhours 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 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	Eating Disorder Psychological Treatment Services – Video Services
		28	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
M12		3	Services provided by a practice nurse or an Aboriginal and Torres Strait Islander health practitioner on behalf of a medical practitioner

1.2 The items identified in this table are provided for in the general medical services table.

Note: For services listed in the below table, the list of items includes MBS items that are not commonly claimed by doctors in primary care.

Non-Standard Primary Care Services Table

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	Cardiothoracic
		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)

1.3 The items identified in this table are provided for in the 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

1.4 The items identified in this table are provided for in the pathology services table.

Group	Group Name
P1	Haematology
P2	Chemical
P9	Simple basic pathology tests
P12	Management of bulkbilled services

Schedule 2—Approved MMM 2-7 clinic locations

2.1 The below table lists the approved clinic locations in Western Australia as agreed under the Western Australia Rural Generalist Single Employer Model Trial.

MMM Classification	Location	Clinic Name	Legal Name	Street Address
2	Bunbury	Australind Medical Centre	The Trustee for COAST ROAD MEDICAL UNIT TRUST	24 Old Coast Rd, Bunbury WA 6233
2	Bunbury	Brecken Health	The trustee for RIGHT WEIGHT TRUST	12-16 Vasse St, South Bunbury WA 6230
2	Bunbury	Eaton Medical Centre	The Trustee for COAST ROAD MEDICAL UNIT TRUST	13 Albatross Cres, Bunbury WA 6232
2	Muchea	Muchea Medical Centre	Muchea Medical Centre Pty Ltd	29 Edwards Pl, Muchea WA 6501
3	Albany	Southern Regional Medical Group	THE TRUSTEE FOR MARMION FAMILY TRUST & Others	32 Albany Hwy, Albany WA 6330
3	Busselton	Busselton Medical Practice	The Trustee for the BMS Unit Trust	21 Albert St, Busselton WA 6280
3	Centennial Park	Pioneer Health Albany	THE TRUSTEE FOR THE NORTH ALBANY DOCTORS UNIT TRUST	2 Pioneer Road, Centennial Park WA 6330
3	Dunsborough	Cape Naturaliste Medical Centre	Cape Naturaliste SuperClinic Pty Ltd	32 Gifford Rd, Dunsborough WA 6281
3	Geraldton	City Health Geraldton	The Trustee for City Health Geraldton Trust	194 Durlacher St, Geraldton WA 6530
3	Geraldton	Panaceum Medical	The Trustee for G.M.G. Service Trust	233 Lester Ave, Geraldton WA 6530
3	Geraldton	Victoria District Medical Centre	The Trustee for VDMC Service Trust	151 Durlacher St, Geraldton WA 6530
3	Kalgoorlie	Alpha Medical Center Kalgoorlie	Ovbiagele Pty Ltd	36 MacDonald St, Kalgoorlie WA 6430
3	Wandina	Panaceum Seacrest	The Trustee for G.M.G. Service Trust	75 Barrett Dr, Wandina WA 6530
4	Collie	Collie River Valley Medical Centre	RIVER VALLEY UNIT TRUST	24 Harvey St, Collie WA 6225
4	Margaret River	Margaret River Medical Centre	Brecken Margaret River Medical Centre Pty Ltd	148 Bussell Hwy, Margaret River WA 6285
4	Margaret River	Margaret River Surgery	THE TRUSTEE FOR MARGARET RIVER SURGERY SERVICES TRUST	1 Station Rd, Margaret River WA 6285
4	Northam	Grey Street Surgery	Jupiter Health and Medical Services Pty Limited	16 Grey St, Northam WA 6401
4	Northam	Northam Family Practice	Jupiter Health and Medical Services Pty Limited	33 Wellington St E, Northam WA 6401
5	Alma	Panaceum Northampton	The Trustee for G.M.G Service Trust	51 Robinson St, Alma WA 6535
5	Augusta	Augusta Clinic	Brecken Margaret River Medical Centre PTY LTD	79 Blackwood Ave, Augusta WA 6290
5	Balingup	Balingup Doctors Surgery	Loryn Nicole Geyer	36 Jayes Rd, Balingup WA 6253
5	Beverley	Vines Medical Practice	Bohan (WA) PTY LTD	135 Vincent St, Beverley WA 6304
5	Bindoon	Chittering Health Centre	Jupiter Health and Medical Services Pty Limited	6138 Great Northern Hwy, Bindoon WA 6502
5	Bridgetown	Bridgetown Medical	BRIDGEMED SERVICES PTY LTD	88 Steere St, Bridgetown WA 6255
5	Cunderdin	Livingston Medical Cunderdin	Livingston Medical PTY LTD	55 Lundy Ave, Cunderdin WA 6407
5	Denmark	Denmark Medical Centre	THE DE KLERK FAMILY TRUST NO 3 & THE FAULKNER FAMILY TRUST NO 3 & THE SWARTS FAMILY TRUST NO 3 & THE WARD FAMILY TRUST NO 3	3 Mount Shadforth Rd, Denmark WA 6333
5	Donnybrook	Donnybrook Family Doctors	DONNYBROOK FAMILY DOCTORS PTY LTD	92 South Western Hwy, Donnybrook WA 6239
5	Harvey	Samy Medical Practice Harvey	Samy Medical Group Pty Ltd	3 Hayward St, Harvey WA 6220
5	Katanning	St Luke's Family Practice	The trustee for St Luke's Family Practice Management Trust	7 Elizabeth St, Katanning WA 6317
5	Kojonup	Livingston Medical Kojonup	Livingston Medical PTY LTD	30 Spring St, Kojonup WA 6395
5	Manjimup	Southern Forests Medical Centre	The Trustee for SFH Unit Trust	4 Lock St, Manjimup WA 6258
5	Nannup	Nannup Medical centre	PANACEA HEALTHCARE PTY LTD	Unit 4/54 Warren Rd, Nannup WA 6275
5	Narrogin	Earl Street Surgery	THE TRUSTEE FOR THE WLTC MEDICAL UNIT TRUST	92 Earl St, Narrogin WA 6312
5	Toodyay	Toodyay Medical Group	Toodyay Medical Group	81 Stirling Terrace, Toodyay WA 6566
6	Bremer Bay	Livingston Medical Jerramungup and Bremer Bay	Livingston Medical PTY LTD	29 John St, Bremer Bay WA 6338
6	Broome	Broome Medical Clinic	LRL BROOME MEDICAL PTY LTD	26 Robinson St, Broome WA 6725
6	Dalwallinu	Dalwallinu Medical Centre	THREE SONS PTY LTD	19 Myers St, Dalwallinu WA 6609
6	Esperance	Banksia Medical and Health	Graham G Jacobs Pty Ltd	2 James St, Esperance WA 6450
6	Gnowangerup	Livingston Medical Gnowangerup	Livingston Medical PTY LTD	32 McDonald St, Gnowangerup WA 6335
6	Karratha	Panaceum Karratha	The Trustee for G.M.G. Service Trust	2 Cockatoo St, Karratha WA 6714
6	Kondinin	Livingston Medical Kondinin and Hyden	Livingston Medical PTY LTD	120 Graham St, Kondinin WA 6367
6	Lake Grace	Livingston Medical Lake Grace and Newdegate	Livingston Medical PTY LTD	338 Memorial Dr, Lake Grace WA 6353
6	Narembeen	Livingston Medical Narembeen	Livingston Medical PTY LTD	19 Churchill St, Narembeen WA 6369
6	Wickham	Panaceum Wickham	The trustee for G.M.G Service Trust	755 Carse St, Wickham WA 6720
7	Hopetoun	Hopetoun Medical Centre	Livingston Medical PTY LTD	46 Veal St, Hopetoun WA 6348
7	Kununurra	Wunan Health	WUNAN FOUNDATION INC.	57 Bandicoot Dr, Kununurra WA 6743
7	Leonora	Leonora Medical practice	PIER STREET MEDICAL PTY LTD	967 Sadie Canning Dr, Leonora WA 6438
7	Ravensthorpe	Ravensthorpe Medical Centre	Livingston Medical PTY LTD	52 Martin St, Ravensthorpe WA 6346
7	Tom Price	Tom Price Medical Centre	Tom Price Medical Centre Pty Ltd	854 Central Rd, Tom Price WA 6751

Overview

The Health Insurance (Medicare Benefits Payable in Respect of Professional Services – Western Australia – Medical Services performed under the Single Employer Model Trial) Direction 2026 was introduced to address the specific healthcare needs in rural and remote areas of Western Australia by facilitating a trial of the Single Employer Model. This trial is aimed at ensuring the provision of medical services by appropriately trained professionals in rural and remote settings. Enacted under the authority of the Health Insurance Act 1973, the policy objective of this instrument is to ensure that eligible patients receive appropriate medical services under the trial, thereby improving access to healthcare in underserved areas. The Direction specifies the conditions under which Medicare benefits will be payable for professional services provided during the trial period, which runs until 31 December 2028. It outlines the types of services eligible for Medicare benefits, the locations where these services can be provided, and the qualifications of the practitioners involved.

Scope and Application

The Health Insurance (Medicare Benefits Payable in Respect of Professional Services – Western Australia – Medical Services performed under the Single Employer Model Trial) Direction 2026 applies to the provision of specific medical services in Western Australia under the Rural Generalist Single Employer Model Trial. This Direction stipulates that a Medicare benefit will be payable for professional services provided under the terms of the Memorandum of Understanding between the Department of Health, Disability and Ageing, the WA Country Health Service, and the Western Australian Department of Health. The services must be rendered to eligible persons by a rural generalist or rural general practice trainee, who is employed by the WA Country Health Service and is participating in a fellowship training program. The services must also correspond with specific Medicare Benefits Schedule (MBS) groups, subgroups, or items and must be provided at general practices in rural or remote locations specified in Schedule 2 of the Direction. The Direction commences on 1 July 2026 and is repealed on 31 December 2028 unless repealed earlier. Subordinate instruments may extend or restrict the application of this Direction.

Key Provisions

The main operative sections of the Health Insurance (Medicare Benefits Payable in Respect of Professional Services – Western Australia – Medical Services performed under the Single Employer Model Trial) Direction 2026 (the Direction) outline the circumstances under which a Medicare benefit will be payable. Section 6 states that a Medicare benefit will be payable for professional services that are provided under the Western Australia Rural Generalist Single Employer Model Trial Memorandum of Understanding. The professional services must be provided to eligible persons who are not receiving the service as part of an episode of hospital treatment or under another government arrangement outside of the Single Employer Model Trial, and the service must correspond with an item specified in Schedule 1 of the Direction. The service must also be provided at a general practice in a rural or remote location specified in Schedule 2 of the Direction by a rural generalist or rural general practice trainee participating in the Single Employer Model Trial, who is employed by the WA Country Health Service and enrolled in a fellowship training program meeting the standards of the Australian College of Rural and Remote Medicine or the Royal Australian College of General Practitioners. The Direction imposes several obligations on the parties involved. Firstly, medical practitioners providing services under the trial must be employed by the WA Country Health Service and enrolled in a fellowship training program meeting the specified standards. Secondly, the services must be provided at a general practice located in a specified rural or remote area, as listed in Schedule 2. Thirdly, the services must be provided to eligible persons who meet the criteria outlined in Section 6 of the Direction. Finally, the services must correspond with an item specified in Schedule 1 of the Direction. There are no specific offences, penalties, or civil/criminal consequences mentioned in the Direction for breach of its provisions. However, non-compliance with the conditions outlined in the Direction could potentially result in the denial of Medicare benefits for the services provided. Furthermore, any fraudulent or deliberate misrepresentation of services to obtain Medicare benefits could lead to civil or criminal penalties under other relevant legislation, such as the Commonwealth's Fraud and Related Activities Act 2004.

Area of Law: Health Law; Insurance Law
Instrument: Notifiable Instrument
Concepts: Definitions & Interpretation; Commencement Provisions; Regulatory Standards; Reporting & Disclosure Obligations

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Sourced from the Federal Register of Legislation at 26 August 2026. For the latest information on Australian Government law please go to https://www.legislation.gov.au.

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