EXPLANATORY STATEMENT
Health Insurance Act 1973
Health Insurance (Section 3C Midwife and Nurse Practitioner Services) Amendment (Patient End Support Services) Determination 2025
Subsection 3C(1) of the Health Insurance Act 1973 (the Act) provides that the Minister may, by legislative instrument, determine that a health service not specified in an item in the general medical services table (the GMST) shall, in specified circumstances and for specified statutory provisions, be treated as if it were specified in the GMST.
The GMST is set out in the regulations made under subsection 4(1) of the Act. The most recent version of the regulations is the Health Insurance (General Medical Services Table) Regulations 2021 (the GMST Regulations).
This instrument is made pursuant to subsection 33(3) of the Acts Interpretation Act 1901, which provides that a power to make a legislative or administrative instrument includes the power to repeal, rescind, revoke amend, or vary any that instrument in the same manner and subject to the same conditions.
Purpose
The purpose of the Health Insurance (Section 3C Midwife and Nurse Practitioner Services) Amendment (Patient End Support Services) Determination 2025 (the Amendment Determination) is to amend the Health Insurance (Section 3C Midwife and Nurse Practitioner Services) Determination 2020 (the Principal Determination) to introduce eight new Medicare Benefits Schedule (MBS) items from 1 March 2026 for patient end support (PES) services rendered by nurse practitioners.
The new MBS items (82250, 82251, 82252, 82253, 82254, 82255, 82256 and 82257) are for professional attendances by a participating nurse practitioner, where the nurse practitioner is providing face to face clinical support to a patient who is participating in a video conference attendance with a consultant physician or specialist. The new items for PES services are time-tiered - of varying durations - and may be provided in consulting rooms or at a place other than consulting rooms. The nurse practitioner providing the PES consultation must be in the same room as the patient for the duration of the service.
The introduction of the eight new items by the Amendment Determination forms part of a broader suite of new PES items. Subject to the making of legislation, from 1 March 2026 the Health Insurance Legislation Amendment (2026 Measures No. 1) Regulations 2026 will introduce an additional 24 new items for PES services rendered by prescribed medical practitioners and general practitioners to the GMST Regulations.
Policy authority was agreed to as part of the 2025-26 Budget under the Strengthening Medicare measure.
Consultation
The new PES items being introduced are pursuant to recommendation 10 of the Telehealth Post-Implementation Review Final Report by the Medical Review Advisory Committee (MRAC), released in March 2024. More than 450 responses were received through the Telehealth Post-Implementation Review, which included consultation with members from health organisations, peak bodies and consumers.
The Amendment Determination is a legislative instrument for the purposes of the Legislation Act 2003.
The Amendment Determination commences on 1 March 2026.
Details of the Amendment Determination are set out in the Attachment.
Authority: Subsection 3C(1) of the
Health Insurance Act 1973
ATTACHMENT
Details of the Health Insurance (Section 3C Midwife and Nurse Practitioner Services) Amendment (Patient End Support Services) Determination 2025
Section 1 – Name
Section 1 provides for the instrument to be referred to as the Health Insurance (Section 3C Midwife and Nurse Practitioner Services) Amendment (Patient End Support Services) Determination 2025 (the Amendment Determination).
Section 2 – Commencement
Section 2 provides for the Amendment Determination to commence on 1 March 2026.
Section 3 – Authority
Section 3 provides that the Amendment Determination is made under subsection 3C(1) of the Health Insurance Act 1973.
Section 4 – Schedules
Section 4 provides that each instrument that is specified in a Schedule to this Amendment Determination is amended or repealed as set out in the applicable items in the Schedule concerned, and any other item in a Schedule to this Amendment Determination has effect according to its terms.
Schedule 1 – Amendments
Item 1 inserts eight new Medicare Benefits Schedule (MBS) items (82250, 82251, 82252, 82253, 82254, 82255, 82256 and 82257) into new ‘Subgroup 15 – Nurse practitioner patient end support for video conferencing consultations with specialists or consultant physicians’ of ‘Group M14 - Nurse practitioners’.
The new items will provide for patient end support professional attendances of varying durations by a participating nurse practitioner providing clinical support if:
- the attendance is provided by way of face to face; and
- the patient who is receiving the service at the time of attendance is participating in a video conference service from a specialist or consultant physician; and
- the patient is in the same room as nurse practitioner providing the service mentioned above.
Statement of Compatibility with Human Rights
Prepared in accordance with Part 3 of the Human Rights (Parliamentary Scrutiny) Act 2011
Health Insurance (Section 3C Midwife and Nurse Practitioner Services) Amendment (Patient End Support Services) Determination 2025
This instrument is compatible with the human rights and freedoms recognised or declared in the international instruments listed in section 3 of the Human Rights (Parliamentary Scrutiny) Act 2011.
Overview of the Determination
The purpose of the Health Insurance (Section 3C Midwife and Nurse Practitioner Services) Amendment (Patient End Support Services) Determination 2025 (the Amendment Determination) is to amend the Health Insurance (Section 3C Midwife and Nurse Practitioner Services) Determination 2020 (the Principal Determination) to introduce eight new Medicare Benefits Schedule (MBS) items from 1 March 2026 for patient end support (PES) services rendered by nurse practitioners.
The new MBS items (82250, 82251, 82252, 82253, 82254, 82255, 82256 and 82257) are for professional attendances by a participating nurse practitioner, where the nurse practitioner is providing face to face clinical support to a patient who is participating in a video conference attendance with a consultant physician or specialist. These items for PES services are time-tiered - of varying durations - and may be provided in consulting rooms or at a place other than consulting rooms. The nurse practitioner providing the PES consultation must be in the same room as the patient for the duration of the service.
The introduction of the eight new items by the Amendment Determination forms part of a broader suite of new PES items. Subject to the making of legislation, from 1 March 2026 the Health Insurance Legislation Amendment (2026 Measures No. 1) Regulations 2026 will introduce an additional 24 new items for PES services rendered by prescribed medical practitioners and general practitioners to the GMST Regulations.
Policy authority was agreed to as part of the 2025-26 Budget under the Strengthening Medicare measure.
Human rights implications
This instrument engages Articles 2, 3, 9, 12, 16, and 26 of the International Covenant on Economic Social and Cultural Rights (ICESCR), specifically the rights to equality and non-discrimination, health and social security.
The Right to Health
The right to the enjoyment of the highest attainable standard of physical and mental health is contained in Article 12(1) of the ICESCR. The UN Committee on Economic Social and Cultural Rights (the Committee) has stated that the right to health is not a right for each individual to be healthy, but is a right to a system of health protection which provides equality of opportunity for people to enjoy the highest attainable level of health.
The Committee reports that the ‘highest attainable standard of health’ takes into account the country’s available resources. This right may be understood as a right of access to a variety of public health and health care facilities, goods, services, programs, and conditions necessary for the realisation of the highest attainable standard of health.
The Right to Social Security
The right to social security is contained in Article 9 of the ICESCR. It requires that a country must, within its maximum available resources, ensure access to a social security scheme that provides a minimum essential level of benefits to all individuals and families that will enable them to acquire at least essential health care. Countries are obliged to demonstrate that every effort has been made to use all resources that are at their disposal in an effort to satisfy, as a matter of priority, this minimum obligation.
The Committee reports that there is a strong presumption that retrogressive measures taken in relation to the right to social security are prohibited under ICESCR. In this context, a retrogressive measure would be one taken without adequate justification that had the effect of reducing existing levels of social security benefits, or of denying benefits to persons or groups previously entitled to them. However, it is legitimate for a Government to re-direct its limited resources in ways that it considers to be more effective at meeting the general health needs of all society, particularly the needs of the more disadvantaged members of society.
The Right of Equality and Non-Discrimination
The rights of equality and non-discrimination are contained in Articles 2, 16 and 26 of the International Covenant on Civil and Political Rights (ICCPR). Article 26 of the ICCPR requires that all persons are equal before the law, are entitled without any discrimination to the equal protection of the law and in this respect, the law shall prohibit any discrimination and guarantee to all persons equal and effective protection against discrimination on any ground such as race, colour, sex, language, religion, political or other opinion, national or social origin, property, birth or other status.
Analysis
This instrument will reflect contemporary clinical practice by allowing nurse practitioners to provide clinical support to patients who are receiving MBS services from consultant physicians or specialists. This will allow patients to receive holistic care for medical issues being treated by a singular consultant physician or specialist. Additionally, the new services will allow nurse practitioners to provide clinical support via video conferencing, increasing patient access to the patient end support services where a consultant physician or specialist is providing a related service in a rural or remote community.
Conclusion
This instrument is compatible with human rights; it maintains the right to health, the right to social security and the right of equality and non-discrimination.
Louise Riley
Assistant Secretary
MBS Policy and Reviews Branch
Medicare Benefits and Digital Health Division
Health Resourcing Group
Department of Health, Disability and Ageing