Health Insurance (Section 3C Midwife and Nurse Practitioner Services) Determination 2020
made under subsection 3C(1) of the
Health Insurance Act 1973
Compilation No. 18
Compilation date: 1 July 2026
Includes amendments: F2026L00519 and F2026L00523
About this compilation
This compilation
This is a compilation of the Health Insurance (Section 3C Midwife and Nurse Practitioner Services) Determination 2020 that shows the text of the law as amended and in force on 1 July 2026 (the compilation date).
The notes at the end of this compilation (the endnotes) include information about amending laws and the amendment history of provisions of the compiled law.
Uncommenced amendments
The effect of uncommenced amendments is not shown in the text of the compiled law. The details of amendments made up to, but not commenced at, the compilation date are underlined in the endnotes. Any uncommenced amendments affecting the law are accessible on the Register (www.legislation.gov.au).
Application, saving and transitional provisions
If the operation of a provision or amendment of the compiled law is affected by an application, saving or transitional provision that is not included in this compilation, details are included in the endnotes.
Editorial changes
For more information about any editorial changes made in this compilation, see the endnotes.
Presentational changes
The Legislation Act 2003 provides for First Parliamentary Counsel to make presentational changes to a compilation. Presentational changes are applied to give a more consistent look and feel to legislation published on the Register, and enable the user to more easily navigate those documents.
Modifications
If the compiled law is modified by another law, the compiled law operates as modified but the modification does not amend the text of the law. Accordingly, this compilation does not show the text of the compiled law as modified. Any modifications affecting the law are accessible on the Register.
Self‑repealing provisions
If a provision of the compiled law has been repealed in accordance with a provision of the law, details are included in the endnotes.
Table of Contents
Part 1 Preliminary
1. Name
3. Authority
5 Definitions
6A. Indexation
6B. Meaning of symbol (H)
Part 2 Midwifery services
7. Interpretation
8. Treatment of midwifery services
10. General requirements
12. Labour and birth
Part 3 Nurse practitioner services
13. Treatment of nurse practitioner services ‑ general
14. Treatment of nurse practitioner services ‑ pathology
15. Scope of practice
16. General requirements
17. Requirements for pathology items
19. Application of items 73826 to 73837
20. Limitation of item 73826
20A. Requirements for item 73825
Part 4 Transitional provisions
21. Transitional provision for item 82115
Schedule 1 Midwifery services and fees
Part 1 Midwifery services and fees
Schedule 2 Nurse practitioner services and fees
Part 1 Nurse practitioner pathology services and fees
Part 2 Nurse practitioner services and fees
2.1 Meaning of amount under clause 2.1
Part 3 Nurse practitioner surgical assistance services and fees
3.1 Meaning of amount under clause 3.1
3.2 Meaning of amount under clause 3.2
3.3 Meaning of amount under clause 3.3
4 Items in Subgroup 1 of Group M33—nurse practitioner providing assistance at operations
Endnotes
Endnote 1—About the endnotes
Endnote 2—Abbreviation key
Endnote 3—Legislation history
Endnote 4—Amendment history
Part 1 Preliminary
1. Name
This instrument is the Health Insurance (Section 3C Midwife and Nurse Practitioner Services) Determination 2020.
3. Authority
This instrument is made under subsection 3C(1) of the Health Insurance Act 1973.
5 Definitions
(1) In this instrument:
Act means the Health Insurance Act 1973.
amount under clause 2.1 has the meaning given by clause 2.1 of Part 2 of Schedule 2.
amount under clause 3.1 has the meaning given by clause 3.1 of Part 3 of Schedule 2.
amount under clause 3.2 has the meaning given by clause 3.2 of Part 3 of Schedule 2.
amount under clause 3.3 has the meaning given by clause 3.3 of Part 3 of Schedule 2.
non‑medicare service means a service provided by a nurse practitioner other than a service that is generally accepted in the nursing profession as being necessary for the appropriate treatment of the patient to whom it is rendered.
relevant provisions means all provisions, relating to professional services or medical services, of:
(a) the Act and regulations made under the Act; and
(b) the National Health Act 1953 and regulations made under that Act.
Note The following terms are defined in subsection 3(1) of the Act:
general medical services table
participating midwife
participating nurse practitioner
pathology services table
(2) Unless the contrary intention appears, a reference in this instrument to a provision of the Act or the National Health Act 1953 or regulations made under the Act or under the National Health Act 1953 as applied, adopted or incorporated in relation to specifying a matter is a reference to those provisions as in force from time to time and any other reference to provisions of an Act or regulations is a reference to those provisions as in force from time to time.
6A. Indexation
(1) At the start of 1 July 2026 (the indexation time), each amount covered by subsection (2) is replaced by the amount worked out using the following formula:
Note: The indexed fees could in 2026 be viewed on the Department of Health, Disability and Ageing’s MBS Online website (www.mbsonline.gov.au).
(2) The amounts covered by this subsection are the fee for each item in a Schedule of this Determination, other than the fee for the following:
(a) an item in Group P9.
(3) An amount worked out under subsection (1) is to be rounded up or down to the nearest 5 cents (rounding down if the amount is an exact multiple of 2.5 cents).
6B. Meaning of symbol (H)
(1) An item in this instrument including the symbol (H) applies only to a service performed or provided in a hospital.
Part 2 Midwifery services
7. Interpretation
(1) In this Part:
birth includes episiotomy and repair of tears.
(2) For this Part, a participating midwife is a member of a practice that provides a patient’s antenatal care if the midwife:
(a) participates (whether as a partner, employee or otherwise) in the provision of professional services as part of the practice; or
(b) provides relief services to the practice; or
(c) provides professional services as part of the practice as a locum.
8. Treatment of midwifery services
For subsection 3C(1) of the Act, a midwifery service provided in accordance with this instrument is to be treated, for the relevant provisions, as if:
(a) it were both a professional service and a medical service; and
(b) there were an item in the general medical services table that:
(i) related to the service; and
(ii) mentioned, for the service, a fee in relation to each State, being the fee mentioned in the item in Schedule 1 for the service.
10. General requirements
(1) An item in Schedule 1 applies to a service only if:
(a) the service is provided in the course of a personal attendance on a single patient on a single occasion by a single participating midwife; and
(b) the midwife:
(i) is not employed by the proprietor of a hospital that is not a private hospital; or
(ii) both:
(A) is employed by the proprietor of a hospital that is not a private hospital; and
(B) provides the service otherwise than in the course of employment by that proprietor.
(2) Subsection (1) applies whether or not another person provides essential assistance to the participating midwife in accordance with accepted clinical practice.
(3) An item in Schedule 1 does not apply to a service provided for a patient if the patient is not in attendance.
Examples — patient not in attendance
1 Completing patient records.
2 Issuing repeat prescriptions.
3 Telephone attendances.
(4) In items 82100 to 82115 and 82130 to 82140 in Part 1 of Schedule 1:
professional attendance includes the provision, for a patient, of any of the following services:
(a) evaluating the patient’s condition or conditions including, if applicable, evaluation using a health screening service mentioned in subsection 19(5) of the Act;
(b) formulating a plan for the management and, if applicable, for the treatment of the patient’s condition or conditions;
(c) giving advice to the patient about the patient’s condition or conditions and, if applicable, about treatment;
(d) if authorised by the patient — giving advice to another person, or other persons, about the patient’s condition or conditions and, if applicable, about treatment;
(e) providing appropriate preventive health care;
(f) recording the clinical details of the service or services provided to the patient.
(5) However, a professional attendance does not include the supply of a vaccine to a patient if:
(a) the vaccine is supplied to the patient in connection with a professional attendance mentioned in any of items 82100 to 82115 and 82130 to 82140 in Part 1 of Schedule 1; and
(b) the cost of the vaccine is not subsidised by the Commonwealth or a State.
(6) If a service described in item 82103 is provided on the same day as a service to which item 82100, 82102, 82105, 82110, 91211, 91212, 91218 or 91219 applies, the subsequent item will only apply if it is:
(a) not a continuation of the first attendance; and
(b) is clinically relevant and distinct from the first attendance.
12. Labour and birth
(1) Items 82116, 82118, 82120, 82123, 82125 and 82127 in Part 1 of Schedule 1 apply only to a service provided by a participating midwife during a period of exclusive care of a patient in labour.
(2) Items 82116, 82118, 82120, 82123, 82125 and 82127 in Part 1 of Schedule 1 do not apply if, before labour, the patient’s care is transferred to an obstetrician or medical practitioner who provides obstetric services, for the obstetrician or practitioner to manage the labour and birth.
(3) Items 82118 and 82120 in Part 1 of Schedule 1 applies to a service provided by a participating midwife (the first midwife) who manages a patient’s labour, but does not undertake the birth, only if:
(a) the patient’s care was transferred from the first midwife to another participating midwife in order to manage fatigue experienced by the first midwife; or
(b) there was a clinical need to transfer the patient’s care to an obstetrician or medical practitioner who provides obstetric services.
(4) Items 82123 and 82125 in Part 1 of Schedule 1 applies to services provided by a participating midwife (the second midwife) who manages a patient’s labour, but does not undertake the birth, only if:
(a) the patient’s care was transferred from the second midwife to another participating midwife in order to manage fatigue experienced by the second midwife; or
(b) there was a clinical need to transfer the patient’s care to an obstetrician or medical practitioner who provides obstetric services.
(5) Item 82127 in Part 1 of Schedule 1 applies to services provided by a participating midwife (the third midwife) who manages a patient’s labour, but does not undertake the birth, only if:
(a) the patient’s care was transferred from the third midwife to another participating midwife to manage fatigue experienced by the third midwife; or
(b) there was a clinical need to transfer the patient’s care to an obstetrician or medical practitioner who provides obstetric services.
Part 3 Nurse practitioner services
13. Treatment of nurse practitioner services ‑ general
Subject to section 14, for subsection 3C(1) of the Act, a nurse practitioner service provided in accordance with this instrument is to be treated, for the relevant provisions, as if:
(a) it were both a professional service and a medical service; and
(b) there were an item in the general medical services table that:
(i) related to the service; and
(ii) mentioned, for the service, a fee in relation to each State, being the fee mentioned in the item in Schedule 2 relating to the service.
14. Treatment of nurse practitioner services ‑ pathology
For subsection 3C(1) of the Act, a nurse practitioner service described in Part 1 of Schedule 2 provided in accordance with this instrument is to be treated, for the relevant provisions, as if:
(a) it were both a professional service and a medical service; and
(b) there were an item in the pathology services table that:
(i) related to the service; and
(ii) mentioned, for the service, a fee in relation to each State, being the fee mentioned in the item in Part 1 of Schedule 2 relating to the service.
Note 1 A participating nurse practitioner performing a service described in items 73828 to 73837 must be the patient’s treating practitioner in order for medicare benefit to be payable — see subsection 16A(7A) of the Act.
15. Scope of practice
(1) For a patient, an item in Schedule 2 applies only if the service mentioned in that item is within the scope of practice of the participating nurse practitioner who provides the service.
16. General requirements
(1) An item in Schedule 2, except an item in Part 1 of Schedule 2, applies to a service only if:
(a) the service is provided in the course of a personal attendance on a single patient on a single occasion by a single participating nurse practitioner; and
(b) the nurse practitioner:
(i) is not employed by the proprietor of a hospital that is not a private hospital; or
(ii) both:
(A) is employed by the proprietor of a hospital that is not a private hospital; and
(B) provides the service otherwise than in the course of employment by that proprietor.
(2) Subsection (1) applies whether or not another person provides essential assistance to the participating nurse practitioner in accordance with accepted clinical practice.
(3) An item in Schedule 2, except an item in Part 1 of Schedule 2, does not apply to a service provided for a patient if the patient is not in attendance.
Examples — patient not in attendance
1 Completing patient records.
2 Issuing repeat prescriptions.
3 Telephone attendances.
(4) In Part 2 of Schedule 2:
professional attendance includes the provision, for a patient, of any of the following services:
(a) evaluating the patient’s condition or conditions including, if applicable, evaluation using a health screening service mentioned in subsection 19 (5) of the Act;
(b) formulating a plan for the management and, if applicable, for the treatment of the patient’s condition or conditions;
(c) giving advice to the patient about the patient’s condition or conditions and, if applicable, about treatment;
(d) if authorised by the patient — giving advice to another person, or other persons, about the patient’s condition or conditions and, if applicable, about treatment;
(e) providing appropriate preventive health care;
(f) recording the clinical details of the service or services provided to the patient.
(5) However, a professional attendance does not include the supply of a vaccine to a patient if:
(a) the vaccine is supplied to the patient in connection with a professional attendance mentioned in Part 2 of Schedule 2; and
(b) the cost of the vaccine is not subsidised by the Commonwealth or a State.
(6) Items 82200, 82205, 82210 and 82215 do not apply to a service described in the item if the service is provided at the same time as, or in connection with, a non‑medicare service.
17. Requirements for pathology items
An item in Part 1 of Schedule 2 applies to a service only if the participating nurse practitioner who renders the service:
(a) is not employed by the proprietor of a hospital that is not a private hospital; or
(b) both:
(i) is employed by the proprietor of a hospital that is not a private hospital; and
(ii) provides the service otherwise than in the course of employment by that proprietor.
19. Application of items 73826 to 73837
Section 7 of the Health Insurance (Prescribed Pathology Services) Determination 2021 shall have effect as if the services specified in items 73826 to 73837 of Schedule 2 Part 1 were also specified in that section.
20. Limitation of item 73826
Item 73826 does not apply to a service provided to a patient who has already been provided, in the last 12 months, 4 other services to which any of the following apply:
(a) item 73826;
(b) item 66551;
(c) item 73812.
20A. Requirements for item 73825
(1) Item 73825 applies to a service only if:
(a) the service is rendered at, or from, a practice location in:
(i) a Modified Monash 6 area; or
(ii) a Modified Monash 7 area;
(b) the nurse practitioner providing the service:
(i) is employed by an organisation that:
(A) delivers health services; and
(B) is participating in the First Nations Molecular Point‑of‑Care (PoC) Testing Program;
(c) the service is provided in accordance with the Program referred to in subparagraph (b)(i)(B);
(d) the service is conducted by a nurse practitioner who has achieved competency as a PoC operator by the First Nations Molecular PoC Testing Program for the test(s) performed; and
(e) the PoC test(s) gives valid patient result(s).
Part 4 Transitional provisions
21. Transitional provision for item 82115
(1) Between 1 March 2022 and 31 August 2022, item 82115 will apply to a service provided to a patient where the participating midwife has not had at least 2 antenatal attendances with the patient in the 6 months prior to the service provided to the patient.
Schedule 1 Midwifery services and fees
Part 1 Midwifery services and fees
Group M13 – Midwifery services | ||
Subgroup 1 – MBS items for participating midwives | ||
Column 1 Item | Column 2 Service | Column 3 Fee ($) |
82100 | Initial antenatal professional attendance by a participating midwife, lasting at least 60 minutes, including all the following: (a) taking a detailed patient history; (b) performing a comprehensive examination; (c) performing a risk assessment; (d) based on the risk assessment — arranging referral or transfer of the patient’s care to an obstetrician; (e) requesting pathology and diagnostic imaging services, when necessary; Payable only once per pregnancy | 84.70 |
82102 | Long antenatal professional attendance by a participating midwife, lasting at least 90 minutes | 127.00 |
82103 | Complex antenatal professional attendance by a participating midwife leading to a hospital admission and lasting at least 3 hours. A maximum of 3 services per pregnancy. Not being a service associated with a service to which intrapartum items 82116, 82118, 82120, 82123, 82125 or 82127 applies (H) | 234.20 |
82104 | Long postnatal professional attendance by a participating midwife, lasting at least 90 minutes, within 6 weeks after birth | 186.75 |
82105 | Short antenatal professional attendance by a participating midwife, lasting at least 10 minutes | 33.60 |
82110 | Routine antenatal professional attendance by a participating midwife, lasting at least 40 minutes | 84.70 |
82115 | Professional attendance by a participating midwife, lasting at least 90 minutes, for assessment and preparation of a maternity care plan for a patient whose pregnancy has progressed beyond 28 weeks, where the participating midwife has had at least 2 antenatal attendances with the patient in the preceding 6 months, if: (a) the patient is not an admitted patient of a hospital; and (b) the participating midwife undertakes a comprehensive assessment of the patient; and (c) the participating midwife develops a written maternity care plan that contains: (i) outcomes of the assessment; and (ii) details of agreed expectations for care during pregnancy, labour and birth; and (iii) details of any health problems or care needs; and (iv) details of any medication taken by the patient during the pregnancy, and any additional medication that may be required by the patient; and (v) details of any referrals or requests for pathology services or diagnostic imaging services for the patient during the pregnancy, and any additional referrals or requests that may be required for the patient; and (d) the maternity care plan is explained and agreed with the patient; and (e) the fee does not include any amount for the management of labour and birth; (Includes any antenatal attendance provided on the same occasion) Payable only once for any pregnancy; This item cannot be claimed if items 16590 or 16591 have previously been claimed during a single pregnancy, except in exceptional circumstances | 331.90 |
82116 | Management of labour for up to 6 hours, not including birth, at a place other than a hospital if: (a) the attendance is by the participating midwife who: (i) provided the patient's antenatal care or (ii) is a member of a practice that has provided the patient's antenatal care; and (b) the total attendance time is documented in the patient notes; This item does not apply if birth is performed during the attendance; Only claimable once per pregnancy | 783.85 |
82118 | Management of labour for up to 6 hours total attendance, including birth where performed if: (a) the patient is an admitted patient of a hospital; and (b) the attendance is by the first participating midwife who: (i) assisted or provided the patient's antenatal care; or (ii) is a member of a practice that has provided the patient's antenatal care; and (c) the total attendance time is documented in the patient notes. (Includes all hospital attendances related to the labour by the first participating midwife) Only claimable once per pregnancy; Not being a service associated with a service to which item 82120 applies (H) | 783.85 |
82120 | Management of labour between 6 and 12 hours total attendance, including birth where performed, if: (a) the patient is an admitted patient of a hospital; and (b) the attendance is by the first participating midwife who: (i) assisted or provided the patient’s antenatal care; or (ii) is a member of a practice that provided the patient’s antenatal care; and (c) the total attendance time is documented in the patient notes; (Includes all hospital attendances related to the labour by the first participating midwife) Only claimable once per pregnancy; Not being a service associated with a service to which item 82118 applies (H) | 1,567.70 |
82123 | Management of labour for up to 6 hours total attendance, including birth where performed if: (a) the patient is an admitted patient of a hospital; and (b) the attendance is by the second participating midwife who either: (i) assisted or provided the patient's antenatal care; or (ii) is a member of a practice that has provided the patient's antenatal care; and (c) the total attendance time is documented in the patient notes; (Includes all hospital attendances related to the labour by the second participating midwife) Only claimable once per pregnancy; Not being a service associated with a service to which item 82125 applies (H) | 783.85 |
82125 | Management of labour between 6 and 12 hours total attendance, including birth where performed, if: (a) the patient is an admitted patient of a hospital; and (b) the attendance is by the second participating midwife who either: (i) assisted or provided the patient’s antenatal care; or (ii) is a member of a practice that provided the patient’s antenatal care; and (c) the total attendance time is documented in the patient notes; (Includes all hospital attendances related to the labour by the second participating midwife) Only claimable once per pregnancy; Not being a service associated with a service to which item 82123 or 82127 applies (H) | 1,567.70 |
82127 | Management of labour for up to 6 hours total attendance, including birth where performed if: (a) the patient is an admitted patient of a hospital; and (b) the attendance is by a third participating midwife who either: (i) assisted or provided the patient's antenatal care; or (ii) is a member of a practice that has provided the patient's antenatal care; and (c) an attendance to which item 82123 applies has been provided by a second participating midwife who is a member of a practice that has provided the patient's antenatal care; and (d) the total attendance time is documented in the patient notes; (Includes all hospital attendances related to the labour by the third participating midwife) Only claimable once per pregnancy; Not being a service associated with a service to which item 82125 applies (H) | 783.85 |
82130 | Short postnatal professional attendance by a participating midwife, lasting at least 20 minutes, within 6 weeks after birth | 55.55 |
82135 | Routine postnatal professional attendance by a participating midwife, lasting at least 40 minutes, within 6 weeks after birth | 124.50 |
82140 | Postnatal professional attendance by a participating midwife on a patient, not less than 4 weeks but not more than 8 weeks after birth of a baby, lasting at least 60 minutes, including all of the following: (a) a comprehensive examination of the patient and baby to ensure normal postnatal recovery; (b) a labour and birth debrief; (c) a mental health assessment or where the patient declines a mental health assessment, the participating midwife records the patient’s decision in the clinical notes; (d) referral of the patient to a primary carer for the ongoing care of the patient and baby or where the patient declines a referral to a primary carer, the participating midwife records the patient’s decision in the clinical notes Payable only once per pregnancy | 55.55 |
Schedule 2 Nurse practitioner services and fees
Part 1 Nurse practitioner pathology services and fees
Group P9 – Simple basic pathology tests | ||
Column 1 Item | Column 2 Service | Column 3 Fee ($) |
73825 | Detection performed by a participating nurse practitioner of: (a) chlamydia trachomatis (CT) and neisseria gonorrhoeae (NG) via molecular point‑of‑care testing for the diagnosis of CT or NG infection; and (b) trichomonas vaginalis (TV) via molecular point‑of‑care testing for the diagnosis of TV infection | 117.65 |
73826 | Quantitation of glycated haemoglobin (HbA1c) performed by a participating nurse practitioner in the management of established diabetes when performed: (a) as a point‑of‑care test; (b) by a nurse practitioner who works in a general practice that is accredited to the Royal Australian College of General Practitioners Standards for point‑of‑care testing under the National General Practice Accreditation Scheme; and (c) using a method and instrument certified by the National Glycohemoglobin Standardization Program (NGSP), if the instrument has a total coefficient variation less than 3.0% at 48 mmol/mol (6.5%) Applicable not more than 3 times per 12 months per patient | 11.80 |
73828 | Semen examination for presence of spermatozoa by a participating nurse practitioner | 6.90 |
73829 | Leucocyte count, erythrocyte sedimentation rate, examination of blood film (including differential leucocyte count), haemoglobin, haematocrit or erythrocyte count by a participating nurse practitioner ‑ 1 test | 4.55 |
73830 | 2 tests described in item 73829 by a participating nurse practitioner | 6.35 |
73831 | 3 or more tests described in item 73829 by a participating nurse practitioner | 8.15 |
73832 | Microscopy of urine, excluding dipstick testing, by a participating nurse practitioner | 4.55 |
73833 | Pregnancy test by 1 or more immunochemical methods by a participating nurse practitioner | 10.15 |
73834 | Microscopy for wet film other than urine, including any relevant stain by a participating nurse practitioner | 6.90 |
73835 | Microscopy of Gram‑stained film, including (if performed) a service described in item 73832 or 73834 by a participating nurse practitioner | 8.65 |
73836 | Chemical tests for occult blood in faeces by reagent stick, strip, tablet or similar method by a participating nurse practitioner | 2.35 |
73837 | Microscopy for fungi in skin, hair or nails by a participating nurse practitioner – 1 or more sites | 6.90 |
Part 2 Nurse practitioner services and fees
2.1 Meaning of amount under clause 2.1
In item 82206:
amount under clause 2.1 means 50% of the fee that would normally apply for item 82201 or 82202 if a service mentioned in the same item had not been discontinued before completion.
Group M14 – Nurse practitioners | |||
Column 1 Item | Column 2 Service | Column 3 Fee ($) | |
Subgroup 1 – Nurse practitioners |
| ||
82200 | Professional attendance by a participating nurse practitioner for an obvious problem characterised by the straightforward nature of the task that requires a short patient history and, if required, limited examination and management | 14.20 | |
82205 | Professional attendance by a participating nurse practitioner lasting at least 6 minutes and less than 20 minutes and including any of the following: (a) taking a history; (b) undertaking clinical examination; (c) arranging any necessary investigation; (d) implementing a management plan; (e) providing appropriate preventive health care; for 1 or more health related issues, with appropriate documentation | 31.05 | |
82210 | Professional attendance by a participating nurse practitioner lasting at least 20 minutes and including any of the following: (a) taking a detailed history; (b) undertaking clinical examination; (c) arranging any necessary investigation; (d) implementing a management plan; (e) providing appropriate preventive health care; for 1 or more health related issues, with appropriate documentation | 58.85 | |
82215 | Professional attendance by a participating nurse practitioner lasting at least 40 minutes and including any of the following: (a) taking an extensive history; (b) undertaking clinical examination; (c) arranging any necessary investigation; (d) implementing a management plan; (e) providing appropriate preventive health care; for 1 or more health related issues, with appropriate documentation | 86.80 | |
82216 | Professional attendance by a participating nurse practitioner lasting at least 60 minutes and including any of the following: (a) taking an extensive patient history; (b) performing a clinical examination; (c) arranging any necessary investigation; (d) implementing a management plan; (e) providing appropriate preventive health care; for one or more health related issues, with appropriate documentation | 131.20 | |
82226 | Burns, involving 1% or more but less than 3% of total body surface, dressing of (including redressing of any related donor site, if required), without anaesthesia, by a participating nurse practitioner—each attendance at which the procedure is performed Not applicable for skin reactions secondary to radiotherapy | 40.00 | |
82227 | Burns, involving 3% or more but less than 10% of total body surface, dressing of (including redressing of any related donor site, if required), without anaesthesia, by a participating nurse practitioner—each attendance at which the procedure is performed Not applicable for skin reactions secondary to radiotherapy | 51.15 | |
82228 | Nipple or areola or both, intradermal colouration of, by a participating nurse practitioner, following breast reconstruction after mastectomy or for congenital absence of nipple | 217.80 | |
Subgroup 4 – Nurse practitioner procedures | |||
82201 | Introduction of an intra‑uterine device for abnormal uterine bleeding or contraception or for endometrial protection during oestrogen replacement therapy (Anaes.) | 215.95 | |
82202 | Removal of etonogestrel subcutaneous implant (Anaes.) | 105.15 | |
82203 | Hormone or living tissue implantation by cannula | 100.40 | |
82204 | A service rendered by a participating nurse practitioner to which item 82201, 82202 or 82203 applies, if the service is bulk‑billed in relation to the fees for: (a) that item; and (b) any other item in Subgroup 1 of Group M14 or item 73832 and 73833 applying to the service | 40% of the fee for the relevant item referred to in paragraph (a) of column 2 | |
82206 | A procedure, being a service to which an item in Subgroup 4 of Group M14 would have applied had the procedure not been discontinued on clinical grounds, other than a service to which 82203 applies | Amount under clause 2.1 | |
Subgroup 5—Participating nurse practitioner patient end support for video conferencing consultations with specialists or consultant physicians | |||
82250 | Professional attendance by a participating nurse practitioner, at consulting rooms, lasting at least 6 minutes but less than 20 minutes, if: (a) the attendance is to provide clinical support to a patient to whom a specialist or consultant physician is providing a service, to which another item applies, by way of a video conferencing consultation; and (b) the patient is not an admitted patient; and (c) the participating nurse practitioner is located in the same room as the patient for the whole of the attendance | 51.80 | |
82251 | Professional attendance by a participating nurse practitioner, at a place other than consulting rooms, lasting at least 6 minutes but less than 20 minutes, if: (a) the attendance is to provide clinical support to a patient to whom a specialist or consultant physician is providing a service, to which another item applies, by way of a video conferencing consultation; and (b) the patient is not an admitted patient; and (c) the participating nurse practitioner is located in the same room as the patient for the whole of the attendance | 51.80 | |
82252 | Professional attendance by a participating nurse practitioner, at consulting rooms, lasting at least 20 minutes but less than 40 minutes, if: (a) the attendance is to provide clinical support to a patient to whom a specialist or consultant physician is providing a service, to which another item applies, by way of a video conferencing consultation; and (b) the patient is not an admitted patient; and (c) the participating nurse practitioner is located in the same room as the patient for the whole of the attendance | 80.25 | |
82253 | Professional attendance by a participating nurse practitioner, at a place other than consulting rooms, lasting at least 20 minutes but less than 40 minutes, if: (a) the attendance is to provide clinical support to a patient to whom a specialist or consultant physician is providing a service, to which another item applies, by way of a video conferencing consultation; and (b) the patient is not an admitted patient; and (c) the participating nurse practitioner is located in the same room as the patient for the whole of the attendance | 80.25 | |
82254 | Professional attendance by a participating nurse practitioner, at consulting rooms, lasting at least 40 minutes but less than 60 minutes, if: (a) the attendance is to provide clinical support to a patient to whom a specialist or consultant physician is providing a service, to which another item applies, by way of a video conferencing consultation; and (b) the patient is not an admitted patient; and (c) the participating nurse practitioner is located in the same room as the patient for the whole of the attendance | 108.90 | |
82255 | Professional attendance by a participating nurse practitioner, at a place other than consulting rooms, lasting at least 40 minutes but less than 60 minutes, if: (a) the attendance is to provide clinical support to a patient to whom a specialist or consultant physician is providing a service, to which another item applies, by way of a video conferencing consultation; and (b) the patient is not an admitted patient; and (c) the participating nurse practitioner is located in the same room as the patient for the whole of the attendance | 108.90 | |
82256 | Professional attendance by a participating nurse practitioner, at consulting rooms, lasting at least 60 minutes, if: (a) the attendance is to provide clinical support to a patient to whom a specialist or consultant physician is providing a service, to which another item applies, by way of a video conferencing consultation; and (b) the patient is not an admitted patient; and (c) the participating nurse practitioner is located in the same room as the patient for the whole of the attendance | 154.35 | |
82257 | Professional attendance by a participating nurse practitioner, at a place other than consulting rooms, lasting at least 60 minutes, if: (a) the attendance is to provide clinical support to a patient to whom a specialist or consultant physician is providing a service, to which another item applies, by way of a video conferencing consultation; and (b) the patient is not an admitted patient; and (c) the participating nurse practitioner is located in the same room as the patient for the whole of the attendance | 154.35 | |
Part 3 Nurse practitioner surgical assistance services and fees
3.1 Meaning of amount under clause 3.1
In item 93719:
amount under clause 3.1, for assistance at an operation or series or combination of operations, means 20% of the sum of the fees payable under the Act for the services provided at that operation, or series of operations, by the practitioner to whom the assistance was given.
3.2 Meaning of amount under clause 3.2
In item 93721:
amount under clause 3.2, for assistance at a series or combination of operations, means:
(a) 20% of the sum of the fees payable under the Act for the services provided at those operations by the practitioner to whom the assistance was given; or
(b) for the caesarean section component of the operations—the fee mentioned in item 16520.
3.3 Meaning of amount under clause 3.3
In item 93722:
amount under clause 3.3, for assistance at a procedure, means 20% of the sum of the fees payable under the Act for the services provided at that procedure or combination of procedures by the practitioner to whom the assistance was given.
4 Items in Subgroup 1 of Group M33—nurse practitioner providing assistance at operations
This clause sets out items in Subgroup 1 of Group M33.
Group M33 – Non‑medical assistance at operations | ||
Subgroup 1 – Assistance at operations provided by a nurse practitioner | ||
Column 1 Item | Column 2 Service | Column 3 Fee ($) |
93718 | Assistance by a participating nurse practitioner at any operation mentioned in an item in Group T8 that includes “(Assist.)” for which the fee does not exceed $668.25 or at a series or combination of operations mentioned in an item in Group T8 that include “(Assist.)” for which the aggregate fee does not exceed $668.25 | 100.65 |
93719 | Assistance by a participating nurse practitioner at any operation mentioned in an item in Group T8 that includes “(Assist.)” for which the fee exceeds $668.25 or at a series or combination of operations mentioned in an item in Group T8 that include “(Assist.)” for which the aggregate fee exceeds $668.25 | Amount under clause 3.1 |
93720 | Assistance by a participating nurse practitioner at a birth involving Caesarean section (H) | 145.45 |
93721 | Assistance by a participating nurse practitioner at a series or combination of operations that include “(Assist.)” and assistance by a participating nurse practitioner at a birth involving Caesarean section (H) | Amount under clause 3.2 |
93722 | Assistance by a participating nurse practitioner at any interventional obstetric procedure covered by items 16606, 16609, 16612, 16615 and 16627 (H) | Amount under clause 3.3 |
93723 | Assistance by a participating nurse practitioner at cataract and intraocular lens surgery covered by item 42698, 42701, 42702, 42704, 42705 or 42707, when performed in association with services covered by item 42551 to 42569, 42653, 42656, 42725, 42746, 42749, 42752, 42776 or 42779 (H) | 317.80 |
93724 | Assistance at cataract and intraocular lens surgery by a participating nurse practitioner, if patient has: (a) total loss of vision, including no potential for central vision, in the fellow eye; or (b) one of the following in the fellow eye: (i) vitreous loss; (ii) rupture of posterior capsule; (iii) loss of nuclear material into the vitreous; (iv) intraocular haemorrhage; (v) intraocular infection (endophthalmitis); (vi) cystoid macular oedema; (vii) corneal decompensation; (viii) retinal detachment; or (c) pseudo exfoliation, subluxed lens, iridodonesis, phacodonesis, retinal detachment, corneal scarring, pre‑existing uveitis, bound down miosed pupil, nanophthalmos, spherophakia, Marfan’s syndrome, homocysteinuria or previous blunt trauma causing intraocular damage (H) | 209.75 |
Endnotes
Endnote 1—About the endnotes
The endnotes provide information about this compilation and the compiled law.
The following endnotes are included in every compilation:
Endnote 1—About the endnotes
Endnote 2—Abbreviation key
Endnote 3—Legislation history
Endnote 4—Amendment history
Abbreviation key—Endnote 2
The abbreviation key sets out abbreviations that may be used in the endnotes.
Legislation history and amendment history—Endnotes 3 and 4
Amending laws are annotated in the legislation history and amendment history.
The legislation history in endnote 3 provides information about each law that has amended (or will amend) the compiled law. The information includes commencement details for amending laws and details of any application, saving or transitional provisions that are not included in this compilation.
The amendment history in endnote 4 provides information about amendments at the provision (generally section or equivalent) level. It also includes information about any provision of the compiled law that has been repealed in accordance with a provision of the law.
Editorial changes
The Legislation Act 2003 authorises First Parliamentary Counsel to make editorial and presentational changes to a compiled law in preparing a compilation of the law for registration. The changes must not change the effect of the law. Editorial changes take effect from the compilation registration date.
If the compilation includes editorial changes, the endnotes include a brief outline of the changes in general terms. Full details of any changes can be obtained from the Office of Parliamentary Counsel.
Misdescribed amendments
A misdescribed amendment is an amendment that does not accurately describe how an amendment is to be made. If, despite the misdescription, the amendment can be given effect as intended, then the misdescribed amendment can be incorporated through an editorial change made under section 15V of the Legislation Act 2003.
If a misdescribed amendment cannot be given effect as intended, the amendment is not incorporated and “(md not incorp)” is added to the amendment history.
Endnote 2—Abbreviation key
ad = added or inserted | orig = original |
am = amended | p = page(s) |
amdt = amendment | para = paragraph(s)/subparagraph(s) |
C[x] = Compilation No. x | /sub‑subparagraph(s) |
ch = Chapter(s) | pres = present |
cl = clause(s) | prev = previous |
cont. = continued | (prev…) = previously |
def = definition(s) | pt = Part(s) |
Dict = Dictionary | r = regulation(s)/Court rule(s) |
disallowed = disallowed by Parliament | reloc = relocated |
div = Division(s) | renum = renumbered |
ed = editorial change | rep = repealed |
exp = expires/expired or ceases/ceased to have | rs = repealed and substituted |
effect | s = section(s)/subsection(s) |
gaz = gazette | /rule(s)/subrule(s)/order(s)/suborder(s) |
LA = Legislation Act 2003 | sch = Schedule(s) |
LIA = Legislative Instruments Act 2003 | SLI = Select Legislative Instrument |
(md) = misdescribed amendment can be given | SR = Statutory Rules |
effect | sub ch = Sub‑Chapter(s) |
(md not incorp) = misdescribed amendment | sub div = Subdivision(s) |
cannot be given effect | sub pt = Subpart(s) |
mod = modified/modification | underlining = whole or part not |
No. = Number(s) | commenced or to be commenced |
Ord = Ordinance |
|
Endnote 3—Legislation history
Name | Registration | Commencement | Application, saving and transitional provisions |
Health Insurance (Section 3C Midwife and Nurse Practitioner Services) Determination 2020 | 16 June 2020 (F2020L00732) | 1 July 2020 (s 2(1) item 1) |
|
Health Insurance Legislation Amendment (Section 3C General Medical and Diagnostic Imaging Services – Medicare Indexation) Determination 2021 | 8 Apr 2021 (F2021L00426) | sch 1 (items 294-315): 1 July 2021 (s 2(1) item 1) | — |
Health Insurance (Section 3C Midwife and Nurse Practitioner Services) Amendment Determination 2021 | 16 Sept 2021 (F2021L01271) | 1 Nov 2021 (s 2(1) item 1) | — |
Health Insurance Legislation Amendment (Telehealth Clinical Support Services) Determination 2021 | 17 Dec 2021 (F2021L01811) | sch 1 (items 1-8): 1 Jan 2022 (s 2(1) item 1) | — |
Health Insurance (Section 3C Midwife and Nurse Practitioner Services) Amendment (No. 2) Determination 2021 | 17 Dec 2021 (F2021L01838) | 1 Mar 2022 (s 2(1) item 1) | — |
Health Insurance (Section 3C Midwife and Nurse Practitioner Services) Amendment (Transitional Provision) Determination 2022 | 28 Mar 2022 (F2022L00399) | 1 Mar 2022 (s 2(1) item 1) | — |
Health Insurance Legislation Amendment (Indexation) Determination 2022 | 7 Apr 2022 (F2022L00553) | sch 1 (item 4): 1 July 2022 (s 2(1) item 1) | — |
Health Insurance Legislation Amendment (Indexation) Determination 2023 | 24 Mar 2023 (F2023L00348) | sch 1 (item 4): 1 July 2023 (s 2(1) item 1) | — |
Health Insurance (Section 3C Midwife and Nurse Practitioner Services) Amendment (No. 1) Determination 2023 | 25 Aug 2023 (F2023L01115) | sch 1: 26 Aug 2023 (s 2(1) item 2) | — |
Health Insurance Legislation Amendment (Indexation No. 2) Determination 2023 | 4 Sept 2023 (F2023L01183) | sch 1 (item 4): 1 Nov 2023 (s 2(1) item 1) | — |
Health Insurance (Section 3C Midwife and Nurse Practitioner Services) Amendment (No. 2) Determination 2023 | 30 Nov 2023 (F2023L01580) | 1 Mar 2024 (s 2(1) item 1) | — |
Health Insurance Legislation Amendment (2024 Measures No. 2) Determination 2024 | 21 May 2024 (F2024L00558) | sch 1 (item 2), sch 2 (item 1): 1 July 2024 (s 2(1) items 2, 3) | — |
Health Insurance (Section 3C Midwife and Nurse Practitioner Services) Amendment (No. 1) Determination 2024 | 27 Sept 2024 (F2024L01226) | 1 Nov 2024 (s 2(1) item 1) | — |
Health Insurance (Section 3C Participating Nurse Practitioner and Midwife Services – Attendances and Other Changes) Amendment Determination 2025 | 4 Feb 2025 (F2025L00078) | sch 1 (items 1-3) and sch 2 (items 1-12): 1 Mar 2025 (s 2(1) item 1) | — |
Health Insurance Legislation Amendment (Indexation) Determination 2025 | 6 May 2025 (F2025L00554) | sch 1 (item 11): 1 July 2025 (s 2(1) item 1) | — |
Health Insurance (Section 3C Midwife and Nurse Practitioner Services) Amendment (No. 1) Determination 2025 | 6 May 2025 (F2025L00559) | sch 2: 1 July 2025 (s 2(1) item 2) | — |
Health Insurance (Section 3C Midwife and Nurse Practitioner Services) Amendment (Nurse Practitioner Surgical Assistance) Determination 2025 | 9 Sept 2025 (F2025L01069) | 1 Nov 2025 (s 2(1) item 1) | — |
Health Insurance Legislation Amendment (2025 Measures No. 6) Determination 2025 | 15 Sept 2025 (F2025L01086) | sch 1 (item 1): 1 Nov 2025 (s 2(1) item 1) | — |
Health Insurance (Section 3C Midwife and Nurse Practitioner Services) Amendment (Long Acting Reversible Contraceptive Services) Determination 2025 | 15 Sept 2025 (F2025L01102) | 1 Nov 2025 (s 2(1) item 1) | — |
Health Insurance (Section 3C Midwife and Nurse Practitioner Services) Amendment (Patient End Support Services) Determination 2025 | 22 Dec 2025 (F2025L01541) | 1 Mar 2026 (s 2(1) item 1) | — |
Health Insurance (Section 3C Midwife and Nurse Practitioner Services) Amendment (Administrative Amendment) Determination 2026 | 27 Jan 2026 (F2026L00046) | 1 Mar 2026 (s 2(1) item 1) | — |
Health Insurance (Section 3C Midwife and Nurse Practitioner Services) Amendment (Management of Labour by a Midwife) Determination 2026 | 5 May 2026 (F2026L00519) | 1 July 2026 (s 2(1) item 1) | — |
Health Insurance Legislation Amendment (Indexation) Determination 2026 | 8 May 2026 (F2026L00523) | sch 1 (items 20, 22): 1 July 2026 (s 2(1) item 2) | — |
Endnote 4—Amendment history
Provision affected | How affected |
Part 1 |
|
s 2..................... | rep LA s 48D |
s 4..................... | rep LA s 48C |
s 5..................... | am F2023L01115; F2025L01069; F2025L01102 |
s 6..................... | rep F2025L01086 |
s 6A.................... | ad F2022L00553 |
| am F2023L00348 |
| ed C7 |
| am F2023L01183; F2024L00558; F2025L00554; F2026L00523 |
s 6B.................... | ad F2025L00078 |
Part 2 |
|
s 7..................... | am F2021L01838; F2024L01226 |
s 9..................... | rep F2024L01226 |
s 10.................... | am F2025L00078 |
s 11.................... | rep F2021L01811 |
s 12.................... | rs F2021L01838 |
Part 3 |
|
s 15.................... | am F2024L01226 |
s 16.................... | am F2023L01115 |
s 18.................... | rep F2021L01811 |
s 19.................... | ad F2021L01271 |
s 20.................... | ad F2021L01271 |
| am F2023L01115 |
s 20A................... | ad F2024L01226 |
| ed C12 |
Part 4 |
|
Part 4................... | ad F2022L00399 |
s 21.................... | ad F2022L00399 |
Schedule 1 |
|
Part 1 |
|
Group M13 table............ | am F2021L00426; F2021L01838; F2024L01226; F2025L00078 (sch 2 items 8, 11 md not incorp) |
| ed C13 |
| am F2025L00559; F2026L00519 |
Part 2 heading............. | rep F2021L01811 |
Group M13 table............ | am F2021L00426 |
| rep F2021L01811 |
Schedule 2 |
|
Part 1 |
|
Group P9 table............. | am F2021L01271; F2023L01115; F2024L01226; F2025L00078 |
| ed C13 |
Part 2 |
|
cl 2.1................... | ad F2025L01102 |
Group M14 table............ | am F2021L00426; F2023L01580; F2024L00558; F2025L00078 |
| ed C13 |
| am F2025L01102; F2025L01541; F2026L00046 |
| ed C17 |
Part 3 |
|
Part 3 heading............. | rep F2021L01811 |
| ad F2025L01069 |
Part 3................... | ad F2025L01069 |
Group M14 table............ | am F2021L00426 |
| ed C1 |
| rep F2021L01811 |
cl 3.1................... | ad F2025L01069 |
cl 3.2................... | ad F2025L01069 |
cl 3.3................... | ad F2025L01069 |
cl 4..................... | ad F2025L01069 |
Group M33 table............ | ad F2025L01069 |
| am F2026L00523 |