{"id":"F2021L00156","name":"Health Insurance (Section 3C General Medical Services – General Practice Attendance for Assessing Patient Suitability for a COVID-19 Vaccine) Determination 2021","slug":"health-insurance-section-3c-general-medical-services-general-practice-attendance-for-assessing-patie","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"repealed","isInForce":false,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":101267,"registerId":"commonwealth-F2021L00156-current","compilationNumber":null,"startDate":"2026-04-02","status":"Repealed","reasons":null,"registeredAt":null},"sections":[{"sectionNumber":"1. Name","sectionType":"section","heading":"1. Name","content":"#### 1. Name\n\n This instrument is the Health Insurance (Section 3C General Medical Services – General Practice Attendance for Assessing Patient Suitability for a COVID‑19 Vaccine) Determination 2021.","sortOrder":0},{"sectionNumber":"3. Authority","sectionType":"section","heading":"3. Authority","content":"#### 3. Authority\n\n This instrument is made under subsection 3C(1) of the Health Insurance Act 1973.","sortOrder":1},{"sectionNumber":"3A. Cessation","sectionType":"section","heading":"3A. Cessation","content":"#### 3A. Cessation\n\n Unless earlier revoked this instrument ceases as if revoked on 30 June 2025 at 11.59pm.","sortOrder":2},{"sectionNumber":"4. Definitions","sectionType":"section","heading":"4. Definitions","content":"#### 4. Definitions\n\n(1) In this instrument:\n\nAct means the Health Insurance Act 1973.\n\nafter‑hours period means any of the following:\n\n(a) a public holiday;\n\n(b) a Sunday;\n\n(c) before 8 am, or after 1 pm, on a Saturday;\n\n(d) before 8 am, or after 8 pm, on a day other than a day mentioned in paragraphs (a) to (c).\n\nbulk‑billed: a medical service is bulk‑billed if:\n\n(a) a medicare benefit is payable to a person in relation to the service; and\n\n(b) under an agreement entered into under section 20A of the Act:\n\n(i) the person assigns to the medical practitioner by whom, or on whose behalf, the service is provided, the person’s right to the payment of the medicare benefit; and\n\n(ii) the medical practitioner accepts the assignment in full payment of the practitioner’s fee for the service provided.\n\nHealth Practitioner Regulation National Law has the meaning given by the Health Insurance Regulations 2018.\n\nModified Monash 1 area means an area that is not a Modified Monash 2 area, Modified Monash 3 area, Modified Monash 4 area, Modified Monash 5 area, Modified Monash 6 area or Modified Monash 7 area.\n\nModified Monash 2 area has the meaning given by Part 7 of the general medical services table.\n\nModified Monash 3 area has the meaning given by Part 7 of the general medical services table.\n\nModified Monash 4 area has the meaning given by Part 7 of the general medical services table.\n\nModified Monash 5 area has the meaning given by Part 7 of the general medical services table.\n\nModified Monash 6 area has the meaning given by Part 7 of the general medical services table.\n\nModified Monash 7 area has the meaning given by Part 7 of the general medical services table.\n\npractice location has the meaning given by Part 7 of the general medical services table.\n\nrelevant health professional means a person who is registered in a health profession regulated under the Health Practitioner Regulation National Law, other than the medical profession.\n\nrelevant service means a health service, as defined in subsection 3C(8) of the Act, that is specified in a Schedule.\n\nresidential aged care facility means a facility where residential care (as defined in section 41‑3 of the Aged Care Act 1997) is provided.\n\nSchedule means a Schedule to this instrument.\n\nstaff member has the same meaning as in Schedule 1 to the Aged Care Act 1997.\n\nNote: The following terms are defined in subsection 3(1) of the Act:\n\n clinically relevant service;\n\n general medical services table;\n\n hospital‑substitute treatment;\n\n hospital treatment;\n\n item;\n\n medical practitioner;\n\n professional service.\n\n(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.","sortOrder":3},{"sectionNumber":"5. Treatment of relevant services","sectionType":"section","heading":"5. Treatment of relevant services","content":"#### 5. Treatment of relevant services\n\n(1) For subsection 3C(1) of the Act, a relevant service, provided in accordance with this instrument and as a clinically relevant service, is to be treated for the purposes of the provisions specified in subsection (2) as if:\n\n(a) it were both a professional service and a medical service; and\n\n(b) there were an item in the general medical services table that:\n\n(i) related to the service; and\n\n(ii) specified in respect of the service a fee in relation to each State, being the fee specified in this instrument in relation to the service.\n\n(2) For the purposes of subsection (1), each provision of the following laws that relates to medical services, professional services or items is specified:\n\n(a) the Act;\n\n(b) the regulations made under the Act;\n\n(c) the National Health Act 1953;\n\n(d) the regulations made under the National Health Act 1953.\n\n(3) However, subsection 19(4) of the Act is not specified for the purposes of subsection (1).","sortOrder":4},{"sectionNumber":"6. Application of general provisions of ","sectionType":"section","heading":"6. Application of general provisions of the general medical services table","content":"#### 6. Application of general provisions of the general medical services table\n\nClause 1.2.8 of the general medical services table shall have effect as if each of the items in the Schedule were also specified in that clause.","sortOrder":5},{"sectionNumber":"7. Services may be rendered on behalf of","sectionType":"section","heading":"7. Services may be rendered on behalf of a medical practitioner","content":"#### 7. Services may be rendered on behalf of a medical practitioner\n\n(1) An item in the Schedule (other than items 10660, 10661, 93660 and 93661) applies to a service whether the service is provided:\n\n(a) by a medical practitioner; or\n\n(b) on behalf of a medical practitioner by a relevant health professional.\n\nNote: see subsection 3(17) of the Act for when a service is taken to be rendered on behalf of a medical practitioner.\n\n(1A) For the purposes of items 93660 and 93661, the medical practitioner on whose behalf the service is provided:\n\n(a) is not required to attend the location where the service is provided by the relevant health professional; and\n\n(b) retains responsibility for the health, safety and clinical outcomes of the patient; and\n\n(c) must be satisfied that the relevant health professional is appropriately qualified and trained to provide the service.\n\n(2) Item 10660 applies to a service provided in the course of a personal attendance by a single general practitioner on a single patient on a single occasion.\n\n(3) Item 10661 applies to a service provided in the course of a personal attendance by a single medical practitioner (other than a general practitioner) on a single patient on a single occasion.","sortOrder":6},{"sectionNumber":"8. Restrictions on items","sectionType":"section","heading":"8. Restrictions on items","content":"#### 8. Restrictions on items\n\nAvailability of COVID‑19 vaccine at service location\n\n(1) An item in the Schedule only applies to a service if:\n\n(a) for a service provided at a practice location ‑ a dose of a COVID‑19 vaccine is immediately available for administration to the patient at that location; or\n\n(b) for a service provided from a practice location ‑ a dose of a COVID‑19 vaccine is immediately available for administration to the patient at the location at which the service is provided.\n\nRestrictions on co‑claiming with item 10988 or the bulk‑billing incentive items\n\n(2) An item in the Schedule does not apply to a service if the service is associated with a service to which any of items 10988, 10990, 10991, 10992, 75855, 75856, 75857 or 75858 in the general medical services table applies.\n\nExclusion of hospital treatment and hospital‑substitute treatment\n\n(3) An item in the Schedule does not apply to a service if the service is provided as part of an episode of hospital treatment or hospital‑substitute treatment.\n\nItems 10660 and 10661 – claiming frequency\n\n(4) A service provided under items 10660 or 10661 cannot be claimed more than once during a patient’s lifetime.","sortOrder":7},{"sectionNumber":"9. Fee in relation to the first patient ","sectionType":"section","heading":"9. Fee in relation to the first patient during each attendance","content":"#### 9. Fee in relation to the first patient during each attendance\n\n(1) Subject to subsections (2) and (3), for the first patient attended during one attendance by a general practitioner or by a medical practitioner (other than a general practitioner) at:\n\n(a) one residential aged care facility, or at consulting rooms situated within such a complex, on one occasion; or\n\n(b) one residential disability setting facility, or at consulting rooms situated within such a complex, on one occasion; or\n\n(c) a person’s place of residence (other than a residential aged care facility) on one occasion;\n\nthe fee for a service described in an item of the Schedule is the amount listed in the item plus $149.75.\n\n(2) Subsection (1) only applies to a service provided at a residential aged care facility if the patient is:\n\n(a) a care recipient in the facility; or\n\n(b) a staff member of the approved provider operating the facility.\n\n(3) Subsection (1) only applies to a service provided in a residential disability facility setting if the patient is:\n\n(a) unable to attend the practice location due to a disability; or\n\n(b) employed, hired, retained or contracted (whether directly or through an employment or recruiting agency) to provide care and other care related services.\n\n(4) Subsection (1) only applies to a service provided at a person’s place of residence if the patient is unable to attend the practice location due to a medical condition, disability, dementia or frailty.\n\n(5) Subsection (1) applies to a service provided on behalf of a medical practitioner by a relevant health professional.","sortOrder":8},{"sectionNumber":"10","sectionType":"section","heading":"Indexation","content":"#### 10 Indexation\n\n (1) At the start of 1 July 2024 (the indexation time), each amount covered by subclause (2) is replaced by the amount worked out using the following formula:\n ![Start formula 1.035 times the amount immediately before the indexation time end formula](image.002.png)\n\n> Note: The indexed fees could in 2024 be viewed on the Department of Health and Aged Care’s MBS Online website (http://www.health.gov.au).\n\n(2) The amounts covered by this subsection are the fee for each item in a Schedule of this Determination.\n\n(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).\n\nSchedule – relevant services\n\n```html\n

Group A44 – General Practice Attendance for Assessing Patient Suitability for a COVID‑19 Vaccine

Subgroup 3— Assessing Patient Suitability for a Dose of a COVID‑19 Vaccine

Item

Service

Fee ($)

93644

Professional attendance by a general practitioner for the purpose of assessing a patient’s suitability for a COVID‑19 vaccine if all of the following apply:
(a) one or both of the following is undertaken, where clinically relevant:
(i) a short patient history;
(ii) limited examination and management;
(b) the service is bulk‑billed;
(c) the service is provided at, or from, a practice location in a Modified Monash 1 area

41.25

93645

Professional attendance by a general practitioner for the purpose of assessing a patient’s suitability for a COVID‑19 vaccine if all of the following apply:
(a) one or both of the following is undertaken, where clinically relevant:
(i) a short patient history;
(ii) limited examination and management;
(b) the service is bulk‑billed;
(c) the service is provided at, or from, a practice location in:
(i) a Modified Monash 2 area; or
(ii) a Modified Monash 3 area; or
(iii) a Modified Monash 4 area; or
(iv) a Modified Monash 5 area; or
(v) a Modified Monash 6 area; or
(vi) a Modified Monash 7 area

45.25

93646

Professional attendance by a medical practitioner (other than a general practitioner) for the purpose of assessing a patient’s suitability for a COVID‑19 vaccine if all of the following apply:
(a) one or both of the following is undertaken, where clinically relevant:
(i) a short patient history;
(ii) limited examination and management;
(b) the service is bulk‑billed;
(c) the service is provided at, or from, a practice location in a Modified Monash 1 area

33.10

93647

Professional attendance by a medical practitioner (other than a general practitioner) for the purpose of assessing a patient’s suitability for a COVID‑19 vaccine if all of the following apply:
(a) one or both of the following is undertaken, where clinically relevant:
(i) a short patient history;
(ii) limited examination and management;
(b) the service is bulk‑billed;
(c) the service is provided at, or from, a practice location in:
(i) a Modified Monash 2 area; or
(ii) a Modified Monash 3 area; or
(iii) a Modified Monash 4 area; or
(iv) a Modified Monash 5 area; or
(v) a Modified Monash 6 area; or
(vi) a Modified Monash 7 area

40.95

Subgroup 4— After‑Hours Assessing Patient Suitability for a Dose of a COVID‑19 Vaccine

93653

Professional attendance by a general practitioner for the purpose of assessing a patient’s suitability for a COVID‑19 vaccine if all of the following apply:

(a) one or both of the following is undertaken, where clinically relevant:

(i) a short patient history;

(ii) limited examination and management;

(b) the service is bulk‑billed;

(c) the service is provided at, or from, a practice location in a Modified Monash 1 area;

(d) the service is rendered in an after‑hours period

55.95

93654

Professional attendance by a general practitioner for the purpose of assessing a patient’s suitability for a dose of a COVID‑19 vaccine if all of the following apply:

(a) one or both of the following is undertaken, where clinically relevant:

(i) a short patient history;

(ii) limited examination and management;

(b) the service is bulk‑billed;

(c) the service is provided at, or from, a practice location in:

(i) a Modified Monash 2 area; or

(ii) a Modified Monash 3 area; or

(iii) a Modified Monash 4 area; or

(iv) a Modified Monash 5 area; or

(v) a Modified Monash 6 area; or

(vi) a Modified Monash 7 area;

(d) the service is rendered in an after‑hours period

59.90

93655

Professional attendance by a medical practitioner (other than a general practitioner) for the purpose of assessing a patient’s suitability for a COVID‑19 vaccine if all of the following apply:

(a) one or both of the following is undertaken, where clinically relevant:

(i) a short patient history;

(ii) limited examination and management;

(b) the service is bulk‑billed;

(c) the service is provided at, or from, a practice location in a Modified Monash 1 area;

(d) the service is rendered in an after‑hours period

45.10

93656

Professional attendance by a medical practitioner (other than a general practitioner) for the purpose of assessing a patient’s suitability for a COVID‑19 vaccine if all of the following apply:

(a) one or both of the following is undertaken, where clinically relevant:

(i) a short patient history;

(ii) limited examination and management;

(b) the service is bulk‑billed;

(c) the service is provided at, or from, a practice location in:

(i) a Modified Monash 2 area; or

(ii) a Modified Monash 3 area; or

(iii) a Modified Monash 4 area; or

(iv) a Modified Monash 5 area; or

(v) a Modified Monash 6 area; or

(vi) a Modified Monash 7 area;

(d) the service is rendered in an after‑hours period

52.65

Subgroup 5 – In‑depth Patient Assessment for a Patient who has Received a Vaccine Suitability

Assessment Service

10660

Professional attendance by a general practitioner, if all of the following apply:

(a) the service is associated with a service to which item 93644, 93645, 93653 or 93654 applies;

(b) the service requires personal attendance by the general practitioner, lasting more than 10 minutes in duration, to provide in‑depth clinical advice on the individual risks and benefits associated with receiving a COVID‑19 vaccine;

(c) one or both of the following is undertaken, where clinically relevant:

(i) a detailed patient history;

(ii) complex examination and management;

(d) the service is bulk‑billed

46.70

10661

Professional attendance by a medical practitioner (other than a general practitioner), if all of the following apply:

(a) the service is associated with a service to which item 93646, 93647, 93655 or 93656 applies;

(b) the service requires personal attendance by the medical practitioner (other than a general practitioner), lasting more than 10 minutes in duration, to provide in‑depth clinical advice on the individual risks and benefits associated with receiving a COVID‑19 vaccine;

(c) one or both of the following is undertaken, where clinically relevant:

(i) a detailed patient history;

(ii) complex examination and management;

(d) the service is bulk‑billed

37.40

Subgroup 6— Off‑Site Patient Assessment on Behalf of a Medical Practitioner

93660

Attendance by a relevant health professional on behalf of a medical practitioner for the purpose of assessing a patient’s suitability for a dose of a COVID‑19 vaccine if all of the following apply:

(a) one or both of the following is undertaken, where clinically relevant:

(i) a short patient history;

(ii) limited examination and management;

(b) the service is bulk‑billed;

(c) the service is not provided at a practice location; and

(d) the service is provided from a practice location in a Modified Monash 1 area

25.10

93661

Attendance by a relevant health professional on behalf of a medical practitioner for the purpose of assessing a patient’s suitability for a dose of a COVID‑19 vaccine if all of the following apply:

(a) one or both of the following is undertaken, where clinically relevant:

(i) a short patient history;

(ii) limited examination and management;

(b) the service is bulk‑billed;

(c) the service is not provided at a practice location; and

(d) the service is provided from a practice location in:

(i) a Modified Monash 2 area; or

(ii) a Modified Monash 3 area; or

(iii) a Modified Monash 4 area; or

(iv) a Modified Monash 5 area; or

(v) a Modified Monash 6 area; or

(vi) a Modified Monash 7 area

28.65

\n```","sortOrder":9}],"analysis":{"kimi_summary":{"_metrics":{"model":"kimi-k2.5","source":"moonshot-realtime","completionTokens":3644},"content_quality":"ok","complexity_score":6,"scope_assessment":{"changed":false,"description":"The instrument establishes Medicare rebate items specifically for COVID-19 vaccine suitability assessments as described in its title and authority provisions. While it includes provisions for both general practitioners and other medical practitioners across varied settings (including delegation to allied health), this remains within the stated purpose of creating a framework for vaccine suitability assessments without significant scope expansion."},"complexity_factors":["12 distinct item numbers with nuanced distinctions based on practitioner type (GP vs non-GP), geographic classification (Modified Monash 1 vs MM2-7), after-hours status, and consultation depth (basic vs in-depth)","Heavy reliance on external geographic classification system (Modified Monash Model) defined in Part 7 of the general medical services table rather than defined within this instrument","Cross-referencing to multiple Acts (Health Insurance Act 1973, National Health Act 1953, Aged Care Act 1997) and dynamic legislative provisions ('as in force from time to time')","Layered conditional restrictions: mandatory bulk-billing, vaccine availability requirement, exclusion of hospital treatment, exclusion of co-claiming with specific incentive items, and lifetime frequency limits on specific items","Delegation framework permitting allied health professionals to render services on behalf of medical practitioners with specific supervision, qualification, and responsibility requirements","Mathematical indexation formula (3.5% multiplier) with specific rounding rules to the nearest 5 cents"],"plain_english_summary":"This law creates specific Medicare rebates for doctors and eligible health professionals to assess whether a patient is medically suitable for a COVID‑19 vaccine. It affects patients needing a pre‑vaccine check, GPs and other doctors who do assessments, and allied health workers who may perform delegated off‑site checks.\n\nPayments vary by practitioner type, location, timing and complexity; bulk‑billing is required, vaccine must be available on site, some in‑depth items are once‑only, travel‑payments apply for first aged‑care/disability/home visit, and the law expires 30 June 2025."}},"importantCases":[],"_links":{"self":"/api/acts/health-insurance-section-3c-general-medical-services-general-practice-attendance-for-assessing-patie","history":"/api/acts/health-insurance-section-3c-general-medical-services-general-practice-attendance-for-assessing-patie/history","analysis":"/api/acts/health-insurance-section-3c-general-medical-services-general-practice-attendance-for-assessing-patie/analysis","conflicts":"/api/acts/health-insurance-section-3c-general-medical-services-general-practice-attendance-for-assessing-patie/conflicts","importantCases":"/api/acts/health-insurance-section-3c-general-medical-services-general-practice-attendance-for-assessing-patie/important-cases","documents":"/api/acts/health-insurance-section-3c-general-medical-services-general-practice-attendance-for-assessing-patie/documents"}}