{"id":"F2018L00874","name":"Health Insurance (Section 3C General Medical Services – Other Medical Practitioner) Determination 2018","slug":"health-insurance-section-3c-general-medical-services-other-medical-practitioner-determination-2018","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"in_force","isInForce":true,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":97547,"registerId":"commonwealth-F2018L00874-current","compilationNumber":null,"startDate":"2026-04-02","status":"InForce","reasons":null,"registeredAt":null},"sections":[{"sectionNumber":"1. Name of Determination","sectionType":"part","heading":"1. Name of Determination","content":"# 1. Name of Determination\n\nThis Determination is the Health Insurance (Section 3C General Medical Services – Other Medical Practitioner) Determination 2018.","sortOrder":0},{"sectionNumber":"3. Authority","sectionType":"part","heading":"3. Authority","content":"# 3. Authority\n\nThis Determination is made under subsection 3C(1) of the Health Insurance Act 1973.","sortOrder":1},{"sectionNumber":"4. Definitions","sectionType":"part","heading":"4. Definitions","content":"# 4. Definitions\n\n(1) In this Determination:\n\nAct means the Health Insurance Act 1973.\n\ngeneral medical services table means the table prescribed under section 4 of the Act as in force from time to time.\n\ngeneral practitioner has a meaning affected by clause 1.1.3 of the general medical services table.\n\nhas effect: when this Determination refers to a provision of the general medical services table as having effect, the provision of the general medical services table has effect as a provision of this Determination.\n\nprescribed medical practitioner means a medical practitioner who is not a general practitioner, specialist or consultant physician, and who:\n\n (a) is registered under section 3GA of the Act, to the extent that the person is practicing during the period in respect of which, and in the location in respect of which, he or she is registered, and insofar as the circumstances specified for paragraph 19AA(3)(b) of the Act apply; or\n (b) is covered by an exemption under subsection 19AB(3) of the Act; or\n (c) first became a medical practitioner before 1 November 1996.\n\nrelevant provisions means all provisions, of the Act and regulations made under the Act, and the National Health Act 1953 and regulations made under the National Health Act 1953, relating to medical services, professional services or items.\n\nrelevant service means a health service, as defined in subsection 3C(8) of the Act, that is specified in a Schedule.\n\nSchedule means a Schedule to this Determination.\n\nNote: The following terms are defined in subsection 3(1) of the Act:\n\n clinically relevant service\n\n consultant physician\n\n item\n\n professional service\n\n specialist\n\n(2) Unless the contrary intention appears, a reference in this Determination 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":2},{"sectionNumber":"5. Treatment of relevant services","sectionType":"part","heading":"5. Treatment of relevant services","content":"# 5. Treatment of relevant services\n\nFor subsection 3C(1) of the Act a relevant service, provided in accordance with this Determination and as a clinically relevant service, is to be treated, for the relevant provisions, 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 for the service a fee in relation to each State, being the fee specified in the Schedule in relation to the service.","sortOrder":3},{"sectionNumber":"6. Application of general provisions of ","sectionType":"part","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\n (1) Clause 1.2.1 of the general medical services table shall have effect as if an item in Schedule 1 of this Determination were specified in Schedule 1 of the general medical services table.\n (2) Clause 1.2.5 of the general medical services table shall have effect as if:\n (a) an item in Schedule 1 of this Determination were specified in subclause 1.2.5(1) of the general medical services table; and\n (b) an item in Schedule 1 of this Determination were specified in subclause 1.2.5(3) of the general medical services table.\n (3) Clause 1.2.7 of the general medical services table shall have effect as if an item in Schedule 1 of this Determination were also specified in subclause 1.2.7(1).\n (4) Clause 1.2.8 of the general medical services table shall have effect as if an item in Schedule 1 of this Determination were also specified in clause 1.2.8.\n (5) Clause 1.2.9 of the general medical services table shall have effect as if an item in Schedule 1 of this Determination were also specified in clause 1.2.9.\n (6) Clause 1.2.10 of the general medical services table shall have effect as if an item in Schedule 1 of this Determination were also specified in clause 1.2.10.","sortOrder":4},{"sectionNumber":"7. Indexation","sectionType":"part","heading":"7. Indexation","content":"# 7. Indexation\n\n (1)\n \n At the start of 1 July 2025 (the\n \n indexation time\n ), each amount covered by subsection\n \n (2) is replaced by the amount worked out using the following formula:\n\n ![1.024 multiplied by the amount immediately before the indexation time](image.002.png)\n Note: The indexed fees could in 2025 be viewed on the Department of Health and Aged Care’s MBS Online website (https://www.mbsonline.gov.au).\n (2) The amounts covered by this subsection are the fee for each item in Schedule 1 of this Determination.\n (3) To avoid doubt, a fee listed in table 1.1.1 is not indexed under subsection (1).\n (4) 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).","sortOrder":5},{"sectionNumber":"Schedule 1","sectionType":"part","heading":"relevant services","content":"# 1. Name of Determination\n\nThis Determination is the Health Insurance (Section 3C General Medical Services – Other Medical Practitioner) Determination 2018.\n\n# 3. Authority\n\nThis Determination is made under subsection 3C(1) of the Health Insurance Act 1973.\n\n# 4. Definitions\n\n(1) In this Determination:\n\nAct means the Health Insurance Act 1973.\n\ngeneral medical services table means the table prescribed under section 4 of the Act as in force from time to time.\n\ngeneral practitioner has a meaning affected by clause 1.1.3 of the general medical services table.\n\nhas effect: when this Determination refers to a provision of the general medical services table as having effect, the provision of the general medical services table has effect as a provision of this Determination.\n\nprescribed medical practitioner means a medical practitioner who is not a general practitioner, specialist or consultant physician, and who:\n\n (a) is registered under section 3GA of the Act, to the extent that the person is practicing during the period in respect of which, and in the location in respect of which, he or she is registered, and insofar as the circumstances specified for paragraph 19AA(3)(b) of the Act apply; or\n (b) is covered by an exemption under subsection 19AB(3) of the Act; or\n (c) first became a medical practitioner before 1 November 1996.\n\nrelevant provisions means all provisions, of the Act and regulations made under the Act, and the National Health Act 1953 and regulations made under the National Health Act 1953, relating to medical services, professional services or items.\n\nrelevant service means a health service, as defined in subsection 3C(8) of the Act, that is specified in a Schedule.\n\nSchedule means a Schedule to this Determination.\n\nNote: The following terms are defined in subsection 3(1) of the Act:\n\n clinically relevant service\n\n consultant physician\n\n item\n\n professional service\n\n specialist\n\n(2) Unless the contrary intention appears, a reference in this Determination 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.\n\n# 5. Treatment of relevant services\n\nFor subsection 3C(1) of the Act a relevant service, provided in accordance with this Determination and as a clinically relevant service, is to be treated, for the relevant provisions, 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 for the service a fee in relation to each State, being the fee specified in the Schedule in relation to the service.\n\n# 6. Application of general provisions of the general medical services table\n\n (1) Clause 1.2.1 of the general medical services table shall have effect as if an item in Schedule 1 of this Determination were specified in Schedule 1 of the general medical services table.\n (2) Clause 1.2.5 of the general medical services table shall have effect as if:\n (a) an item in Schedule 1 of this Determination were specified in subclause 1.2.5(1) of the general medical services table; and\n (b) an item in Schedule 1 of this Determination were specified in subclause 1.2.5(3) of the general medical services table.\n (3) Clause 1.2.7 of the general medical services table shall have effect as if an item in Schedule 1 of this Determination were also specified in subclause 1.2.7(1).\n (4) Clause 1.2.8 of the general medical services table shall have effect as if an item in Schedule 1 of this Determination were also specified in clause 1.2.8.\n (5) Clause 1.2.9 of the general medical services table shall have effect as if an item in Schedule 1 of this Determination were also specified in clause 1.2.9.\n (6) Clause 1.2.10 of the general medical services table shall have effect as if an item in Schedule 1 of this Determination were also specified in clause 1.2.10.\n\n# 7. Indexation\n\n (1)\n \n At the start of 1 July 2025 (the\n \n indexation time\n ), each amount covered by subsection\n \n (2) is replaced by the amount worked out using the following formula:\n\n ![1.024 multiplied by the amount immediately before the indexation time](image.002.png)\n Note: The indexed fees could in 2025 be viewed on the Department of Health and Aged Care’s MBS Online website (https://www.mbsonline.gov.au).\n (2) The amounts covered by this subsection are the fee for each item in Schedule 1 of this Determination.\n (3) To avoid doubt, a fee listed in table 1.1.1 is not indexed under subsection (1).\n (4) 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\n# Schedule 1 – relevant services\n\n## Part 1—Services and fees—Non‑Specialist Practitioner services\n\n## Division 1.1—Services and fees—Multiple patients in a single attendance\n\n1.1.1 Meaning of amount under table 1.1.1\n\n(1) An amount under table 1.1.1, for an item mentioned in column 1 of table 1.1.1, means the sum of:\n\n(a) the fee for the item mentioned in column 2 of the table; and\n\n(b) either:\n\n(i) if not more than 6 patients are attended at a single attendance—the amount mentioned in column 3 for the item, divided by the number of patients attended; or\n\n(ii) if more than 6 patients are attended at a single attendance—the amount mentioned in column 4 for the item.\n\n```html\n

Table 1.1.1—Amount under clause 1.1.1

Item

Column 1

Item/s of the table

Column 2

Fee

Column 3

Amount if not more than 6 patients (to be divided by the number of patients) ($)

Column 4

Amount if more than 6 patients ($)

1

761

The fee for item 733

$24.25

$1.90

2

763

The fee for item 737

$24.25

$1.90

3

766

The fee for item 741

$24.25

$1.90

4

769

The fee for item 745

$24.25

$1.90

5

772

The fee for item 733

$43.60

$3.05

6

776

The fee for item 737

$43.60

$3.05

7

788

The fee for item 741

$43.60

$3.05

8

789

The fee for item 745

$43.60

$3.05

9

2198

The fee for item 2197

$24.25

$1.90

10

2200

The fee for item 2197

$43.60

$3.05

\n```\n\n#### Division 1.10—Services and fees—Non‑Specialist Practitioner after‑hours attendances to which no other item applies\n\n1.10.1 Application of items in Division 1.10\n\n(1) Clause 2.24.1 of the general medical services table shall have effect as if:\n\n(a) items 733, 745, 766 and 776 were also specified in subclause 2.24.1(1).\n\n(b) all items in Division 1.10 were also specified in subclause 2.24.1(2).\n\n```html\n

Group A7 – Acupuncture and Non‑Specialist Practitioner Items

Subgroup 10 – Prescribed Medical Practitioner after‑hours attendances to which no other item applies

Item

Description

Fee ($)

733

Professional attendance at consulting rooms of not more than 5 minutes in duration (other than a service to which another item applies) by a prescribed medical practitioner—each attendance

25.50

737

Professional attendance at consulting rooms of more than 5 minutes in duration but not more than 25 minutes in duration (other than a service to which another item applies) by a prescribed medical practitioner—each attendance

43.10

741

Professional attendance at consulting rooms of more than 25 minutes in duration but not more than 45 minutes in duration (other than a service to which another item applies) by a prescribed medical practitioner—each attendance

73.95

745

Professional attendance at consulting rooms of more than 45 minutes in duration but not more than 60 minutes (other than a service to which another item applies) by a prescribed medical practitioner—each attendance

103.70

761

Professional attendance by a prescribed medical practitioner (other than attendance at consulting rooms, a hospital or a residential aged care facility or a service to which another item in the table applies), lasting not more than 5 minutes—an attendance on one or more patients on one occasion—each patient

Amount under clause 1.1.1

763

Professional attendance by a prescribed medical practitioner (other than attendance at consulting rooms, a hospital or a residential aged care facility or a service to which another item in the table applies), lasting more than 5 minutes, but not more than 25 minutes—an attendance on one or more patients on one occasion—each patient

Amount under clause 1.1.1

766

Professional attendance by a prescribed medical practitioner (other than attendance at consulting rooms, a hospital or a residential aged care facility or a service to which another item in the table applies), lasting more than 25 minutes, but not more than 45 minutes—an attendance on one or more patients on one occasion—each patient

Amount under clause 1.1.1

769

Professional attendance by a prescribed medical practitioner (other than attendance at consulting rooms, a hospital or a residential aged care facility or a service to which another item in the table applies), lasting more than 45 minutes, but not more than 60 minutes—an attendance on one or more patients on one occasion—each patient.

Amount under clause 1.1.1

772

Professional attendance (other than a service to which another item applies) at a residential aged care facility (other than a professional attendance at a self‑contained unit) or professional attendance at consulting rooms situated within such a complex if the patient is accommodated in the residential aged care facility (other than accommodation in a self‑contained unit) of not more than 5 minutes in duration by a prescribed medical practitioner—an attendance on one or more patients at one residential aged care facility on one occasion—each patient

Amount under clause 1.1.1

776

Professional attendance (other than a service to which another item applies) at a residential aged care facility (other than a professional attendance at a self‑contained unit) or professional attendance at consulting rooms situated within such a complex if the patient is accommodated in the residential aged care facility (other than accommodation in a self‑contained unit) of more than 5 minutes in duration but not more than 25 minutes in duration by a prescribed medical practitioner—an attendance on one or more patients at one residential aged care facility on one occasion—each patient

Amount under clause 1.1.1

788

Professional attendance (other than a service to which another item applies) at a residential aged care facility (other than a professional attendance at a self‑contained unit) or professional attendance at consulting rooms situated within such a complex if the patient is accommodated in the residential aged care facility (other than accommodation in a self‑contained unit) of more than 25 minutes in duration but not more than 45 minutes by a prescribed medical practitioner—an attendance on one or more patients at one residential aged care facility on one occasion—each patient

Amount under clause 1.1.1

789

Professional attendance (other than a service to which another item applies) at a residential aged care facility (other than a professional attendance at a self‑contained unit) or professional attendance at consulting rooms situated within such a complex if the patient is accommodated in the residential aged care facility (other than accommodation in a self‑contained unit) of more than 45 minutes but not more than 60 minutes in duration by a prescribed medical practitioner—an attendance on one or more patients at one residential aged care facility on one occasion—each patient

Amount under clause 1.1.1

2197

Professional attendance at consulting rooms of more than 60 minutes in duration (other than a service to which another item applies) by a prescribed medical practitioner—each attendance.

176.20

2198

Professional attendance by a prescribed medical practitioner (other than attendance at consulting rooms, a hospital or a residential aged care facility or a service to which another item in the table applies), lasting more than 60 minutes—an attendance on one or more patients on one occasion—each patient.

Amount under clause 1.1.1

2200

Professional attendance (other than a service to which another item applies) at a residential aged care facility (other than a professional attendance at a self‑contained unit) or professional attendance at consulting rooms situated within such a complex if the patient is accommodated in the residential aged care facility (other than accommodation in a self‑contained unit) of more than 60 minutes in duration by a prescribed medical practitioner—an attendance on one or more patients at one residential aged care facility on one occasion—each patient.

Amount under clause 1.1.1

\n```","sortOrder":6},{"sectionNumber":"Part 1","sectionType":"part","heading":"Services and fees—Non‑Specialist Practitioner services","content":"# 1. Name of Determination\n\nThis Determination is the Health Insurance (Section 3C General Medical Services – Other Medical Practitioner) Determination 2018.\n\n# 3. Authority\n\nThis Determination is made under subsection 3C(1) of the Health Insurance Act 1973.\n\n# 4. Definitions\n\n(1) In this Determination:\n\nAct means the Health Insurance Act 1973.\n\ngeneral medical services table means the table prescribed under section 4 of the Act as in force from time to time.\n\ngeneral practitioner has a meaning affected by clause 1.1.3 of the general medical services table.\n\nhas effect: when this Determination refers to a provision of the general medical services table as having effect, the provision of the general medical services table has effect as a provision of this Determination.\n\nprescribed medical practitioner means a medical practitioner who is not a general practitioner, specialist or consultant physician, and who:\n\n (a) is registered under section 3GA of the Act, to the extent that the person is practicing during the period in respect of which, and in the location in respect of which, he or she is registered, and insofar as the circumstances specified for paragraph 19AA(3)(b) of the Act apply; or\n (b) is covered by an exemption under subsection 19AB(3) of the Act; or\n (c) first became a medical practitioner before 1 November 1996.\n\nrelevant provisions means all provisions, of the Act and regulations made under the Act, and the National Health Act 1953 and regulations made under the National Health Act 1953, relating to medical services, professional services or items.\n\nrelevant service means a health service, as defined in subsection 3C(8) of the Act, that is specified in a Schedule.\n\nSchedule means a Schedule to this Determination.\n\nNote: The following terms are defined in subsection 3(1) of the Act:\n\n clinically relevant service\n\n consultant physician\n\n item\n\n professional service\n\n specialist\n\n(2) Unless the contrary intention appears, a reference in this Determination 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.\n\n# 5. Treatment of relevant services\n\nFor subsection 3C(1) of the Act a relevant service, provided in accordance with this Determination and as a clinically relevant service, is to be treated, for the relevant provisions, 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 for the service a fee in relation to each State, being the fee specified in the Schedule in relation to the service.\n\n# 6. Application of general provisions of the general medical services table\n\n (1) Clause 1.2.1 of the general medical services table shall have effect as if an item in Schedule 1 of this Determination were specified in Schedule 1 of the general medical services table.\n (2) Clause 1.2.5 of the general medical services table shall have effect as if:\n (a) an item in Schedule 1 of this Determination were specified in subclause 1.2.5(1) of the general medical services table; and\n (b) an item in Schedule 1 of this Determination were specified in subclause 1.2.5(3) of the general medical services table.\n (3) Clause 1.2.7 of the general medical services table shall have effect as if an item in Schedule 1 of this Determination were also specified in subclause 1.2.7(1).\n (4) Clause 1.2.8 of the general medical services table shall have effect as if an item in Schedule 1 of this Determination were also specified in clause 1.2.8.\n (5) Clause 1.2.9 of the general medical services table shall have effect as if an item in Schedule 1 of this Determination were also specified in clause 1.2.9.\n (6) Clause 1.2.10 of the general medical services table shall have effect as if an item in Schedule 1 of this Determination were also specified in clause 1.2.10.\n\n# 7. Indexation\n\n (1)\n \n At the start of 1 July 2025 (the\n \n indexation time\n ), each amount covered by subsection\n \n (2) is replaced by the amount worked out using the following formula:\n\n ![1.024 multiplied by the amount immediately before the indexation time](image.002.png)\n Note: The indexed fees could in 2025 be viewed on the Department of Health and Aged Care’s MBS Online website (https://www.mbsonline.gov.au).\n (2) The amounts covered by this subsection are the fee for each item in Schedule 1 of this Determination.\n (3) To avoid doubt, a fee listed in table 1.1.1 is not indexed under subsection (1).\n (4) 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\n# Schedule 1 – relevant services\n\n## Part 1—Services and fees—Non‑Specialist Practitioner services\n\n## Division 1.1—Services and fees—Multiple patients in a single attendance\n\n1.1.1 Meaning of amount under table 1.1.1\n\n(1) An amount under table 1.1.1, for an item mentioned in column 1 of table 1.1.1, means the sum of:\n\n(a) the fee for the item mentioned in column 2 of the table; and\n\n(b) either:\n\n(i) if not more than 6 patients are attended at a single attendance—the amount mentioned in column 3 for the item, divided by the number of patients attended; or\n\n(ii) if more than 6 patients are attended at a single attendance—the amount mentioned in column 4 for the item.\n\n```html\n

Table 1.1.1—Amount under clause 1.1.1

Item

Column 1

Item/s of the table

Column 2

Fee

Column 3

Amount if not more than 6 patients (to be divided by the number of patients) ($)

Column 4

Amount if more than 6 patients ($)

1

761

The fee for item 733

$24.25

$1.90

2

763

The fee for item 737

$24.25

$1.90

3

766

The fee for item 741

$24.25

$1.90

4

769

The fee for item 745

$24.25

$1.90

5

772

The fee for item 733

$43.60

$3.05

6

776

The fee for item 737

$43.60

$3.05

7

788

The fee for item 741

$43.60

$3.05

8

789

The fee for item 745

$43.60

$3.05

9

2198

The fee for item 2197

$24.25

$1.90

10

2200

The fee for item 2197

$43.60

$3.05

\n```\n\n#### Division 1.10—Services and fees—Non‑Specialist Practitioner after‑hours attendances to which no other item applies\n\n1.10.1 Application of items in Division 1.10\n\n(1) Clause 2.24.1 of the general medical services table shall have effect as if:\n\n(a) items 733, 745, 766 and 776 were also specified in subclause 2.24.1(1).\n\n(b) all items in Division 1.10 were also specified in subclause 2.24.1(2).\n\n```html\n

Group A7 – Acupuncture and Non‑Specialist Practitioner Items

Subgroup 10 – Prescribed Medical Practitioner after‑hours attendances to which no other item applies

Item

Description

Fee ($)

733

Professional attendance at consulting rooms of not more than 5 minutes in duration (other than a service to which another item applies) by a prescribed medical practitioner—each attendance

25.50

737

Professional attendance at consulting rooms of more than 5 minutes in duration but not more than 25 minutes in duration (other than a service to which another item applies) by a prescribed medical practitioner—each attendance

43.10

741

Professional attendance at consulting rooms of more than 25 minutes in duration but not more than 45 minutes in duration (other than a service to which another item applies) by a prescribed medical practitioner—each attendance

73.95

745

Professional attendance at consulting rooms of more than 45 minutes in duration but not more than 60 minutes (other than a service to which another item applies) by a prescribed medical practitioner—each attendance

103.70

761

Professional attendance by a prescribed medical practitioner (other than attendance at consulting rooms, a hospital or a residential aged care facility or a service to which another item in the table applies), lasting not more than 5 minutes—an attendance on one or more patients on one occasion—each patient

Amount under clause 1.1.1

763

Professional attendance by a prescribed medical practitioner (other than attendance at consulting rooms, a hospital or a residential aged care facility or a service to which another item in the table applies), lasting more than 5 minutes, but not more than 25 minutes—an attendance on one or more patients on one occasion—each patient

Amount under clause 1.1.1

766

Professional attendance by a prescribed medical practitioner (other than attendance at consulting rooms, a hospital or a residential aged care facility or a service to which another item in the table applies), lasting more than 25 minutes, but not more than 45 minutes—an attendance on one or more patients on one occasion—each patient

Amount under clause 1.1.1

769

Professional attendance by a prescribed medical practitioner (other than attendance at consulting rooms, a hospital or a residential aged care facility or a service to which another item in the table applies), lasting more than 45 minutes, but not more than 60 minutes—an attendance on one or more patients on one occasion—each patient.

Amount under clause 1.1.1

772

Professional attendance (other than a service to which another item applies) at a residential aged care facility (other than a professional attendance at a self‑contained unit) or professional attendance at consulting rooms situated within such a complex if the patient is accommodated in the residential aged care facility (other than accommodation in a self‑contained unit) of not more than 5 minutes in duration by a prescribed medical practitioner—an attendance on one or more patients at one residential aged care facility on one occasion—each patient

Amount under clause 1.1.1

776

Professional attendance (other than a service to which another item applies) at a residential aged care facility (other than a professional attendance at a self‑contained unit) or professional attendance at consulting rooms situated within such a complex if the patient is accommodated in the residential aged care facility (other than accommodation in a self‑contained unit) of more than 5 minutes in duration but not more than 25 minutes in duration by a prescribed medical practitioner—an attendance on one or more patients at one residential aged care facility on one occasion—each patient

Amount under clause 1.1.1

788

Professional attendance (other than a service to which another item applies) at a residential aged care facility (other than a professional attendance at a self‑contained unit) or professional attendance at consulting rooms situated within such a complex if the patient is accommodated in the residential aged care facility (other than accommodation in a self‑contained unit) of more than 25 minutes in duration but not more than 45 minutes by a prescribed medical practitioner—an attendance on one or more patients at one residential aged care facility on one occasion—each patient

Amount under clause 1.1.1

789

Professional attendance (other than a service to which another item applies) at a residential aged care facility (other than a professional attendance at a self‑contained unit) or professional attendance at consulting rooms situated within such a complex if the patient is accommodated in the residential aged care facility (other than accommodation in a self‑contained unit) of more than 45 minutes but not more than 60 minutes in duration by a prescribed medical practitioner—an attendance on one or more patients at one residential aged care facility on one occasion—each patient

Amount under clause 1.1.1

2197

Professional attendance at consulting rooms of more than 60 minutes in duration (other than a service to which another item applies) by a prescribed medical practitioner—each attendance.

176.20

2198

Professional attendance by a prescribed medical practitioner (other than attendance at consulting rooms, a hospital or a residential aged care facility or a service to which another item in the table applies), lasting more than 60 minutes—an attendance on one or more patients on one occasion—each patient.

Amount under clause 1.1.1

2200

Professional attendance (other than a service to which another item applies) at a residential aged care facility (other than a professional attendance at a self‑contained unit) or professional attendance at consulting rooms situated within such a complex if the patient is accommodated in the residential aged care facility (other than accommodation in a self‑contained unit) of more than 60 minutes in duration by a prescribed medical practitioner—an attendance on one or more patients at one residential aged care facility on one occasion—each patient.

Amount under clause 1.1.1

\n```","sortOrder":7},{"sectionNumber":"Division 1.1","sectionType":"part","heading":"Services and fees—Multiple patients in a single attendance","content":"## Division 1.1—Services and fees—Multiple patients in a single attendance\n\n1.1.1 Meaning of amount under table 1.1.1\n\n(1) An amount under table 1.1.1, for an item mentioned in column 1 of table 1.1.1, means the sum of:\n\n(a) the fee for the item mentioned in column 2 of the table; and\n\n(b) either:\n\n(i) if not more than 6 patients are attended at a single attendance—the amount mentioned in column 3 for the item, divided by the number of patients attended; or\n\n(ii) if more than 6 patients are attended at a single attendance—the amount mentioned in column 4 for the item.\n\n```html\n

Table 1.1.1—Amount under clause 1.1.1

Item

Column 1

Item/s of the table

Column 2

Fee

Column 3

Amount if not more than 6 patients (to be divided by the number of patients) ($)

Column 4

Amount if more than 6 patients ($)

1

761

The fee for item 733

$24.25

$1.90

2

763

The fee for item 737

$24.25

$1.90

3

766

The fee for item 741

$24.25

$1.90

4

769

The fee for item 745

$24.25

$1.90

5

772

The fee for item 733

$43.60

$3.05

6

776

The fee for item 737

$43.60

$3.05

7

788

The fee for item 741

$43.60

$3.05

8

789

The fee for item 745

$43.60

$3.05

9

2198

The fee for item 2197

$24.25

$1.90

10

2200

The fee for item 2197

$43.60

$3.05

\n```","sortOrder":8},{"sectionNumber":"Division 1.10","sectionType":"subdivision","heading":"Services and fees—Non‑Specialist Practitioner after‑hours attendances to which no other item applies","content":"#### Division 1.10—Services and fees—Non‑Specialist Practitioner after‑hours attendances to which no other item applies\n\n1.10.1 Application of items in Division 1.10\n\n(1) Clause 2.24.1 of the general medical services table shall have effect as if:\n\n(a) items 733, 745, 766 and 776 were also specified in subclause 2.24.1(1).\n\n(b) all items in Division 1.10 were also specified in subclause 2.24.1(2).\n\n```html\n

Group A7 – Acupuncture and Non‑Specialist Practitioner Items

Subgroup 10 – Prescribed Medical Practitioner after‑hours attendances to which no other item applies

Item

Description

Fee ($)

733

Professional attendance at consulting rooms of not more than 5 minutes in duration (other than a service to which another item applies) by a prescribed medical practitioner—each attendance

25.50

737

Professional attendance at consulting rooms of more than 5 minutes in duration but not more than 25 minutes in duration (other than a service to which another item applies) by a prescribed medical practitioner—each attendance

43.10

741

Professional attendance at consulting rooms of more than 25 minutes in duration but not more than 45 minutes in duration (other than a service to which another item applies) by a prescribed medical practitioner—each attendance

73.95

745

Professional attendance at consulting rooms of more than 45 minutes in duration but not more than 60 minutes (other than a service to which another item applies) by a prescribed medical practitioner—each attendance

103.70

761

Professional attendance by a prescribed medical practitioner (other than attendance at consulting rooms, a hospital or a residential aged care facility or a service to which another item in the table applies), lasting not more than 5 minutes—an attendance on one or more patients on one occasion—each patient

Amount under clause 1.1.1

763

Professional attendance by a prescribed medical practitioner (other than attendance at consulting rooms, a hospital or a residential aged care facility or a service to which another item in the table applies), lasting more than 5 minutes, but not more than 25 minutes—an attendance on one or more patients on one occasion—each patient

Amount under clause 1.1.1

766

Professional attendance by a prescribed medical practitioner (other than attendance at consulting rooms, a hospital or a residential aged care facility or a service to which another item in the table applies), lasting more than 25 minutes, but not more than 45 minutes—an attendance on one or more patients on one occasion—each patient

Amount under clause 1.1.1

769

Professional attendance by a prescribed medical practitioner (other than attendance at consulting rooms, a hospital or a residential aged care facility or a service to which another item in the table applies), lasting more than 45 minutes, but not more than 60 minutes—an attendance on one or more patients on one occasion—each patient.

Amount under clause 1.1.1

772

Professional attendance (other than a service to which another item applies) at a residential aged care facility (other than a professional attendance at a self‑contained unit) or professional attendance at consulting rooms situated within such a complex if the patient is accommodated in the residential aged care facility (other than accommodation in a self‑contained unit) of not more than 5 minutes in duration by a prescribed medical practitioner—an attendance on one or more patients at one residential aged care facility on one occasion—each patient

Amount under clause 1.1.1

776

Professional attendance (other than a service to which another item applies) at a residential aged care facility (other than a professional attendance at a self‑contained unit) or professional attendance at consulting rooms situated within such a complex if the patient is accommodated in the residential aged care facility (other than accommodation in a self‑contained unit) of more than 5 minutes in duration but not more than 25 minutes in duration by a prescribed medical practitioner—an attendance on one or more patients at one residential aged care facility on one occasion—each patient

Amount under clause 1.1.1

788

Professional attendance (other than a service to which another item applies) at a residential aged care facility (other than a professional attendance at a self‑contained unit) or professional attendance at consulting rooms situated within such a complex if the patient is accommodated in the residential aged care facility (other than accommodation in a self‑contained unit) of more than 25 minutes in duration but not more than 45 minutes by a prescribed medical practitioner—an attendance on one or more patients at one residential aged care facility on one occasion—each patient

Amount under clause 1.1.1

789

Professional attendance (other than a service to which another item applies) at a residential aged care facility (other than a professional attendance at a self‑contained unit) or professional attendance at consulting rooms situated within such a complex if the patient is accommodated in the residential aged care facility (other than accommodation in a self‑contained unit) of more than 45 minutes but not more than 60 minutes in duration by a prescribed medical practitioner—an attendance on one or more patients at one residential aged care facility on one occasion—each patient

Amount under clause 1.1.1

2197

Professional attendance at consulting rooms of more than 60 minutes in duration (other than a service to which another item applies) by a prescribed medical practitioner—each attendance.

176.20

2198

Professional attendance by a prescribed medical practitioner (other than attendance at consulting rooms, a hospital or a residential aged care facility or a service to which another item in the table applies), lasting more than 60 minutes—an attendance on one or more patients on one occasion—each patient.

Amount under clause 1.1.1

2200

Professional attendance (other than a service to which another item applies) at a residential aged care facility (other than a professional attendance at a self‑contained unit) or professional attendance at consulting rooms situated within such a complex if the patient is accommodated in the residential aged care facility (other than accommodation in a self‑contained unit) of more than 60 minutes in duration by a prescribed medical practitioner—an attendance on one or more patients at one residential aged care facility on one occasion—each patient.

Amount under clause 1.1.1

\n```","sortOrder":9}],"analysis":{"kimi_summary":{"_metrics":{"completionTokens":566},"content_quality":"ok","complexity_score":6,"scope_assessment":{"changed":false,"description":"The legislation appears focused on its original purpose of setting Medicare fees for non-specialist practitioners. The 2025 indexation provision is a standard temporal update rather than scope expansion."},"complexity_factors":["Multiple nested definitions referencing other legislation (Health Insurance Act 1973, National Health Act 1953)","Complex fee calculation formula with conditional logic based on patient numbers (6-patient threshold)","Cross-referencing to external 'general medical services table' which is not fully reproduced","'Has effect' provisions that incorporate external rules by reference","Indexation formula with specific rounding rules (2.5 cent multiples)","Multiple location types (consulting rooms, residential aged care, 'other') with different fee structures","Duplicated content in the source text creating parsing challenges"],"plain_english_summary":"This instrument sets Medicare rebates for non‑specialist medical practitioners (those outside GP, specialist, or consultant categories), specifying after‑hours consultation item numbers and fees that vary by consultation length and location (consulting rooms, other locations, residential aged care). It includes special per‑patient adjustments when a practitioner sees multiple patients at one site and applies a 2.4% indexation to fees from 1 July 2025 (with some table fees excluded)."},"flash_summary_failed":{"failed":true,"reason":"A positive credit balance is required for all requests, including BYOK, so fallback providers remain available. Add credits at https://vercel.com/d?to=%2F%5Bteam%5D%2F%7E%2Fai%3Fmodal%3Dtop-up to continue.","source":"analysis-cron"},"flash_summary":{"complexity_score":6,"scope_assessment":{"changed":false,"description":"The instrument exercises the power in subsection 3C(1) to treat specified services as if items existed in the general medical services table and to fix fees and application rules (see cl.3, cl.5, Schedule 1). Nothing in the text indicates an expansion beyond that authorising purpose; it implements itemisation, context‑specific application and indexation rather than altering the Act's substantive scope."},"complexity_factors":["Extensive cross‑references to the general medical services table and to multiple provisions of the Act and National Health Act (see cl.4(2), cl.6)","Definition of 'prescribed medical practitioner' that depends on registration and exemptions in other provisions (cl.4(1))","Detailed fee schedule with per‑item fees and contextual descriptions across consulting rooms, domiciliary attendances and residential aged care (Schedule 1 Divs 1.1 & 1.10)","Multi‑patient calculation rule requiring division or alternative lump sums (clause 1.1.1 and Table 1.1.1)","After‑hours and multiple application clauses that modify how general table clauses operate (cl.6; cl.1.10.1)","Indexation rule with a specific multiplier and rounding rule to nearest 5 cents (cl.7(1),(4))","Incorporation by reference of provisions 'as in force from time to time' creating ongoing interaction with future legislative changes (cl.4(2))"],"plain_english_summary":"This Determination designates a set of services provided by \"prescribed medical practitioners\" as medical and professional services under the Health Insurance Act 1973 and supplies item numbers, state‑based fees and application rules in Schedule 1 (cl.5–6). It prescribes how multi‑patient attendances are calculated, extends items to after‑hours and aged‑care contexts, and applies a 1.024 indexation to Schedule fees on 1 July 2025 (cl.7). It affects prescribed medical practitioners, patients and the Act’s fee/claiming rules."}},"importantCases":[],"_links":{"self":"/api/acts/health-insurance-section-3c-general-medical-services-other-medical-practitioner-determination-2018","history":"/api/acts/health-insurance-section-3c-general-medical-services-other-medical-practitioner-determination-2018/history","analysis":"/api/acts/health-insurance-section-3c-general-medical-services-other-medical-practitioner-determination-2018/analysis","conflicts":"/api/acts/health-insurance-section-3c-general-medical-services-other-medical-practitioner-determination-2018/conflicts","importantCases":"/api/acts/health-insurance-section-3c-general-medical-services-other-medical-practitioner-determination-2018/important-cases","documents":"/api/acts/health-insurance-section-3c-general-medical-services-other-medical-practitioner-determination-2018/documents"}}