{"id":"F2020L00248","name":"Health Insurance (Section 3C General Medical Services – Specialist, Consultant Physician and Consultant Psychiatrist COVID-19 Telehealth Services) Determination 2020","slug":"health-insurance-section-3c-general-medical-services-specialist-consultant-physician-and-consultant-","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"repealed","isInForce":false,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":100793,"registerId":"commonwealth-F2020L00248-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Repealed","reasons":null,"registeredAt":null},"sections":[{"sectionNumber":"1.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 – Specialist, Consultant Physician and Consultant Psychiatrist COVID-19 Telehealth Services) Determination 2020.","sortOrder":0},{"sectionNumber":"2. Commencement","sectionType":"section","heading":"2. Commencement","content":"#### 2. Commencement\n\n(1) Each provision of this instrument specified in column 1 of the table commences, or is taken to have commenced, in accordance with column 2 of the table. Any other statement in column 2 has effect according to its terms.\n\n```html\n

Commencement information

Column 1

Column 2

Column 3

Provisions

Commencement

Date/Details

1. The whole of this instrument

13 March 2020

\n```\n\nNote: This table relates only to the provisions of this instrument as originally made. It will not be amended to deal with any later amendments of this instrument.\n\n(2) Any information in column 3 of the table is not part of this instrument. Information may be inserted in this column, or information in it may be edited, in any published version of this instrument.","sortOrder":1},{"sectionNumber":"3. Cessation","sectionType":"section","heading":"3. Cessation","content":"#### 3. Cessation\n\n Unless earlier revoked, this instrument ceases on 30 September 2020.","sortOrder":2},{"sectionNumber":"4. Authority","sectionType":"section","heading":"4. Authority","content":"#### 4. Authority\n\n This instrument is made under subsection 3C(1) of the Health Insurance Act 1973.","sortOrder":3},{"sectionNumber":"5. Definitions","sectionType":"section","heading":"5. Definitions","content":"#### 5. Definitions\n\n(1) In this instrument:\n\nAct means the Health Insurance Act 1973.\n\nadmitted patient means a patient who is receiving a service that is provided:\n\n(a) as part of an episode of hospital treatment; or\n\n(b) as part of an episode of hospital substitute treatment in respect of which the person to whom the treatment is provided chooses to receive a benefit from a private health insurer.\n\nNote: hospital treatment and hospital-substitute treatment have the same meaning as defined in the Health Insurance Act 1973.\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 as full payment of the medical practitioner’s fee for the service provided.\n\nconsultant psychiatrist means a consultant physician in the practice of the consultant physician’s specialty of psychiatry.\n\ngeneral medical services table means the table prescribed under subsection 4(1) of the Act.\n\nHealth professional at risk of COVID-19 virus means a person that:\n\n(a) has been diagnosed with COVID-19 virus but who is not a patient of a hospital; or\n\n(b) has been required to isolate themselves in quarantine in accordance with home isolation guidance issued by Australian Health Protection Principal Committee.\n\npatient at risk of COVID-19 virus means a person that:\n\n(a) has been diagnosed with COVID-19 virus but who is not a patient of a hospital; or\n\n(b) has been required to isolate themselves in quarantine in accordance with home isolation guidance issued by Australian Health Protection Principal Committee; or\n\n(c) is considered more susceptible to the COVID-19 virus being a person who is:\n\n(i) at least 70 years old; or\n\n(ii) at least 50 years old and is of Aboriginal or Torres Strait Islander descent; or\n\n(iii) pregnant; or\n\n(iv) a parent of a child under 12 months; or\n\n(v) already under treatment for chronic health conditions or is immune compromised; or\n\n(d) the person meets the current national triage protocol criteria for suspected COVID-19 infection.\n\nphone attendance means a professional attendance by telephone where the health practitioner:\n\n(a) has the capacity to provide the full service through this means safely and in accordance with professional standards; and\n\n(b) is satisfied that it is clinically appropriate to provide the service to the patient; and\n\n(c) maintains an audio link with the patient.\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 instrument.\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 item;\n\n medical practitioner;\n\n professional service.\n\ntelehealth attendance means a professional attendance by video conference where the health practitioner:\n\n(a) has the capacity to provide the full service through this means safely and in accordance with professional standards; and\n\n(b) is satisfied that it is clinically appropriate to provide the service to the patient; and\n\n(c) maintains a visual and audio link with the patient; and\n\n(d) is satisfied that the software and hardware used to deliver the service meets the applicable laws for security and privacy.\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":4},{"sectionNumber":"6. Treatment of relevant services","sectionType":"section","heading":"6. Treatment of relevant services","content":"#### 6. Treatment of relevant services\n\nFor 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 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\ni. related to the service; and\n\nii. specified for the service a fee in relation to each State, being the fee specified in the Schedule in relation to the service.\n\nAn item in a Schedule to this Determination only applies to a service provided on and after 13 March 2020 and before the commencement of the Health Insurance (Section 3C General Medical Services –COVID-19 Services) Determination 2020.","sortOrder":5},{"sectionNumber":"7. Application of provisions of the gene","sectionType":"section","heading":"7. Application of provisions of the general medical services table","content":"#### 7. Application of provisions of the general medical services table\n\n (1) Clause 1.1.5 of the general medical services table shall have effect as if items 91822 to 91826 of this Determination were specified in subclause 1.1.5(1) of the general medical services table.\n (2) Clause 1.2.2 of the general medical services table shall have effect as if items in Schedule 1 of this Determination were specified in clause 1.2.2.\n (3) Clause 1.2.4 of the general medical services table shall have effect as if items in Schedule 1 of this Determination were specified in subclause 1.2.4(1).\n\nSchedule 1 – relevant services\n\nDivision 1.1 – Services and fees – specialist attendances via video conference\n\n```html\n

Group A40 – COVID-19 – medical practitioner telehealth services

Subgroup 4 – COVID-19 – specialist attendances telehealth services

Item

Description

Fee ($)

91822

Telehealth attendance for a person by a specialist in the practice of the specialist’s specialty if:

(a) the attendance is where:

(i) the person is a patient at risk of COVID-19 virus; or

(ii) the specialist is a health professional at risk of COVID-19 virus; and

(b) the attendance follows referral of the patient to the specialist; and

(c) the attendance was of more than 5 minutes in duration; and

(d) the patient is not an admitted patient; and

(e) the service is bulk-billed.

Where the attendance was other than a second or subsequent attendance as part of a single course of treatment.

88.25

91823

Telehealth attendance for a person by a specialist in the practice of the specialist’s specialty if:

(a) the attendance is where:

(i) the person is a patient at risk of COVID-19 virus; or

(ii) the specialist is a health professional at risk of COVID-19 virus; and

(b) the attendance follows referral of the patient to the specialist; and

(c) the attendance was of more than 5 minutes in duration; and

(d) the patient is not an admitted patient; and

(e) the service is bulk-billed.

Where the attendance is after the first attendance as part of a single course of treatment.

44.35

\n```\n\n \n\nDivision 1.2 – Services and fees – consultant physician (other than psychiatry) attendances via video conference\n\n```html\n

Group A40 – COVID-19 – medical practitioner telehealth services

Subgroup 5 – COVID-19 – consultant physician telehealth services

Item

Description

Fee ($)

91824

Telehealth attendance for a person by a consultant physician in the practice of the consultant physician’s specialty (other than psychiatry) if:

(a) the attendance is where:

(i) the person is a patient at risk of COVID-19 virus; or

(ii) the consultant physician is a health professional at risk of COVID-19 virus; and

(b) the attendance follows referral of the patient to the specialist; and

(c) the attendance was of more than 5 minutes in duration; and

(d) the patient is not an admitted patient; and

(e) the service is bulk-billed.

Where the attendance was other than a second or subsequent attendance as part of a single course of treatment.

155.60

91825

Telehealth attendance for a person by a consultant physician in the practice of the consultant physician’s specialty (other than psychiatry) if:

(a) the attendance is where:

(i) the person is a patient at risk of COVID-19 virus; or

(ii) the consultant physician is a health professional at risk of COVID-19 virus; and

(b) the attendance follows referral of the patient to the specialist; and

(c) the attendance was of more than 5 minutes in duration; and

(d) the patient is not an admitted patient; and

(e) the service is bulk-billed.

Where the attendance is not a minor attendance after the first as part of a single course of treatment.

77.90

91826

Telehealth attendance for a person by a consultant physician in the practice of the consultant physician’s specialty (other than psychiatry) if:

(a) the attendance is where:

(i) the person is a patient at risk of COVID-19 virus; or

(ii) the specialist is a health professional at risk of COVID-19 virus; and

(b) the attendance follows referral of the patient to the specialist; and

(c) the attendance was of more than 5 minutes in duration; and

(d) the patient is not an admitted patient; and

(e) the service is bulk-billed.

Where the attendance is a minor attendance after the first as part of a single course of treatment.

44.35

\n```\n\n \n\nDivision 1.3 – Services and fees – Consultant psychiatrist attendances via video conference\n\n```html\n

Group A40 – COVID-19 – medical practitioner telehealth services

Subgroup 6 – COVID-19 – consultant psychiatrist telehealth services

91827

Telehealth attendance for a person by a consultant psychiatrist; if:

(a) the attendance is where:

(i) the person is a patient at risk of COVID-19 virus; or

(ii) the consultant psychiatrist is a health professional at risk of COVID-19 virus; and

(b) the attendance follows a referral of the patient to the consultant psychiatrist by a referring practitioner; and

(c) the attendance was not more than 15 minutes duration; and

(d) the patient is not an admitted patient; and

(e) the service is bulk-billed.

44.70

91828

Telehealth attendance for a person by a consultant psychiatrist; if:

(a) the attendance is where:

(i) the person is a patient at risk of COVID-19 virus; or

(ii) the consultant psychiatrist is a health professional at risk of COVID-19 virus; and

(b) the attendance follows a referral of the patient to the consultant psychiatrist by a referring practitioner; and

(c) the attendance was at least 15 minutes, but not more than 30 minutes in duration; and

(d) the patient is not an admitted patient; and

(e) the service is bulk-billed.

89.15

91829

Telehealth attendance for a person by a consultant psychiatrist; if:

(a) the attendance is where:

(i) the person is a patient at risk of COVID-19 virus; or

(ii) the consultant psychiatrist is a health professional at risk of COVID-19 virus; and

(b) the attendance follows a referral of the patient to the consultant psychiatrist by a referring practitioner; and

(c) the attendance was at least 30 minutes, but not more than 45 minutes in duration; and

(d) the patient is not an admitted patient; and

(e) the service is bulk-billed.

137.25

91830

Telehealth attendance for a person by a consultant psychiatrist; if:

(a) the attendance is where:

(i) the person is a patient at risk of COVID-19 virus; or

(ii) the consultant psychiatrist is a health professional at risk of COVID-19 virus; and

(b) the attendance follows a referral of the patient to the consultant psychiatrist by a referring practitioner; and

(c) the attendance was at least 45 minutes, but not more than 75 minutes in duration; and

(d) the patient is not an admitted patient; and

(e) the service is bulk-billed.

189.40

91831

Telehealth attendance for a person by a consultant psychiatrist; if:

(a) the attendance is where:

(i) the person is a patient at risk of COVID-19 virus; or

(ii) the consultant psychiatrist is a health professional at risk of COVID-19 virus; and

(b) the attendance follows a referral of the patient to the consultant psychiatrist by a referring practitioner; and

(c) the attendance was at least 75 minutes in duration; and

(d) the patient is not an admitted patient; and

(e) the service is bulk-billed.

219.80

\n```\n\nDivision 1.4 Services and fees – specialist attendances via phone services\n\n1.4.1 Application of COVID-19 medical practitioner phone services\n\nInsert:\n\n (1) For items in Subgroups 4, and 7 the rendering practitioner must not perform a service in subgroup 7 if the practitioner and the patient have the capacity to undertake an attendance by telehealth.\n\n```html\n

Group A40 – COVID-19 – medical practitioner phone services

Subgroup 7 – COVID-19 – specialist attendances phone services

Item

Description

Fee ($)

91832

Phone attendance for a person by a specialist in the practice of the specialist’s specialty if:

(a) the attendance is where:

(i) the person is a patient at risk of COVID-19 virus; or

(ii) the specialist is a health professional at risk of COVID-19 virus; and

(b) the attendance follows referral of the patient to the specialist; and

(c) the attendance was of more than 5 minutes in duration; and

(d) the patient is not an admitted patient; and

(e) the service is bulk-billed.

Where the attendance was other than a second or subsequent attendance as part of a single course of treatment.

88.25

91833

Phone attendance for a person by a specialist in the practice of the specialist’s specialty if:

(a) the attendance is where:

(i) the person is a patient at risk of COVID-19 virus; or

(ii) the specialist is a health professional at risk of COVID-19 virus; and

(b) the attendance follows referral of the patient to the specialist; and

(c) the attendance was of more than 5 minutes in duration; and

(d) the patient is not an admitted patient; and

(e) the service is bulk-billed.

Where the attendance is after the first attendance as part of a single course of treatment.

44.35

\n```\n\nDivision 1.5 – Services and fees – consultant physician (other than psychiatry) attendances via phone services\n\n1.5.1 Application of COVID-19 medical practitioner phone services\n\nInsert:\n\n (1) For items in Subgroups 5, and 8 the rendering practitioner must not perform a service in subgroup 8 if the practitioner and the patient have the capacity to undertake an attendance by telehealth.\n\n```html\n

Group A40 – COVID-19 – medical practitioner phone services

Subgroup 8 – COVID-19 – consultant physician phone services

Item

Description

Fee ($)

91834

Phone attendance for a person by a consultant physician in the practice of the consultant physician’s specialty (other than psychiatry) if:

(a) the attendance is where:

(i) the person is a patient at risk of COVID-19 virus; or

(ii) the consultant physician is a health professional at risk of COVID-19 virus; and

(b) the attendance follows referral of the patient to the specialist; and

(c) the attendance was of more than 5 minutes in duration; and

(d) the patient is not an admitted patient; and

(e) the service is bulk-billed.

Where the attendance was other than a second or subsequent attendance as part of a single course of treatment.

155.60

91835

Phone attendance for a person by a consultant physician in the practice of the consultant physician’s specialty (other than psychiatry) if:

(a) the attendance is where:

(i) the person is a patient at risk of COVID-19 virus; or

(ii) the consultant physician is a health professional at risk of COVID-19 virus; and

(b) the attendance follows referral of the patient to the specialist; and

(c) the attendance was of more than 5 minutes in duration; and

(d) the patient is not an admitted patient; and

(e) the service is bulk-billed.

Where the attendance is not a minor attendance after the first as part of a single course of treatment.

77.90

91836

Phone attendance for a person by a consultant physician in the practice of the consultant physician’s specialty (other than psychiatry) if:

(a) the attendance is where:

(i) the person is a patient at risk of COVID-19 virus; or

(ii) the specialist is a health professional at risk of COVID-19 virus; and

(b) the attendance follows referral of the patient to the specialist; and

(c) the attendance was of more than 5 minutes in duration; and

(d) the patient is not an admitted patient; and

(e) the service is bulk-billed.

Where the attendance is a minor attendance after the first as part of a single course of treatment.

44.35

\n```\n\nDivision 1.6 – Services and fees – Consultant psychiatrist attendances via phone services\n\n1.6.1 Application of COVID-19 medical practitioner phone services\n\nInsert:\n\n (1) For items in Subgroups 6, and 9 the rendering practitioner must not perform a service in subgroup 9 if the practitioner and the patient have the capacity to undertake an attendance by telehealth.\n\n```html\n

Group A40 – COVID-19 – medical practitioner phone services

Subgroup 9 – COVID-19 – consultant psychiatrist phone services

Item

Description

Fee($)

91837

Phone attendance for a person by a consultant psychiatrist; if:

(a) the attendance is where:

(i) the person is a patient at risk of COVID-19 virus; or

(ii) the consultant psychiatrist is a health professional at risk of COVID-19 virus; and

(b) the attendance follows a referral of the patient to the consultant psychiatrist by a referring practitioner; and

(c) the attendance was not more than 15 minutes duration; and

(d) the patient is not an admitted patient; and

(e) the service is bulk-billed.

44.70

91838

Phone attendance for a person by a consultant psychiatrist; if:

(a) the attendance is where:

(i) the person is a patient at risk of COVID-19 virus; or

(ii) the consultant psychiatrist is a health professional at risk of COVID-19 virus; and

(b) the attendance follows a referral of the patient to the consultant psychiatrist by a referring practitioner; and

(c) the attendance was at least 15 minutes, but not more than 30 minutes in duration; and

(d) the patient is not an admitted patient; and

(e) the service is bulk-billed.

89.15

91839

Phone attendance for a person by a consultant psychiatrist; if:

(f) the attendance is where:

(j) the person is a patient at risk of COVID-19 virus; or

(jj) the consultant psychiatrist is a health professional at risk of COVID-19 virus; and

(g) the attendance follows a referral of the patient to the consultant psychiatrist by a referring practitioner; and

(h) the attendance was at least 30 minutes, but not more than 45 minutes in duration; and

(i) the patient is not an admitted patient; and

(j) the service is bulk-billed.

137.25

91840

Phone attendance for a person by a consultant psychiatrist; if:

(a) the attendance is where:

(i) the person is a patient at risk of COVID-19 virus; or

(ii) the consultant psychiatrist is a health professional at risk of COVID-19 virus; and

(b) the attendance follows a referral of the patient to the consultant psychiatrist by a referring practitioner; and

(c) the attendance was at least 45 minutes, but not more than 75 minutes in duration; and

(d) the patient is not an admitted patient; and

(e) the service is bulk-billed.

189.40

91841

Phone attendance for a person by a consultant psychiatrist; if:

(a) the attendance is where:

(i) the person is a patient at risk of COVID-19 virus; or

(ii) the consultant psychiatrist is a health professional at risk of COVID-19 virus; and

(b) the attendance follows a referral of the patient to the consultant psychiatrist by a referring practitioner; and

(c) the attendance was at least 75 minutes in duration; and

(d) the patient is not an admitted patient; and

(e) the service is bulk-billed.

219.80

\n```\n\nDivision 1. 7– Services and Fees – obstetric attendances via telehealth services\n\n1.7.1 – Application of COVID-19 obstetrics telehealth and phone services\n\n(1) For items in Division 1.7, ‘midwife’ has the same meaning as provided in clause 2.41.2 of the Health Insurance (General Medical Services Table) Regulations 2019.\n\n(2) Application of item 91850 and 91855\n\n1) Item 91850 and 91855 applies to an antenatal service provided to a patient by a midwife, nurse or Aboriginal and Torres Strait Islander health practitioner only if:\n\n(a) the midwife, nurse or Aboriginal and Torres Strait Islander health practitioner has the appropriate training and skills to perform an antenatal service; and\n\n(b) the medical practitioner under whose supervision the antenatal service is provided retains responsibility for clinical outcomes and for the health and safety of the patient; and\n\n(c) the midwife, nurse or Aboriginal and Torres Strait Islander health practitioner complies with relevant legislative or regulatory requirements regarding the provision of the antenatal service in the State or Territory where the service is provided.\n\n2) Item 91850 and 91855 does not apply in conjunction with another antenatal attendance item for the same patient, on the same day by the same practitioner.\n\n3) Item 91850 and 91855 does not apply in conjunction with items 10990, 10991 or 10992.\n\n4) For any particular patient, item 91850 and 91855 applies not more than 10 times in a 9 month period.\n\n (3) For items in Subgroups 1 the rendering practitioner must not perform a service in subgroup 2 if the practitioner and the patient have the capacity to undertake an attendance by telehealth.\n\n```html\n

Group T4—Obstetrics

Item

Description

Fee ($)

Subgroup 1 – COVID-19 obstetric telehealth services

91850

Antenatal telehealth service provided by a midwife, nurse or an Aboriginal and Torres Strait Islander health practitioner, to a maximum of 10 services per pregnancy, if:

(a) the attendance is where:

(i) the person is at risk of COVID-19 virus; or

(ii) the practitioner rendering the service is a health professional at risk of COVID-19 virus; and

(b) the service is provided on behalf of, and under the supervision of, a medical practitioner; and

(c) the service is provided at, or from, a practice location in a regional, rural or remote area; and

(d) the service is not performed in conjunction with another antenatal attendance item in Group T4 for the same patient on the same day by the same practitioner; and

(e) the service is not provided for an admitted patient of a hospital or approved day facility; and

(f) The services is bulk billed.

27.70

91851

Postnatal telehealth attendance by an obstetrician or general practitioner (other than a service to which any other item applies) if:

(a) the attendance is where:

(i) the person is at risk of COVID-19 virus; or

(ii) the practitioner rendering the service is a health professional at risk of COVID-19 virus; and

(b) is between 4 and 8 weeks after the birth; and

(c) lasts at least 20 minutes in duration; and

(d) includes a mental health assessment (including screening for drug and alcohol use and domestic violence) of the patient; and

(e) is for a pregnancy in relation to which a service to which item 82140 applies is not provided; and

(f) the service is bulk billed.

Applicable once for a pregnancy

72.85

91852

Postnatal telehealth attendance (other than attendance at consulting rooms, a hospital or a residential aged care facility or a service to which any other item applies) if:

(a) the attendance is rendered by:

(i) a midwife (on behalf of and under the supervision of the medical practitioner who attended the birth); or

(ii) an obstetrician; or

(iii) a general practitioner; and

(b) the attendance is where:

(i) the person is at risk of COVID-19 virus; or

(ii) the practitioner rendering the service is a health professional at risk of COVID-19 virus; and

(c) is between 1 week and 4 weeks after the birth; and

(d) lasts at least 20 minutes; and

(e) is for a patient who was privately admitted for the birth; and

(f) is for a pregnancy in relation to which a service to which item 82130, 82135 or 82140 applies is not provided; and

(g) the service is bulk billed.

Applicable once for a pregnancy

54.25

91853

Antenatal telehealth attendance if:

(a) the attendance is where:

(i) the person is at risk of COVID-19 virus; or

(ii) the practitioner rendering the service is a health professional at risk of COVID-19 virus; and

(b) the service is bulk billed.

47.90

Subgroup 2 – COVID-19 obstetric phone services

91855

Antenatal phone service provided by a midwife, nurse or an Aboriginal and Torres Strait Islander health practitioner, to a maximum of 10 services per pregnancy, if:

(a) the attendance is where:

(i) the person is at risk of COVID-19 virus; or

(ii) the practitioner rendering the service is a health professional at risk of COVID-19 virus; and

(b) the service is provided on behalf of, and under the supervision of, a medical practitioner; and

(c) the service is provided at, or from, a practice location in a regional, rural or remote area; and

(d) the service is not performed in conjunction with another antenatal attendance item in Group T4 for the same patient on the same day by the same practitioner; and

(e) the service is not provided for an admitted patient of a hospital or approved day facility; and

(f) The services is bulk billed.

27.70

91856

Postnatal phone attendance by an obstetrician or general practitioner (other than a service to which any other item applies) if:

(a) the attendance is where:

(i) the person is at risk of COVID-19 virus; or

(ii) the practitioner rendering the service is a health professional at risk of COVID-19 virus; and

(b) is between 4 and 8 weeks after the birth; and

(c) lasts at least 20 minutes in duration; and

(d) includes a mental health assessment (including screening for drug and alcohol use and domestic violence) of the patient; and

(e) is for a pregnancy in relation to which a service to which item 82140 applies is not provided; and

(f) the service is bulk billed.

Applicable once for a pregnancy

72.85

91857

Postnatal phone attendance other than attendance at consulting rooms, a hospital or a residential aged care facility or a service to which any other item applies) if:

(a) the attendance is rendered by:

(i) a midwife (on behalf of and under the supervision of the medical practitioner who attended the birth); or

(ii) an obstetrician; or

(iii) a general practitioner; and

(b) the attendance is where:

(i) the person is at risk of COVID-19 virus; or

(ii) the practitioner rendering the service is a health professional at risk of COVID-19 virus; and

(c) is between 1 week and 4 weeks after the birth; and

(d) lasts at least 20 minutes; and

(e) is for a patient who was privately admitted for the birth; and

(f) is for a pregnancy in relation to which a service to which item 82130, 82135 or 82140 applies is not provided; and

(g) the service is bulk billed.

Applicable once for a pregnancy

54.25

91858

Antenatal phone attendance if:

(a) the attendance is where:

(i) the person is at risk of COVID-19 virus; or

(ii) the practitioner rendering the service is a health professional at risk of COVID-19 virus; and

(b) the service is bulk billed.

47.90

\n```","sortOrder":6}],"analysis":{"kimi_summary":{"_metrics":{"model":"kimi-k2.5","source":"moonshot-realtime","completionTokens":3276},"content_quality":"ok","complexity_score":6,"scope_assessment":{"changed":false,"description":"This is the original determination establishing temporary COVID-19 telehealth items; it has not expanded beyond its original purpose of creating emergency remote consultation Medicare rebates during the pandemic."},"complexity_factors":["Multiple defined terms requiring cross-referencing (e.g., 'patient at risk', 'health professional at risk', 'admitted patient')","Hierarchical service rules mandating video over phone where capacity exists","Conditional eligibility requiring assessment of either patient or practitioner risk status","Time-based itemisation creating tiered fee structures (especially for psychiatry)","Cross-references to the Health Insurance Act 1973 and National Health Act 1953","Nested conditions within service items (e.g., referrals, duration limits, bulk-billing mandates)","Specific exclusions (hospital admitted patients) and quantitative limits (10 antenatal services per pregnancy)","Sunset clause with fixed cessation date"],"plain_english_summary":"This instrument temporarily expanded Medicare to fund remote specialist care (video or phone) during the early COVID-19 response, letting high‑risk patients and those isolating see psychiatrists, consultant physicians, obstetricians and other specialists from home. \n\nIt mattered because it reduced infection risk and preserved access to care, subject to billing and modality rules (bulk‑billing, video preferred, referrals usually required) and expired automatically after the emergency period."},"flash_summary":{"complexity_score":7,"scope_assessment":{"changed":true,"description":"The Determination temporarily extends the Medicare schedule by creating specific telehealth and phone items for specialists, consultant physicians, consultant psychiatrists and certain obstetric attendances, treating those attendances as both professional and medical services with specified fees and conditions (cl.6; Schedule 1). It narrows eligibility to non‑admitted patients where the patient or practitioner is 'at risk' of COVID‑19, requires bulk‑billing and referral/duration conditions, and applies only between 13 March 2020 and 30 September 2020 (cl.2–3; Schedule 1)."},"complexity_factors":["Multiple parallel item sets and fee levels across specialties (Items 91822–91841) create many permutations of service type, duration and fee (Schedule 1).","Layered eligibility conditions: 'patient at risk' and 'health professional at risk' definitions are multi‑part and affect entitlement (Definitions, cl.5).","Operational constraints: bulk‑billing is mandatory for listed items, referral required, patient must be non‑admitted and attendances have explicit duration thresholds (see items e.g. 91822, 91824, 91827).","Telehealth technical and privacy/security requirement for video services imposes compliance obligations on practitioners (Definition of telehealth attendance, cl.5).","Substitution rule between telehealth and phone: practitioner must not use phone items if practitioner and patient can undertake telehealth (Divisions 1.4, 1.5, 1.6 inserts).","Special rules for obstetric/midwife antenatal items: supervision, training, location and per‑pregnancy limits (Division 1.7, cl.1.7.1).","Interaction with existing law and schedules: instrument treats specified services 'as if' items existed in the general medical services table and cross‑applies clauses from that table (cl.6–7), requiring cross‑reference reading.","Time‑limited scope and sequencing: the Determination specifies commencement (13 March 2020) and cessation (30 September 2020) and limits application relative to other Determinations (cl.2–3, cl.6).","Administrative and billing complexity for practices to ensure correct item selection, bulk‑billing assignment, referral documentation and duration recording for Medicare claims (Schedules and item conditions)."],"plain_english_summary":"This Determination temporarily adds Medicare items (from 13 March to 30 September 2020) to cover specialist, consultant physician, consultant psychiatrist and certain obstetric attendances delivered by telehealth or phone. It treats those attendances as medical and professional services, sets item-specific fees, and imposes operational conditions (bulk‑billing, referral, clinical appropriateness, duration and non‑admitted status). The instrument targets care where a patient or practitioner is defined as “at risk” of COVID‑19 and limits who can claim which items."}},"importantCases":[],"_links":{"self":"/api/acts/health-insurance-section-3c-general-medical-services-specialist-consultant-physician-and-consultant-","history":"/api/acts/health-insurance-section-3c-general-medical-services-specialist-consultant-physician-and-consultant-/history","analysis":"/api/acts/health-insurance-section-3c-general-medical-services-specialist-consultant-physician-and-consultant-/analysis","conflicts":"/api/acts/health-insurance-section-3c-general-medical-services-specialist-consultant-physician-and-consultant-/conflicts","importantCases":"/api/acts/health-insurance-section-3c-general-medical-services-specialist-consultant-physician-and-consultant-/important-cases","documents":"/api/acts/health-insurance-section-3c-general-medical-services-specialist-consultant-physician-and-consultant-/documents"}}