Health Insurance (Section 3C General Medical Services – Allied Health and other Primary Health Care Services) Determination 2024
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Aboriginal and Torres Strait Islander health and wellbeing service means:
(a) a health service of a kind prescribed by section 12 of the Health Insurance Regulations 2018;
(b) that is specified in an item in Schedule 2, Group M3, Group M11 and Subgroup 2 of Group M10.
Aboriginal and Torres Strait Islander Health Practice Board of Australia means that board established under section 31 of the National Law.
Aboriginal and Torres Strait Islander primary health care professional, for the provision of an Aboriginal and Torres Strait Islander health and wellbeing service, means a person:
(a) who meets the qualification requirements set out in Schedule 1 for the provision of the service; and
(b) whose name is entered in the register, kept by the Chief Executive Medicare, of Aboriginal and Torres Strait Islander primary health care professionals who are qualified to provide a service of that kind.
Act means the Health Insurance Act 1973.
admitted patient means a patient who is receiving a service that is provided:
(a) as part of an episode of hospital treatment; or
(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.
allied health professional, for the provision of an allied health service, means a person:
(a) who meets the qualification requirements set out in Schedule 1 for the provision of the service; and
(b) whose name is entered in the register, kept by the Chief Executive Medicare, of allied health professionals who are qualified to provide a service of that kind.
Note: Allied health professionals in relation to the provision of a focussed psychological strategies health service are subject to the requirements of section 10.
allied health service means:
(a) a health service of a kind prescribed by section 12 of the Health Insurance Regulations 2018; or
(b) a health service that is an optometry treatment service;
that is specified in an item in Schedule 2.
case conference service means a service to which item 10955, 10957, 10959, 80176, 80177, 80178, 82001, 82002 or 82003 applies, which is one of the following health services:
Section 4 - Health Insurance (Section 3C General Medical Services – Allied Health and other Primary Health Care Services) Determination 2024 - Interpretation | Zoe
(a) Aboriginal and Torres Strait Islander health and wellbeing service;
(b) audiology service;
(c) chiropractic service;
(d) diabetes education service;
(e) dietetics service;
(f) exercise physiology service;
(g) focussed psychological strategies service;
(h) mental health service;
(i) nurse practitioner service;
(j) occupational therapy service;
(k) orthoptics service;
(l) osteopathy service;
(m) physiotherapy service;
(n) podiatry service;
(o) psychological therapy service;
(p) psychology service;
(q) speech pathology service.
Chiropractic Board of Australia means that board established under section 31 of the National Law.
clinically relevant service means a service rendered by an allied health professional, nurse practitioner or Aboriginal and Torres Strait Islander primary health care professional that is generally accepted in the relevant health profession (as the case may be) as being necessary for the appropriate treatment of the patient to whom it is rendered.
course of assessment means:
(a) for complex neurodevelopmental disorder services—up to 4 services to which any of items 82000, 82005, 82010, 82030 or items 93032, 93033, 93040 and 93041 of the Telehealth Attendance Determination applies provided, on referral by a consultant physician specialising in the practice of the consultant physician’s field of psychiatry or paediatrics, by any of the following persons:
(i) an eligible audiologist;
(ii) an eligible occupational therapist;
(iii) an eligible optometrist;
(iv) an eligible orthoptist;
(v) an eligible physiotherapist;
(vi) an eligible psychologist;
(vii) an eligible speech pathologist;
(viii) an eligible dietitian;
(ix) an eligible exercise physiologist; or
(b) for disability services—up to 4 services to which any of items 82000, 82005, 82010, 82030 or items 93032, 93033, 93040 and 93041 of the Telehealth Attendance Determination applies provided, on referral by a specialist or consultant physician practising in the practice of their field of specialty or a general practitioner, by any of the following persons:
(i) an eligible audiologist;
(ii) an eligible occupational therapist;
(iii) an eligible optometrist;
(iv) an eligible orthoptist;
(v) an eligible physiotherapist;
(vi) an eligible psychologist;
(vii) an eligible speech pathologist;
(viii) an eligible dietitian; or
(ix) an eligible exercise physiologist.
course of treatment means:
(a) for psychological therapy and focussed psychological strategies—up to 6 services to which any of items 80000, 80002, 80005, 80006, 80010, 80012, 80015, 80016, 80100, 80102, 80105, 80106, 80110, 80112, 80115, 80116, 80125, 80129, 80130, 80131, 80135, 80137, 80140, 80141, 80150, 80154, 80155, 80156, 80160, 80162, 80165 or 80166 or items 91166, 91167, 91168, 91169, 91170, 91171, 91172, 91173, 91174, 91175, 91176, 91177, 91181, 91182, 91183, 91184, 91185, 91186, 91187, 91188, 91194, 91195, 91196, 91197, 91198, 91199, 91200, 91201, 91202, 91203, 91204 or 91205 of the Telehealth Attendance Determination applies (subject to subclause 2.1.1(4)), provided on referral by a medical practitioner, by any of the following persons:
(i) an eligible clinical psychologist;
(ii) an eligible psychologist;
(iii) an eligible occupational therapist;
(iv) an eligible social worker; or
(b) for complex neurodevelopmental disorder services—up to 10 treatment services to which any of items 82015, 82020, 82025, 82035 or items 93035, 93036, 93043 and 93044 of the Telehealth Attendance Determination applies provided, on referral by a consultant physician specialising in the practice of the consultant physician’s field of psychiatry or paediatrics, by any of the following persons:
(i) an eligible audiologist;
(ii) an eligible occupational therapist;
(iii) an eligible optometrist;
(iv) an eligible orthoptist;
(v) an eligible physiotherapist;
(vi) an eligible psychologist;
(vii) an eligible speech pathologist;
(viii) an eligible dietitian;
(ix) an eligible exercise physiologist, or
(c) for disability services—up to 10 treatment services to which any of items 82015, 82020, 82025, 82035 or items 93035, 93036, 93043 and 93044 of the Telehealth Attendance Determination applies provided, on referral by a specialist or consultant physician specialising in the practice of their field of specialty, or a general practitioner, by any of the following persons:
(i) an eligible audiologist;
(ii) an eligible occupational therapist;
(iii) an eligible optometrist;
(iv) an eligible orthoptist;
(v) an eligible physiotherapist;
(vi) an eligible psychologist;
(vii) an eligible speech pathologist;
(viii) an eligible dietitian; or
(ix) an eligible exercise physiologist.
CPD year means the period of time in which focussed psychological strategies continuing professional development must be completed being from 1 July to 30 June annually.
eating disorder dietetic treatment service means a service to which any of items 10954 or 82350, or items 93074 or 93108 of the Telehealth Attendance Determination applies.
eating disorder treatment and management plan has the same meaning as in the general medical services table.
eligible Aboriginal and Torres Strait Islander health practitioner means a person who is an Aboriginal and Torres Strait Islander primary health care professional in relation to the provision of one or both of the following:
(a) an Aboriginal and Torres Strait Islander health and wellbeing service because of section 1 of item 1 of Schedule 1 of this instrument;
(b) a mental health service.
eligible Aboriginal and Torres Strait Islander health worker means a person who is an:
(a) Aboriginal health worker; or
(b) Aboriginal and Torres Strait Islander health worker; or
(c) Torres Strait Islander health worker
who is an Aboriginal and Torres Strait Islander primary health care professional in relation to the provision of one or both of the following:
(i) an Aboriginal and Torres Strait Islander health and wellbeing service because of section 2 of item 1(2) of Schedule 1 of this instrument;
(ii) a mental health service.
eligible audiologist means a person who is an allied health professional in relation to the provision of an audiology health service.
eligible chiropractor means a person who is an allied health professional in relation to the provision of a chiropractic health service.
eligible clinical psychologist means a person who is an allied health professional in relation to the provision of one or more of the following:
(a) a psychological therapy health service;
(b) a focussed psychological strategies health service
(c) an eating disorder psychological treatment service.
eligible diabetes educator means a person who is an allied health professional in relation to the provision of a diabetes education health service.
eligible dietitian means a person who is an allied health professional in relation to the provision of a dietetics health service.
eligible disability has the meaning given by clause 2.6.1 of the Health Insurance (General Medical Services Table) Regulations 2021.
eligible exercise physiologist means a person who is an allied health professional in relation to the provision of an exercise physiology service.
eligible mental health nurse means a person who is an allied health professional in relation to the provision of one or more of the following:
(a) a non‑directive pregnancy support counselling health service;
(b) a mental health service.
eligible mental health worker means a person who is an allied health professional or Aboriginal and Torres Strait Islander primary health care professional in relation to the provision of a mental health service.
eligible occupational therapist means a person who is an allied health professional in relation to the provision of one or both of the following:
(a) a focussed psychological strategies health service;
(b) an occupational therapy health service;
(c) a mental health service;
(d) an eating disorder psychological treatment service.
eligible optometrist means a person who is an allied health professional in relation to the provision of an optometry health service.
eligible orthoptist means a person who is an allied health professional in relation to the provision of an orthoptic health service.
eligible osteopath means a person who is an allied health professional in relation to the provision of an osteopathy health service.
eligible physiotherapist means a person who is an allied health professional in relation to the provision of a physiotherapy health service.
eligible podiatrist means a person who is an allied health professional in relation to the provision of a podiatry health service.
eligible psychologist means a person who is an allied health professional in relation to the provision of one or more of the following:
(a) a focussed psychological strategies health service;
(b) a non‑directive pregnancy support counselling health service;
(c) a psychology health service;
(d) a mental health service;
(e) an eating disorder psychological treatment service.
eligible social worker means a person who is an allied health professional in relation to the provision of one or both of the following:
(a) a focussed psychological strategies health service;
(b) a non‑directive pregnancy support counselling health service;
(c) a mental health service;
(d) an eating disorder psychological treatment service.
eligible speech pathologist means a person who is an allied health professional in relation to the provision of a speech pathology health service.
focussed psychological strategies means any of the following mental health care management strategies, each of which has been derived from evidence‑based psychological therapies:
(a) psycho‑education;
(b) cognitive‑behavioural therapy that involves cognitive or behavioural interventions;
(c) relaxation strategies;
(d) skills training;
(e) interpersonal therapy;
(f) eye movement desensitisation and reprocessing;
(g) narrative therapy (for Aboriginal and Torres Strait Islander people).
focussed psychological strategies continuing professional development means the completion of 10 continuing professional development units per CPD year, each unit being 1 hour that relate to the delivery of focussed psychological strategies in any of the following areas:
(a) psycho‑education;
(b) cognitive‑behavioural therapy including;
(i) behavioural interventions;
(ii) behaviour modification;
(iii) exposure techniques;
(iv) activity scheduling;
(c) cognitive interventions including:
(i) cognitive therapy;
(d) relaxation strategies including;
(i) progressive muscle relaxation;
(ii) controlled breathing;
(e) skills training including;
(i) problem solving skills and training;
(ii) anger management;
(iii) social skills training;
(iv) communication training;
(v) stress management;
(vi) parent management training;
(f) interpersonal therapy;
(g) eye movement desensitisation and reprocessing;
(h) narrative therapy (for Aboriginal and Torres Strait Islander people);
(i) clinical skills to undertake a full assessment of a patient in order to form a diagnosis and commence treatment planning.
GP chronic condition management plan has the meaning given by clause 3.1.1 of the general medical services table.
GP Management Plan, for a patient, means a GP management plan prepared prior to 1 July 2025 to which item 229 or 721 of the general medical services table or item 92024 or 92055 of the Telehealth = Determination applies.
GP Mental Health Treatment Plan, for a patient, means a GP Mental Health Treatment Plan for the patient to which item 272, 276, 281, 282, 2700, 2701, 2715 or 2717 of the general medical services table applies, or item 92112, 92113, 92116, 92117, 92118, 92119, 92122 or 92123 of the Telehealth Attendance Determination applies.
multidisciplinary care plan, for a patient, means a multidisciplinary care plan to which item 231, 232, 729 or 731 of the general medical services table, or item 92026, 92027, 92070, 92071, 92057, 92058, 92101 or 92102 of the Telehealth Attendance Determination applies.
MyMedicare has the meaning given in clause 7.1.1 of the general medical services table.
National Law means:
(a) for a State or Territory other than Western Australia—the Health Practitioner Regulation National Law set out in the Schedule to the Health Practitioner Regulation National Law Act 2009 (Qld) as it applies (with or without modifications) as a law of the State or Territory; and
(b) for Western Australia—the legislation enacted by the Health Practitioner Regulation National Law (WA) Act 2010 that corresponds to the Health Practitioner Regulation National Law.
non‑directive pregnancy support counselling has the meaning given in subsection (2).
Occupational Therapy Board of Australia means that board established under section 31 of the National Law.
Optometry Board of Australia means that board established under section 31 of the National Law.
Osteopathy Board of Australia means that board established under section 31 of the National Law.
Physiotherapy Board of Australia means that board established under section 31 of the National Law.
Podiatry Board of Australia means that board established under section 31 of the National Law.
provider number has the meaning given by section 4 of the Health Insurance Regulations 2018.
Psychology Board of Australia means that board established under section 31 of the National Law.
relevant provisions means all provisions, relating to professional services or to medical services, of the Act and regulations made under the Act, and the National Health Act 1953 and regulations under that Act.
Team Care Arrangements, for the patient, means GP coordination of the development of team care arrangements prior to 1 July 2025 to which item 230 or 723 of the general medical services table or item 92025 or 92056 of the Telehealth Determination applies.
Telehealth Attendance Determination means the Health Insurance (Section 3C General Medical Services – Telehealth and Telephone Attendances) Determination 2021.
telehealth eligible area has the meaning given by section 9.
Note: The following terms are defined in subsection 3(1) of the Act:
dental practitioner
general medical services table
item
medical practitioner
Chief Executive Medicare
optometrist
professional service
participating nurse practitioner.
(2) A reference in this instrument to non‑directive pregnancy support counselling is a reference to counselling provided to a patient, who is currently pregnant or who has been pregnant in the preceding 12 months, by a health professional in which:
(a) information and issues relating to pregnancy are discussed; but
(b) the health professional does not impose their views or values about what the person should or should not do in relation to the pregnancy.