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Commonwealth Coat of Arms of Australia

 

Health Insurance (Section 3C General Medical Services –COVID-19 Services) Determination 2020

I, GREG HUNT, Minister for Health, make the following determination.

Dated 23 March 2020

 

 

 

 

Greg Hunt

Minister for Health

 

 

 

 

 

Contents

1. Name

2. Commencement

3. Cessation

4. Authority

5. Definitions

6. Treatment of relevant services

7. Application of items - general

Schedule 1 – Relevant Services - GP, medical practitioner, allied health, participating nurse practitioner and participating midwife services

Schedule 2 – Relevant Services - specialist, consultant physician and consultant psychiatrist services

 

 

1. Name

 This instrument is the Health Insurance (Section 3C General Medical Services –COVID-19 Services) Determination 2020.

2. Commencement

(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.

 

• Commencement information
• Column 1 Column 2 Column 3
• Provisions Commencement Date/Details
• 1. The whole of this instrument Immediately after the instrument is registered

 Note: This table relates only to the provisions of this instrument as originally made.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.

(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.

3. Cessation

Unless earlier revoked this instrument ceases on 30 September 2020. 

4. Authority

This instrument is made under subsection 3C(1) of the Health Insurance Act 1973.

5. Definitions

(1) In this instrument:

Act means the Health Insurance Act 1973.

admitted patient means a patient who is receiving a service that is provided:

1.    as part of an episode of hospital treatment; or
2.    as part of an episode of hospital-substitute treatment in respect of which the person to whom the treatment is provided choses to receive a benefit from a private health insurer.

bulk‑billed: a service is bulk‑billed if:

(a) a medicare benefit is payable to a person in relation to the service; and

(b) under an agreement entered into under section 20A of the Act:

(i) the person assigns to the practitioner by whom, or on whose behalf, the service is provided, the person’s right to the payment of the medicare benefit; and

(ii) the practitioner accepts the assignment in full payment of the practitioner’s fee for the service provided.

consultant psychiatrist means a consultant physician in the practice of the consultant physician’s specialty of psychiatry.

eligible clinical psychologist has the meaning given by section 4 of the Health Insurance (Allied Health Services) Determination 2014.

eligible occupational therapist has the meaning given by section 4 of the Health Insurance (Allied Health Services) Determination 2014.

eligible psychologist has the meaning given by section 4 of the Health Insurance (Allied Health Services) Determination 2014.

eligible social worker has the meaning given by section 4 of the Health Insurance (Allied Health Services) Determination 2014.

GP mental health treatment plan has the meaning given by section 4 of the Health Insurance (Allied Health Services) Determination 2014.

health professional at risk of COVID-19 virus means a person that:

1.     has been diagnosed with COVID-19 virus but who is not a patient of a  hospital; or

2.   has been required to isolate themselves in quarantine in accordance with home isolation guidance issued by Australian Health Protection Principal Committee; or

3.   is considered more susceptible to the COVID-19 virus being:

4.           at least 70 years old; or

5.           at least 50 years old or over if of Aboriginal or Torres Strait Islander descent; or

6.           pregnant; or

7.           a parent of a child under 12 months; or

8.           a person under treatment for chronic health conditions or who is immune compromised; or

9.   meets the current national triage protocol criteria for suspected COVID-19 infection.

patient at risk of COVID-19 virus means a person that:

1.     has been diagnosed with COVID-19 virus but who is not a patient of a hospital; or

2.    has been required to isolate themselves in quarantine in accordance with home isolation guidance issued by Australian Health Protection Principal Committee; or

3.   is considered more susceptible to the COVID-19 virus being:

4.           at least 70 years old; or

5.           at least 50 years old or over if of Aboriginal or Torres Strait Islander descent; or

6.           pregnant; or

7.           a parent of a child under 12 months; or

8.           a person under treatment for chronic health conditions or who is immune compromised; or

9.    meets the current national triage protocol criteria for suspected COVID-19 infection.

phone attendance means a professional attendance by telephone where the health practitioner:

1.    has the capacity to provide the full service through this means safely and in accordance with professional standards; and
2.    is satisfied that it is clinically appropriate to provide the service to the patient; and
3.    maintains an audio link with the patient.

psychiatrist assessment and management plan means a psychiatrist assessment and management plan under item 291 of the general medical services table.

referring practitioner, in relation to a referral, means the person making the referral.

relevant 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.

relevant service means a health service, as defined in subsection 3C(8) of the Act, that is specified in a Schedule.

Schedule means a Schedule to this instrument.

telehealth attendance means a professional attendance by video conference where the rendering health practitioner:

1.           has the capacity to provide the full service through this means safely and in accordance with relevant professional standards; and
2.           is satisfied that it is clinically appropriate to provide the service to the patient; and
3.           maintains a visual and audio link with the patient; and
4.           is satisfied that the software and hardware used to deliver the service meets the applicable laws for security and privacy.

Note:     The following terms are defined in subsection 3(1) of the Act:

          clinically relevant service

          general medical services table

          hospital treatment

          hospital-substitute treatment

          item

          participating midwife

          participating nurse practitioner

         professional service

 (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.

6. Treatment of relevant services

For subsection 3C(1) of the Act a relevant service, provided in accordance with this Instrument where a clinically relevant service, is to be treated, for the relevant provisions, as if:

(a) it were both a professional service and a medical service; and

(b) there were an item in the general medical services table that:

(i) related to the service; and

(ii) specified for the service a fee in relation to each State, being the fee specified in the Schedule in relation to the service.

7. Application of items - general

1.      An item in Schedule 1 or Schedule 2 does not apply to a service mentioned in the item if the patient is an admitted patient.

2.      Clause 1.2.2 of the general medical services table shall have effect as if all items in Schedule 2 of this determination, other than items 91850, 91853, 91855 and 91857, were specified in the clause.

3.      An item in Subgroup 3 or 10 of Group A40, Subgroups 1 to 4 of Group M18  or Subgroups 6 to 9 of Group M18 of the Schedules does not apply to a service provided to a patient who has already been provided, in the calendar year, with 10 other services to which any of the following items apply:

4.    an item in Subgroup 2 of Group A20 of the general medical services table;

5.    items 283, 285, 286, 287, 371 and 372 of the general medical services table; or

6.    items 80000 to 80015, 80100 to 80115, 80125 to 80140 or 80150 to 80165 of the Health Insurance (Allied Health Services) Determination 2014 apply.

 

 

Schedule 1 – Relevant Services - GP, medical practitioner, allied health, participating nurse practitioner and participating midwife services

Division 1.1 – Services and fees – COVID-19 medical practitioner attendances

 1.1.1 – Application of COVID-19 medical practitioner telehealth services

(1)   For items 91794, 91799, 91806, 91807, 91808, 91815, 91816 and 91817, eligible area has the meaning given by section 4 of the Health Insurance (Section 3C General Medical Services – Other Medical Practitioner) Determination 2018.

(2)   For items in Division 1.1 of Schedule 1, medical practitioner has the meaning given by section 4 of the Health Insurance (Section 3C General Medical Services – Other Medical Practitioner) Determination 2018.

(3)   Clause 2.22.7 of the general medical services table shall have effect as if items 91818 and 91819 were also specified in that clause.

(4)    An item in Subgroup 3 of Group A40 only applies to a service which:

(a)      is clinically indicated under a GP mental health treatment plan or a psychiatrist assessment and management plan; and

(b)  is provided by a medical practitioner who meets any training and skills requirements, as determined by the General Practice Mental Health Standards Collaboration for providing services to which Subgroup 2 of Group A20 of the general medical services table or items 283, 285, 286, 287, 371 and 372 applies.

(5)    An item in Subgroup 2 of Group A40 does not apply if the rendering practitioner and the patient have the capacity to undertake an attendance by telehealth.

(6)    An item in Subgroup 1 or 2 of Group A40 does not apply to a person who is a patient at risk of COVID-19 virus only because of paragraph (c) of the definition unless the person:

(a)   has had at least one face to face attendance rendered in the preceding 12 months by the practitioner who renders the COVID-19 virus service; or

(b)   has had at least one face to face attendance service rendered in the preceding 12 months at (or arranged by) the medical practice where the practitioner who renders the COVID-19 virus service is employed or engaged.

 

• Group A40 – COVID-19 general practice telehealth services
• Item Description Fee ($)
• Subgroup 1 – COVID-19 general practice telehealth services
• 91790 Telehealth attendance by a general practitioner for an obvious problem characterised by the straightforward nature of the task that requires a short patient history and, if required, limited management if:

1. the attendance is where:(i) the person is a patient at risk of COVID-19 virus; or(ii) the general practitioner is a health professional at risk of COVID-19 virus; where the service is bulk-billed 20.55

• 91800 Telehealth attendance by a general practitioner lasting less than 20 minutes if:

1. the attendance is where:(i) the person is a patient at risk of COVID-19 virus; or(ii) the general practitioner is a health professional at risk of COVID-19 virus; and

2. the attendance includes any of the following that are clinically relevant:

3. taking a short patient history;

4. arranging any necessary investigation

5. implementing a management plan;

6. providing appropriate preventative health care;where the service is bulk-billed 44.90

• 91801 Telehealth attendance by a general practitioner lasting at least 20 minutes if:

1. the attendance is where:(i) the person is a patient at risk of COVID-19 virus; or(ii) the general practitioner is a health professional at risk of COVID-19 virus; and

2. the attendance includes any of the following that are clinically relevant:

3. taking a detailed patient history;

4. arranging any necessary investigation

5. implementing a management plan;

6. providing appropriate preventative health care;where the service is bulk-billed 87.00

• 91802 Telehealth attendance by a general practitioner lasting at least 40 minutes if:

1. the attendance is where:(i) the person is a patient at risk of COVID-19 virus; or(ii) the general practitioner is a health professional at risk of COVID-19 virus; and

2. the attendance includes any of the following that are clinically relevant:

3. taking an extensive patient history;

4. arranging any necessary investigation

5. implementing a management plan;

6. providing appropriate preventative health care;where the service is bulk-billed 128.05

• 91792 Telehealth attendance by a medical practitioner of not more than 5 minutes if: (a) the attendance is where:(i) the person is a patient at risk of COVID-19 virus; or(ii) the medical practitioner is a health professional at risk of COVID-19 virus; where the service is bulk-billed 12.90
• 91803 Telehealth attendance by a medical practitioner of more than 5 minutes in duration but not more than 25 minutes if:

1. the attendance is where:(i) the person is a patient at risk of COVID-19 virus; or(ii) the medical practitioner is a health professional at risk of COVID-19 virus; and

2. the attendance includes any of the following that are clinically relevant:

3. taking a short patient history;

4. arranging any necessary investigation

5. implementing a management plan;

6. providing appropriate preventative health care;where the service is bulk-billed 24.70

• 91804 Telehealth attendance by a medical practitioner of more than 25 minutes in duration but not more than 45 minutes if:

1. the attendance is where:(i) the person is a patient at risk of COVID-19 virus; or(ii) the medical practitioner is a health professional at risk of COVID-19 virus; and

2. the attendance includes any of the following that are clinically relevant:

3. taking a detailed patient history;

4. arranging any necessary investigation

5. implementing a management plan;

6. providing appropriate preventative health care;where the service is bulk-billed 44.70

• 91805 Telehealth attendance by a medical practitioner of at least 45 minutes in duration if:

1. the attendance is where:(i) the person is a patient at risk of COVID-19 virus; or(ii) the medical practitioner is a health professional at risk of COVID-19 virus; and

2. the attendance includes any of the following that are clinically relevant:

3. taking an extensive patient history;

4. arranging any necessary investigation

5. implementing a management plan;

6. providing appropriate preventative health care;where the service is bulk-billed 71.75

• 91794 Telehealth attendance by a medical practitioner, in an eligible area, of not more than 5 minutes if: (a) the attendance is where:(i) the person is a patient at risk of COVID-19 virus; or(ii) the medical practitioner is a health professional at risk of COVID-19 virus; where the service is bulk-billed 16.45
• 91806 Telehealth attendance by a medical practitioner, in an eligible area, of more than 5 minutes in duration but not more than 25 minutes if:

1. the attendance is where:(i) the person is a patient at risk of COVID-19 virus; or(ii) the medical practitioner is a health professional at risk of COVID-19 virus; and

2. the attendance includes any of the following that are clinically relevant:

3. taking a short patient history;

4. arranging any necessary investigation

5. implementing a management plan;

6. providing appropriate preventative health care;where the service is bulk-billed 35.90

• 91807 Telehealth attendance by a medical practitioner, in an eligible area, of more than 25 minutes in duration but not more than 45 minutes if:

1. the attendance is where:(i) the person is a patient at risk of COVID-19 virus; or(ii) the medical practitioner is a health professional at risk of COVID-19 virus; and

2. the attendance includes any of the following that are clinically relevant:

3. taking a detailed patient history;

4. arranging any necessary investigation

5. implementing a management plan;

6. providing appropriate preventative health care;where the service is bulk-billed 69.55

• 91808 Telehealth attendance by a medical practitioner, in an eligible area, of at least 45 minutes in duration if:

1. the attendance is where:(i) the person is a patient at risk of COVID-19 virus; or(ii) the medical practitioner is a health professional at risk of COVID-19 virus; and

2. the attendance includes any of the following that are clinically relevant:

3. taking an extensive patient history;

4. arranging any necessary investigation

5. implementing a management plan;

6. providing appropriate preventative health care;where the service is bulk-billed 102.45

• Subgroup 2 – COVID-19 general practice phone services
• 91795 Phone attendance by a general practitioner for an obvious problem characterised by the straightforward nature of the task that requires a short patient history and, if required, limited management if:(a) the attendance is where:(i) the person is a patient at risk of COVID-19 virus; or(ii) the general practitioner is a health professional at risk of COVID-19 virus; where the service is bulk-billed 20.55
• 91809 Phone attendance by a general practitioner lasting less than 20 minutes if:

1. the attendance is where:(i) the person is a patient at risk of COVID-19 virus; or(ii) the general practitioner is a health professional at risk of COVID-19 virus; and

2. the attendance includes any of the following that are clinically relevant:

3. taking a short patient history;

4. arranging any necessary investigation;

5. implementing a management plan;

6. providing appropriate preventative health care;where the service is bulk-billed 44.90

• 91810 Phone attendance by a general practitioner lasting at least 20 minutes if:

1. the attendance is where:(i) the person is a patient at risk of COVID-19 virus; or(ii) the general practitioner is a health professional at risk of COVID-19 virus; and

2. the attendance includes any of the following that are clinically relevant:

3. taking a detailed patient history;

4. arranging any necessary investigation;

5. implementing a management plan;

6. providing appropriate preventative health care;where the service is bulk-billed 87.00

• 91811 Phone attendance by a general practitioner lasting at least 40 minutes if:

1. the attendance is where:(i) the person is a patient at risk of COVID-19 virus; or(ii) the general practitioner is a health professional at risk of COVID-19 virus; and

2. the attendance includes any of the following that are clinically relevant:

3. taking an extensive patient history;

4. arranging any necessary investigation;

5. implementing a management plan;

6. providing appropriate preventative health care;where the service is bulk-billed 128.05

• 91797 Phone attendance by a medical practitioner of not more than 5 minutes if:

1. the attendance is where:

2. the person is a patient at risk of COVID-19 virus; or

3. the medical practitioner is a health professional at risk of COVID-19 virus;where the service is bulk-billed 12.90

• 91812 Phone attendance by a medical practitioner of more than 5 minutes in duration but not more than 25 minutes if:

1. the attendance is where:(i) the person is a patient at risk of COVID-19 virus; or(ii) the medical practitioner is a health professional at risk of COVID-19 virus; and

2. the attendance includes any of the following that are clinically relevant:

3. taking a short patient history;

4. arranging any necessary investigation;

5. implementing a management plan;

6. providing appropriate preventative health care;where the service is bulk-billed 24.70

• 91813 Phone attendance by a medical practitioner of at least 25 minutes in duration but not more than 45 minutes if:

1. the attendance is where:(i) the person is a patient at risk of COVID-19 virus; or(ii) the medical practitioner is a health professional at risk of COVID-19 virus; and

2. the attendance includes any of the following that are clinically relevant:

3. taking a detailed patient history;

4. arranging any necessary investigation;

5. implementing a management plan;

6. providing appropriate preventative health care;where the service is bulk-billed 44.70

• 91814 Phone attendance by a medical practitioner of at least 45 minutes in duration if:

1. the attendance is where:(i) the person is a patient at risk of COVID-19 virus; or(ii) the medical practitioner is a health professional at risk of COVID-19 virus; and

2. the attendance includes any of the following that are clinically relevant:

3. taking an extensive patient history;

4. arranging any necessary investigation;

5. implementing a management plan;

6. providing appropriate preventative health care;where the service is bulk-billed 71.75

• 91799 Phone attendance by a medical practitioner, in an eligible area, of not more than 5 minutes if:

1. the attendance is where:

2. the person is a patient at risk of COVID-19 virus; or

3. the medical practitioner is a health professional at risk of COVID-19 virus;where the service is bulk-billed 16.45

• 91815 Phone attendance by a medical practitioner, in an eligible area, of more than 5 minutes in duration but not more than 25 minutes if:

1. the attendance is where:(i) the person is a patient at risk of COVID-19 virus; or(ii) the medical practitioner is a health professional at risk of COVID-19 virus; and

2. the attendance includes any of the following that are clinically relevant:

3. taking a short patient history;

4. arranging any necessary investigation;

5. implementing a management plan;

6. providing appropriate preventative health care;where the service is bulk-billed 35.90

• 91816 Phone attendance by a medical practitioner, in an eligible area, of more than 25 minutes in duration but not more than 45 minutes if:

1. the attendance is where:(i) the person is a patient at risk of COVID-19 virus; or(ii) the medical practitioner is a health professional at risk of COVID-19 virus; and

2. the attendance includes any of the following that are clinically relevant:

3. taking a detailed patient history;

4. arranging any necessary investigation;

5. implementing a management plan;

6. providing appropriate preventative health care;where the service is bulk-billed 69.55

• 91817 Phone attendance by a medical practitioner, in an eligible area, of more than 45 minutes in duration if:

1. the attendance is where:(i) the person is a patient at risk of COVID-19 virus; or(ii) the medical practitioner is a health professional at risk of COVID-19 virus; and

2. the attendance includes any of the following that are clinically relevant:

3. taking an extensive patient history;

4. arranging any necessary investigation

5. implementing a management plan;

6. providing appropriate preventative health care;where the service is bulk-billed 102.45

• Subgroup 3 – COVID-19 Focussed Psychological Strategies telehealth services
• 91818 Telehealth attendance by a general practitioner, for the purpose of providing focussed psychological strategies for assessed mental disorders if:

1. the attendance is where:(i) the person is a patient at risk of COVID-19 virus; or(ii) the general practitioner is a health professional at risk of COVID-19 virus; and

2. the practitioner is registered with the Chief Executive Medicare as meeting the credentialing requirements for provision of this service; and

3. the service lasts at least 30 minutes, but less than 40 minutes;where the service is bulk-billed 110.85

• 91819 Telehealth attendance by a general practitioner, for the purpose of providing focussed psychological strategies for assessed mental disorders if:

1. the attendance is where:(i) the person is a patient at risk of COVID-19 virus; or(ii) the general practitioner is a health professional at risk of COVID-19 virus; and

2. the practitioner is registered with the Chief Executive Medicare as meeting the credentialing requirements for provision of this service; and

3. the service lasts at least 40 minutes;where the service is bulk-billed 158.60

• 91820 Telehealth attendance by a medical practitioner, for the purpose of providing focussed psychological strategies for assessed mental disorders if:

1. the attendance is where:(i) the person is a patient at risk of COVID-19 virus; or(ii) the medical practitioner is a health professional at risk of COVID-19 virus; and

2. the practitioner is registered with the Chief Executive Medicare as meeting the credentialing requirements for provision of this service; and

3. the service lasts at least 30 minutes, but less than 40 minutes;where the service is bulk-billed 88.70

• 91821 Telehealth attendance by a medical practitioner, for the purpose of providing focussed psychological strategies for assessed mental disorders if:

1. the attendance is where:(i) the person is a patient at risk of COVID-19 virus; or(ii) the medical practitioner is a health professional at risk of COVID-19 virus; and

2. the practitioner is registered with the Chief Executive Medicare as meeting the credentialing requirements for provision of this service; and

3. the service lasts at least 40 minutes;where the service is bulk-billed 126.90

 

Division 1.2 – Services and fees – COVID-19 allied health telehealth services

1.2.1 – Application of COVID-19 allied health attendances

1.    For items 91169 to 91176:

2.     the referral by a consultant physician specialising in the practice of his or her field of psychiatry must be a referral for a service to which any of items 293 to 370 of the general medical services table applies;

3.    the referral by a consultant physician specialising in the practice of his or her field of paediatrics must be a referral for a service to which any of items 110 to 133 of the general medical services table applies;

4.     the referral by a specialist in the practice of his or her field of psychiatry or paediatrics must be a referral for a service to which any of items 104 to 109 of the general medical services table applies; and

5.    where the referral is by a medical practitioner as part of a shared care plan, the shared care plan must include, in addition to any matters required by section 9B:

6.        a record of the patient’s agreement to mental health services;

7.      an outline of assessment of the patient’s mental disorder, including the mental health formulation and diagnosis or provisional diagnosis; and

8.   if appropriate, a plan for one or more of: 1.         crisis intervention; 2.          relapse prevention.     

9.    Items 91169 to 91176 apply only if a private health insurance benefit has not been claimed for the service.

 

• Group M18 – COVID-19 allied health telehealth services
• Item Description Fee ($)
• Subgroup 1 – COVID-19 psychological therapies telehealth services
• 91166 Psychological therapy health service provided by telehealth attendance by an eligible clinical psychologist if:(a) the attendance is where:(i) the person is a patient at risk of COVID-19 virus; or(ii) the eligible clinical psychologist is a health professional at risk of COVID-19 virus; and(b) the person is referred by:(i) a medical practitioner, either as part of a GP Mental Health Treatment Plan, or as part of a shared care plan or as part of a psychiatrist assessment and management plan; or(ii) a specialist or consultant physician specialising in the practice of his or her field of psychiatry; or(iii) a specialist or consultant physician specialising in the practice of his or her field of paediatrics; and(c) the service is provided to the person individually; and(d) at the completion of a course of treatment, the referring medical practitioner reviews the need for a further course of treatment; and(e) on the completion of the course of treatment, the eligible clinical psychologist gives a written report to the referring medical practitioner on assessments carried out, treatment provided and recommendations on future management of the person’s condition; and(f) the service is at least 30 minutes but less than 50 minutes duration; where the service is bulk-billed 101.35
• 91167 Psychological therapy health service provided by telehealth attendance by an eligible clinical psychologist if:(a) the attendance is where:(i) the person is a patient at risk of COVID-19 virus; or(ii) the eligible clinical psychologist is a health professional at risk of COVID-19 virus; and(b) the person is referred by:(i) a medical practitioner, either as part of a GP Mental Health Treatment Plan, or as part of a shared care plan or as part of a psychiatrist assessment and management plan; or(ii) a specialist or consultant physician specialising in the practice of his or her field of psychiatry; or(iii) a specialist or consultant physician specialising in the practice of his or her field of paediatrics; and(c) the service is provided to the person individually; and(d) at the completion of a course of treatment, the referring medical practitioner reviews the need for a further course of treatment; and(e) on the completion of the course of treatment, the eligible clinical psychologist gives a written report to the referring medical practitioner on assessments carried out, treatment provided and recommendations on future management of the person’s condition; and(f) the service is at least 50 minutes duration;where the service is bulk-billed 148.80
• Subgroup 2 – COVID-19 psychologist focussed psychological strategies telehealth services
• | 91169 | Focussed psychological strategies health service provided by telehealth attendance by an eligible psychologist if:<br>(a) the attendance is where:<br>(i) the person is a patient at risk of COVID-19 virus; or<br>(ii) the eligible psychologist is a health professional at risk of COVID-19 virus; and<br>(b) the person is referred by:<br>(i) a medical practitioner, either as part of a GP Mental Health Treatment Plan, or as part of a shared care plan or as part of a psychiatrist assessment and management plan; or<br>(ii) a specialist or consultant physician specialising in the practice of his or her field of psychiatry; or<br>(iii) a specialist or consultant physician specialising in the practice of his or her field of paediatrics; and<br>(c) the service is provided to the person individually; and<br>(d) at the completion of a course of treatment, the referring medical practitioner reviews the need for a further course of treatment; and<br>(e) on the completion of the course of treatment, the eligible psychologist gives a written report to the referring medical practitioner on assessments carried out, treatment provided and recommendations on future management of the person’s condition; and<br>(g) the service is at least 20 minutes but less than 50 minutes duration;<br>where the service is bulk-billed | 71.80 | | --- | --- | --- | | 91170 | Focussed psychological strategies health service provided by telehealth attendance by an eligible psychologist if:<br>(a) the attendance is where:<br>(i) the person is a patient at risk of COVID-19 virus; or<br>(ii) the eligible psychologist is a health professional at risk of COVID-19 virus; and<br>(b) the person is referred by:<br>(i) a medical practitioner, either as part of a GP Mental Health Treatment Plan, or as part of a shared care plan or as part of a psychiatrist assessment and management plan; or<br>(ii) a specialist or consultant physician specialising in the practice of his or her field of psychiatry; or<br>(iii) a specialist or consultant physician specialising in the practice of his or her field of paediatrics; and<br>(c) the service is provided to the person individually; and<br>(d) at the completion of a course of treatment, the referring medical practitioner reviews the need for a further course of treatment; and<br>(e) on the completion of the course of treatment, the eligible psychologist gives a written report to the referring medical practitioner on assessments carried out, treatment provided and recommendations on future management of the person’s condition; and<br>(f) the service is at least 50 minutes duration;<br>where the service is bulk-billed | 101.35 |
• Subgroup 3 – COVID-19 occupational therapist focussed psychological strategies telehealth services
• | 91172 | Focussed psychological strategies health service provided by telehealth attendance by an eligible occupational therapist if:<br>(a) the attendance is where:<br>(i) the person is a patient at risk of COVID-19 virus; or<br>(ii) the eligible occupational therapist is a health professional at risk of COVID-19 virus; and<br>(a) the person is referred by:<br>(i) a medical practitioner, either as part of a GP Mental Health Treatment Plan, or as part of a shared care plan or as part of a psychiatrist assessment and management plan; or<br>(ii) a specialist or consultant physician specialising in the practice of his or her field of psychiatry; or<br>(iii) a specialist or consultant physician specialising in the practice of his or her field of paediatrics; and<br>(b) the service is provided to the person individually; and<br>(c) at the completion of a course of treatment, the referring medical practitioner reviews the need for a further course of treatment; and<br>(d) on the completion of the course of treatment, the eligible occupational therapist gives a written report to the referring medical practitioner on assessments carried out, treatment provided and recommendations on future management of the person’s condition; and<br>(e) the service is at least 20 minutes but less than 50 minutes duration<br>where the service is bulk-billed | 63.25 | | --- | --- | --- | | 91173 | Focussed psychological strategies health service provided by telehealth attendance by an eligible occupational therapist if:<br>(a) the attendance is where:<br>(i) the person is a patient at risk of COVID-19 virus; or<br>(ii) the eligible occupational therapist is a health professional at risk of COVID-19 virus; and<br>(b) the person is referred by:<br>(i) a medical practitioner, either as part of a GP Mental Health Treatment Plan, or as part of a shared care plan or as part of a psychiatrist assessment and management plan; or<br>(ii) a specialist or consultant physician specialising in the practice of his or her field of psychiatry; or<br>(iii) a specialist or consultant physician specialising in the practice of his or her field of paediatrics; and<br>(c) the service is provided to the person individually; and<br>(d) at the completion of a course of treatment, the referring medical practitioner reviews the need for a further course of treatment; and<br>(e) on the completion of the course of treatment, the eligible occupational therapist gives a written report to the referring medical practitioner on assessments carried out, treatment provided and recommendations on future management of the person’s condition; and<br>(f) the service is at least 50 minutes in duration<br>where the service is bulk-billed | 89.35 |
• Subgroup 4 – COVID-19 social worker focussed psychological strategies telehealth services
• 91175 Focussed psychological strategies health service provided by telehealth attendance by an eligible social worker if:(a) the attendance is where:(i) the person is a patient at risk of COVID-19 virus; or(ii) the eligible social worker is a health professional at risk of COVID-19 virus; and(b) the person is referred by:(i) a medical practitioner, either as part of a GP Mental Health Treatment Plan, or as part of a shared care plan or as part of a psychiatrist assessment and management plan; or(ii) a specialist or consultant physician specialising in the practice of his or her field of psychiatry; or(iii) a specialist or consultant physician specialising in the practice of his or her field of paediatrics; and(b) the service is provided to the person individually; and(c) at the completion of a course of treatment, the referring medical practitioner reviews the need for a further course of treatment; and(d) on the completion of the course of treatment, the eligible social worker gives a written report to the referring medical practitioner on assessments carried out, treatment provided and recommendations on future management of the person’s condition; and(e) the service is at least 20 minutes but less than 50 minutes durationwhere the service is bulk-billed 63.25
• 91176 Focussed psychological strategies health service provided by telehealth attendance by an eligible social worker if:(a) the attendance is where:(i) the person is a patient at risk of COVID-19 virus; or(ii) the eligible social worker is a health professional at risk of COVID-19 virus; and(b) the person is referred by:(i) a medical practitioner, either as part of a GP Mental Health Treatment Plan, or as part of a shared care plan or as part of a psychiatrist assessment and management plan; or(ii) a specialist or consultant physician specialising in the practice of his or her field of psychiatry; or(iii) a specialist or consultant physician specialising in the practice of his or her field of paediatrics; and(c) the service is provided to the person individually; and(d) at the completion of a course of treatment, the referring medical practitioner reviews the need for a further course of treatment; and(e) on the completion of the course of treatment, the eligible social worker gives a written report to the referring medical practitioner on assessments carried out, treatment provided and recommendations on future management of the person’s condition; and(f) the service is at least 50 minutes durationwhere the service is bulk-billed 89.35
• Subgroup 5 – COVID-19 nurse practitioner telehealth services
• 91192 Telehealth attendance by a participating nurse practitioner for an obvious problem characterised by the straightforward nature of the task that requires a short patient history and, if required, limited management, if:

1. the attendance is where:

2. the person is at risk of COVID-19 virus; or

3. the participating nurse practitioner is a health professional at risk of COVID-19 virus;where the service is bulk-billed 9.75

• 91178 Telehealth attendance by a participating nurse practitioner lasting less than 20 minutes if: (a) the attendance is where: (i) the person is at risk of COVID-19 virus; or (ii) the participating nurse practitioner is a health professional at risk of COVID-19 virus; and (b) the attendance includes any of the following that are clinically relevant: (i) taking a short history; (ii) arranging any necessary investigation; (iii) implementing a management plan; (iv) providing appropriate preventive health care;where the service is bulk-billed 21.30
• 91179 Telehealth attendance by a participating nurse practitioner lasting at least 20 minutes if: (a) the attendance is where: (i) the person is at risk of COVID-19 virus; or (ii) the participating nurse practitioner is a health professional at risk of COVID-19 virus; and (b) the attendance includes any of the following that are clinically relevant: (i) taking a detailed history; (ii) arranging any necessary investigation; (iii) implementing a management plan; (iv) providing appropriate preventive health care;where the service is bulk-billed 40.40
• 91180 Telehealth attendance by a participating nurse practitioner lasting at least 40 minutes if: (a) the attendance is where: (i) the person is at risk of COVID-19 virus; or (ii) the participating nurse practitioner is a health professional at risk of COVID-19 virus; and (b) the attendance includes any of the following that are clinically relevant: (i) taking an extensive history; (ii) arranging any necessary investigation; (iii) implementing a management plan; (iv) providing appropriate preventive health care;where the service is bulk-billed 59.50

Division 1.3 - Services and fees – COVID-19 medical practitioner attendances

1.3.1 Application of COVID-19 medical practitioner phone services

(1)     An item in Subgroup 10 of Group A40 does not apply if the rendering practitioner and the patient have the capacity to undertake an attendance by telehealth

(2)      An item in Subgroup 10 of Group A40 only applies to a service which:

(a)    is clinically indicated under a GP mental health treatment plan or a psychiatrist assessment and management plan; and

(b)   is provided by a medical practitioner who meets any training and skills requirements, as determined by the General Practice Mental Health Standards Collaboration for providing services to which Subgroup 2 of Group A20 of the general medical services table or items 283, 285, 286, 287, 371 and 372 applies.

 

• Group A40 – COVID-19 medical practitioner phone services
• Item Description Fee ($)
• Subgroup 10 – COVID-19 Focussed Psychological Strategies phone services
• 91842 Phone attendance by a general practitioner, for the purpose of providing focussed psychological strategies for assessed mental disorders if:

1. the attendance is where:

2. the person is a patient at risk of COVID-19 virus; or

3. the general practitioner is a health professional at risk of COVID-19 virus; and

4. the practitioner is registered with the Chief Executive Medicare as meeting the credentialing requirements for provision of this service; and

5. the service lasts at least 30 minutes, but less than 40 minutes;where the service is bulk-billed 110.85

• 91843 Phone attendance by a general practitioner, for the purpose of providing focussed psychological strategies for assessed mental disorders if:

1. the attendance is where:

2. the person is a patient at risk of COVID-19 virus; or

3. the general practitioner is a health professional at risk of COVID-19 virus; and

4. the practitioner is registered with the Chief Executive Medicare as meeting the credentialing requirements for provision of this service; and

5. the service lasts at least 40 minutes;where the service is bulk-billed 158.60

• 91844 Phone attendance by a medical practitioner, for the purpose of providing focussed psychological strategies for assessed mental disorders if:

1. the attendance is where:

2. the person is a patient at risk of COVID-19 virus; or

3. the medical practitioner is a health professional at risk of COVID-19 virus; and

4. the practitioner is registered with the Chief Executive Medicare as meeting the credentialing requirements for provision of this service; and

5. the service lasts at least 30 minutes, but less than 40 minutes;where the service is bulk-billed 88.70

• 91845 Phone attendance by a medical practitioner, for the purpose of providing focussed psychological strategies for assessed mental disorders if:

1. the attendance is where:

2. the person is a patient at risk of COVID-19 virus; or

3. the medical practitioner is a health professional at risk of COVID-19 virus; and

4. the practitioner is registered with the Chief Executive Medicare as meeting the credentialing requirements for provision of this service; and

5. the service lasts at least 40 minutes;where the service is bulk-billed 126.90

 

Division 1.4 - Services and fees – Services and fees – COVID-19 allied health phone services

1.4.1 – Application of COVID-19 allied health attendances

1.      For items 91181 to 91189:

2.     the referral by a consultant physician specialising in the practice of his or her field of psychiatry must be a referral for a service to which any of items 293 to 370 of the general medical services table applies;

3.    the referral by a consultant physician specialising in the practice of his or her field of paediatrics must be a referral for a service to which any of items 110 to 133 of the general medical services table applies;

4.     the referral by a specialist in the practice of his or her field of psychiatry or paediatrics must be a referral for a service to which any of items 104 to 109 of the general medical services table applies; and

5.    where the referral is by a medical practitioner as part of a shared care plan, the shared care plan must include, in addition to any matters required by section 9B:

6.   a record of the patient’s agreement to mental health services;

7.      an outline of assessment of the patient’s mental disorder, including the mental health formulation and diagnosis or provisional diagnosis; and

8.        if appropriate, a plan for one or more of: 1.             crisis intervention; 2.              relapse prevention.     

(3)     Items 91181 to 91189 apply only if a private health insurance benefit has not been claimed for the service.

(4)      An item in Subgroups 6 to 10 of Group M18 does not apply if the rendering practitioner and the patient have the capacity to undertake an attendance by telehealth.

 

• Group M18 – COVID-19 allied health telehealth services
• Item Description Fee ($)
• Subgroup 6 – COVID-19 psychological therapies phone services
• 91181 Psychological therapy health service provided by phone attendance by an eligible clinical psychologist if:(a) the attendance is where:(i) the person is a patient at risk of COVID-19 virus; or(ii) the eligible clinical psychologist is a health professional at risk of COVID-19 virus; and(b) the person is referred by:(i) a medical practitioner, either as part of a GP Mental Health Treatment Plan, or as part of a shared care plan or as part of a psychiatrist assessment and management plan; or(ii) a specialist or consultant physician specialising in the practice of his or her field of psychiatry; or(iii) a specialist or consultant physician specialising in the practice of his or her field of paediatrics; and(c) the service is provided to the person individually; and(d) at the completion of a course of treatment, the referring medical practitioner reviews the need for a further course of treatment; and(e) on the completion of the course of treatment, the eligible clinical psychologist gives a written report to the referring medical practitioner on assessments carried out, treatment provided and recommendations on future management of the person’s condition; and(f) the service is at least 30 minutes but less than 50 minutes duration; where the service is bulk-billed 101.35
• 91182 Psychological therapy health service provided by phone attendance by an eligible clinical psychologist if:(a) the attendance is where:(i) the person is a patient at risk of COVID-19 virus; or(ii) the eligible clinical psychologist is a health professional at risk of COVID-19 virus; and(b) the person is referred by:(i) a medical practitioner, either as part of a GP Mental Health Treatment Plan, or as part of a shared care plan or as part of a psychiatrist assessment and management plan; or(ii) a specialist or consultant physician specialising in the practice of his or her field of psychiatry; or(iii) a specialist or consultant physician specialising in the practice of his or her field of paediatrics; and(c) the service is provided to the person individually; and(d) at the completion of a course of treatment, the referring medical practitioner reviews the need for a further course of treatment; and(e) on the completion of the course of treatment, the eligible clinical psychologist gives a written report to the referring medical practitioner on assessments carried out, treatment provided and recommendations on future management of the person’s condition; and(f) the service is at least 50 minutes duration;where the service is bulk-billed 148.80
• Subgroup 7 – COVID-19 psychologist focussed psychological strategies phone services
• | 91183 | Focussed psychological strategies health service provided by phone attendance by an eligible psychologist if:<br>(a) the attendance is where:<br>(i) the person is a patient at risk of COVID-19 virus; or<br>(ii) the eligible psychologist is a health professional at risk of COVID-19 virus; and<br>(b) the person is referred by:<br>(i) a medical practitioner, either as part of a GP Mental Health Treatment Plan, or as part of a shared care plan or as part of a psychiatrist assessment and management plan; or<br>(ii) a specialist or consultant physician specialising in the practice of his or her field of psychiatry; or<br>(iii) a specialist or consultant physician specialising in the practice of his or her field of paediatrics; and<br>(c) the service is provided to the person individually; and<br>(d) at the completion of a course of treatment, the referring medical practitioner reviews the need for a further course of treatment; and<br>(e) on the completion of the course of treatment, the eligible psychologist gives a written report to the referring medical practitioner on assessments carried out, treatment provided and recommendations on future management of the person’s condition; and<br>(g) the service is at least 20 minutes but less than 50 minutes duration;<br>where the service is bulk-billed | 71.80 | | --- | --- | --- | | 91184 | Focussed psychological strategies health service provided by phone attendance by an eligible psychologist if:<br>(a) the attendance is where:<br>(i) the person is a patient at risk of COVID-19 virus; or<br>(ii) the eligible psychologist is a health professional at risk of COVID-19 virus; and<br>(b) the person is referred by:<br>(i) a medical practitioner, either as part of a GP Mental Health Treatment Plan, or as part of a shared care plan or as part of a psychiatrist assessment and management plan; or<br>(ii) a specialist or consultant physician specialising in the practice of his or her field of psychiatry; or<br>(iii) a specialist or consultant physician specialising in the practice of his or her field of paediatrics; and<br>(c) the service is provided to the person individually; and<br>(d) at the completion of a course of treatment, the referring medical practitioner reviews the need for a further course of treatment; and<br>(e) on the completion of the course of treatment, the eligible psychologist gives a written report to the referring medical practitioner on assessments carried out, treatment provided and recommendations on future management of the person’s condition; and<br>(f) the service is at least 50 minutes duration;<br>where the service is bulk-billed | 101.35 |
• Subgroup 8 – COVID-19 occupational therapist focussed psychological strategies phone services
• | 91185 | Focussed psychological strategies health service provided by phone attendance by an eligible occupational therapist if:<br>(a) the attendance is where:<br>(i) the person is a patient at risk of COVID-19 virus; or<br>(ii) the eligible occupational therapist is a health professional at risk of COVID-19 virus; and<br>(b) the person is referred by:<br>(i) a medical practitioner, either as part of a GP Mental Health Treatment Plan, or as part of a shared care plan or as part of a psychiatrist assessment and management plan; or<br>(ii) a specialist or consultant physician specialising in the practice of his or her field of psychiatry; or<br>(iii) a specialist or consultant physician specialising in the practice of his or her field of paediatrics; and<br>(c) the service is provided to the person individually; and<br>(d) at the completion of a course of treatment, the referring medical practitioner reviews the need for a further course of treatment; and<br>(e) on the completion of the course of treatment, the eligible occupational therapist gives a written report to the referring medical practitioner on assessments carried out, treatment provided and recommendations on future management of the person’s condition; and<br>(f) the service is at least 20 minutes but less than 50 minutes duration<br>where the service is bulk-billed | 63.25 | | --- | --- | --- | | 91186 | Focussed psychological strategies health service provided by phone attendance by an eligible occupational therapist if:<br>(a) the attendance is where:<br>(i) the person is a patient at risk of COVID-19 virus; or<br>(ii) the eligible occupational therapist is a health professional at risk of COVID-19 virus; and<br>(b) the person is referred by:<br>(i) a medical practitioner, either as part of a GP Mental Health Treatment Plan, or as part of a shared care plan or as part of a psychiatrist assessment and management plan; or<br>(ii) a specialist or consultant physician specialising in the practice of his or her field of psychiatry; or<br>(iii) a specialist or consultant physician specialising in the practice of his or her field of paediatrics; and<br>(c) the service is provided to the person individually; and<br>(d) at the completion of a course of treatment, the referring medical practitioner reviews the need for a further course of treatment; and<br>(e) on the completion of the course of treatment, the eligible occupational therapist gives a written report to the referring medical practitioner on assessments carried out, treatment provided and recommendations on future management of the person’s condition; and<br>(f) the service is at least 50 minutes in duration<br>where the service is bulk-billed | 89.35 |
• Subgroup 9 – COVID-19 social worker focussed psychological strategies phone services
• | 91187 | Focussed psychological strategies health service provided by phone attendance by an eligible social worker if:<br>(a) the attendance is where:<br>(i) the person is a patient at risk of COVID-19 virus; or<br>(ii) the eligible social worker is a health professional at risk of COVID-19 virus; and<br>(b) the person is referred by:<br>(i) a medical practitioner, either as part of a GP Mental Health Treatment Plan, or as part of a shared care plan or as part of a psychiatrist assessment and management plan; or<br>(ii) a specialist or consultant physician specialising in the practice of his or her field of psychiatry; or<br>(iii) a specialist or consultant physician specialising in the practice of his or her field of paediatrics; and<br>(b) the service is provided to the person individually; and<br>(c) at the completion of a course of treatment, the referring medical practitioner reviews the need for a further course of treatment; and<br>(d) on the completion of the course of treatment, the eligible social worker gives a written report to the referring medical practitioner on assessments carried out, treatment provided and recommendations on future management of the person’s condition; and<br>(e) the service is at least 20 minutes but less than 50 minutes duration<br>where the service is bulk-billed | 63.25 | | --- | --- | --- | | 91188 | Focussed psychological strategies health service provided by phone attendance by an eligible social worker if:<br>(a) the attendance is where:<br>(i) the person is a patient at risk of COVID-19 virus; or<br>(ii) the eligible social worker is a health professional at risk of COVID-19 virus; and<br>(b) the person is referred by:<br>(i) a medical practitioner, either as part of a GP Mental Health Treatment Plan, or as part of a shared care plan or as part of a psychiatrist assessment and management plan; or<br>(ii) a specialist or consultant physician specialising in the practice of his or her field of psychiatry; or<br>(iii) a specialist or consultant physician specialising in the practice of his or her field of paediatrics; and<br>(c) the service is provided to the person individually; and<br>(d) at the completion of a course of treatment, the referring medical practitioner reviews the need for a further course of treatment; and<br>(e) on the completion of the course of treatment, the eligible social worker gives a written report to the referring medical practitioner on assessments carried out, treatment provided and recommendations on future management of the person’s condition; and<br>(f) the service is at least 50 minutes duration<br>where the service is bulk-billed | 89.35 |
• Subgroup 10 – COVID-19 nurse practitioner phone services
• 91193 Phone attendance by a participating nurse practitioner for an obvious problem characterised by the straightforward nature of the task that requires a short patient history and, if required, limited management, if:

1. the attendance is where:

2. the person is at risk of COVID-19 virus; or

3. the participating nurse practitioner is a health professional at risk of COVID-19 virus;where the service is bulk-billed 9.75

• 91189 Phone attendance by a participating nurse practitioner lasting less than 20 minutes if:

1. the attendance is where:

2. the person is a patient at risk of COVID-19 virus; or

3. the participating nurse practitioner is a health professional at risk of COVID-19 virus; and

4. the attendance includes any of the following that are clinically relevant:

5. taking a short history;

6. arranging any necessary investigation;

7. implementing a management plan;

8. providing appropriate preventive health care;where the service is bulk-billed. 21.30

• 91190 Phone attendance by a participating nurse practitioner lasting at least 20 minutes if:

1. the attendance is where:

2. the person is a patient at risk of COVID-19 virus; or

3. the participating nurse practitioner is a health professional at risk of COVID-19 virus; and

4. the attendance includes any of the following that are clinically relevant:

5. taking a detailed history;

6. arranging any necessary investigation;

7. implementing a management plan;

8. providing appropriate preventive health care;where the service is bulk-billed. 40.40

• 91191 Phone attendance by a participating nurse practitioner lasting at least 40 minutes if:

1. the attendance is where:

2. the person is a patient at risk of COVID-19 virus; or

3. the participating nurse practitioner is a health professional at risk of COVID-19 virus; and

4. the attendance includes any of the following that are clinically relevant:

5. taking an extensive history;

6. arranging any necessary investigation;

7. implementing a management plan;

8. providing appropriate preventive health care;where the service is bulk-billed. 59.50

Division 1.5 - Services and fees – COVID-19 midwifery telehealth and phone services

1.      An item in Subgroup 2 of Group M19 does not apply if the rendering practitioner and the patient have the capacity to undertake an attendance by telehealth.

• Group M19 – COVID-19 midwifery telehealth and phone services
• Item Description Fee ($)
• Subgroup 1 – COVID-19 midwifery telehealth services
• 91211 Short antenatal telehealth attendance by a participating midwife, lasting up to 40 minutes, if:

1. the attendance is where:

2. the person is a patient at risk of COVID-19 virus; or

3. the participating midwife is a health professional at risk of COVID-19 virus; and

4. the attendance is bulk-billed 32.80

• 91212 Long antenatal telehealth attendance by a participating midwife, lasting at least 40 minutes, if:

1. the attendance is where:

2. the person is a patient at risk of COVID-19 virus; or

3. the participating midwife is a health professional at risk of COVID-19 virus; and

4. the attendance is bulk-billed 54.25

• 91214 Short postnatal telehealth attendance by a participating midwife, lasting up to 40 minutes, if:

1. the attendance is where:

2. the person is a patient at risk of COVID-19 virus; or

3. the participating midwife is a health professional at risk of COVID-19 virus; and

4. the attendance is bulk-billed 54.25

• 91215 Long postnatal telehealth attendance by a participating midwife, lasting at least 40 minutes, if:

1. the attendance is where:

2. the person is a patient at risk of COVID-19 virus; or

3. the participating midwife is a health professional at risk of COVID-19 virus; and

4. the attendance is bulk-billed 79.75

• Subgroup 2 – COVID-19 midwifery phone services
• 91218 Short antenatal phone attendance by a participating midwife, lasting up to 40 minutes, if:

1. the attendance is where:

2. the person is a patient at risk of COVID-19 virus; or

3. the participating midwife is a health professional at risk of COVID-19 virus; and

4. the attendance is bulk-billed 32.80

• 91219 Long antenatal phone attendance by a participating midwife, lasting at least 40 minutes, if:

1. the attendance is where:

2. the person is a patient at risk of COVID-19 virus; or

3. the participating midwife is a health professional at risk of COVID-19 virus; and

4. the attendance is bulk-billed 54.25

• 91221 Short postnatal phone attendance by a participating midwife, lasting up to 40 minutes, if:

1. the attendance is where:

2. the person is a patient at risk of COVID-19 virus; or

3. the participating midwife is a health professional at risk of COVID-19 virus; and

4. the attendance is bulk-billed 54.25

• 91222 Long postnatal phone attendance by a participating midwife, lasting at least 40 minutes, if:

1. the attendance is where:

2. the person is a patient at risk of COVID-19 virus; or

3. the participating midwife is a health professional at risk of COVID-19 virus; and

4. the attendance is bulk-billed 79.75

 

Schedule 2 – Relevant Services - specialist, consultant physician and consultant psychiatrist services

Division 1.1 – Services and fees – specialist attendances via video conference

 

1.      Clause 1.1.5 of the general medical services table shall have effect as if items 91822 to 91826 were specified in subclause 1.1.5(1).

• 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:

1. the attendance is where:
2. the person is a patient at risk of COVID-19 virus; or
3. the specialist is a health professional at risk of COVID-19 virus; and
4. the attendance follows referral of the patient to the specialist; and
5. the attendance was of more than 5 minutes in duration; and
6. 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:

1. the attendance is where:
2. the person is a patient at risk of COVID-19 virus; or
3. the specialist is a health professional at risk of COVID-19 virus; and
4. the attendance follows referral of the patient to the specialist; and
5. the attendance was of more than 5 minutes in duration; and
6. the service is bulk-billed. Where the attendance is after the first attendance as part of a single course of treatment. 44.35

 

Division 1.2 – Services and fees – consultant physician (other than psychiatry) attendances via video conference

 

• 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:

1. the attendance is where:
2. the person is a patient at risk of COVID-19 virus; or
3. the consultant physician is a health professional at risk of COVID-19 virus; and
4. the attendance follows referral of the patient to the specialist; and
5. the attendance was of more than 5 minutes in duration; and
6. 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:

1. the attendance is where:
2. the person is a patient at risk of COVID-19 virus; or
3. the consultant physician is a health professional at risk of COVID-19 virus; and
4. the attendance follows referral of the patient to the specialist; and
5. the attendance was of more than 5 minutes in duration; and
6. 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:

1. the attendance is where:
2. the person is a patient at risk of COVID-19 virus; or
3. the specialist is a health professional at risk of COVID-19 virus; and
4. the attendance follows referral of the patient to the specialist; and
5. the attendance was of more than 5 minutes in duration; and
6. 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

 

Division 1.3 – Services and fees – Consultant psychiatrist attendances via video conference

 

• 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:

1. the attendance is where:
2. the person is a patient at risk of COVID-19 virus; or
3. the consultant psychiatrist is a health professional at risk of COVID-19 virus; and
4. the attendance follows a referral of the patient to the consultant psychiatrist by a referring practitioner; and
5. the attendance was not more than 15 minutes duration; and
6. the service is bulk-billed. 44.70

• 91828 Telehealth attendance for a person by a consultant psychiatrist; if:

1. the attendance is where:
2. the person is a patient at risk of COVID-19 virus; or
3. the consultant psychiatrist is a health professional at risk of COVID-19 virus; and
4. the attendance follows a referral of the patient to the consultant psychiatrist by a referring practitioner; and
5. the attendance was at least 15 minutes, but not more than 30 minutes in duration; and
6. the service is bulk-billed. 89.15

• 91829 Telehealth attendance for a person by a consultant psychiatrist; if:

1. the attendance is where:
2. the person is a patient at risk of COVID-19 virus; or
3. the consultant psychiatrist is a health professional at risk of COVID-19 virus; and
4. the attendance follows a referral of the patient to the consultant psychiatrist by a referring practitioner; and
5. the attendance was at least 30 minutes, but not more than 45 minutes in duration; and
6. the service is bulk-billed. 137.25

• 91830 Telehealth attendance for a person by a consultant psychiatrist; if:

1. the attendance is where:
2. the person is a patient at risk of COVID-19 virus; or
3. the consultant psychiatrist is a health professional at risk of COVID-19 virus; and
4. the attendance follows a referral of the patient to the consultant psychiatrist by a referring practitioner; and
5. the attendance was at least 45 minutes, but not more than 75 minutes in duration; and
6. the service is bulk-billed. 189.40

• 91831 Telehealth attendance for a person by a consultant psychiatrist; if:

1. the attendance is where:
2. the person is a patient at risk of COVID-19 virus; or
3. the consultant psychiatrist is a health professional at risk of COVID-19 virus; and
4. the attendance follows a referral of the patient to the consultant psychiatrist by a referring practitioner; and
5. the attendance was at least 75 minutes in duration; and
6. the service is bulk-billed. 219.80

 

Division 1.4 – Services and fees – specialist attendances via phone services

1.4.1 Application of COVID-19 medical practitioner phone services

1.      An item in Subgroup 7 of Group A40 does not apply if the rendering practitioner and the patient have the capacity to undertake an attendance by telehealth.

 

• 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:

1. the attendance is where:
2. the person is a patient at risk of COVID-19 virus; or
3. the specialist is a health professional at risk of COVID-19 virus; and
4. the attendance follows referral of the patient to the specialist; and
5. the attendance was of more than 5 minutes in duration; and
6. 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:

1. the attendance is where:
2. the person is a patient at risk of COVID-19 virus; or
3. the specialist is a health professional at risk of COVID-19 virus; and
4. the attendance follows referral of the patient to the specialist; and
5. the attendance was of more than 5 minutes in duration; and
6. the service is bulk-billed. Where the attendance is after the first attendance as part of a single course of treatment. 44.35

 

Division 1.5 – Services and fees – consultant physician (other than psychiatry) attendances via phone services

1.5.1 Application of COVID-19 medical practitioner phone services

1.      An item in Subgroup 8 of Group A40 does not apply if the rendering practitioner and the patient have the capacity to undertake an attendance by telehealth.

 

• 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:

1. the attendance is where:
2. the person is a patient at risk of COVID-19 virus; or
3. the consultant physician is a health professional at risk of COVID-19 virus; and
4. the attendance follows referral of the patient to the specialist; and
5. the attendance was of more than 5 minutes in duration; and
6. 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:

1. the attendance is where:
2. the person is a patient at risk of COVID-19 virus; or
3. the consultant physician is a health professional at risk of COVID-19 virus; and
4. the attendance follows referral of the patient to the specialist; and
5. the attendance was of more than 5 minutes in duration; and
6. 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:

1. the attendance is where:
2. the person is a patient at risk of COVID-19 virus; or
3. the specialist is a health professional at risk of COVID-19 virus; and
4. the attendance follows referral of the patient to the specialist; and
5. the attendance was of more than 5 minutes in duration; and
6. 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

 

Division 1.6 – Services and fees – Consultant psychiatrist attendances via phone services

1.6.1 Application of COVID-19 medical practitioner phone services

1.      An item in Subgroup 9 of Group A40 does not apply if the practitioner and the patient have the capacity to undertake an attendance by telehealth.

 

• 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:

1. the attendance is where:
2. the person is a patient at risk of COVID-19 virus; or
3. the consultant psychiatrist is a health professional at risk of COVID-19 virus; and
4. the attendance follows a referral of the patient to the consultant psychiatrist by a referring practitioner; and
5. the attendance was not more than 15 minutes duration; and
6. the service is bulk-billed. 44.70

• 91838 Phone attendance for a person by a consultant psychiatrist; if:

1. the attendance is where:
2. the person is a patient at risk of COVID-19 virus; or
3. the consultant psychiatrist is a health professional at risk of COVID-19 virus; and
4. the attendance follows a referral of the patient to the consultant psychiatrist by a referring practitioner; and
5. the attendance was at least 15 minutes, but not more than 30 minutes in duration; and
6. the patient is not an admitted patient; and
7. the service is bulk-billed. 89.15

• 91839 Phone attendance for a person by a consultant psychiatrist; if:

1. the attendance is where:
2. the person is a patient at risk of COVID-19 virus; or
3. the consultant psychiatrist is a health professional at risk of COVID-19 virus; and
4. the attendance follows a referral of the patient to the consultant psychiatrist by a referring practitioner; and
5. the attendance was at least 30 minutes, but not more than 45 minutes in duration; and
6. the service is bulk-billed. 137.25

• 91840 Phone attendance for a person by a consultant psychiatrist; if:

1. the attendance is where:
2. the person is a patient at risk of COVID-19 virus; or
3. the consultant psychiatrist is a health professional at risk of COVID-19 virus; and
4. the attendance follows a referral of the patient to the consultant psychiatrist by a referring practitioner; and
5. the attendance was at least 45 minutes, but not more than 75 minutes in duration; and
6. the service is bulk-billed. 189.40

• 91841 Phone attendance for a person by a consultant psychiatrist; if:

1. the attendance is where:
2. the person is a patient at risk of COVID-19 virus; or
3. the consultant psychiatrist is a health professional at risk of COVID-19 virus; and
4. the attendance follows a referral of the patient to the consultant psychiatrist by a referring practitioner; and
5. the attendance was at least 75 minutes in duration; and
6. the service is bulk-billed. 219.80

 

Division 1.7– Services and Fees – obstetric attendances via telehealth services  

1.7.1        Application of COVID-19 obstetrics telehealth and phone services

1.      For an item in Division 1.7 of Schedule 2, midwife has the same meaning as in clause 2.41.2 of the general medical services table.

2.      For items 91850 and 91855:

3.     the items apply to an antenatal service provided to a patient by a midwife, nurse or Aboriginal and Torres Strait Islander health practitioner only if: 1.        the midwife, nurse or Aboriginal and Torres Strait Islander health practitioner has the appropriate training and skills to perform an antenatal service; and 2.      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 3.   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.

4.    the items do not apply in conjunction with another antenatal attendance item for the same patient, on the same day by the same practitioner.

5.     the items do not apply in conjunction with items 10990, 10991 or 10992; and

6.    for any particular patient, item 91850 and 91855 applies not more than 10 times in a 9 month period.

7.      An item in Subgroup 2 of Group T4 does not apply if the rendering practitioner and the patient have the capacity to undertake an attendance by telehealth.

 

• 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:

1. the attendance is where:

2. the person is at risk of COVID-19 virus; or

3. the practitioner rendering the service is a health professional at risk of COVID-19 virus; and

4. the service is provided on behalf of, and under the supervision of, a medical practitioner; and

5. the service is provided at, or from, a practice location in a regional, rural or remote area; and

6. 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

7. the service 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:

1. the attendance is where:

2. the person is at risk of COVID-19 virus; or

3. the practitioner rendering the service is a health professional at risk of COVID-19 virus; and

4. is between 4 and 8 weeks after the birth; and

5. lasts at least 20 minutes in duration; and

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

7. is for a pregnancy in relation to which a service to which item 82140 applies is not provided; and

8. 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:

1. the attendance is rendered by:

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

3. an obstetrician; or

4. a general practitioner; and

5. the attendance is where:

6. the person is at risk of COVID-19 virus; or

7. the practitioner rendering the service is a health professional at risk of COVID-19 virus; and

8. is between 1 week and 4 weeks after the birth; and

9. lasts at least 20 minutes; and

10. is for a patient who was privately admitted for the birth; and

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

12. the service is bulk billed.Applicable once for a pregnancy 54.25

• 91853 Antenatal telehealth attendance if:

1. the attendance is where:

2. the person is at risk of COVID-19 virus; or

3. the practitioner rendering the service is a health professional at risk of COVID-19 virus; and

4. 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:

1. the attendance is where:

2. the person is at risk of COVID-19 virus; or

3. the practitioner rendering the service is a health professional at risk of COVID-19 virus; and

4. the service is provided on behalf of, and under the supervision of, a medical practitioner; and

5. the service is provided at, or from, a practice location in a regional, rural or remote area; and

6. 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

7. 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:

1. the attendance is where:

2. the person is at risk of COVID-19 virus; or

3. the practitioner rendering the service is a health professional at risk of COVID-19 virus; and

4. is between 4 and 8 weeks after the birth; and

5. lasts at least 20 minutes in duration; and

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

7. is for a pregnancy in relation to which a service to which item 82140 applies is not provided; and

8. 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:

1. the attendance is rendered by:

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

3. an obstetrician; or

4. a general practitioner; and

5. the attendance is where:

6. the person is at risk of COVID-19 virus; or

7. the practitioner rendering the service is a health professional at risk of COVID-19 virus; and

8. is between 1 week and 4 weeks after the birth; and

9. lasts at least 20 minutes; and

10. is for a patient who was privately admitted for the birth; and

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

12. the service is bulk billed.Applicable once for a pregnancy 54.25

• 91858 Antenatal phone attendance if:

1. the attendance is where:

2. the person is at risk of COVID-19 virus; or

3. the practitioner rendering the service is a health professional at risk of COVID-19 virus; and

4. the service is bulk billed. 47.90