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Commonwealth legislation
This rulebook defines how Medicare funds telehealth consultations—phone or video—so patients and a wide range of health professionals can be paid for remote care. It sets eligibility, referral and claiming rules, and service limits to govern mental health, chronic disease and other remotely delivered care.
By making telehealth a funded, permanent option, it expands access for rural, mobility‑limited or time‑constrained patients while creating detailed controls to prevent misuse and manage quality and costs.
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Zoe can write the in-depth analysis on top of the summary above: how it works, who it affects and what each part actually does.
Direct links to the current provisions in Health Insurance (Section 3C General Medical Services – Telehealth Attendances) Determination 2021.
Sourced from the Federal Register of Legislation (legislation.gov.au), CC BY 4.0.
This instrument is the Health Insurance (Section 3C General Medical Services – Telehealth Attendances) Determination 2021.
This instrument is made under subsection 3C(1) of the Health Insurance Act 1973.
Unless earlier revoked, Schedule 6 of this instrument ceases as if revoked on 31 October 2026 at 11.59pm.
Note: The following terms are defined in subsection 3(1) of the Act:
clinically relevant service
consultant physician
dental practitioner
general medical services table
hospital‑substitute treatment
hospital treatment
item
participating midwife
participating nurse practitioner
professional service
(1) In this instrument:
Aboriginal and Torres Strait Islander health practitioner has the meaning given by Part 7 of the general medical services table.
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;
other than an outpatient hospital service to which an item in Schedule 1, 2, 4 or 5 or item 11342 or 11345 in Schedule 4A applies.
Allied Health and other Primary Health Care Services Determination means the Health Insurance (Section 3C General Medical Services – Allied Health and other Primary Health Care Services) Determination 2024.
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 of the Allied Health and other Primary Health Care Services Determination 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 of the Allied Health and other Primary Health Care Services Determination.
Aboriginal and Torres Strait Islander primary health care professional has the meaning given by section 4 of the Allied Health and other Primary Health Care Services Determination.
Commonwealth Urgent Care Clinic Program means the Commonwealth Urgent Care Clinic Program administered by the Department of Health, Disability and Ageing.
consultant psychiatrist means a consultant physician in the practice of the consultant physician’s specialty of psychiatry.
contribute to a multidisciplinary care plan has the meaning given by clause 2.16.3 of the general medical services table.
eating disorder treatment and management plan has the same meaning as in the general medical services table.
eligible Aboriginal and Torres Strait Islander health worker has the meaning given by section 4 of the Allied Health and other Primary Health Care Services Determination.
eligible Aboriginal and Torres Strait Islander health practitioner has the meaning given by section 4 of the Allied Health and other Primary Health Care Services Determination.
eligible allied health practitioner means:
(a) an eligible diabetes educator;
(b) an eligible audiologist;
(c) an eligible dietitian;
(d) an eligible mental health worker;
(e) an eligible occupational therapist;
(f) an eligible exercise physiologist;
(g) an eligible physiotherapist;
(h) an eligible podiatrist;
(i) an eligible chiropractor;
(j) an eligible osteopath;
(k) an eligible psychologist; or
(l) an eligible speech pathologist.
Note: Eligible allied health practitioner for subgroups 15 and 16 of Group M18 means:
(a) an eligible psychologist;
(b) an eligible speech pathologist;
(c) an eligible occupational therapist;
(d) an eligible audiologist;
(e) an eligible dietitian
(f) an eligible exercise physiologist
(g) an eligible optometrist;
(h) an eligible orthoptist;
(i) an eligible physiotherapist;
eligible audiologist has the meaning given by section 4 of the Allied Health and other Primary Health Care Services Determination.
eligible chiropractor has the meaning given by section 4 of the Allied Health and other Primary Health Care Services Determination.
eligible clinical psychologist has the meaning given by section 4 of the Allied Health and other Primary Health Care Services Determination.
eligible diabetes educator has the meaning given by section 4 of the Allied Health and other Primary Health Care Services Determination.
eligible dietitian has the meaning given by section 4 of the Allied Health and other Primary Health Care Services Determination.
eligible exercise physiologist has the meaning given by section 4 of the Allied Health and other Primary Health Care Services Determination.
eligible mental health worker has the meaning given by section 4 of the Allied Health and other Primary Health Care Services Determination.
eligible occupational therapist has the meaning given by section 4 of the Allied Health and other Primary Health Care Services Determination.
eligible optometrist has the meaning given by section 4 of the Allied Health and other Primary Health Care Services Determination
eligible orthoptist has the meaning given by section 4 of the Allied Health and other Primary Health Care Services Determination.
eligible osteopath has the meaning given by section 4 of the Allied Health and other Primary Health Care Services Determination.
eligible physiotherapist has the meaning given by section 4 of the Allied Health and other Primary Health Care Services Determination.
eligible psychologist has the meaning given by section 4 of the Allied Health and other Primary Health Care Services Determination.
eligible podiatrist has the meaning given by section 4 of the Allied Health and other Primary Health Care Services Determination.
eligible social worker has the meaning given by section 4 of the Allied Health and other Primary Health Care Services Determination.
eligible speech pathologist has the meaning given by section 4 of the Allied Health and other Primary Health Care Services Determination.
eligible urgent care clinic means:
(a) the trustee for Kimberley Medical Unit Trust trading as the Kimberley Medical Group located in Broome Western Australia; or
(b) the My Clinic Plus Pty Ltd as Trustee for My Clinic Plus Trust trading as My Clinic Plus located in Devonport Tasmania.
focussed psychological strategies has the meaning given by clause 2.20.1 of the general medical services table.
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 92025 applies.
GP mental health treatment plan has the meaning given by section 4 of the Allied Health and other Primary Health Care Services Determination.
multidisciplinary care plan:
(a) for items 92026, 92027, 92070, 92071, 92057, 92058, 92101 and 92102—has the meaning given by clause 2.16.6 of the general medical services table; and
(b) for items 93201 and 93203—has the meaning given by clause 3.1.1 of the general medical services table.
MyMedicare has the meaning given in clause 7.1.1 of the general medical services table.
non‑directive pregnancy support counselling means counselling provided to a person, 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 his or her views or values about what the person should or should not do in relation to the pregnancy.
Other Medical Practitioner Determination means the Health Insurance (Section 3C General Medical Services ‑ Other Medical Practitioner) Determination 2018.
outpatient hospital service, for the purposes of an item specified in Schedule 1, 2, 4 or 5 or item 11342 or 11345 in Schedule 4A of this instrument, means a service provided, or arranged, with the direct involvement of a hospital where the service is:
(a) provided by a practitioner located at the hospital;
(b) provided to a patient who is not located at the hospital and who previously received hospital treatment as an admitted patient of the hospital; and
(c) a service for which a private health insurance benefit is not payable.
person who has tested positive for COVID‑19 means a patient who has received a positive COVID‑19 test result within the last 7 days, confirmed by either:
(a) Laboratory testing (PCR); or
(b) A COVID‑19 rapid antigen self test (RAT) which has been approved for supply in Australia by the Therapeutic Goods Administration.
person who is experiencing homelessness means when a person does not have suitable accommodation alternatives they are considered homeless if their current living arrangement:
(a) is in a dwelling that is inadequate; or
(b) has no tenure, or if their initial tenure is short and not extendable; or
(c) does not allow them to have control of, and access to space for social relations.
person who is in a natural disaster affected area means a patient who, at the time of accessing the telehealth service, is located within a State or Territory local government area which is declared as a natural disaster area by a State or Territory Government.
phone attendance means a professional attendance by telephone where the health practitioner:
(a) has the capacity to provide the full service through this means safely and in accordance with professional standards; and
(b) is satisfied that it is clinically appropriate to provide the service to the patient; and
(c) maintains an audio link with the patient.
preparing a GP chronic condition management plan has the meaning given by clause 2.16.7 of the general medical services table.
prescribed medical practitioner has the meaning given by clause 7.1.1 of the general medical services table.
provider number has the meaning given by section 4 of the Health Insurance Regulations 2018.
psychiatrist assessment and management plan means a psychiatrist assessment and management plan prepared by a consultant physician in the practice of the consultant physician’s specialty of psychiatry in accordance with item 92435, 92475 or 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.
residential aged care facility has the meaning given in Part 7 of the general medical services table.
reviewing a GP chronic condition management plan has the meaning given by clause 2.16.8 of the general medical services table.
Schedule means a Schedule to this instrument.
single course of treatment has the meaning given by clause 1.1.6 of the general medical services table.
Team Care Arrangements, for a patient, means GP coordination of the development of team care arrangements prior to 1 July 2025 to which item 230 or 729 of the general medical services table or item 92025 or 92056 applies.
telehealth means a professional attendance by video attendance or phone attendance.
video attendance means a professional attendance by video conference where the rendering health practitioner:
(a) has the capacity to provide the full service through this means safely and in accordance with relevant professional standards; and
(b) is satisfied that it is clinically appropriate to provide the service to the patient; and
(c) maintains a visual and audio link with the patient; and
(d) is satisfied that the software and hardware used to deliver the service meets the applicable laws for security and privacy.
(2) Unless the contrary intention appears, a reference in this instrument to a provision of the Act or the National Health Act 1953 or a legislative instrument 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 instrument is a reference to those provisions as in force from time to time.
(3) In this instrument, a general practitioner includes a kind of medical practitioner specified in clause 1.1.3 of the general medical services table.
A health service provided in accordance with this Determination 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 item in the Schedule relating to the service.
Note: For this Determination, an internal Territory is deemed to form part of the State of New South Wales—see subsection 3C(7) of the Act.
(1) An item in a Schedule does not apply to a service mentioned in the item if the service is provided to a patient, or in relation to a patient, who is an admitted patient. (1A) Subsection (1) does not apply to item 91874, 91875, 91876, 91877, 91878, 91882, 91883 or 91884 of Schedule 2 or an item listed in Schedule 6 of this Determination. (2) 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 does not apply to a service provided to a patient, or to a person other than the patient as part of the patient’s treatment, who has already been provided, in the calendar year, with 10 services to which any of those items or the following items apply: (a) an item in Subgroup 2 of Group A20 of the general medical services table; (b) items 283, 285, 286, 287, 309, 311, 313 or 315 of the general medical services table; or (c) items 80000 to 80016, 80100 to 80116, 80125 to 80141 or 80150 to 80166 of the Allied Health and other Primary Health Care Services Determination. (3) Subject to subsection (4), an item in a Schedule only applies to a service that is an attendance by a single health professional on a single person.
Note: Health professionals who can provide services under this instrument include general practitioners, medical practitioners, specialists and consultant physicians, allied health professionals, Aboriginal and Torres Strait Islander primary health care professionals and participating nurses and midwives.
(4) Subsection (3) does not apply to items 92029, 92030, 92060 and 92061 and items 92455 to 92457 and 92495 to 92497. (5) An item in Schedule 1 or 8, or Subgroup 5 or 10 of Group M18 applies to a service performed by the patient’s eligible telehealth practitioner. (6) Subsection (5) does not apply to a service provided to the following individuals: (a) a person who is under the age of 12 months; or (b) a person who is experiencing homelessness; or (c) a person who is in COVID‑19 isolation because of a State or Territory public health order; or (d) a person who is in COVID‑19 quarantine because of a State or Territory public health order; or (e) a person who receives the service from a medical or nu
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