Health Insurance (Section 3C Midwife and Nurse Practitioner Services) Determination 2020
10. General requirements10. General requirements
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10. General requirements
(1) An item in Schedule 1 applies to a service only if:
(a) the service is provided in the course of a personal attendance on a single patient on a single occasion by a single participating midwife; and
(b) the midwife:
(i) is not employed by the proprietor of a hospital that is not a private hospital; or
(ii) both:
(A) is employed by the proprietor of a hospital that is not a private hospital; and
(B) provides the service otherwise than in the course of employment by that proprietor.
(2) Subsection (1) applies whether or not another person provides essential assistance to the participating midwife in accordance with accepted clinical practice.
(3) An item in Schedule 1 does not apply to a service provided for a patient if the patient is not in attendance.
Examples — patient not in attendance
1 Completing patient records.
2 Issuing repeat prescriptions.
3 Telephone attendances.
(4) In items 82100 to 82115 and 82130 to 82140 in Part 1 of Schedule 1:
professional attendance includes the provision, for a patient, of any of the following services:
(a) evaluating the patient’s condition or conditions including, if applicable, evaluation using a health screening service mentioned in subsection 19(5) of the Act;
(b) formulating a plan for the management and, if applicable, for the treatment of the patient’s condition or conditions;
(c) giving advice to the patient about the patient’s condition or conditions and, if applicable, about treatment;
(d) if authorised by the patient — giving advice to another person, or other persons, about the patient’s condition or conditions and, if applicable, about treatment;
(e) providing appropriate preventive health care;
(f) recording the clinical details of the service or services provided to the patient.
(5) However, a professional attendance does not include the supply of a vaccine to a patient if:
(a) the vaccine is supplied to the patient in connection with a professional attendance mentioned in any of items 82100 to 82115 and 82130 to 82140 in Part 1 of Schedule 1; and
(b) the cost of the vaccine is not subsidised by the Commonwealth or a State.
(6) If a service described in item 82103 is provided on the same day as a service to which item 82100, 82102, 82105, 82110, 91211, 91212, 91218 or 91219 applies, the subsequent item will only apply if it is:
(a) not a continuation of the first attendance; and
(b) is clinically relevant and distinct from the first attendance.