Health Insurance (Section 3C Midwife and Nurse Practitioner Services) Determination 2020
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Health Insurance (Section 3C Midwife and Nurse Practitioner Services) Determination 2020
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Turn the raw legal text into a practical explanation grounded in Health Insurance (Section 3C Midwife and Nurse Practitioner Services) Determination 2020.
(1) An item in Schedule 2, except an item in Part 1 of Schedule 2, 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 nurse practitioner; and
(b) the nurse practitioner:
(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 nurse practitioner in accordance with accepted clinical practice.
(3) An item in Schedule 2, except an item in Part 1 of Schedule 2, 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 Part 2 of Schedule 2:
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 Part 2 of Schedule 2; and
(b) the cost of the vaccine is not subsidised by the Commonwealth or a State.
(6) Items 82200, 82205, 82210 and 82215 do not apply to a service described in the item if the service is provided at the same time as, or in connection with, a non‑medicare service.