Details: F2020C00413
Health Insurance (Section 3C General Medical Services – Specialist, Consultant Physician and Consultant Psychiatrist COVID-19 Telehealth Services) Determination 2020
- F2020C00413
Determinations/Health as amended, taking into account amendments up to Health Insurance (Section 3C General Medical Services – Application of GP and Allied Health COVID-19 Services and Specialist, Consultant Physician and Consultant Psychiatrist COVID-19 Telehealth Services) Amendment Determination 2020
Administered by: Health
Incorporated Amendments
Health Insurance (Section 3C General Medical Services – Application of GP and Allied Health COVID-19 Services and Specialist, Consultant Physician and Consultant Psychiatrist COVID-19 Telehealth Services) Amendment Determination 2020 - F2020L00298
sch 2 (item 1)
Registered 21 May 2020
Date ceased to have effect 30 Sep 2020
Ceased by Self Ceasing
F2020C00413
made under subsection 3C(1) of the
Health Insurance Act 1973
Compilation No. 3
Compilation date: 23 March 2020
Includes amendments up to: F2020L00298
Registered: 21 May 2020
About this compilation
This compilation
This is a compilation of the Health Insurance (Section 3C General Medical Services – Specialist, Consultant Physician and Consultant Psychiatrist COVID-19 Telehealth Services) Determination 2020 that shows the text of the law as amended and in force on 23 March 2020 (the compilation date).
The notes at the end of this compilation (the endnotes) include information about amending laws and the amendment history of provisions of the compiled law.
Uncommenced amendments
The effect of uncommenced amendments is not shown in the text of the compiled law. Any uncommenced amendments affecting the law are accessible on the Legislation Register (www.legislation.gov.au). The details of amendments made up to, but not commenced at, the compilation date are underlined in the endnotes. For more information on any uncommenced amendments, see the series page on the Legislation Register for the compiled law.
Application, saving and transitional provisions for provisions and amendments
If the operation of a provision or amendment of the compiled law is affected by an application, saving or transitional provision that is not included in this compilation, details are included in the endnotes.
Editorial changes
For more information about any editorial changes made in this compilation, see the endnotes.
If the compiled law is modified by another law, the compiled law operates as modified but the modification does not amend the text of the law. Accordingly, this compilation does not show the text of the compiled law as modified. For more information on any modifications, see the series page on the Legislation Register for the compiled law.
Self-repealing provisions
If a provision of the compiled law has been repealed in accordance with a provision of the law, details are included in the endnotes.
1............ Name............................................................................................................................. 1
2............ Commencement............................................................................................................. 1
3............ Cessation....................................................................................................................... 1
4............ Authority....................................................................................................................... 1
5............ Definitions..................................................................................................................... 1
6............ Treatment of relevant services....................................................................................... 3
7............ Application of provisions of the general medical services table..................................... 4
Schedule 1 – relevant services 5
Division 1.1 – Services and fees – specialist attendances via video conference 5
Division 1.2 – Services and fees – consultant physician (other than psychiatry) attendances via video conference 6
Division 1.3 – Services and fees – Consultant psychiatrist attendances via video conference 8
Division 1.4 Services and fees – specialist attendances via phone services 10
Division 1.5 – Services and fees – consultant physician (other than psychiatry) attendances via phone services 12
Division 1.6 – Services and fees – Consultant psychiatrist attendances via phone services 14
Division 1. 7– Services and Fees – obstetric attendances via telehealth services 16
Endnotes 20
Endnote 1—About the endnotes 20
Endnote 2—Abbreviation key 21
Endnote 3—Legislation history 22
Endnote 4—Amendment history 23
1. Name
This instrument is the Health Insurance (Section 3C General Medical Services – Specialist, Consultant Physician and Consultant Psychiatrist COVID-19 Telehealth 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.
1. The whole of this instrument
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.
(1) In this instrument:
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.
Note: hospital treatment and hospital-substitute treatment have the same meaning as defined in the Health Insurance Act 1973.
bulk-billed: a medical 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 medical 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 medical practitioner accepts the assignment as full payment of the medical practitioner's fee for the service provided.
consultant psychiatrist means a consultant physician in the practice of the consultant physician's specialty of psychiatry.
general medical services table means the table prescribed under subsection 4(1) of the Act.
Health professional at risk of COVID-19 virus means a person that:
(a) has been diagnosed with COVID-19 virus but who is not a patient of a hospital; or
(b) has been required to isolate themselves in quarantine in accordance with home isolation guidance issued by Australian Health Protection Principal Committee.
patient at risk of COVID-19 virus means a person that:
(b) has been required to isolate themselves in quarantine in accordance with home isolation guidance issued by Australian Health Protection Principal Committee; or
(c) is considered more susceptible to the COVID-19 virus being a person who is:
(i) at least 70 years old; or
(ii) at least 50 years old and is of Aboriginal or Torres Strait Islander descent; or
(iii) pregnant; or
(iv) a parent of a child under 12 months; or
(v) already under treatment for chronic health conditions or is immune compromised; or
(d) the person meets the current national triage protocol criteria for suspected COVID-19 infection.
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.
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.
Note: The following terms are defined in subsection 3(1) of the Act:
· clinically relevant service;
· general medical services table;
· item;
· medical practitioner;
· professional service.
telehealth attendance means a professional attendance by video conference where the health practitioner:
(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 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 and as 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.
An item in a Schedule to this Determination only applies to a service provided on and after 13 March 2020 and before the commencement of the Health Insurance (Section 3C General Medical Services –COVID-19 Services) Determination 2020.
7. Application of provisions of the general medical services table
(1) Clause 1.1.5 of the general medical services table shall have effect as if items 91822 to 91826 of this Determination were specified in subclause 1.1.5(1) of the general medical services table.
(2) Clause 1.2.2 of the general medical services table shall have effect as if items in Schedule 1 of this Determination were specified in clause 1.2.2.
(3) Clause 1.2.4 of the general medical services table shall have effect as if items in Schedule 1 of this Determination were specified in subclause 1.2.4(1).
Schedule 1 – relevant services
Division 1.1 – Services and fees – specialist attendances via video conference
Group A40 – COVID-19 – medical practitioner telehealth services
Subgroup 4 – COVID-19 – specialist attendances telehealth services
Fee ($)
Telehealth attendance for a person by a specialist in the practice of the specialist's specialty if:
(a) the attendance is where:
(i) the person is a patient at risk of COVID-19 virus; or
(ii) the specialist is a health professional at risk of COVID-19 virus; and
(b) the attendance follows referral of the patient to the specialist; and
(c) the attendance was of more than 5 minutes in duration; and
(d) the patient is not an admitted patient; and
(e) the service is bulk-billed.
Where the attendance was other than a second or subsequent attendance as part of a single course of treatment.
Where the attendance is after the first attendance as part of a single course of treatment.
Division 1.2 – Services and fees – consultant physician (other than psychiatry) attendances via video conference
Subgroup 5 – COVID-19 – consultant physician telehealth services
Telehealth attendance for a person by a consultant physician in the practice of the consultant physician's specialty (other than psychiatry) if:
(ii) the consultant physician is a health professional at risk of COVID-19 virus; and
Where the attendance is not a minor attendance after the first as part of a single course of treatment.
Where the attendance is a minor attendance after the first as part of a single course of treatment.
Division 1.3 – Services and fees – Consultant psychiatrist attendances via video conference
Subgroup 6 – COVID-19 – consultant psychiatrist telehealth services
Telehealth attendance for a person by a consultant psychiatrist; if:
(ii) the consultant psychiatrist is a health professional at risk of COVID-19 virus; and
(b) the attendance follows a referral of the patient to the consultant psychiatrist by a referring practitioner; and
(c) the attendance was not more than 15 minutes duration; and
(c) the attendance was at least 15 minutes, but not more than 30 minutes in duration; and
(c) the attendance was at least 75 minutes in duration; and
Division 1.4 Services and fees – specialist attendances via phone services
1.4.1 Application of COVID-19 medical practitioner phone services
(1) For items in Subgroups 4, and 7 the rendering practitioner must not perform a service in subgroup 7 if the 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
Phone attendance for a person by a specialist in the practice of the specialist's specialty if:
Division 1.5 – Services and fees – consultant physician (other than psychiatry) attendances via phone services
Subgroup 8 – COVID-19 – consultant physician phone services
Phone attendance for a person by a consultant physician in the practice of the consultant physician's specialty (other than psychiatry) if:
Division 1.6 – Services and fees – Consultant psychiatrist attendances via phone services
Subgroup 9 – COVID-19 – consultant psychiatrist phone services
Fee($)
Phone attendance for a person by a consultant psychiatrist; if:
(f) the attendance is where:
(j) the person is a patient at risk of COVID-19 virus; or
(jj) the consultant psychiatrist is a health professional at risk of COVID-19 virus; and
(g) the attendance follows a referral of the patient to the consultant psychiatrist by a referring practitioner; and
(h) the attendance was at least 30 minutes, but not more than 45 minutes in duration; and
(i) the patient is not an admitted patient; and
(j) the service is bulk-billed.
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 items in Division 1.7, 'midwife' has the same meaning as provided in clause 2.41.2 of the Health Insurance (General Medical Services Table) Regulations 2019.
(2) Application of item 91850 and 91855
1) Item 91850 and 91855 applies to an antenatal service provided to a patient by a midwife, nurse or Aboriginal and Torres Strait Islander health practitioner only if:
(a) the midwife, nurse or Aboriginal and Torres Strait Islander health practitioner has the appropriate training and skills to perform an antenatal service; and
(b) 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
(c) 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.
2) Item 91850 and 91855 does not apply in conjunction with another antenatal attendance item for the same patient, on the same day by the same practitioner.
3) Item 91850 and 91855 does not apply in conjunction with items 10990, 10991 or 10992.
4) For any particular patient, item 91850 and 91855 applies not more than 10 times in a 9 month period.
(3) For items in Subgroups 1 the rendering practitioner must not perform a service in subgroup 2 if the practitioner and the patient have the capacity to undertake an attendance by telehealth.
Group T4—Obstetrics
Subgroup 1 – COVID-19 obstetric telehealth services
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:
(i) the person is at risk of COVID-19 virus; or
(ii) the practitioner rendering the service is a health professional at risk of COVID-19 virus; and
(b) the service is provided on behalf of, and under the supervision of, a medical practitioner; and
(c) the service is provided at, or from, a practice location in a regional, rural or remote area; and
(d) 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
(e) the service is not provided for an admitted patient of a hospital or approved day facility; and
(f) The services is bulk billed.
Postnatal telehealth attendance by an obstetrician or general practitioner (other than a service to which any other item applies) if:
(b) is between 4 and 8 weeks after the birth; and
(c) lasts at least 20 minutes in duration; and
(d) includes a mental health assessment (including screening for drug and alcohol use and domestic violence) of the patient; and
(e) is for a pregnancy in relation to which a service to which item 82140 applies is not provided; and
(f) the service is bulk billed.
Applicable once for a pregnancy
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:
(a) the attendance is rendered by:
(i) a midwife (on behalf of and under the supervision of the medical practitioner who attended the birth); or
(ii) an obstetrician; or
(iii) a general practitioner; and
(b) the attendance is where:
(c) is between 1 week and 4 weeks after the birth; and
(d) lasts at least 20 minutes; and
(e) is for a patient who was privately admitted for the birth; and
(f) is for a pregnancy in relation to which a service to which item 82130, 82135 or 82140 applies is not provided; and
(g) the service is bulk billed.
Antenatal telehealth attendance if:
(b) the service is bulk billed.
Subgroup 2 – COVID-19 obstetric phone services
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:
Postnatal phone attendance by an obstetrician or general practitioner (other than a service to which any other item applies) if:
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:
Antenatal phone attendance if:
Endnote 1—About the endnotes
The endnotes provide information about this compilation and the compiled law.
The following endnotes are included in every compilation:
Endnote 2—Abbreviation key
Endnote 3—Legislation history
Endnote 4—Amendment history
Abbreviation key—Endnote 2
The abbreviation key sets out abbreviations that may be used in the endnotes.
Legislation history and amendment history—Endnotes 3 and 4
Amending laws are annotated in the legislation history and amendment history.
The legislation history in endnote 3 provides information about each law that has amended (or will amend) the compiled law. The information includes commencement details for amending laws and details of any application, saving or transitional provisions that are not included in this compilation.
The amendment history in endnote 4 provides information about amendments at the provision (generally section or equivalent) level. It also includes information about any provision of the compiled law that has been repealed in accordance with a provision of the law.
The Legislation Act 2003 authorises First Parliamentary Counsel to make editorial and presentational changes to a compiled law in preparing a compilation of the law for registration. The changes must not change the effect of the law. Editorial changes take effect from the compilation registration date.
If the compilation includes editorial changes, the endnotes include a brief outline of the changes in general terms. Full details of any changes can be obtained from the Office of Parliamentary Counsel.
Misdescribed amendments
A misdescribed amendment is an amendment that does not accurately describe the amendment to be made. If, despite the misdescription, the amendment can be given effect as intended, the amendment is incorporated into the compiled law and the abbreviation "(md)" added to the details of the amendment included in the amendment history.
If a misdescribed amendment cannot be given effect as intended, the abbreviation "(md not incorp)" is added to the details of the amendment included in the amendment history.
ad = added or inserted
o = order(s)
am = amended
Ord = Ordinance
amdt = amendment
orig = original
c = clause(s)
par = paragraph(s)/subparagraph(s)
C[x] = Compilation No. x
/sub‑subparagraph(s)
Ch = Chapter(s)
pres = present
def = definition(s)
prev = previous
Dict = Dictionary
(prev…) = previously
disallowed = disallowed by Parliament
Pt = Part(s)
Div = Division(s)
r = regulation(s)/rule(s)
ed = editorial change
reloc = relocated
exp = expires/expired or ceases/ceased to have
renum = renumbered
rep = repealed
F = Federal Register of Legislation
rs = repealed and substituted
gaz = gazette
s = section(s)/subsection(s)
LA = Legislation Act 2003
Sch = Schedule(s)
LIA = Legislative Instruments Act 2003
Sdiv = Subdivision(s)
(md) = misdescribed amendment can be given
SLI = Select Legislative Instrument
SR = Statutory Rules
(md not incorp) = misdescribed amendment
Sub‑Ch = Sub‑Chapter(s)
cannot be given effect
SubPt = Subpart(s)
mod = modified/modification
underlining = whole or part not
No. = Number(s)
commenced or to be commenced
Application, saving and transitional provisions
12 Mar 2020 (F2020L00248)
13 Mar 2020 (s 2(1) item 1)
Health Insurance (Section 3C General Medical Services – Specialist, Consultant Physician and Consultant Psychiatrist COVID-19 Telehealth Services) Amendment Determination No.1 2020
Health Insurance (Section 3C General Medical Services – Application of GP and Allied Health COVID-19 Services and Specialist, Consultant Physician and Consultant Psychiatrist COVID-19 Telehealth Services) Amendment Determination 202
Sch 1: 23 Mar 2020 (s 2(1) item 1)
Provision affected
How affected
s 2.............................................
rep LA s 48D
am F2020L00254
ed C1
Group A40 table.......................
Division 1.4..............................
ad F2020L00254
c 1.4.1.......................................