AUSTRALIAN GOVERNMENT DEPARTMENT OF HEALTH AND AGED CARE HEALTH INSURANCE ACT 1973 Health Insurance (Medicare Benefits Payable in Respect of Professional Services – Council of Australian Governments' Improving Access to Primary Care in Rural and Remote Areas – COAG s19(2) Exemptions Initiative – South Australia) Direction (No. 1) 2025 I, Nigel Murray, Assistant Secretary, MBS Policy and Specialist Programs Branch, Medicare Benefits and Digital Health Division, Health Resourcing Group, delegate for the Minister for Health and Aged Care, acting under subsection 19(2) of the Health Insurance Act 1973 (the Act), hereby: 1. REPEAL the Health Insurance (Medicare Benefits Payable in Respect of Professional Services – Council of Australian Governments' Improving Access to Primary Care in Rural and Remote Areas – COAG s19(2) Exemptions Initiative – South Australia) Direction (No. 3) 2024; and 2. DIRECT that Medicare Benefits shall be payable in respect of: 1. A professional service (as defined in Section 3 of the Act) which has been agreed to be provided under the Memorandum of Understanding (MOU) between the Department of Health and Aged Care (ABN: 83 605 426 759) and South Australia (ABN: 52 786 403 404) dated 19 May 2022 as part of the Council of Australian Governments' Improving Access to Primary Care in Rural and Remote Areas – COAG s19(2) Exemptions Initiative relating to primary care services for which: 1. items specified in Schedule A of this Direction; and of the general medical services table (means the table prescribed under subsection 4(1) of the Act), diagnostic imaging services table (means the table prescribed under subsection 4AA(1) of the Act) or pathology services table (means the table prescribed under subsection 4A(1) of the Act) relates; and 2. Where the professional service is provided to: 1. an eligible person (as defined in Section 3 of the Act); and 2. a patient who is not part of an episode of hospital treatment (as defined in Section 121-5 of the Private Health Insurance Act 2007); and 3. The professional service referred to in paragraph (2)(a): 1. is provided at an approved Modified Monash Model 5-7 area (as defined in Section 7.1.1 of the general medical services table) practice location specified in Schedule B; and 2. is either: 1. a professional non-referred service provided by a state remunerated prescribed medical practitioner, participating midwife, or participating nurse practitioner; or 2. a professional referred service provided by a state remunerated allied health professional or dental practitioner. 1. DECLARE that this Direction commences on 24 January 2025 and ceases to have effect at the end of 30 June 2025 unless earlier revoked. Note, a number of expressions used in this direction are defined in the below instruments: * Health Insurance Act 1973: the meaning of dental practitioner, participating midwife, participating nurse practitioner, and professional service; and * Health Insurance (General Medical Services Table) Regulations 2021: the meaning of prescribed medical practitioner. * Health Insurance (Section 3C General Medical Services – Allied Health Services) Determination 2024: the meaning of allied health professional. Date: 23 January 2025 Nigel Murray Assistant Secretary MBS Policy and Specialist Programs Branch Medicare Benefits and Digital Health Division Health Resourcing Group Department of Health and Aged Care SCHEDULE A MEDICARE BENEFITS SCHEDULE ITEMS AT Approved Practice Locations AS AGREED under the Council of Australian Governments' Improving Access to Primary Care in Rural and Remote Areas – COAG s19(2) Exemptions Initiative – south australia For services listed in the below tables, all provisions of the Health Insurance Act 1973 (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 apply. General Medical Services Table Group Group Name Subgroup Subgroup Name A1 General practitioner attendances to which no other item applies A2 Other non‑referred attendances to which no other item applies A5 Prolonged attendances to which no other item applies A6 Group therapy A7 Acupuncture and non‑specialist practitioner items A9 Contact lenses A10 Optometric services provided by optometrist A11 Urgent attendances after—hours A14 Health assessments A15 GP management plans, team care arrangements and multidisciplinary care plans and case conferences 1 GP management plans, team care arrangements and multidisciplinary care plans A17 Domiciliary and residential medication management reviews A20 Mental health care A22 General practitioner after‑hours attendances to which no other item applies A23 Other non‑referred after‑hours attendances to which no other item applies A27 Pregnancy support counselling A35 Non‑referred attendance at a residential aged care facility A40 Telehealth and phone attendance services 1 General practice telehealth services 2 General practice phone services 3 Focussed Psychological Strategies telehealth services 10 Focussed Psychological Strategies phone services 11 Health Assessments for Aboriginal and Torres Strait Islander People ‑ Telehealth Service 13 GP management plans, team care arrangements and multidisciplinary care plans via telehealth attendance 15 GP Pregnancy Support Counselling ‑ Telehealth Service 16 GP Pregnancy Support Counselling ‑ Phone Service 19 GP Mental Health Treatment Plan ‑ Telehealth Service 20 GP Mental Health Treatment Plan ‑ Phone Service 21 GP Eating Disorder Treatment and Management Plan – Telehealth Service 27 Eating Disorder Psychological Treatment Services – Telehealth Service 28 Eating Disorder Psychological Treatment Strategies – Phone Service 29 GP and Other Medical Practitioner ‑ Urgent After Hours Service in Unsociable Hours ‑ Telehealth Service 39 GP Blood Borne Viruses, Sexual or Reproductive Health Consultation – Telehealth Service 40 GP Blood Borne Viruses, Sexual or Reproductive Health Consultation – Phone Service M1 Management of bulk‑billed services 1 Management of general bulk‑billed services 2 General support service 3 Patients enrolled in MyMedicare M3 Allied health services M6 Psychological Therapy Services M7 Focussed Psychological Strategies (Allied Mental Health) M8 Pregnancy support counselling M9 Allied health group services M10 Complex neurodevelopmental disorder and disability services M11 Allied health services for Aboriginal and Torres Strait Islander people M12 Services provided by a practice nurse, an Aboriginal health worker or an Aboriginal and Torres Strait Islander health practitioner on behalf of a medical practitioner M14 Nurse practitioners M15 Diagnostic audiology services M16 Eating disorders services M18 Allied health telehealth and phone services 1 Psychological therapies telehealth services 2 Psychologist focussed psychological strategies telehealth services 3 Occupational therapist focussed psychological strategies telehealth services 4 Social worker focussed psychological strategies telehealth services 5 Nurse practitioner telehealth services 6 Psychological therapies phone services 7 Psychologist focussed psychological strategies phone service 8 Occupational therapist focussed psychological strategies phone services 9 Social worker focussed psychological strategies phone services 10 Nurse practitioner phone services 11 General allied health telehealth services 12 General allied health phone services 13 Pregnancy support counselling telehealth services 14 Pregnancy support counselling phone services 15 Complex neurodevelopmental disorder and disability telehealth services 16 Complex neurodevelopmental disorder and disability phone services 17 Telehealth attendance to person of Aboriginal and Torres Strait Islander descent 18 Phone attendance to person of Aboriginal and Torres Strait Islander descent 23 Follow up service provided by a practice nurse or Aboriginal and Torres Strait Islander health practitioner – Telehealth Services 25 Allied health, group dietetics telehealth services 26 Allied health, group dietetics phone services T1 Miscellaneous therapeutic procedures 6 Gastroenterology General Medical Services Table – permitted items Group Group Name Items Item overview A15 GP management plans, team care arrangements and multidisciplinary care plans 735, 739, 743, 747-758, 930-945 Case conferences A29 Attendance services for complex neurodevelopmental disorder or disability 139 Professional attendance by a general practitioner for assessment, diagnosis and preparation of a treatment and management plan for a patient with an eligible disability A36 Eating disorder services 90250-90257, 90264, 90265, 90271-90282 Eating disorder services provided by General Practitioners or Medical Practitioners A40 Telehealth and phone attendance services 92142, 92170, 92171, 92176, 92177 General Practitioner and Prescribed Medical Practitioner items A44 General Practice attendance for assessing patient suitability for a COVID-19 vaccine 93645, 93647, 93654, 93656, 93661, 93666, 10660, 10661 General Practice Attendance for Assessing Patient Suitability for a COVID-19 Vaccine D1 Miscellaneous diagnostic procedures and investigations 11300-11318, 11505, 11506, 11602-11615, 11707, 11729, 11730, 12001-12004, 12012, 12017, 12200, 12306, 12312, 12315, 12320-12322, 12325, 12326 Non-referred services only D2 Nuclear medicine (non‑imaging) 12500, 12524, 12527 Nuclear Medicine (non-imaging) M13 Midwifery services 82100-82115, 82130-82140 Midwifery items T1 Miscellaneous therapeutic procedures 13105, 14206 Haemodialysis provided by a registered nurse, Aboriginal health worker or Aboriginal and Torres Strait Islander health practitioner in a very remote location Hormone or living tissues implantation by cannula T4 Obstetrics 16400, 16406-16500, 16502-16514, 16530, 16590, 16591, 91850-91858 Antenatal and postnatal attendances T8 Surgical operations 30003, 30006, 30023, 30026-30055, 30061-30072, 30107, 30192-30207, 30216, 30219, 31356, 32072, 32147, 35503, 41500, 47015, 47042, 47057, 47069, 47301, 47348, 47354, 47361, 47387, 47423, 47444, 47453, 47462, 47466, 47471, 47543, 47561, 47579, 47595, 47663, 47735, 47904, 47915, 47916, 47918 Minor surgical procedures O1 Consultations 51700-51703, 54001-54004 Dental practitioner attendances Diagnostic Imaging Services Table Group Group Name I1 ultrasound I3 diagnostic radiology I6 management of bulk‑billed services Pathology Services Table Group Group Name P9 simple basic pathology tests P12 management of bulk‑billed services P13 bulk‑billing incentive SCHEDULE B Approved Practice Locations AS AGREED under the Council of Australian Governments' Improving Access to Primary Care in Rural and Remote Areas – COAG s19(2) Exemptions Initiative – South Australia Approved locations: Location Practice Name Legal Name Street Address Mailing Address Ceduna Ceduna District Health Service and Ceduna Family Medical Practice Eyre and Far North Local Health Network Inc 3 Eyre Highway, Ceduna SA 5690 PO Box 178 Ceduna SA 5690 Cleve (Outreach service of Ceduna) Mid Eyre Medical Practice – Cleve Eyre and Far North Local Health Network Inc 15 Main Street, Cleve SA 5640 PO Box 178 Ceduna SA 5690 Coober Pedy (Outreach service of Ceduna) Coober Pedy Hospital and Coober Pedy Medical Practice Eyre and Far North Local Health Network Inc 89 McDougall Street, Coober Pedy SA 5723 PO Box 178 Ceduna SA 5690 Cowell (Outreach service of Ceduna) Cowell Hospital and Mid Eyre Medical Practice – Cowell Eyre and Far North Local Health Network Inc 17 South Terrace, Cowell SA 5602 PO Box 178 Ceduna SA 5690 Elliston (Outreach service of Ceduna) Elliston Hospital and Mid Eyre Medical Practice – Elliston Eyre and Far North Local Health Network Inc 1 Memorial Drive, Elliston SA 5670   PO Box 178 Ceduna SA 5690 Karoonda Karoonda and District Soldiers' Memorial Hospital & Mallee Medical Practice - Karoonda Riverland Mallee Coorong Local Health Network Inc 13 Stokes Road, Karoonda SA 5307 PO Box 145 Karoonda SA 5307 Kimba (Outreach service of Ceduna) Mid Eyre Medical Practice – Kimba Eyre and Far North Local Health Network Inc 34 Park Terrace, Kimba SA 5641  PO Box 178 Ceduna SA 5690 Lameroo Mallee Medical Practice, Lameroo Riverland Mallee Coorong Local Health Network Inc 1 Vardon Terrace, Lameroo SA 5302 1 Vardon Terrace Lameroo, SA, 5302 Pinnaroo Pinnaroo Soldiers' Memorial Hospital Riverland Mallee Coorong Local Health Network Inc Bundey Terrace, Pinnaroo SA 5304 PO Box 234 Pinnaroo SA 5304 Pinnaroo (Outreach service of Pinnaroo) Mallee Medical Practice, Pinnaroo Riverland Mallee Coorong Local Health Network Inc 1 Gilbert Avenue, Pinnaroo SA 5304 1 Gilbert Avenue, Pinnaroo SA 5304 Wallaroo Wallaroo Hospital and Health Service Yorke and Northern Local Health Network Inc 1 Ernest Terrace, Wallaroo SA 5556 1 Ernest Terrace Wallaroo SA 5556