Legislation Extract

Extract from the Health Insurance (Section 3C General Medical Services – COVID-19 Telehealth and Telephone Attendances) Determination 2020

Dated   28 March 2020

Accessed 31 March 2020

Item Service Fee ($)

Subgroup 11 – general allied health telehealth services

93000 Telehealth attendance by an eligible allied health practitioner if:

(a)   the service is provided to a person who has:

(i)        a chronic condition; and

(ii)       complex care needs being managed by a medical practitioner (including a general practitioner, but not a specialist or consultant physician) under a shared care plan or under both a GP Management Plan and Team Care Arrangements or, if the person is a resident of an aged care facility, the person’s medical practitioner has contributed to a multidisciplinary care plan; and

(b)     the service is recommended in the person’s Team Care Arrangements, multidisciplinary care plan or shared care plan as part of the management of the person’s chronic condition and complex care needs; and

(c)     the person is referred to the eligible allied health practitioner by the medical practitioner using a referral form that has been issued by the Department or a referral form that contains all the components of the form issued by the Department; and

(d)   the service is provided to the person individually; and

(e)     the service is of at least 20 minutes duration; and

(f)     after the service, the eligible allied health practitioner gives a written report to the referring medical practitioner mentioned in paragraph (c):

(i)         if the service is the only service under the referral—in relation to that service; or

(ii)      if the service is the first or last service under the referral—in relation to that service; or

(iii)     if neither subparagraph (i) nor (ii) applies but the service involves matters that the referring medical practitioner would reasonably expect to be informed of —in relation to those matters;

to a maximum of 5 services (including any services to which this item, item 93013 or any item in Part 1 of the Schedule to the Health Insurance (Allied Health Services) Determination 2014 applies) in a calendar year.

63.25

  Subgroup 12 – telephone allied health services

93013 Phone attendance by an eligible allied health practitioner if:

(a)   the service is provided to a person who has:

(i)        a chronic condition; and

(ii)       complex care needs being managed by a medical practitioner (including a general practitioner, but not a specialist or consultant physician) under a shared care plan or under both a GP Management Plan and Team Care Arrangements or, if the person is a resident of an aged care facility, the person’s medical practitioner has contributed to a multidisciplinary care plan; and

(b)     the service is recommended in the person’s Team Care Arrangements, multidisciplinary care plan or shared care plan as part of the management of the person’s chronic condition and complex care needs; and

(c)     the person is referred to the eligible allied health practitioner by the medical practitioner using a referral form that has been issued by the Department or a referral form that contains all the components of the form issued by the Department; and

(d)   the service is provided to the person individually; and

(e)     the service is of at least 20 minutes duration; and

(f)     after the service, the eligible allied health practitioner gives a written report to the referring medical practitioner mentioned in paragraph (c):

(i)         if the service is the only service under the referral—in relation to that service; or

(ii)      if the service is the first or last service under the referral—in relation to that service; or

(iii)     if neither subparagraph (i) nor (ii) applies but the service involves matters that the referring medical practitioner would reasonably expect to be informed of —in relation to those matters;

to a maximum of 5 services (including any services to which this item, item 93000 or any item in Part 1 of the Schedule to the Health Insurance (Allied Health Services) Determination 2014 applies) in a calendar year.

63.25

Legislation Extract

Extract from the Health Insurance (Section 3C General Medical Services – COVID-19 Telehealth and Telephone Attendances) Determination 2020

Dated   28 March 2020

Accessed 31 March 2020

Item Service Fee ($)

Subgroup 11 – general allied health telehealth services

93000 Telehealth attendance by an eligible allied health practitioner if:

(a)   the service is provided to a person who has:

(i)        a chronic condition; and

(ii)       complex care needs being managed by a medical practitioner (including a general practitioner, but not a specialist or consultant physician) under a shared care plan or under both a GP Management Plan and Team Care Arrangements or, if the person is a resident of an aged care facility, the person’s medical practitioner has contributed to a multidisciplinary care plan; and

(b)     the service is recommended in the person’s Team Care Arrangements, multidisciplinary care plan or shared care plan as part of the management of the person’s chronic condition and complex care needs; and

(c)     the person is referred to the eligible allied health practitioner by the medical practitioner using a referral form that has been issued by the Department or a referral form that contains all the components of the form issued by the Department; and

(d)   the service is provided to the person individually; and

(e)     the service is of at least 20 minutes duration; and

(f)     after the service, the eligible allied health practitioner gives a written report to the referring medical practitioner mentioned in paragraph (c):

(i)         if the service is the only service under the referral—in relation to that service; or

(ii)      if the service is the first or last service under the referral—in relation to that service; or

(iii)     if neither subparagraph (i) nor (ii) applies but the service involves matters that the referring medical practitioner would reasonably expect to be informed of —in relation to those matters;

to a maximum of 5 services (including any services to which this item, item 93013 or any item in Part 1 of the Schedule to the Health Insurance (Allied Health Services) Determination 2014 applies) in a calendar year.

63.25

  Subgroup 12 – telephone allied health services

93013 Phone attendance by an eligible allied health practitioner if:

(a)   the service is provided to a person who has:

(i)        a chronic condition; and

(ii)       complex care needs being managed by a medical practitioner (including a general practitioner, but not a specialist or consultant physician) under a shared care plan or under both a GP Management Plan and Team Care Arrangements or, if the person is a resident of an aged care facility, the person’s medical practitioner has contributed to a multidisciplinary care plan; and

(b)     the service is recommended in the person’s Team Care Arrangements, multidisciplinary care plan or shared care plan as part of the management of the person’s chronic condition and complex care needs; and

(c)     the person is referred to the eligible allied health practitioner by the medical practitioner using a referral form that has been issued by the Department or a referral form that contains all the components of the form issued by the Department; and

(d)   the service is provided to the person individually; and

(e)     the service is of at least 20 minutes duration; and

(f)     after the service, the eligible allied health practitioner gives a written report to the referring medical practitioner mentioned in paragraph (c):

(i)         if the service is the only service under the referral—in relation to that service; or

(ii)      if the service is the first or last service under the referral—in relation to that service; or

(iii)     if neither subparagraph (i) nor (ii) applies but the service involves matters that the referring medical practitioner would reasonably expect to be informed of —in relation to those matters;

to a maximum of 5 services (including any services to which this item, item 93000 or any item in Part 1 of the Schedule to the Health Insurance (Allied Health Services) Determination 2014 applies) in a calendar year.

63.25