Health Insurance (Section 3C Midwife and Nurse Practitioner Services) Determination 2020

law://au/li/2020/f2020l00732@2026-11-13

Contents

This instrument is the Health Insurance (Section 3C Midwife and Nurse Practitioner Services) Determination 2020.

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.

amount under clause 2.1 has the meaning given by clause 2.1 of Part 2 of Schedule 2.

amount under clause 3.1 has the meaning given by clause 3.1 of Part 3 of Schedule 2.

amount under clause 3.2 has the meaning given by clause 3.2 of Part 3 of Schedule 2.

amount under clause 3.3 has the meaning given by clause 3.3 of Part 3 of Schedule 2.

non-medicare service means a service provided by a nurse practitioner other than a service that is generally accepted in the nursing profession as being necessary for the appropriate treatment of the patient to whom it is rendered.

relevant provisions means all provisions, relating to professional services or medical services, of:

(a) the Act and regulations made under the Act; and

(b) the National Health Act 1953 and regulations made under that Act.

Note The following terms are defined in subsection 3(1) of the Act:

 general medical services table

 participating midwife

 participating nurse practitioner

 pathology services table

(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.

(1) At the start of 1 July 2026 (the indexation time), each amount covered by subsection (2) is replaced by the amount worked out using the following formula:

Note: The indexed fees could in 2026 be viewed on the Department of Health, Disability and Ageing’s MBS Online website (www.mbsonline.gov.au).

(2) The amounts covered by this subsection are the fee for each item in a Schedule of this Determination, other than the fee for the following:

(a) an item in Group P9.

(3) An amount worked out under subsection (1) is to be rounded up or down to the nearest 5 cents (rounding down if the amount is an exact multiple of 2.5 cents).

(1) An item in this instrument including the symbol (H) applies only to a service performed or provided in a hospital.

(1) In this Part:

birth includes episiotomy and repair of tears.

(2) For this Part, a participating midwife is a member of a practice that provides a patient’s antenatal care if the midwife:

(a) participates (whether as a partner, employee or otherwise) in the provision of professional services as part of the practice; or

(b) provides relief services to the practice; or

For subsection 3C(1) of the Act, a midwifery service provided in accordance with this instrument 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) mentioned, for the service, a fee in relation to each State, being the fee mentioned in the item in Schedule 1 for the service.

(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;

(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.

(1) Items 82116, 82118, 82120, 82123, 82125 and 82127 in Part 1 of Schedule 1 apply only to a service provided by a participating midwife during a period of exclusive care of a patient in labour.

(2) Items 82116, 82118, 82120, 82123, 82125 and 82127 in Part 1 of Schedule 1 do not apply if, before labour, the patient’s care is transferred to an obstetrician or medical practitioner who provides obstetric services, for the obstetrician or practitioner to manage the labour and birth.

(3) Items 82118 and 82120 in Part 1 of Schedule 1 applies to a service provided by a participating midwife (the first midwife) who manages a patient’s labour, but does not undertake the birth, only if:

(a) the patient’s care was transferred from the first midwife to another participating midwife in order to manage fatigue experienced by the first midwife; or

(b) there was a clinical need to transfer the patient’s care to an obstetrician or medical practitioner who provides obstetric services.

(4) Items 82123 and 82125 in Part 1 of Schedule 1 applies to services provided by a participating midwife (the second midwife) who manages a patient’s labour, but does not undertake the birth, only if:

(a) the patient’s care was transferred from the second midwife to another participating midwife in order to manage fatigue experienced by the second midwife; or

(b) there was a clinical need to transfer the patient’s care to an obstetrician or medical practitioner who provides obstetric services.

(5) Item 82127 in Part 1 of Schedule 1 applies to services provided by a participating midwife (the third midwife) who manages a patient’s labour, but does not undertake the birth, only if:

(a) the patient’s care was transferred from the third midwife to another participating midwife to manage fatigue experienced by the third midwife; or

(b) there was a clinical need to transfer the patient’s care to an obstetrician or medical practitioner who provides obstetric services.

Subject to section 14, for subsection 3C(1) of the Act, a nurse practitioner service provided in accordance with this instrument 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) mentioned, for the service, a fee in relation to each State, being the fee mentioned in the item in Schedule 2 relating to the service.

For subsection 3C(1) of the Act, a nurse practitioner service described in Part 1 of Schedule 2 provided in accordance with this instrument 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 pathology services table that:

(i) related to the service; and

(ii) mentioned, for the service, a fee in relation to each State, being the fee mentioned in the item in Part 1 of Schedule 2 relating to the service.

Note 1 A participating nurse practitioner performing a service described in items 73828 to 73837 must be the patient’s treating practitioner in order for medicare benefit to be payable — see subsection 16A(7A) of the Act.

(1) For a patient, an item in Schedule 2 applies only if the service mentioned in that item is within the scope of practice of the participating nurse practitioner who provides the service.

(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;

(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.

An item in Part 1 of Schedule 2 applies to a service only if the participating nurse practitioner who renders the service:

(a) is not employed by the proprietor of a hospital that is not a private hospital; or

(b) both:

(i) is employed by the proprietor of a hospital that is not a private hospital; and

(ii) provides the service otherwise than in the course of employment by that proprietor.

Section 7 of the Health Insurance (Prescribed Pathology Services) Determination 2021 shall have effect as if the services specified in items 73826 to 73837 of Schedule 2 Part 1 were also specified in that section.

Item 73826 does not apply to a service provided to a patient who has already been provided, in the last 12 months, 4 other services to which any of the following apply:

(a) item 73826;

(b) item 66551;

(1) Item 73825 applies to a service only if:

(a) the service is rendered at, or from, a practice location in:

(i) a Modified Monash 6 area; or

(ii) a Modified Monash 7 area;

(b) the nurse practitioner providing the service:

(i) is employed by an organisation that:

(A) delivers health services; and

(B) is participating in the First Nations Molecular Point-of-Care (PoC) Testing Program;

(d) the service is conducted by a nurse practitioner who has achieved competency as a PoC operator by the First Nations Molecular PoC Testing Program for the test(s) performed; and

(e) the PoC test(s) gives valid patient result(s).

(1) Between 1 March 2022 and 31 August 2022, item 82115 will apply to a service provided to a patient where the participating midwife has not had at least 2 antenatal attendances with the patient in the 6 months prior to the service provided to the patient.

Group M13 – Midwifery services
Subgroup 1 – MBS items for participating midwives
Column 1Item	Column 2Service	Column 3Fee ($)
82100	Initial antenatal professional attendance by a participating midwife, lasting at least 60 minutes, including all the following:(a) taking a detailed patient history;(b) performing a comprehensive examination;(c) performing a risk assessment;(d) based on the risk assessment — arranging referral or transfer of the patient’s care to an obstetrician;(e) requesting pathology and diagnostic imaging services, when necessary;Payable only once per pregnancy	84.70
82102	Long antenatal professional attendance by a participating midwife, lasting at least 90 minutes	127.00
82103	Complex antenatal professional attendance by a participating midwife leading to a hospital admission and lasting at least 3 hours.A maximum of 3 services per pregnancy.Not being a service associated with a service to which intrapartum items 82116, 82118, 82120, 82123, 82125 or 82127 applies (H)	234.20
82104	Long postnatal professional attendance by a participating midwife, lasting at least 90 minutes, within 6 weeks after birth	186.75
82105	Short antenatal professional attendance by a participating midwife, lasting at least 10 minutes	33.60
82110	Routine antenatal professional attendance by a participating midwife, lasting at least 40 minutes	84.70
82115	Professional attendance by a participating midwife, lasting at least 90 minutes, for assessment and preparation of a maternity care plan for a patient whose pregnancy has progressed beyond 28 weeks, where the participating midwife has had at least 2 antenatal attendances with the patient in the preceding 6 months, if:(a) the patient is not an admitted patient of a hospital; and(b) the participating midwife undertakes a comprehensive assessment of the patient; and(c) the participating midwife develops a written maternity care plan that contains:(i) outcomes of the assessment; and(ii) details of agreed expectations for care during pregnancy, labour and birth; and(iii) details of any health problems or care needs; and(iv) details of any medication taken by the patient during the pregnancy, and any additional medication that may be required by the patient; and(v) details of any referrals or requests for pathology services or diagnostic imaging services for the patient during the pregnancy, and any additional referrals or requests that may be required for the patient; and(d) the maternity care plan is explained and agreed with the patient; and(e) the fee does not include any amount for the management of labour and birth;(Includes any antenatal attendance provided on the same occasion)Payable only once for any pregnancy;This item cannot be claimed if items 16590 or 16591 have previously been claimed during a single pregnancy, except in exceptional circumstances	331.90
82116	Management of labour for up to 6 hours, not including birth, at a place other than a hospital if:(a) the attendance is by the participating midwife who:(i) provided the patient's antenatal care or(ii) is a member of a practice that has provided the patient's antenatal care; and(b) the total attendance time is documented in the patient notes;This item does not apply if birth is performed during the attendance;Only claimable once per pregnancy	783.85
82118	Management of labour for up to 6 hours total attendance, including birth where performed if:(a) the patient is an admitted patient of a hospital; and(b) the attendance is by the first participating midwife who:(i) assisted or provided the patient's antenatal care; or(ii) is a member of a practice that has provided the patient's antenatal care; and(c) the total attendance time is documented in the patient notes.(Includes all hospital attendances related to the labour by the first participating midwife)Only claimable once per pregnancy;Not being a service associated with a service to which item 82120 applies (H)	783.85
82120	Management of labour between 6 and 12 hours total attendance, including birth where performed, if:(a) the patient is an admitted patient of a hospital; and(b) the attendance is by the first participating midwife who:(i) assisted or provided the patient’s antenatal care; or(ii) is a member of a practice that provided the patient’s antenatal care; and(c) the total attendance time is documented in the patient notes;(Includes all hospital attendances related to the labour by the first participating midwife)Only claimable once per pregnancy;Not being a service associated with a service to which item 82118 applies (H)	1,567.70
82123	Management of labour for up to 6 hours total attendance, including birth where performed if:(a) the patient is an admitted patient of a hospital; and(b) the attendance is by the second participating midwife who either:(i) assisted or provided the patient's antenatal care; or(ii) is a member of a practice that has provided the patient's antenatal care; and(c) the total attendance time is documented in the patient notes;(Includes all hospital attendances related to the labour by the second participating midwife)Only claimable once per pregnancy;Not being a service associated with a service to which item 82125 applies (H)	783.85
82125	Management of labour between 6 and 12 hours total attendance, including birth where performed, if:(a) the patient is an admitted patient of a hospital; and(b) the attendance is by the second participating midwife who either:(i) assisted or provided the patient’s antenatal care; or(ii) is a member of a practice that provided the patient’s antenatal care; and(c) the total attendance time is documented in the patient notes;(Includes all hospital attendances related to the labour by the second participating midwife)Only claimable once per pregnancy;Not being a service associated with a service to which item 82123 or 82127 applies (H)	1,567.70
82127	Management of labour for up to 6 hours total attendance, including birth where performed if:(a) the patient is an admitted patient of a hospital; and(b) the attendance is by a third participating midwife who either:(i) assisted or provided the patient's antenatal care; or(ii) is a member of a practice that has provided the patient's antenatal care; and(c) an attendance to which item 82123 applies has been provided by a second participating midwife who is a member of a practice that has provided the patient's antenatal care; and(d) the total attendance time is documented in the patient notes;(Includes all hospital attendances related to the labour by the third participating midwife)Only claimable once per pregnancy;Not being a service associated with a service to which item 82125 applies (H)	783.85
82130	Short postnatal professional attendance by a participating midwife, lasting at least 20 minutes, within 6 weeks after birth	55.55
82135	Routine postnatal professional attendance by a participating midwife, lasting at least 40 minutes, within 6 weeks after birth	124.50
82140	Postnatal professional attendance by a participating midwife on a patient, not less than 4 weeks but not more than 8 weeks after birth of a baby, lasting at least 60 minutes, including all of the following:(a) a comprehensive examination of the patient and baby to ensure normal postnatal recovery;(b) a labour and birth debrief;(c) a mental health assessment or where the patient declines a mental health assessment, the participating midwife records the patient’s decision in the clinical notes;(d) referral of the patient to a primary carer for the ongoing care of the patient and baby or where the patient declines a referral to a primary carer, the participating midwife records the patient’s decision in the clinical notesPayable only once per pregnancy	55.55

Group P9 – Simple basic pathology tests
Column 1Item	Column 2Service	Column 3Fee ($)
73825	Detection performed by a participating nurse practitioner of:(a) chlamydia trachomatis (CT) and neisseria gonorrhoeae (NG) via molecular point-of-care testing for the diagnosis of CT or NG infection; and(b) trichomonas vaginalis (TV) via molecular point-of-care testing for the diagnosis of TV infection	117.65
73826	Quantitation of glycated haemoglobin (HbA1c) performed by a participating nurse practitioner in the management of established diabetes when performed:(a) as a point-of-care test;(b) by a nurse practitioner who works in a general practice that is accredited to the Royal Australian College of General Practitioners Standards for point-of-care testing under the National General Practice Accreditation Scheme; and(c) using a method and instrument certified by the National Glycohemoglobin Standardization Program (NGSP), if the instrument has a total coefficient variation less than 3.0% at 48 mmol/mol (6.5%)Applicable not more than 3 times per 12 months per patient	11.80
73828	Semen examination for presence of spermatozoa by a participating nurse practitioner	6.90
73829	Leucocyte count, erythrocyte sedimentation rate, examination of blood film (including differential leucocyte count), haemoglobin, haematocrit or erythrocyte count by a participating nurse practitioner - 1 test	4.55
73830	2 tests described in item 73829 by a participating nurse practitioner	6.35
73831	3 or more tests described in item 73829 by a participating nurse practitioner	8.15
73832	Microscopy of urine, excluding dipstick testing, by a participating nurse practitioner	4.55
73833	Pregnancy test by 1 or more immunochemical methods by a participating nurse practitioner	10.15
73834	Microscopy for wet film other than urine, including any relevant stain by a participating nurse practitioner	6.90
73835	Microscopy of Gram-stained film, including (if performed) a service described in item 73832 or 73834 by a participating nurse practitioner	8.65
73836	Chemical tests for occult blood in faeces by reagent stick, strip, tablet or similar method by a participating nurse practitioner	2.35
73837	Microscopy for fungi in skin, hair or nails by a participating nurse practitioner – 1 or more sites	6.90

2.1 Meaning of amount under clause 2.1 #

In item 82206:

amount under clause 2.1 means 50% of the fee that would normally apply for item 82201 or 82202 if a service mentioned in the same item had not been discontinued before completion.

Group M14 – Nurse practitioners
Column 1Item	Column 2Service	Column 3Fee ($)
Subgroup 1 – Nurse practitioners
82200	Professional attendance by a participating nurse practitioner for an obvious problem characterised by the straightforward nature of the task that requires a short patient history and, if required, limited examination and management	14.20
82205	Professional attendance by a participating nurse practitioner lasting at least 6 minutes and less than 20 minutes and including any of the following:(a) taking a history;(b) undertaking clinical examination;(c) arranging any necessary investigation;(d) implementing a management plan;(e) providing appropriate preventive health care;for 1 or more health related issues, with appropriate documentation	31.05
82210	Professional attendance by a participating nurse practitioner lasting at least 20 minutes and including any of the following:(a) taking a detailed history;(b) undertaking clinical examination;(c) arranging any necessary investigation;(d) implementing a management plan;(e) providing appropriate preventive health care;for 1 or more health related issues, with appropriate documentation	58.85
82215	Professional attendance by a participating nurse practitioner lasting at least 40 minutes and including any of the following:(a) taking an extensive history;(b) undertaking clinical examination;(c) arranging any necessary investigation;(d) implementing a management plan;(e) providing appropriate preventive health care;for 1 or more health related issues, with appropriate documentation	86.80
82216	Professional attendance by a participating nurse practitioner lasting at least 60 minutes and including any of the following:(a) taking an extensive patient history;(b) performing a clinical examination;(c) arranging any necessary investigation;(d) implementing a management plan;(e) providing appropriate preventive health care;for one or more health related issues, with appropriate documentation	131.20
82226	Burns, involving 1% or more but less than 3% of total body surface, dressing of (including redressing of any related donor site, if required), without anaesthesia, by a participating nurse practitioner—each attendance at which the procedure is performedNot applicable for skin reactions secondary to radiotherapy	40.00
82227	Burns, involving 3% or more but less than 10% of total body surface, dressing of (including redressing of any related donor site, if required), without anaesthesia, by a participating nurse practitioner—each attendance at which the procedure is performedNot applicable for skin reactions secondary to radiotherapy	51.15
82228	Nipple or areola or both, intradermal colouration of, by a participating nurse practitioner, following breast reconstruction after mastectomy or for congenital absence of nipple	217.80
Subgroup 4 – Nurse practitioner procedures
82201	Introduction of an intra-uterine device for abnormal uterine bleeding or contraception or for endometrial protection during oestrogen replacement therapy(Anaes.)	215.95
82202	Removal of etonogestrel subcutaneous implant(Anaes.)	105.15
82203	Hormone or living tissue implantation by cannula	100.40
82204	A service rendered by a participating nurse practitioner to which item 82201, 82202 or 82203 applies, if the service is bulk-billed in relation to the fees for:(a) that item; and(b) any other item in Subgroup 1 of Group M14 or item 73832 and 73833 applying to the service	40% of the fee for the relevant item referred to in paragraph (a) of column 2
82206	A procedure, being a service to which an item in Subgroup 4 of Group M14 would have applied had the procedure not been discontinued on clinical grounds, other than a service to which 82203 applies	Amount under clause 2.1
Subgroup 5—Participating nurse practitioner patient end support for video conferencing consultations with specialists or consultant physicians
82250	Professional attendance by a participating nurse practitioner, at consulting rooms, lasting at least 6 minutes but less than 20 minutes, if:(a) the attendance is to provide clinical support to a patient to whom a specialist or consultant physician is providing a service, to which another item applies, by way of a video conferencing consultation; and(b) the patient is not an admitted patient; and(c) the participating nurse practitioner is located in the same room as the patient for the whole of the attendance	51.80
82251	Professional attendance by a participating nurse practitioner, at a place other than consulting rooms, lasting at least 6 minutes but less than 20 minutes, if:(a) the attendance is to provide clinical support to a patient to whom a specialist or consultant physician is providing a service, to which another item applies, by way of a video conferencing consultation; and(b) the patient is not an admitted patient; and(c) the participating nurse practitioner is located in the same room as the patient for the whole of the attendance	51.80
82252	Professional attendance by a participating nurse practitioner, at consulting rooms, lasting at least 20 minutes but less than 40 minutes, if:(a) the attendance is to provide clinical support to a patient to whom a specialist or consultant physician is providing a service, to which another item applies, by way of a video conferencing consultation; and(b) the patient is not an admitted patient; and(c) the participating nurse practitioner is located in the same room as the patient for the whole of the attendance	80.25
82253	Professional attendance by a participating nurse practitioner, at a place other than consulting rooms, lasting at least 20 minutes but less than 40 minutes, if:(a) the attendance is to provide clinical support to a patient to whom a specialist or consultant physician is providing a service, to which another item applies, by way of a video conferencing consultation; and(b) the patient is not an admitted patient; and(c) the participating nurse practitioner is located in the same room as the patient for the whole of the attendance	80.25
82254	Professional attendance by a participating nurse practitioner, at consulting rooms, lasting at least 40 minutes but less than 60 minutes, if:(a) the attendance is to provide clinical support to a patient to whom a specialist or consultant physician is providing a service, to which another item applies, by way of a video conferencing consultation; and(b) the patient is not an admitted patient; and(c) the participating nurse practitioner is located in the same room as the patient for the whole of the attendance	108.90
82255	Professional attendance by a participating nurse practitioner, at a place other than consulting rooms, lasting at least 40 minutes but less than 60 minutes, if:(a) the attendance is to provide clinical support to a patient to whom a specialist or consultant physician is providing a service, to which another item applies, by way of a video conferencing consultation; and(b) the patient is not an admitted patient; and(c) the participating nurse practitioner is located in the same room as the patient for the whole of the attendance	108.90
82256	Professional attendance by a participating nurse practitioner, at consulting rooms, lasting at least 60 minutes, if:(a) the attendance is to provide clinical support to a patient to whom a specialist or consultant physician is providing a service, to which another item applies, by way of a video conferencing consultation; and(b) the patient is not an admitted patient; and(c) the participating nurse practitioner is located in the same room as the patient for the whole of the attendance	154.35
82257	Professional attendance by a participating nurse practitioner, at a place other than consulting rooms, lasting at least 60 minutes, if:(a) the attendance is to provide clinical support to a patient to whom a specialist or consultant physician is providing a service, to which another item applies, by way of a video conferencing consultation; and(b) the patient is not an admitted patient; and(c) the participating nurse practitioner is located in the same room as the patient for the whole of the attendance	154.35

3.1Meaning of amount under clause 3.1#

In item 93719:

amount under clause 3.1, for assistance at an operation or series or combination of operations, means 20% of the sum of the fees payable under the Act for the services provided at that operation, or series of operations, by the practitioner to whom the assistance was given.

3.2Meaning of amount under clause 3.2#

In item 93721:

amount under clause 3.2, for assistance at a series or combination of operations, means:

(a)20% of the sum of the fees payable under the Act for the services provided at those operations by the practitioner to whom the assistance was given; or

(b)for the caesarean section component of the operations—the fee mentioned in item 16520.

3.3Meaning of amount under clause 3.3#

In item 93722:

amount under clause 3.3, for assistance at a procedure, means 20% of the sum of the fees payable under the Act for the services provided at that procedure or combination of procedures by the practitioner to whom the assistance was given.

4Items in Subgroup 1 of Group M33—nurse practitioner providing assistance at operations#

This clause sets out items in Subgroup 1 of Group M33.

Group M33 – Non-medical assistance at operations
Subgroup 1 – Assistance at operations provided by a nurse practitioner
Column 1Item	Column 2Service	Column 3Fee ($)
93718	Assistance by a participating nurse practitioner at any operation mentioned in an item in Group T8 that includes “(Assist.)” for which the fee does not exceed $668.25 or at a series or combination of operations mentioned in an item in Group T8 that include “(Assist.)” for which the aggregate fee does not exceed $668.25	100.65
93719	Assistance by a participating nurse practitioner at any operation mentioned in an item in Group T8 that includes “(Assist.)” for which the fee exceeds $668.25 or at a series or combination of operations mentioned in an item in Group T8 that include “(Assist.)” for which the aggregate fee exceeds $668.25	Amount under clause 3.1
93720	Assistance by a participating nurse practitioner at a birth involving Caesarean section (H)	145.45
93721	Assistance by a participating nurse practitioner at a series or combination of operations that include “(Assist.)” and assistance by a participating nurse practitioner at a birth involving Caesarean section (H)	Amount under clause 3.2
93722	Assistance by a participating nurse practitioner at any interventional obstetric procedure covered by items 16606, 16609, 16612, 16615 and 16627 (H)	Amount under clause 3.3
93723	Assistance by a participating nurse practitioner at cataract and intraocular lens surgery covered by item 42698, 42701, 42702, 42704, 42705 or 42707, when performed in association with services covered by item 42551 to 42569, 42653, 42656, 42725, 42746, 42749, 42752, 42776 or 42779 (H)	317.80
93724	Assistance at cataract and intraocular lens surgery by a participating nurse practitioner, if patient has:(a) total loss of vision, including no potential for central vision, in the fellow eye; or(b) one of the following in the fellow eye:(i) vitreous loss;(ii) rupture of posterior capsule;(iii) loss of nuclear material into the vitreous;(iv) intraocular haemorrhage;(v) intraocular infection (endophthalmitis);(vi) cystoid macular oedema;(vii) corneal decompensation;(viii) retinal detachment; or(c) pseudo exfoliation, subluxed lens, iridodonesis, phacodonesis, retinal detachment, corneal scarring, pre-existing uveitis, bound down miosed pupil, nanophthalmos, spherophakia, Marfan’s syndrome, homocysteinuria or previous blunt trauma causing intraocular damage(H)	209.75

Sourced from the Federal Register of Legislation at legislation.gov.au, © Commonwealth of Australia, licensed under CC BY 4.0. Compilations may have been reformatted.

Health Insurance (Section 3C Midwife and Nurse Practitioner Services) Determination 2020

Health Insurance (Section 3C Midwife and Nurse Practitioner Services) Determination 2020

2.1 Meaning of amount under clause 2.1 #

3.1Meaning of amount under clause 3.1#

3.2Meaning of amount under clause 3.2#

3.3Meaning of amount under clause 3.3#

4Items in Subgroup 1 of Group M33—nurse practitioner providing assistance at operations#

Connections

Defined terms · 1

History · 1 version

Key facts

2.1 Meaning of amount under clause 2.1 #

3.1Meaning of amount under clause 3.1#

3.2Meaning of amount under clause 3.2#

3.3Meaning of amount under clause 3.3#

4Items in Subgroup 1 of Group M33—nurse practitioner providing assistance at operations#

2.1 Meaning of amount under clause 2.1#

3.1Meaning of amount under clause 3.1#

3.2Meaning of amount under clause 3.2#

3.3Meaning of amount under clause 3.3#

4Items in Subgroup 1 of Group M33—nurse practitioner providing assistance at operations#

Connections

Defined terms · 1

History · 1 version

Key facts

2.1 Meaning of amount under clause 2.1#

3.1Meaning of amount under clause 3.1#

3.2Meaning of amount under clause 3.2#

3.3Meaning of amount under clause 3.3#

4Items in Subgroup 1 of Group M33—nurse practitioner providing assistance at operations#

2.1 Meaning of amount under clause 2.1 #

2.1 Meaning of amount under clause 2.1 #