Health Insurance Midwife and Nurse Practitioner Services Determination 2020
Summary
The Health Insurance (Section 3C Midwife and Nurse Practitioner Services) Determination 2020, issued under the Health Insurance Act 1973, outlines the conditions under which midwife and nurse practitioner services are covered by health insurance in Australia. This determination specifies the treatment of these services, including general requirements and specific provisions for pathology and labour/birth services.
What changed
The Health Insurance (Section 3C Midwife and Nurse Practitioner Services) Determination 2020 establishes the framework for health insurance coverage of services provided by midwives and nurse practitioners in Australia. It details specific conditions, requirements, and the scope of practice for these healthcare professionals when their services are eligible for Medicare benefits. The determination is authorised by the Health Insurance Act 1973 and administered by the Department of Health.
Healthcare providers offering these services must adhere to the outlined requirements to ensure eligibility for reimbursement. Patients seeking these services should be aware of the conditions under which they are covered by health insurance. The determination includes specific provisions for different types of services, such as pathology and labour/birth care, and may involve indexation of associated fees. The latest version of this determination is set to take effect on March 1, 2026.
What to do next
- Review the specific requirements for midwife and nurse practitioner services eligibility for health insurance coverage.
- Ensure all services provided by midwives and nurse practitioners comply with the conditions outlined in the determination, particularly regarding pathology and labour/birth services.
- Stay informed of the upcoming effective date of March 1, 2026, for the latest version of the determination.
Source document (simplified)
- Interactions
Health Insurance (Section 3C Midwife and Nurse Practitioner Services) Determination 2020
In force Administered by
- Department of Health, Disability and Ageing
This item is authorised by the following title:
- Health Insurance Act 1973 Latest version View as made version F2026C00237 C17 01 March 2026
View document Legislative instrument Filter active Table of contents
- Part 1 Preliminary
- 1. Name
- 3. Authority
- 5 Definitions
- 6A. Indexation
- 6B. Meaning of symbol (H)
- Part 2 Midwifery services
- 7. Interpretation
- 8. Treatment of midwifery services
- 10. General requirements
- 12. Labour and birth
- Part 3 Nurse practitioner services
- 13. Treatment of nurse practitioner services - general
- 14. Treatment of nurse practitioner services - pathology
- 15. Scope of practice
- 16. General requirements
- 17. Requirements for pathology items
- 19. Application of items 73826 to 73837
- 20. Limitation of item 73826
- 20A. Requirements for item 73825
- Part 4 Transitional provisions
- 21. Transitional provision for item 82115
- Schedule 1 Midwifery services and fees
- Part 1 Midwifery services and fees
- Schedule 2 Nurse practitioner services and fees
- Part 1 Nurse practitioner pathology services and fees
- Part 2 Nurse practitioner services and fees
- 2.1 Meaning of amount under clause 2.1
- Part 3 Nurse practitioner surgical assistance services and fees
- 3.1 Meaning of amount under clause 3.1
- 3.2 Meaning of amount under clause 3.2
- 3.3 Meaning of amount under clause 3.3
- 4 Items in Subgroup 1 of Group M33—nurse practitioner providing assistance at operations
- Endnotes
- Endnote 1—About the endnotes
- Endnote 2—Abbreviation key
- Endnote 3—Legislation history
- Endnote 4—Amendment history
- Endnote 5—Editorial changes
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