All states and the Northern Territory (NT) that have signed a Memorandum of Understanding with the Australian Government for the COAG Section 19(2) Exemptions Initiative (the Initiative) may bulk-bill the Medicare Benefits Schedule (MBS) for people provided with eligible services at an approved eligible rural and remote location. The Australian Capital Territory does not qualify for the Initiative as it does not include any rural or remote regions.
Page last updated: 26 July 2022
The former COAG introduced the Initiative in conjunction with the Better Health for All Australians Action Plan under the 2006–2007 Federal Budget to improve access to primary care for people living in rural and remote areas of Australia.
Unless an exemption applies, states and territories are not permitted to bill Medicare for services delivered in public hospitals as the Australian Government already provides funding through its national public hospitals funding.
The Initiative aims to improve access to primary health care services in rural and remote communities, including after hours, in public hospital and other health service settings. It does this by granting states and the NT conditional access to Australian Government funding through the MBS to assist with the challenges in attracting and retaining an adequate primary health care workforce in these communities. A state or the NT may put forward a health facility (site) for eligibility consideration by the Australian Government. Approved eligible sites may bulk-bill the MBS for the following services provided in emergency departments and outpatient clinics:
- professional non-admitted, non-referred services provided by state remunerated medical practitioners, participating midwives and participating nurse practitioners
- professional non-admitted, referred services provided by state remunerated allied health and dental health professionals.
At least 70 per cent of the funding received under the Initiative must be invested in new services and improvements at approved eligible sites or outreach services. This includes the purchasing of new equipment.
Eligibility Criteria
States and the NT participate under the Initiative through a bilateral Memorandum of Understanding (MoU) with the Australian Government.
Under the MoU 2022–25 eligibility criteria, sites must be located in areas classified as:
- Modified Monash (MM) 5 (small rural towns) or
- MM 6 (remote communities) or
- MM 7 (very remote communities)
under the Modified Monash Model classification system (MMM).
The MMM was introduced in 2015 to better target health workforce programs, in recognition of the challenges in attracting health professionals to regional, rural and remote parts of Australia. The MMM is a geographical classification system that was developed by rural academics at Monash University and modified following consultation with key Health stakeholders.
The MMM categorises metropolitan, regional, rural and remote areas according to both geographical remoteness, as defined by the Australian Bureau of Statistics (ABS) and town size.
The ABS conducts the national Census every five years, after which the MMM is then reviewed and updated, where required.
The methodology supporting the MMM may be updated from time to time at the discretion of the Australian Government. If an eligible site becomes ineligible under the Initiative due to changes in MMM classification of the site, it will continue to be treated as an eligible site for the term of the MoU. This allows the site time to source alternative funding.
Transparency is an important objective under the Initiative and for this reason, states, the NT and sites must consult with and seek local support from primary health care providers and other relevant stakeholders.
Other requirements under the Initiative include submitting a site operational plan to the Australian Government, the state and NT committing to providing site annual reports, an annual review of site operational plans and providing financial year summary statistics.
Approved eligible sites
Directions are notifiable instruments made by the Minister for Health and Aged Care under subsection19(2) of the Health Insurance Act 1973 (the HI Act). These directions list the sites that have been approved as eligible to participate under the Initiative.
The following hospitals and health services in New South Wales, NT, Queensland, South Australia and Western Australia have been assessed and approved as eligible sites under the Initiative.
There is currently a total of 122 approved sites that participate under the Initiative. Note, Tasmania and Victoria do not have any active sites and the Australian Capital Territory is not eligible to participate under the eligibility criteria of the Initiative.
Some approved eligible sites have outreach services that operate out of the eligible site. These are listed under the approved eligible site that provides those services however are not included in the count of the eligible sites approved under the Initiative. This is the case for Queensland and Western Australia.
New South Wales | ||||
Location | Practice Name | Street Address | Mailing Address | |
1 | Balranald | Balranald Multi Purpose Service | 41-43 Court Street | 41-43 Court Street |
2 | Barham | Barham Multi-Purpose Service | 80 Punt Road | 80 Punt Road |
3 | Batlow | Batlow-Adelong Multi-Purpose Service | 61-81 Pioneer Street | 61-81 Pioneer Street |
4 | Berrigan | Berrigan Health Service | 47-49 Davis Street | 47-49 Davis Street |
5 | Bingara | Bingara Multipurpose Service | Copeton Dam Road | Copeton Dam Road |
6 | Blayney | Blayney Health Service | 3 Osman Street | 3 Osman Street |
7 | Boorowa | Boorowa Multipurpose Service | 62-80 Dry Street | 62-80 Dry Street |
8 | Coolamon | Coolamon-Ganmain Multipurpose Service | 1 Doctor Buchanan Drive | 1 Doctor Buchanan Drive |
9 | Culcairn | Culcairn Multipurpose Service | 51-55 Balfour Street | 51-55 Balfour Street |
10 | Dareton | Dareton Primary and Community Health Centre | 42-44 Tapio Avenue | 42-44 Tapio Avenue |
11 | Dungog | Dungog Community Hospital | 22 Hospital Road | 22 Hospital Road |
12 | Finley | Finley Health Service | 24 Dawe Avenue | 24 Dawe Avenue |
13 | Gloucester | Gloucester Soldiers Memorial Hospital & Gloucester Community Health Centre | Church Street | Church Street |
14 | Gundagai | Gundagai Health (Multipurpose) Service | 50 Tor Street | 50 Tor Street |
15 | Guyra | Guyra Multipurpose Service | 44-48 Sole Street | 44-48 Sole Street |
16 | Harden | Murrumburrah-Harden Hospital and Health Service | 53 Scott Street | 53 Scott Street |
17 | Hay | Hay District Hospital | 351 Murray St | 351 Murray St |
18 | Henty | Henty Multipurpose Service | 7 Keighran Street | 7 Keighran Street |
19 | Hillston | Hillston Hospital and Health Service | 48C Burns Street | 48C Burns Street |
20 | Holbrook | Holbrook Hospital | 30 Bowler Street | 30 Bowler Street |
21 | Jerilderie | Jerilderie Hospital and Health Service | 33-39 Southey Street | PO Box 116 |
22 | Junee | Junee Multi-Purpose Service | 67 Broadway Street | 67 Broadway Street |
23 | Kyogle | Kyogle Multipurpose Service | Summerland Way | Summerland Way |
24 | Lake Cargelligo | Lake Cargelligo Hospital and Health Service | 34 Uabba Street | 34 Uabba Street |
25 | Lockhart | Lockhart Hospital and Health Service | 53-55 Hebden Street | 53-55 Hebden Street |
26 | Manilla | Manilla Multipurpose Service | Court Street | Court Street |
27 | Merriwa | Merriwa Multipurpose Service | Mackenzie Street | Mackenzie Street |
28 | Murrurundi | Wilson Memorial Community Hospital Murrurundi & Murrurundi Community Health Centre | Corner Paradise and O'Connell Streets | PO Box 8 |
29 | Narrandera | Narrandera Health Service | 54 Adams Street | 54 Adams Street |
30 | Nimbin | Nimbin Multipurpose Service | 35 Cullen Street | 35 Cullen Street |
31 | Nyngan | Nyngan Hospital and Community Health Service | Hoskins Street | PO Box 96 |
32 | Oberon | Oberon Health Service | North St | North Street |
33 | Quirindi | Quirindi Health Service | 50 Nowland Street | 50 Nowland Street |
34 | Rylstone | Rylstone Multi-Purpose Service | Fitzgerald Street | Fitzgerald Street |
35 | Temora | Temora Health Service | 169-189 Loftus Street | 169-189 Loftus Street |
36 | Tocumwal | Tocumwal Health Service | 6-12 Adams Street | 6-12 Adams Street |
37 | Tottenham | Tottenham Multi-Purpose Service | 10 Moondana Street | 10 Moondana Street |
38 | Trangie | Trangie Multi-Purpose Service | 28 Harris Street | 28 Harris Street |
39 | Trundle | Trundle Multi-Purpose Service | 44 Brookview Street | 44 Brookview Street |
40 | Tullamore | Tullamore Multi-Purpose Service | Kitchener Street | Kitchener Street |
41 | Tumbarumba | Tumbarumba Multipurpose Service | 4 Mitchell Street | 4 Mitchell Street |
42 | Urana | Urana Health Multipurpose Service | 127-129 Princess Street | 127-129 Princess Street |
43 | Urbenville | Urbenville Multipurpose Service | 45 Beaury Street | 45 Beaury Street |
44 | Warialda | Warialda Multi-Purpose Service | Long Street | Long Street |
45 | Wee Waa | Wee Waa Community Hospital & Wee Waa Community Health Centre | 60 Alma Street | PO Box 417 |
46 | Wentworth | Wentworth Health Services | Silver City Highway | Silver City Highway |
47 | West Wyalong | West Wyalong Hospital | 70 Ungarie Road | 70 Ungarie Road |
Northern Territory | ||||
Location | Practice Name | Street Address | Mailing Address | |
1 | Adelaide River | Adelaide River Health Centre | 21 Becker Street | C/- Adelaide River PO |
2 | Batchelor | Batchelor Health Clinic | 27 Pinaroo Crescent Batchelor NT 0845 | C/- Batchelor Post Office |
3 | Jabiru | Jabiru Community Health Centre | Lot 2021 | PO Box 221 |
4 | Katherine | Katherine Hospital | Gorge Road | PMB 73 |
5 | Nhulunbuy | Gove District Hospital | Matthew Flinders Way Nhulunbuy NT 0880 | PO Box 421 |
6 | Tennant Creek | Tennant Creek Hospital | 45 Schmidt Street | PO Box 346 |
7 | Yulara | Yulara Community Health Centre | 233 Yulara Drive | 233 Yulara Drive |
Queensland | ||||
Location | Practice Name | Street Address | Mailing Address | |
1 | Babinda | Babinda Hospital Multi-Purpose Health Service | 128 Munro Street | PO Box 160 |
Barcaldine provides outreach services to Alpha, Aramac, Jericho and Muttaburra | ||||
2 | Barcaldine | Barcaldine Hospital Multi-Purpose Health Service | 25 Oak Street | 25 Oak Street |
Alpha | Alpha Hospital and Multipurpose Health Service | 1 Burns Street | 1 Burns Street | |
Aramac | Aramac Primary Health Clinic | 2 Lodge Street | 2 Lodge Street | |
Jericho | Jericho Health Clinic | 19 Pasteur Street | 19 Pasteur Street | |
Muttaburra | Muttaburra Primary Health Care Centre | Edkins Street | Edkins Street | |
3 | Biggenden | Biggenden MPHS | 57 Alice Street | 57 Alice St |
4 | Blackall | Blackall Hospital | Hospital Road | PO BOX 131 |
5 | Blackwater | Blackwater Hospital Multi-Purpose Health Service | 41 McKenzie Street | PO Box 47 |
6 | Boulia | Boulia Primary Health Centre | 49 Wills Street | 49 Wills Street |
7 | Capella | Capella Outpatients Clinic | 5 Slider Street | 5 Slider Street |
8 | Cardwell | Cardwell Community Health Centre | Victoria Street | PO Box 391 |
9 | Childers | Childers Hospital Multi-Purpose Health Service | 44 Broadhurst Street Childers QLD 4660 | PO Box 62 |
10 | Chillagoe | Chillagoe Primary Health Centre | 21 Hospital Avenue Chillagoe QLD 4871 | PO Box 4 |
11 | Collinsville | Collinsville Hospital | 81-91 Garrick Street | PO Box 56 |
12 | Dimbulah | Dimbulah Primary Health Centre | 1-5 Stephen Street Dimbulah QLD 4872 | PO Box 148 |
13 | Dirranbandi | Dirranbandi Multipurpose Health Service | Corner of Jane and Crothers Streets | PO Box 20 |
14 | Eidsvold | Eidsvold Multi-Purpose Health Service | Cracow Rd | PO Box 40 |
15 | Gayndah | Gayndah Hospital | 69 Warton Street | PO Box 41 |
16 | Gin Gin | Gin Gin Hospital | 5 King Street | PO Box 14 |
17 | Hughenden | Hughenden Health Centre | Richmond Hill Drive | PO Box 228 |
18 | Inglewood | Inglewood Multi-Purpose Health Service | Cunningham Highway | PO Box 42 |
19 | Injune | Injune Multi-Purpose Health Service | Fifth Avenue | PO Box 35 |
20 | Isisford | Isisford Primary Health Centre | St Helena Street | St Helena Street |
21 | Jandowae | Jandowae Health Services | Jandowae Hospital | PO Box 75 |
22 | Jundah | Jundah Primary Health Centre | 1 Hospital Road | 1 Hospital Road |
23 | Longreach | Longreach Hospital | Corner Jabiru and Plover Streets | Corner Jabiru and Plover Streets |
24 | Miles | Miles Hospital Health Service | 5-11 Colamba Street | PO Box 187 |
Millmerran provides outreach services to Cecil Plains | ||||
25 | Millmerran | Millmerran Multi-Purpose Health Service | 50 Commens Street | 50 Commens Street |
Cecil Plains | Millmerran Multi-Purpose Health Service - Outreach Primary Clinic (Cecil Plains) | Co located at Anglicare | Co located at Anglicare | |
26 | Mitchell | Mitchell Hospital | 95 Ann Street | 95 Ann Street |
27 | Monto | Monto Health Service | Flinders Street | PO Box 220 |
Mossman provides outreach services to Cow Bay | ||||
28 | Mossman | Mossman Multi-Purpose Health Service | 9 Hospital Street | 9 Hospital Street |
Cow Bay | Cow Bay Primary Health Centre | 69 Tea Tree Road | PMB 3 | |
29 | Moura | Moura Multi-Purpose Health Service | 14 Nott Street | 14 Nott Street |
30 | Mundubbera | Mundubbera Health Service | 96 Leichardt Street | PO Box 35 |
31 | Mungindi | Mungindi Multi-Purpose Health Service | 90 Barwon St | 90 Barwon St |
32 | Murgon | Murgon Health Service | Coronation Drive | Coronation Drive |
33 | Nanango | Nanango Health Service | 135 Brisbane Street | PO Box 60 |
34 | Oakey | Oakey Health Services – Oakey Hospital | Cnr Beale and Fitzpatrick Streets | Cnr Beale and Fitzpatrick Streets |
35 | Proserpine | Proserpine Hospital and Community Health Centre | 26-32 Taylor Street | PO Box 229 |
36 | Quilpie | Quilpie Multi-Purpose Health Service | 30 Gyrica Street | PO Box 27 |
37 | Richmond | Richmond Health Service | Gallagher Drive | PO Box 24 |
38 | Sapphire | Gemfields Outpatient Clinic | 984 Rubyvale Road | PO Box 342 |
39 | Springsure | Springsure Multi-Purpose Health Service | 21 Woodbine Street | PO Box 14 |
40 | Surat | Surat Hospital Multi-Purpose Health Service | 2 Ivan St | PO Box 2, |
41 | Tambo | Tambo Primary Health Care Centre | Garden Street | Garden Street |
42 | Tara | Tara Hospital | 15 Bilton Street | 15 Bilton Street |
43 | Taroom | Taroom Hospital | 14 Miller Street | PO Box 358 |
44 | Texas | Texas Multi Purpose Health Service | Mingoola Road | PO Box 91 |
45 | Tully | Tully Hospital | 17 Bryant Street | PO Box 489 |
46 | Wallumbilla | Wallumbilla Community Health Care Clinic | Stakeyard Road | PO Box 21 |
47 | Windorah | Windorah Primary Healthcare Centre | 15 Victoria Street | 15 Victoria Street |
48 | Winton | Winton Hospital and Multi-Purpose Health Service | Oondooroo Street | Oondooroo Street |
South Australia | |||||
Location | Practice Name | Street Address | Mailing Address | ||
1 | Ceduna | Ceduna District Health Service | 3 Eyre Highway | 3 Eyre Highway | |
2 | Lameroo | Riverland Mallee Coorong Local Health Network – Mallee Medical Practice | 1 Vardon Terrace | 1 Vardon Terrace | |
3 | Wallaroo | Northern Yorke Peninsula Health Service – Wallaroo | 1 Ernest Terrace | 1 Ernest Terrace |
Western Australia | ||||
Location | Practice Name | Street Address | Mailing Address | |
1 | Bridgetown | Bridgetown Hospital | 28 Peninsula Road | PO Box 136 |
Carnarvon provides outreach services to Burringurrah, Coral Bay, Denham, Gascoyne Junction and Useless Loop | ||||
2 | Carnarvon | Carnarvon Hospital | Cleaver Street | PO Box 417 |
Burringurrah | Burringurrah Nursing Post | Sixth Street | C/- PO Box 417 | |
Coral Bay | Coral Bay Nursing Post | 67 Robinson Street | 67 Robinson Street | |
Denham | Shark Bay Silver Chain Health Centre | 53 Hughes Street | 53 Hughes Street | |
Gascoyne Junction | Gascoyne Junction Outreach Clinic | C/- Community Resource Centre | C/- PO Box 417 | |
Useless Loop | Useless Loop Medical Centre | 1 Wilson Rise | 1 Wilson Rise | |
Derby provides outreach services to Lombadina, Looma and One Arm Point | ||||
3 | Derby | Derby Hospital | 67-71 Clarendon Street | PMB 938 |
Lombadina | Lombadina Health Centre | Lot 404 Lombadina Road | PMB 6 | |
Looma | Looma Clinic | 19H Ngaliwanya Street | PMB 903 | |
One Arm Point | One Arm Point Health Centre | One Arm Point Community | PMB 13 | |
4 | Exmouth | Exmouth Health Service | Lot 1448 Lyon Street Exmouth WA 6707 | Lot 1448 Lyon Street |
Fitzroy Crossing provides outreach services to Bayulu, Nookanbah and Wangkatjungka | ||||
5 | Fitzroy Crossing | Fitzroy Crossing Health Service | 82 Fallon Road | PO Box 5 |
Bayulu | Bayulu Clinic | Lot 10 Lamey Ave | PO Box 27 | |
Nookanbah | Nookanbah Clinic | Nookanbah Community | PO Box 14 | |
Wangkatjungka | Wangkatjungka Clinic | Wangkatjungka Clinic | PO Box 288 | |
Halls Creek provides outreach services to Yiyili | ||||
6 | Halls Creek | Halls Creek Hospital | 70 Roberta Ave | 70 Roberta Ave |
Yiyili | Yiyili Clinic | Lot 1 Louisa Downs Rd | PMB 12 | |
Katanning provides outreach services to Gnowangerup, Kojonup and Tambellup | ||||
7 | Katanning | Katanning Health Service | 11-31 Kobeelya Avenue | Katanning Hospital Site |
Gnowangerup | Gnowangerup Hospital | 3493 Broomehill-Gnowangerup Road Gnowangerup WA 6335 | 3493 Broomehill-Gnowangerup Road | |
Kojonup | Kojonup Hospital | 36-50 Spring Street | 36-50 Spring Street | |
Tambellup | Tambellup Health Centre | 30 Norrish Street | 30 Norrish Street | |
Kununurra provides outreach services to Kalumburu and Warmun | ||||
8 | Kununurra | Kununurra District Hospital | 96 Coolibah Drive | PO Box 239 |
Kalumburu | Kalumburu Health Clinic | 138 Kalumburu Bvd | PMB 12 | |
Warmun | Warmun Health Clinic | Ord Street | Ord Street | |
9 | Laverton | Laverton District Hospital | 2 Beria Road | 2 Beria Road |
10 | Leonora | Leonora District Hospital | 967 Sadie Canning Drive Leonora WA 6438 | 967 Sadie Canning Drive |
11 | Manjimup | Warren(Manjimup)Health Service | 16 Hospital Avenue | 16 Hospital Avenue |
12 | Meekatharra | Meekatharra Hospital | Savage Street | Savage Street |
13 | Mount Barker | Plantagenet – Cranbrook Health Service | 59 Langton Road | 59 Langton Road |
14 | Norseman | Norseman District Hospital | 1 Talbot Street | 1 Talbot Street |
15 | Onslow | Onslow Hospital | 73 Second Avenue | 73 Second Avenue |
Ravensthorpe provides outreach services to Bremer Bay and Jerramungup | ||||
16 | Ravensthorpe | Ravensthorpe Health Centre | Martin Street | PO Box 53 |
Bremer Bay | Bremer Bay Health Centre | 29 John Street | 29 John Street | |
Jerramungup | Bremer Bay (Jerramungup) Health Centre | 7 Kokoda Road | 7 Kokoda Road | |
17 | Wyndham | Wyndham District Hospital | 43 Minderoo St | 43 Minderoo St |
Legislation
Section 19 of the HI Act provides that Medicare benefits are not payable for certain professional services (provided in hospitals, multipurpose services and community clinics) where other government funding is already provided for that service, unless the Minister for Health and Aged Care makes directions under subsection 19(2) of the HI Act.
The Minister’s directions (notifiable instruments) enable approved eligible sites to bulk-bill against the MBS for non-admitted, non-referred professional services (including nursing, midwifery, allied and dental services) provided in emergency departments and outpatient clinic settings in eligible rural and remote locations in Australia.
The Minister’s directions list the sites that are eligible to participate under the Initiative. The following states and the NT have current directions in place as of 29 June 2022 that have been registered on the Federal Register of Legislation:
The Minister’s directions also set out the MBS groups, subgroups and items that are eligible to be bulk billed under the Initiative.
Evaluation
In 2021, an independent evaluation was conducted on the Initiative to assess the extent to which the Initiative has been appropriate, effective, efficient and of quality and value to the Australian Government and participating states and the NT.
Consultations were undertaken with a range of stakeholders. States and the Northern Territory were also invited to respond to the draft findings of the evaluation with responses considered in the final report. The evaluation findings provided valuable information on the operation and implementation of the Initiative, which were considered in the development of the MoU 2002–25.
The evaluation can be accessed at the Evaluation of the COAG Section 19(2) exemptions initiative – improving access to primary care in rural and remote areas final report.
Resources
The following guidance material has been developed to assist states, the NT and approved eligible sites in implementing the Initiative.
- 2022–25 Operational Plan template (PDF 331 KB)
- 2022–25 Operational Plan template (Word 118 KB)
- 2022–25 Site Annual Report template (PDF 208 KB)
- 2022–25 Site Annual Report template (Word 107 KB)
Enquiries by the general public or health facilities
For specific information about how the Initiative operates in your area, please contact your health department in your state or the NT.
If you are a health facility and would like to know more about the Initiative, please contact your health department in your state or the NT.
In this section
- Medical Rural Bonded Scholarship Scheme 2014
- National Rural Health Students' Network
- Nursing and Allied Health Scholarship and Support Scheme (NAHSSS)
- Alcohol
- Children of Parents with a Mental Illness
- headspace (National Youth Mental Health Foundation)
- KidsMatter
- Living is for everyone (LiFE)
- Mental Health Council of Australia
- Mental Health in Multicultural Australia
- Mental Health Nurse Incentive Program
- Mental Health Professionals Network
- Mindmatters
- National Youth Mental Health Foundation (headspace)
- ResponseAbility Education
- Ban on the use of animal test data for cosmetics
- Council of Australian Governments (COAG) Improving Access to Primary Care in Rural and Remote Areas – COAG Section 19(2) Exemptions Initiative
- Health Policy Research and Data Program
- Overview
- Packer Policy Fellowship Program
- Pharmaceutical Benefits Scheme (PBS) Growth Hormone Program
- Pharmaceutical Benefits Scheme Collection of Under Co-payment Data
- Review of the eligibility of retirement visa holders for Medicare under relevant reciprocal health care agreements
- The Australian-American Health Policy Fellowship