S.I. No. 692/2019 - Public Service Pay and Pensions Act 2017 (Section 42) (Payments to General Practitioners) Regulations 2019

Notice of the making of this Statutory Instrument was published in

“Iris Oifigiúil” of 7th January, 2020.

I, SIMON HARRIS, Minister for Health, in exercise of the powers conferred on me by section 42 of the Public Service Pay and Pensions Act 2017 (No. 34 of 2017), being satisfied that subsection (6) of that section has been complied with; having complied with subsection (9) of that section; having had regard to the matters specified in paragraphs (a) to (e) of subsection (10) of that section, with the consent of the Minister for Public Expenditure and Reform, hereby make the following regulations:

1. These Regulations may be cited as the Public Service Pay and Pensions Act 2017 (Section 42) (Payments to General Practitioners) Regulations 2019.

2. These Regulations shall come into operation on 1 January 2020.

3. In these Regulations -

“6 in 1 vaccine” means a vaccine against Diphtheria, Tetanus, Pertussis, Haemophilus influenzae type b, Poliomyelitis and Hepatitis B;

“4 in 1 vaccine” means a booster vaccine against Diphtheria, Tetanus, Pertussis and Poliomyelitis;

“Act of 1970” means the Health Act 1970 (No. 1 of 1970);

“Agreement of 2019” means the agreement dated 23 May 2019 between the Minister, the Health Service Executive and the Irish Medical Organisation known as the General Practitioner Contractual Reform and Service Development Agreement;

“Capitation Agreement” means an agreement between the Health Service Executive and a general practitioner made in accordance with the conditions specified by the Minister in 1989 regarding the provision of services to eligible persons under section 58 of the Act of 1970 by general practitioners, as amended from time to time;

“combined Hib/Men C vaccine” means a vaccine against Haemophilus influenzae type b and Meningococcal group C bacteria;

“day consultation” means a consultation during normal hours of a general practitioner’s surgery as agreed between the Health Service Executive and that general practitioner;

“Fee Per Item Agreement” means an agreement between the Health Service Executive and a general practitioner made in accordance with the conditions specified by the Minister in 1972 regarding the provision of services to eligible persons under section 58 of the Act of 1970 by general practitioners, as amended from time to time;

“General Medical Services Scheme” has the meaning assigned to it by section 1 of the Health (Provision of General Practitioner Services) Act 2012 (No. 4 of 2012);

“GMS panel” means the total number of patients of a general practitioner to whom the general practitioner provides services under the General Medical Services Scheme;

“influenza vaccine” means a vaccine against seasonal influenza;

“late consultation” means a consultation other than a day consultation or a night consultation;

“Men B vaccine” means a vaccine against Meningococcal group B bacteria;

“Men C vaccine” means a vaccine against Meningococcal group C bacteria;

“Minister” means the Minister for Health;

“MMR vaccine” means a vaccine against Measles, Mumps and Rubella;

“night consultation” means a consultation during the period between midnight and 8 a.m. the following day;

“PCV” means the Pneumococcal Conjugate Vaccine;

“PPV” means the Pneumococcal Polysaccharide Vaccine;

“practice unit” means -

(a) a practice comprised of a single general practitioner or a partnership of more than one general practitioner, or

(b) a group practice of more than one general practitioner providing general practitioner services from the same centre of practice;

“qualifying area” means an area which has a population of less than or equal to 2,000 within a 4.8 kilometre radius of the principal practice address of a practice unit;

“registered child”, in relation to a service provider, means a child to whom that service provider has been assigned for the purposes of the administration of vaccines under the Primary Childhood Immunisation Programme;

“Regulations of 2016” means the Health Professionals (Variation of Payments to General Practitioners) Regulations 2016 ( S.I. No. 233 of 2016 );

“Rotavirus vaccine” means a vaccine against Rotavirus disease;

“service” means a service specified in Schedules 1 to 34 rendered by a service provider under and in accordance with the terms of the General Medical Services Scheme, the Health (Amendment) Act 1996 (No. 15 of 1996), the Mental Health Act 2001 (No. 25 of 2001), the National Cervical Screening Programme, the Primary Childhood Immunisation Programme and the National Immunisation Programmes;

“service provider” means a general practitioner who renders a service to or on behalf of the Health Service Executive under and in accordance with the terms of the General Medical Services Scheme, the Health (Amendment) Act 1996 , the Mental Health Act 2001 , the National Cervical Screening Programme, the Primary Childhood Immunisation Programme and the National Immunisation Programmes;

“set of vaccines”, in relation to a particular age or particular ages referred to under the Primary Childhood Immunisation Programme, means the specific vaccine or vaccines which are scheduled to be administered to a child at that age or those ages, as the case may be;

“under 6 contract” means an agreement between the Health Service Executive and a general practitioner made in accordance with the conditions specified by the Minister in section 58C of the Act of 1970 regarding the provision of services to eligible persons under section 58B of that Act by the general practitioner.

4. These Regulations shall apply to payments in respect of services rendered by a service provider to or on behalf of the Health Service Executive under and in accordance with the terms of the General Medical Services Scheme, the Health (Amendment) Act 1996 , the Mental Health Act 2001 , the National Cervical Screening Programme, the Primary Childhood Immunisation Programme and the National Immunisation Programmes.

5. Subject to Regulation 6, the amount of the payments specified in column (3) of each Schedule opposite a particular reference number in column (1) thereof is prescribed as the payment to be made to a service provider in respect of the particular service specified in column (2) thereof.

6. In determining the size of a general practitioner’s GMS panel for the purposes of calculating the amount of an allowance referred to in Schedule 10 or 21 that is payable (if any) to the general practitioner in respect of practice support, every patient on that general practitioner’s GMS panel who is 70 years or over shall count as 2 patients.

7. The Public Service Pay and Pensions Act 2017 (Payments In Respect of Certain Services Under the Health Act 1970 ) Regulations 2019 ( S.I. No. 290 of 2019 ) are revoked.

SCHEDULE 1

Services rendered under the General Medical Services Scheme – Agreement of 2019 – general practitioner capitation rates (all amounts inclusive of former payments towards practice maintenance, equipment and development and former payments in respect of discretionary medical cards)
Reference Number (1)	Description (2)	Amount (Total) (3)
1.	Male patient aged under 5 years – where GP does not hold an under 6 contract	€74.59
2.	Male patient aged 5 years - where GP does not hold an under 6 contract	€43.29
3.	Male patient aged 6 years or more and less than 16 years	€53.38
4.	Male patient aged 16 years or more and less than 45 years	€68.15
5.	Male patient aged 45 years or more and less than 65 years	€136.12
6.	Male patient aged 65 years or more and less than 70 years	€143.39
7.	Patient aged 70 years or more residing in the community	€334.95
8.	Patient aged 70 years or more residing in a private nursing home (approved by the HSE) for continuous periods in excess of 5 weeks	€535.38
9.	Female patient aged under 5 years – where GP does not hold an under 6 contract	€72.76
10.	Female patient aged 5 years – where GP does not hold an under 6 contract	€43.79
11.	Female patient aged 6 years or more and less than 16 years	€54.00
12.	Female patient aged 16 years or more and less than 45 years	€111.44
13.	Female patient aged 45 years or more and less than 65 years	€149.57
14.	Female patient aged 65 years or more and less than 70 years	€159.97
15.	Supplementary out of hours fee	€3.64

SCHEDULE 2

Services rendered under the General Medical Services Scheme – Agreement of 2019 – payments in respect of delivery of Chronic Disease Management Programme
Reference Number (1)	Description (2)	Amount (3)
1.	Annual fee payable in respect of eligible patient (aged 75 years and over) with one of the chronic conditions listed in the Agreement of 2019	€210.00
2.	Annual fee payable in respect of eligible patient (aged 75 years and over) with two of the chronic conditions listed in the Agreement of 2019	€250.00
3.	Annual fee payable in respect of eligible patient (aged 75 years and over) with three or more of the chronic conditions listed in the Agreement of 2019	€300.00

SCHEDULE 3

Services rendered under the General Medical Services Scheme – Agreement of 2019 – payments in respect of delivery of Diabetes Cycle of Care Programme
Reference Number (1)	Description (2)	Amount (3)
1.	Once-off registration fee per patient with Type 2 Diabetes aged 18 years or more and less than 75 years registered on the Diabetes Cycle of Care Programme	€30.00
2.	Annual capitation fee per patient with Type 2 Diabetes aged 18 years or more and less than 75 years registered on the Diabetes Cycle of Care Programme	€100.00

SCHEDULE 4

Services rendered under the General Medical Services Scheme – Agreement of 2019 – out- of -hours payments (in respect of consultations other than day consultations or consultations occurring as part of an overflow in respect of normal surgery hours) (all amounts inclusive of the former additional allowance for the provision of rostering and out of hours arrangements)
Reference Number (1)	Description (2)	Amount (3)
1.	Surgery consultation Monday to Friday (excluding public holidays) between the hours of 5 p.m. and 6 p.m. on the same day and 8 a.m. and 9 a.m. on the same day	€13.88
2.	Surgery consultation Monday to Friday between the hours of 6 p.m. and 8 a.m. the following day and any time on Saturday, Sunday and public holidays	€41.63
3.	Domiciliary visit out-of-hours	€41.63
4.	Surgery consultation or domiciliary visit out-of-hours where a general practitioner sees an additional patient under the General Medical Services Scheme during the same consultation or visit	€13.88

SCHEDULE 5

Services rendered under the General Medical Services Scheme – Agreement of 2019 – payments in respect of temporary residents, EEA visitors and emergency consultations where a general practitioner sees another general practitioner’s patient under the General Medical Services Scheme in an emergency
Reference Number (1)	Description (2)	Amount (3)
1.	Surgery consultation	€40.94
2.	Domiciliary visit	€40.94

SCHEDULE 6

Services rendered under the General Medical Services Scheme – Agreement of 2019 – payments in respect of special items of service
Reference Number (1)	Description (2)	Amount (3)
1.	Excisions/cryotherapy/diathermy of skin lesions	€24.80
2.	Suturing of cuts and lacerations – including application of tissue glue (does not include paper sutures)	€50.00
3.	Draining of hydroceles	€24.80
4.	Treatment and plugging of dental and nasal haemorrhages	€24.80
5.	Cardiovascular investigations, solely for cases of individual patient care and not general screening or routine screening of individuals or both:
	(a) Electrocardiography (ECG) tests and interpretation;	€24.80
	(b) 24 Hour Ambulatory Blood Pressure Monitoring for diagnosis and treatment of hypertension	€60.00
6.	Removal of adherent foreign bodies from the conjunctival surface of the eye	€24.80
7.	Removal of lodged or impacted foreign bodies from the ear, nose and throat	€24.80
8.	Nebuliser treatment in the case of acute asthmatic attack	€37.21
9.	Bladder catheterization – composite fee for insertion and removal	€60.00
10.	Long Acting Reversible Contraceptive Device (LARC) for counselling, insertion and monitoring	€70.00
11.	Removal of a Long Acting Reversible Contraceptive Device (LARC)	€50.00
12.	Attendance by general practitioner at HSE-convened case conference	€62.02
13.	GP participation in a Health Service Executive approved Virtual Heart Failure Clinic facilitated by a Consultant Cardiologist – fee per eligible patient with heart failure reviewed at virtual clinic	€100
14.	Provision of therapeutic phlebotomy for eligible patients with haemochromatosis	€100

SCHEDULE 7

Services rendered under the General Medical Services Scheme – Agreement of 2019 – allowance in respect of a general practitioner or general practice unit
Reference Number (1)	Description (2)	Amount (3)
1.	Rural practice allowance per annum per general practitioner: (a) where – (i) a general practitioner was in receipt of the rural practice allowance under Schedule 5 of the Regulations of 2016 immediately before the coming into operation of these Regulations, and (ii) that general practitioner is not eligible for the rural practice support framework allowance referred to at reference number 2 of this Schedule; or (b) where – (i) a general practitioner was in receipt of the rural practice allowance under Schedule 5 of the Regulations of 2016 immediately before the coming into operation of these Regulations, (ii) that general practitioner is eligible for the rural practice support framework allowance referred to at reference number 2 of this Schedule, and (iii) after the coming into operation of these Regulations, that general practitioner - (I) ceases to be eligible for the rural practice support framework allowance referred to at reference number 2 of this Schedule, and (II) continues to provide general practitioner services in the same qualifying area for which he or she received that allowance.	€16,216.07
2.	Rural practice support framework allowance per annum per practice unit: (a) where – (i) after the coming into operation of these Regulations, the practice unit is eligible for, and elects to receive, the rural practice support framework allowance under these Regulations, and (ii) there is no other practice unit in the same qualifying area on the coming into operation of these Regulations; or (b) where – (i) immediately before the coming into operation of these Regulations, a general practitioner in a practice unit was in receipt of the allowance under Schedule 5 of the Regulations of 2016, (ii) on the coming into operation of these Regulations, that practice unit is eligible for, and elects to receive, the rural practice support framework allowance under this Schedule, and (iii) there is one other practice unit in the same qualifying area.	€22,000
3.	Modified rural practice support framework allowance per annum, per practice unit: (a) where – (i) 2 practice units were, on the coming into operation of these Regulations, providing general practitioner services in the same qualifying area, and (ii) both of those practice units were not in receipt of the rural practice allowance under Schedule 5 of the Regulations of 2016 immediately before the coming into operation of these Regulations, or (b) where – (i) 2 practice units were, on the coming into operation of these Regulations, providing general practitioner services in the same qualifying area, and (ii) one of such 2 practice units was not in receipt of the rural practice allowance under Schedule 5 of the Regulations of 2016 immediately before the coming into operation of these Regulations, the modified rural practice support framework allowance is payable to the practice unit which was not in receipt of that rural practice allowance.	€11,000

SCHEDULE 8

Services rendered under the General Medical Services Scheme – Agreement of 2019 – fees payable to a general practitioner (GP) for dispensing in accordance with Circular titled “Certain Matters Relating to the Provision of Services Under Section 58 of the Health Act 1970 ” dated 24 September 1999
Reference Number (1)	Description (2)	Amount (3)
1.	Opt-in GP (dispensing doctor)	€42.39
2.	Pilot GP (dispensing doctor)	€48.90
3.	Continuous GP (dispensing doctor)	€12.48

SCHEDULE 9

Services rendered under the General Medical Services Scheme – Agreement of 2019 – payment to a general practitioner for a second medical opinion
Reference Number (1)	Description (2)	Amount (3)
1.	Fee for second medical opinion	€26.46

SCHEDULE 10

Services rendered under the General Medical Services Scheme – Agreement of 2019 – maximum allowances in respect of practice support payable on the basis of a general practitioner’s GMS panel size as determined in accordance with Regulation 6 (all amounts inclusive of the former supplementary grant to general practitioners who employed secretaries or nurses or both)
Reference Number (1)	Description (2)	Amount (3)
1.	Nursing subsidy (per year) – 1 year’s experience	€30,945.86
2.	Nursing subsidy (per year) – 2 years’ experience	€32,665.07
3.	Nursing subsidy (per year) – 3 years’ experience	€34,384.29
4.	Nursing subsidy (per year) – 4 or more years’ experience	€37,822.72
5.	Secretarial subsidy (per year) – 1 year’s experience	€20,630.57
6.	Secretarial subsidy (per year) – 2 years’ experience	€22,349.80
7.	Secretarial subsidy (per year) – 3 or more years’ experience	€24,068.99
8.	Practice manager subsidy (per year) – based on first point of nursing subsidy	€30,945.86

SCHEDULE 11

Services rendered under the General Medical Services Scheme – Agreement of 2019 – maximum allowances payable in respect of locum expenses
Reference Number (1)	Description (2)	Amount (3)
1.	Annual leave (per day)	€197.24
2.	Annual leave (per week)	€1,380.65
3.	Sick leave (per day) during the first week	€197.24
4.	Sick leave (per week) for the first week	€986.18
5.	Sick leave (per day) from week 2 to week 26	€197.24
6.	Sick leave (per week) from week 2 to week 26	€1,380.65
7.	Sick leave (per day) from week 27 to week 52	€98.62
8.	Sick leave (per week) from week 27 to week 52	€690.33
9.	Study leave (per day)	€197.24
10.	Study leave (per week)	€1,380.65
11.	Maternity leave (per day)	€394.48
12.	Maternity leave (per week)	€2,761.30
13.	Paternity leave (per day)	€394.48
14.	Paternity leave (per week)	€2,761.30
15.	Adoptive leave (per day)	€394.48
16.	Adoptive leave (per week)	€2,761.30
17.	Annual leave – former District Medical Officer:
	(a) maximum rate – payable for each of the first 3 days annual leave in a year	€66.47
	(b) medium rate – payable for each of the next 25 days annual leave day in that year	€56.86
	(c) minimum rate – payable for each other annual leave day in that year	€48.92
18.	Statutory leave – meetings of statutory bodies (per day)	€197.24
19.	Attendance at Irish Medical Organisation GP meetings (per day)	€197.24

SCHEDULE 12

Services rendered under the General Medical Services Scheme – Agreement of 2019 – payment to a general practitioner in respect of the registration of asylum seekers
Reference Number (1)	Description (2)	Amount (3)
1.	Asylum seeker/non-EU registration fee (a once-off superannuable registration fee)	€173.69

SCHEDULE 13

Services rendered under General Medical Services Scheme – Capitation Agreement – capitation rates (all amounts inclusive of former payments towards practice maintenance, equipment and development and former payments in respect of discretionary medical cards)
Reference Number (1)	Description (2)	Amount (Total) (3)
1.	Male patient aged under 5 years (where GP does not hold an under 6 contract)	€74.59
2.	Male patient aged 5 years or more and less than 16 years (where GP does not hold an under 6 contract)	€43.29
3.	Male patient aged 6 years or more and less than 16 years	€43.29
4.	Male patient aged 16 years or more and less than 45 years	€55.26
5.	Male patient aged 45 years or more and less than 65 years	€110.38
6.	Male patient aged 65 years or more and less than 70 years	€116.28
7.	Patient aged 70 years or more residing in the community	€271.62
8.	Patient aged 70 years or more residing in a private nursing home (approved by the HSE) for continuous periods in excess of 5 weeks	€434.15
9.	Female patient aged under 5 years (where GP does not hold an under 6 contract)	€72.76
10.	Female patient aged 5 years or more and less than 16 years (where GP does not hold an under 6 contract)	€43.79
11.	Female patient aged 6 years or more and less than 16 years	€43.79
12.	Female patient aged 16 years or more and less than 45 years	€90.37
13.	Female patient aged 45 years or more and less than 65 years	€121.29
14.	Female patient aged 65 years or more and less than 70 years	€129.72
15.	Supplementary out of hours fee	€3.64

SCHEDULE 14

Services rendered under the General Medical Services Scheme – Capitation Agreement- Delivery of services under the Diabetes Cycle of Care Programme to registered patients aged 18 years and older with a diagnosis of Type 2 Diabetes
Reference Number (1)	Description (2)	Amount (3)
1.	Once-off registration fee per patient with Type 2 Diabetes registered on the programme	€30.00
2.	Annual capitation fee per patient with Type 2 Diabetes registered on the programme	€100.00

SCHEDULE 15

Services rendered under the General Medical Services Scheme – Capitation Agreement – out of hours payments (in respect of consultations other than day consultations or consultations occurring as part of an overflow in respect of normal surgery hours) (all amounts inclusive of the former additional allowance for the provision of rostering and out of hours arrangements)
Reference Number (1)	Description (2)	Amount (3)
1.	Surgery consultation Monday to Friday (excluding public holidays) between the hours of 5 p.m. and 6 p.m. on the same day and 8 a.m. and 9 a.m. on the same day	€13.88
2.	Surgery consultation Monday to Friday between the hours of 6 p.m. and 8 a.m. the following day and any time on Saturday, Sunday and public holidays	€41.63
3.	Domiciliary visit out-of-hours	€41.63
4.	Surgery consultation or domiciliary visit out-of-hours where a general practitioner sees an additional patient under the General Medical Services Scheme during the same consultation or visit	€13.88

SCHEDULE 16

Services rendered under the General Medical Services Scheme – Capitation Agreement – payments to a general practitioner in respect of temporary residents, EEA visitors and emergency consultations where a general practitioner sees another general practitioner’s patient under the General Medical Services Scheme in an emergency
Reference Number (1)	Description (2)	Amount (3)
1.	Surgery consultation	€40.94
2.	Domiciliary visit	€40.94

SCHEDULE 17

Services rendered under the General Medical Services Scheme – Capitation Agreement – payments in respect of special items of service
Reference Number (1)	Description (2)	Amount (3)
1.	Excisions/cryotherapy/diathermy of skin lesions	€24.80
2.	Suturing of cuts and lacerations – including application of tissue glue (does not include paper sutures)	€50.00
3.	Draining of hydroceles	€24.80
4.	Treatment and plugging of dental and nasal haemorrhages	€24.80
5.	Cardiovascular investigations, solely for cases of individual patient care and not general screening or routine screening of individuals or both:
	(a) Electrocardiography (ECG) tests and interpretation;	€24.80
	(b) 24 Hour Ambulatory Blood Pressure Monitoring for diagnosis and treatment of hypertension	€60.00
6.	Removal of adherent foreign bodies from the conjunctival surface of the eye	€24.80
7.	Removal of lodged or impacted foreign bodies from the ear, nose and throat	€24.80
8.	Nebuliser treatment in the case of acute asthmatic attack	€37.21
9.	Bladder catheterization – composite fee for insertion and removal	€60.00
10.	Long Acting Reversible Contraceptive Device (LARC) for counselling, insertion and monitoring	€70.00
11.	Removal of a Long Acting Reversible Contraceptive Device (LARC)	€50.00
12.	Attendance by general practitioner at HSE-convened case conference	€62.02

SCHEDULE 18

Services rendered under the General Medical Services Scheme – Capitation Agreement – allowance in respect of a general practitioner or general practice unit
Reference Number (1)	Description (2)	Amount (3)
1.	Rural practice allowance per annum per general practitioner: (a) where – (i) a general practitioner was in receipt of the rural practice allowance under Schedule 5 of the Regulations of 2016 immediately before the coming into operation of these Regulations, and (ii) that general practitioner is not eligible for the rural practice support framework allowance referred to at reference number 2 of this Schedule; or (b) where – (i) a general practitioner was in receipt of the rural practice allowance under Schedule 5 of the Regulations of 2016 immediately before the coming into operation of these Regulations, (ii) that general practitioner is eligible for the rural practice support framework allowance referred to at reference number 2 of this Schedule, and (iii) after the coming into operation of these Regulations, that general practitioner – (I) ceases to be eligible for the rural practice support framework allowance referred to at reference number 2 of this Schedule, and (II) continues to provide general practitioner services in the same qualifying area for which he or she received that allowance.	€16,216.07
2.	Rural practice support framework allowance per annum per practice unit: (a) where – (i) after the coming into operation of these Regulations, the practice unit is eligible for, and elects to receive, the rural practice support framework allowance under these Regulations, and (ii) there is no other practice unit in the same qualifying area on the coming into operation of these Regulations; or (b) where – (i) immediately before the coming into operation of these Regulations, a general practitioner in a practice unit was in receipt of the allowance under Schedule 5 of the Regulations of 2016, (ii) on the coming into operation of these Regulations, that practice unit is eligible for, and elects to receive, the rural practice support framework allowance under this Schedule, and (iii) there is one other practice unit in the same qualifying area.	€20,000
3.	Modified rural practice support framework allowance per annum, per practice unit: (a) where – (i) 2 practice units were, on the coming into operation of these Regulations, providing general practitioner services in the same qualifying area, and (ii) both of those practice units were not in receipt of the rural practice allowance under Schedule 5 of the Regulations of 2016 immediately before the coming into operation of these Regulations, or (b) where – (i) 2 practice units were, on the coming into operation of these Regulations, providing general practitioner services in the same qualifying area, and (ii) one of such 2 practice units was not in receipt of the rural practice allowance under Schedule 5 of the Regulations of 2016 immediately before the coming into operation of these Regulations, the modified rural practice support framework allowance is payable to the practice unit which was not in receipt of that rural practice allowance.	€10,000

SCHEDULE 19

Services rendered under the General Medical Services Scheme – Capitation Agreement – fees payable to a general practitioner (GP) for dispensing in accordance with Circular titled “Certain Matters Relating to the Provision of Services Under Section 58 of the Health Act 1970 ” dated 24 September 1999
Reference Number (1)	Description (2)	Amount (3)
1.	Opt-in GP (dispensing doctor)	€38.03
2.	Pilot GP (dispensing doctor)	€43.88
3.	Continuous GP (dispensing doctor)	€12.48

SCHEDULE 20

Services rendered under the General Medical Services Scheme - Capitation Agreement – payment to a general practitioner for a second medical opinion
Reference Number (1)	Description (2)	Amount (3)
1.	Fee for second medical opinion	€26.46

SCHEDULE 21

Services rendered under the General Medical Services Scheme – Capitation Agreement – maximum allowances in respect of practice support payable on the basis of a general practitioner’s GMS panel size as determined in accordance with Regulation 6 (all amounts inclusive of the former supplementary grant to general practitioners who employed secretaries or nurses or both)
Reference Number (1)	Description (2)	Amount (3)
1.	Nursing subsidy (per year) – 1 year’s experience	€30,945.86
2.	Nursing subsidy (per year) – 2 years’ experience	€32,665.07
3.	Nursing subsidy (per year) – 3 years’ experience	€34,384.29
4.	Nursing subsidy (per year) – 4 or more years’ experience	€37,822.72
5.	Secretarial subsidy (per year) – 1 year’s experience	€20,630.57
6.	Secretarial subsidy (per year) – 2 years’ experience	€22,349.80
7.	Secretarial subsidy (per year) – 3 or more years’ experience	€24,068.99
8.	Practice manager subsidy (per year) – based on first point of nursing subsidy	€30,945.86

SCHEDULE 22

Services rendered under the General Medical Services Scheme – Capitation Agreement – maximum allowances payable in respect of locum expenses
Reference Number (1)	Description (2)	Amount (3)
1.	Annual leave (per day)	€197.24
2.	Annual leave (per week)	€1,380.65
3.	Sick leave (per day) during the first week	€197.24
4.	Sick leave (per week) for the first week	€986.18
5.	Sick leave (per day) from week 2 to week 26	€197.24
6.	Sick leave (per week) from week 2 to week 26	€1,380.65
7.	Sick leave (per day) from week 27 to week 52	€98.62
8.	Sick leave (per week) from week 27 to week 52	€690.33
9.	Study leave (per day)	€197.24
10.	Study leave (per week)	€1,380.65
11.	Maternity leave (per day)	€197.24
12.	Maternity leave (per week)	€1,380.65
13.	Paternity leave (per day)	€197.24
14.	Adoptive leave (per day)	€197.24
15.	Adoptive leave (per week)	€1,380.65
16.	Annual leave – former District Medical Officer:
	(a) maximum rate – payable for each of the first 3 days annual leave in a year	€66.47
	(b) medium rate – payable for each of the next 25 days annual leave day in that year	€56.86
	(c) minimum rate – payable for each other annual leave day in that year	€48.92
17.	Statutory leave – meetings of statutory bodies (per day)	€197.24
18.	Attendance at Irish Medical Organisation GP meetings (per day)	€197.24

SCHEDULE 23

Services rendered under the General Medical Services Scheme – Capitation Agreement – payment in respect of the registration of asylum seekers
Reference Number (1)	Description (2)	Amount (3)
1.	Asylum seeker/non-EU registration fee (a once-off superannuable registration fee)	€173.69

SCHEDULE 24

Services rendered under the General Medical Services Scheme – Fee Per Item Agreement – general practitioner consultation fees
Reference Number (1)	Description (2)	Amount (3)
1.	Surgery - day consultation with patient	€11.87
2.	Surgery - late consultation with patient	€16.88
3.	Surgery - night consultation with patient	€33.38
4.	Domiciliary visit - day consultation with patient	€17.51
5.	Domiciliary visit - late consultation with patient	€22.93
6.	Domiciliary visit - night consultation with patient	€44.96

SCHEDULE 25

Services rendered under the General Medical Services Scheme – Fee Per Item Agreement – payment for a consultation by a general practitioner at a home for the aged
Reference Number (1)	Description (2)	Amount (3)
1.	Consultation at home for the aged per 3-hour session	€73.18

SCHEDULE 26

Services rendered under the General Medical Services Scheme – Fee Per Item Agreement – payments to a general practitioner in respect of temporary residents, EEA visitors and emergency consultations where a general practitioner sees another general practitioner’s patient under the General Medical Services Scheme in an emergency
Reference Number (1)	Description (2)	Amount (3)
1.	Surgery consultation	€40.94
2.	Domiciliary visit	€40.94

SCHEDULE 27

Services rendered under the General Medical Services Scheme – Fee Per Item Agreement – payments in respect of special items of service
Reference Number (1)	Description (2)	Amount (3)
1.	Excisions/cryotherapy/diathermy of skin lesions	€22.43
2.	Suturing of cuts and lacerations	€22.43
3.	Draining of hydroceles	€22.43
4.	Treatment and plugging of dental and nasal haemorrhages	€22.43
5.	Recognised vein treatment	€22.43
6.	Electrocardiography (ECG) tests & their interpretation	€22.43
7.	Instruction in the fitting of a diaphragm	€22.43

SCHEDULE 28

Services rendered under the General Medical Services Scheme – Fee Per Item Agreement – allowance in respect of a general practitioner whose practice is eligible for a rural practice allowance
Reference Number (1)	Description (2)	Amount (3)
1.	Rural practice allowance (per annum)	€7,042.91

SCHEDULE 29

Services rendered under the General Medical Services Scheme – Fee Per Item Agreement – allowance in respect of locum and practice expenses
Reference Number (1)	Description (2)	Amount (3)
1.	Allowance in respect of locum and practice expenses (per annum)	€1,371.06

SCHEDULE 30

Services rendered under the Health (Amendment) Act 1996
Reference Number (1)	Description (2)	Amount (3)
1.	Surgery consultation	€30.53
2.	Domiciliary visit	€40.27

SCHEDULE 31

Services rendered under the Mental Health Act 2001
Reference Number (1)	Description (2)	Amount (3)
1.	Examination of a person and making a recommendation for that person to be involuntarily admitted to an approved centre under section 10 of the Mental Health Act 2001	€150

SCHEDULE 32

Services rendered under the National Cervical Screening Programme
Reference Number (1)	Description (2)	Amount (3)
1.	Payment in respect of the provision of a smear service under the National Cervical Screening Programme	€49.10

SCHEDULE 33

Part A Services rendered in respect of the administration of vaccines to a registered child under the Primary Childhood Immunisation Programme
Reference Number (1)	Service (2)	Amount (3)
1.	Once-off amount payable to a general practitioner in respect of a registered child.	€37.78
2.	Amount payable to a general practitioner for administering to a registered child all of the following vaccines: (a) 6 in 1 vaccine, Rotavirus vaccine and Men B vaccine scheduled to be administered at 2 months of age; (b) 6 in 1 vaccine, Rotavirus vaccine and Men B vaccine scheduled to be administered at 4 months of age; (c) 6 in 1 vaccine and Men C vaccine scheduled to be administered at 6 months of age; (d) MMR vaccine and Men B vaccine scheduled to be administered at 12 months of age.	€206.31
3.	Once-off bonus amount payable to a general practitioner in respect of a registered child who has reached his or her second birthday in a particular year where the general practitioner concerned has administered all of the following vaccines under the Primary Childhood Immunisation Programme to that registered child and to at least 95 per cent of the registered children of that general practitioner who have reached their second birthday in that year: (a) 6 in 1 vaccine, Rotavirus vaccine and Men B vaccine scheduled to be administered at 2 months of age; (b) 6 in 1 vaccine, Rotavirus vaccine and Men B vaccine scheduled to be administered at 4 months of age; (c) 6 in 1 vaccine and Men C vaccine scheduled to be administered at 6 months of age; (d) MMR vaccine and Men B vaccine scheduled to be administered at 12 months of age.	€60.63
4.	Amount payable to a general practitioner for administering to a registered child under the Primary Childhood Immunisation Programme, after the child has reached 12 months of age, a combined Hib/Men C vaccine scheduled to be administered at 13 months of age.	€18.82
5.	Amount payable to a general practitioner per PCV up to a maximum of 3 PCVs administered to a registered child under the Primary Childhood Immunisation Programme provided that the amount payable for administering the third PCV is payable only where the PCV concerned is administered to the registered child on or after the day on which he or she reaches 12 months of age and before the day on which he or she reaches 24 months of age.	€18.82

Part B Services rendered in respect of the administration of vaccines to a registered child under the Primary Childhood Immunisation Programme where the general practitioner does not administer all of the vaccines under that Programme to that child
Reference Number (1)	Service (2)	Amount (3)
1.	Amount payable to a general practitioner for administering to a registered child a 6 in 1 vaccine, Rotavirus vaccine and Men B vaccine scheduled to be administered at 2 months of age where another general practitioner administers to the child concerned other vaccines scheduled to be administered to that child under the Primary Childhood Immunisation Programme after 2 months of age.	€29.95
2.	Amount payable to a general practitioner for administering to a registered child all of the following vaccines where another general practitioner administers to the child concerned other vaccines scheduled to be administered to that child under the Primary Childhood Immunisation Programme after 4 months of age: (a) 6 in 1 vaccine, Rotavirus vaccine and Men B vaccine scheduled to be administered at 2 months of age; (b) 6 in 1 vaccine, Rotavirus vaccine and Men B vaccine scheduled to be administered at 4 months of age.	€121.90
3.	Amount payable to a general practitioner for administering to a registered child all of the following vaccines where another general practitioner administers to the child concerned other vaccines scheduled to be administered to that child under the Primary Childhood Immunisation Programme after 6 months of age: (a) 6 in 1 vaccine, Rotavirus vaccine and Men B vaccine scheduled to be administered at 2 months of age; (b) 6 in 1 vaccine, Rotavirus vaccine and Men B vaccine scheduled to be administered at 4 months of age; (c) 6 in 1 vaccine and Men C vaccine scheduled to be administered at 6 months of age.	€206.31
4.	Amount payable to a general practitioner for administering to a registered child all of the following vaccines where another general practitioner administers to the child concerned other vaccines scheduled to be administered to that child under the Primary Childhood Immunisation Programme after 12 months of age: (a) 6 in 1 vaccine, Rotavirus vaccine and Men B vaccine scheduled to be administered at 2 months of age; (b) 6 in 1 vaccine, Rotavirus vaccine and Men B vaccine scheduled to be administered at 4 months of age; (c) 6 in 1 vaccine and Men C vaccine scheduled to be administered at 6 months of age; (d) MMR and Men B vaccine scheduled to be administered at 12 months of age.	€206.31

Part C Services rendered in respect of the administration of vaccines to a child who is not a registered child in respect of the general practitioner under the Primary Childhood Immunisation Programme where that general practitioner does not administer all of the vaccines under that Programme to that child
Reference Number (1)	Service (2)	Amount (3)
1.	Amount payable to a general practitioner for administering to a child any of the following sets of vaccines where the child concerned, although a registered child in respect of another general practitioner, has not received any vaccines under the Primary Childhood Immunisation Programme from the general practitioner in respect of whom the child is a registered child, provided that the general practitioner administers the set of vaccines scheduled to be administered to that child under the Programme at 2 months of age: (a) 6 in 1 vaccine, Rotavirus vaccine and Men B vaccine scheduled to be administered at 2 months of age; (b) 6 in 1 vaccine, Rotavirus vaccine and Men B vaccine scheduled to be administered at 4 months of age; (c) 6 in 1 vaccine and Men C vaccine scheduled to be administered at 6 months of age; (d) MMR and Men B vaccine scheduled to be administered at 12 months of age.	€76.41
2.	Amount payable to a general practitioner for administering to a child any of the following sets of vaccines where the child concerned is a registered child in respect of another general practitioner, and has received all vaccines under the Primary Childhood Immunisation Programme from another general practitioner (whether or not the general practitioner in respect of whom the child is a registered child), provided that the general practitioner administers the set of vaccines scheduled to be administered to that child under the Programme and referred to in paragraph (a): (a) 6 in 1 vaccine, Rotavirus vaccine and Men B vaccine scheduled to be administered at 4 months of age; (b) 6 in 1 vaccine and Men C vaccine scheduled to be administered at 6 months of age; (c) MMR vaccine and Men B vaccine scheduled to be administered at 12 months of age.	€91.90
3.	Amount payable to a general practitioner for administering to a child either of the following sets of vaccines where the child concerned is a registered child in respect of another general practitioner and has received vaccines scheduled to be administered at 2 and 4 months of age under the Primary Childhood Immunisation Programme from another general practitioner (whether or not the general practitioner in respect of whom the child is a registered child), provided that the general practitioner administers the set of vaccines scheduled to be administered to that child under the Programme at 6 months of age: (a) 6 in 1 vaccine and Men C vaccine scheduled to be administered at 6 months of age; (b) MMR vaccine and Men B vaccine scheduled to be administered at 12 months of age.	€91.90
4.	Amount payable to a general practitioner for administering to a child both an MMR vaccine and Men B vaccine scheduled to be administered at 12 months of age.	€99.38
5.	Amount payable to a general practitioner for administering to a child a combined Hib/Men C vaccine scheduled to be administered at 13 months of age under the Primary Childhood Immunisation Programme where the child concerned is not a registered child in respect of the general practitioner but is a registered child in respect of another general practitioner.	€18.82
6.	Amount payable to a general practitioner per PCV up to a maximum of 3 PCVs administered to a child under the Primary Childhood Immunisation Programme where the child concerned is not a registered child in respect of the general practitioner and provided that the amount payable for administering the third PCV is payable only where the PCV concerned is administered to the child on or after the day on which he or she reaches 12 months of age and before the day on which he or she reaches 24 months of age.	€18.82

Part D Services rendered in respect of the administration of vaccines to a registered child under the Primary Childhood Immunisation Programme where no other vaccines are administered to that child under that Programme by any other general practitioner
Reference Number (1)	Service (2)	Amount (3)
1.	Amount payable to a general practitioner for administering to a registered child a 6 in 1 vaccine, Rotavirus vaccine and Men B vaccine scheduled to be administered at 2 months of age under the Primary Childhood Immunisation Programme, where no vaccines scheduled to be administered after 2 months of age under that Programme are administered, by the general practitioner concerned or any other general practitioner, to the registered child concerned.	€5.16
2.	Amount payable to a general practitioner for administering to a registered child a 6 in 1 vaccine, Rotavirus vaccine and Men B vaccine scheduled to be administered at 4 months of age under the Primary Childhood Immunisation Programme, where no vaccines scheduled to be administered after 4 months of age under that Programme are administered, by the general practitioner concerned or any other general practitioner, to the registered child concerned.	€72.24
3.	Amount payable to a general practitioner for administering to a registered child all of the following vaccines, where no vaccines scheduled to be administered after 4 months of age under that Programme are administered, by the general practitioner concerned or any other general practitioner, to the registered child concerned: (a) 6 in 1 vaccine, Rotavirus vaccine and Men B vaccine scheduled to be administered at 2 months of age; (b) 6 in 1 vaccine, Rotavirus vaccine and Men B vaccine scheduled to be administered at 4 months of age.	€77.40

Part E

Services rendered in respect of opportunistic screening and administration of one set of vaccines to a child under the Primary Childhood Immunisation Programme

Reference Number (1)

Service (2)

Amount (3)

Amount payable to a general practitioner for administering to an individual any one of the following sets of vaccines where the individual is not a registered child in relation to any general practitioner provided that the set of vaccines concerned is administered to the individual on the same day by the general practitioner (or by the general practitioner concerned and another general practitioner in the same practice) and that the general practitioner or general practitioners concerned do not administer any of the other sets of vaccines to the individual concerned:

(a) 6 in 1 vaccine, Rotavirus vaccine and Men B vaccine scheduled to be administered at 2 months of age;

(b) 6 in 1 vaccine, Rotavirus vaccine and Men B vaccine scheduled to be administered at 4 months of age;

(d) MMR vaccine and Men B vaccine scheduled to be administered at 12 months of age.

€67.04

Part F Services rendered in respect of the administration of a 4 in 1 vaccine or an MMR vaccine or both scheduled to be administered under the Primary Childhood Immunisation Programme to a child who is more than 4 years of age where the general practitioner has been informed that it is not possible for the vaccine or vaccines concerned to be administered by the Health Service Executive in a school setting
Reference Number (1)	Service (2)	Amount (3)
1.	Amount payable to a general practitioner for administering to a child either - (a) a 4 in 1 vaccine, or (b) an MMR vaccine, where the child is more than 4 years of age provided that the vaccine which is administered is not administered by the general practitioner (or by another general practitioner in the same practice) on the same day as the other vaccine.	€36.03
2.	Amount payable to a general practitioner for administering to a child – (a) a 4 in 1 vaccine, and (b) an MMR vaccine, where the child is more than 4 years of age and both vaccines are administered on the same day by the general practitioner or by the general practitioner concerned and another general practitioner in the same practice.	€54.04

SCHEDULE 34

Services rendered under other National Immunisation Programmes
Reference Number (1)	Description (2)	Amount (3)
1.	Amount payable to a general practitioner for administering to an individual a vaccine in situations of disease outbreak in a specific area in the State.	€28.50
2.	Amount payable to a general practitioner for administering to an individual a vaccine during a pandemic.	€10.00
3.	Amount payable to a general practitioner under the General Medical Services Scheme for administering a full course of vaccines against Hepatitis B, including post-vaccination testing where necessary, to an individual in an at-risk category.	€142.57
4.	Amount payable to a general practitioner for administering a PPV vaccine to an individual in an at-risk category under the General Medical Services Scheme provided that the vaccine which is administered is not administered by the general practitioner (or by another general practitioner in the same practice) on the same day as an influenza vaccine.	€28.50
5.	Amount payable to a general practitioner for administering an influenza vaccine to an individual in an at-risk category under the General Medical Services Scheme provided that the vaccine which is administered is not administered by the general practitioner (or by another general practitioner in the same practice) on the same day as a PPV vaccine.	€15.00
6.	Amount payable to a general practitioner for administering an influenza vaccine to an individual in an at-risk category – (a) a PPV, and (b) an influenza vaccine, under the General Medical Services Scheme where both vaccines are administered on the same day by the general practitioner or by the general practitioner concerned and another general practitioner in the same practice.	€42.75

The Minister for Public Expenditure and Reform consents to the foregoing Regulations.

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GIVEN under my Official Seal of the Minister for Public Expenditure and Reform,

20 December, 2019.

PASCHAL DONOHOE,

Minister for Public Expenditure and Reform.

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GIVEN under my Official Seal,

20 December, 2019.

SIMON HARRIS,

Minister for Health.

EXPLANATORY NOTE

(This note is not part of the Instrument and does not purport to be a legal interpretation)

These Regulations shall apply to payments in respect of services rendered by a general practitioner to or on behalf of the Health Service Executive under and in accordance with the terms of the General Medical Services Scheme, the Health (Amendment) Act 1996 , the Mental Health Act 2001 , the National Cervical Screening Programme, the Primary Childhood Immunisation Programme and the National Immunisation Programmes.