23 or 36 or 44. The ‘tricky’ items.
The consultation items are time-related. 23 – less than 20 min, 36 – 20 to 40 min, 44 – longer than 40 min. There is a good reason why I call them ‘tricky’ because these items are not just about time spent with the patient. There must be an element of complexity involved. That is poorly reflected in the schedule.
Who determines whether your consultation was complex enough? There usually, some GP consultants working for Medicare. Those consultants may state that in their view, consultation 36 was not complex enough and they would perform the same work in 18 minutes. Medicare will ask you for repayment of money as a result.
Practice points: a) Keep good notes. If you are not great at typing – look into buying speech to text software (the most common one is Dragon Naturally Speaking)
b) Notate any health education about conditions you have provided and print out health education leaflets for patients. Most clinical software records this action in your notes automatically. It will be hard to argue that the consultation should have been shorter.