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.

Yes, there is a formula of ‘safe’ billing:

bill what is appropriate + keep good notes + ask yourself how would you be judged by your peers later = being prepared and confident that you will pass any audit. 

The difference between ‘safe’ billing of 23/36/44 as 32/3/1 will make you feel safe, however, you will be audited for something else anyway. So, there is no point to be ‘careful’ with the numbers of items billed. I would rather concentrate on the quality of the notes for the services billed.

Practice points:

a) Keep good notes. If you are not great at typing – look into buying speech to text software (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 of the clinical software records this action in your notes automatically. It will be hard to argue that the consultation should have been shorter.