UPDATED 29.03.20
o From 30 March 2020, telehealth (video-conference) and phone consultation items are available to all Australians. This is stage 4 of the COVID-19 response.
o The schedule fees for the bulk billing incentive items have been increased, to encourage medical practitioners to provide bulk-billed services to vulnerable patient groups. Bulk-billing incentives items are available for medical services (items 10990, 10991 and 10992), diagnostic imaging services (items 64990 and 64991) and pathology services (74990 and 74991) for patients who are either under 16 years old, or who are a Commonwealth concessional beneficiary.
| GENERAL PRACTITIONER ATTENDANCESThese services need to be bulk-billed, and are for non-admitted patients | |||
| Service | Existing Items face to face | COVID-19 Telehealth items video-conference | COVID-19 Telephone items – for when video-conferencing is not available |
| GP attendance for an obvious problem | 3 | 91790 | 91795 |
| GP attendance less than 20 minutes | 23 | 91800 | 91809 |
| GP attendance at least 20 minutes | 36 | 91801 | 91810 |
| GP attendance at least 40 minutes | 44 | 91802 | 91811 |
| Health assessment | |||
| * GP ATSI health assessment | 715 | 92004 | 92016 |
| Chronic Disease Management | |||
| * GP management plan, prepare | 721 | 92024 | 92068 |
| * GP team care arrangement, co-ordinate development | 723 | 92025 | 92069 |
| * GP contribution to prepare or review a multidisciplinary care plan, prepared by another provider | 729 | 92026 | 92070 |
| * GP contribution to prepare or review a multidisciplinary care plan, prepared by a provider when the patient was admitted or by a RACF | 731 | 92027 | 92071 |
| * GP attendance to coordinate a GP management plan or team care arrangements | 732 | 92028 | 92072 |
| Autism Management | |||
| * GP early intervention services for children with autism, pervasive developmental disorder or disability | 139 | 92142 | 92145 |
| Pregnancy Support | |||
| * GP pregnancy support item, more than 20 minutes | 4001 | 92136 | 92138 |
| Eating Disorder Management | |||
| * GP without mental health training, prepare an eating disorder treatment and management plan, 20 to 40 minutes | 90250 | 92146 | 92154 |
| * GP without mental health training, prepare an eating disorder treatment and management plan, more than 40 minutes | 90251 | 92147 | 92155 |
| * GP with mental health training, prepare an eating disorder treatment and management plan, 20 to 40 minutes | 90252 | 92148 | 92156 |
| * GP with mental health training, prepare an eating disorder treatment and management plan, more than 40 minutes | 90253 | 92149 | 92157 |
| * GP to review an eating disorder plan | 90264 | 92170 | 92176 |
| * GP eating disorder FPS treatment, 30 to 40 minutes | 90271 | 92182 | 92194 |
| * GP eating disorder FPS treatment, more than 40 minutes | 90273 | 92184 | 92196 |
| Mental Health | |||
| General Practitioners (credentialed with CEM) | |||
| * GP without mental health training, prepare a mental health plan, 20 to 40 minutes | 2700 | 92112 | 92124 |
| * GP without mental health training, prepare a mental health plan, more than 40 minutes | 2701 | 92113 | 92125 |
| * GP to review a mental health plan | 2712 | 92114 | 92126 |
| * GP mental health consult, more than 20 minutes | 2713 | 92115 | 92127 |
| * GP with mental health training, prepare a mental health plan, 20 to 40 minutes | 2715 | 92116 | 92128 |
| * GP with mental health training, prepare a mental health plan, more than 40 minutes | 2717 | 92117 | 92129 |
| FPS treatment of 30 to 40 minutes | 2729 | 91818 | 91842 |
| FPS treatment of more than 40 minutes | 2731 | 91819 | 91843 |
| Urgent After Hours | |||
| * GP urgent after hours, unsociable | 599 | 92210 | 92216 |
| OTHER MEDICAL PRACTITIONER ATTENDANCES These services need to be bulk-billed, and are for non-admitted patients | |||
| Service | Existing Items face to face | COVID-19 Telehealth items video-conference | COVID-19 Telephone items – for when video-conferencing is not available |
| Attendance of not more than 5 minutes | 52 | 91792 | 91797 |
| Attendance of more than 5 minutes but not more than 25 minutes | 53 | 91803 | 91812 |
| Attendance of more than 25 minutes but not more than 45 minutes | 54 | 91804 | 91813 |
| Attendance of more than 45 minutes | 57 | 91805 | 91814 |
| Attendance of not more than 5 minutes | 179 | 91794 | 91799 |
| Attendance of more than 5 minutes but not more than 25 minutes. Modified Monash 2-7 area | 185 | 91806 | 91815 |
| Attendance of more than 25 minutes but not more than 45 minutes. Modified Monash 2-7 area | 189 | 91807 | 91816 |
| Attendance of more than 45 minutes. Modified Monash 2-7 area | 203 | 91808 | 91817 |
| Health assessment | |||
| * OMP ATSI health assessment | 228 | 92011 | 92023 |
| Chronic Disease Management | |||
| * OMP management plan, prepare | 229 | 92055 | 92099 |
| * OMP team care arrangement, coordinate development | 230 | 92056 | 92100 |
| * OMP contribution to prepare or review a multidisciplinary care plan, prepared by another provider | 231 | 92057 | 92101 |
| * OMP contribution to prepare or review a multidisciplinary care plan, prepared by a provider when the patient was admitted or by a RACF | 232 | 92058 | 92102 |
| * OMP attendance to coordinate a GP management plan or team care arrangements | 233 | 92059 | 92103 |
| Pregnancy support | |||
| * OMP pregnancy support item, more than 20 minutes | 792 | 92137 | 92139 |
| Eating Disorder Management | |||
| * OMP without mental health training, prepare an eating disorder treatment and management plan, 20 to 40 minutes | 90254 | 92150 | 92158 |
| * OMP without mental health training, prepare an eating disorder treatment and management plan, more than 40 minutes | 90255 | 92151 | 92159 |
| * OMP with mental health training, prepare an eating disorder treatment and management plan, 20 to 40 minutes | 90256 | 92152 | 92160 |
| * OMP with mental health training, prepare an eating disorder treatment and management plan, at least 40 minutes | 90257 | 92153 | 92161 |
| * OMP to review an eating disorder plan | 90265 | 92171 | 92177 |
| * OMP eating disorder FPS treatment, 30 to 40 minutes | 90275 | 92186 | 92198 |
| * OMP eating disorder FPS treatment, more than 40 minutes | 90277 | 92188 | 92200 |
| Urgent after hours | |||
| * OMP urgent after hours, unsociable | 600 | 92211 | 92217 |
| Mental Health | |||
| * OMP without mental health training, prepare a mental health plan, 20 to 40 minutes | 272 | 92118 | 92130 |
| * OMP without mental health training, prepare a mental health plan, more than 40 minutes | 276 | 92119 | 92131 |
| * OMP to review a mental health plan | 277 | 92120 | 92132 |
| * OMP mental health consult, more than 20 minutes | 279 | 92121 | 92133 |
| * OMP with mental health training, prepare a mental health plan, 20 to 40 minutes | 281 | 92122 | 92134 |
| * OMP with mental health training, prepare a mental health plan, more than 40 minutes | 282 | 92123 | 92135 |
| FPS treatment of 30 to 40 minutes | 371 | 91820 | 91844 |
| FPS treatment of more than 40 minutes | 372 | 91821 | 91845 |
Telehealth and phone consultation became available from 13 March 2020. Below are the procedures to be followed by doctors and staff.
Billing telehealth items. All new items are divided into the items for video consultations (e.g. Skype, Whatsapp) and telephone consultations. Telephone consults should be provided where video-conferencing is not available.
Requirements. All Australians with Medicare card are eligible.
Progress notes, Prescriptions, Medical Certificates and referrals. There is no difference in the requirements for progress notes. Referrals and prescriptions can be sent/faxed at the end of the consultation. If the phone consultation is conducted from GPs home, GP can access the system remotely.
Patient identification. Privacy and Confidentiality. There is a requirement for privacy and confidentiality. If a consultation conducted from home, GP is to make sure that no members of the family can hear the consultation.
Patient identification MUST be competed by three approved identifiers:
How patients will know about Telehealth? Patients will be told by Reception staff, website, online appointment system and online advertising.
Triage. Reception. Website. Online appointment system.
A receptionist to ask EVERY caller: “Is this about Coronavirus or are you concerned about Coronavirus?” If the answer is YES, read them the following definitions.
What if a GP cannot complete the attendance via the phone or video-link?
If a GP cannot complete the consultation via the phone/ video for clinical reasons, he/she must call the patient into the practice to attend if safe to do so OR refer to another appropriate service.
Policy on the use of Whatsapp on a mobile phone. The phone is set on autoresponder with the following message: “This phone is not monitored and calls and messages are not taken. If it is an emergency, please, attend your local hospital. Otherwise, call us during the business hours on 03 XXXX XXXX.
Strategies and Scenarios. Reactive and Proactive strategies can be used in telehealth consultations. The goal of both scenarios is to reduce the exposure by patients and staff. In other words, reducing the number of face-to-face consultations.
Reactive scenario.
Step 1. Patients are made aware of telehealth opportunity via Reception, website and online appointment system as it was discussed earlier in this document.
Step 2. The appointment is made.
Proactive scenario.
Step 1. A GP identifies the patient that falls into ‘vulnerable category’ as discussed above. The patient needs a follow up of some sort.
Step 2. Instead of calling the patient in, a GP calls the patient and discusses the issue over the phone.
Step 3. In the course of that consultation, a GP informs the patient that this telephone consultation to avoid personal attendance in times of Coronavirus.
Telehealth for the non-COVID-19 matter. Can a patient receive telehealth consultation for any matter not related to COVID-19? YES, if this patient has seen this GP at least once before in the past. People in isolation or quarantine for COVID-19 can see any eligible health provider through new telehealth items REGARDLESS of the past visits.
