Q: Hi Paul, We have a doctor who does acupuncture as well as he has got 20 years of experience and he is getting lot of patients for acupuncture service. We have one question that how many visits we can charge to Medicare for acupuncture treatment because some of the patients are coming once a week for ongoing, so can we justify these many acupuncture as part of the general practice consult and what sort of documentation we require for that.
A: Hi XXXXXXX,There are no particular guidelines on how many acupuncture items can be billed per patients, per day etc. for as long as the items match the MBS descriptor. Please, exercise caution with the overall number of patients seen on a day. There is a formal 80/20 rule* and an informal 60/15 rule. Some GPs were picked for medicare audits for exceeding 60 patients a day over any 15 days in 12 months period.
Kindest regards, Paul
* 80/20 rule. It an absolute indefensible offence to see 80 or more patients over any 20 days in 12 months period.