Details of permanent telehealth arrangements published

Jolyon Attwooll

16/12/2021 3:23:44 PM

The fact sheets for ongoing MBS telehealth have now been released, with the changes to come into effect from the beginning of 2022.

A GP on the telephone
A new ‘30/20’ rule will be introduced for GP telephone services.

Full details of the permanent telehealth arrangements announced earlier this week have now been published by the Department of Health (DoH).
The fact sheets, available on the DoH’s MBS Online website, include permanent MBS item numbers that will allow telehealth services – initially fast-tracked in response to the pandemic – to continue indefinitely. The new arrangement comes into effect from 1 January, 2022.
A number of changes have been flagged, including:

  • an extended phone consultation item for 20 minutes or more has been resinstated for patients in rural and remote communities (Modified Monash 6 and 7 regions)
  • COVID-19 GP ‘hotspot’ telephone items for consultations longer than 20 minutes will stop
  • patients isolating or in quarantine due to COVID-19 public health orders will have unrestricted access to telehealth and will not need to demonstrate an established clinical relationship with their telehealth provider
  • specific GP nicotine and smoking cessation services including telehealth have been extended until 31 December 2023. These services do not require an established clinical relationship when provided by telehealth
  • GP sexual and reproductive health services and non-directive pregnancy support counselling will now continue until 30 June 2023. Again, no established clinical relationship will be required.
Apart from limited exceptions, GPs and other medical professionals (OMPs) working in general practice will only be able to use telehealth for patients with whom they have an existing clinical relationship.
As announced on Monday, MBS telehealth items will also now contribute to Standardised Whole Patient Equivalent (SWPE) calculations, another move the college had sought. These will be used to work out Practice Incentives Program (PIP) and the Workforce Incentive Program – Practice Stream (WIP) payments.  
There are also updated Medicare compliance rules to include telephone and video services following the established 80/20 rule, with a new ‘30/20’ rule to be introduced for GP telephone services.
Telehealth items that existed before the pandemic will be removed to avoid duplication. These include pre-COVID items for GP and OMP mental health consultations and general attendances by video. GP and OMP patient-end support items linked to pre-COVID medical specialist and consultant physician telehealth services are also being removed.

Confirmation of telehealth’s permanent place in the healthcare system was welcomed by RACGP president Dr Karen Price earlier this week, following extensive advocacy from the college. Federal Minister for Health and Aged Care Greg Hunt said that over the next four years $106 million of Federal Government funding will be set aside to facilitate telehealth’s introduction on a permanent basis.
Mor information on the incoming telehealth changes is available on the RACGP website.
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Dr Ian   17/12/2021 7:50:23 AM

Anything that improves the quality of care is great and Telehealth enables follow up as well as the the advantages for people living in Remote Settings and those who may be home bound on that particular day .
It can increase interactions and reduce feeling of isolation .
It allows Doctors who are ill or in quarantine to still consult with patients .
There will be people who rort the system medicos have faults like other people and this spoils it for the more honest providers .

Dr Thomas Hilliar   17/12/2021 8:19:57 AM

Where is our advocacy RACGP?
This PSR rule is insane?
Basically any dr that works from home in quarantine for 2 weeks will be referred to the PSR.
How did we trip over this landmine?
"""In addition, any GP who provides more than 30 telephone consultations on 20 or more days in a 12-month period will be referred to the PSR"""

Dr Jonny Bigwood   17/12/2021 12:04:45 PM

I agree Thomas. That rule is ridiculous and will restrict patients continuity of care.

For example I see 30-35 patients on typical day. If I have to isolate due to covid exposure or illness or quarantine after travel I could easily switch to telehealth for 20+ days for my patients but not now.

An arbitrary rule brought in without thinking about the consequences which will have a negative impact on patients. It won't even save money - if my patients see someone else Medicare still pays the same amount!

Dr Greg   17/12/2021 2:15:37 PM

Dr Hilliar,
Unfortunately these restrictions are needed because some doctors try to rort the Medicare system. So this doesn't have to be a landmine; it's there to control greedy doctors. I am sure that is not you.
BTW, you only have to isolate for 10 days (if you are double vaccinated) not "2 weeks". And trust me, for the first five or so days of quarantine (if you have COVID-19) you will not feel like doing ANY work. So unless you intend to contract COVID-19 more then 3 times a year, you should be OK.
So the rule isn't as "insane" as you initially thought.

Dr Alan Graham MacKenzie   18/12/2021 1:12:33 AM

The 30/20 seems counterproductive
Working 4 full days face to face in the clinic and the 5 th day from home doing Telehealth to tidy up all the outstanding pathology and radiology and specialist reports is actually quite an effective Method of practice for patient and doctor.
Not sure why a 30/20 limit would be imposed on this

Dr Elia Botros   20/12/2021 11:19:43 PM

Dr Greg, 30/20 is unfair. You can't reject half of the patients to control greedy GPs
In my practice most patients now prefer Telehealth and I can see over 40 appointment slots booked for Telehealth everyday
Do I call half of them and reject the other half to be safe or to make Medicare happy?