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DoH releases 30/20 rule fact sheet


Matt Woodley


3/10/2022 1:34:34 PM

The new telehealth compliance measure came into effect on 1 October, despite calls to delay its implementation.

GP picking up the phone
The 30/20 rule limits the number of MBS items GPs can claim for providing telehealth services.

The Department of Health and Aged Care (DoH) has released a new fact sheet aimed at helping GPs to comply with the recently implemented 30/20 telehealth rule.
 
The new compliance measure means any GP, other medical professional (OMP) or consultant physician who claims 30 or more relevant telephone attendance services on 20 or more days in a rolling 12-month period will be in breach of the 30/20 telephone rule.
 
All breaches of the rule will be referred to the Director of the Professional Services Review (PSR).
 
‘With telephone items now a permanent feature of the MBS, high-value comprehensive patient care will be supported by this rule,’ the fact sheet states.
 
‘This new rule seeks a balance between improved access to services enabled by telehealth and maintenance of high-quality care. This approach is consistent with and complements the existing clinical relationship required for most GP telehealth services.
 
‘Legislated rules, such as the 30/20 telephone rule … help ensure that public health funding is directed towards services that are clinically effective, cost effective and achieve their intended health outcomes for all Australians.’
 
The fact sheet details the MBS items for which the rule applies, as well as exceptions, namely:

  • temporary MBS items for telephone services for assessing patients’ suitability for COVID-19 oral antiviral medications (item 93716 for GPs, and 93717 for OMP)
  • MBS telephone items for midwives, allied health practitioners, allied mental health practitioners and nurse practitioners
  • MBS items for services provided on behalf of a medical practitioner (items 93202 and 93203)
  • obstetric services (items 91855, 91856, 91857 and 91858).
Originally due to be implemented in January, the rule has been delayed twice – including a last-minute reprieve in July – due to the ongoing impact of the COVID-19 pandemic.
 
The RACGP has long opposed the new compliance measure’s introduction, with Vice President Dr Bruce Willett earlier this year calling for a review of the 30/20 rule prior to it being implemented to ensure it is ‘fit for purpose’.
 
A joint RACGP and AMA appeal was also launched on Friday 30 September – the day before the rule was due to come into effect – but was met with silence from the DoH.
 
Federal Health and Aged Care Minister Mark Butler did not respond to requests for comment around the concerns raised in the appeal.
 
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30/20 rule compliance Medicare Professional Services Review PSR telehealth


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Dr Nisha Mahajan   4/10/2022 6:48:29 AM

Is it only the telephone consults that require compliance with 30/20 rule? Are video consults exempt from 30/20 rule?