DoH responds to RACGP call for vaccine counselling flexibility

Matt Woodley

2/08/2021 1:36:45 PM

The need for patients seeking advice to be vaccinated on the same day for GPs to generate a Medicare rebate no longer applies in all circumstances.

GP consultation
If a patient is assessed and not vaccinated ‘due to unforeseen circumstances’ they can now return to the practice at a later date to receive their vaccination.

Ever since the rare cases of thrombosis with thrombocytopenia syndrome (TTS) were linked to the AstraZeneca vaccine, GPs have been inundated with patients wanting to discuss the risks and benefits of vaccination against COVID-19.
Following RACGP advocacy, a new vaccine counselling MBS item (10660) was created to support these consultations. But strict criteria that essentially mean patients have to proceed with vaccination immediately following the counselling consultation have made it difficult for GPs to bill the item, as many practices typically have their vaccine clinics booked weeks in advance.
But that requirement appears to no longer apply in all circumstances following updates made to the Department of Health (DoH) Medicare Support for COVID-19 Vaccinations FAQs.
‘If a patient is assessed as being suitable to receive a COVID-19 vaccine, it is expected the vaccine will be administered to the patient a short time after the assessment on the same day,’ the fact sheet states.
‘However, in situations where a patient is assessed and elects to be vaccinated, but the vaccination cannot be delivered due to unforeseen circumstances, the patient may return to the medical practice at a later date to receive their vaccination.
‘A further vaccine suitability assessment service would also need to be provided, to ensure that the patient can still receive the vaccine safely. Circumstances that may lead to this kind of delay include unanticipated staff absences leading to reduced capacity to vaccinate all patients on the day of service.’
Practices not participating in the rollout cannot bill the vaccine-counselling item.
RACGP President Dr Karen Price told newsGP the new billing flexibility is welcome, as the previous criteria had rendered the vaccine counselling item almost unusable.
‘This is good news for GPs all across Australia who are involved in the vaccine rollout, and I commend the Department for responding to feedback and making the change,’ she said.
‘The emergence of Delta in Australia, particularly Sydney, has led to more and more patients wanting to discuss the risks and benefits of vaccination, which is a good thing but has also increased pressure on general practice.’
However, Dr Price said there is still some uncertainty regarding what constitutes ‘unforeseen circumstances’ and the RACGP is also seeking to confirm that the counselling item can be claimed if the conversation occurs during a consultation for an unrelated health issue.
‘GPs can’t simply turn around and grab a dose out of the fridge if a patient asks about COVID vaccines during a consultation for an unrelated health issue – the clinics are not set up that way,’ she said. ‘And there are also limitations due to each vial having more than one dose.
‘The Medicare system also needs to be properly set up so that GPs don’t get rejected should they attempt to co-claim 10660 with another item.
‘The college will continue undertaking advocacy work to ensure GPs and patients are supported to have these important conversations, so we can continue getting on with the task of vaccinating every eligible Australian to protect them against COVID-19.’
A record number of vaccines were administered via primary care on Wednesday (114,565) – before being immediately surpassed the following day (121,626) – which Dr Price said is further proof of general practice’s central role in the national vaccine rollout.
‘GPs continue to administer more vaccines than any other distribution channel in the country. We are the nation’s vaccinators,’ she said.
‘While the daily numbers are higher than they’ve ever been, GPs are still being constrained by the limited supply of Pfizer and I am confident that those totals will only increase once major shipments start coming through later in the year.
‘It’s been tough, but we’re getting there. GPs and patients just need to stay the course for a little while longer because even though it seems pretty dark in some parts of Australia right now, there is light at the end of the tunnel.’
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