Fact sheet clarifies billing rights when using interpreters

The Department of Health (DoH) has published a new fact sheet to provide information on the inclusion of communication time when claiming time-tiered MBS items.
 
If GPs use an interpreter to communicate effectively with a patient and the consultation therefore requires more time than usual, they can now bill a longer attendance item (Level C or D). This applies to both face-to-face and telehealth services.
 
When claiming for time-tiered MBS items, the total consultation time involved includes the time required to communicate effectively with the patient.
 
According to the DoH, the service will help to ensure effective communication among patients from culturally and linguistically diverse (CALD) backgrounds, patients with a disability, or cognitive impairment.
 
Dr Rebecca Farley, Chair of RACGP Specific Interests Refugee Health, says the update gives GPs adequate billing options and will allow more time with patients to ensure high-quality care is delivered.
 
‘Whether it is appropriate to claim a longer attendance item than might otherwise be expected when increased time is required to communicate effectively with our patients, has been an area of uncertainty for many GPs for a long time,’ she told newsGP.
 
‘This fact sheet provides welcome clarity around this issue.
 
‘Being able to communicate effectively with our patients is an essential component of delivering healthcare. As GPs we have a professional obligation to understand our patients’ needs and in turn, ensure they fully understand the information and recommendations we are providing.
 
‘For patients with low-English proficiency, working with professional, credentialed interpreters is crucial to being able to achieve this.’
 
The fact sheet was developed in consultation with the RACGP following member enquiries about billing longer consultation items when an interpreter is required.
 
In December 2021, college President Professor Karen Price wrote to the DoH recommending a change to MBS item descriptors to reflect the additional time required for GP consultations when an interpreter is used, to reassure GPs that they are billing correctly when a longer consultation item is required.
 
This recommendation was partly in response to member feedback revealing that many GPs are unsure if they can bill a longer consultation item when additional time is required for consultations involving interpreters.
 
Professor Price highlighted that CALD patients have been particularly impacted by the COVID-19 pandemic and often experience poorer health outcomes than the rest of the population, and interpreters are underutilised in the primary care setting due to a number of disincentives and barriers, sometimes resulting in this cohort avoiding healthcare.
 
‘Boosting uptake of interpreters in general practice is arguably more important than ever to
reduce health inequality and minimise the impact of the pandemic on vulnerable communities,’ Professor Price wrote.
 
‘Greater use of interpreters can result in more effective healthcare provision, improved communication between clinicians and patients, better comprehension by patients of medical instructions, and mitigation of medico-legal risks around duty of care.’
 
While the DoH responded that descriptors could not be amended, the new fact sheet confirms that GPs are billing correctly when a longer consultation item is required due to the extended nature of consultations involving interpreters.
 
Dr Farley said it is ‘wonderful’ to see the work of the college and DoH in responding to the concerns of GPs and other healthcare professionals to bring clarity to the issue.
 
‘I feel this is an important step in supporting equity of access to healthcare for CALD communities, including people from a refugee background and those seeking asylum,’ she said.
 
‘It supports GPs to engage interpreters were appropriate, which is an essential component of delivering care.’
 
Further resources for GPs working with interpreters:
 

• The RACGP’s Telehealth consultations with patients requiring an interpreter
• Guide for clinicians working with interpreters in healthcare settings
• Australian refugee health practice guide
• GPs can register for a free TIS code by calling 1300 131 450 or visiting the TIS website

CALD patients interpreters MBS billing time-tiered items