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Updated spirometry rebates still too low: RACGP


Doug Hendrie


31/07/2019 2:48:04 PM

The RACGP believes the recent increase was not enough given general practice spirometry saves the health system money.

Spirometry rebates are not high enough: RACGP
Spirometry rebates are up – but not enough, the RACGP says.

In a submission to the Department of Health (DoH), the college states that the new rebate of $35.50 for item 11505 ‘does not reflect the true cost of providing properly performed office-based spirometry’.
 
The call for a higher rebates comes after the DoH asked for feedback on changes made to Medicare Benefits Schedule (MBS) items for thoracic medicine (respiratory function tests and sleep studies) in November last year following recommendations by the MBS Review Taskforce.
 
Several GPs wrote to the RACGP during a recent consultation period on the changes, stating that even with the new rebate, office-based spirometry is still not financially viable. By contrast, other GPs said the new rebate is an improvement on the previous rate of $17.50.
 
‘GPs undertake these tests when it is clinically necessary to do so, as options for accessing spirometry locally are often limited. Inappropriate support for office-based spirometry could limit patient access to this important service,’ the RACGP submission states.
 
‘The provision of office-based spirometry by GPs reduces the cost and inconvenience associated with referring patients to specialists or hospital providers. Therefore, savings achieved through increased office-based spirometry should be redirected to ensure this service is appropriately supported.
 
‘[R]eassessment of rebate value should consider the savings and efficiencies gained through not requiring hospital or laboratory-based spirometry.’
 
Since the increased rebate for item 11505 has been introduced, between 20% and 25% of spirometry tests have been billed using that item.
 
But the RACGP has also called for clearer descriptions for the circumstances in which items 11505 and 11506 can be claimed, given the only difference appears to be that three or more recordings must be made to claim 11505.
 
Other recommendations include ensuring there is capacity to claim an MBS rebate for spirometry not requiring reversibility testing, developing a defined list of conditions to determine eligibility of patients with a high pre-test probability of sleep apnoea for a diagnostic sleep study, and better communication around MBS changes.
 
‘GPs have also raised concerns about the inability to claim spirometry items for spirometry that does not require time consuming reversibility testing, for example for patients on long-acting bronchodilators who require a quick check of their lung function,’ the submission states.
 
‘Some GPs have reported that they use a spirometer that integrates into their clinical software and enables easy comparison between a patient’s previous results. This type of spirometry is widely used, however is not remunerated under the MBS.
 
‘The RACGP recommends that the department ensure that there is capacity within the MBS for spirometry providers to be supported to provide spirometry that does not require reversibility testing.’
 
The submission also states that GPs have found departmental fact sheets about the changes ‘unhelpful’ given some fact sheets do not contain the new item descriptors.



MBS spirometry thoracic medicine


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