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Longer telehealth consultations reinstated in COVID hotspots

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This story was updtated at 12.10 pm on Friday 16 July to include more information on the newly-created MBS item 92746.

At a press conference on Thursday, Prime Minster Scott Morrison said Medicare-supported telephone consultations lasting more than 20 minutes will return to COVID-19 hotspots recognised by the Commonwealth.
 
‘We will be restoring the temporary Medicare telehealth system,’ Prime Minister Morrison said.
 
‘That means there will be a new Medicare item [92746] reintroduced to ensure people in COVID-19 hotspots … have access to longer phone consultations for chronic conditions or other health issues that may require doctors to spend more time with patients.’
 
The Prime Minister said the re-introduction was done on the recommendation of the Federal Health Minister Greg Hunt.
 
During the press conference he also noted 14 July was a record day for the number of vaccine doses administered in primary care.
 
‘GPs continue to carry the lion’s share of that burden of getting those jabs in arms, [they’re] doing an amazing job,’ he said.
 
According to the Federal Government, triggers that could lead to a hotspot being declared include:

• any area where this is a community acquired case of a more transmissible variant of SARS-CoV-2 and opportunities for wide community exposure
• a metropolitan area where the rolling three-day average is 10 locally acquired cases per day, equivalent to more than 30 cases in three consecutive days
• a rural or regional area where the rolling three-day average is three locally acquired cases per day, ie nine cases over three consecutive days.

Commonwealth-declared hotspots currently include all of Greater Sydney, as well as the Central Coast, Blue Mountains, Wollongong and Shell Harbour areas of New South Wales.
 
Victoria has also been declared a COVID hotspot and entered a snap lockdown that will last at least five days.
 
The MBS rebate will apply to Level C telephone consultations and will be in place from Friday 16 July.

According to the MBS website, patients will be able to access a rebate for phone attendance by a GP lasting at least 20 minutes, if the service is performed on a person who is in:
 

• a COVID-19 Commonwealth declared hotspot
• COVID-19 isolation or quarantine because of a state or territory public health order.

 The attendance must also include any of the following that are clinically relevant:
 

• Taking a detailed patient history
• Arranging any necessary investigation
• Implementing a management plan
• Providing appropriate preventive healthcare

RACGP President Dr Karen Price said the announcement will make ‘a real difference’ in ensuring access to care for patients in hotspots.
 
‘With an extended lockdown in Greater Sydney and COVID-19 cases in other states, we need this more than ever,’ she said.
 
‘We know from experience that patients tend to avoid care during lockdowns and outbreaks, particularly those who are vulnerable. This leads to worsening health conditions and a greater burden on our already overloaded hospitals down the track.
 
‘And I know from my own practice that many patients are either not comfortable accessing video consultations or are unable to do so, particularly those who are older, and economically disadvantaged.’
 
Dr Price said the college has consistently advocated for the importance of telephone consultations as part of the telehealth mix, and that the new item number is ‘welcome recognition of its value’.
 
‘Anecdotally, patients have expressed relief at being able to contact their usual GP for care during such a stressful time,’ she said. 
 
‘[Along] with a move to e-prescriptions, this is really enhancing the modern version of continuity of care and is progressive policy responding to the needs of the community.’
 
Dr Michael Wright, Chair of RACGP Expert Committee – Funding and Health System Reform, also welcomed the announcement.
 
‘It’s great to see a broader range of GPs and their patients having access to longer consultations funded by Medicare,’ he told newsGP.
 
‘Although video and face-to-face might be preferred in many situations, sometimes telephone consultations are the only option.
 
‘Particularly in lockdown areas, it is crucial patients can access care.’
 
Dr Wright says the RACGP will continue to push for longer telephone consultations in areas beyond hotspots, and that they should have a permanent place in the healthcare system.
 
Rebates for Level C and D telephone consultations were previously removed from the MBS at the end of the last financial year on 30 June.
 
The RACGP has strongly advocated that they remain available to general practice and Dr Price said the college will continue working with the Government to find long-term telehealth solutions.
 
‘The evidence shows it’s convenient for patients, is appropriate for a variety of consultations and it enhances access to care,’ she said.
 
‘RACGP advocacy saw telehealth introduced in a matter of months, rather than the years it might have taken without a pandemic.
 
‘As a GP myself, I see the value of telehealth and how it enhances care every day. And I look forward to continuing discussions with the Government to find a long-term solution for telehealth – because I know what it can do for patients.’
 
The introduction of telehealth was fast-tracked as a result of the COVID-19 pandemic, and was made a permanent feature of the health service last November. 
 
Earlier this year, the Department of Health (DoH) advised it would undertake a telehealth compliance campaign targeting GPs who had not been adhering to the ‘12-month rule’, but the scale of the crackdown was greatly reduced following RACGP advocacy.
 
Patients in hotspots, as well as those under stay-at-home orders, do not need to have physically been to their general practice within the past 12 months to qualify for MBS telehealth rebates.
 
Other patients who have access to the subsidy include:
 

• Those diagnosed with COVID-19 who are isolating at home
• Returned Medicare-eligible overseas travellers in hotel quarantine whose healthcare is not being provided by a state or territory government
• People going into another state with border restrictions who need to self-isolate on arrival
• Close contacts of a confirmed COVID-19 case who are required to self-isolate
• Close contacts of a possible COVID-19 case
• People awaiting the results of a COVID-19 test

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care chronic consults continuity COVID-19 disease longer MBS of telehealth

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