News

RACGP secures $500m to help general practice fight coronavirus


Doug Hendrie


29/03/2020 11:11:19 AM

In the most far-reaching change for general practice in a generation, telehealth will be broadened to include all Australians and new incentives introduced to keep GPs and patients safe during the pandemic.

Greg Hunt, Scott Morrison
Prime Minister Scott Morrison Federal Health Minister Greg Hunt announced the package this morning.

UPDATED

An estimated $500 million in new telehealth measures and incentives for GPs has been announced following strong RACGP advocacy to keep patients and frontline doctors safe from the coronavirus.
 
The package includes opening up telehealth and telephone Medicare Benefits Schedule (MBS) items to all Australians, doubling the bulk-billing incentive for GPs, and the introduction of a new incentive payment to help general practices stay open to provide face-to-face services for patients with conditions that cannot be treated via telehealth.
 
The range of services GPs can now provide over phone or video have also grown to include mental health treatment, chronic disease management and Aboriginal and Torres Strait Islander health assessments, as well as services to people with eating disorders, pregnancy support counselling, services to patients in aged care facilities, children with autism, and after-hours consultations.
 
Launching the package today, Prime Minister Scott Morrison said the changes are about ‘getting health services into your home.’
 
Federal Health Minister Greg Hunt said the changes are a ‘radical transformation’ of the way healthcare is delivered.
 
‘As of tomorrow, we will have universal telehealth available in Australia. It’s a decade’s worth of work in a matter of days,’ he said.
 
Minister Greg Hunt thanked Principal Medical Adviser – and former RACGP President – Professor Michael Kidd for the work his team had done, as well as the RACGP and other peak bodies.
 
Professor Kidd described the changes as the most dramatic of his whole career.
 
‘From tomorrow morning, as a patient you can reach out to your GP, specialist or other healthcare provider. If you’re a GP, you will be able to reach out to their patients to make sure they are okay and adhering to their plans for management of chronic disease,’ he said.
 
‘We know that during a pandemic, one of the greatest risks to the population is if we see a collapse of services available to patients with chronic health or mental health conditions. The measures put in place will ensure the people of Australia continue to have access to high-quality [medical services].’
 
Professor Kidd thanked the peak medical bodies and health organisations that have worked at an ‘extraordinary level’ to make this happen.
 
In a release, Minister Hunt said telehealth is a ‘key weapon in the fight against the COVID-19 pandemic’.
 
‘Australia’s primary health workers are our frontline in leading the fight against this pandemic,’ he said.
 
The welcome news is set to continue for general practice, with Minister Hunt indicating that private billing for telehealth and telephone items will be permitted for non-concessional patients, with an official announcement expected within a fortnight.
 
The changes will begin from 8.00 am 30 March:

  • Items for telehealth/telephone consultations will mirror general practice, other specialist, and allied health item numbers
  • Doubling the bulk-billing incentive payment for pensioners, under-16s and concession card holders
  • Doubling of Quality Improvement Practice Incentive Payments (QI PIP) to support face-to-face consultations
The RACGP has actively lobbied for the changes to keep GPs safe through major reductions in face-to-face consultations and a shift to telehealth, as well as allowing practices to weather the coronavirus storm.
 
RACGP President Dr Harry Nespolon hailed the package as a major win for Australia’s GPs.  
 
‘It is positive news that the Federal Government is listening to the RACGP’s calls at this critical time – telehealth is a key weapon in the fight against this pandemic,’ he said.
 
‘The reason we have been pushing so hard for the telehealth expansion is because GPs on the frontline battling COVID-19 know that it will make a real difference in limiting the spread of the virus.
 
‘It is vital to provide extra support to keep general practices open so they can continue to provide essential support to their communities. Like the multitude of other small businesses, general practices have seen the number of patients drop and we need our practices to stay open during the crisis and beyond.’
 
Dr Nespolon said it is important to note that the MBS items apply to telephone consultations as well as video calls. 
 
‘We need to be technologically agnostic and not have the public or GPs think that this MBS item is limited to video consultations,’ he said. ‘An old-fashioned phone will do just fine.’

Michael-Kidd-hero.jpg
‘This has been one of the most significant changes we’ve seen in Australian general practice in my working lifetime of 35 years,’ Professor Michael Kidd, Principal Medical Adviser to the Department of Health, said.

Telehealth is seen as a vital way of keeping GPs safe, allowing patients who are self-isolating or quarantining to still get access to medical care while minimising exposure to their doctor.
 
The sweeping changes are among the largest announced for general practice in decades, and will be in place at least until 30 September, after which time they will be reviewed.  
 
The Government consulted widely before announcing the changes, collaborating directly with the RACGP, the Australian Medical Association and other stakeholders.
 
Patients are being advised to discuss whether telehealth or face-to-face consults are the most appropriate with their GP.
 
The general practice package was the largest plank of a wider suite of measures boosting services during the pandemic, with mental health and family violence service providers also receiving a funding boost to help telephone services expand to meet significant and growing demand. 
 
Other nations around the world have been moving to implement telehealth during the crisis, beginning with China’s early move to get half of all consultations done by phone or video.
 
The UK and US and other affected nations are also moving to telehealth.


Expanded telehealth items as announced on 29 March (table updated with rebate values)

Item Descriptor Rebate
Consultation items – Telehealth/videoconference  
91790 Level A – General Consult $17.50
91800 Level B – General Consult $38.20
91801 Level C – General Consult $73.95
91802 Level D – General Consult $108.85
Consultation items – Phone consultation
91795 Level A – General Consult $17.50
91809 Level B – General Consult $38.20
91810 Level C – General Consult $73.95
91811 Level D – General Consult $108.85
Focussed Psychological Strategies – Telehealth/videoconference
91818 Telehealth consultation lasting 30–40 minutes $94.25
91819 Telehealth consultation lasting at least 40 minutes $134.85
Focussed Psychological Strategies – Phone consultation
91842 Phone consultation lasting 30–40 minutes $94.25
91843 Phone consultation lasting at least 40 minutes $134.85
GP mental health treatment plan – Telehealth/videoconference
92112 Telehealth attendance lasting at least 20 minutes for the preparation of a GP mental health treatment plan (no additional mental health skills training)  $72.85
92113 Telehealth attendance lasting at least 40 minutes for the preparation of a GP mental health treatment plan (no additional mental health skills training)  $107.25
92114 Telehealth attendance to review a GP mental health treatment plan $72.85
92115 Telehealth attendance relating to mental disorder and consultation lasting at least 20 minutes $72.85
92116 Telehealth attendance lasting at least 20 minutes for the preparation of a GP mental health treatment plan (with additional mental health skills training)  $92.50
92117 Telehealth attendance lasting at least 40 minutes for the preparation of a GP mental health treatment plan (with additional mental health skills training)  $136.25
GP mental health treatment plan – Phone consultation  
92124 Phone attendance lasting at least 20 minutes for the preparation of a GP mental health treatment plan (no additional mental health skills training)  $72.85
92125 Phone attendance lasting at least 40 minutes for the preparation of a GP mental health treatment plan (no additional mental health skills training)  $107.25
92126 Telehealth attendance to review a GP mental health treatment plan $72.85
92127 Phone attendance relating to mental disorder and consultation lasting at least 20 minutes $72.85
92128 Phone attendance lasting at least 20 minutes for the preparation of a GP mental health treatment plan (with additional mental health skills training)  $92.50
92129 Phone attendance lasting at least 40 minutes for the preparation of a GP mental health treatment plan (with additional mental health skills training)  $136.25
GPMP, TCA and multidisciplinary care plans via telehealth/videoconference
92024 Preparation of a General Practitioner Management Plan   $146.55
92025 Coordinate the development of team care arrangements $116.15
92026 Contribute to care plan or review   $71.55
92027 Contribute to care plan or review for a patient in a residential aged care facility or a patient being discharged from hospital $71.55
92028 Review or coordinate review of:
  • a GP Management Plan  to which items 721, 229, or item 92024 or 92068 applies; or
  • team care arrangements to which item 723 of the general medical services table, item 230, or item 92025 or 92069 or items applies
$73.20
GPMP, TCA and multidisciplinary care plans via phone consultation
92068 Preparation of a General Practitioner Management Plan  
 
$146.55
92069 Coordinate the development of team care arrangements $116.15
92070 Contribute to care plan or review   $71.55
92071 Contribute to care plan or review for a patient in a residential aged care facility or a patient being discharged from hospital $71.55
92072 Review or coordinate review of:
  • a GP Management Plan to which item 721 of the general medical services table, item 229, or items 92074 to 92078 or 92030 to 92034, or items 92024 or 92068 applies; or
  •  team care arrangements to which item 723 of the general medical services table or item 92025 or 92069 or items applies
$73.20
Health assessment – Aboriginal and Torres Strait Islander People – Telehealth/videoconference  
92004 Health assessment   $215.65
Health assessment – Aboriginal and Torres Strait Islander People – Phone consultation   
92016 Health assessment $215.65
GP pregnancy support counselling – Telehealth/videoconference  
92136 Telehealth attendance of at least 20 minutes   $77.85
GP pregnancy support counselling – Phone consultation
92138 Phone attendance of at least 20 minutes $77.85
GP, specialist and consultant physician autism service – Telehealth/videoconference
92142 Telehealth attendance of at least 45 minutes $136.65
GP, specialist and consultant physician autism service – Phone consultation  
92145 Phone attendance of at least 45 minutes $136.65
GP eating disorder treatment and management plan – Telehealth/videoconference
92146
 
Telehealth attendance, no additional mental health skills training of at least 20 minutes for preparation of written eating disorder treatment and management plan for eligible patient     $72.85
92147 Telehealth attendance, no additional mental health skills training lasting at least 40 minutes for the preparation of a written eating disorder treatment and management plan for an eligible patient $107.25
92148 Telehealth attendance, additional mental health skills training, lasting at least 20 minutes for the preparation of a written eating disorder treatment and management plan for an eligible patient $92.50
92149 Telehealth attendance, additional mental health skills training, lasting at least 40 minutes for the preparation of a written eating disorder treatment and management plan for an eligible patient $136.25
GP eating disorder treatment and management plan – Phone consultation 
92154 Phone attendance, no additional mental health skills training, lasting at least 20 minutes for preparation of written eating disorder treatment and management plan for eligible patient     $72.85
92155 Phone attendance, no additional mental health skills training lasting at least 40 minutes for the preparation of a written eating disorder treatment and management plan for an eligible patient $107.25
92156 Phone attendance, additional mental health skills training, lasting at least 20 minutes for the preparation of a written eating disorder treatment and management plan for an eligible patient $92.50
92157 Phone attendance additional mental health skills training, lasting at least 40 minutes for the preparation of a written eating disorder treatment and management plan for an eligible patient $136.25
Review of an eating disorder plan – Telehealth/videoconference  
92170 Telehealth attendance to review an eating disorder treatment and management plan   $72.85
Review of an eating disorder plan – Phone consultation  
92176 Phone attendance to review an eating disorder treatment and management plan   $72.85
GP eating disorder – Focussed Psychological Strategies telehealth/videoconference  
92182 Telehealth attendance consultation for providing eating disorder psychological treatment services, lasting at least 30 minutes $94.25
92184 Telehealth attendance consultation for providing eating disorder psychological treatment services, lasting at least 40 minutes $134.85
GP eating disorder – Focussed Psychological Strategies – Phone consultation  
92194 Phone attendance for providing eating disorder psychological treatment services, lasting at least 30 minutes $94.25
92196 Phone attendance consultation for providing eating disorder psychological treatment services, lasting at least 40 minutes $134.85
GP – urgent after hours in unsociable hours – Telehealth/videoconference  
92210 Telehealth attendance in unsociable hours if:
(a) the attendance is requested by the patient or a responsible person in the same unbroken after-hours period; and
(b) the patient’s medical condition requires urgent assessment
$155.45
GP – urgent after hours in unsociable hours – Phone consultation   
92216 Phone attendance in unsociable hours if:
(a) the attendance is requested by the patient or a responsible person in the same unbroken after-hours period; and
(b) the patient’s medical condition requires urgent assessment
$155.45
Obstetric services – Telehealth/videoconference
91850 Antenatal telehealth service provided by a nurse, midwife or an Aboriginal and Torres Strait Islander health practitioner on behalf of, and under the supervision of, a medical practitioner $23.55
91851 Postnatal telehealth attendance by an obstetrician or GP $61.95
91852 Postnatal telehealth attendance by:
(i) a midwife (on behalf of and under the supervision of the medical practitioner who attended the birth); or
(ii) an obstetrician; or
(iii) a general practitioner
$46.15
91853 Antenatal telehealth attendance $40.75
Obstetric services – Phone attendance
91855 Antenatal phone service provided by a nurse, midwife or an Aboriginal and Torres Strait Islander health practitioner on behalf of, and under the supervision of, a medical practitioner $23.55
91856 Postnatal phone attendance by an obstetrician or GP $61.95
91857 Postnatal phone attendance by:
(i) a midwife (on behalf of and under the supervision of the medical practitioner who attended the birth); or
(ii) an obstetrician; or
(iii) a general practitioner
$46.15
91858 Antenatal telehealth attendance $40.75
Important: Review full item descriptors and notes via MBS Online

Detailed fact sheets on the temporary telehealth bulk-billed items for COVID-19 are available on the Department of Health website. And GPs who would like more information and advice on primary care telehealth consultations should access the new RACGP guidelines on the college website.
 
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bulk bill coronavirus COVID-19 general practice telehealth



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Dr Olufemi Onikola   29/03/2020 12:19:08 PM

Different challenging times
Dynamic good efforts
Thank you


Dr Ian Mark Light   29/03/2020 12:43:54 PM

A great initiative and increases checking on patients ought give Aged Care Facilities the ability also by having the smart phones with apps like Zoom .
For the face - face consults with the Viral infections they may well be less of this with the physical distancing - but stringent PPE - Full Face Shields Masks Double Gloves Gowns including head and neck cover with putting on and taking off training and practicing are essential .
Patients can self swab in the nasal swab if there is nasal congestion Viral particles will be there as found in Chinese studies .


Dr Marita Anne Carman   29/03/2020 1:02:55 PM

Good news - but face to face remains risky with minimal access to PPE. We really need to gat distribution happening.


Dr Ayanthi Sonali Rodrigo Goonewardene   29/03/2020 1:03:25 PM

If a GP has a chronic medical condition requiring Telehealth for all patients, does the BB incentive apply to all patients? Or restrictions still apply on who’s eligible for BB incentives?


Dr Yimei Sun   29/03/2020 1:41:56 PM

this is great news for GPs. We actually can do a lot of things via phone or video than we thought. In this special difficulty time, teleconsult s can protect GP and patients.


Dr Susan Margaret McDonald   29/03/2020 2:33:25 PM

Well done RACGP! This will be a huge advance for Australian general practice and is a win win for all.


Dr Caetlin Jill Jopson   29/03/2020 2:46:24 PM

Great news
Thank you
Now for LOCKDOWN please!!


Dr Assem Al Alwani   29/03/2020 3:07:10 PM

Good news to reduce risk for doctors and patient alike while keeping the service viable!
Are care plans , health assessment and Mental health plans included ?


Dr Uma Bhatta Prasad   29/03/2020 3:10:54 PM

Excellent news especially for us senior doctors


Dr Fiona Jane Henneuse-Blunt   29/03/2020 3:16:58 PM

Great news. I hope these items continue afterwards as they are a common sense solution . UK GPs are so used to phone consultations that it had always seemed backward here in Australia to not be allowed to manage patient problems that way. Well done


Dr Dileep Singh   29/03/2020 3:51:11 PM

Contgrats RACGP //. Query ,, Is electronic signature accepted on prescriptions,Pathology and radiology request //can you issue medical certificates on telehealth consult ??


Dr Surendar Kumar Advani.   29/03/2020 4:06:03 PM

So does it mean we do any consult on telephone?
Thank you RACGP and Aus Gov for the support.


Dr Ike Eustace Emezie   29/03/2020 4:21:37 PM

Well done RACGP.
Now time to reopen Special approved placement program (SAPP Category F -provider number) - Emegency Pandemic Respondent to increase the Gp workforce. This will help all GPs work towards fighting covid -19 . Some of he Gps are already fatigued and need some rest.


Dr Dileep Singh   29/03/2020 4:48:26 PM

Contgrats RACGP //. Query ,, Is electronic signature accepted on prescriptions,Pathology and radiology request //can you issue medical certificates on telehealth consult ??


Dr Stephen Phillip Ginsborg   29/03/2020 5:07:00 PM

Well done Harry !


Dr David Zhi Qiang Yu   29/03/2020 5:26:52 PM

It is good news for GPs and patients in this difficult time. Many thanks for RACGP!!!


Dr Joseph Thabet Sous   29/03/2020 5:43:28 PM

I propose in the view of the Corona virus pandemic that the department of health should review the need for a DPA categorisation map
As all the country as a whole is considered a DPA (DWS) in the case of the pandemic, especially the most crowded cities in Australia.

And I urge my fellow GPs to support this proposal so that more health care providers can be in the frontline and available for patients


Dr Harry Van Rensburg   29/03/2020 6:03:52 PM

Common sense has prevailed and now a lockdown is needed to get control of this horrendous situation we are currently faced with. Trusting the broader public is beginning to realise the importance of GP’s.


Dr Felicity Bidencope   29/03/2020 9:26:15 PM

Can we use new item numbers for everyone with whom we provide Telehealth consultation?
Does everyone also attract 10990 or only concessional patients?


Dr Samir Munaim   30/03/2020 12:01:29 AM

Do these new items numbers apply for both VR and non VR GPs .?


Dr Shireen Teves Macabulos   30/03/2020 8:30:36 AM

Thank you very much Dr Harry Nespolon and the RACGP team! Thanks to the Australian Government for listening to our concerns and helping the RACGP put it to action! This will also be useful for GPs who have chronic medical conditions themselves. Excellent timing and effort!


Dr Muhammad Shahbaz Sharif   30/03/2020 2:24:00 PM

is there an equivalent phone consult for ante natal care ? item 16500


Dr Sudeer Rajbally Mahadeo   31/03/2020 7:01:18 AM

It takes a pandemic for the government and other previously resistant doctors to see the value of tele-consultations . We at URBAN-DOC have been saying this since 2015 and we are currently the most advances tele-consultation service available. I applaud the RACGP and GP at large for their efforts in lobbying government but they now should also relax DPA restrictions so we can galvanise the workforce in heavily populated cities where the spread will be quicker. They also need to look at restrictions like the 80/20 rule because I am sure a lot of Gps will be inundated.
Dr Mahadeo


Dr Pushpakumari Sarathy   31/03/2020 7:24:52 AM

Well done
Thanks Harry


A.Prof Ralph Gustav Audehm   31/03/2020 10:16:20 AM

Great to see rapid change when needed!

PIP does not help me as a subcontractor - all proceeds kept by the practice.