Medicare Benefits Schedule - Item 92478

Telehealth attendance for an admitted patient by a consultant psychiatrist; if:

(a) the attendance follows referral of the patient to the consultant psychiatrist by a referring practitioner; and

(b) the patient is located at a hospital; and

(c) the attendance is not more than 15 minutes duration; and

(d) the patient has not received a service to which item 92479, 92480, 92481, 92482 or 92483 applies in the last seven days

(H)

Fee: $50.10 Benefit: 75% = $37.60

(See para AN.8.1 of explanatory notes to this Category)

Item will expire on 31-Oct-2026

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6 items are available on the Medicare Benefits Schedule (MBS) for inpatient telehealth psychiatry. The items are:

·         Item 92483 - available for new patient telehealth consultations in hospital of more than 45 minutes.

·         Item 92478 - available for a subsequent telehealth consultation in hospital of less than 15 minutes.

·         Item 92479 - available for a subsequent telehealth consultation in hospital of at least 15 minutes and not more than 30 minutes.

·         Item 92480 - available for a subsequent telehealth consultation in hospital of at least 30 minutes and not more than 45 minutes.

·         Item 92481 - available for a subsequent telehealth consultation in hospital of at least 45 minutes and not more than 75 minutes.

·         Item 92482 - available for a subsequent telehealth consultation in hospital of more than 75 minutes.

 The intention of this suite of items is to provide for one telehealth consultation on admission and one subsequent telehealth consultation per week of admission with the remaining consultations to be provided face to face using existing in-hospital subsequent consultation items. Psychiatrists are able to use items 92478 to 92482 for initial video consultations (which may be admission consultations) for patients who are not new to the psychiatrist).

 Telehealth MBS items provide Medicare benefits for services provided by video conferencing. Telehealth MBS items can’t be used for phone or email consultations.

 Considerations for appropriate care

In claiming the items, the practitioner must ensure that the telehealth appointment is safe, clinically appropriate and suitable for the patient. Psychiatric practice using this suite of items should be guided by the RANZCP Professional Practice Guideline 19 Telehealth in Psychiatry, the Ahpra guidance in relation to Telehealth consultations with patients and the National Safety and Quality Digital Mental Health Standards.

 Particularly, psychiatrists should consider:

·         the suitability of using telehealth in the inpatient setting for a consultation in partnership with hospital staff, the referrer, patient and, where appropriate, their carer(s) or guardians. Further, the psychiatrist using the items must provide continuity of care and keep other practitioners informed of the treatment they are providing when sharing the care of the patient;

·         that any practitioner using telehealth services is expected to continuously assess the appropriateness and safety of[A1] using telehealth for the consultation and make arrangements for the patient to be seen in-person, if necessary;

·         that the use of digital services in the mental health setting must be safe. To ensure this, there must be a model of care that includes clear roles and responsibilities and determines how the private psychiatrist works with the staff on the unit to provide safe care for the person. There is also a need to have clear mechanisms for assessing and responding to risk, and communicating for safety;

·         that it is expected that the psychiatrist would consult with the patient face to face within 48 hours of a telehealth admission[A2]. 48 hours is considered a maximum and the clinician should consult with the patient face to face sooner, if necessary; and

·         that the items are expected to be used for emergency and acute admissions and are not intended for elective admissions.

 Compliance Requirements

The inpatient telehealth psychiatry items will be subject to MBS compliance processes and activities, including audits, which may require a provider to submit evidence about the services claimed.

 Further Information

Further information about the MBS items and provision of inpatient telehealth psychiatry services is available on MBS Online under ‘Fact Sheets’. The information on the website may be updated from time to time in response to questions or feedback from providers, patients and other stakeholders.

Related Items: 92478 92479 92480 92481 92482 92483