Medicare Benefits Schedule - Item 10987

Search Results for Item 10987

View Associated Notes

Category 8 - MISCELLANEOUS SERVICES

10987

10987 - Additional Information

Item Start Date:
01-Nov-2008
Description Start Date:
01-Jul-2012
Schedule Fee Start Date:
01-Nov-2012

Group
M12 - Services Provided By A Practice Nurse Or Aboriginal And Torres Strait Islander Health Practitioner On Behalf Of A Medical Practitioner
Subgroup
3 - Services Provided By A Practice Nurse Or Aboriginal And Torres Strait Islander Health Practitioner On Behalf Of A Medical Practitioner

Follow up service provided by a practice nurse or Aboriginal and Torres Strait Islander health practitioner, on behalf of a medical practitioner, for an Indigenous person who has received a health assessment if:

a)    The service is provided on behalf of and under the supervision of a

medical practitioner; and

b)    the person is not an admitted patient of a hospital; and

c)    the service is consistent with the needs identified through the health assessment;

    -    to a maximum of 10 services per patient in a calendar year

Fee: $24.00 Benefit: 100% = $24.00

(See para MN.12.3 of explanatory notes to this Category)

Extended Medicare Safety Net Cap: $72.00


Associated Notes

Category 8 - MISCELLANEOUS SERVICES

MN.12.3

Follow up service provided by a practice nurse or Aboriginal and Torres Strait Islander health practitioner, on behalf of a Medical Practitioner, for an Indigenous person who has received a health assessment (Item 10987)

Item 10987 may be claimed by a medical practitioner, where a follow up service is provided by a practice nurse or Aboriginal and Torres Strait Islander health practitioner on behalf of that medical practitioner for an Indigenous person who has received a health check. 

All GPs whether vocationally registered or not are eligible to claim this item.  District Medical Officers (DMOs) employed by state/territory health Departments are also eligible to claim this item.  The term 'GP' is used in these notes as a generic reference to medical practitioners able to claim this item. 

Item 10987 does not apply for services that are provided by any other Commonwealth or State funded services.  However, where an exemption under subsection 19(2) of the Health Insurance Act 1973 has been granted to an Aboriginal Community Controlled Health Service or State/Territory Government Health clinic, item 10987 can be claimed for services provided by practice nurses or Aboriginal and Torres Strait Islander health practitioner salaried or contracted to, the Service or Health clinic.  All requirements of the item must be met. 

Item 10987 will assist Indigenous patients who have received a health check which has identified a need for follow up services which can be provided by a practice nurse or Aboriginal and Torres Strait Islander health practitioner between further consultations with the patient's GP. 

Item 10987 may be used to provide:

  • Examinations/interventions as indicated by the health check;
  • Education regarding medication compliance and associated monitoring;
  • Checks on clinical progress and service access;
  • Education, monitoring and counselling activities and lifestyle advice;
  • Taking a medical history; and
  • Prevention advice for chronic conditions, and associated follow up. 

Item 10987 may be claimed up to a maximum of 10 times per patient per calendar year. 

Item 10987 may be accessed by an Indigenous patient who has received the Aboriginal and Torres Strait Islander Peoples Health Assessment (item 715), which is available to:

a) children between the ages of 0 and 14 years;

b) adults between the ages of 15 and 54 years; and 

c) older people over the age of 55 years. 

The item can also be accessed by a child who has received a health check as part of the Northern Territory Emergency Response (NTER). 

Patients whose condition is unstable/deteriorating should be referred to their GP for further treatment. 

A practice nurse means a registered or enrolled nurse who is employed by, or whose services are otherwise retained by a general practice or by a health service that has an exemption to claim Medicare benefits under sub-section 19(2) of the Health Insurance Act 1973

An Aboriginal and Torres Strait Islander health practitioner means a person who has been registered as an Aboriginal and Torres Strait Islander health practitioner by the Aboriginal and Torres Strait Islander Health Practice Board of Australia and meets the Board's registration standards. The Aboriginal and Torres Strait Islander health practitioner must be employed or retained by a general practice, or by a health service that has an exemption to claim Medicare benefits under subsection 19(2) of the Health Insurance Act 1973. 

An Aboriginal and Torres Strait Islander health practitioner may use any of the titles authorised by the Aboriginal and Torres Strait Islander Health Practice Board: Aboriginal health practitioner; Aboriginal and Torres Strait Islander health practitioner; or Torres Strait Islander health practitioner. 

In all cases, the GP under whose supervision the health check follow-up is being provided retains responsibility for the health, safety and clinical outcomes of the patient.  The GP must be satisfied that the practice nurse or Aboriginal and Torres Strait Islander health practitioner is appropriately qualified and trained to provide the relevant follow up for the patient.  GPs are advised to consult their insurer concerning indemnity coverage for services provided on their behalf. 

General practices where nurses or Aboriginal and Torres Strait Islander health practitioners provide follow up for Indigenous people who have received a health check, should also have a written clinical risk management strategy covering issues like clinical roles, patient follow up and patient consent. 

Continuing professional development is recommended for all nurses and an Aboriginal and Torres Strait Islander health practitioners providing follow up services for Indigenous people who have received a health check. 

Supervision of the practice nurse/Aboriginal and Torres Strait Islander health practitioner by the GP at a distance is recognised as an acceptable form of supervision.  This means that the claiming GP does not have to be physically present at the time the service is provided.  However the GP should be able to be contacted if required. 

Where the GP and practice nurse/Aboriginal and Torres Strait Islander health practitioner are at the same location, the GP is not required to be present while the health check follow up is undertaken.  It is up to the GP to decide whether they need to see the patient.  Where the GP has a consultation with the patient, then the GP is entitled to claim a Medicare item for the time and complexity of their personal attendance on the patient.  The time the patient spends receiving a service from the practice nurse or Aboriginal and Torres Strait Islander health practitioner is itemised separately under item 10987 and should not be counted as part of the Medicare items claimed for time spent with the GP.  Where the practice nurse or Aboriginal and Torres Strait Islander health practitioner provides another service (eg immunisation, cervical screening) on the same day, the GP is able to claim for all practice nurse/ Aboriginal and Torres Strait Islander health practitioner services provided. 

Item 10990 or 10991 (bulk billing incentives) can be claimed in conjunction with item 10987 provided the conditions of item 10990 or 10991 are satisfied.

Related Items: 10987


Legend

  • Assist - Addition/Deletion of (Assist.)
  • Amend - Amended Description
  • Anaes - Anaesthetic Values Amended
  • Emsn - EMSN Change
  • Fee - Fee Amended
  • Renum - Item Number Change (renumbered)
  • New - New Item
  • NewMin - New Item (previous Ministerial Determination)
  • Qfe - QFE Change