View Associated Notes
Category 1 - PROFESSIONAL ATTENDANCES
869 - Additional Information
Professional attendance of less than 20 minutes in duration (whether or not continuous) by a medical practitioner providing clinical support to a patient who:
(a) is participating in a video conferencing consultation with a specialist or consultant physician; and
(b) is a care recipient in a residential care service; and
(c) is not a resident of a self‑contained unit;
for an attendance on one or more patients at one place on one occasion—each patient
The fee for item 867, plus $37.95 divided by the number of patients seen, up to a maximum of six patients. For seven or more patients - the fee for item 867 plus $2.70 per patient.
Extended Medicare Safety Net Cap: 300% of the Derived fee for this item, or $500, whichever is the lesser amount.
Category 1 - PROFESSIONAL ATTENDANCES
Attendances by Medical Practitioners
Items 179-181, 185-187, 189-197, 203-206, 215-287, 371, 372, 733-789, 792, 812-892, 90092-93, 90095-96, 90183, 90188, 90202, and 90212 relate to attendances rendered by a medical practitioner who is not a general practitioner, specialist or consultant physician, and who:
(a) is registered under section 3GA of the Act, to the extent that the person is practising during the period in respect of which, and in the location in respect of which, he or she is registered, and insofar as the circumstances specified for paragraph 19AA(3)(b) of the Act apply; or
(b) is covered by an exemption under subsection 19AB(3) of the Act; or
(c) first became a medical practitioner before 1 November 1996.
Related Items: 179 181 185 187 189 191 203 206 214 215 218 219 220 221 222 223 224 225 226 227 228 229 230 231 232 233 235 236 237 238 239 240 243 244 245 249 251 252 253 254 255 256 257 259 260 261 262 263 264 265 266 268 269 270 271 272 276 277 279 281 282 283 285 286 287 371 372 733 737 741 745 761 763 766 769 772 776 788 789 792 812 827 829 867 868 869 873 876 881 885 891 892 90092 90093 90095 90096 90183 90188 90202 90212
Category 1 - PROFESSIONAL ATTENDANCES
Medical Practitioner Telehealth Patient-End Support Services (Items 812 to 892)
This note provides information on the telehealth MBS attendance items for medical practitioners to provide clinical support to their patients, when clinically relevant, during video consultations with specialists or consultant physicians under items 812, 827, 829, 867, 868, 869, 873, 876, 881, 885 and 892.
Telehealth patient-end support services can only be claimed where:
- a Medicare eligible specialist service is claimed;
- the service is rendered in Australia; and
- where this is necessary for the provision of the specialist service.
A video consultation will involve a single specialist or consultant physician attending to the patient, with the possible participation of another medical practitioner, a participating optometrist, a participating nurse practitioner, a participating midwife, practice nurse, Aboriginal and Torres Strait Islander health practitioner or Aboriginal health worker at the patient end. The above time-tiered items provide for patient-end support services by a medical practitioner in various settings including consulting rooms, other than consulting rooms, eligible residential aged care services and Aboriginal Medical Services.
The specialist or consultant physician must be satisfied that it is clinically appropriate to provide a video consultation to a patient. The decision to provide clinically relevant support to the patient is the responsibility of the specialist or physician.
Telehealth specialist services can be provided to patients when there is no patient-end support service provided.
The medical practitioner, who provides assistance to the patient where this is necessary for the provision of the specialist service, may seek assistance from a health professional (e.g. a practice nurse, Aboriginal or Torres Strait Islander health practitioner or Aboriginal health worker) but only one item is billable for the patient-end support service. The medical practitioner must be present during part or all of the consultation in order to bill an appropriate time-tiered MBS item. Any time spent by another health professional called to assist with the consultation may not be counted against the overall time taken to complete the video consultation.
The MBS telehealth attendance items are not payable for services to an admitted hospital patient (this includes Hospital in the Home patients). Benefits are not payable for telephone or email consultations. In order to fulfil the item descriptor there must be a visual and audio link between the patient and the remote practitioner. If the remote practitioner is unable to establish both a video and audio link with the patient, a MBS rebate for a telehealth attendance is not payable.
Eligible Geographical Areas
Geographic eligibility for telehealth services funded under Medicare is determined according to the Australian Standard Geographical Classification Remoteness Area (ASGC-RA) classifications. Telehealth Eligible Areas are those areas that are outside a Major City (RA1) according to ASGC-RA (RA2-5). Patients and providers are able to check their eligibility by following the links on the MBS Online website (www.mbsonline.gov.au/telehealth).
There is a requirement for the patient and specialist to be located a minimum of 15km apart at the time of the consultation. Minimum distance between specialist and patient video consultations are measured by the most direct (ie least distance) route by road. The patient or the specialist is not permitted to travel to an area outside the minimum 15 km distance in order to claim a video conference.
This rule will not apply to specialist video consultation with patients who are a care recipient in an eligible residential care service; or at an eligible Aboriginal Medical Service or Aboriginal Community Controlled Health Service for which there is a direction, made under subsection 19(2) of the Health Insurance Act 1973, as these patients are able to receive telehealth services anywhere in Australia.
Telehealth Eligible Service Areas are defined at www.mbsonline.gov.au/telehealtheligibleareas
Participating telehealth medical practitioners must keep contemporaneous notes of the consultation including documenting that the service was performed by video conference, the date, time and the people who participated.
Only clinical details recorded at the time of the attendance count towards the time of the consultation. It does not include information added at a later time, such as reports of investigations.
Multiple attendances on the same day
In some situations a patient may receive a telehealth consultation and a face to face consultation by the same or different medical practitioner on the same day.
Medicare benefits may be paid for more than one video consultation on a patient on the same day by the same medical practitioner, provided the second (and any following) video consultations are not a continuation of the initial or earlier video consultations. Medical practitioners will need to provide the times of each consultation on the patient's account or bulk billing voucher.
Extended Medicare Safety Net (EMSN)
Items which provide for telehealth patient-end support services are subject to EMSN caps equal to 300% of the schedule fee (to a maximum of $500). This is consistent with Government policy relating to capping EMSN for MBS consultation services.
Video consultations are subject to the same aftercare rules as face to face consultations.
The referral procedure for a video consultation is the same as for conventional face-to-face consultations.
In order to fulfil the item descriptor there must be a visual and audio link between the patient and the remote practitioner. If the remote practitioner is unable to establish both a video and audio link with the patient, a MBS rebate for a specialist video consultation is not payable.
Individual clinicians must be confident that the technology used is able to satisfy the item descriptor and that software and hardware used to deliver a videoconference meets the applicable laws for security and privacy.
Bulk bill incentive items 10990 or 10991 may be billed in conjunction with the telehealth items 812, 827, 829, 867, 868, 869, 873, 876, 881, 885 and 892.
Duration of attendance
The medical practitioner attending at the patient end of the video consultation does not need to be present for the entire consultation, only as long as is clinically relevant - this can be established in consultation with the specialist. The MBS fee payable for the supporting medical practitioner will be determined by the total time spent assisting the patient. This time does not need to be continuous.
- 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