Medicare Benefits Schedule - Note AN.30.4

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Category 1 - PROFESSIONAL ATTENDANCES

AN.30.4

Telehealth (Other Medical Practitioner)

These four services are available to patients who are unable to attend the practitioners’ practice and reside in a Telehealth eligible areas MMM 6 or MMM 7.

Items 2480, 2481, 2482 and 2483, are for services provided by other medical practitioners and have the same clinical requirements, including time, as the equivalent face-to-face attendance services for items 179, 185, 189 and 203.

The patient will also need to have received at least three face-to-face attendances from the same practitioner providing the video conferencing service in the preceding 12 months. This confirms that the video conferencing attendance services can only be rendered by a practitioner with an existing clinical relationship with the patient.

Eligible Geographical Areas

Geographic eligibility for these telehealth services funded under Medicare are determined according to the Modified Monash Model (MMM) classifications. 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 practitioner 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 practitioner is not permitted to travel to an area outside the minimum 15 km distance in order to claim a video conference. 

Aftercare Rule

Video consultations are subject to the same aftercare rules as practitioners providing face-to-face consultations.

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 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 practitioner, provided the second (and any following) video consultations are not a continuation of the initial or earlier video consultations. Practitioners will need to provide the times of each consultation on the patient's account or bulk billing voucher.

Restrictions

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.

Technical requirements

In order to fulfill the item descriptor there must be a visual and audio link between the patient and the practitioner. If the practitioner is unable to establish both a video and audio link with the patient, a MBS rebate for a telehealth attendance is not payable. Individual practitioners 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.

Record Keeping

Participating telehealth 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.


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