Medicare Benefits Schedule - Note MN.16.4

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Category 8 - MISCELLANEOUS SERVICES

MN.16.4

Eating Disorders Services Telehealth

Eating Disorders Services Telehealth – (items 82351, 82353, 82356, 82359, 82361, 82364, 82367, 82369, 82372, 82375, 82377, 82380, 82383)


This note provides telehealth supporting information for eating disorders Items provided via telehealth by a medical practitioner in general practice and should be read in conjunction with Eating Disorders General Explanatory Notes.

Eligible Geographical Areas

Geographic eligibility for eating disorders telehealth services funded under Medicare (in Group M16) is determined according to the Modified Monash Model (MMM) classifications. Telehealth Eligible Areas are those areas that are within MMM classifications 4 to 7. Patients and providers are able to check their eligibility using the Modified Monash Model locator on the Department of Health’s website at Health Workforce Locator. 

There is a requirement for the patient and practitioner to be located a minimum of 15 kilometres apart at the time of the consultation. Minimum distance between practitioner 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 kilometres distance in order to claim a video consultation.

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.

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.

Aftercare Rule

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

Multiple Attendances on the Same Day

In some situations a patient may receive a consultation via video conference and a face-to-face consultation by the same or different clinical psychologist 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 clinical psychologist, provided the second (and any following) video consultations are not a continuation of the initial or earlier video consultations. Clinical psychologists will need to provide the times of each consultation on the patient’s account or bulk-billing voucher.

Referrals

The referral procedure for a video consultation is the same as for conventional face-to-face consultations.

 

Related Items: 82351 82353 82356 82359 82361 82364 82367 82369 82372 82375 82377 82380 82383


Related Items

Category 8 - MISCELLANEOUS SERVICES

82351

82351 - Additional Information

Item Start Date:
01-Nov-2019
Description Updated:
01-Nov-2019
Schedule Fee Updated:
01-Jul-2020

Dietetics health service provided to an eligible patient by an eligible dietitian if:

(a)     the service is recommended in the patient’s eating disorder treatment and management plan; and

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

(c)     the attendance is by video conference; and

(d)     the patient is located within a telehealth eligible area; and

(e)     the patient is, at the time of the attendance, at least 15 kilometres by road from the dietitian; and

(f)      the service is of at least 20 minutes duration

Fee: $64.20 Benefit: 85% = $54.60

(See para MN.16.1, MN.16.2, MN.16.4 of explanatory notes to this Category)

Category 8 - MISCELLANEOUS SERVICES

82361

82361 - Additional Information

Item Start Date:
01-Nov-2019
Description Updated:
01-Nov-2019
Schedule Fee Updated:
01-Jul-2020

Eating disorder psychological treatment service provided to an eligible patient by an eligible psychologist if:

(a)     the service is recommended in the patient’s eating disorder treatment and management plan; and

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

(c)     the attendance is by video conference; and

(d)     the patient is located within a telehealth eligible area; and

(e)     the patient is, at the time of the attendance, at least 15 kilometres by road from the psychologist; and

(f)      the service is at least 20 minutes but less than 50 minutes in duration.

Fee: $72.90 Benefit: 85% = $62.00

(See para MN.16.1, MN.16.3, MN.16.4 of explanatory notes to this Category)

Category 8 - MISCELLANEOUS SERVICES

82364

82364 - Additional Information

Item Start Date:
01-Nov-2019
Description Updated:
01-Nov-2019
Schedule Fee Updated:
01-Jul-2020

Eating disorder psychological treatment service provided to an eligible patient by an eligible psychologist if:

 

(a)     the service is recommended in the patient’s eating disorder treatment and management plan; and

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

(c)     the attendance is by video conference; and

(d)     the patient is located within a telehealth eligible area; and

(e)     the patient is, at the time of the attendance, at least 15 kilometres by road from the psychologist; and
(f)      the service is at least 50 minutes in duration.

 

Fee: $102.85 Benefit: 85% = $87.45

(See para MN.16.1, MN.16.3, MN.16.4 of explanatory notes to this Category)

Category 8 - MISCELLANEOUS SERVICES

82367

82367 - Additional Information

Item Start Date:
01-Nov-2019
Description Updated:
01-Nov-2019
Schedule Fee Updated:
01-Jul-2020

Eating disorder psychological treatment service provided to an eligible patient as part of a group of 6 to 10 patients by an eligible psychologist if:

(a)     the service is recommended in the patient’s eating disorder treatment and management plan; and

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

(c)     the attendance is by video conference; and

(d)     the patient is located within a telehealth eligible area; and

(e)     the patient is, at the time of the attendance, at least 15 kilometres by road from the clinical psychologist; and

(f)      the service is at least 60 minutes in duration.

Fee: $26.25 Benefit: 85% = $22.35

(See para MN.16.1, MN.16.3, MN.16.4 of explanatory notes to this Category)

Category 8 - MISCELLANEOUS SERVICES

82377

82377 - Additional Information

Item Start Date:
01-Nov-2019
Description Updated:
01-Nov-2019
Schedule Fee Updated:
01-Jul-2020

Eating disorder psychological treatment service provided to an eligible patient by an eligible social worker if:

(a)     the service is recommended in the patient’s eating disorder treatment and management plan; and

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

(c)     the attendance is by video conference; and

(d)     the patient is located within a telehealth eligible area; and

(e)     the patient is, at the time of the attendance, at least 15 kilometres by road from the psychologist; and

(f)      the service is at least 20 minutes but less than 50 minutes in duration

Fee: $64.20 Benefit: 85% = $54.60

(See para MN.16.1, MN.16.3, MN.16.4 of explanatory notes to this Category)

Category 8 - MISCELLANEOUS SERVICES

82380

82380 - Additional Information

Item Start Date:
01-Nov-2019
Description Updated:
01-Nov-2019
Schedule Fee Updated:
01-Jul-2020

Eating disorder psychological treatment service provided to an eligible patient by an eligible social worker if:

(a)     the service is recommended in the patient’s eating disorder treatment and management plan; and

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

(c)     the attendance is by video conference; and

(d)     the patient is located within a telehealth eligible area; and

(e)     the patient is, at the time of the attendance, at least 15 kilometres by road from the psychologist; and

(f)      the service is at least 50 minutes in duration.

Fee: $90.70 Benefit: 85% = $77.10

(See para MN.16.1, MN.16.3, MN.16.4 of explanatory notes to this Category)

Category 8 - MISCELLANEOUS SERVICES

82383

82383 - Additional Information

Item Start Date:
01-Nov-2019
Description Updated:
01-Nov-2019
Schedule Fee Updated:
01-Jul-2020

Eating disorder psychological treatment service provided to a person as part of a group of 6 to 10 patients (but not as an admitted patient of a hospital) by an eligible social worker if:

(a)     the service is recommended in the patient’s eating disorder treatment and management plan; and

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

(c)     the attendance is by video conference; and

(d)     the patient is located within a telehealth eligible area; and

(e)     the patient is, at the time of the attendance, at least 15 kilometres by road from the clinical psychologist; and

(f)      the service is at least 60 minutes in duration.

Fee: $23.05 Benefit: 85% = $19.60

(See para MN.16.1, MN.16.3, MN.16.4 of explanatory notes to this Category)

Category 8 - MISCELLANEOUS SERVICES

82353

82353 - Additional Information

Item Start Date:
01-Nov-2019
Description Updated:
01-Nov-2019
Schedule Fee Updated:
01-Jul-2020

Eating disorder psychological treatment service provided to an eligible patient by an eligible clinical psychologist if:

(a)     the service is recommended in the patient’s eating disorder treatment and management plan; and

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

(c)     the attendance is by video conference; and

(d)     the patient is located within a telehealth eligible area; and

(e)     the patient is, at the time of the attendance, at least 15 kilometres by road from the clinical psychologist; and

(f)      the service is at least 30 minutes but less than 50 minutes in duration.

Fee: $102.85 Benefit: 85% = $87.45

(See para MN.16.1, MN.16.3, MN.16.4 of explanatory notes to this Category)

Category 8 - MISCELLANEOUS SERVICES

82356

82356 - Additional Information

Item Start Date:
01-Nov-2019
Description Updated:
01-Nov-2019
Schedule Fee Updated:
01-Jul-2020

Eating disorder psychological treatment service provided to an eligible patient by an eligible clinical psychologist if:

(a)     the service is recommended in the patient’s eating disorder treatment and management plan; and

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

(c)     attendance is by video conference; and

(d)     the patient is located within a telehealth eligible area; and

(e)     the patient is, at the time of the attendance, at least 15 kilometres by road from the clinical psychologist; and

(f)      the service is at least 50 minutes in duration.

Fee: $151.05 Benefit: 85% = $128.40

(See para MN.16.1, MN.16.3, MN.16.4 of explanatory notes to this Category)

Category 8 - MISCELLANEOUS SERVICES

82359

82359 - Additional Information

Item Start Date:
01-Nov-2019
Description Updated:
01-Nov-2019
Schedule Fee Updated:
01-Jul-2020

Eating disorder psychological treatment service provided to an eligible patient as part of a group of 6 to 10 patients by an eligible clinical psychologist if:

(a)     the service is recommended in the patient’s eating disorder treatment and management plan; and

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

(c)     the attendance is by video conference; and

(d)     the patient is located within a telehealth eligible area; and

(e)     the patient is, at the time of the attendance, at least 15 kilometres by road from the clinical psychologist; and

(f)      the service is at least 60 minutes in duration.

Fee: $38.35 Benefit: 85% = $32.60

(See para MN.16.1, MN.16.3, MN.16.4 of explanatory notes to this Category)

Category 8 - MISCELLANEOUS SERVICES

82369

82369 - Additional Information

Item Start Date:
01-Nov-2019
Description Updated:
01-Nov-2019
Schedule Fee Updated:
01-Jul-2020

Eating disorder psychological treatment service provided to an eligible patient by an eligible occupational therapist if:

(a)     the service is recommended in the patient’s eating disorder treatment and management plan; and

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

(c)     the attendance is by video conference; and

(d)     the patient is located within a telehealth eligible area; and

(e)     the patient is, at the time of the attendance, at least 15 kilometres by road from the psychologist; and

(f)      the service is at least 20 minutes but less than 50 minutes in duration.

Fee: $64.20 Benefit: 85% = $54.60

(See para MN.16.1, MN.16.3, MN.16.4 of explanatory notes to this Category)

Category 8 - MISCELLANEOUS SERVICES

82372

82372 - Additional Information

Item Start Date:
01-Nov-2019
Description Updated:
01-Nov-2019
Schedule Fee Updated:
01-Jul-2020

Eating disorder psychological treatment service provided to an eligible patient by an eligible occupational therapist if:

(a)     the service is recommended in the patient’s eating disorder treatment and management plan; and

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

(c)     the attendance is by video conference; and

(d)     the patient is located within a telehealth eligible area; and

(e)     the patient is, at the time of the attendance, at least 15 kilometres by road from the psychologist; and

(f)      the service is at least 50 minutes in duration.

Fee: $90.70 Benefit: 85% = $77.10

(See para MN.16.1, MN.16.3, MN.16.4 of explanatory notes to this Category)

Category 8 - MISCELLANEOUS SERVICES

82375

82375 - Additional Information

Item Start Date:
01-Nov-2019
Description Updated:
01-Nov-2019
Schedule Fee Updated:
01-Jul-2020

Eating disorder psychological treatment service provided to an eligible patient as part of a group of 6 to 10 patients by an eligible occupational therapist if:

(a)     the service is recommended in the patient’s eating disorder treatment and management plan; and

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

(c)     the attendance is by video conference; and

(d)     the patient is located within a telehealth eligible area; and

(e)     the patient is, at the time of the attendance, at least 15 kilometres by road from the clinical psychologist; and

(f)      the service is at least 60 minutes in duration.

Fee: $23.05 Benefit: 85% = $19.60

(See para MN.16.1, MN.16.3, MN.16.4 of explanatory notes to this Category)


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