MBS options for GPs caring for patients in the West Metro COVID-19 Positive Care Pathway

  7 December 2021  NWMPHN

The North Western Melbourne Primary Health Network region is no longer a Commonwealth declared hotspot for the purposes of MBS support. 

Patients must still have an ‘established relationship’ with the medical practitioner performing the service.

The Australian Department of Health says such a relation exists if a GP:

  • has provided at least one face-to-face service to the patient in the 12 months preceding the telehealth attendance; or
  • is located at a medical practice where the patient has had at least one face-to-face service arranged by that practice in the 12 months preceding the telehealth attendance (including services performed by another doctor located at the practice, or a service performed by another health professional located at the practice, such as a practice nurse or Aboriginal and Torres Strait Islander health worker); or
  • is a participant in the Approved Medical Deputising Service program, and the Approved Medical Deputising Service provider employing the medical practitioner has a formal agreement with a medical practice that has provided at least one face-to-face service to the patient in the 12 months preceding the telehealth attendance.

Exemptions

However, the ‘established relationship’ requirement does not apply to:

  • children under the age of 12 months;
  • people who are homeless;
  • patients receiving an urgent after-hours (unsociable hours) service;
  • patients of medical practitioners at an Aboriginal Medical Service or an Aboriginal Community Controlled Health Service;
  • people who are in a COVID-19 Commonwealth declared hotspot, or in COVID-19 isolation or quarantine because of a state or territory public health order.

It also does not apply to patients accessing specific MBS items for:

  • blood borne viruses, sexual or reproductive health consultations (new items); and
  • pregnancy counselling services (under MBS Group A40);
  • mental health services (under MBS Group A40); and
  • nicotine and smoking cessation counselling (new items).

Practices managing COVID-19 positive patients by telehealth are still able to claim the MBS telephone items (92746 and 92747) to manage these patients. This also applies to those patients that practices may be taking on that are new to the clinic as part of the model.

 For more information and fact sheets visit MBS Online.