Telehealth rules update for general practice: the “existing relationship” rule

Woman talking to her GP via telehealth using her laptop.
  2 December 2020  Dr Jeannie Knapp   

By Dr Jeannie Knapp, GP and Primary Health Care Improvement GP Adviser, North Western Melbourne Primary Health Network.

The existing relationship/12-month rule applies in Victoria now that stay-at-home restrictions have eased.

What are the rules?

GP telehealth providers are required to have an existing and continuous relationship with a patient in order to provide telehealth services. This is defined as:

  • the patient having seen the same practitioner for a face-to-face service in the last 12 months; or
  • the patient having seen another health professional (such as a doctor, nurse or Aboriginal or Torres Strait Islander health worker) at the same practice for a face-to-face service during the same period; or
  • the medical practitioner 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 last 12 months.

Are there any exceptions?

The new rules do not apply to:

  • Infants (under 12 months old)
  • Homeless people
  • People living in a COVID-19 impacted area – which is one where a person’s movement is restricted by a State or Territory public health requirement that applies to the person’s location. This includes patients subject to quarantine, and other restrictions intended to support infection control. At the time of writing, AskMBS has confirmed that Victoria is no longer classified as a COVID-19 impacted area.
  • Active cases/those self-isolating as a contact/those in quarantine
  • Referrals from a non-GP specialist

What about new patients to your practice?

Patients are required to have had a face-to-face visit in the previous 12 months. So, new patients will be required to have a face-to-face visit with a practitioner in the practice prior to being able to access MBS-rebateable telehealth items from that practice.

A patient who has not been seen face-to-face in the past 12 months may still prefer to be seen by telehealth. In this case you can, with their consent, conduct a non-MBS rebated telehealth consultation. This would be a fully privately billed consultation.

We recommend having policies in place for your booking processes to ensure that new patients have a face-to-face appointment as their first contact with your practice.

What about existing patients who have not been seen for more than 12 months?

Existing patients who have not been seen face-to-face in the past 12 months will require a face-to-face visit in order to be able to claim subsequent Medicare-rebateable telehealth visits. Essentially, all patients will require one face-to-face visit every 12 months.

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