What are the new rules?
From 20 July 2020, GPs and other medical practitioners working in general practice can only provide telehealth where they have an existing and continuous relationship with a patient in order to provide telehealth services. Patients can now only access telehealth services under the Medicare Benefits Schedule (MBS) through their regular GP or practice.
This means patients will be eligible telehealth services from GPs and other medical practitioners if they have seen their GP or another medical practitioner or health practitioner (such as a practice nurse of Aboriginal and Torres Strait Islander health worker) within the same practice at least once in the preceding 12 months.
However, this requirement does not apply in areas under stage three restrictions in Victoria, which currently includes 11 of the 13 local government areas in the NWMPHN region.
Why have these rules been introduced?
To ensure patients continue to receive quality, ongoing care from a practitioner who knows their medical history and needs.
Are there any exceptions?
The new rules don’t apply to:
- Infants (under 12 months old)
- People who are homeless
- People living in COVID-19 “impacted area”, which at the time of writing includes metropolitan Melbourne and Mitchell Shire
- 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
What about new patients to my practice?
Patients who are new patients who are new to the practice wishing the practice will be required to have a face-to-face visit with a practitioner in the practice prior to being able to access MBS-funded telehealth items from that practice. This also applies to existing patients of the practice who have not had a face-to-face visit within the previous 12 months.
A new patient insists on a telehealth appointment as their first contact. Can I claim the MBS?
No. As they have not had a face-to-face appointment with yourself or another practitioner at your practice within the past 12 months, you cannot use an MBS item for the telehealth consult outside of the stage three restricted area.
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 the practice.
A doctor in our practice is doing 100 per cent telehealth. How do we book new patients with them?
New patients will have to see a different doctor in the practice as a face-to-face consultation on their first visit to be able to claim a Medicare rebate for subsequent telehealth appointments with another GP.
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 a Medicare rebate in subsequent telehealth appointments.
Essentially, all patients will require at least one face-to-face visit every 12 months to be able to continue claiming Medicare rebates for telehealth appointments.
Where can I get more information?
- Commonwealth Department of Health media release
- MBS fact sheets:
Access the COVID-19 MBS items pathway on HealthPathways Melbourne.
Don’t have a login? Request access here.
Pen CS have added new telehealth items in the MBS Items tab in CAT4. New graphs show the total number of patients who had any of the telehealth items claimed by:
- Medical practitioner: any telehealth MBS item at consulting room/not at consulting room
- Practice nurse or Aboriginal health worker: any telehealth MBS item in the practice or at a residential aged care facility (RACF)
- Nurse practitioner: any telehealth MBS item at RACF/at Practice