Medicare Benefits Scheme

1. Medicare Benefits Scheme

2. The MBS Telehealth Initiative • Under the Connecting Health Services with the Future: Modernising Medicare by Providing Rebates for Online Consultations initiative (announced 2010) • Medicare rebates and financial incentives for online consultations across a range of medical specialties. • 23 new MBS support items available for patient-end services. • 11 new items for specialist services

3. What is covered? • Telehealth MBS items may be billed where a specialist consultation is conducted via video conferencing with a non-admitted patient who is: • in an eligible Aboriginal Community Controlled Health Service (ACCHS) (regardless of location) • a care recipient at a Residential Aged Care Facility (regardless of location) • located outside Major Cities - http://www.doctorconnect.gov.au– for a map • ‘Store-and-forward’ Telehealth consultations (e.g. for dermatology, ophthalmology, radiology) are not funded via MBS at this stage.

4. Eligible areas • Outside RA 1 areas (major cities)

5. Eligible Staff under MBS item numbers • Doctors • Specialists, consultant physicians, consultant psychiatrists • Practice Nurses and Nurse Practitioners • Aboriginal Health Workers • Note: Under Telehealth, two clinicians may bill the MBS for the same consultation

6. Eligible Staff under MBS item numbers • Doctors • Specialists, consultant physicians, consultant psychiatrists • Practice Nurses and Nurse Practitioners • Aboriginal Health Workers • Note: Under Telehealth, two clinicians may bill the MBS for the same consultation

7. Aboriginal Health Worker eligibility • According to the MBS guidelines an Aboriginal Health Worker: • Holds a Certificate III in Aboriginal or Torres Strait Islander Health Worker Primary Health Care (Clinical) or other appropriate qualifications; or • Is registered, and holds a current registration issued by a State or Territory regulatory authority, as an Aboriginal Health Worker; and • Is employed by, or whose services are otherwise retained by a medical practitioner or their practice.

8. Aboriginal Health Worker eligibility (continued) • 'Other appropriate qualifications' may be appropriate for individuals who consider their qualification to be equivalent or higher than the qualifications listed above, they will need to contact a registered training organisation in their state or Territory to have the qualification assessed. • When acting on behalf of a medical practitioner during a Telehealth consultation (items 10983 & 10984) the Aboriginal Health Worker doesn’t require a provider number. • For more information about registration and accessing Medicare as a AHW go to the AHPRA website • .

9. Medicare incentives (on top of item numbers)

10. Medicare rebates – Health Worker or Nurse Example of fees (table below) reimbursed for each 15 minute video consultation with a specialist when the Health Worker/Nurse is present with the patient in the room with the Telehealth Service and Bulk Billing incentives added.

11. Medicare rebates – GP Example of fees (see table below) reimbursed for each 15 minute video consultation by a patient and GP, with a specialist

12. The item numbers – Medicare website Patient-End Services MEDICAL PRACTITIONER (INCLUDING A GENERAL PRACTITIONER, SPECIALIST OR CONSULTANT PHYSICIAN) TELEHEALTH ATTENDANCES PRACTICE NURSE OR ABORIGINAL HEALTH WORKER TELEHEALTH ATTENDANCE PROVIDED ON BEHALF OF A MEDICAL PRACTITIONER

13. The item numbers (continued) If you are bulk billing and your patient is under 16, or is a Commonwealth concession card holder (and the person is not an admitted patient) you can also claim MBS item 1090 ($6.00) or 10991 ($9.10) The latter applies to regional, rural or other specified geographic locations.

14. Discussion and Questions Refer to information sheets