Connecting Health Services With the Future: Overview for Patient-end Practitioners
From 1 July 2011, Medicare and DVA rebates and financial incentives will be available for telehealth under the Connecting Health Services With the Future initiative. This page provides information about the initiative for practitioners who will provide face-to-face clinical services to patients having an online consultation,
In 2010, the Government committed to providing Medicare and DVA rebates to patients for video consultations across a range of medical specialties.
Under this initiative, Medicare rebates and financial incentives will also be available for a range of health practitioners to provide face-to-face services to a patient during a video consultation (patient-end practitioners).
Telehealth services can offer real benefits for Australians. This initiative will help Australians in remote, regional and outer metropolitan areas, Aboriginal and Torres Strait Islander people receiving care at eligible Aboriginal Medical Service (AMS) or Aboriginal Community Controlled Health Service (ACCHS), and Australians in residential aged care to access specialist medical services earlier and without the time and expense of travelling to major cities.
- Telehealth MBS Items
- Financial Incentives
- Eligibility
- Clinical Practice and Technology for Telehealth
- Questions and Answers for Patient-end Practitioners
Telehealth MBS Items
The Government is introducing new MBS items for telehealth which will be available from 1 July 2011.
There will be items which will enable a range of specialist consultations to be provided to eligible patients via video conferencing and there will be items for services provided by a health professional who is located with the patient during a specialist video consultation.
Telehealth MBS Items can be billed where a specialist consultation is conducted via video conferencing with a non-admitted patient who is:
- in an Eligible Geographical Area;
- a care recipient at a Residential Aged Care Facility (RACF); or
- in an eligible Aboriginal Medical Service.
Further information on eligibility is available here.
A list of Telehealth MBS Items is available here.
Specialist Video Consultation Items
11 new MBS items will be available for video consultations provided by specialists, consultant physicians and psychiatrists. These new items will link to a range of existing MBS attendance items that can be provided via video conferencing and add a derived fee to the base item fee. This derived fee recognises the increased time and complexity of undertaking a consultation via video conferencing.
Patient-End Items
23 new MBS items will be available for patient-end services. These enable GPs, other medical practitioners, participating nurse practitioners, participating midwives, Aboriginal health workers and practice nurses to provide clinical assistance to the patient during the specialist video consultation.
Financial Incentives
The Government is introducing financial incentives, from 1 July 2011, to encourage and support the provision of telehealth services to Australians in Eligible Geographical Areas and in RACFs, and to Aboriginal and Torres Strait Islander People.
These financial incentives will encourage:
- Eligible Telehealth Practitioners to provide Telehealth Services to their patients;
- Eligible Practitioners to Bulk Bill Telehealth Services; and
- RACFs to provide Hosting Services to their residents.
Five types of Incentives are available for practitioners and RACFs:
- Telehealth On-Board Incentive;
- Telehealth Service Incentive;
- Telehealth Bulk Billing Incentive;
- RACF On-Board Incentive; and
- RACF Hosting Service Incentive.
Incentive amounts are shown in the table below:
 | 2011-12 | 2012-13 | 2013-14 | 2014-15 |
| Telehealth On-Board (one-off) | $6,000 | $4,800 | $3,900 | $3,300 |
| Telehealth Service (specialist) | $60 | $48 | $39 | $33 |
| Telehealth Service (patient-end) | $40 | $32 | $26 | $22 |
| Telehealth Bulk Billing | $20 | $16 | $13 | $11 |
| RACF On-Board Incentive (one-off) | $6,000 | $4,800 | $3,900 | $3,300 |
| Telehealth Hosting Service Incentive | $60 | $48 | $39 | $33 |
The simplified descriptions on this web page are provided for information only. For full details on eligibility and processes, refer to the telehealth program guidelines.
Telehealth On-Board Incentive
A Telehealth On-Board Incentive is a one-off payment for Eligible Telehealth Practitioners who provide at least one MBS claimed telehealth service (paid when a Medicare benefit is paid for a Telehealth MBS Item billed against a practitioner’s provider number).
Telehealth Service Incentive
Telehealth Service Incentives encourage Eligible Practitioners (specialist and patient-end practitioner) to continue to provide Telehealth Services.
the Dept of Human Services automatically accrues Telehealth Service Incentives to a practitioner each time a Medicare benefit is paid for a Telehealth MBS Item billed against their provider number (by using bulk billing and patient claims data). Practitioners then receive a single payment each quarter for all Telehealth Service Incentives they have accrued.
Telehealth Bulk Billing Incentive
Telehealth Bulk Billing Incentives encourage Eligible Practitioners to bulk bill Telehealth Services.
the Dept of Human Services automatically accrues Telehealth Bulk Billing Incentives to a practitioner each time they bulk bill a Telehealth MBS Item. Practitioners then receive a single payment each quarter for all Telehealth Bulk Billing Incentives they have accrued.
Incentives for Residential Aged Care Facilities
Financial Incentives are also available for residential aged care facilities. Further information on these incentives is available here.
Eligibility
MBS Items
Practitioners providing a MBS billed service at the patient-end of a video consultation should be aware of the eligibility requirements for these services.
In order to bill a MBS item for a patient-end service (items 2100, 2122, 2126, 2125, 2137, 2138, 2143, 2147, 2179, 2195, 2199, 2220, 10983, 10984, 82150, 82151, 82152, 82220, 82221, 82222, 82223, 82224 or 82225) all of the following conditions must be met:
- The patient-end practitioner must be supporting a patient who is participating in a consultation via video conference with a specialist or consultant physician and there is an MBS item that relates to that service;
- the specialist or consultant physician’s service must be rendered in Australia;
- the specialist or consultant physician service must be provided via video conferencing (where both video and audio communication between the patient and specialist occurs);
- the patient must not be an admitted patient; and
- the patient must be either:
- a care recipient receiving care in a residential care service; or
- at an eligible Aboriginal Medical Service or Aboriginal Community Controlled Health Service in relation to which a direction made under subsection 19(2) of the Act applies; or
- located in an eligible geographical area.
A patient-end practitioner must be a medical practitioner, participating nurse practitioner, participating midwife, Aboriginal health worker or practice nurse. There are specific MBS items for the types of practitioner providing the patient-end service and these items have their own eligibility requirements. For example, participating midwives may only provide patient-end services to a patient for a video consultation with an obstetric specialist or paediatrician. Practitioners should consult the MBS item descriptors and the explanatory notes in the MBS which are available from mbsonline.gov.au
Patient-end practitioners who provide patient-end services to residents of a RACF or to patients receiving treatment in an Aboriginal Medical Service should have a Medicare provider number linked to those locations and this will allow the practitioner to bill the appropriate MBS item.
Financial Incentives
Each of the financial incentives for telehealth has specific eligibility requirements, which are outlined in the Telehealth Program Guidelines.
Generally, the Dept of Human Services will automatically determine the incentive amount payable to a practitioner based on claiming information.
Geographical Requirements
Telehealth Eligible Areas are those areas of Australia, not defined as inner metropolitan, where patients are can receive MBS billed video consultations.
Patients who are residents at RACFs, or who are receiving health services at an eligible Aboriginal Medical Service are eligible to receive telehealth services under the MBS anywhere in Australia. Telehealth Eligible Areas only affect the eligibility of patients in other locations.
Further information, including maps of eligible areas, is available from Eligible Geographical Areas.
Clinical Practice and Technology for Telehealth
Telehealth is a new way of practicing for most medical practitioners, and it presents new clinical and technological challenges.
The Government has not established clinical standards and is not mandating any particular technological solution for telehealth. These issues are appropriately being addressed by medical colleges, standards organisations (such as Standards Australia), and technology suppliers.
The appropriateness of any clinical activity, or of particular technological solutions, are decisions which should be made by the individual health professional, with regard to individual circumstances and requirements.
There is guidance provided here on types of issues practitioners may want to consider in undertaking online consultations. Please note that these are not Government requirements.