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Determinations/Health as made
This instrument amends the Health Insurance (Section 3C General Medical Services – Specialist, Consultant Physician and Consultant Psychiatrist COVID-19 Telehealth Services) Determination 2020 to include ten new temporary Medicare Benefits Schedule (MBS) items to allow specialists, consultant physicians and consultant psychiatrists to provide these services via the phone when video conferencing is unavailable to patients who have been diagnosed with the COVID-19 virus, or who are vulnerable of contracting the COVID-19 virus.
Administered by: Health
Registered 13 Mar 2020
Tabling HistoryDate
Tabled HR23-Mar-2020
Tabled Senate23-Mar-2020
To be repealed 18 Sep 2020
Repealed by Division 1 of Part 3 of Chapter 3 of the Legislation Act 2003
Table of contents.

Commonwealth Coat of Arms of Australia

 

Health Insurance (Section 3C General Medical Services – Specialist, Consultant Physician and Consultant Psychiatrist COVID-19 Telehealth Services) Amendment Determination No.1 2020 

I, DAVID WEISS delegate of the Minister for Health, make the following Determination.

Dated 13 March 2020

David Weiss

First Assistant Secretary

Medical Benefits Division

Health Financing Group

Department of Health

 

 

 


Contents

1  Name........................................................................................................................................ 1

2  Commencement........................................................................................................................ 1

3  Authority.................................................................................................................................. 1

4  Schedules................................................................................................................................. 1

Schedule 1— Amendments to Health Insurance (Section 3C General Medical Services – Specialist, Consultant Physician and Consultant Psychiatrist COVID-19 Telehealth Services) Determination 2020 2

Division 1.4 Services and fees – specialist attendances via phone services            2

Division 1.5 – Services and fees – consultant physician (other than psychiatry) attendances via phone services                                                                                                       3

Division 1.6 – Services and fees – Consultant psychiatrist attendances via phone services       5

 

 


1  Name

                        This instrument is the Health Insurance (Section 3C General Medical Services – Specialist, Consultant Physician and Consultant Psychiatrist COVID-19 Telehealth Services) Amendment Determination No.1 2020.

2  Commencement

(1)       Each provision of this instrument specified in column 1 of the table commences, or is taken to have commenced, in accordance with column 2 of the table. Any other statement in column 2 has effect according to its terms.

 

Commencement information

Column 1

Column 2

Column 3

Provisions

Commencement

Date/Details

1.  The whole of this instrument

Immediately after the commencement of the Health Insurance (Section 3C General Medical Services – Specialist, Consultant Physician and Consultant Psychiatrist COVID-19) Telehealth Services) Determination 2020

 

                Note:        This table relates only to the provisions of this instrument as originally made. It will not be amended to deal with any later amendments of this instrument.

(2)       Any information in column 3 of the table is not part of this instrument. Information may be inserted in this column, or information in it may be edited, in any published version of this instrument.

3  Authority

                        This instrument is made under subsection 3C(1) of the Health Insurance Act 1973.

4  Schedules

                        Each instrument that is specified in a Schedule to this instrument is amended or repealed as set out in the applicable items in the Schedule concerned, and any other item in a Schedule to this instrument has effect according to its terms.


 

Schedule 1— Amendments to Health Insurance (Section 3C General Medical Services – Specialist, Consultant Physician and Consultant Psychiatrist COVID-19 Telehealth Services) Determination 2020

1.    Within the definition of ‘Patient at risk of COVID-19 virus’ of section 5 Definitions

Insert after (c)(v):

or

(d)          the person meets the current national triage protocol criteria for suspected COVID-19 infection

2.    After ‘Patient at risk of COVID-19 virus’ of section 5 Definition

            Insert:

            phone attendance means a professional attendance by telephone where the health practitioner:

(a)           has the capacity to provide the full service through this means safely and in accordance with professional standards; and

(b)          is satisfied that it is clinically appropriate to provide the service to the patient; and

(c)           maintains an audio link with the patient.

3.    After Division 1.3 of Schedule 1

Insert:

Division 1.4 Services and fees – specialist attendances via phone services

1.4.1 Application of COVID-19 medical practitioner phone services

Insert:

(1) For items in Subgroups 4, and 7 the rendering practitioner must not perform a service in subgroup 7 if the practitioner and the patient have the capacity to undertake an attendance by telehealth.

 

Group A40 – COVID-19 – medical practitioner phone services

Subgroup 7 – COVID-19 – specialist attendances phone services

Item

Description

Fee ($)

91832

 

Phone attendance for a person by a specialist in the practice of the specialist’s specialty if:

(a)    the attendance is where:

(i)                     the person is a patient at risk of COVID-19 virus; or

(ii)                   the specialist is a health professional at risk of COVID-19 virus; and

(b)          the attendance follows referral of the patient to the specialist; and

(c)          the attendance was of more than 5 minutes in duration; and

(d)      the patient is not an admitted patient; and

(e)       the service is bulk-billed.

 

Where the attendance was other than a second or subsequent attendance as part of a single course of treatment.

88.25

91833

 

 

Phone attendance for a person by a specialist in the practice of the specialist’s specialty if:

(a)    the attendance is where:

(i)                     the person is a patient at risk of COVID-19 virus; or

(ii)                   the specialist is a health professional at risk of COVID-19 virus; and

(b)          the attendance follows referral of the patient to the specialist; and

(c)          the attendance was of more than 5 minutes in duration; and

(d)         the patient is not an admitted patient; and

(e)          the service is bulk-billed.

 

Where the attendance is after the first attendance as part of a single course of treatment.

44.35

 

Division 1.5 – Services and fees – consultant physician (other than psychiatry) attendances via phone services

1.5.1 Application of COVID-19 medical practitioner phone services

Insert:

(1)     For items in Subgroups 5, and 8 the rendering practitioner must not perform a service in subgroup 8 if the practitioner and the patient have the capacity to undertake an attendance by telehealth.

 

 

Group A40 – COVID-19 – medical practitioner phone services

 

 

Subgroup 8 – COVID-19 – consultant physician phone services

 

Item

Description

Fee ($)

 

91834

 

Phone attendance for a person by a consultant physician in the practice of the consultant physician’s specialty (other than psychiatry) if:

(a)    the attendance is where:

(i)                     the person is a patient at risk of COVID-19 virus; or

(ii)                   the consultant physician is a health professional at risk of COVID-19 virus; and

(b)          the attendance follows referral of the patient to the specialist; and

(c)          the attendance was of more than 5 minutes in duration; and

(d)         the patient is not an admitted patient; and

(e)          the service is bulk-billed.

 

Where the attendance was other than a second or subsequent attendance as part of a single course of treatment.

155.60

 

91835

 

Phone attendance for a person by a consultant physician in the practice of the consultant physician’s specialty (other than psychiatry) if:

(a)    the attendance is where:

(i)                     the person is a patient at risk of COVID-19 virus; or

(ii)                   the consultant physician is a health professional at risk of COVID-19 virus; and

(b)          the attendance follows referral of the patient to the specialist; and

(c)          the attendance was of more than 5 minutes in duration; and

(d)         the patient is not an admitted patient; and

(e)          the service is bulk-billed.

 

Where the attendance is not a minor attendance after the first as part of a single course of treatment.

77.90

 

91836

 

Phone attendance for a person by a consultant physician in the practice of the consultant physician’s specialty (other than psychiatry) if:

(a)    the attendance is where:

(i)                     the person is a patient at risk of COVID-19 virus; or

(ii)                   the specialist is a health professional at risk of COVID-19 virus; and

(b)          the attendance follows referral of the patient to the specialist; and

(c)          the attendance was of more than 5 minutes in duration; and

(d)         the patient is not an admitted patient; and

(e)          the service is bulk-billed.

 

Where the attendance is a minor attendance after the first as part of a single course of treatment.

44.35

 

Division 1.6 – Services and fees – Consultant psychiatrist attendances via phone services

1.6.1 Application of COVID-19 medical practitioner phone services

Insert:

(1) For items in Subgroups 6, and 9 the rendering practitioner must not perform a service in subgroup 9 if the practitioner and the patient have the capacity to undertake an attendance by telehealth.

 

Group A40 – COVID-19 – medical practitioner phone services

Subgroup 9 – COVID-19 – consultant psychiatrist phone services

Item

Description

Fee($)

 

91837

 

Phone attendance for a person by a consultant psychiatrist; if:

(a)    the attendance is where:

(i)                     the person is a patient at risk of COVID-19 virus; or

(ii)                   the consultant psychiatrist is a health professional at risk of COVID-19 virus; and

(b)   the attendance follows a referral of the patient to the consultant psychiatrist by a referring practitioner; and

(c)    the attendance was not more than 15 minutes duration; and

(d)   the patient is not an admitted patient; and

(e)    the service is bulk-billed.

44.70

 

91838

 

Phone attendance for a person by a consultant psychiatrist; if:

(a)    the attendance is where:

(i)                     the person is a patient at risk of COVID-19 virus; or

(ii)                   the consultant psychiatrist is a health professional at risk of COVID-19 virus; and

(b)   the attendance follows a referral of the patient to the consultant psychiatrist by a referring practitioner; and

(c)    the attendance was of more than 15 minutes, but not more than 30 minutes in duration; and

(d)   the patient is not an admitted patient; and

(e)    the service is bulk-billed.

89.15

 

91839

 

Phone attendance for a person by a consultant psychiatrist; if:

(a)    the attendance is where:

(i)                     the person is a patient at risk of COVID-19 virus; or

(ii)                   the consultant psychiatrist is a health professional at risk of COVID-19 virus; and

(b)   the attendance follows a referral of the patient to the consultant psychiatrist by a referring practitioner; and

(c)    the attendance was of more than 30 minutes, but not more than 45 minutes in duration; and  

(d)   the patient is not an admitted patient; and

(e)    the service is bulk-billed.

137.25

 

91840

 

Phone attendance for a person by a consultant psychiatrist; if:

(a)    the attendance is where:

(i)                     the person is a patient at risk of COVID-19 virus; or

(ii)                   the consultant psychiatrist is a health professional at risk of COVID-19 virus; and

(b)   the attendance follows a referral of the patient to the consultant psychiatrist by a referring practitioner; and

(c)    the attendance was of more than 45 minutes, but not more than 75 minutes in duration; and

(d)   the patient is not an admitted patient; and

(e)    the service is bulk-billed.

189.40

 

91841

 

Phone attendance for a person by a consultant psychiatrist; if:

(a)    the attendance is where:

(i)                     the person is a patient at risk of COVID-19 virus; or

(ii)                   the consultant psychiatrist is a health professional at risk of COVID-19 virus; and

(b)   the attendance follows a referral of the patient to the consultant psychiatrist by a referring practitioner; and

(c)    the attendance was of more than 75 minutes in duration; and

(d)   the patient is not an admitted patient; and

(e)    the service is bulk-billed.

219.80