News

RACGP secures $500m to help general practice fight coronavirus

Doug Hendrie 29/03/2020 11:11:19 AM In the most far-reaching change for general practice in a generation, telehealth will be broadened to include all Australians and new incentives introduced to keep GPs and patients safe during the pandemic.

Prime Minister Scott Morrison Federal Health Minister Greg Hunt announced the package this morning.

UPDATED



An estimated $500 million in new telehealth measures and incentives for GPs has been announced following strong RACGP advocacy to keep patients and frontline doctors safe from the coronavirus.



The package includes opening up telehealth and telephone Medicare Benefits Schedule (MBS) items to all Australians, doubling the bulk-billing incentive for GPs, and the introduction of a new incentive payment to help general practices stay open to provide face-to-face services for patients with conditions that cannot be treated via telehealth.



The range of services GPs can now provide over phone or video have also grown to include mental health treatment, chronic disease management and Aboriginal and Torres Strait Islander health assessments, as well as services to people with eating disorders, pregnancy support counselling, services to patients in aged care facilities, children with autism, and after-hours consultations.



Launching the package today, Prime Minister Scott Morrison said the changes are about ‘getting health services into your home.’



Federal Health Minister Greg Hunt said the changes are a ‘radical transformation’ of the way healthcare is delivered.



‘As of tomorrow, we will have universal telehealth available in Australia. It’s a decade’s worth of work in a matter of days,’ he said.



Minister Greg Hunt thanked Principal Medical Adviser – and former RACGP President – Professor Michael Kidd for the work his team had done, as well as the RACGP and other peak bodies.



Professor Kidd described the changes as the most dramatic of his whole career.



‘From tomorrow morning, as a patient you can reach out to your GP, specialist or other healthcare provider. If you’re a GP, you will be able to reach out to their patients to make sure they are okay and adhering to their plans for management of chronic disease,’ he said.



‘We know that during a pandemic, one of the greatest risks to the population is if we see a collapse of services available to patients with chronic health or mental health conditions. The measures put in place will ensure the people of Australia continue to have access to high-quality [medical services].’



Professor Kidd thanked the peak medical bodies and health organisations that have worked at an ‘extraordinary level’ to make this happen.



In a release, Minister Hunt said telehealth is a ‘key weapon in the fight against the COVID-19 pandemic’.



‘Australia’s primary health workers are our frontline in leading the fight against this pandemic,’ he said.



The welcome news is set to continue for general practice, with Minister Hunt indicating that private billing for telehealth and telephone items will be permitted for non-concessional patients, with an official announcement expected within a fortnight.



The changes will begin from 8.00 am 30 March:

Items for telehealth/telephone consultations will mirror general practice, other specialist, and allied health item numbers

Doubling the bulk-billing incentive payment for pensioners, under-16s and concession card holders

Doubling of Quality Improvement Practice Incentive Payments (QI PIP) to support face-to-face consultations

‘This has been one of the most significant changes we’ve seen in Australian general practice in my working lifetime of 35 years,’ Professor Michael Kidd, Principal Medical Adviser to the Department of Health, said.



Expanded telehealth items as announced on 29 March (table updated with rebate values)

Item Descriptor Rebate Consultation items – Telehealth/videoconference 91790 Level A – General Consult $17.50 91800 Level B – General Consult $38.20 91801 Level C – General Consult $73.95 91802 Level D – General Consult $108.85 Consultation items – Phone consultation 91795 Level A – General Consult $17.50 91809 Level B – General Consult $38.20 91810 Level C – General Consult $73.95 91811 Level D – General Consult $108.85 Focussed Psychological Strategies – Telehealth/videoconference 91818 Telehealth consultation lasting 30–40 minutes $94.25 91819 Telehealth consultation lasting at least 40 minutes $134.85 Focussed Psychological Strategies – Phone consultation 91842 Phone consultation lasting 30–40 minutes $94.25 91843 Phone consultation lasting at least 40 minutes $134.85 GP mental health treatment plan – Telehealth/videoconference 92112 Telehealth attendance lasting at least 20 minutes for the preparation of a GP mental health treatment plan (no additional mental health skills training) $72.85 92113 Telehealth attendance lasting at least 40 minutes for the preparation of a GP mental health treatment plan (no additional mental health skills training) $107.25 92114 Telehealth attendance to review a GP mental health treatment plan $72.85 92115 Telehealth attendance relating to mental disorder and consultation lasting at least 20 minutes $72.85 92116 Telehealth attendance lasting at least 20 minutes for the preparation of a GP mental health treatment plan (with additional mental health skills training) $92.50 92117 Telehealth attendance lasting at least 40 minutes for the preparation of a GP mental health treatment plan (with additional mental health skills training) $136.25 GP mental health treatment plan – Phone consultation 92124 Phone attendance lasting at least 20 minutes for the preparation of a GP mental health treatment plan (no additional mental health skills training) $72.85 92125 Phone attendance lasting at least 40 minutes for the preparation of a GP mental health treatment plan (no additional mental health skills training) $107.25 92126 Telehealth attendance to review a GP mental health treatment plan $72.85 92127 Phone attendance relating to mental disorder and consultation lasting at least 20 minutes $72.85 92128 Phone attendance lasting at least 20 minutes for the preparation of a GP mental health treatment plan (with additional mental health skills training) $92.50 92129 Phone attendance lasting at least 40 minutes for the preparation of a GP mental health treatment plan (with additional mental health skills training) $136.25 GPMP, TCA and multidisciplinary care plans via telehealth/videoconference 92024 Preparation of a General Practitioner Management Plan $146.55 92025 Coordinate the development of team care arrangements $116.15 92026 Contribute to care plan or review $71.55 92027 Contribute to care plan or review for a patient in a residential aged care facility or a patient being discharged from hospital $71.55 92028 Review or coordinate review of: a GP Management Plan to which items 721, 229, or item 92024 or 92068 applies; or

team care arrangements to which item 723 of the general medical services table, item 230, or item 92025 or 92069 or items applies $73.20 GPMP, TCA and multidisciplinary care plans via phone consultation 92068 Preparation of a General Practitioner Management Plan

$146.55 92069 Coordinate the development of team care arrangements $116.15 92070 Contribute to care plan or review $71.55 92071 Contribute to care plan or review for a patient in a residential aged care facility or a patient being discharged from hospital $71.55 92072 Review or coordinate review of: a GP Management Plan to which item 721 of the general medical services table, item 229, or items 92074 to 92078 or 92030 to 92034, or items 92024 or 92068 applies; or

team care arrangements to which item 723 of the general medical services table or item 92025 or 92069 or items applies $73.20 Health assessment – Aboriginal and Torres Strait Islander People – Telehealth/videoconference 92004 Health assessment $215.65 Health assessment – Aboriginal and Torres Strait Islander People – Phone consultation 92016 Health assessment $215.65 GP pregnancy support counselling – Telehealth/videoconference 92136 Telehealth attendance of at least 20 minutes $77.85 GP pregnancy support counselling – Phone consultation 92138 Phone attendance of at least 20 minutes $77.85 GP, specialist and consultant physician autism service – Telehealth/videoconference 92142 Telehealth attendance of at least 45 minutes $136.65 GP, specialist and consultant physician autism service – Phone consultation 92145 Phone attendance of at least 45 minutes $136.65 GP eating disorder treatment and management plan – Telehealth/videoconference 92146

Telehealth attendance, no additional mental health skills training of at least 20 minutes for preparation of written eating disorder treatment and management plan for eligible patient $72.85 92147 Telehealth attendance, no additional mental health skills training lasting at least 40 minutes for the preparation of a written eating disorder treatment and management plan for an eligible patient $107.25 92148 Telehealth attendance, additional mental health skills training, lasting at least 20 minutes for the preparation of a written eating disorder treatment and management plan for an eligible patient $92.50 92149 Telehealth attendance, additional mental health skills training, lasting at least 40 minutes for the preparation of a written eating disorder treatment and management plan for an eligible patient $136.25 GP eating disorder treatment and management plan – Phone consultation 92154 Phone attendance, no additional mental health skills training, lasting at least 20 minutes for preparation of written eating disorder treatment and management plan for eligible patient $72.85 92155 Phone attendance, no additional mental health skills training lasting at least 40 minutes for the preparation of a written eating disorder treatment and management plan for an eligible patient $107.25 92156 Phone attendance, additional mental health skills training, lasting at least 20 minutes for the preparation of a written eating disorder treatment and management plan for an eligible patient $92.50 92157 Phone attendance additional mental health skills training, lasting at least 40 minutes for the preparation of a written eating disorder treatment and management plan for an eligible patient $136.25 Review of an eating disorder plan – Telehealth/videoconference 92170 Telehealth attendance to review an eating disorder treatment and management plan $72.85 Review of an eating disorder plan – Phone consultation 92176 Phone attendance to review an eating disorder treatment and management plan $72.85 GP eating disorder – Focussed Psychological Strategies telehealth/videoconference 92182 Telehealth attendance consultation for providing eating disorder psychological treatment services, lasting at least 30 minutes $94.25 92184 Telehealth attendance consultation for providing eating disorder psychological treatment services, lasting at least 40 minutes $134.85 GP eating disorder – Focussed Psychological Strategies – Phone consultation 92194 Phone attendance for providing eating disorder psychological treatment services, lasting at least 30 minutes $94.25 92196 Phone attendance consultation for providing eating disorder psychological treatment services, lasting at least 40 minutes $134.85 GP – urgent after hours in unsociable hours – Telehealth/videoconference 92210 Telehealth attendance in unsociable hours if:

(a) the attendance is requested by the patient or a responsible person in the same unbroken after-hours period; and

(b) the patient’s medical condition requires urgent assessment $155.45 GP – urgent after hours in unsociable hours – Phone consultation 92216 Phone attendance in unsociable hours if:

(a) the attendance is requested by the patient or a responsible person in the same unbroken after-hours period; and

(b) the patient’s medical condition requires urgent assessment $155.45 Obstetric services – Telehealth/videoconference 91850 Antenatal telehealth service provided by a nurse, midwife or an Aboriginal and Torres Strait Islander health practitioner on behalf of, and under the supervision of, a medical practitioner $23.55 91851 Postnatal telehealth attendance by an obstetrician or GP $61.95 91852 Postnatal telehealth attendance by:

(i) a midwife (on behalf of and under the supervision of the medical practitioner who attended the birth); or

(ii) an obstetrician; or

(iii) a general practitioner $46.15 91853 Antenatal telehealth attendance $40.75 Obstetric services – Phone attendance 91855 Antenatal phone service provided by a nurse, midwife or an Aboriginal and Torres Strait Islander health practitioner on behalf of, and under the supervision of, a medical practitioner $23.55 91856 Postnatal phone attendance by an obstetrician or GP $61.95 91857 Postnatal phone attendance by:

(i) a midwife (on behalf of and under the supervision of the medical practitioner who attended the birth); or

(ii) an obstetrician; or

(iii) a general practitioner $46.15 91858 Antenatal telehealth attendance $40.75

The RACGP has actively lobbied for the changes to keep GPs safe through major reductions in face-to-face consultations and a shift to telehealth, as well as allowing practices to weather the coronavirus storm.RACGP President Dr Harry Nespolon hailed the package as a major win for Australia’s GPs.‘It is positive news that the Federal Government is listening to the RACGP’s calls at this critical time – telehealth is a key weapon in the fight against this pandemic,’ he said.‘The reason we have been pushing so hard for the telehealth expansion is because GPs on the frontline battling COVID-19 know that it will make a real difference in limiting the spread of the virus.‘It is vital to provide extra support to keep general practices open so they can continue to provide essential support to their communities. Like the multitude of other small businesses, general practices have seen the number of patients drop and we need our practices to stay open during the crisis and beyond.’Dr Nespolon said it is important to note that the MBS items apply to telephone consultations as well as video calls.‘We need to be technologically agnostic and not have the public or GPs think that this MBS item is limited to video consultations,’ he said. ‘An old-fashioned phone will do just fine.’Telehealth is seen as a vital way of keeping GPs safe, allowing patients who are self-isolating or quarantining to still get access to medical care while minimising exposure to their doctor.The sweeping changes are among the largest announced for general practice in decades, and will be in place at least until 30 September, after which time they will be reviewed.The Government consulted widely before announcing the changes, collaborating directly with the RACGP, the Australian Medical Association and other stakeholders.Patients are being advised to discuss whether telehealth or face-to-face consults are the most appropriate with their GP.The general practice package was the largest plank of a wider suite of measures boosting services during the pandemic, with mental health and family violence service providers also receiving a funding boost to help telephone services expand to meet significant and growing demand.Other nations around the world have been moving to implement telehealth during the crisis, beginning with China’s early move to get half of all consultations done by phone or video.The UK and US and other affected nations are also moving to telehealth.Detailed fact sheets on the temporary telehealth bulk-billed items for COVID-19 are available on the Department of Health website . And GPs who would like more information and advice on primary care telehealth consultations should access the new RACGP guidelines on the college website Log in below to join the conversation.

bulk bill coronavirus COVID-19 general practice telehealth