If your private practice has been struggling to adapt to the changes that have swept through the Australian Medicare system in the wake of COVID, you’re not alone. It seems like every day there are new regulations and standards that need to be met. Governmental departments seem to have different rules, and even private health insurance providers vary widely in how they reimburse Telehealth in Australia.
But while you’re trying to see clients and work with new technologies, you can’t fall behind on the financial side of your business. With this in mind, we’ve created a reference guide to help make billing and receiving reimbursement for Telehealth services easier.
What Steps are the Australian Government Taking to Support Permanent Telehealth Services?
Over the next four years, the Australian government will invest $106 million to allow GPs, specialists and allied health professionals to continue with Telehealth in Australia. From 1 January 2022, eligible clients will be able to continue accessing Telehealth services provided by medical professionals, including general practitioners (GPs), specialists and consultant physicians, allied health providers, mental health professionals, and nurse practitioners. For clients living in remote areas of Australia, an extended GP telephone consultation item has been added.
The updated fact sheets for temporary specialists, psychiatry, specialists, GPs and other medical practitioners are available MBS Online here.
What are the Requirements for Providers?
In order to provide Telehealth services, the technology you use needs to meet your clinical requirements and satisfy privacy laws (here’s a checklist supplied by MBS Online), but there are no specific equipment requirements.
Your clients will still require a valid referral from an eligible medical practitioner, which may form part of any number of plans, including chronic disease management, shared care, team care, multidisciplinary care, eating disorder treatment and management, and more.
1. Medicare & Telehealth Reimbursements
Telehealth Items for Allied Health Professionals
From 1 January 2022, thirty-nine allied health Telehealth services will continue to be available, covering:
- Chronic disease management
- Follow-ups for patients of Aboriginal and Torres Strait Islander descent
- Pregnancy support counselling
- Early intervention services for children
- Eating disorder services
- Group dietetics services
Download the PDF version of the MBS Telehealth Services Factsheet for Allied Health Professionals.
Telehealth Items for Mental Health Professionals
As of 1 January 2022, twenty-four mental health Telehealth services will remain in place until December 2022. These services include four psychological therapy items for clinical psychologist services; and twenty Focused Psychological Strategies items for services provided by a psychologist, GP, non-specialist medical practitioner, occupational therapist or social worker.
Download the PDF version of the MBS Telehealth Services Factsheet for Mental Health Professionals.
2. Department of Veteran Affairs & Telehealth Reimbursement
All allied health services will continue to be delivered via Telehealth in Australia except for dental, optical and neuropsychology services. This means that from 1 January 2022, allied health professionals can claim under the new DVA fee schedule.
Note that the intention is not to replace in-person services, and Telehealth services are only available for subsequent consultations (not initial and extended consultations). There are several specific limitations on Telehealth appointments, a list of which are available in the updated Notes for Allied Health Providers – Section One – General.
For updates on fee schedules, please have a look at the DVA website here and refer to the notes in section 1 for allied health providers.
3. National Disability Insurance Scheme (NDIS) & Telehealth Reimbursement
The NDIS makes provision for support activities to be delivered online using the line items provided in the NDIS Pricing Arrangements and Price Limits. They are available for participants who cannot be in the same location as the health care provider and should be billed using the new ‘Telehealth’ claim field that has been added to the myplace provider portal.
4. My Aged Care & Telehealth Reimbursement
The Commonwealth Home Support Programme (CHSP) and Home Care Packages Programme (HCP) are funding allied health services through Telehealth and have been since before COVID-19. They allow for the reimbursement of Telehealth services, and the full details can be seen in the CHSP Programme Manual.
5. Private Health Insurance & Telehealth Reimbursement
Coverage of Telehealth for allied health professionals varies widely between health insurers, so it’s important to speak to the specific insurance provider to confirm what telehealth reimbursements they offer.
HICAPS has partnered with all Australian private health insurers to make processing claims easier for patients and healthcare providers. Their Allied Health Items numbers cover Telehealth services offered by:
- Exercise psychologists
- Occupational therapists
- Speech pathologists
With nearly 70% of Australia’s healthcare funding provided by the government, it’s encouraging to know that Medicare is on-board with the shift to Telehealth solutions for allied health practitioners. It’s also essential in this unprecedented time of social distancing.
Reimbursements for Telehealth appointments make it easier for providers to offer necessary services for their clients to access the care they need. We hope this resource will make the transition smoother for private practices in 2022, and if you know of a private practice struggling to navigate Telehealth in Australia, please pass on this article for their reference.
This article was originally published in 2020 and has been updated for comprehensiveness and accuracy.