Medicare Telehealth Items for GPs

Revenue

(Medicare Benefit)

Revenue with Regional/Remote

Bulk Billing Incentive (10991)

1. Drought Communities Programme (DCP)

• Telehealth consultation providing mental health services to drought-affected communities
• GP must be located in regions belonging to DCP in Modified Monash Model areas 3-7
• Patient must be located at least 15km by road from GP at time of appointment
• An existing relationship between GP and patient must be present
• Admitted hospital or hospital in the home patients not eligible 

No extra training is needed to provide these services

2. GP Focussed Psychological Strategies (since 1 Nov 2018) under the Better Access Scheme

• Telehealth consultation for providing focussed psychological strategies 
• GPs must undergo training and be approved as a Focussed Psychological Strategy provider
• Patients must be in telehealth eligible area (Modified Monash Model 4-7)
• Patients must be located at least 15 km by road from GP at time of appointment
• Admitted hospital or hospital in the home patients not eligible 

 30-40 minutes

≥ 40 minutes

3. Telehealth Services Provided by GPs and Non-Specialist Medical Practitioners to Patients in Rural and Remote Areas

People  living in rural and remote communities will be able to request a video consultation with their doctor, if they:

• are not an admitted patient; and
• are living in a MMM 6 or 7 area; and
• have received three face-to-face professional attendances in the preceding twelve months from the practitioner who will provide the telehealth service; and
• at the time of the consultation, be at least 15 kilometres by road from the practitioner.

The first four items are for General Practitioners:

The next four items are for non-specialist medical practitioners (GP, Specialist, Consultant Physician) in Modified Monash Model (MMM) area 1:

The final four items are for non-specialist medical practitioners (GP, Specialist, Consultant Physician) in Modified Monash Model (MMM) areas 2-7:

4. Telehealth Patient-end Support Services

For patients in telehealth eligible areas OR patients of Aboriginal Medical Service/Aboriginal Community Controlled Health Service :

• GP is alongside patient at consulting rooms whilst participating in telehealth consultation with specialist   
• Patient must either be located in a telehealth eligible area or be a patient of an Aboriginal Medical Service/Aboriginal Community Controlled Health Service 
• Patient must be located at least 15 kilometres by road from specialist 
• Admitted hospital or hospital in the home patients not eligible 

For patients in residential care services:

• GP is alongside patient in residential care service whilst participating in telehealth consultation with specialist
• Patients in self-contained units not eligible

First 6 patients: $22.90 + ($46.70/number of patients seen)

or

7+ patients: $22.90 + ($3.30 x number of patients seen)

First 6 patients: $32.40 +  ($46.70/number of patients seen)

or

7+ patients: $32.40 + ($3.30 x number of patients seen)

First 6 patients: $49.95 + ($46.70/number of patients seen)

or

7+ patients: $49.95 + ($3.30 x number of patients seen)

First 6 patients: $59.45 + ($46.70/number of patients seen)

or

7+ patients: $59.45 + ($3.30 x number of patients seen)

<20 minutes

First 6 patients: $96.85 + ($46.70/number of patients seen)

or

7+ patients: $96.85 + ($3.30 x number of patients seen)

First 6 patients: $106.35 + ($46.70/number of patients seen)

or

7+ patients: $106.35 + ($3.30 x number of patients seen)

 First 6 patients: $142.50 + ($46.70/number of patients seen)

or

7+ patients: $142.50 + ($3.30 x number of patients seen)

First 6 patients: $152 + ($46.70/number of patients seen)

or

7+ patients: $152 + ($3.30 x number of patients seen

≥40 minutes

Home visits for telehealth eligible patients:

• GP is alongside patient at home whilst participating in telehealth consultation with specialist 
• Patient must be located in telehealth eligible area
• Patient must be at least 15 kilometres by road from specialist
• Patient must not be admitted to a hospital or hospital in the home service
• Patient must not be a care recipient in a residential care service

First 6 patients: $22.90 + ($25.95/ number of patients seen)

or

7+ patients: $22.90 + ($2.00 x number of patients seen)

First 6 patients: $32.40 + ($25.95/ number of patients seen)

or

7+ patients: $32.40 + ($2.00 x number of patients seen)

First 6 patient: $49.95 + ($25.95/ number of patients seen)

or

7+ patients: $49.95 + ($2.00 x number of patients seen)

First 6 patient: $59.45 + ($25.95/ number of patients seen)

or

7+ patients: $59.45 + ($2.00 x number of patients seen)

First 6 patients: $96.85 + ($25.95/no. patients seen)

7+ patients: $96.85 + ($2.00 x no. patients seen)

First 6 patients: $106.35 + ($25.95/no. patients seen)

7+ patients: $106.35 + ($2.00 x no. patients seen)

 ≥ 20 minutes

 First 6 patients: $142.50 + ($25.95/ number of patients seen)

7+ patients: $142.50 + ($2.00 x number of patients seen)

First 6 patients: $152 + ($25.95/ number of patients seen)

7+ patients: $152 + ($2.00 x number of patients seen)

  ≥40 minutes