Medicare telehealth reimbursements
Medicare telehealth reimbursements summary
1. New: MBS item numbers for COVID-19
The MBS is regularly updating items regarding COVID-19. Please refer to the MBS online listing of all items numbers.
2. Reimbursements for bushfire victims
Following the devastating bushfires that continue to burn across the nation, the government has responded with a mental health care package that extends the existing Better Access Scheme. $30m of the total funding is going directly to boosting telehealth services and increasing the amount of free psychological therapy sessions bushfire-affected people can access through Medicare.
The items are as follows:
| Health professional | Telehealth services |
|---|---|
| General practitioner | 91729, 91731 |
| Medical practitioner | 91371, 91372 |
| Clinical psychologist | 91001, 91011 |
| Registered psychologist | 91101, 91111 |
| Occupational therapist | 91126, 91136 |
| Social worker | 91151, 91161 |
Patients can claim up to 10 sessions and they do not need a referral. These items can be used in addition to the mental health care plan under the Better Access Scheme.
3. Drought Communities Program (DCP) – increasing access to mental health services
- No additional training required for GPs
- GP and patient located in DCP region in Modified Monash Model (MMM) areas 3-7
- Patient >15 km by road from GP at the appointment time
- Pre-existing relationship between GP and patient
- Not eligible: admitted hospital or hospital-in-the-home patients
Read more about healthdirect Video Call available free to GPs to support patients in drought-affected areas.
| MBS Item Number | Revenue | Revenue with Bulk Billing Incentive 10991 | Duration (minutes) |
| 2121 | $38.20 | $47.85 | <20 |
| 2150 | $73.95 | $83.60 | 20-40 |
| 2196 | $108 .85 | $118.50 | > 40 |
4. Better Access Scheme – GP-focused Psychological Strategies(FPS)
- Additional training required for GPs to provide FPS for all 10 sessions of mental health plan
- Patient in telehealth-eligible area (MMM 4-7)
- Patient >15 km by road from GP at the appointment time
- Not eligible: admitted hospital or hospital-in-the-home patients
| MBS Item Number | Revenue | Revenue with Bulk Billing Incentive 1099 | Duration (minutes) |
2729
|
$94.25 | $103.90 | >30 but <40 |
| 2731 | $134.85 | $144.50 | >40 |
5. Telehealth patient-end support services
| MBS Item Number | Revenue | Revenue with Bulk Billing Incentive 10991 | Duration (minutes) |
|
Patient in telehealth eligible areas OR patient of Aboriginal Community Controlled Health Service
| |||
| 2100 | $23.25 | $32.90 | >5 |
| 2126 | $50.75 | $60.40 | <20 |
| 2143 | $98.40 | $108.05 | >20 |
| 2195 | $144.80 | $154.45 | >40 |
|
Patient in residential care services
| |||
| 2125 |
First 6 patients: $23.25 + ($47.45/# pts) or 7+ patients: $23.25 + ($3.35 x # pts) |
First 6 patients: $32.90 + ($47.45/# pts) 7+ patients: $32.90 + ($3.35 x # pts) |
>5
|
| 2138 | First 6 patients: $50.75 + ($47.45/# pts) or 7+ patients: $50.75 + ($3.35 x # pts) |
First 6 patients: $60.40 + ($47.45/# pts) or 7+ patients: $60.40 + ($3.35 x # pts) |
<20 |
|
2179
|
First 6 patients: $98.40 + ($47.45/# pts) or |
First 6 patients: $108.05+ ($47.45/# pts) or 7+ patients: $108.05 + ($3.35 x # pts) |
>20 |
|
2220
|
First 6 patients: $144.80 + ($47.45/# pts) or 7+ patients: $144.80 + ($3.35 x # pts) |
First 6 patients: $154.45 + ($47.45/# pts) or 7+ patients: $154.45 + ($3.35 x # pts) |
>40
|
|
Home visits for telehealth-eligible patients
Not eligible: care recipients in residential care service | |||
| 2122 | First 6 patients: $23.25 + ($26.35/# pts) or 7+ patients: $22.90 + ($2.05 x # pts) |
First 6 patients: $32.90 + ($26.35/# pts) or 7+ patients: $32.90 + ($2.05 x # pts) |
<5 |
| 2137 |
First 6 patients: $50.75 + ($26.35/ # pts) 7+ patients: $50.75 + ($2.05 x # pts) |
First 6 patients: $60.40 + ($26.35/# pts) or 7+ patients: $60.40 + ($2.05 x # pts) |
>20 |
| 2147 | First 6 patients: $98.40 + ($26.35/# pts) or 7+ patients: $98.40+ ($2.05 x # pts) |
First 6 patients: $108.05 + ($26.35/# pts) or 7+ patients: $108.05 + ($2.05 x # pts) |
>20 |
| 2199 | First 6 patients: $144.80 + ($26.35/# pts) or 7+ patients: $144.80 + ($2.05 x # pts) |
First 6 patients: $154.45 + ($26.35/# pts) or 7+ patients: $154.45 + ($2.05 x # pts) |
>40 |
6. GP and non-specialist medical practitioner items for general attendance
- Patients must be located in MMM 6-7
- Patients must have already received three face-to-face attendances in the prior 12 months from the same practitioner
- Patient > 15 km by road from GP at appointment time
- No restrictions for the geographic location of the provider
- 2461, 2463, 2464, 2465- for general practitioners
- 2471, 2472, 2475, 2478 – for non-specialist medical practitioners in MMM 1
- 2480, 2482, 2482, 2483 – for non-specialist medical practitioners in MMM 2-7
| The Australian Dept of Health has published a Factsheet, Quick Reference Guide, and Frequently Asked Questions for GP telehealth items in MMM 6 and 7. For a visual representation (similar to the image shown alongside) of the MMM classification status of specific locations, refer to Healthdirect Health Map |
 |
| MBS Item Number | Revenue | Revenue with Bulk Billing Incentive 10991 | Duration (minutes) |
| 2461 | $17.50 | $27.15 | Short & straightforward visit |
| 2463 | $38.20 | $47.85 | <20 |
| 2464 | $73.95 | $83.60 | >20 but <40 |
| 2465 | $108.85 | $118.50 | >40 |
| 2471 | $11.00 | $20.65 | <5 
|
| 2472 | $21.00 | $30.65 | >5 but >25 |
 2475 |
$38.00 | $47.65 |
  >25 but <45 |
| 2478 | $61.00 | $70.65 | >45 |
| 2480 | $14.00 | $23.65 | 5 |
| 2481 | $30.55 | $40.20 | >5 but <25 |
| 2482 | $59.15 | $68.80 | >25 but <45 |
| 2483 | $87.10 | $96.75 | >45 |
Source of compilation: Coviu
Source of all MBS information: Department of Health
With the ongoing MBS review and the changing nature of MBS items and their associated terms, for 100% guarantee of information accuracy, It is always best to contact MBS directly on their item interpretation phone line on 13 21 50 or access their official website here to ensure you receive the most up-to-date information.