Healthdirect Australia Help Center

    Medicare telehealth reimbursements

    8th January, 2020

    This page provides a summary of available Medicare telehealth reimbursements. Please check with MBS online to ensure accuracy.

    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. 

    Reference 



    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

    rrr

    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) 
    2729page1image11018496

    $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

    • GP alongside patient at consulting rooms while participating in telehealth consultation with a specialist 
    • Patient > 15 km by road from specialist
    • Not eligible: admitted hospital or hospital-in-the-home patients 

    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 

    • GP alongside patient in residential care service while participating in telehealth consultation with a specialist 
    • Not eligible: patients in self-contained units 

    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)
    or

    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
    7+ patients: $98.40 + ($3.35 x # pts)
    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 

    • GP alongside patient at home while participating in telehealth consultation with a specialist 
    • Patient located in a telehealth-eligible area 
    • Patient > 15 km by road from specialist 
    • Not eligible: patients admitted to hospital or hospital-in-the-home service 
    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)
     or

    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 

    Reference 


    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 toHealthdirect 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 page4image10590016

    2472 

    $21.00 

    $30.65 

    >5 but >25 

    page4image114271362475

    $38.00 

    $47.65 

    page4image10590592page4image10590976>25 but <45

    2478 

    $61.00 

    $70.65 

    >45 

    2480 

    $14.00 

    $23.65 

    2481 

    $30.55 

    $40.20 

    >5 but <25 

    2482 

    $59.15 

    $68.80 

    >25 but <45 

    2483 

    $87.10 

    $96.75 

    >45 

    Reference 



    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.

    Can’t find what you’re looking for?

    We are currently setting up a GP-specific support line.

    In the meantime please use these other support options.

    Email support

    or speak to the Video Call team on 02 8069 6079

    Internal Content