Providing health care remotely during COVID-19
From 13 March to 31 March 2021, new temporary MBS telehealth items have been made available to help reduce the risk of community transmission of coronavirus (COVID-19) and provide protection for patients and health care providers.
The Australian Government has added a number of temporary Medicare items to help health care practitioners deliver telehealth services via phone or video conferencing.
Telehealth services will help protect health care professionals, their staff and patients from unnecessary risk of infection.
These measures will be in place until 31 March 2021. The Government will consider extending beyond 31 March 2021 if the Australian Health Protection Principal Committee (AHPPC) recommends it.
Who can provide telehealth services
A range of health care providers can now provide telehealth services to patients. These include:
- general practitioners (GPs)
- allied health providers
- mental health professionals
- nurse practitioners
MBS Online has a series of COVID-19 Temporary MBS Telehealth Services fact sheets. This includes lists of the types of health care professionals who can provide telehealth services and the relevant MBS item numbers.
Telehealth bulk billing for GPs
Between 6 April and 19 April 2020 (inclusive) the requirement to bulk bill applied to:
- Commonwealth concession card holders
- children under 16 years old
- patients who are more vulnerable to COVID-19
However, from 20 April 2020, this is no longer a requirement for specialists and consultant physicians, nurse practitioners, midwives and allied health professionals.
This means the bulk billing requirement now only applies to GP and other medical practitioners (OMP – practitioners not vocationally recognised as GPs, providing non-referred services).
Bulk billing for other providers of COVID-19 services is at their discretion, provided they obtain informed financial consent prior to the service. However, GPs and OMPs claiming antenatal and postnatal services in Group T4 of the MBS are not subject to the bulk billing requirements.
A person who is more vulnerable to COVID-19 is someone who:
- is required to isolate or quarantine according to Australian Health Protection Principal Committee guidance
- is at least 70 years old
- identifies as being of Aboriginal or Torres Strait Islander descent and is at least 50 years old
- is pregnant
- is the parent of a child aged under 12 months
- is being treated for a chronic health condition
- is of any age and has suppressed immunity
- meets the national triage protocol criteria for suspected COVID-19 infection
Health care providers may apply their usual billing practices to the telehealth items for patients who do not fit the above criteria.
How to provide health services remotely
Videoconferencing is the preferred way to do a telehealth consultation. However, you can offer telephone services if video is not available.
You do not need specific equipment to provide Medicare-compliant telehealth services. Make sure your chosen telecommunications solution meets your clinical requirements and satisfies privacy laws. See the Australian Cyber Security Centre for advice on how to select a web conferencing solution.
How to provide prescriptions and prescription medication via telehealth
We are working with clinical software providers to upgrade prescribing and dispensing software so it supports electronic prescribing. Electronic prescribing is being rolled out nationally in the coming months. In addition, patients are able to receive medicines via telehealth services and image based prescribing.
For now, at a telehealth consultation, a prescriber can prescribe medication by writing a paper prescription and providing it to the patient (for example, by post). If this is not practical, a prescriber can instead turn the prescription into an ‘image-based prescription’. This is a digital image of the paper prescription, which can then be sent by the prescriber to the patient’s preferred pharmacy. Where electronic prescribing is available, it should be used instead of image-based prescriptions.
The Commonwealth has changed legislation to temporarily allow prescribers to create a digital image of the patient’s prescription to support supply of their medicines. This interim arrangement supports telehealth before electronic prescribing becomes available.
Pharmacists can dispense medications and make Pharmaceutical Benefits Scheme (PBS) claims from the digital image of the prescription sent through by the prescriber.
Under the temporary arrangement, patients do not need to sign to acknowledge receipt of supply if it is not practical for them to do so. The pharmacist may sign on behalf of the patient, unless it is not practical for them to do so.
If the prescriber has authorised repeats, the pharmacist may create a repeat authorisation and attach it to a print out of the digital image of the prescription. The pharmacy must retain the prescription repeats for subsequent supply of the medication.
For image-based prescriptions, prescribers must keep the paper prescription for 2 years (for audit and compliance purposes). Pharmacists must keep the digital image of the prescription for 2 years.
Medicines in Schedule 8 and Schedule 4 Appendix D in the Poisons Standard are not part of this interim arrangement, unless specifically permitted by relevant state or territory rules. Supply these medicines according to your state and territory legislation.
While the vast majority of health care providers do the right thing, please report any fraudulent and inappropriate practice against Medicare and the PBS.
Home delivery for medicines
The Home Medicines Service is a temporary program paying a fee per delivery to Australian pharmacies for home delivery to vulnerable people of:
- Pharmaceutical Benefits Scheme medications
- Repatriation Pharmaceutical Benefits Scheme medicines
Pharmacists can find out more about patient eligibility criteria and how to take part at the Pharmacy Programs Administrator site.
For patients who do not meet the program’s criteria for a vulnerable person, pharmacies may charge a home delivery fee.
Pharmacies should advise patients at the time of receipt of the prescription from the dispenser or the patient if they are not able to provide a home delivery service.
Information for patients
If patients are seeking further information on how to access telehealth and prescriptions from home, please see the following guides:
- Accessing health services during COVID-19 restrictions
- Getting medicines during COVID-19 restrictions
- Prescriptions via telehealth – a guide for patients
- Consumer fact sheet on telehealth services at MBS Online
- Home Medicines Service – information for consumers (for vulnerable people)
More resources for the general public are available at our coronavirus (COVID-19) resources collection.
To stay up to date on COVID-19:
You can also join our WhatsApp channel or use our Coronavirus Australia app.
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A 30-minute online module — COVID-19 infection control training — is available for care workers across all health care settings.
This training is hosted on an external site, provided by our COVID-19 training partner Aspen Medical.
Publications and fact sheets
A collection of resources for health professionals, including aged care providers, pathology providers and health care managers, about coronavirus (COVID-19).
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