From 1 November 2023, higher bulk billing incentives for Commonwealth concession card holders and patients under 16 years of age will be introduced and may be co claimed with the following consultation items:
- MBS Levels B, C, D, and E face-to-face general attendance consultations (and out of rooms, residential aged care facilities and after-hours equivalents),
- MBS Level B telehealth (video and telephone) general attendance consultations,
- MBS Levels C, and D telehealth (video and telephone) general attendance consultations, where a patient is registered with a general practice through MyMedicare and receives the service through the practice where they are registered,
- Level E telehealth (video only) general attendance consultations, where a patient is registered with their general practice through MyMedicare and receives the service through the practice where they are registered.
Please see the MBS Online Fact Sheet for Bulk Billing in General Practice for further information.
What Do I Need To Know?
The new MBS Item numbers that are being released on 1 November to support the triple incentive items will be made available as part of our planned November Data Update. This update will also include the logic changes that are required to automatically apply the incentives based on the applicable billing workflow, with an exception to the Video and Phone Telehealth consultations.
We are currently unable to automatically add the relevant incentives to the 91801, 91802 and 91920 Video Telehealth, and the 91900 and 91910 Phone Telehealth items as this incentive is reliant on the patient being registered at their practice through MyMedicare. At this stage, a patient’s MyMedicare registration is not stored in Bp and therefore unable to be verified as part of this billing workflow.
For MyMedicare patients eligible for these new incentives:
For Video Telehealth Consultations:
- The standard 10990 (or regional variant) incentive will automatically be added to the account when created with any of these item numbers which will be unable to be removed,
- The 75880 incentive item will then need to be manually added to the account,
- Account to be submitted to Medicare with both incentive items included and then managed using the standard Medicare exception process.
For Phone Telehealth Consultations:
- The new incentives will not automatically be added to the account, and will need to be manually added by practice staff. (Please note: in this scenario, the 10990 (or regional variant) incentive will not be applied, and will therefore not need to be managed using the standard Medicare exception process.)
The addition of a patient’s MyMedicare registration status is planned to be made available in the next release of our Bp Premier product scheduled for the coming months. The introduction of patients’ MyMedicare status in Bp Premier will remove the need to manually manage these incentives.
Further information regarding these changes can be accessed via the Bp Premier Knowledge Base and via the MBS Online website.
Authored by:
Jessica White
Head of Commercial and Government at Best Practice Software
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