Medicopolitical

Dermatologists less likely to bulk-bill than other specialists: Govt cost site


Dermatologists are less likely than almost any other specialists to bulk-bill an initial appointment while also charging some of the highest fees, patients are being told.

The figures come from the federal government’s Medical Costs Finder website, which is currently recruiting specialists ahead of a $17 million relaunch later this year.

After the redesign, it will list specific fee details and gap fee arrangements from individual practitioners across about 100 medical services, the Department of Health and Aged Care says.

While individual specialist fees remain unavailable for the time being, a beta version has been launched already and the site now shows aggregate fees across MBS items broken down by specialty and location.

Based on historic data, it shows that for initial consultations claimed under MBS item 104, dermatologists bulk-billed some 9% of patients, leaving the rest with an out-of-pocket cost of $150 on average.

The top 10% highest charging dermatologists had fees of $270 on average, or roughly $195 after rebates.

According to the website, the only specialists charging more than this on average under the item were sports and exercise physicians, whose patients typically paid $165 out-of-pocket.

It also showed significant regional variation when it came to specialist fee setting.

Initial attendances (MBS item 104)

NSW VIC QLD SA WA TAS NT ACT
% Bulk-billed 27% 24% 28% 31% 32% 27% 33% 18%
Typical doctors’ fees $205 $190 $190 $165 $180 $175 $200 $225
Patients typically pay $130 $115 $115 $90 $105 $100 $125 $150

The same was true of subsequent consultations billed under MBS item 105, which had bulk-billing rates of 42% in the NT, compared to only 27% in the ACT.

But the highest fees were levied by specialists in the ACT at $130 on average, according to the website.

Subsequent attendances (MBS item 105)

NSW VIC QLD SA WA TAS NT ACT
% Bulk-billed 35% 34% 36% 37% 30% 31% 42% 29%
Typical doctors’ fees $120 $100 $100 $95 $100 $100 $110 $130
Patients typically pay $82 $62 $62 $57 $62 $62 $72 $92

The department has not said how many doctors have signed up so far, but if the testing goes as planned their fees will be made public by the end of July.

It has also stressed participation will remain strictly voluntary and individual doctor’s information will not be used for compliance purposes.

“The department will not be checking the data against Medicare claims data,” it said in an FAQ earlier this year.

“The portal will run a data assurance check against typical data to ensure that any errors (significant variance from other data) are identified by the system.”

“Where a discrepancy is detected, the user will be notified so they can check their entry for potential errors.”

Specialty % of bulk-billed initial consults (MBS item 104) Average out-of-pocket cost initial consults (MBS item 104) % of bulk-billed subsequent consults (MBS item 116) Average out-of-pocket cost subsequent consults (MBS item 116)
Oral and Maxillofacial Surgery 25% $75 86% $52
Ophthalmology 16% $95 23% $62
Gastroenterology and Hepatology 39% $103
General Surgery 29% $105 45% $62
Plastic and Reconstructive Surgery 16% $105  

63%

$52
Vascular Surgery 23% $105 35% $57
Obstetrics and Gynaecology 26% $125 38% $67
Orthopaedic Surgery 15% $125 34% $62
Urological surgery 11% $125 21% $67
Paediatric Surgery 31% $125 50% $62
Cardio-Thoracic Surgery 37% $125 35% $72
Surgery- Otolaryngologist (ENT) 14% $135 36% $72
Dermatology 9% $150 22% $102
Sport and Exercise Medicine 10% $165 13% $102

 

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