Medicopolitical

Medicare phone items for specialists still on the chopping block, COSA warns      


Professor Fran Boyle

Patients may face reduced access to telehealth because neither major party will commit to continuing all the MBS items for phone consults, COSA says.

There is significant uncertainty over the funding for both initial and subsequent consultations by phone, with officials originally planning to delete them from the MBS in January.

Following a campaign by specialist groups, the items were granted a temporary reprieve – officially remaining on the schedule until 30 June this year (see below for a full list).

However, what would happen beyond then was a mystery, said COSA president Professor Fran Boyle.

She stressed the Federal Government had already pledged to make the current video consultation items permanent, along with a single item for minor phone attendances.

But all other phone attendance items were facing the axe, despite uptake being more than double that of their video equivalents, Professor Boyle said.

Official MBS statistics for initial attendances (equivalent to item 110) showed 685,000 had been provided over the phone since the item became available, compared to 189,000 over video.

Some 5.3 million had been face-to-face over the same period.

“We’ll be wasting an advancement which was one of the few silver linings of COVID-19,” Professor Boyle said.

“There are circumstances when video is perfect – and we’ll go on training people in how to use it – but there are many where it isn’t.”

While there was an argument that video consultations provided a richer clinical interaction compared to phone calls, there were many reasons why the former could be impractical, Professor Boyle added.

“Not everyone is comfortable with the technology,” she said.

“My parents in their 80s can’t make the family Zoom work particularly well, not to mention all those people without good internet connections.”

“All we’re really asking for is flexibility”.

With only three weeks left until Australians headed to the polls, she said it was time for both Labor and The Coalition to commit to the future of the items.

However, she stressed that COSA was resigned to the end of the pre-pandemic items for rural telehealth, which had rebates 50% above those for face-to-face consults.

Other items on COSA’s pre-election wish list included funding for coordinated care and navigation for all cancer patients, similar to that offered for those with breast cancer, and additional funding for patient travel and accommodation.

MBS telehealth changes for consultant physician attendances (items scheduled for removal shaded in green)

Service Face-to-face item Video item Telephone item
Initial attendance 110 91824 91834
Subsequent attendance 116 91825 91835
Minor attendance 119 91826 91836
Complex initial assessment (at least 45 minutes) 132 92422  92431
Complex subsequent assessment (at least 20 minutes) 133 92423 92432

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