Through AMA advocacy, the federal government has extended telehealth access to patients with a Covid positive test in the past 7 days, exempt from the 12-month rule.
When states and territories dropped public health orders last week requiring covid positive patients to self-isolate, many patients with COVID would have been unable to access MBS-funded telehealth services from a GP unless they had attended a face-to-face visit in the last 12 months. The AMA raised this directly with the department and pushed strongly for a reinstatement.
While the AMA fully supports the provision of telehealth through a patient’s usual GP or practice, it is important that rules do not prevent patients from accessing care when they have COVID and need to stay at home.
The Government has agreed to a new exemption from the existing clinical relationship requirement (often referred to as the 1 in 12 rule). Effective from Thursday 13 October 2022 until 31 December 2022, an exemption has been implemented for COVID-19 positive patients from the established relationship requirement for telehealth services provided by General Practitioners (GPs) and Other Medical Practitioners (OMPs). This will enable COVID-19 positive patients to access Medicare rebates for telehealth services with any GP.
A COVID-19 positive patient is defined under these new arrangements as a person who has received a positive COVID-19 test result within the last 7 days, confirmed by either a laboratory test (PCR) or a COVID-19 rapid antigen self-test (RAT) which has been approved for supply in Australia by the Therapeutic Goods Administration.
For clarity, the level C telehealth item for assessment and consideration of COVID-19 antivirals is excluded from the 1 in 12 rule. That is, there is no requirement for a pre-existing relationship and this item is unaffected by any change in state and territory Public Health Orders.
In relation to broader telehealth, it is important to note that the established relationship requirement still does not apply to:
children under the age of 12 months;
people who are homeless;
patients receiving an urgent after-hours (unsociable hours) service; or
patients of medical practitioners at an Aboriginal Medical Service or an Aboriginal Community Controlled Health Service; or
people isolating because of a COVID-related State or Territory public health order, or in COVID-19 quarantine because of a State or Territory public health order; or
people living in a flood-affected area, defined as a State or Territory local government area which is currently declared as a natural disaster area due to flood by a State or Territory Government.
An MBS online factsheet on these changes can be found here.
