Medicare

Medicare

Earn an additional 15 per cent or more on consultations by not bulk-billing

Charging a full fee instead of bulk-billing is not for everyone but it should be considered. The non bulk-billing option has become more attractive with the removal of the fee cap for Medicare services and the advent of electronic billing systems that allow the patient to pay the bill electronically and have the rebate transferred into their bank account almost immediately. 

Bill for additional Medicare listed services

The items for computerised perimetry (item 10940, item 10941) are paid in addition to the consultation fee and not instead of the consultation fee. Some practitioners think that only one or the other may be billed. You may not charge items 10940 and 10941 with a subsequent consultation item.

Similarly the Low Vision Assessment and Children’s Vision Assessment and Domiciliary Visit fees are paid in addition to a consultation item and not instead of a consultation item. Make sure you understand these items and charge them accordingly.

Charge appropriate fees for non-Medicare contact lens consultations

Only a small number of contact lens patients (~30%) are eligible for a medicare rebate for their contact lens consultations. The fees that optometrists may charge for consultations with contact lens patients who do not fall within the guidelines of items between 10921 and 10930 are a matter between the patient and the optometrist. You do not have to charge fees at the Medicare level and can charge what you think is appropriate. Optometrists are encourage to charge appropriately for their services and advise patients of they criteria they (the patient) must meet so as to be eligible for a rebate.  

Bill for items specifically excluded from Medicare Benefits

The Government has announced that Medicare rebates will not be paid for digital imaging, pachymetry, ocular coherance tomography, lacrimal lavage and other private procedures and that additional private fees may be charged. There are no controls over how much may be charged.

Our Fee Calculator tool and additional information on private billing can be found in Billing Practices and consultation fees

 

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