Q&A on Medicare changes with Optometry Australia CEO

Optometry Australia CEO Genevieve Quilty
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Q: Will the Medicare billing changes go ahead and when?

Genevieve: Yes, the changes to legislation required have been made, effective from 1 January 2015.

 

Q: What impact will the changes have on optometry services?

Genevieve: The key changes are:

• The cap on fees optometrists can charge under Medicare will be removed so you can now determine what fee to charge your patients for clinical services. Remember, if you choose to bulk bill you cannot charge a separate private fee.
• Medicare rebates for optometry services will be reduced. The full scheduled fee for each item will be reduced around five per cent. Patients will be able to access a rebate of 85 per cent of the new scheduled fee, which will be equivalent to 80 per cent of the pre 1 January 2015 scheduled fee.
• Item 10900 will be replaced by two new items:

10910 that supports patients aged younger than 65 years to access a rebate for an initial comprehensive exam every 36 months. 

10911 that supports patients aged 65 years or older to access a rebate for an initial comprehensive examination annually.

 

Q: What is Optometry Australia doing to support its members through these changes?

Genevieve:  We have made our concerns about the rebate reduction very clear to the Health Minister and government decision-makers. Ultimately, it is patients, communities and population health that lose. 

We’ve also been focused on advocating for a reversal of the decision to reduce access to an initial comprehensive assessment for those under 65 years, particularly those in the 40-65 years age group where there is strong evidence of increasing risk of eye disease and vision loss.

We have developed numerous practical resources to help members understand these changes and be prepared. Log-in to the Members area of the website where the resources are in one central location, accessible through the front page of the website.

They include:

• A check-list of what you need to do to be prepared
• More detailed explanations of the changes
• Practical resources to help you in thinking through your billing practices, setting fees and instituting changes to your billing approach
• A customisable explanation of the changes you can give to your patients

If you haven’t yet listened to it, this 10-minute podcast explains how Medicare changes will affect optometry. The podcast was produced by Optometry NSW/ACT.