Optometrist Simon Hanna conducts a podcast on the new MBS items
By Helen Carter
Details including pricing of four new MBS optometry items enabling optometrist reimbursement for telehealth services and one for the removal of embedded corneal foreign body (CFB) have been released.
The items will be introduced in the Optometrical Schedule of Services on 1 September.
Item 10944, the first procedural item for the profession, carries a full scheduled fee of $72.15 and enables optometrists to claim an 85 per cent MBS fee of $61.35 for the complete removal of an embedded foreign body from the cornea, not more than once on the same day by the same practitioner, excluding after-care.
The item is not to be billed on the same occasion as MBS items 10905, 10907, 10910, 10911, 10912, 10913, 10914, 10915, 10916 or 10918. Where the embedded CFB has not been completely removed, benefits are payable only under item 10916.
A telehealth consultation is a consultation in which the optometrist and patient are present together while an ophthalmologist participates via online video technology.
• Telehealth item 10945 for optometrist attendance of less than 15 minutes attracts a full scheduled fee of $33.45 and enables optometrists to claim an 85 per cent rebate of $28.45.
• Telehealth item 10946 for attendance of 15 minutes or more attracts a full MBS fee of $66.80 and an 85 per cent rebate of $56.80.
These telehealth items cover optometrist attendance, whether or not continuous, to provide clinical support to a patient who is participating in a video conferencing consultation with a specialist practising in ophthalmology.
Patients must be located in a telehealth eligible area, generally outside a metropolitan city or anywhere in Tasmania or the Northern Territory, and at the time of the consultation, be at least 15 kilometres by road from the ophthalmologist’s consulting rooms. Details of the telehealth eligible areas are available on the MBS website.
Patients of an Aboriginal Medical Service or an Aboriginal Community Controlled Health Service are also eligible, regardless of remote classification.
Two other items for domiciliary telehealth enable residential aged-care patients to access telehealth items regardless of remote classification.
• Telehealth item 10947 for optometrist attendance of less than 15 minutes attracts a full scheduled fee of $33.45 and enables optometrists to claim an 85 per cent rebate of $28.45.
• Telehealth item 10948 for attendance of 15 minutes or more, whether or not continuous, attracts a full MBS fee of $66.80 and an 85 per cent rebate of $56.80.
The attendance is to provide clinical support to a care recipient in a residential aged-care facility who is participating in a video-conferencing consultation with an ophthalmologist.
The consultation can take place in consulting rooms within the facility or elsewhere in the facility but the patient must not be a resident of a self-contained unit.
Consistent with existing MBS telehealth items, the new telehealth items will place no limitation on a patient attending an optometric consultation on the same day as an optometric telehealth consultation.
There will also be no limitation on the number of times in one day a patient may attend a patient-end support telehealth consultation, as long as each consultation is for an unrelated condition.
‘This is great news for the profession and for patients, and will ensure appropriate access and provision of care,’ Optometry Australia’s national clinical policy advisor Simon Hanna said.
‘Essentially, optometrists can provide an eye examination and then if the patient needs emergency ophthalmological care and is eligible for the rebate as per location rules, they can dial into a video conference on the same day, possibly even at the same consultation, and get the specialist care required.’
Telehealth services do not cover hospital inpatients.
A Practice Note written by Optometry Australia to guide practitioners on telehealth items advises that optometrists will generally be in a telehealth-eligible area if they provide services outside a metropolitan capital city or anywhere in Tasmania or the Northern Territory.
‘It is expected telehealth will help a range of optometry patients by providing a means of accessing ophthalmology services,’ the note states.
These include patients with an urgent ocular symptom and who might benefit from prompt clinical input from an ophthalmologist, or patients with chronic conditions for whom travel is impractical.
The note provides advice on communications technology required, including a reliable video-conferencing system, broadband access, an ISDN phone connection or if visiting services, a laptop. It states that Skype can be an alternative but privacy issues mean images containing personal information should not be sent using Skype.
Costs and how to conduct a telehealth consultation are covered.
The note recommends keeping a record of the consultation and recording notes on the patient’s clinical record, documenting diagnoses, test results, clinical advice given or other health information.
It suggests conducting tests beforehand and providing them to the specialist, and delivering a live summary at the conclusion of the consultation.
The telehealth Practice Note and a Clinical Note on the CFB item are available on the Optometry Australia website.
Optometry NSW/ACT has developed a podcast about the five new Medicare items. It features Optometry Australia’s national clinical policy advisor Simon Hanna educating members on the purpose, appropriate use, restrictions and eligibility surrounding the items. Optometry NSW/ACT sent an e-Note in August, alerting members to the podcast which is available to all Optometry Australia members via a link on Optometry Australia’s Facebook page.