Dear Doctors and Health Care Workers
Here are the answers to today’s questions.
1. Can a specialist bill a gap for a consultation fee to a patient over the age of 70 years using codes 91822/91823?
Yes. Mandatory bulk billing was lifted for specialists from 20 April 2020. You can read more about it in Bulletin 31.
2. I’m a geriatrician in Sydney providing services as a VMO in a fee-for-service bulk billed clinic in a regional public hospital. During COVID I have been assisting with an established telehealth service run by the same LHD. I saw a patient who was meant to be an outpatient but ended up in hospital the night before and they wanted the consult to go ahead. I did a general geriatric assessment but now I don’t know how to bill it.
Both usual telehealth and COVID telehealth services are restricted to outpatients only, so it would appear you cannot bill this service within the Medicare scheme at all, because the patient was admitted. Your only option may be to bill a private fee to the patient without a Medicare item number, but IFC should have been provided before going down that path. Not many viable options here unfortunately.
Thanks everyone
Margaret and the Synapse team.