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COVID MBS items Explainer and FAQs, No. 39, 4 May 2020

Dear Doctors and Health Care Workers

A warm welcome to the new week and thank you to those of you who have submitted questions.

We have received so many intelligent and thought provoking non-COVID questions over the weekend, covering a vast array of important billing law issues from how to bill specific item numbers correctly, to the application of supervision rules, GST arrangements, the complexities around sharing referrals and locums, consumer law questions around price fixing, and more. I love this stuff!

We are so excited to see this engagement and are developing a snazzy new platform with a searchable format so we can continue offering this service for all medical billing questions post COVID. However, for now, this forum is for COVID billing questions only so we will hold your non-COVID questions and will answer them soon. Thank you for your patience as we work behind the scenes to make this happen.

Here is the answer to today’s only Covid telehealth question.

1.  Is a retirement village considered residential care for telehealth purposes?

Good question. The answer is no.

The legal definition of ‘residential aged care telehealth facility’ is surprisingly hard to find in the regulations, but there is enough interpretation available to state that a retirement village does not meet the requirements to enable the billing of usual telehealth services.

Firstly, the information on the Aged Care website states:

Retirement villages or independent living units

Retirement villages or independent living units are not aged care facilities. They offer a range of services for older people who need less care than offered by aged care homes. They are not regulated or subsidised by the Australian Government, but they are regulated by state and territory governments.

Secondly, MBS Online uses the below definition

What is an eligible residential aged care telehealth facility?
An eligible residential aged care telehealth facility is a facility where care and accommodation are provided to residents under the Aged Care Act 1997 and which meets the eligibility requirements described in the guidelines; and is registered with the Department of Human Services. A residential aged care telehealth facility will need to register with the Department of Human Services and provide reports on telehealth consultations provided in order to receive telehealth hosting service incentives.

Thirdly, the guidelines referred to are copied below and linked here

An Eligible Residential Aged Care Facility is a facility where care and accommodation are provided to residents under the Aged Care Act 1997 (including Residential Aged Care Services) and which meets the following eligibility requirements:

– possesses sufficient equipment and facilities to host a telehealth consultation;

– is registered with Human Services; and

– has been assessed by Human Services as meeting the above eligibility requirements.

The only variable may be that some retirement villages may have a qualifying residential aged care facility onsite, in which case you could bill usual telehealth for residents living in that specific part of the facility within the retirement living complex.

You can of course use COVID telehealth items for patients living in retirement villages, until they sunset on 30 September 2020.

Thanks everyone

Margaret and the Synapse team.

COVID MBS FAQs and Explainer No. 40, 6 May 2020…Read more

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