GPs can claim longer MBS consults for PCEHR

General practitioners will be able to claim for longer consultations under the Medical Benefits Scheme if they spend time creating or adding to shared health summaries in patients' PCEHRs.

Federal health minister Tanya Plibersek announced today that MBS consultation items will be available to GPs as part of providing continuity of care to a patient and “if they are creating or adding to a shared health summary on an eHealth record which involves taking a patient’s medical history as part of a consultation”.

“The Level B, $35.60 benefit will be available for consultations that involve taking a medical history for less than 20 minutes,” Ms Plibersek said.

“The Level C, $69 benefit will be available for consultations that involve taking a detailed medical history for more than 20 minutes.

“And the Level D, $101.55 benefit will be available for consultations that involve taking a more extensive medical history for more than 40 minutes.”

The Australian Medical Association queried the announcement, saying it was not clear whether Medicare rebates will be available for a new clinical service.

“The government has acknowledged that preparing shared health summaries with patients will require considerable extra work for GPs, but there is no clarity that the longer consultation items will apply to cover this extra work,” AMA president Steve Hambleton said.

“For example, if preparing a shared health summary as part of a standard 20 minute (Level B) consultation stretches it out to 30 minutes, will the longer Level C item apply? Similarly, if the more complex Level C consultation stretches out to more than 40 minutes, will the Level D item apply?”

Mike Civil, the eHealth spokesman for the Royal Australian College of General Practitioners, said his understanding was that if a normal B consultation took extra time, then GPs could claim for a C consultation.

“Any time that you spend purely doing management of the PCEHR, whether you are uploading a patient summary or working with the patient on the PCEHR, then that time component can be recognised for compensation,” Dr Civil said.

“If you have say a patient with a back problem, you would have a normal B consultation dealing with the back problem, but then I notice that the patient has indicated they would like to get their PCEHR updated, then I can go through their medical history with them and there is extra time, then that extra 10 minutes or 12 minutes will take me into the next level of C consultation.

“It will mean that unrecognised work is now recognised.”

Dr Civil said there was not going to be any new item numbers and he hadn't expected there to be.

“It is purely a recognition that it will take more time for a GP to be involved in this and they should be recognised. It is a good step.”

Concerns have been raised that Medicare might start asking more questions of GPs who make more C and D consultation claims, but Ms Plibersek said she could confirm that the use of the longer consultation items “will be seen as appropriate by the Medicare Australia Practitioner Review Process and the Professional Services Review in circumstances where there is clear evidence of patient complexity and there is documentation of a substantial patient history.”

Dr Civil said that GPs might be asked by Medicare why they are putting through more Cs and Ds “but I got the impression that they are not going to worry because it will take a reasonable amount of time to update their record”.

“Of course, it still doesn't take away from the fact that you have to find that extra time, but now we will at least get remunerated for it,” he said.

RACGP president Claire Jackson welcomed the government’s announcement, saying she thanked Ms Plibersek for “listening to the profession on this critical issue”.

“While some of the details still need to be further discussed, I am delighted that MBS consultation items will be available to GPs if they are adding a shared health summary to the patient's PCEHR, which involves taking a patient’s medical history as part of a consultation,” Professor Jackson said.

“Together with United General Practice Australia, the college has pushed hard to ensure individual general practices and GPs are properly funded and supported by the government to assist in the smooth implementation of the PCEHR.”

The Australian General Practice Network (AGPN) also welcomed the announcement, saying the financial support was an important step in the right direction for the uptake of the PCEHR.

AGPN chair Emil Djakic said the announcement was recognition of the work that is involved in creating the PCEHR.

"The three MBS items provided that cover the extra time it can take to record a patient's medical history of up to 20min, more than 20min or for more than 40min, provides a realistic incentive framework in which GPs can operate," Dr Djakic said.

"At a macro level though, AGPN is still urging the federal government to realise the need for two other elements that will be critical in changing business processes required to have general practices successfully adopt the PCEHR.”

He repeated the AGPN's call for an eHealth practice incentive payment (PIP) to support the establishment of the necessary PCEHR infrastructure and the adequate resourcing of Medicare Locals to support general practices to build up the foundations and infrastructure needed to get the PCEHR up and running.

Posted in Australian eHealth

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