We know you have some questions around the new telehealth consultations and so have put these together to assist you. You will find the most up to date information here.
Telehealth services provides a way of connecting patients with their health service provider while limiting both parties’ potential exposure to COVID19. HICAPS has worked with Private Health Insurers so that practitioners can provide telehealth services and receive payments for those services over the phone by enabling a functionality to key in a members card number. This allows for remote claiming of services.
Benefits toward telehealth services have broadly been communicated for Psychologists and Physiotherapists, however some health funds may have extended these to other modalities. There is specific criteria dependant on the type of allied health service being provided, that must be met in order for benefits to be provided. Please ensure you check eligibility requirements with your relevant professional Association.
The new telehealth services item numbers for Psychologists, Physiotherapists, Podiatrists, Occupational Therapists, Exercise Physiologists, Speech Pathologists and Dietitians have been approved for use via HICAPS terminals. Please be aware that not all the Health Funds will be supporting these services. Health Funds that have enabled these temporary items numbers can be found here.
Due to the rapid rate at which the COVID-19 pandemic is evolving, it is possible that this information could change in response to these changing circumstances. This could include health service provider eligibility, as well as availability of specific telehealth items numbers and services. Please check with your professional Association or visit www.hicaps.com.au/coronavirus as this will be updated as information becomes available.
The full list of current participating health funds for Telehealth services can be found here. We will continue to update the website as more Health Funds join to approve the processing of these claims.
Before you process your first telehealth claim, you will need to ensure your terminal has been enabled with the new functionality (key entry). Then you need to take your patients card details over the phone and ensure you don’t accept any instructions via email or write down or store any of the patients’ card details. Once you have payment details follow the step by step key entry Instructions here. If a Health Fund does not participate in processing telehealth consultations via HICAPS, patients will have to pay for the consultation and then claim the benefit directly through their health fund.
For these telehealth services, the patient will have the ability to supply their health Fund member card details over the phone to the eligible practitioner. The practitioner (Psychologist or Physiotherapist) will then use these details to process a key enter claim transaction for the patient.
Unfortunately HICAPS Go is not enabled to process remote/telehealth consultations. These can only be processed through HICAPS Terminals.
Australian residents or citizens are eligible for telehealth consultations and depending on which health fund they have cover with, they may be covered by their Private Health Insurance.
For Non-residents who have overseas visitors cover, depending on which Health Fund they have cover with, they may be covered by their Private Health Insurance for Telehealth. Patients would need to confirm eligibility with their Health Fund.
HICAPS can deliver the functionality to you by doing an update to your terminal. You will need to download this update for it to take effect. You can perform the following steps on your terminal for the update to be downloaded:
Press the [FUNCTION ]button on the home screen
Select option . Terminal SW Load
Select [YES] to begin the software load
Your terminal will now be updated to have key entry functionality enabled.
For more information regarding these telehealth services you should contact your applicable professional allied health Association.
HICAPS terminals are now enabled with a temporary increased contactless card (payment) limit from $100 to $200 to help reduce exposure to COVID-19.
Patients with enabled cards can tap their card for payment, up to $200 to pay for treatment or services at participating HICAPS health service providers.
If you are unsure if your terminal has received the software that increases the new contactless limit, you can download the update by following the below steps on your terminal:
1. Press the [FUNCTION] button on the home screen
2. Select option . Terminal SW Load
3. Select [YES] to begin the software load
Your terminal will then be updated to allow contactless payments up to $200 and the new items for Allied Health.
Telehealth services provides a way of connecting patients with their health service provider while limiting both parties’ potential exposure to COVID19. Telehealth consultations will be temporarily covered by Medicare Benefits Schedule (MBS) items to allow for bulk billed phone or video consultations by certain practitioners to reduce the exposure to COVID-19.
Videoconference services are the preferred approach for substituting a face-to-face consultation. However, in response to the COVID-19 pandemic, providers will also be able to offer audio-only services via telephone if video is not available. There are separate items numbers available for the audio-only services. All new MBS telehealth items must be bulk billed and providers cannot charge an additional fee for these items.
GPs, specialists, consultant physicians, obstetricians, consultant psychiatrists, nurse practitioners, allied mental health workers and midwives as well as pathology testing are all eligible to provide Telehealth consultations under the MBS. Other Allied health providers including speech pathologists, occupational therapists, optometry and physiotherapists have been added for certain types of consultations only.
MBS items numbers and descriptions can be found on the MBS Online website www.mbsonline.gov.au. Medicare Telehealth consultations came into effect from the 13th March 2020 and will be valid for use for until the 30th September
All new MBS telehealth items must be bulk billed and providers cannot charge an additional fee for these items.
You need to take your patients Medicare card details over the phone and ensure you don’t accept any instructions via email or write down or store any of the patients’ card details. Once you have the patient card details follow the step by step key entry Instructions on how to process a Medicare Easyclaim claim transaction.
The Department of Health have advised that because of the exceptional and temporary circumstances of COVID-19, for these items only, the practitioner’s documentation in the clinical notes of the patient’s agreement to assign their benefit as full payment for the service would be sufficient.
This means that the assignment of benefit can be obtained through one of the following options;
• in writing
• by email
• verbally through the technology with which the attendance is conducted. This agreement can be provided by a patient, or another person, such as the person’s carer or family member. The practitioner should keep their own record that the patient agreed or acknowledged that the service was provided, and that the Medicare benefit could be paid directly to the practitioner.
You can add the new item numbers to your terminal to allow ease of processing for future transactions. To do this refer to the Medicare easy claim user guide, section 8.1 pg. 103 here.
Due to the rapid rate at which the COVID-19 pandemic is evolving, it is possible that this information could change in response to these changing circumstances. This could include provider eligibility, as well as availability of specific items and services. Please continue to check MBS Online (www.mbsonline.gov.au) regularly for further updates. You can also subscribe to future MBS updates by visiting MBS Online and clicking ‘Subscribe’.
Unfortunately HICAPS Go is not enabled to process Medicare remote/telehealth consultations. These can only be processed through a HICAPS Terminal.
These telehealth service items have been implemented in response to COVID19 and are temporarily in place till 30th September 2020.
All Medicare eligible Australians are eligible to receive telehealth services.
For Non-residents who have overseas visitors cover, depending on which Health Fund they have cover with, they may be covered by their Private Health Insurance for telehealth. Patients would need to confirm eligibility with their Health Fund.