2013-14 Budget Measure – Removal of same day billing for CDM and standard consultation items


Running a practice Practice resources Medicare 2013-14 Budget Measure – Removal of same day billing for CDM and standard consultation items

Introduction

From 1 November 2014, patients will not be eligible to claim a Medicare benefit for a standard consultation if they are also claiming a Chronic Disease Management (CDM) service on the same day.

If claiming…

…your patient cannot claim on the same day

Item 721 (preparation of a General Practitioner Management Plan (GPMP))

Item 3, 4, 23, 24, 36, 37, 44, 47, 52, 53, 54, 57, 58, 59, 60, 65, 597, 599, 598, 600, 5000, 5003, 5020, 5023, 5040, 5043, 5060, 5063, 5200, 5203, 5207, 5208, 5220, 5223, 5227 and 5228 (level A-D attendances)

Item 732 (review of a GPMP or TCA)

Item 723 (preparation of TCA)

 

Download 1 November 2014 MBS files here


Background

This change was announced in the 2013-14 Budget as a cost-saving measure to prevent ‘double billing’ by GPs.

The RACGP lobbied the Department of Health to prevent this measure from coming into effect. RACGP representatives had a series of meetings with departmental officers and provided two submissions (December 2013 and July 2014) on the issue. This advocacy work was informed by members and significant input from the National Standing Committee – General Practice Advocacy and Support.

While the department acknowledged that there may be clinically relevant and legitimate reasons for same day billing of the MBS item numbers, the measure is being implemented to prevent inappropriate billing of these items by a small number of providers.

Impact

As per member advice received, the RACGP believes that this change will adversely affect patients, particularly high-need patients who require care unrelated to their chronic condition.

This change forces patients to return to the practice on another day or incur a full consultation fee, inconveniencing the patient and their carers while negatively impacting your capacity to provide comprehensive care. It will also reduce practice efficiency and patient flow.

Informing your patients

To support you to inform your patients about this measure, the RACGP has developed a flyer describing the change. A visual guide on the change is also available for patients with lower levels of literacy or non-English speaking backgrounds.

Patients should be advised to direct their complaints about the change to their local member of parliament. Local members of parliament can be found on the Australian Parliament’s website.