Telehealth is simply the modality used to connect and provide care – linking clinicians (or any other person(s) responsible for providing care) to patients and carers.
Telehealth can be used for the purposes of assessment, intervention, consultation, education and/or supervision.
Anyone working in NSW Health can set up telehealth. This information will help you get started.
Resources for clinicians
- Attending a consultation with your patient using telehealth: Clinician guide
- Telehealth: Getting started guide
- Telehealth: Quick start guide summary
- Telehealth readiness checklist
- Virtual care in practice guide
- Telehealth in Mental Health
Spotlight on virtual care
- In-home monitoring program for people with chronic conditions
- Geriatric Medicine Outreach Service
- Virtual Allied Health Service
- Virtual care initiative - COVID 19 remote monitoring
- Royal North Shore Hospital ICU Patient and Family Videoconferencing Model
- Virtual rural generalist service
Key points about telehealth
- Where clinically appropriate, telehealth is a safe, effective and a valuable modality to support patient and family-centred care.
- All models of care should consider how telehealth can be used to enhance access without compromising the quality and standards of care provided.
- Clinicians need to be creative, responsive and flexible to integrate telehealth into their clinical practice, determining the most appropriate modality to support the clinical needs of the patient.
- Telehealth provides the opportunity for clinical teams to truly integrate health and social care sectors to enhance the patient journey and outcomes.
- Telehealth can provide an equitable service delivery mechanism for people in NSW to access quality healthcare. This includes (but is not limited to) Aboriginal populations , people from culturally and linguistically diverse ( CALD ) backgrounds and people with disadvantage or disability.
- Telehealth provides more opportunities to support flexible workplaces and ensures health providers are well connected and supported in their roles.
- Telehealth technology alone will not bring about the change in practice. A key factor to success will be embedding behavioural change in the use of the technology.
- Telehealth should generally not be adopted as standard practice for the provision of all violence, abuse and neglect health services – refer to NSW Health for information
The Telehealth in Practice guide has detailed information.
|For patients and their carers||For providers and local delivery systems|
Delivery of telehealth
Different organisations in the NSW Health system have a role in delivering telehealth:
- The Agency for Clinical Innovation ( ACI ) supports models of care and protocols for service delivery. The ACI works in partnership with local health districts ( LHDs ) and pillar agencies to enable telehealth as a safe and effective modality for clinical care.
- Local health districts deliver telehealth services, including local telehealth managers who provide support in the establishment and integration of telehealth into clinical practice.
- The Ministry of Health provides the planning, policy and service development.
- eHealth provides the technical infrastructure, advice and support.
Having the appropriate set up ensures you will have a successful telehealth appointment:
- set up a professional space for your virtual appointment
- set up the webcam at eye level
- use approved platforms and hardware
- be punctual
- dress appropriately
- engage your patient
- communicate when you have to look away from the screen
- keep lag time in mind
- be clear with any pre- and post-appointment instructions.
For details, see the fact sheet, Telehealth etiquette for clinicians.
Medicare funding for telehealth
The Department of Health has released new items for telehealth and telephone consults (item numbers are for specialists and consultant physicians). It is now possible to bill for Telehealth and Telephone consults regardless of where the patient is located.
Medicare released new MBS numbers specifically to be used for the COVID-19 pandemic, in order to keep patients at home. They are substitute items of MBS items we currently use, created for:
- SPECIALIST, CONSULTANT PHYSICIAN AND PSYCHIATRIST TELEHEALTH ATTENDANCES for COVID-19 for vulnerable and/or isolated patients and for isolated health professionals providing medical services and
- SPECIALIST, CONSULTANT PHYSICIAN AND PSYCHIATRIST TELEPHONE ATTENDANCES for COVID-19 for vulnerable and/or isolated patients and for isolated health professionals providing medical services
See below and refer to the MBS website for the latest information.
What’s the difference between telehealth and telephone? Isn’t it the same?
For statistical purposes, the Government has separated telephone and telehealth consults. So, there are two sets of codes, one for video and another for telephone. The rates are the same for both.
Should I continue billing with my usual codes and just add the COVID codes for telehealth?
If you are continuing to see patients face to face, then keep billing your usual codes (nothing changes). But, if you’d prefer to limit the number of face-to-face consults you are doing and there are some patients who meet the vulnerable patient criteria, then you can use the new COVID-19 codes and consult via telephone/video, even if the patient lives only five minutes from your practice.
What are the criteria for vulnerable patients?
Vulnerable/isolated patients are those where at least one of the following apply:
(a) the person has been diagnosed with COVID-19 virus but who is not a patient of a hospital; or
(b) the person has been required to isolate themselves in quarantine in accordance with home isolation guidance issued by Australian Health Protection Principal Committee (AHPPC); or
(c) the person is considered more susceptible to the COVID-19 virus being a person who is:
(i) at least 70 years old; or
(ii) at least 50 years old and is of Aboriginal or Torres Strait Islander descent; or
(iii) is pregnant; or
(iv) is a parent of a child under 12 months; or
(v) is already under treatment for chronic health conditions or is immune compromised; or
(d) the person meets the current national triage protocol criteria for suspected COVID-19 infection.
Why don’t I just use my usual telehealth codes like (99, 112, 149, etc.) instead of the new COVID-19 telehealth codes?
The main practical difference between the usual telehealth codes and the new COVID-19 telehealth codes is the location of the patient. If you are conducting usual telehealth attendances with patients in telehealth eligible areas, then you should continue to use the usual telehealth codes (for example, claim a 116 with a 112 and so on). Only use the COVID codes for patients who are not in a telehealth eligible area but need to ‘see’ you.
As per Medicare, if the patient doesn’t meet the eligibility criteria then code the COVID-19 telehealth Items (stand-alone).
|MBS item code||Description|
|91824||Telehealth initial consult – Covid-19 item code replacement 110|
|91825||Telehealth follow-up consultation – Covid 19 item code replacement 116|
|91834||Telephone initial consult - Covid-19 item code replacement 110|
|91835||Telephone follow-up consult - Covid-19 item code replacement 116|
What are the equivalent COVID-19 codes for items 132 and 133?
Do referral rules apply to COVID-19 services?
Yes. To claim COVID-19 services, the patient has to be referred to you by another specialist or a GP as usual. Referrals will still need to be valid in order to bill updated MBS item codes.
I have arrived home from overseas this morning and have to self-isolate for 14 days. Can I keep practising?
Yes. The COVID-19 codes can be used for both vulnerable patients, and health providers in isolation for possible COVID-19 infection.
Which codes should I use for telehealth?
Below are your common codes and their COVID-19 counterparts to use if your patient meets the vulnerability criteria above and the consultation takes place via video. Always check the MBS website [link] to ensure the code is accurate.
|Usual MBS item||Equivalent new COVID item||Comments|
Which codes should I use for telephone?
Below are common codes and their COVID-19 counterparts to use if your patient meets the vulnerability criteria above and the consultation takes place by phone.
|Usual MBS item||Equivalent new COVID item||Comments|
What are the rates?
The Schedule fee for each service is the same as the Schedule fee for the equivalent usual service. For example, the Schedule fee for item 110 is the same as for item 91824 and 91834. The difference is the Government is trying to make you bulk bill if you use the COVID-19 services.
Does the single course of treatment rule apply?
Yes. You do not get to start with a fresh initial consultation just because you are switching from face to face to video/telephone. If you have been reviewing your patient for the same condition and now switch to the COVID items, your first claim should be for one of the follow up consults, not an initial consultation.
Can I use the new COVID codes for my admitted patients as well as outpatients?
No. The COVID-19 services apply to outpatients only.
Do the Private Health Fund gap cover schemes apply to the COVID-19 services?
No, the COVID-19 services are for outpatients only and the private insurers are not permitted to cover outpatient medical services.
How long will these codes be available?
Current information is they will be available for six months (approximately August/September). Check the MBS website for updated information.
For more information
- See the MBS Online Schedule
- Refer to the Australian Government Department of Health fact sheet (12 March 2020)