Telehealth has become an integral part of the Australian health care system. It makes it easier for you to fit seeing a doctor into your schedule, reduces wait times, and brings better coverage to remote, regional, and rural Australians. But do you know what rules there are around medical certificates, bulk-billed consults with Nurse Practitioners (NPs) and General Practitioners (GPs), Mental Health Treatment Plans (MHTP), or eScripts? The requirements have changed significantly in the last few years [1] to reflect the growing popularity of telehealth, particularly following the COVID-19 pandemic, as well as fires and flooding. Here is a plain English rundown of some of the most important updates and rules that you should be aware of.
Australian Telehealth Rules Made Easy
Australian Telehealth Rules Made Easy
Bulkbilling Availability
While Medicare does not cover all telehealth consults, there are now a lot of specific items available to providers to charge under the Medicare Benefits Scheme (MBS) [2]. However, similar to how doctors’ practices can set their own fees and some providers offer only privately paid consultations, telehealth providers can choose to charge privately or offer their services with or without a gap fee. Some services also require a video consultation, while others are available over the phone [2]. It is worth checking before the consultation whether the provider offers bulk billing covering your needs. You could contact their customer service or visit the MediCompare bulk billing page.
GP and NP online consults are covered, so long as continuity of care is guaranteed and you regularly see a GP for physical assessments as well. These are the requirements:
- GP telehealth consultations with your primary doctor are covered under Medicare if you have had an in-person visit in the last 12 months.
- A virtual consult with an NP is covered under bulk billing, provided you have had a physical appointment with any GP in the last twelve months. Some providers, like My Telehealth Clinic, specialise in NP-only telehealth.
After-hours doctors’ telehealth appointments are included under Medicare for urgent concerns and minor illnesses. Some telehealth providers offer this service for a few hours at night, on weekends and public holidays, for example, 13SICK, while others, such as PrimeMedic, only have specific doctors offering these bulk-billed consults.
Online mental health consultations and plans are covered for up to 10 sessions a year, provided you are eligible and a GP or psychiatrist issues an MHTP. You will need a review after five sessions. The assessments and sessions can now all be online. Examples of providers offering these services can be found on the MediCompare mental health page. GP2U, for example, partners with PSYCH2U.
Specialist telehealth appointments are also covered, provided you have the relevant referral. This can also be obtained online.
Virtual paediatric consults with a specialist or GP for growth, development, or minor illnesses are also fully covered.
As you can see, most of your needs can now be addressed under the MBS. Here’s a quick tip to save you money on your telehealth consults: Before you book, ask customer service, “Which MBS item will this be billed under? Will it be bulkbilled to my Medicare card?”
Telehealth Consultation Standards
The Medical Board of Australia & AHPRA released updated telehealth guidelines in 2024 [3]. These changes come on top of existing requirements and are essentially designed to make sure you are kept safe within the telehealth system. The key takeaways for you are:
- Not everything belongs online. Acute abdominal pain, possible stroke, severe skin infections and a few other urgent conditions still need an in-person exam.
- Clear hand-off plan. If the clinician believes you cannot be adequately cared for via telehealth and requires in-person care, they must provide you with a written referral and arrange the next steps. This is to ensure you are well cared for and have a well-informed in-person consultation as soon as possible.
- Full documentation is a must. The doctor must note the technology used for the consult, any connection glitches, and a complete clinical summary – just like with a face-to-face visit. You can check out their notes in My Health Record.
- Phone or video consultations required. Doctors’ services should include a video or phone consultation. This includes eScripts (both repeats and new prescriptions), medical certificates, and referrals (to specialists, pathology, and imaging). While some providers offer them via questionnaire without consult, the requirements mean the health professional should do a follow-up call before issuing.
Telehealth and Privacy
You may have seen privacy policies on various telehealth providers' websites. Here are some of the most important aspects to be aware of. The Australian Digital Health Agency’s National Digital Health Strategy 20232028 now requires every Medicare-eligible telehealth platform to use end-to-end encryption [1]. You should normally be asked for your written consent. These forms must be saved for all sessions with your My Health Record. All telehealth providers must maintain an audit trail for a minimum of seven years. A quick way to check whether a provider handles your data well is to see whether they share your data with any third parties and how to opt out. They should also allow you to access their records and request changes.
Summary
In short, Australia’s telehealth landscape now offers extensive Medicare coverage for a wide range of services. With the Australian telehealth industry rapidly evolving, rules and regulations are also being adapted to keep you safe and ensure continuity of care. Knowing your rights and what to expect can help you identify a good provider and feel more empowered. You can also ensure that you take advantage of the bulk billing options available.
Disclaimer
This article is for informational purposes only and is no substitute for professional medical advice. Please choose your provider with care. Always consult your doctor or a qualified health professional regarding any health-related questions or concerns.