AMA items for Video Consultations
The AMA Video Consultation Fees Calculator assists members to set their own fees for video consultations based on their own practice cost experience and expected utilisation.
On 1 July 2011, items for referred attendances provided via video conferencing facilities and medical practitioner attendance to provide clinical support at the patient end were introduced on the Medicare Benefits Schedule (MBS). The MBS rebates apply to patients who are: in a Residential Aged Care Facility; at an Aboriginal Medical Service or Aboriginal Community Controlled Health Service; or located outside an inner metropolitan area.
The Medicare rebates go some way to cover the additional time doctors will spend providing video consultations compared to in-person consultations. The Government’s brochure on Medicare Rebates for Specialist Video Consultations states the MBS fee recognises the time, complexity and administration involved in providing video consultations.
However, the MBS fees do not include a component for the direct costs to medical practices for providing video consultation facilities. Instead, medical practitioners will receive the following incentive payments when they bill one of the MBS items:
Telehealth On-Board (all practitioners) (one-off)
Telehealth Service (referred attendance)
Telehealth Service (patient end)
Telehealth Bulk Billing (all practitioners)
While these incentive payments cover the direct costs during the first four years, the MBS fees should have been structured in a way that provides patients with rebates that reflect the true costs of providing video consultations on an ongoing basis.
The AMA has introduced three items for video consultation in the AMA List of Medical Services and Fees:
- medical practitioner attendance on a patient via video consultation;
- medical practitioner to provide clinical support to a patient during a video consultation with another medical practitioner; and
- practice nurse or Aboriginal Health Worker attendance on a patient during a video consultation with a medical practitioner.
Setting AMA fees for video consultations is challenging for three reasons:
- initially, we can expect that the direct input costs for video facilities will be high and initial usage will be low;
- direct input costs will vary across specialities and geographically; and
- there will be significant variance in utilisation by medical practices.
Over time, technology costs and practice input costs will reduce as the use of the technology becomes more commonplace and utilisation increases. Accordingly, AMA fees will need to be constantly reviewed to reflect this.
Video consultations will introduce new costs for medical practices. There are administrative costs to arrange the consultation so that the patient, the specialist and the referring medical practitioner are all available at the scheduled time. There are costs of high speed broadband access, real time IT support services in case the system goes down just before or during a consultation, and upgrading equipment over time.
While the AMA items contain indicative fees, it is acknowledged that fees will vary considerably based on the type of video facilities used and how frequently they are used. To assist members to calculate their fees based on their own practice cost experience and expected utilisation, the AMA has developed a Video Consultation Fees Calculator.
Members can access the AMA items and Video Consultation Fees Calculators from the Members Only area of the Federal AMA website. To access this part of the website, simply enter your username and password in the box on the top right hand side of the screen and follow the prompts.
Members who do not currently have a username and password should email their name, address and AMA membership number to email@example.com requesting a username and password, or call the membership services line on 1300 133 655.
Published: 18 Sep 2011