Covid telehealth rebate expiry looms large

The RACGP has penned a letter of concern to DoHAC as level C phone rebates for antiviral consultations are set to expire at the end of the month.

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The RACGP has issued a letter to the federal health minister warning against the expiration of a number of covid telehealth rebates at the end of the month. 

On Monday 1 July, temporary level C phone consultations for covid antiviral assessment (items 93716 and 93717) are set to expire, as is the 12-month exemption rule for some covid-related telehealth measures, raising alarm bells for the RACGP due to their wide uptake particularly among older Australians. 

“Medicare statistics show there has been strong uptake of the covid antiviral items in the last two years,” said RACGP president Dr Nicole Higgins in the letter. 

“Since it was introduced, GP item 93716 has been billed 288,541 times (189,994 in FY22/23 and 98,547 in FY23/24 [to April 2024]).  

“The most common patient age groups utilising this item are 65–74 (28%) and 75–84 (26%), reflecting the ongoing threat of covid to older people and those in aged care.” 

Should these measures expire, only patients on MyMedicare would have access to level C phone items (for consultations longer than 20 mins) and these would be subject to the 12-month rule, meaning patients would need to have seen the GP face-to-face in the 12 months prior to any telehealth appointment. 

Amid “significant concerns” over the impact of this change, Dr Higgins called for the item numbers to remain on the MBS for the “foreseeable future, given the ongoing spread of covid in the community and the clinical guidelines associated with timely treatments”. 

In the letter, Dr Higgins outlined, as an example, the prescription of Paxlovid which requires doctors to enact an extensive review of a patient’s medical history, which likely requires at least 20-minutes. 

Next months will also see the end of the 12-month rule exemption for patients with covid looking for a PCR referral, which Dr Higgins labelled “highly concerning” as it put other patients and staff at risk. 

“With winter now upon us and respiratory illnesses projected to rise sharply in the coming weeks, maintaining access to telehealth rebates for people with covid is a simple and logical step to reduce the spread of infection,” she said. 

“I strongly encourage the Federal Government to reconsider the decision to end these temporary measures.” 

Speaking to newsGP, a DoHAC spokesperson said that the changes were part of a “staged de-escalation” of the covid response. 

“Now that the covid pandemic is over, covid pandemic measures have been progressively scaled back as the community and health system reverts to a post-pandemic business as usual environment,” they said. 

“Almost two years later, GPs and patients have had more time to familiarise themselves with the medication and their health risks and needs. 

“High risk patients have, in particular, been encouraged to develop an established relationship with a GP, or general practice and discuss their risks and possible treatment options ahead of a possible infection.”