The items account for close to 85% of all GP Medicare services – any tweak to the way they work will significantly impact practice.
The set of five time-tiered items which make up the vast majority of day-to-day GP Medicare services are up for review with the MBS Review Advisory Committee, set to report in late 2025.
According to the latest set of Medicare quarterly data MBS items 3 (level A, <6 minutes), 23 (level B, <20 minutes), 36 (level C, >20 minutes), 44 (level D, >40 minutes) and 123 (level E, >60 minutes) and their various telehealth, home visit and after-hours equivalents were claimed 36.7 million times in the first quarter of this financial year.
Level B items alone accounted for 66% of all GP non-referred attendance services claimed in that period, with the time-based items altogether accounting for 85%.
Across all MBS services, time-tiered GP items make up about one third of services.
But not all time-based items are created equal.
One of the bugs – or perhaps features – of the item set is that, generally, the per-minute rebate decreases as appointment time increases.
A patient can claim $42.85 back for a 10-minute appointment, which works out to $4.29 per minute – but if they see the GP for 30 minutes, their rebate per minute shrinks to $2.76.
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As part of the review, MRAC will consider issues like item consistency, opportunities to streamline and whether the current system appropriately supports contemporary practice.
The working group includes three GPs – former RACGP president Associate Professor Elizabeth Marles, National Aboriginal Community Controlled Health Organisation senior medical advisor Dr Jason Agostino and Queensland rural generalist Dr Sue Masel.
The other members include the Department of Health and Aged Care principal medical advisor, a patient representative, a health economist, a health policy researcher and the immediate past president of the Australian College for Emergency Medicine.
Having already met twice this year, the group is expected to start consultation on a findings report in the new year.
RACGP president Dr Michael Wright is calling on members to share their views with the college via an online survey to help determine its advocacy points.
“These items are the main funding source for general practice, so we need to make sure changes support access for our patients, don’t increase bureaucracy or regulation, and meet the future needs of our population and of Australian general practice,” he told NewsGP.
The RACGP’s member consultation closes on 10 January.
