MBS ANSWERS

Can GPs bill Medicare for shared medical appointments?

Context

We received the following information. The questioner had received conflicting advice from multiple sources.

Shared Medical Appointments (SMA) as provided by our questioner are a type of group medical appointment that typically lasts 90 minutes during which 8-12 patients have individual and consecutive consultations with a GP, while other participants listen and can participate.

SMAs are not group education, they are individual and consecutive medical appointments, usually with a GP. There is also a trained facilitator present to manage the overall flow of each session.

The typical SMA workflow is as follows:

  1. Patients arrive at the nominated time and are greeted by a trained facilitator.
  2. For the first 20-30 minutes the facilitator conducts welcome formalities. There is no GP present during this period.
  3. A GP joins the SMA after welcome formalities have been completed.
  4. The GP commences the first consultation with the first patient, with other patients being present who are listening and able to participate.
  5. A timekeeper rings a bell (or similar) at 5 minutes and 6 minutes to notify the GP that it is time to complete the first patient consultation and move on to the second.
  6. This continues for approximately 1 hour during which all patients have had their one-on-one consultation with the GP.

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