General

Can a specialist bill a 91836 as their first billing in a private practice setting?

4 October 24

The specialist had received a referral from another respiratory physician to perform a bronchoscopy on a patient. The specialist called the patient to discuss the procedure, make them aware of…

Why are outpatient item numbers that attract 85% of the Medicare Schedule Fee not listed by the private health insurers?

3 October 24

The question was posed in the context of public hospital outpatient services where clinicians can bulk bill when exercising a Right of Private Practice providing all other criteria are met. Th…

When bulk billing, is the patient’s agreement to assign their Medicare benefit required for all items or just the consultation items?

2 October 24

The questioner added that everything they had read talks about telehealth items only. Their understanding was that the assignment of benefit is only required for consultation items but not for…

Can we charge facility fees to cover the cost of consumables when bulk billing?

30 September 24

A GP practice wanted to know how to “manage” facility fees for bulk billing patients. The question said that the practice needed to charge this fee to cover the cost of consumables, but the doctors …

If a patient presents at a public hospital outpatient clinic with a named referral from their GP and needs admission but wants to go to a private hospital, is a new referral required?

27 September 24

If I see patients referred to me in the public clinic, and they are unwell and require admission to hospital at presentation to the clinic as patients with chronic disease sometimes are, do I …

Is there a legal restriction to claiming a new initial day of ICU when the patient was discharged from ICU and readmitted within 3 days?

25 September 24

If a patient is discharged from ICU and readmitted within 3 days and we claim a new initial day of ICU management (13870), the claims reject. We find that if we resubmit the claim as item …

Can a fellow of the Australasian College for Emergency Medicine (FACEM) bill MBS codes outside of a private emergency department?

24 September 24

This FACEM was planning to open a walk-in emergency clinic similar to a GP urgent care centre. Importantly, this would not be an approved private emergency department (ED).
The following …

Can a podiatrist’s receptionist sign the acceptance of a GP referral?

24 September 24

When a podiatrist has received a referral from a GP to be involved in a coordinated care plan, can their receptionist sign the acceptance of the referral?

…

Do items 60506 and 60509 refer to surgical procedure time or fluoroscopy time?

23 September 24

No context was provided.

…

Do you have to withhold billing item 723 until a formal acceptance to participate is received from at least 2 care team members?

19 September 24

At our practice we do not hold the billing, and we charge item 723 on the same day as the GPMP (721). I have heard of other practices who withhold the 723 billing until signed faxes are exchanged wi…

Can a cardiologist self-refer to follow up a patient post discharge from hospital?

24 February 21

The question posed was: “Cardiologist, Dr Z, performs a procedure (permanent pacemaker implant) at hospital A (provider number 1), but would like to see the patient for ongoing care/follow up …

If a public inpatient is discharged and then referred back to the hospital outpatient clinic by the GP (so, no previous Medicare billing), can I bill item 132 if I spend more than an hour with the patient?

28 January 21

A hospital billing manager asked: If we have a public inpatient that is discharged from the brain injury unit to the outpatient clinic for follow up (at this point no previous Medicare billing…

Can I take over a named referral in a public hospital outpatient setting if I am of the same specialty?

22 January 21

Doctor A was a rehabilitation physician working in a public hospital day rehabilitation unit. Prior to patients commencing the day rehab program (where they are admitted inpatients on each day…

Is there any way to charge only the gap and receive the Medicare rebate directly to our account rather than via a cheque sent to the patient?

20 January 21

The question asked was: Is there any way to do outpatient billings where the patient pays the gap only on the day, and then the clinic submits a claim for the unpaid Medicare rebate? Currently…

Can we obtain the patient’s signature to consent to bulk billing once, and use it for ongoing care?

20 January 21

The question posed was: Can the bulk bill “Assignment of Benefit” be specific to the hospital setting? We understand that patients sign this upon admission, and while it is not specific to any…

Can I bill a private patient in a private hospital who was transferred from a public hospital, and who should the referral be from?

20 January 21

Dr A was unsure about correct referral pathways for patients transferred to a private hospital after an episode of care in a public hospital, and how such patients should be billed.

…

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Topics

Specialities

General

Can a specialist bill a 91836 as their first billing in a private practice setting?

Why are outpatient item numbers that attract 85% of the Medicare Schedule Fee not listed by the private health insurers?

When bulk billing, is the patient’s agreement to assign their Medicare benefit required for all items or just the consultation items?

Can we charge facility fees to cover the cost of consumables when bulk billing?

If a patient presents at a public hospital outpatient clinic with a named referral from their GP and needs admission but wants to go to a private hospital, is a new referral required?

Is there a legal restriction to claiming a new initial day of ICU when the patient was discharged from ICU and readmitted within 3 days?

Can a fellow of the Australasian College for Emergency Medicine (FACEM) bill MBS codes outside of a private emergency department?

Can a podiatrist’s receptionist sign the acceptance of a GP referral?

Do items 60506 and 60509 refer to surgical procedure time or fluoroscopy time?

Do you have to withhold billing item 723 until a formal acceptance to participate is received from at least 2 care team members?

Can a cardiologist self-refer to follow up a patient post discharge from hospital?

If a public inpatient is discharged and then referred back to the hospital outpatient clinic by the GP (so, no previous Medicare billing), can I bill item 132 if I spend more than an hour with the patient?

Can I take over a named referral in a public hospital outpatient setting if I am of the same specialty?

Is there any way to charge only the gap and receive the Medicare rebate directly to our account rather than via a cheque sent to the patient?

Can we obtain the patient’s signature to consent to bulk billing once, and use it for ongoing care?

Can I bill a private patient in a private hospital who was transferred from a public hospital, and who should the referral be from?

Topics

Specialities

General

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