I am a rehabilitation physician that works in a private hospital that is offering a hospital substitution program for post joint replacement rehabilitation. Under the plan the surgeon will determine if the person is suitable for post joint replacement rehabilitation in the home and then the insurer pays the hospital to provide physio and occupational therapy services in the home. I have been asked to participate and offer medical governance through telehealth and case conferences to manage analgesia, blood thinning medications and to offer guidance re safe discharge from the program. Can I charge a no gap fee to the insurers for telehealth item numbers (91824 or 116) or do I have to visit people in their home (128 or 116) and can I charge for case conferences (is it 880 or 820)?

I am a rehabilitation physician that works at a public hospital that offers rehab in the home and hospital in the home for patients, as part of early discharge or hospital substitution strategies. If a patient chooses to use their private health insurance while in a public hospital for the purposes of a joint replacement and is then discharged home for rehab in the home as part of the hospital the hospital substitution scheme – Can I charge the insurer a gap payment for my home visit to them and what item number should I charge a 116 (in hospital follow up) or a 128 (follow as part of a home visit)?