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Health assessment item clarity imminent


The Department of Health is putting the finishing touches to updated advice about including practice nurse time when claiming health assessment item rebates.

It is understood the Department in coming days will publicly release the criteria, approved by the AMA, that are to be used in determining the eligibility of nurse practitioner time used in preparing health assessments when claiming a Medicare rebate.

The clarification is expected to bring to an end an embarrassing episode for the Government in which it unexpectedly implemented a major change in the criteria for applying the health assessment item rebate before beating a hasty retreat in the face of widespread doctor outrage.

The AMA has been in liaison with both the DoH and Department of Human Services (DHS) ever since to ensure doctors and practices have clear advice and guidance about their eligibility.

The long-standing position of the Department has been that practice nurses and Aboriginal and Torres Strait Islander health practitioners can assist GPs in performing a health assessment, in accordance with accepted medical practice, and that both GP and practice nurse time can be used to decide which Medicare item would be the most appropriate to bill Medicare for a particular health assessment.

But that understanding was thrown into confusion last month when DHS revised advice in the 2010 Health Assessment Factsheet in a way that created doubt about whether nurse time could still included when claiming a health assessment rebate.

The DoH scrambled to dispel the uncertainty by issuing a vaguely-worded statement that practice nurses may assist GPs in performing health assessments, but the position remained ambiguous, and the AMA has instead pressed the Department to make a clear and definitive statement.

The updated advice, which is being finalised, is expected to allay outstanding concerns by detailing the precise circumstances in which both GP and practice nurse time can be included, and which Medicare item would be the most appropriate to use in billing Medicare for a particular health assessment.

Adrian Rollins