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Medicare

MEDICARE REBATES
FOR INSULIN
PUMPS

MEDICARE REBATES FOR INSULIN PUMPS

INSULIN PUMPS
ON THE PROSTHESIS LIST

Under the Private Health Insurance Act 2007, private health insurers are required to pay mandatory benefits for a range of prostheses that are provided as part of an episode of hospital treatment (or hospital substitute treatment), where a Medicare benefit is payable for the associated professional service.

Insulin pumps are a part of Prosthesis list C. The full list and further information can be viewed here:

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Medicare rebates for telehealth consultations

People in telehealth eligible areas of Australia have access to specialist video consultations under Medicare. This can provide patients with easier access to specialists, specifically endocrinologists, without the time and expense involved in travelling to major cities.

Medicare rebates are available for video consultations between specialists and patients in telehealth eligible areas, in eligible aged care facilities and Aboriginal Medical Services throughout Australia. Rebates are also available for clinical services provided by a healthcare professional located with the patient during the video consultation.

Telehealth: Patient items under the Medicare Benefits Schedule

The Medicare Benefits Schedule (MBS) items allow a range of existing specialist consultation items to be provided via video conferencing when the patient and the specialist are located more than 15kms apart at the time of the consultation.

Other items enable medical practitioners and other health professionals to provide clinical services, where clinically appropriate, to the patient during an MBS video consultation with a specialist. From 1 January 2013, a further 6 MBS items were introduced for short initial video consultations that are 10 minutes or less in duration. Patient-end items can only be provided when clinically necessary and the specialist service is an MBS rebateable video-consultation.

Telehealth: How does it work?

As an endocrinologist or a GP treating a patient in a telehealth eligible area, you can refer the patient to a specialist for a consultation via telehealth. During the consultation, the patient and the GP or another health professional will be able to see and hear each other via video conferencing and the specialist may also be at the patient-end of the consultation, to provide clinical services where appropriate.

Find out more information here:

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