LEVEL D
A Level D item will be used for a consultation lasting at least 40 minutes for cases in relation to one or more health related issues. The medical practitioner may undertake all or some of the tasks set out in the item descriptor as clinically relevant, and this should be reflected in the practitioner’s record. In the item descriptor singular also means plural and vice versa.
Creating and Updating a Personally Controlled Electronic Health Record (PCEHR)
The time spent by a medical practitioner on the following activities may be counted towards the total consultation time:
- Reviewing a patient’s clinical history, in the patient’s file and/or the PCEHR, and preparing or updating a Shared Health Summary where it involves the exercise of clinical judgement about what aspects of the clinical history are relevant to inform ongoing management of the patient’s care by other providers; or
- Preparing an Event Summary for the episode of care.
Preparing or updating a Shared Health Summary and preparing an Event Summary are clinically relevant activities. When either of these activities are undertaken with any form of patient history taking and/or the other clinically relevant activities that can form part of a consultation, the item that can be billed is the one with the time period that matches the total consultation time.
MBS rebates are not available for creating or updating a Shared Health Summary as a stand alone service.
Counselling or Advice to Patients or Relatives
For items 23 to 51 and 5020 to 5067 ‘implementation of a management plan’ includes counselling services.
Items 3 to 51 and 5000 to 5067 include advice to patients and/or relatives during the course of an attendance. The advising of relatives at a later time does not extend the time of attendance.
Recording Clinical Notes
In relation to the time taken in recording appropriate details of the service, only clinical details recorded at the time of the attendance count towards the time of consultation. It does not include information added at a later time, such as reports of investigations.
Other Services at the Time of Attendance
Where, during the course of a single attendance by a general practitioner, both a consultation and another medical service are rendered, Medicare benefits are generally payable for both the consultation and the other service. Exceptions are in respect of medical services which form part of the normal consultative process, or services which include a component for the associated consultation (see the General Explanatory Notes for further information on the interpretation of the Schedule).
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