Telehealth Billing in Australia: What Patients Need to Know

Since the COVID-19 pandemic, telehealth has become a new reality in Australian healthcare. Today, up to a third of GP consultations might take place over the phone or via video. This shift has helped reduce infection risks, improved access to care, and encouraged ongoing follow-up. But one of the most confusing aspects for many health consumers is how telehealth billing actually works.

Understanding the 12-Month Rule
Typically, for a patient to be eligible for Medicare-rebated telehealth services, they must have had a face-to-face consultation at that clinic in the last 12 months. If more than 12 months go by without an in-person visit, the patient loses that eligibility. Of course, there are some exceptions for vulnerable groups—like children under 12 months old, individuals experiencing domestic violence, or people in disaster zones—who can still access telehealth without meeting this rule.

The MyMedicare Exception
Another pathway is through MyMedicare. If a patient is registered with a practice under MyMedicare, they can have telehealth consultations without worrying about the 12-month requirement. However, to register for MyMedicare, a patient must have seen their GP twice in the last 24 months. Essentially, this rule encourages continuity of care—making sure patients stick with their regular GP rather than hopping between telehealth providers.

In short, while telehealth is convenient and safe, understanding these billing rules can help patients navigate their options and avoid any surprises. And of course, these rules are current as of now, with no new health orders or disaster zone exceptions in place.