Information about coronavirus (COVID-19)

Updated: 7 April 2020 @ 10.26am AEST  

What is telehealth?
Also referred to as video or online sessions/consultations. ESSA has defined telehealth as 'Delivery of technology-based exercise and sports science services supporting wellness, prevention, health management and performance improvement. Telehealth involves the transmission of information using telecommunication technologies including but not restricted to video, telephone and internet.'

This page covers:
- The latest industry updates - ESSA's lobbying for telehealth item numbers for EP services.
- The compensable schemes that approve telehealth for EP services
- How to implement telehealth in your practice  - guidelines and examples of how other exercise professionals are adapting services


The Latest industry updates

State Insurance Regulatory Authority (SIRA) update – AEPs and Certificates of Capacity/Fitness
ESSA advocated to SIRA in March 2020 that AEPs were the most appropriate allied health professionals to be included in any legislative amendments enabling a second or subsequent Certificate of Capacity/Fitness as part of the NSW Government’s COVID-19 emergency plan.

SIRA confirmed with ESSA today (6 April, 2020) that allied health providers cannot currently submit a Certificate of Capacity because the legislative amendment allows for a second or subsequent Certificate of Capacity/Fitness provided by a claimant to the insurer be a certificate that complies with the requirements prescribed by the Motor Accident Guidelines (MAGs) and the Workers’ Compensation Regulations. SIRA is currently updating the MAGs and the Regulations to enact this amendment and will advise ESSA once the updates are confirmed. Therefore, at present only a medical practitioner can issue a Certificate of Capacity.

Private Health Insurers (PHI)

BUPA: Current item numbers should be used until you receive a formal communication from ESSA confirming the new item numbers. BUPA has prepared Guidelines for Telehealth Consultations for Practitioners - please read these Guidelines before delivering services to BUPA members.

ESSA expects more private health insurers to include telehealth soon.

 

Compensable Schemes that approve EP services via Telehealth

Private Health Insurers (as at 6 April 2020)
The following insurers have approved AEPs to deliver services via telehealth. Australian Unity, BUPA, CBHS, CUA, Mildura District Hospital Fund,Teacher’s Health and TUH. All receipts should include providers details (including name, practice address, contact details), business details (business name, ABN), member details (name, address), service details (receipt number, date of service, explanation of the type of service, item code). Please continue to use the same item codes. 

DVA
The Department of Veterans’ Affairs (DVA) has confirmed it will allow all DVA clients to access allied health services via telehealth, where clinically necessary. For the updated fee schedule click here.


Phone consultations are available but should only be provided when video conferencing is unavailable.  The relevant items are also claimable for telehealth treatment delivered to clients in hospital or residential aged care facilities, where prior approval is not required.

 

Treatment cycle arrangements continue to apply for DVA clients seeking to access allied health services through telephone and video conferencing at this time.  Where required, clients may also access a GP referral or re-referral for clinically required allied health treatment via a telehealth consultation.

 

Allied health providers are able to claim for telehealth items from 1 April 2020 until 30 September 2020.  An assessment will be made by Government prior to 30 September to determine whether an extension of arrangements will be required.

 

Medicare
Four new temporary item numbers were released on 29 March 2020 to assist in containing COVID-19 and enable AEPs to continue to provide healthcare services safely. A service may only be provided by telehealth where it is safe and clinically appropriate to do so. ESSA encourages you to provide the very best telehealth services to clients. We will be advocating for the continuation of these items beyond 30 September 2020. However, the success of our advocacy will be contingent on how well you and other allied health professionals deliver those services. The new temporary MBS telehealth items must be bulk billed and are for non-admitted patients. Exercise physiologists have access to four new item numbers:

Category and Service Descriptors                           

Telehealth items - videoconference                     
Chronic disease management      93000                                                                     
Chronic disease management for ATSI clients      93408   
                                                                 

Telephone items - when videoconferencing is not available
Chronic disease management     93013
Chronic disease management for ATSI clients   93061

*For more information refer to ESSA's full communique for 30 March 2020. and 
Factsheet on MBS changes:COVID-19 Bulk Billed MBS Telehealth Service Allied Health


NDIS
The NDIS recognises ‘telepractice’ as an alternative method of delivering therapy supports, which can be used to assist participants to receive support that may otherwise not be available to them in their surrounding areas (for example participants living in more remote locations). This not only allows more choice and control for participants but may also provide value for money in instances where telepractice can be used to compliment and/or supplement face-to-face delivery of support. Providers wishing to use telepractice services should ensure they have met the appropriate quality and safeguard requirements. The NDIA do not have an item number for telepractice. They consider telepractice to be a mode of delivering a service, not a separate service.  Please refer to the Support Catalogue for exercise physiology support items. Click here for FAQs.

State Insurance Regulatory Authority (SIRA) 
The Fees Order 2020 - Accredited Exercise Physiology No 2 outlines that Telehealth services means delivery of consultations via video or telephone. Consultations would be inclusive of any electronic communication to support the delivery of the treatment service. Accredited Exercise Physiologists must consider the appropriateness of this mode of service delivery for each worker on a case-by-case basis. Telehealth services require pre-approval from the insurer and must be consented to by all parties – the worker, Accredited Exercise Physiologist and insurer.

Under both the MACA and MAIA, CTP insurers are only obliged to pay for treatment that is considered ‘reasonable and necessary’. You need to take this into account when proposing treatment (including those delivered via telehealth) or equipment.   

WorkCover QLD 
The Exercise Physiology Table of Costs July 2019 already supports telehealth as a method of service delivery. Exercise Physiology telehealth services are restricted to video consultations only and requires prior approval from WorkCover Queensland.

WorkSafe Victoria
New Item Codes for Exercise Physiology have been introduced. These items codes are temporary measure and will be reviewed regularly. It is expected that telehealth services are provided when clinically appropriate and should not replace face-to-face consultations unless there is a need.

WorkCover WA 
To help minimise social contact and the demands currently placed on medical resources, the use of telehealth services are encouraged for consultations where direct patient contact and examination is not essential.As there are no specific service codes for telehealth, medical and allied health providers should use the relevant service codes that apply to consultations generally. The fees for these services should also be applied. Click here for more information. 

Return to Work SA
ESSA has successfully lobbied for an initial consult telehealth item number for AEPs.New fee information is available to download on their website. Further information about the new telehealth fee can also be found on the ReturntoWorkSA website.  

Comcare
Accepted and awaiting finalised rates. 

 

Implementing Telehealth in your practice

ESSA Telepractice Policy Statement
Thanks to some amazing work by ESSA staff and feedback from our member advisory groups, we are proud to release our ESSA Telepractice Policy Statement today. Editable check list here These documents will help guide a best practice approach to delivery of services via telehealth. 


*We have fast tracked this statement to help you to deliver telehealth services under various compensable schemes and to private clients. Please note the Policy Statement applies to all ESSA professions including Accredited Exercise Physiologists (AEPs), Accredited Exercise Scientists (AESs), Accredited Sports Scientists (ASpSs) and Accredited High Performance Managers (AHPMs).


Choosing an online platform
There are many options available. ESSA has put together a list of commonly used digital platforms for ESSA members to review. ESSA urges all members to review page 5 of the Telepractice Policy Statement and checklist (above) for guidance on choosing a secure and suitable platform. 

Click here to access this list

Informed Consent - Code of Conduct

Informed consent is an ongoing process that covers service options, service purpose, risks and benefits, and client rights and responsibilities. Consent is usually a combination of verbal and written approval and continues across the life of services. In addition to these standard considerations for consent, telehealth services should also address: 
• telehealth specific risk management strategies for privacy, security and emergencies - this includes steps that you as the practitioner provide, as well as what steps the client should take to protect their privacy; 

• how the service will run including technology requirements and what will happen in the service; 

• outcomes expected - these considerations should be addressed with the client before delivering the service, and you should check in with the client regularly.



Being found via the ESSA Search Function

The public/referrers may wish to find an exercise professional! If you are delivering your services via telehelath please add this as a 'specialty' to your ESSA profile in My Account so you can be found in the ESSA Search Function. 

Insurance
Please consult your insurer whenever you make changes to your service delivery. 
Guild Insurance recognise telehealth as an accepted service modality for all Guild insured policy holders. No income thresholds apply for Guild policy holders.

Resources on how you can get started
The following ESSA Chats (video/audio recordings) provide great insight into telehealth in practice.