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Lack of access to Medicare Rebates for Podiatry nail surgery

Discussion in 'Australia' started by surfboy, Apr 20, 2014.

  1. surfboy

    surfboy Active Member


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    Hello,

    I have been examining the MBS recently and the following questions came to my attention.

    Why is it that GP's are able to perform ingrown toenail surgeries in their offices, and receive a Medicare rebate of $176.65 when bulk billing.?

    Additionally, for measurement of ankle brachial index and associated Doppler assessment of the Tibialis posterior and dorsalis pedis waveforms, GPs are able to claim item 11610 at $54.20 bulk billed.

    I am interested to know your thoughts as to why Podiatrists in Australia, being the supposed experts in foot and lower limb pathology, do not have access to the above MBS item numbers. Especially for nail surgery - surely it is contradictory that we are able to administer local anaesthesia drugs and perform the surgery, yet are not able to access any MBS item number for it.

    It deeply concerns me that Podiatry is completely unrecognised in the MBS, apart from the 10962 Chronic Disease Management item number.

    Is the Podiatry lobby in Australia doing anything about this ?? Why are our skills in nail surgery and measurement of peripheral blood flow being fundamentally disregarded in the MBS, but GP's are green lighted to proceed.???
     
  2. APodC

    APodC Active Member

    Hi SB,

    Great questions, these issues concern me too. It should come as no surprise that we regularly raise these and many other questions with ministers, advisers and the head of the MBS at the department of health.

    What may surprise people is that patients were given access to many thousands of codes when performed by GP's when Medicare was introduced in 1975. For the past ten years at least, we've been arguing for access to the MBS for podiatry patients however the medical lobbyists and surprisingly the health consumers forum fight hard to prevent an expansion (they argue its growth is already unsustainable). It may also surprise people that the vast majority of GP codes have NEVER been reviewed, therefore they've never been looked at with a critical eye.

    Currently, podiatry enjoys the greatest support from the MBS allied health items of the physical sciences with podiatrists now providing around 2.25mil services under the MBS, up nearly 20% in two years. Physio is around 1.2mil and everyone else is under 1mil. That said, we fight on because we're arguing that there should be more direct access to podiatry specific items so we can better manage patients needs.

    At the APodC we have a policy committee that helps us to prioritise which issues are most important to the profession that and is helping us develop what the policy position on these issues should be. We then make an assessment of each item according to how likely we think we are to get government to make changes before deciding which issues to lobby on. The previous government was more focused on Medicare Locals rather than changing the MBS however we hope this government will be more receptive to direct fee for service models under the MBS.

    As I regularly say to people, lobbying is 50% hard work and 50% dumb luck. If you don't do the hard work, you don't the dumb luck so we're in Canberra lobbying at every opportunity (most sitting weeks).

    Any member that is interested in getting their hands dirty on what we say to government should speak to us about joining the policy committee and helping to make a difference.
     
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