Medicare Item Numbers

 Recent changes
 36’s
 Wedges
 Items of use
 30192 vs. 30195
 45030
The MOST CONSIDERATION
Medicare is what the
government rebates patients
NOT what the cost of delivering
health is!
Level C – Item #36
 Original descriptor covered that the presentation of
the patient included more than one system of the body
 Now it has been changed so it can be used on one
system of the body
 Consult still needs to be over 20 minutes and fulfil the
descriptor (ensure your notes match)
 Be mindful of your medical software if it has a timer on
it
Level C
Professional attendance by a general practitioner (not being a
service to which any other item in this table applies) lasting at
least 20 minutes, including any of the following that are
clinically relevant:
a) taking a detailed patient history;
b) performing a clinical examination;
c) arranging any necessary investigation;
d) implementing a management plan;
e) providing appropriate preventive health care;
in relation to 1 or more health-related issues, with appropriate
documentation.
Fee: $78.10 Benefit: 75% = $58.60 85% = $66.40
Wedge resections
 Medicare has recently changed the guidance of
how you can bill a wedge
 You can only bill the wedge – not the wedge +
lesion
Treatment of Keratoses, Warts etc
30192 vs. 30195
 Managing a lesion without histology
 For a 30192 (cryotherapy) you need more than 10
lesions to be able to qualify for Medicare rebate
 For a 30195 you can use it on a single lesion
 For example consider a thick solar keratoses
which you couldn't freeze and want to remove
without Histo
30192
 PREMALIGNANT SKIN LESIONS (including solar
keratoses), treatment of, by ablative technique (10 or
more lesions)
Multiple Services Rule

Fee: $37.40 Benefit: 75% = $28.05 85% = $31.80

30195
 BENIGN NEOPLASM OF SKIN, other than viral verrucae
(common warts) seborrheic keratoses, cysts and skin tags,
treatment by electrosurgical destruction, simple
curettage or shave excision, or laser photocoagulation,
not being a service to which item 30196, 30197, 30202,
30203 or 30205 applies (1 or more lesions)
Multiple Services Rule

Fee: $60.00 Benefit: 75% = $45.00 85% = $51.00

45030
 ANGIOMA (haemangioma or lymphangioma or both)
of skin and subcutaneous tissue (excluding facial
muscle or breast) or mucous surface, small, excision
and suture of
Multiple Services Rule

Fee: $122.15 Benefit: 75% = $91.65 85% = $103.85

Innovations for the clinic
 If you have too many patients
 Facilitated skin checks
 Training admin staff to assist doctors
 Concierge service at the front door
 MoleMap
 External 3rd party service
 Clinic Ambassadors
 Local referrals from GPs and hospitals
Electronic Communications
 Email
 Do you collect every patients email address?
 E-Newsletters
 Low cost reminder for family and friends
 SMS reminders for appointments
 Low cost / bulk communication
 Website
 Most people now research via the internet prior to
purchase
 Socialnomics strategy
What is Socialnomics?
The way the younger people of the world communicates
The way the whole world will communicate in the future
 Now the #1 use of the internet (overtaking porn)
 You can ignore it now (as we may have with
computers, internet, email etc) but you will eventually
have to communicate via these methods
Socialnomics – what does it mean
for Medicine
 Patients talking to patients
 Clinics talking to patients
 Identifying disgruntled patients and engaging them
 Products and services will find us NOT we seek these
services out
 Could be the main way we will communicate with patients
in the future
 Answer questions in a public forum
 Inform patients of new methods of diagnosing and managing
skin cancer
 Introduce new doctors
Facebook, Twitter powerful
business tools
"The findings we've uncovered in this social media
report highlight, beyond a shadow of a doubt, that
social media is here to stay and needs to be taken
seriously by the broader business community," said
Megan Clarken, managing director of Nielsen's online
business in the Asia Pacific.
Clarken added that "businesses can no longer afford to
simply observe the social media phenomenon, they
need to embrace it.“
The Age – July 1st 2010 “Facebook, Twitter powerful business tools”
Electronic Media Strategy
 If you or your business doesn't have one...you need to
develop one
 E-newsletter
 Facebook for the clinic?
 Email communication
 SMS
 We know that Gen Y, Z and Millennials are in love with
this form of communication
 Baby boomers, Gen X – maybe / not yet but it will
happen
What I see but don’t like...
 Most doctors have no idea what they are worth and
where all their money is
 No idea how much the need to save to have the life
they want at retirement
 I.e. If you want $150K pa in retirement you will need $3M
in income producing assets (based on 5% returns)
 Too scared to charge the right price for their services
 Don't focus on their performance at their clinic
 How much per hour do you earn?
How to build value...
 Focus on what you would like to achieve
 Family
 kids schooling, holidays etc
 Home
 what type of house, where?
 Work
 do you enjoy where you are, if not where would you prefer to be?
 Personal
 Health, hobbies

 What are your retirement goals?

 Write it down and review it daily, weekly, monthly (score
yourself )
How to build value...
 Look to professionally develop on all levels inc outside
of medicine
 Where are you knowledge gaps?
 Basic accounting, share market etc
 Must have a good professionals who know you and
your business:
 Accountant
 Bank manager (inc merchant if you own your clinic)
 Lawyer
 Financial Planner
Last things to think about...
 Put 10% of what you earn away (so you can’t spend it).
 We are all going to outlive our parents and (in theory)
we are meant to retire at 65 so you will have 20+ years
of zero income. Plan for this!

 Ultimately TAKE CONTROL of your environment and

finances...it will empower you and be rewarding in the
long term!
Clinical Tour
Clinical Tour
Thank you!
 Tony Dicker & Master Faculty
 UQ
 Presenters
 HealthCert Team
 You!