Medicare Item Number for GP
900  | |
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Participation by a medical practitioner (including a general practitioner, but not including a specialist or consultant physician) in a Domiciliary Medication Management Review (DMMR) for patients living in the community setting, where the medical practitioner:
- assesses a patient's medication management needs, and following that assessment, refers the patient to a community pharmacy or an accredited pharmacist for a DMMR, and provides relevant clinical information required for the review, with the patient's consent; and
- discusses with the reviewing pharmacist the results of that review including suggested medication management strategies; and
- develops a written medication management plan following discussion with the patient.
Benefits under this item are payable not more than once in each 24 month period (as of 1/3/2014), except where there has been a significant change in the patient's condition or medication regimen requiring a new HMR or RMMR.
Fee: $151.75 Benefit: 100% = $151.75
(See para A42 of explanatory notes to this Category)
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Patient eligibility
A GP must determine if a patient is eligible for a HMR.
GPs must assess whether they need to review the patient’s medicines to make sure medicine is being used properly to achieve the best outcome for the patient.
Patients could be eligible for a HMR if they:
- take more than 12 doses of medicine per day
- have difficulty managing their own medicines because of literacy or language difficulties, or impaired sight
- attend a number of different doctors, both general practitioners and specialists
- have been discharged from hospital in the previous four weeks
- have had a significant change to their medicine regimen in the past three months
- have experienced a change in their medical condition or abilities. This could include falls, cognition, physical function
- use prescription medicine with a narrow therapeutic index or medicine that needs therapeutic monitoring
- have symptoms of an adverse drug reaction
- have a sub-therapeutic response to therapy
- have problems managing medication devices, such as dose administration aids, or
- are at risk of, or can’t manage their own medicine due to, changes in dexterity, confusion or impaired vision.
- have not had a HMR or RMMR within the past 24 months.
Any reasons outside the basic patient eligibility criteria must be specified in the referral.
If the patient requires a HMR within 24 months of their last HMR, this needs to be documented in the referral.
The HMR service is not available to in-patients of a hospital, day hospital facility or care recipients in residential aged care facilities. For individuals living in Australian Government funded residential aged care facilities, see the Residential Medication Management Review (RMMR) webpage.
A HMR must be conducted in the patient’s home. When this isn’t possible, accredited pharmacists must get approval from DoHA before the review takes place. To get approval, complete the Prior Approval Request form – Interview Conducted Outside the Patient’s Home
The HMR process
A HMR involves the following steps:
- Identification of a person who needs a HMR.
- A GP assesses if there is a clinical need for a HMR from a quality use of medicines perspective with the patient as the focus
- Formal initiation of HMR.
- The patient is informed and gives their consent to GP during consultation.
- The GP generates a direct referral for the patient for a HMR, with an accredited pharmacist. Alternatively the GP may generate a referral to the patient's preferred community pharmacy (who must then coordinate the HMR and notify the GP of the details of the accredited pharmacist who will conduct the service) .
- The accredited pharmacist will contact the patient to arrange the preferred address and time for the HMR.
- Appropriately accredited pharmacist conducts HMR
- The accredited pharmacist reviews the information from the HMR and develops a suggested management strategy
- The accredited pharmacist prepares a report
- The report is provided to, and discussed with the GP
- The patient and GP agree on the medication management plan in the consult (MBS 900 may be claimed at this point)
- Agreed plan is implemented with appropriate follow-up and monitoring.
Reference from Medicare Australia Website, MBSonline
