Medicare Telehealth Billing Rules for ADHD Assessments: MyMedicare and ECR Explained

If you are booking a telehealth ADHD assessment with a GP you have never seen before, Medicare will not automatically cover the consultation. Since 1 November 2023, a rebate for telehealth requires either MyMedicare registration or a recent in-person visit at the practice. This guide explains exactly how these rules work and what to do before your first appointment.

What changed on 1 November 2023

During COVID, the Australian Government introduced temporary telehealth MBS items so patients could see their GP by video or phone without an in-person visit. Those temporary items ended on 31 December 2022. From 1 January 2023, a new set of permanent telehealth items took effect, and from 1 November 2023, an existing clinical relationship requirement was introduced.

The permanent telehealth items sit in MBS Group A40. For a GP video consultation lasting 40 minutes or more (the length of a typical initial ADHD assessment), the relevant item is MBS Item 91802. The schedule fee is $125.10, and the Medicare rebate is 100% of that amount. For shorter follow-up consultations (20 minutes or more), the item is MBS Item 91801 with a schedule fee of $84.90.

The schedule fees for video consultations are identical to in-person equivalents. You get the same rebate whether you attend in person or by video. For a full breakdown of fees and out-of-pocket costs, see our guide to Medicare rebates for telehealth ADHD assessments.

The existing clinical relationship requirement

To claim a Medicare rebate for a GP telehealth consultation, the service must be performed by an “eligible telehealth practitioner.” MBS Note AN.1.1 defines what this means. You qualify for a rebate if at least one of these is true:

You are registered with MyMedicare at the practice providing the telehealth service.
You have had a face-to-face appointment at the practice within the preceding 12 months. This does not have to be with the same GP. Any GP at the practice counts. The visit must be in-person. A previous phone or video consultation does not count.

If neither of these applies, the GP cannot bill Medicare for the telehealth consultation. You would either need to pay the full fee without a rebate, or take one of the steps described in the new patient section below.

The rationale behind the rule is continuity of care. The Department of Health wants telehealth to supplement an ongoing relationship with a GP or practice, not replace it. RACGP President Dr Michael Wright noted in 2026 that telehealth compliance is a priority area, with “concerns about some of the telehealth-only providers in particular.”

What is MyMedicare

MyMedicare is a voluntary registration scheme run by Services Australia. It launched on 1 October 2023. When you register, you formally link yourself to one GP practice. Registration is free.

For telehealth, MyMedicare registration serves as proof of an existing relationship with the practice. If you are registered with a practice via MyMedicare, you automatically satisfy the existing clinical relationship requirement for telehealth billing. However, to register for MyMedicare you must have already attended the practice in person: at least one face-to-face visit in the past 24 months for practices in remote locations (Modified Monash Model categories 6 and 7), or at least two face-to-face visits for practices in all other locations.

You can only be registered with one practice at a time. If you register with a new practice, you are automatically de-registered from the previous one. This does not stop you from seeing GPs at other practices. It only affects which practice counts as your “registered” practice for MyMedicare purposes.

How to register for MyMedicare

There are two ways to register:

Through myGov. Log in to your myGov account, go to Medicare services, and select MyMedicare. You will need the practice’s name or provider number. The practice must already be signed up for MyMedicare on their end.
At the practice. The reception staff at the GP practice can register you in person or over the phone.

Once the face-to-face visit requirement is met, you can register through myGov or at the practice. Registration takes effect immediately, and from that point all telehealth consultations with that practice are Medicare-eligible.

What if you are a new patient

If you have never attended a practice and you want a telehealth ADHD assessment there, you have three options:

Attend one in-person appointment first. A single face-to-face visit establishes the existing clinical relationship for the next 12 months. After that visit, all telehealth consultations at that practice are Medicare-eligible. If the practice is in a non-remote area and you want ongoing MyMedicare registration, you will need a second visit within 24 months.
Register for MyMedicare after your initial visit. Once you have met the face-to-face requirement (one visit for remote practices, two for others within 24 months), you can register through MyMedicare for ongoing telehealth eligibility without needing to re-establish the relationship every 12 months. Note: registering with a new practice will de-register you from your current MyMedicare practice.
Pay privately for the first telehealth consultation. If travelling for an in-person visit is not practical, the practice can bill the consultation as a private (non-Medicare) service. You pay the full fee without a rebate for that appointment. This is less common and more expensive, so attending in person first is usually the better option.

For patients in regional or remote areas of Queensland who want a telehealth ADHD assessment, attending one in-person appointment is the most straightforward path. Practices in remote locations (MM 6 and 7) require only one face-to-face visit in the past 24 months for MyMedicare registration, compared to two visits for practices in other areas. Once registered, all subsequent telehealth appointments with that practice are Medicare-eligible.

Exemptions from the relationship requirement

The existing clinical relationship requirement does not apply in all situations. Under MBS Note AN.1.1, the following patients are exempt:

Patients under 12 months old
People experiencing homelessness
People in natural disaster-declared areas
Patients receiving care from Aboriginal medical services
People isolating under COVID-related public health orders

Certain service types are also exempt, including urgent after-hours care, some mental health services, blood-borne virus services, and chronic condition management plan preparation. The mental health exemption is specific to certain MBS items and does not automatically cover all ADHD-related consultations. If you are unsure whether an exemption applies to your situation, ask the practice before your appointment.

GPs are required to document any exemption and the clinical reasoning in the patient’s notes.

This article is general information only and is not personal medical or financial advice. Medicare rules and schedule fees are subject to change. For the most current item numbers and fees, check MBS Online. For individual advice about your Medicare eligibility, contact Services Australia or talk to your GP practice.

Frequently asked questions

Do I need to see a GP in person before a telehealth ADHD assessment?

In most cases, yes. To claim a Medicare rebate for a telehealth consultation, you need an existing clinical relationship with the practice. This is established by attending at least one face-to-face appointment at the practice within the preceding 12 months. If you want to register for MyMedicare instead, you also need prior in-person visits: one visit in the past 24 months for remote practices (MM 6 and 7), or two visits for practices in other locations.

What is the existing clinical relationship (ECR) requirement for telehealth?

Since 1 November 2023, Medicare requires that patients have an existing clinical relationship with the practice before claiming a rebate for a GP telehealth consultation. This is satisfied by either registering with the practice through MyMedicare or having had a face-to-face appointment at the practice within the preceding 12 months. Both pathways require at least one prior in-person visit to the practice.

How do I register for MyMedicare?

First, you must meet the face-to-face visit requirement: one visit in the past 24 months for practices in remote locations (MM 6 and 7), or two visits for practices in all other locations. Once eligible, you can register through your myGov account under Medicare services, or by contacting the GP practice directly. Registration is free and takes effect immediately.

Will registering with a new practice remove me from my current MyMedicare practice?

Yes. You can only be registered with one practice at a time through MyMedicare. Registering with a new practice automatically de-registers you from the previous one. This does not stop you from seeing GPs at other practices, but only your registered practice counts for MyMedicare telehealth eligibility.

What Medicare item numbers apply to a telehealth ADHD assessment?

A GP video consultation of 40 minutes or more, which is typical for an initial ADHD assessment, uses MBS Item 91802 with a schedule fee of $125.10. Shorter follow-up consultations of 20 minutes or more use MBS Item 91801 with a schedule fee of $84.90. The rebate is 100% of the schedule fee. These are the same rates as equivalent in-person consultations.

General health information

This article is general health information only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always speak with a qualified health professional before making any changes to your medication or treatment plan.

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Medicare Telehealth Billing Rules for ADHD Assessments: What You Need to Know

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