The eligible telehealth practitioner rule and its exemptions
The rule that decides Medicare rebates, and the exemptions that matter most to your service.
What this is: a plain explanation of the rule that decides when virtual care attracts a Medicare rebate, and its exemptions.
Who it's for: practice managers, GPs, ACCHO leaders and billing staff.
Verify before you bill. This guidance is current as at June 2026. The rules change. Confirm the current detail on MBS Online at mbsonline.gov.au and Services Australia before you rely on it.
What the rule is
To attract a Medicare rebate for a virtual consultation, a patient usually needs an existing relationship with the GP or practice. In practice, the patient must have had a face-to-face service with you or your practice in the previous 12 months. The name for this changed on 1 November 2025, from the established clinical relationship requirement to the eligible telehealth practitioner rule, but the 12-month idea is the same.
This is a billing rule, not a clinical standard. No clinical guideline requires a prior in-person visit. It decides who gets a rebate, not who can safely receive virtual care.
The exemptions that matter most to you
The rule has exemptions, and several are exactly the patients a remote or community health service sees most. A patient does not need a prior face-to-face visit in these cases:
- Patients registered with your practice through MyMedicare. Registration itself satisfies the requirement.
- Patients receiving a service at an Aboriginal Medical Service.
- Patients in an area affected by a declared natural disaster.
- People experiencing homelessness.
- Children under 12 months of age.
- Certain consultations, including some after-hours care, care for a patient isolating under a public health order, and services for blood-borne viruses or sexual and reproductive health.
Confirm the full and current list on MBS Online, because the exemptions are updated from time to time.
Why MyMedicare is the key move for your service
For a service that wants to make virtual care viable, registering eligible patients through MyMedicare is the single most useful step. It satisfies the eligible telehealth practitioner rule for those patients, so their video and phone consultations attract a rebate without a recent in-person visit. It also unlocks the longer phone consultation items and supports continuity for chronic condition management.
Registration is voluntary for the patient and free. A practical approach is to identify your patients with chronic or complex conditions, explain that registering links them to your practice for their ongoing care, and register those who agree. If a patient prefers not to register, reassure them they can still receive care through your practice.
A note for an Aboriginal Medical Service or ACCHS
If you work in an Aboriginal Medical Service, the exemption above means many of your virtual consultations are rebatable without a recent in-person visit. Where your service holds an exemption under section 19(2) of the Health Insurance Act, salaried or contracted practitioners may be able to bill some MBS items for services that would otherwise be blocked. The rules here are specific, so confirm your service's arrangements with Services Australia.
Need help?
- Visionflex support: visionflex.com/support | support@visionflex.com | +61 2 8914 4000 (9am to 5pm AEST)
- See also: MBS telehealth items: what you can bill now, Chronic condition management and health assessment billing, Funding beyond MBS, Standards and regulatory alignment
Visionflex acknowledges the Traditional Custodians of Country throughout Australia and pays respect to Elders past, present and emerging.