Who must comply with MBS telehealth item rules + continuous-care rules?
The applicability test for Comply with MBS telehealth item rules + continuous-care rules, computed across 35 industries, 9 business structures and 6 size bands.
Short answer: Only if
Applies only if you claim MBS telehealth items. Whether it applies turns on a fact that no industry, structure or size settles on its own.
What the obligation is
MBS telehealth requires existing-patient relationship (12-month rule) for most consultations.
Medicare Benefits Schedule telehealth items require an established clinician–patient relationship (typically a face-to-face consultation in the prior 12 months). Limited exceptions for some specialties + populations. Non-compliant claims attract recovery.
The applicability test
Applies only if you claim MBS telehealth items. Whether it applies turns on a fact that no industry, structure or size settles on its own.
How the regulator frames it: GPs + specialists claiming MBS telehealth items.
What triggers it: Providing a telehealth consultation.
Jurisdiction: Commonwealth law, so the test is the same in every state and territory.
Which industries are in or out
Outcome across the 35 industries Rules Mate maps (1 of 35: only if a further fact applies; 34 of 35: no).
| Industry | Answer |
|---|---|
| Health practitioners | Only if a further fact applies |
| No | 34 other industries |
Business structure and size
Structure does not change the answer in health practitioners: for every structure the answer is "only if a further fact applies".
Size does not change the answer in health practitioners: at every size band the answer is "only if a further fact applies".
Worked examples
Each line is one run of the Rules Mate applicability engine for a single business profile, with the reason the engine gives:
- Pty Ltd company in real estate agents with 6–19 employees, turnover $1M–$3M: does not apply. Requires a trigger outside this questionnaire.
- Pty Ltd company in health practitioners with 6–19 employees, turnover $1M–$3M: check whether it applies. applies only if you claim MBS telehealth items.
When you need to check further
The engine shows this obligation as "check whether this applies" when a business has industry: Health practitioners. It then applies only if you claim MBS telehealth items. That fact is not something Rules Mate can infer from industry, structure or size.
What you must do, and when
- When due
- Per consultation; recordkeeping.
- Frequency
- Ongoing
- Evidence to keep
- Patient records demonstrating prior face-to-face contact; consultation notes.
- Status
- Current
- Priority
- High
Penalty for not complying
Maximum penalty: Recovery of incorrect claims; Practitioner Review Program referral.
Audit or assurance level
Rules Mate has not yet classified the audit or assurance level for this obligation. Any audit, review or certification requirement is set by the regulator source listed below.
Where it sits in the corpus
Rules Mate tracks 8 published obligations tagged "health practitioners", 7 of them rated critical. For a professional services Pty Ltd company with 6–19 employees operating in every state, 0 of those apply outright. This obligation is rated high priority, and is an ongoing duty.
Regulator, legislation and tools
Free tools that help with this obligation:
Questions
- Who must comply with MBS telehealth item rules + continuous-care rules?
- Applies only if you claim MBS telehealth items. Whether it applies turns on a fact that no industry, structure or size settles on its own.
- Do sole traders need to comply with MBS telehealth item rules + continuous-care rules?
- Only if a further fact applies. Looking in health practitioners and every size band, the engine's answer for a sole trader is: only if a further fact applies.
- Do businesses with 1–5 employees need to comply with MBS telehealth item rules + continuous-care rules?
- Only if a further fact applies (1–5 employees, turnover $100K–$1M).
- When is "Comply with MBS telehealth item rules + continuous-care rules" due?
- Per consultation; recordkeeping.
Related
Sources
Computed by the Rules Mate applicability engine from the published obligation corpus; facts last checked 3 October 2026. Rules Mate is not a law firm and this is general information, not legal advice. Confirm your position with the regulator source or a qualified adviser before acting.