Exam Billing

Published on
December 4, 2023
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The 2014 Budget made significant changes to how optometrists can subsidise by the government in Australia. As a result, both our Adelaide and Henley Beach practices have altered how we bill our consultations so that we may continue to provide our patients with the best eye care, vision and access to technology in the future.

Standard fees

Consultation fees will now be standardised, rather than varying in line with the Medicare rebate as they have in the past. The frequency and quality of your eye care should not be dictated by government budgets and therefore we believe this is a positive move to allow our patients the best service when they need it. The majority of consultation items will include a proportion covered by the Medicare rebate although the amount will vary depending on your eligibility and the consultation type (chosen at your optometrist’s discretion). Details of these fees can be found in the table below:

Consultation Type Fee Medicare Rebate
Full Consultation
$100.00
$31.30 - $62.45 (eligibility dependent)
Short Consultation
$60.00
$31.30
Diagnostic Imaging
$100.00 per adult
$70.00 per child or concession
Not eligible for rebate
Subsequent Diagnostic
Imaging
$50.00 per adult
$35.00 per child and concession
Not eligible for rebate
Medicare Eligible Contact*
Lens Fitting
$250.00 - $300.00 $155.15 - $195.80 (eligibility dependent)
* Contact lens fitting fees do not apply for all contact lens types. Only applicable in certain circumstances.

We are still pleased to be able to bulk-bill health care and pension card holders.

We continue to use the Easy claim system to claim your Medicare rebate for you on the spot. This is then paid back onto your cheque or savings card.

The costs of the additional equipment such as retinal photography and anterior imaging, corneal topography and OCT scans has never been covered by Medicare and unfortunately this has not changed. Because we believe this technology is important in providing quality eye care, we continue to offer this technology at discounted cost for health card and pension card holders as well as children to enable access.

We love it when patients that have had a great experience at Innovative Eye Care mention this to their friends, family and colleagues. We will send you a $50 voucher if you refer someone you know to our practice! This can be used on full-price sunglasses or spectacles frames within 3 months.

Changes to the Medicare system

Since 1975, many optometric clinical services have been included in the Medicare Schedule. This means that when visiting your local optometrist as a patient, you have received a contribution from the government towards the cost of your appointment. The rebate amount has always only been 85% of the value that the government suggests is inappropriate full fee for the consultation.

In the 2014 Budget, the government announced significant changes to the Medicare rebates for optometry services, even though these went largely unnoticed in the media. These included a cut of almost five per cent in the rebate you receive and a freezing of the Medicare rebate until this year. This means the rebate has remained unchanged while costs of providing care continue to rise. The changes come on top of many years of inadequate indexing of the rebate, which means the rebate hasn’t increased in line with costs. The government rebate is continuing to fall further behind the true cost of providing quality eye care.

Figure 1. Graph showing the Medicare rebate today, vs what it should be had they been indexed by CPI

The other change made is a removal of the Medicare fee-cap for optometry services. Prior to 1st January 2015 optometrists were unable to charge for their professional services beyond the scheduled fee, unlike all other health professions. Now optometrists may set their own fees for clinical services under Medicare. This means that, in line with other healthcare providers, optometrists can charge above the Medicare scheduled fee without impacting the patient’s ability to claim the Medicare rebate.

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