• Riwka Hagen

QI-PIP and SIP Item Numbers

Now that QI-PIP is underway with new payment structures for participating in this new program, there is some confusion about what has happened to the 'old' SIP (Service Incentives Payment) items for completion of Diabetes Cycles of Care (2517 - 2526 and 2620 - 2635), Asthma Cycle of Care (2546 - 2599 and 2664 - 2677) and Cervical Screening for under-screened women (2497 - 2509 and 2598 - 2616).


To best understand these items, we need to remember the payment structure consisted of 2 elements;

1. The Medicare Rebate - which is the equivalent Level B, C or D attendance items

2. The Service Incentive Payment (SIP) which was the quarterly ADDITIONAL payment for recognition of completion of the clinical activities.


With the QI-PIP changes, it is the second payment (the SIP which is now no longer paid), however the item numbers and Medicare Rebate components are still active and available to be claimed.


WHEN DO YOU USE SIP ITEM NUMBERS?


With the cessation of the SIP payments, there is far less compulsion to continue to use these item numbers, especially considering that the Medicare rebates for these items have not indexed recently which means they pay at a lower level than equivalent attendance items.

So, are there any circumstances where these items are still relevant?

The answer is - YES!


For the Diabetes Cycle of Care completion, these are still useful items to charge when also completing Care Planning items such as GP Management Plans and/or Team Care Arrangements. These cannot be charged routinely at the same time with attendance items (3, 23, 36, 44 etc), however they can be combined with the old 'SIP' item numbers.

As always, you must ensure that ALL Medicare compliance requirements have been met in order to claim the item.


At all other times, it is recommended to use attendance items to benefit from the slightly higher Medicare rebates (as well as relaxing the compliance requirements of the 'SIP' items - given that you are now charging an attendance item).

If you have questions - feel free to contact us hello@medicalbusiness.services



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