Education guide - Aboriginal and Torres Strait Islander health assessments and follow-up services

Information on Indigenous health assessments and follow up services for Aboriginal and Torres Strait Islander patients.

We recommend you also read the relevant Medicare Benefits Schedule (MBS) item descriptors and explanatory notes available at the MBS Online website.

Health assessment - MBS item 715

This item is for patients of Aboriginal and Torres Strait Islander descent and can be claimed once every 9 months. The purpose of this item is to:

  • provide a comprehensive health check for all ages
  • evaluate a patient’s health considering their physical, psychological and social wellbeing
  • help general practitioners (GPs) develop suitable plans for their patients to:
    • support good health or improve health
    • prevent or reduce chronic disease risk factors

In-patients of hospitals and residents of aged care facilities aren't eligible for item 715.

General item 715 elements

Item 715 requires that:

  • a GP personally attends the patient 
  • a patient history is taken
  • examinations and investigations are undertaken as required
  • an overall assessment is made
  • appropriate interventions are recommended
  • advice and information is provided
  • a health assessment record is kept

Specific elements for patient life stages

The MBS explanatory notes on the MBS Online website outlines specific elements required for item 715 at different life stages.

Life stage Age in years
child 0 to 14
adult 15 to 54
older person 55 and over

Written report

On completion, the patient should be offered a written report on the health assessment, covering recommendations made in the health assessment. Where applicable, a copy or relevant extracts, may be offered to the patient’s carer, provided the patient agrees to this.

Completing a health assessment and follow-up services

This flowchart shows the process for completing an Aboriginal and Torres Strait Islander health assessment and follow up services.

Flowchart diagram of steps used for the Aboriginal and Torres Strait Islander health assessment and follow-up services

  • GP completes a health assessment and claims item 715
  • helping the GP – GPs determine if they need a practice nurse, Aboriginal health worker or Aboriginal and Torres Strait Islander health practitioner to help collect information
  • up to 10 follow up services for item 10987 can be provided, per calendar year, by a practice nurse or Aboriginal and Torres Strait Islander health practitioner on behalf of GPs
  • GPs can refer patients for up to 5 follow up allied health services in total per calendar year, if identified in the health assessment

Considerations for undertaking health assessments

Generally, the patient's usual doctor undertakes the health assessment. When undertaking a health assessment, make sure you consider the following:

  • GPs must explain what's involved in the health assessment to patients, parents or carers
  • patients must give their consent for the health assessment and for their personal information to be collected
  • the patient’s consent must be recorded
  • health assessments are not the same as a health screening service
  • GPs must be satisfied that under their supervision, suitably qualified practice nurses, Aboriginal health workers and Aboriginal and Torres Strait Islander health practitioners have the necessary skills, expertise and training to:
    • collect information, and
    • provide information on recommended interventions to patients, parents or carers

Follow-up services on behalf of GPs

After completing a health assessment, GPs can claim item 10987 for follow-up services. Practice nurses and Aboriginal and Torres Strait Islander health practitioners must provide these services on behalf of and under GP supervision.

Follow up services provide Indigenous patients with preventative health care and education between consultations with the GP. These can include:

  • examinations and interventions indicated in the health assessment
  • education on medication compliance and related monitoring
  • checks on clinical progress and service access
  • education, monitoring and counselling activities and lifestyle advice
  • taking a medical history
  • preventative advice for chronic conditions and related follow-up

Patients can have up to 10 item 10987 follow up services in total per calendar year. For bulk bill claims, incentive items 10990 or 10991 also apply when claimed in conjunction with item 10987.

GP attendance for follow-up services

GPs aren't required to be present for health assessment follow up services under item 10987 and can decide whether they need to see the patient. If a GP decides they need to see a patient, they can claim a Medicare attendance item for the time and complexity of their attendance with the patient.

Practice nurses and Aboriginal and Torres Strait Islander health practitioners can also provide separate follow up services under item 10987. The time spent for this service does not count towards the time taken for any GP follow up attendance on the patient.

Aboriginal and Torres Strait Islander health practitioners can provide another service, for example immunisation or wound management, on the same day. GPs can claim for all Aboriginal and Torres Strait Islander health practitioner services provided.

Patient eligibility for referred allied health services

These items are only available for Aboriginal or Torres Strait Islander Australians.

Where follow up allied health services are identified in the patient’s health assessment, GPs can refer for up to 5 services in total per calendar year.

The total of up to 5 services includes items 81300 to 81360 and can be made up of:

  • 1 service type, for example 5 physiotherapy services
  • a combination of different service types, for example 1 dietetic, 2 podiatry and 2 physiotherapy services

Referral requirements

GP must use either the referral form issued by the Department of Health or a form that contains all the components of this form.

GPs Referred services Service type Example
May use 1 referral form
  • single
  • multiple
same
  • 5 dietetic services
Must use a separate referral form for each service type
  • single
  • multiple
different
  • 2 dietetic services
  • 3 podiatry services

A health assessment referral form and proformas are available on the Department of Health website.

Reporting requirements

Allied health professionals must provide a written report for the referring GP, including details about:

  • the investigations, tests and assessments performed on the patient
  • the treatment provided
  • the future management needed for the patient’s condition or problem

Where multiple follow up services are provided, the allied health professional must provide a report after the first and last service, or more often if clinically necessary. Where only a single service is provided, a report is required after that service.

Closing the Gap (CTG) on Indigenous health

The Practice Incentive Program Indigenous Health Incentive and CTG Pharmaceutical Benefits Scheme Co-payment Measure also provide support for Aboriginal and Torres Strait Islanders to better manage chronic disease. Read more on the Practice Incentives Program.

Case Study

A 55 year old Indigenous patient presents with moderately severe impetigo requiring antibiotic treatment. As their usual GP, you are concerned about improving their general health and make the clinical decision to undertake a health assessment today while the patient is at the practice.

The below table shows the actions for health assessment stages between the GP and the patient.

Health assessment stage GP actions Patient
Before
  • discuss the patient's health and potential benefits of a health assessment to identify and prevent or reduce chronic disease risk factors
  • explain what's involved in the health assessment
  • ask if they mind having the practice nurse help with collecting information for the health assessment
gives consent
During
  • undertake assessment including physical, psychological and social factors
  • conduct an examination
  • identify issues including:
    • hypertension
    • obesity
    • poor diet
    • smoking
    • a family history of heart disease
    • low literacy
    • crowded living conditions
 
After
  • discuss health issues identified in the health assessment with the patient
  • agree on a strategy to improve their health and reduce the risk of future disease

As part of this strategy you:

  • refer the patient for 5 follow-up allied health services including:
    • dietitian - item 81320 x 2
    • Aboriginal health worker - item 81300 x 3
  • ask them to return for follow-up services with the practice nurse to encourage medication compliance and give education and lifestyle advice under item 10987
  • offer a written report on the health assessment with recommendations on matters covered
agrees to this

Additional bulk billing for item 10990 or 10991 also applies to the health assessment service item 715 and follow-up services under item 10987.

More information

Online:

Contact us at MBS item interpretation.

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Page last updated: 15 September 2016

This information was printed Sunday 4 December 2016 from humanservices.gov.au/health-professionals/enablers/education-guide-aboriginal-and-torres-strait-islander-health It may not include all of the relevant information on this topic. Please consider any relevant site notices at humanservices.gov.au/siteinformation when using this material.