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 descriptions and explanatory notes. Check MBS Online on the Department of Health website.

Health assessment - MBS items 228 and 715

These items are for patients of Aboriginal and Torres Strait Islander descent.  You can claim them once every 9 months. These items:

  • provide a comprehensive health check for all ages
  • evaluate a patient’s health. This includes their physical, psychological and social wellbeing
  • help general practitioners (GPs) and non-vocationally recognised medical practitioners (non-VR MPs) develop health plans for their patients. These plans help 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 items 228 and 715.

Items 228 and 715 requirements

Items 228 and 715 require that the practitioner:

  • is an eligible practitioner working in general practice (other than a specialist or consultant physician) who personally attends the patient 
  • takes a patient history 
  • does an examination and investigates as required
  • makes an overall assessment 
  • recommends appropriate interventions
  • advises and informs the patient
  • keeps a health assessment record 

Specific requirements for patient life stages

The explanatory notes on MBS Online outline specific requirements for items 228 and 715 at different patient life stages.

Life stage Age in years
child 0 to less than 15
adult 15 to under 55
older person 55 and over

Written report

The practitioner should offer the patient a written report including any recommendations on the health assessment. If the patient agrees, the practitioner may provide relevant extracts, to the patient’s carer.

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.

The eligible practitioner completes a health assessment and claims items 228 or 715.

The eligible practitioner determines if a practice nurse, Aboriginal health worker or Aboriginal and Torres Strait Islander health practitioner can help collect information.

The practice nurse or Aboriginal and Torres Strait Islander health practitioner can provide up to 10 follow up services for item 10987 per calendar year, on behalf of an eligible practitioner.

An eligible practitioner can refer patients for up to 5 follow up allied health services per calendar year, if identified in the health assessment.

Considerations when doing health assessments

Generally, the patient's usual doctor does the health assessment.

When doing a health assessment:

  • eligible practitioners 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 and non-VR MPs must be satisfied that under their supervision, suitably qualified practice nurses, Aboriginal health workers and Aboriginal and Torres Strait Islander health practitioners have the required skills, expertise and training to:
    • collect information, and
    • provide information on recommended interventions to patients, parents or carers

Follow-up services on behalf of eligible practitioners

After completing a health assessment, eligible practitioners 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 the practitioner's supervision.

Supervision of the practice nurse or Aboriginal and Torres Strait Islander health practitioner at a distance is acceptable.

Follow up services give Indigenous patients preventative health care and education between consultations with the eligible practitioner. 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 on 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 with item 10987.

Follow-up services by eligible practitioners

GPs and non-VR MPs don't need to be present for health assessment follow up services under item 10987. They can decide whether they need to see the patient. If 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 doesn't count towards the time taken for any GP or non-VR MP follow up attendance with the patient.

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

In-patients of hospitals aren't eligible for item 10987.

Patient eligibility for referred allied health services

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

Eligible practitioners can refer for up to 5 services per calendar year if they identify follow up allied health services in the patient’s health assessment.

The 5 services include items 81300 to 81360 and can include:

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

In-patients of hospitals aren't eligible for follow up allied health items.

Referral requirements

To access follow-up allied health services, eligible practitioners must refer patients to the relevant allied health professional. The referring practitioner must identify which allied health services are appropriate for the patient.

The referring practitioner must use the referral form issued by the Department of Health or a form that contains all the components of this form.

GPs and non-VR MPs 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 practitioner, 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.

Checking patient eligibility

You can check a patient’s eligibility:

  • by using the MBS Online Items Checker in HPOS to:
    • view and check patient eligibility based on their MBS history
    • check your own eligibility for claiming MBS items
    • check claiming conditions for MBS items
  • or you can call us

Closing the Gap (CTG) on Indigenous health

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

Case Study

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

This table shows the health assessment actions for the medical practitioner and patient.

Health assessment stage Eligible practitioner 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
  • do the assessment considering 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 back 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 incentive item 10990 or 10991 also applies to the health assessment service items 228 and 715 and follow-up services under item 10987.

More information

Read more about:

Contact us at MBS item interpretation.

To give feedback on our education resources, contact us.

Page last updated: 27 September 2018