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Indigenous-specific MBS services

Indigenous-specific MBS services

ItemDescription
715 (Group A14)
228 (Subgroup A7.5)
Health assessment for Aboriginal and Torres Strait Islander peoples.
Maximum of 1 service in a 9 month period
10987Follow up service for an Indigenous person who’s had a health
assessment (item 715 or 228), done by a practice nurse or Aboriginal and
Torres Strait Islander health practitioner
12325Diabetic retinopathy assessment
73839Blood test (glycated haemoglobin) for the diagnosis of diabetes in high risk,
but asymptomatic patients. 1 test in 12 months
73840Blood test (glycosylated haemoglobin) for the management of established
diabetes. Maximum of 4 tests in 12 months
73844Urinary ACR (albumin/creatinine ratio) in the management of established
diabetes. Determined on a first morning urine sample
Indigenous-specific MBS services—follow-up allied health services identified in a health check
ItemDescription
81300Aboriginal and Torres Strait Islander health service
81305Diabetes education
81310Audiology
81315Exercise physiology
81320Dietitian
81325Mental health
81330Occupational therapy
81335Physiotherapy
81340Podiatry
81345Chiropractic
81350Osteopathy
81355Psychology
81360Speech pathology
Pathology services within the practice— QAAMS pathology program

The Quality Assurance in Aboriginal and Torres Strait Islander Medical Services (QAAMS) pathology program provides Medicare benefits for diabetes diagnosis and monitoring tests at Aboriginal and Torres Strait Islander primary health care sites.

ItemDescription
73839Blood test (glycated haemoglobin) for the diagnosis of diabetes in high risk, but
asymptomatic patients. 1 test in 12 months
73840Blood test (glycosylated haemoglobin) for the management of established diabetes.
Maximum of 4 tests in 12 months
73844Urinary ACR (albumin/creatinine ratio) in the management of established diabetes.
Determined on a first morning urine sample
Health assessments

A health assessment involves:
• checking a patient’s health and physical, psychological and social functions
• deciding if preventive health care and education should be offered to the patient to improve their health and wellbeing. Items 715/228 are available for people of all ages of Aboriginal or Torres Strait Islander descent.

ItemDescription
715 (Group A14) 228 (Subgroup A7.5)Health assessment for a patient of Aboriginal or
Torres Strait Islander descent

Items 715/228:
• can only be paid once every nine months
• shouldn’t be claimed with any general attendance item (for example item 23) unless the patient
has an acute problem that needs to be managed separately from the health check
• should be performed by the patient’s ‘usual doctor’. This is the doctor (or another doctor in the
same practice) who provided most of the primary care to the patient over the last 12 months or
will be providing most of the primary care to the patient over the next 12 months.

Health assessments—assisting the GP

Practice nurses, Aboriginal health workers or Aboriginal and Torres Strait Islander health practitioners

may help with the health check as long as it’s accepted medical practice and under supervision of the GP.

They may help with:

• collecting information

• giving patients information about recommended interventions at the direction of the GP.

The GP should be comfortable the assisting health professional has the necessary skills, expertise and

training to help with the health assessment.

Access to other MBS services

Patients who’ve had item 715/228 may also be eligible for the following MBS services:
• follow-up allied health services (items 81300–81360)
• follow-up service by a practice nurse or Aboriginal and Torres Strait Islander health practitioner
(item 10987).

Chronic Disease Management (CDM) items

These items help GPs plan and coordinate the health care of patients with chronic or terminal medical conditions. 

ItemDescription
721 (Group A15)
229 (Subgroup A7.6)
GP Management Plan (GPMP)
723 (Group A15)
230 (Subgroup A7.6)
Team Care Arrangements (TCAs)
732 (Group A15)
233 (Subgroup A7.6)
Review of a GPMP or TCAs


Important

• Items 721/229 and 723/230 are limited to one service in 12 months. Items 732/233 is limited to one service in three months. Where a review of TCAs and a GPMP occurs on the same day, claims should note they were done at different times.

• The same GP can’t claim a general attendance item (for example item 23) on the same day as claiming these items.

• These items should be done by the patient’s usual doctor. This is the doctor (or another doctor in the same practice) who has provided most of the patient’s primary care in the last 12 months, or will be providing most of the primary care over the next 12 months.


CDM items—assisting the GP

Practice nurses, Aboriginal health workers or Aboriginal and Torres Strait Islander health practitioners may help with CDM services as long as it’s accepted medical practice and under the supervision of the GP. This can include help with:

• patient assessment

• identification of patient needs

• making arrangements for services.

The GP should review and confirm all assessments undertaken on their behalf and be comfortable the assisting health worker has the right skills, expertise and training.

Access to other MBS services

Patients who are managed under a GPMP and TCAs or a MBS multidisciplinary care plan
arrangement can be referred for the following MBS services:
• allied health individual services (items 10950–10970)
• group allied health services (items 81100–81125)
• services by a practice nurse or an Aboriginal and Torres Strait Islander health practitioner for
ongoing support and monitoring for patients with chronic diseases (item 10997).


Go to mbsonline.gov.au for rules and referral details for these services.


Individual allied health services (MBS items 10950–10970)

These services are for patients with chronic conditions and complex care needs who are managed under MBS multidisciplinary care plan arrangements.

ItemDescription
10950Aboriginal and Torres Strait Islander health service
10951Diabetes education
10952Audiology
10953Exercise physiology
10954Dietitian
10956Mental health
10958Occupational therapy
10960Physiotherapy
10962Podiatry
10964Chiropractic
10966Osteopathy
10968Psychology
10970Speech pathology

GP mental health services

These items are for early intervention, assessment and management of patients with mental disorders.

Consultation
ItemDescription
2713 (Group A20)
279 (Subgroup A7.9)
GP mental health consultation (20 minutes or more)
Treatment Plans

Choosing the right GP mental health treatment plan item depends on whether the GP has done recognised mental health skills training. The exception to this is the review item 2712/277, which can be done by all GPs.

Item DescriptionGP has recognised mental health
skills training
2715 (Group A20)
281 (Subgroup A7.9)
GP mental health treatment plan
(20–39 minutes)
Yes
2700 (Group A20)
272 (Subgroup A7.9)
GP mental health treatment plan
(20–39 minutes)
No
2717 (Group A20)
282 (Subgroup A7.9)
GP mental health treatment plan
(40 minutes or more)
Yes
2701 (Group A20)
276 (Subgroup A7.9)
GP mental health treatment plan
(40 minutes or more)
No
2712 (Group A20)
277 (Subgroup A7.9)
Review of GP mental health treatment
plan or of Psychiatrist Assessment
and Management Plan
Not applicable


GP mental health services—access to other MBS services

Eligible patients who are managed under a mental health treatment plan or assessment and management plan may get the following MBS services:

• individual psychological assessment and therapy (items 80000–80015)

• individual focussed psychological strategies (items 80100–80115, 80125–80140, 80150–80165 and items 2721–2731/283–287, 371 and 372)

• group services (items 80020, 80021, 80120, 80121, 80145, 80146, 80170 and 80171).

Go to mbsonline.gov.au for rules and referral details for these services.