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.

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.

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.

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).

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

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.

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.

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

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

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.

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.