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Read the relevant item descriptions, fact sheets and explanatory notes on the MBS Online website.
A health assessment looks at your patient’s health, physical, psychological and social function.
There are Medicare Benefits Schedule (MBS) items covering health assessments for specific target groups.
Health assessments aren’t available to hospital in-patients. They also aren’t available to aged care residents except for either:
- comprehensive medical assessments
- Aboriginal and Torres Strait Islander patients.
When billing and claiming health assessments you should consider all of the following:
- time taken to complete the assessment
- complexity of your patient’s needs
- specific requirements for each target group.
The following table provides service descriptions, item numbers and the time required for each MBS item.
| Item numbers | Item name | Item description | Time required |
|---|---|---|---|
| 224, 701 | Brief health assessment | A simple health assessment | 30 minutes or less |
| 225, 703 | Standard health assessment | An assessment for when the patient needs more than a brief assessment, but doesn’t have complex health issues | More than 30 but less than 45 minutes |
| 226, 705 | Long health assessment | An extensive assessment for when the patient has complex health issues | At least 45 but less than 60 minutes |
| 227, 707 | Prolonged health assessment | A complex assessment of a patient with significant, long-term health needs managed through a comprehensive preventative healthcare management plan | 60 or more minutes |
| 228, 715 | Indigenous health assessment | A health assessment for Aboriginal and Torres Strait Islander patients | No time requirements |
| 177, 699 | Heart health assessment | A health assessment for patients with cardiovascular disease or at risk of developing cardiovascular disease | At least 20 minutes |
Claiming limits
In some cases, you can do a subsequent health assessment in the same 12-month period. You can do them if your patient is eligible for another health assessment under a different target group.
To help us assess your claim, you need to tell us which target groups the health assessment claim is for.
If you don’t specify that the subsequent health assessment was for a different target group, we’ll reject your claim.
Heart health checks
You can bill a heart health check for your patient once every 12 months if your patient meets the criteria for these items.
Find out more about items 699 and 177 for these criteria on MBS Online.
You can’t bill a heart health check item for your patient if, in the last 12 months, they had another health assessment under: