Health Assessment Item Numbers Explained

Health assessments are structured consultations aimed at identifying and managing the specific health needs of various patient groups. These assessments combine time spent by both the GP and practice nurse, with the total duration determining the applicable item number for billing. By using these item numbers effectively, GPs can deliver targeted care while maximising patient rebates.

Types of Health Assessments and Their Frequency

Different health assessments cater to various populations, each with specific schedules:

• Indigenous Health Assessments (715): Every 9 months

• Intellectual Disability Assessments: Annually

• Over 75 Health Assessments: Annually

• At Risk of Type 2 Diabetes (Ages 40-49): Every 3 years

• Refugee Health Checks: One-off

• Veteran Health Checks: One-off

• 45-49 Health Checks: One-off

• 699 Heart Checks: Annually

• Comprehensive Medical Assessment (CMA) for Aged Care Residents: Annually

How Health Assessments Are Billed

‍Billing for health assessments depends on the combined time spent by the GP and practice nurse:

• 701: Less than 30 minutes

• 703: 30 to 45 minutes

• 705: 45 to 60 minutes

• 707: Over 60 minutes

‍Restrictions on Billing Health Assessments

• Separate Consultations: Separate consultations cannot be billed alongside health assessments unless there is a clear clinical necessity, as specified in Clause 2.15.14 of the Medicare Regulations.

• Proper documentation is crucial to ensure compliance with Medicare requirements.

Conclusion

‍Health assessments provide valuable opportunities for GPs to deliver targeted care while supporting preventive health strategies for specific patient groups. By understanding the types of assessments, appropriate billing practices, and time-based item numbers, GPs can optimise both patient outcomes and practice efficiency.