Medicare Benefits Schedule - Note AN.7.11

Last reviewed: 1 November 2023

Items 224, 225, 226 and 227 may be used to undertake a health assessment for refugees and other humanitarian entrants.

The purpose of this health assessment is to introduce new refugees and other humanitarian entrants to the Australian primary health care system, as soon as possible (within 12 months) of their arrival in Australia.

The health assessment applies to humanitarian entrants who reside in Australia and are eligible to access Medicare services, including Refugees, Special Humanitarian Program, Temporary Humanitarian and Protection Program entrants with the following relevant visas granted under the Migration Act 1958: 

Offshore Refugee Category including:

(a) Subclass 200 (Refugee) visa;

(b) Subclass 201 (In-Country Special Humanitarian) visa;

(c) Subclass 203 (Emergency Rescue) visa; and

(d) Subclass 204 (Woman at Risk) visa.

Offshore - Special Humanitarian Program:

(e) Subclass 202 (Global Special Humanitarian) visa.

Offshore - Temporary Humanitarian Visas (THV) including:

(f) Subclass 070 Bridging (Removal Pending) visa;

(g) Subclass 786 (Temporary (Humanitarian Concern)) visa; and

(h) Subclass 790 (Safe Haven Enterprise) visa.

Onshore Protection Program including:

(i) Subclass 866 (Protection) visa.

Patients are required to provide their prescribed medical practitioner (see note AN.7.1) with proof of their visa status and date of arrival in Australia. Alternatively, medical practitioners may telephone Services Australia on 132011 to check the patient’s eligibility. The patient must be present with the prescribed medical practitioner at the time that Services Australia is contacted.

The prescribed medical practitioner and the patient can access translator services, through the Commonwealth Government's Translating and Interpreting Service (TIS) and the Doctors Priority Line. To be eligible for the fee-free TIS and Doctors Priority Line, medical practitioners must be in a general practice providing Medicare services to patients who are permanent residents in Australia and do not speak English. 

A health assessment for refugees and other humanitarian entrants may only be claimed once by an eligible patient.

Related Items: 224 225 226 227

• Previous - Note AN.7.10
• Next - Note AN.7.12

Professional attendance by a prescribed medical practitioner to perform a brief health assessment, lasting not more than 30 minutes and including:
(a) collection of relevant information, including taking a patient history; and
(b) a basic physical examination; and
(c) initiating interventions and referrals as indicated; and
(d) providing the patient with preventive health care advice and information

Fee: $52.25 Benefit: 100% = $52.25

(See para AN.7.1, AN.7.5, AN.7.6, AN.7.7, AN.7.8, AN.7.9, AN.7.10, AN.7.11, AN.7.12 of explanatory notes to this Category)

Professional attendance by a prescribed medical practitioner to perform a standard health assessment, lasting more than 30 minutes but less than 45 minutes, including:
(a) detailed information collection, including taking a patient history; and
(b) an extensive physical examination; and
(c) initiating interventions and referrals as indicated; and
(d) providing a preventive health care strategy for the patient

Fee: $121.45 Benefit: 100% = $121.45

(See para AN.7.1, AN.7.5, AN.7.6, AN.7.7, AN.7.8, AN.7.9, AN.7.10, AN.7.11, AN.7.12 of explanatory notes to this Category)

Professional attendance by a prescribed medical practitioner to perform a long health assessment, lasting at least 45 minutes but less than 60 minutes, including:
(a) comprehensive information collection, including taking a patient history; and
(b) an extensive examination of the patient’s medical condition and physical function; and
(c) initiating interventions and referrals as indicated; and
(d) providing a basic preventive health care management plan for the patient

Fee: $167.55 Benefit: 100% = $167.55

(See para AN.7.1, AN.7.5, AN.7.6, AN.7.7, AN.7.8, AN.7.9, AN.7.10, AN.7.11, AN.7.12 of explanatory notes to this Category)

Professional attendance by a prescribed medical practitioner to perform a prolonged health assessment, lasting at least 60 minutes, including:
(a) comprehensive information collection, including taking a patient history; and
(b) an extensive examination of the patient’s medical condition, and physical, psychological and social function; and
(c) initiating interventions and referrals as indicated; and
(d) providing a comprehensive preventive health care management plan for the patient

Fee: $236.70 Benefit: 100% = $236.70

(See para AN.7.1, AN.7.5, AN.7.6, AN.7.7, AN.7.8, AN.7.9, AN.7.10, AN.7.11, AN.7.12 of explanatory notes to this Category)