Medicare Benefits Schedule - Note AN.7.12

Last reviewed: 1 November 2023

Items 224, 225, 226 and 227 may be used to undertake a health assessment for a former serving member of the Australian Defence Force, including a former member of permanent and reserve forces.

A health assessment for a former serving member of the Australian Defence Force is an assessment of:

• a patient's physical and psychological health and social function; and
• whether health care, education and other assistance should be offered to the patient to improve their physical, psychological health or social function.

This health assessment must include:

1.     a personal attendance by a prescribed medical practitioner (see note AN.7.1); and

2.     taking the patient's history, including the following:

i       the patient's service with the Australian Defence Force, including service type, years of service, field of work, number of deployments and reason for discharge;

ii      the patient's social history, including relationship status, number of children (if any) and current occupation;

iii     the patient's current medical conditions;

iv     whether the patient suffers from hearing loss or tinnitus;

v      the patient's use of medication, including medication prescribed by another doctor and medication obtained without a prescription;

vi     the patient's smoking, if applicable;

vii    the patient's alcohol use, if applicable;

viii   the patient's substance use, if applicable;

ix     the patient's level of physical activity;

x      whether the patient has bodily pain;

xi     whether the patient has difficulty getting to sleep or staying asleep;

xii    whether the patient has psychological distress;

xiii   whether the patient has posttraumatic stress disorder;

xiv   whether the patient is at risk of harm to self or others;

xv    whether the patient has anger problems;

xvi   the patient's sexual health;

xvii  any other health concerns the patient has.

The assessment must also include the following:

1.     measuring the patient's height;

2.     weighing the patient and ascertaining, or asking the patient, whether the patient's weight has changed in the last 12 months;

3.     measuring the patient's waist circumference;

4.     taking the patient's blood pressure;

5.     using information gained in the course of taking the patient's history to assess whether any further assessment of the patient's health is necessary;

6.     either making the further assessment or referring the patient to another medical practitioner who can make the further assessment;

7.     documenting a strategy for improving the patient's health;

8.     offering to give the patient a written report of the assessment that makes recommendations for treating the patient including preventive health measures;

9.     keeping a record of the assessment.

A prescribed medical practitioner may use the 'Veteran Health Check' as a screening tool for the health assessment. This assessment tool can be viewed on the Department of Veterans' Affairs' website at: https://www.dva.gov.au/about-us/dva-forms/veteran-health-check-assessment-tool.

This health assessment may only be claimed once by an eligible patient.

The health assessment must not be performed in conjunction with a separate consultation in relation to the patient unless the consultation is clinically necessary.

The health assessment must be performed by the patient's usual doctor.

Related Items: 224 225 226 227

• Previous - Note AN.7.11
• Next - Note AN.7.13

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)