Medicare Benefits Schedule - Note AN.0.37

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Category 1 - PROFESSIONAL ATTENDANCES

AN.0.37

Health Assessment provided as a type 2 diabetes risk evaluation for people aged 40-49 years with a high risk of developing type 2 diabetes as determined by the Australian Type 2 Diabetes Risk Assessment Tool

Items 701, 703, 705 and 707 may be used to undertake a type 2 diabetes risk evaluation for people aged 40-49 years (inclusive) with a high risk of developing type 2 diabetes, as determined by the Australian Type 2 Diabetes Risk Assessment Tool. 

The aim of this health assessment is to review the factors underlying the 'high risk' score identified by the Australian Type 2 Diabetes Risk Assessment Tool to instigate early interventions, such as lifestyle modification programs, to assist with the prevention of type 2 diabetes. 

The Australian Type 2 Diabetes Risk Assessment Tool has been developed to provide a basis for both health professionals and health consumers to assess the risk of type 2 diabetes.  It consists of a short list of questions which, when completed, provides a guide to a patient's current level of risk of developing type 2 diabetes.  The item scores and risk rating calculations in the tool have been developed using demographic, lifestyle, anthropometric and biomedical data from the 2000 Australian Diabetes, Obesity and Lifestyle baseline survey and the AusDiab 2005 follow-up study. 

The Australian Type 2 Diabetes Risk Assessment Tool can be obtained from the Department's prevention of diabetes web page

Clinical risk factors that the general practitioner must consider when providing this health assessment include:

(a) lifestyle, such as smoking, physical inactivity and poor nutrition;

(b) biomedical risk factors, such as high blood pressure, impaired glucose metabolism and excess weight;

(c) any relevant recent diagnostic test results; and

(d) a family history of chronic disease. 

The health assessment must include the following:

(a) evaluating a patient's high risk score, as determined by the Australian Type 2 Diabetes Risk Assessment Tool which has been completed by the patient within a period of 3 months prior to undertaking the health assessment;

(b) updating the patient's history and undertaking physical examinations and clinical investigations in accordance with relevant guidelines;

(c) making an overall assessment of the patient's risk factors and of the results of relevant examinations and investigations;

(d) initiating interventions, if appropriate, including referral to a lifestyle modification program and follow-up relating to the management of any risk factors identified (further information is available at the Department's prevention of diabetes web page.); and

(e) providing the patient with advice and information (such as the Lifescript resources produced by the Department of Health), including strategies to achieve lifestyle and behaviour changes if appropriate (further information is available at the Department's Lifescript web page). 

The completion of the Australian Type 2 Diabetes Risk Assessment Tool is mandatory for patient access to this health assessment.  The tool can be completed either by the patient or with the assistance of a health professional or practice staff.  Patients with a 'high' score result are eligible for the health assessment, and subsequent referral to the subsidised lifestyle modification programs if appropriate (further information is available at the Department's prevention of diabetes web page). 

A health assessment for a type 2 diabetes risk evaluation for people aged 40-49 years with a high risk of developing type 2 diabetes as determined by the Australian Type 2 Diabetes Risk Assessment Tool may only be claimed once every three years by an eligible patient.

Related Items: 701 703 705 707


Related Items


Health Assessments

The category of people eligible for health assessments are :

a)     People aged 40 to 49 years (inclusive) with a high risk of developing type 2 diabetes as determined by the Australian     Type 2 Diabetes Risk Assessment Tool

b)     People between the age of 45 and 49 (inclusive) who are at risk of developing a chronic disease

c)     People aged 75 years and older

d)     Permanent residents of a Residential Aged Care Facility

e)     People who have an intellectual disability

f)     Humanitarian entrants who are resident in Australia with access to Medicare services, including Refugees and Special     Humanitarian Program and Protection Program entrants

g)     Former serving members of the Australian Defence Force including former members of permanent and reserve forces

Category 1 - PROFESSIONAL ATTENDANCES

701

701 - Additional Information

Item Start Date:
01-May-2010
Description Start Date:
01-Jul-2018
Schedule Fee Start Date:
01-Jul-2019

Professional attendance by a general 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: $60.30 Benefit: 100% = $60.30

(See para AN.0.36, AN.0.37, AN.0.38, AN.0.39, AN.0.40, AN.0.41, AN.0.42, AN.0.69 of explanatory notes to this Category)

Category 1 - PROFESSIONAL ATTENDANCES

703

703 - Additional Information

Item Start Date:
01-May-2010
Description Start Date:
01-Jul-2018
Schedule Fee Start Date:
01-Jul-2019

Professional attendance by a general 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: $140.10 Benefit: 100% = $140.10

(See para AN.0.36, AN.0.37, AN.0.38, AN.0.39, AN.0.40, AN.0.41, AN.0.42, AN.0.69 of explanatory notes to this Category)

Category 1 - PROFESSIONAL ATTENDANCES

705

705 - Additional Information

Item Start Date:
01-May-2010
Description Start Date:
01-Jul-2018
Schedule Fee Start Date:
01-Jul-2019

Professional attendance by a general 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: $193.35 Benefit: 100% = $193.35

(See para AN.0.36, AN.0.37, AN.0.38, AN.0.39, AN.0.40, AN.0.41, AN.0.42, AN.0.69 of explanatory notes to this Category)

Category 1 - PROFESSIONAL ATTENDANCES

707

707 - Additional Information

Item Start Date:
01-May-2010
Description Start Date:
01-Jul-2018
Schedule Fee Start Date:
01-Jul-2019

Professional attendance by a general 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 or referrals as indicated; and

(d) providing a comprehensive preventive health care management plan for the patient

Fee: $273.10 Benefit: 100% = $273.10

(See para AN.0.36, AN.0.37, AN.0.38, AN.0.39, AN.0.40, AN.0.41, AN.0.42, AN.0.69 of explanatory notes to this Category)


Legend

  • Assist - Addition/Deletion of (Assist.)
  • Amend - Amended Description
  • Anaes - Anaesthetic Values Amended
  • Emsn - EMSN Change
  • Fee - Fee Amended
  • Renum - Item Number Change (renumbered)
  • New - New Item
  • NewMin - New Item (previous Ministerial Determination)
  • Qfe - QFE Change