Medicare Benefits Schedule - Item 10987

Follow up service provided by a practice nurse or Aboriginal and Torres Strait Islander health practitioner, on behalf of a medical practitioner, for an Indigenous person who has received a health assessment if:

a)    The service is provided on behalf of and under the supervision of a

medical practitioner; and

b)    the person is not an admitted patient of a hospital; and

c)    the service is consistent with the needs identified through the health assessment;

    -    to a maximum of 10 services per patient in a calendar year

Fee: $27.95 Benefit: 100% = $27.95

(See para AN.14.3, MN.12.3 of explanatory notes to this Category)

Extended Medicare Safety Net Cap: $83.85

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Publication date: 1 November 2025 

SUMMARY 

This note sets out the requirements for health assessment services for eligible patients experiencing signs or symptoms relating to menopause or perimenopause.
  
USE OF THE ITEMS 

Health assessment items are used to assess eligible patients’ health and physical, psychological and social function. This includes the medical practitioner’s consideration of whether relevant health care and education should be offered to the patient to improve their health or function.
 
The specific requirements of the menopause and perimenopause health assessment are set out in the Health Insurance (Section 3C General Medical Services – Menopause and Perimenopause Health Assessment Services) Determination 2025 (the Determination) and the Health Insurance (General Medical Services Table) Regulations 2021 (the Regulations). 

The Determination requires that a menopause and perimenopause health assessment must include, but is not limited to: 

• collection of relevant information, including taking a patient history to determine pre-, peri- or post-menopausal status, patient wellbeing and contraindications for management; and 
  
  
• a basic physical examination, including recording blood pressure, and review of height and weight; and
  
  
• initiating investigations and referrals as clinically indicated, with consideration given to the need for cervical screening, mammography and bone densitometry; and 
  
  
• discussion of management options including non-pharmacological and pharmacological strategies including risks and benefits; and
  
  
• implementing a management plan which includes patient centred symptoms management; and 
  
  
• providing the patient with preventative health care advice and information as clinically indicated, including advice on physical activity, smoking cessation, alcohol consumption, nutritional intake and weight management.  

The items apply only to a service provided in the course of a personal attendance by a single general practitioner (GP) or prescribed medical practitioner (PMP) on a single patient.
  
Information on practitioner types is available in Note GN.4.13 for GPs and AN.7.1 for PMPs. 

Medical practitioners may refer to A Practitioner’s Toolkit for Managing Menopause for guidance with this assessment.

Is a health assessment a health screening service? 

No. Clause 2.15.14 of the Regulations specifies that a health assessment must not include a screening service.
 
The Health Insurance Act 1973 (the Act) defines a health screening service as a medical examination or test that is not reasonably required for the management of the medical condition of the patient.

A health screening service does not include a medical examination or a test on a symptomless patient by the that patient’s own medical practitioner in the course of normal medical practice, to ensure the patient receives any medical advice or treatment necessary to maintain their state of health. 

Further information is available in Note GN.13.33. 

Can another person assist the medical practitioner to undertake the health assessment? 

Yes. Clause 2.15.14 of the Regulations states that practice nurses, Aboriginal and Torres Strait Islander health workers and Aboriginal and Torres Strait Islander health practitioners may assist in accordance with accepted medical practice under the supervision of the medical practitioner. 

Assistance provided must be in accordance with accepted medical practice and under the supervision of the GP or PMP. This may include activities associated with: 

• information collection, and 
  
  
• providing patients with information about recommended interventions, at the direction of the medical practitioner. 

The GP or PMP should be satisfied that the assisting health professional has the necessary skills, expertise and training to collect the information required for the health assessment.

MBS items for Health Assessments are for a complete service. On behalf of items, such as item 10997 and 10987, may not be claimed when assisting with the provision of a health assessment service. 

Additional advice on the use of other health professionals’ time when undertaking health assessments can be found in the AskMBS Advisory – General Practice Services 1. 

A Practice nurse means a registered or an enrolled nurse who is employed by, or whose services are otherwise retained by, a general practice or by a health service to which a direction made under subsection 19(2) of the Act applies.

For the purpose of items 695 and 19000, an Aboriginal and Torres Strait Islander health practitioner means a person who:

• is registered as an Aboriginal and Torres Strait Islander health practitioner with the Aboriginal and Torres Strait Islander Health Practice Board of Australia, and
  
  
• is employed by, or whose services are otherwise retained by, a medical practitioner in a general practice, or a health service to which a direction made under subsection 19(2) of the Act applies. 

For the purpose of items 695 and 19000, an Aboriginal and Torres Strait Islander health worker means a person who:

• has a Certificate III or above in Aboriginal and/or Torres Strait Islander Primary Health Care from the Health (HLT) training package, and 
  
  
• is engaged by a medical practitioner in a general practice or a health service to which a direction made under subsection 19(2) of the Act applies. 

Can a patient be eligible for more than one category of health assessment?

Where eligible, a patient may receive both a menopause and perimenopause health assessment service and a separate time tiered or Aboriginal and Torres Strait Islander health assessment service (for example, a Type 2 diabetes risk evaluation). There is no minimum interval of time between the provision of the different health assessments. 

Attendance time for the completion of a health assessment service cannot be billed under multiple items. Practitioners are required to satisfy themselves that they have met the requirements of each individual MBS item descriptor prior to billing.  

Information on MBS time-tiered health assessment services is available at AN.0.36.

Can I include additional time required for communications (e.g. with an interpreter) in the time taken for the health assessment?

Yes, a wide range of factors may affect the time needed to communicate effectively with a patient during a consultation. These include, but are not limited to, situations where a language barrier exists between the medical practitioner and patient (including when an interpreter is required), or when a patient has hearing problems, difficulty with speech, an intellectual disability, and/or dementia.

When claiming MBS items with time requirements, the total consultation time includes the time required to communicate effectively with the patient. Where more time than usual is required to communicate effectively with a particular patient, it is considered reasonable to claim a longer attendance item than might otherwise be expected for the service. 

In such situations, medical practitioners should make a brief record in the patient’s notes including details about why the additional time was required. For example, stating ‘consultation extended due to use of interpreter’ and, if relevant, citing the Translating and Interpreting Service (TIS) job number. 

ELIGIBLE PATIENTS 

Any patient who is eligible to receive Medicare benefits, has not received this service in the previous 12-month period, and is experiencing premature ovarian insufficiency, early menopause, perimenopause or menopause symptoms, or undergoing treatment for their symptoms.

ELIGIBLE PRACTITIONERS 

Health assessment items are available for different practitioner types: 

• the GP item 695 can be claimed by GPs only (see GN.4.13). 
  
  
• the PMP item 19000 can be claimed by PMPs only (see AN.7.1). 

Note: Clause 2.15.14 of the Regulations specifies patients must access health assessment services through their usual GP or PMP, if reasonably practicable. 

The patient’s usual GP or PMP means the practitioner: 

• who has provided the majority of services to the patient in the past 12 months, or
  
  
• who is likely to provide the majority of services to the patient in the following 12 months, or 
  
  
• is located at a medical practice that: 
  
  
  • has provided the majority of services to the patient in the past 12 months, or
    
    
  • is likely to provide the majority of services to the patient in the next 12 months. 

CO-CLAIMING RESTRICTIONS 

Clause 2.15.14 of the Regulations specifies a separate consultation must not be performed in conjunction with a health assessment, unless clinically necessary. 

RECORD KEEPING AND REPORTING REQUIREMENTS 

Providers are responsible for ensuring services claimed from Medicare using their provider number meet all legislative requirements and they may be required to submit evidence for compliance checks related to Medicare claims. Practitioners should ensure they keep adequate and contemporaneous records. For information on what constitutes adequate and contemporaneous records see GN.15.39. 

Clause 4.3 of the Act specifies that, where an item specifies the creation of a document (however described) and a document is created, the document must be retained for the period of 2 years. 

RELEVANT LEGISLATION 

Details about the legislative requirements of the MBS items can be found on the Federal Register of Legislation at www.legislation.gov.au. Menopause and perimenopause health assessment items are set out in the following regulatory instruments: 

• Health Insurance (Section 3C General Medical Services – Menopause and Perimenopause Health Assessment Services) Determination 2025 
  
  
• Health Insurance (General Medical Services Table) Regulations 2021 

Related Items: 695 10987 10997 19000

Item 10987 may be claimed by a medical practitioner, where a follow up service is provided by a practice nurse or Aboriginal and Torres Strait Islander health practitioner on behalf of that medical practitioner for an Indigenous person who has received a health check. 

All GPs whether vocationally registered or not are eligible to claim this item.  District Medical Officers (DMOs) employed by state/territory health Departments are also eligible to claim this item.  The term 'GP' is used in these notes as a generic reference to medical practitioners able to claim this item. 

Item 10987 does not apply for services that are provided by any other Commonwealth or State funded services.  However, where an exemption under subsection 19(2) of the Health Insurance Act 1973 has been granted to an Aboriginal Community Controlled Health Service or State/Territory Government Health clinic, item 10987 can be claimed for services provided by practice nurses or Aboriginal and Torres Strait Islander health practitioner salaried or contracted to, the Service or Health clinic.  All requirements of the item must be met. 

Item 10987 will assist Indigenous patients who have received a health check which has identified a need for follow up services which can be provided by a practice nurse or Aboriginal and Torres Strait Islander health practitioner between further consultations with the patient's GP. 

Item 10987 may be used to provide:

• Examinations/interventions as indicated by the health check;
• Education regarding medication compliance and associated monitoring;
• Checks on clinical progress and service access;
• Education, monitoring and counselling activities and lifestyle advice;
• Taking a medical history; and
• Prevention advice for chronic conditions, and associated follow up. 

Item 10987 may be claimed up to a maximum of 10 times per patient per calendar year. 

Item 10987 may be accessed by an Indigenous patient who has received the Aboriginal and Torres Strait Islander Peoples Health Assessment (item 715), which is available to:

a) children between the ages of 0 and 14 years;

b) adults between the ages of 15 and 54 years; and 

c) older people over the age of 55 years. 

The item can also be accessed by a child who has received a health check as part of the Northern Territory Emergency Response (NTER). 

Patients whose condition is unstable/deteriorating should be referred to their GP for further treatment. 

A practice nurse means a registered or enrolled nurse who is employed by, or whose services are otherwise retained by a general practice or by a health service that has an exemption to claim Medicare benefits under sub-section 19(2) of the Health Insurance Act 1973. 

An Aboriginal and Torres Strait Islander health practitioner means a person who has been registered as an Aboriginal and Torres Strait Islander health practitioner by the Aboriginal and Torres Strait Islander Health Practice Board of Australia and meets the Board's registration standards. The Aboriginal and Torres Strait Islander health practitioner must be employed or retained by a general practice, or by a health service that has an exemption to claim Medicare benefits under subsection 19(2) of the Health Insurance Act 1973. 

An Aboriginal and Torres Strait Islander health practitioner may use any of the titles authorised by the Aboriginal and Torres Strait Islander Health Practice Board: Aboriginal health practitioner; Aboriginal and Torres Strait Islander health practitioner; or Torres Strait Islander health practitioner. 

In all cases, the GP under whose supervision the health check follow-up is being provided retains responsibility for the health, safety and clinical outcomes of the patient.  The GP must be satisfied that the practice nurse or Aboriginal and Torres Strait Islander health practitioner is appropriately qualified and trained to provide the relevant follow up for the patient.  GPs are advised to consult their insurer concerning indemnity coverage for services provided on their behalf. 

General practices where nurses or Aboriginal and Torres Strait Islander health practitioners provide follow up for Indigenous people who have received a health check, should also have a written clinical risk management strategy covering issues like clinical roles, patient follow up and patient consent. 

Continuing professional development is recommended for all nurses and an Aboriginal and Torres Strait Islander health practitioners providing follow up services for Indigenous people who have received a health check. 

Supervision of the practice nurse/Aboriginal and Torres Strait Islander health practitioner by the GP at a distance is recognised as an acceptable form of supervision.  This means that the claiming GP does not have to be physically present at the time the service is provided.  However, the GP should be able to be contacted if required. 

Where the GP and practice nurse/Aboriginal and Torres Strait Islander health practitioner are at the same location, the GP is not required to be present while the health check follow up is undertaken.  It is up to the GP to decide whether they need to see the patient.  Where the GP has a consultation with the patient, then the GP is entitled to claim a Medicare item for the time and complexity of their personal attendance on the patient.  The time the patient spends receiving a service from the practice nurse or Aboriginal and Torres Strait Islander health practitioner is itemised separately under item 10987 and should not be counted as part of the Medicare items claimed for time spent with the GP.  Where the practice nurse or Aboriginal and Torres Strait Islander health practitioner provides another service (eg immunisation, cervical screening) on the same day, the GP is able to claim for all practice nurse/ Aboriginal and Torres Strait Islander health practitioner services provided. 

Item 10990 or 10991 (bulk billing incentives) can be claimed in conjunction with item 10987 provided the conditions of items 10990 or 10991 are satisfied.

Related Items: 10987