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Category 1 - PROFESSIONAL ATTENDANCES
Prescribed Medical Practitioner Health Assessment for an Aboriginal and Torres Strait Islander People (Item 228)
Last reviewed: 1 November 2023
This health assessment is available to all people of Aboriginal and Torres Strait Islander descent and should be used for health assessments for the following age categories:
- An Aboriginal or Torres Strait Islander child who is less than 15 years.
- An Aboriginal or Torres Strait Islander person who is aged between 15 years and 54 years.
- An Aboriginal or Torres Strait Islander older person who is aged 55 years and over.
A health assessment means the assessment of a patient's health and physical, psychological and social function and consideration of whether preventive health care and education should be offered to the patient, to improve that patient's health and physical, psychological and social function.
MBS item 228 must include the following elements:
(a) information collection, including taking a patient history and undertaking examinations and investigations as required;
(b) making an overall assessment of the patient;
(c) recommending appropriate interventions;
(d) providing advice and information to the patient; and
(e) keeping a record of the health assessment, and offering the patient, and/or patient's carer, a written report about the health assessment with recommendations about matters covered by the health assessment; and
(f) offering the patient's carer (if any, and if the prescribed medical practitioner [see note AN.7.1] considers it appropriate and the patient agrees) a copy of the report or extracts of the report relevant to the carer.
If, after receiving this health assessment, a patient who is aged fifteen years and over but under the age of 55 years, is identified as having a high risk of developing type 2 diabetes as determined by the Australian Type 2 Diabetes Risk Assessment Tool, the prescribed medical practitioner may refer that person to a subsidised lifestyle modification program, along with other possible strategies to improve the health status of the patient.
The Australian Type 2 Diabetes Risk Assessment Tool can be obtained from https://www.health.gov.au/resources/apps-and-tools/the-australian-type-2-diabetes-risk-assessment-tool-ausdrisk.
A health assessment may only be claimed by a prescribed medical practitioner.
A health assessment should generally be undertaken by the patient's 'usual doctor'. For the purpose of the health assessment, "usual doctor" means the prescribed medical practitioner, or a medical practitioner working in the same medical practice, which has provided the majority of primary health care to the patient over the previous twelve months and/or will be providing the majority of care to the patient over the next twelve months.
The health assessment for Aboriginal and Torres Strait Islander People is not available to people who are in-patients of a hospital or care recipients in a residential aged care facility.
A health assessment should not take the form of a health screening service (see General Explanatory Note GN.13.33).
MBS health assessment item 228 must be provided by a prescribed medical practitioner personally attending upon a patient. Suitably qualified health professionals, such as practice nurses, Aboriginal health workers or Aboriginal and Torres Strait Islander health practitioners employed and/or otherwise engaged by a general practice or health service, may assist prescribed medical practitioners in performing this health assessment. Such assistance must be provided in accordance with accepted medical practice and under the supervision of the prescribed medical practitioner. This may include activities associated with:
- information collection; and
- providing patients with information about recommended interventions at the direction of the prescribed medical practitioner.
The prescribed medical practitioner should be satisfied that the assisting health professional has the necessary skills, expertise and training to collect the information required for the health assessment.
Prescribed medical practitioners should not conduct a separate consultation in conjunction with a health assessment unless it is clinically necessary (ie. the patient has an acute problem that needs to be managed separately from the assessment).
Item 228 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 228 can be claimed for services provided by prescribed medical practitioners salaried by or contracted to, the Service or health clinic. All requirements of the item must be met.
Item 10990 or 10991 (bulk billing incentives) can be claimed in conjunction with any health assessment provided to an Aboriginal and Torres Strait Islander person, provided the conditions of items 10990 and 10991 are satisfied.
An eligible patient may only receive the Health Assessment for Aboriginal and Torres Strait Islander People using either item 228 or item 715 once in a 9-month period.
Related Items: 228
Category 1 - PROFESSIONAL ATTENDANCES
228 - Additional Information
Professional attendance by a prescribed medical practitioner at consulting rooms or in a place other than a hospital or a residential aged care facility, for a health assessment of a patient who is of Aboriginal or Torres Strait Islander descent—applicable not more than once in a 9 month period and only if the following items are not applicable within the same 9 month period:
(a) item 715;
(b) item 92004 or 92011 of the Telehealth and Telephone Determination
Fee: $186.90 Benefit: 100% = $186.90
- 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