Indigenous Chronic Disease Package
Health Assessments
Table of contents
- Improve your Aboriginal and Torres Strait Islander patients’ health
- GP and Patient Journey flowchart
How to participate in this program- Registering your practice/service for the PIP Indigenous Health Incentive
- Registering your eligible patients for the PBS Co-payment measure
- Cultural awareness training: who needs it?
- Defining ‘chronic disease’ and ‘at risk’
- Identifying and signing up eligible patients
- Specialist Outreach Programs and Care Coordination
- Indigenous Health Project Officers: A resource for General Practices and Indigenous Health Services
- Aboriginal and Torres Strait Islander Outreach Workers
- Chronic disease self-management accredited training for staff
- National Tackling Smoking Workforce
- Healthy Lifestyle Workers
MBS Item numbers for Aboriginal and Torres Strait Islander health services- General restrictions
Item 715: Aboriginal and Torres Strait Islander Health Assessment
Available to all Aboriginal and/or Torres Strait Islander people, but requirements vary according to age group: 0-14, 15-54, and 55+ years of age.| Fee* | Benefit | Where | Frequency |
|---|---|---|---|
| $200.20 | 100% = $200.20 | Place other than a hospital or residential aged care facility | Once in a 9 month period |
_ATSI_mbsha_resource_kit. Proformas provide useful guidance, but are not mandatory to claim items as long as all requirements are met.
Item 10987: Follow-up service by a Practice Nurse or registered Aboriginal Health Worker†
Follow-up services for an Aboriginal and/or Torres Strait Islander person who has received a health assessment.| Fee* | Benefit | Frequency |
|---|---|---|
| $23.10 | 100% = $23.10 | Maximum of 10 services per year |
Patient eligibility
Item 10987 may be accessed by an Aboriginal and/or Torres Strait Islander patient who has received a health assessment (eg. an Aboriginal and Torres Strait Islander Health Assessment (Item 715), or a child who has received a health check as part of the Northern Territory Emergency Response (NTER).Eligible practitioners
Item 10987 may be claimed by a medical practitioner, where a follow-up service is provided by a practice nurse or registered Aboriginal Health Worker on behalf of that medical practitioner for an Aboriginal and/or Torres Strait Islander person who has received a health assessment.Item description
Item 10987 may be used to provide:- examinations/interventions as indicated by the health assessment;
- 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.
To claim this item, the following criteria must be met:
- the service is provided on behalf of and under the supervision of a medical practitioner;
- the person is not an admitted patient of a hospital; and
- the service is consistent with the needs identified through the health assessment.
For updates on MBS item information visit: www.health.gov.au/mbsonline
Items 81300 to 81360: Allied health services
Available to any Aboriginal and/or Torres Strait Islander person who has had a health
assessment during which the need for follow-up allied health services has been identified.
| Fee* | Benefit | Frequency |
|---|---|---|
| $59.90 | 85% = $50.95 | Maximum 5 health services per year |
Patient eligibility
A person who is of Aboriginal and/or Torres Strait Islander descent may be referred by their GP for allied health services under items 81300 to 81360 when the GP has undertaken a health assessment and identified a need for follow-up allied health services.Items 81300 to 81360 are available in addition to items 10950-10970 or they provide an alternative pathway to allied health services for Aboriginal and/or Torres Strait Islander people.
| Item | Description |
|---|---|
| 81300 | Aboriginal or Torres Strait Islander Health Service provided by an eligible Aboriginal Health worker† |
| 81305 | Diabetes Education |
| 81310 | Audiology Health Service |
| 81315 | Exercise Physiology |
| 81320 | Dietetics |
| 81325 | Mental Health Services |
| 81330 | Occupational Therapy |
| 81335 | Physiotherapy |
| 81340 | Podiatry |
| 81345 | Chiropractic |
| 81350 | Osteopathy |
| 81355 | Psychology |
| 81360 | Speech Pathology |
Eligible Practitioners
Items 81300 to 81360 can only be claimed for services provided by eligible allied health professionals who meet eligibility requirements, are in private practice and registered with Medicare Australia. There are specific eligibility requirements for allied health professionals providing services under these items and full item descriptions should be reviewed before undertaking these services.Services provided by eligible allied health professionals under these items must meet the requirements set out in the item descriptors.
These requirements include:
- Service is of at least 20 minutes duration;
- Service is provided to the person individually (i.e. not as part of a group service) and in person (i.e. the allied health professional must personally attend the patient);
- Person is not an admitted patient of a hospital; and
- After the service the allied health professional must provide a written report to the GP.
Restrictions
Items 81300 to 81360 do not apply for services that are provided by any Australian Government or state or territory government funded services or provided to an admitted patient of a hospital. However, where an exemption under subsection 19(2) of the Health Insurance Act 1973 has been granted to an Aboriginal and Torres Strait Islander Community Controlled Health Service or state/territory health clinic, items 81300 to 81360 can be claimed for services provided by eligible allied health professionals salaried by, or contracted to, the service or health clinic. All requirements of the relevant item must be met, including registration of the allied health professional with Medicare Australia. Medicare services provided under a subsection 19(2)exemption must be bulk billed.
For updates on MBS item information visit: www.health.gov.au/mbsonline
6 Department of Health and Ageing. MBS Online. Canberra:DOHA;2010. Available at: www.health.gov.au/mbsonline
† A registered Aboriginal Health Worker means a person in the Northern Territory who is registered as an Aboriginal Health Worker under the Health Practitioners Act 2004 (NT), who is employed or 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.
† Aboriginal Health Workers who have been awarded a Certificate Level III in Aboriginal and Torres Strait Islander Health (or an equivalent or higher qualification) from a Registered Training Organisation that meets training standards set by the Australian National Training Authority’s Australian Quality Training Framework can register with Medicare Australia to provide this item.
* Current as at 1 Nov 2010.