Aboriginal and Torres Strait Islander health practitioner and Aboriginal health worker MBS items

Medicare Benefits Schedule (MBS) requirements for claiming services if you’re an Aboriginal and Torres Strait Islander health practitioner or Aboriginal health worker.

You can claim the following items if you’re an Aboriginal and Torres Strait Islander health practitioner or Aboriginal health worker.

These items don’t apply for patients admitted to hospital. You must provide the services face-to-face unless noted otherwise. You can bill these items using your Medicare provider number.

ItemServiceMBS requirements

10950 - Face-to-face

93000 - Telehealth

93013 - Phone

Individual allied health service for chronic disease management

This service is only available to patients with either a:

  • Multidisciplinary Care Plan in place
  • GP Management Plan (GPMP) and Team Care Arrangements (TCAs) in place.

The medical practitioner referred the patient using a referral form, and the service is at least 20 minutes long.

You can claim up to 5 services per patient in a calendar year.

81300 - Face-to-face

93048 - Telehealth

93061 - Phone

Follow-up allied health service for people of Aboriginal or Torres Strait Islander descent

Service provided to a patient after a medical practitioner has done a health assessment and identified a need for follow-up allied health services.

The medical practitioner referred the patient using a referral form, and the service is at least 20 minutes long.

You can claim up to 5 services per patient in a calendar year. This is on top of the annual limit of 5 individual allied health services for chronic disease management.

If you perform these services on behalf of a supervising medical practitioner, you can bill these items using the medical practitioner’s provider number. These items don’t apply for patients admitted to hospital unless noted otherwise.

ItemServiceMBS requirements
10983Telehealth support service

The patient must have a video conference consultation with a specialist, consultant physician or psychiatrist.

Your support must be necessary for provision of the specialist service.

10987 - Face-to-face

93200 - Telehealth

93202 - Phone

Follow up service for an Indigenous patient who has received a health assessment

Service provided in between consultations with the medical practitioner, in line with the patient’s health assessment.

You must be an Aboriginal and Torres Strait Islander health practitioner to perform this service.

Only available to Indigenous patients who’ve had a health assessment.

You can claim up to 10 services per patient in a calendar year.

10988Immunisation service

You must be an Aboriginal and Torres Strait Islander health practitioner to perform this service, for immunising a patient.

You can only claim once per patient visit, even if you give more than one vaccine in the same visit.

The medical practitioner can also claim for the professional attendance they provide to the patient, along with the immunisation service.

10989Wound management service

Treatment of a patient’s wound other than normal aftercare.

You must be an Aboriginal and Torres Strait Islander health practitioner to perform this service.

You can only claim once per patient visit, even if you treated more than one wound during the same visit.

The medical practitioner must assess the patient in order to give instruction in relation to the treatment of wound. However, they’re not required to give instruction or see the patient during each subsequent visit.

10997 - Face-to-face

93201 - Telehealth

93203 - Phone

Monitoring and support for a person with chronic disease

You must be an Aboriginal and Torres Strait Islander health practitioner to perform this service.

Ongoing care, routine treatment and ongoing monitoring and support. This is between the more structured reviews of the care plan by the patient’s medical practitioner. Services should be consistent with the care plan.

Only available to patients with either a:

  • Multidisciplinary Care Plan in place
  • GPMP and TCAs in place.

You can claim up to 5 services per patient in a calendar year.

12325Aboriginal and Torres Strait Islander Peoples assessment of visual acuity and bilateral retinal photography

This service can be provided in or out of hospital.

The patient must be of Aboriginal and Torres Strait Islander descent.

The assessment must be performed by a medical practitioner providing the primary glycaemic management of the patient's diabetes. This must not be an optometrist or ophthalmologist.

The patient must not have received a service under this item or item 12326 in the preceding 12 months and must not also have:

  • an existing diagnosis of diabetic retinopathy
  • visual acuity of less than 6/12 in either eye
  • a difference of more than 2 lines of vision between the 2 eyes at the time of presentation.

Any personnel performing any elements of this service under the direction of the medical practitioner must be appropriately trained or qualified. If diabetic retinopathy is found, the medical practitioner should refer the patient to an optometrist or ophthalmologist.

13105Haemodialysis management for patients in very remote areas

Haemodialysis management for patients with end-stage renal disease.

Haemodialysis is provided in a Modified Monash Model 7 area (very remote).

Patient’s care is managed by a nephrologist and reviewed every 3 to 6 months.

The nephrologist can review the patient and supervise haemodialysis in person or remotely.

16400 - Face-to-face

91850 - Telehealth

91855 - Phone

Antenatal service

You must be an Aboriginal and Torres Strait Islander health practitioner to perform this service.

Antenatal service provided either at or from, an eligible practice location in a regional, rural or remote area.

You can’t claim them with another antenatal attendance item for the same patient, on the same day, by the same practitioner.

You can claim up to 10 services per patient, per pregnancy.

Quality Assurance for Aboriginal and Torres Strait Islander Medical Services (QAAMS)

If you perform these services on behalf of a supervising medical practitioner, you can bill these items using the medical practitioner’s provider number. The practice or medical practitioner must be certified as competent by the QAAMS Program.

ItemServiceMBS requirements
73839Diabetes diagnosis blood test
  • Diagnosis in asymptomatic patients at high risk
  • Once per 12 months
73840Established diabetes management blood test
  • Assesses how well a patient’s diabetes (glucose levels) has been managed
  • Up to 4 tests per 12 months
73844Urine test in the management of established diabetes or patients at risk of microalbuminuria
  • For detecting early signs of renal disease
  • Determined on a random spot collection urine sample.

Find out more about the QAAMS Pathology Program.

Contact us for Medicare provider enquiries.

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Page last updated: 6 December 2023.
QC 51394