Health assessments and your record keeping responsibilities

Find out about health assessments and records you need to keep for Medicare items 224-227, 701-707, 228, 715, 177, and 699.

Make sure you read the relevant Medicare Benefits Schedule (MBS) item descriptions, fact sheets and explanatory notes on MBS Online.

Health assessments

A health assessment looks at a patient’s health, physical, psychological and social function.

There are MBS items covering health assessments for specific target groups.

Health assessments aren’t available to hospital in-patients. They also aren’t available to aged care residents except for either:

  • comprehensive medical assessments
  • Aboriginal and Torres Strait Islander patients.

Patient eligibility

The decision to perform a health assessment on your patient will depend on both:

  • your clinical judgement
  • if your patient meets the criteria for one or more of the eligible target groups.

Patient consent

Before you do a health assessment, you must explain to your patient, their parent or carer about the:

  • health assessment process
  • benefits.

Your patient must consent to the health assessment and you must note this on their record.

The below table lists eligible target groups and the frequency for each type of health assessment.

Patient eligibility for items 224-227 or 701-707 How often

A type 2 diabetes risk evaluation for people who are both:

  • aged 40-49 years (inclusive)
  • at a high risk of developing type 2 diabetes, as determined by the Australian Type 2 Diabetes Risk Assessment Tool.
Once every 3 years
People aged 45-49 years inclusive who are at risk of developing chronic disease Once only
People aged 75 years and older Once every 12 months
Permanent residents of residential aged care facilities Once every 12 months
People with an intellectual disability Once every 12 months
Refugees or other humanitarian entrants Once only
Former serving members of the Australian Defence Force Once only
Patient eligibility for item 177 or 699 How often
Patient with or at risk of developing cardiovascular disease Once every 12 months
Who is eligible for item 228 or 715 How often

Aboriginal or Torres Strait Islander people

Read more about health assessments for Aboriginal and Torres Strait Islander people.

Once every 9 months

Who should undertake a health assessment

The patient’s usual medical practitioner should do the health assessment.

You are the patient’s usual medical practitioner if you:

  • or a medical practitioner in the same practice have provided the majority of health care to the patient over the last 12 months
  • will provide the majority of health care to the patient over the next 12 months
  • are a general practitioner or non-vocationally recognised medical practitioner.

If a different medical practitioner performs a health assessment, they should send a copy to you with your patient’s consent.

MBS items

There are 4 time-based MBS health assessment services. When billing you should consider all of the following:

  • time taken to complete the assessment
  • complexity of your patient’s needs
  • specific requirements for each target group.

The table below provides service descriptions, item numbers and the time required for each MBS item.

Item numbers Item name Item description Time required
224, 701 Brief health assessment A simple health assessment 30 minutes or less
225, 703 Standard health assessment An assessment for when the patient needs more than a brief assessment, but doesn’t have complex health issues More than 30 but less than 45 minutes
226, 705 Long health assessment An extensive assessment for when the patient has complex health issues At least 45 but less than 60 minutes
227, 707 Prolonged health assessment A complex assessment of a patient with significant, long-term health needs managed through a comprehensive preventative healthcare management plan 60 or more minutes
228, 715 Indigenous health assessment A health assessment for Aboriginal and Torres Strait Islander patients No time requirements
177, 699 Heart health assessment A health assessment for patients with cardiovascular disease or at risk of developing cardiovascular disease At least 20 minutes

Claiming limits

In some cases you can do a subsequent health assessment in the same 12-month period. You can do them if your patient is eligible for another health assessment under a different target group.

To help us assess your claim, please tell us which target groups the health assessment claim is for.

If you don’t specify the subsequent health assessment was for a different target group, we’ll reject your claim.

Heart health checks

You can bill a heart health check for your patient once every 12 months if your patient meets the criteria for these items.

Find out more about items 699 and 177 for these criteria on MBS Online.

You can’t bill a heart health check item for your patient if, in the last 12 months, they had another health assessment under:

Record keeping

Make sure you:

  • offer your patient a copy of the health assessment, including recommendations
  • keep a copy of the health assessment for 2 years.

The Privacy Act 1988 covers information about medical records.

Find out more on the Department of Health and Aged Care website.

Page last updated: 1 July 2023.
QC 32851